Mikrobiyol Bul
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Comparative Study
[Comparison of conventional methods and real-time multiplex polymerase chain reaction for identification and typing of Brucella isolates of human origin].
Brucellosis which is a worldwide zoonotic disease, still constitutes a major public health problem in rural areas of Turkey. The aim of the present study was to evaluate the species and biovar distribution of 187 presumptive Brucella strains isolated from patients inhabiting at the provinces in Eastern, South Eastern and Mediterranean regions over a 7-years period (from 2001 to 2007) and to compare multiplex real-time-polymerase chain reaction (M-RT-PCR) and conventional biotyping for the differentiation of three Brucella species. The isolates were identified at genus level by conventional microbiological methods and classified using the classical Brucella species biotyping scheme based on CO2 requirement for growth, urease activity, H2S production, sensitivity to basic fuchsin and thionin (20 and 40 µg/ml), lysis by Tbilisi and Berkeley phages, and agglutination with monospecific antisera for A and M antigens. ⋯ M-RT-PCR results were found to be 100% compatible with the reference conventional typing methods. Due to its high sensitivity, the M-RT-PCR assay could be a valuable tool for the rapid detection and differentiation of Brucella species in clinical samples which usually have very low bacterial load. These findings indicated that B.melitensis biovar 3 was by far the most frequent species for human brucellosis in these specific regions of Turkey and multiplex-RT-PCR seemed to be promising in the detection and differentiation of Brucella species.
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Candida species which are currently the fourth most common cause of nosocomial bloodstream infections, are associated with a significant morbidity and mortality. The aim of this retrospective case-control study which included adult patients was to determine the epidemiology of candidemia and to evaluate risk factors for the development of candidemia and mortality at a tertiary-care education hospital over a 1-year period. A total of 38 candidemia cases (23 were male; age range: 17-82 yrs; mean age: 61.4 ± 13.5 years) were identified among 22.507 patients hospitalized during the study period (January 1-December 31, 2008) and the overall incidence was found as 16.8 per 10.000 hospital admissions. ⋯ Risk factors for mortality due to candidemia in the univariate analysis were detected as no response to antifungal treatment (OR: 0.23; CI: 0.11-0.51, p< 0.001), underlying disease other than trauma (OR: 0.06; CI: 0.003-1.24, p= 0.02), and high Charlson index (OR: 0.60; CI: 0.38-0.93, p= 0.03), however those factors were not found significant by multivariate analysis. There was also a statistically significant correlation between Charlson index and treatment response (mean Charlson index was 3.5 ± 1.9 in therapy-responded patients and 4.8 ± 1.8 in non-responders; p= 0.03). Since the risk of developing candidemia was significantly higher in severely diseased patients using central venous catheter or with prolonged hospitalization, response to antifungal therapy may be insufficient, leading to higher mortality.
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Nosocomial infections which exhibit an increasing trend worldwide, are important contributors to morbidity and mortality. Most bacteria that cause nosocomial infections can retain their viability even after exposure to disinfectants in routine practice. This study was conducted to determine the susceptibilities of nosocomial Staphylococcus aureus and Enterococcus spp. isolates to various disinfectants. ⋯ However, 12 S.aureus (5 MSSA, 7 MRSA) and 3 enterococci (2 E.faecium, 1 E.faecalis) isolates were found susceptible to hydrogen peroxide (3%) at 3 minutes contact time; 11 S.aureus (4 MSSA, 7 MRSA) and 7 E.faecalis isolates were found susceptible at 5 minutes contact time, and 6 S.aureus (4 MSSA, 2 MRSA) and 3 enterococci (1 E.faecium, 2 E.faecalis) isolates were found susceptible at 10 minutes contact time. One MSSA and 8 enterococci (4 E.faecium, 3 E.faecalis, 1 Enterococcus spp.) isolates were found resistant to hydrogen peroxide (3%) at 10 minutes contact time. In conclusion, glutaraldehyde (2%), chlorhexidine gluconate (4%), povidone iodine (7.5%), povidone iodine (10%) and 2-propanol (70%) can be safely used against S.aureus and Enterococcus spp. owing to their high effectiveness, however, hydrogen peroxide (3%) should not be preferred against those strains due to the presence of resistant isolates, in Ankara University Ibn-i Sina Hospital.