Sürdürülebilir Kalkınma Amaçları
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- ArticleAçık Erişim2019Evaluation of portal vein doppler findings in patients with Crimean–Congo hemorrhagic fever
Karavaş, Erdal; Karakeçili, Faruk
Background and objectives: In this study, we compare portal vein Doppler ultrasound (US) findings between patients with Crimean–Congo hemorrhagic fever (CCHF) and healthy persons and investigate the practicability of these findings in the prediction of disease severity. Materials and Methods: In this prospective study, portal vein Doppler US was performed in patients diagnosed with CCHF and healthy persons between March 2016 and May 2018. The patients were grouped according to mild-to-moderate and severe progression of CCHF. Liver size, portal vein diameter, portal vein flow rate, spleen volume, and splenic vein diameter were recorded in the patients and healthy controls. Results: Of the 48 patients diagnosed with CCHF, 25 were male. According to the scoring made, 38 patients were evaluated as having mild-to-moderate disease progression, and 10 were evaluated as having severe disease progression. With respect to the Doppler US findings, liver size, spleen volume, portal vein diameter, splenic vein diameter, and portal vein flow rate were significantly higher in the patient group compared with the controls. However, no significant difference was found in these parameters between the severe and mild-to-moderate progression groups. Conclusions: In the evaluation of and follow-up with patients with CCHF, portal vein Doppler US is a non-invasive and reliable tool for diagnosis.
RDL Kalıcı Kaydıİncele - ArticleAçık Erişim2018Evaluation of Sharps Injuries in a Training and Research Hospital
Dizili-Yelgin, Canan; Çikman, Aytekin; Karakeçili, Faruk; Gülhan, Baris; Aydin, Merve
Objective: In this study, we aimed to assess sharps injuries occuring in a training and research hospital retrospectively and to clarify the current situation in order to reach conclusions and suggestions about the subject. Methods: The data was obtained from the notification forms with 18 questions filled by 124 health workers who were exposed to sharps injuries and applied to the infection control committee unit at the relevant dates. The data was statistically analysed with a p value of <0.05 being considered as significant. Results: At the end of the study, it was found out that 63.7% of the workers exposed to injuries were <30 years old and the average age was 27.9. A statistically significant correlation was found between the relevant age groups and injury prevalence. Injuries in the 16-30 age group were more frequent in clinical services, emergency services and blood sampling unit whereas injuries in >30 age group were mostly observed in clinic services (internal and surgical units) and operating rooms. It was found that hand injuries were the most common and needle sticks were the most frequent (91.1%) cause of injury. Conclusions: The primary way to prevent the sharps injuries is to improve safety and to develop effective employee safety policies. Additionally, taking universal precautions, regular trainings, reducing staff workload and provision of safe and useful materials can be among the suggestions that can prevent injuries.
RDL Kalıcı Kaydıİncele - ArticleAçık Erişim2018Common Carotid, Internal Carotid and Vertebral Artery Doppler Ultrasonography Findings in Patients With Crimean-Congo Haemorrhagic Fever
Karavas, Erdal; Karakeçili, Faruk
Objective: The aim of this study was to perform common carotid, internal carotid and vertebral artery Doppler ultrasound imaging of patients with Crimean-Congo haemorrhagic fever (CCHF), to compare the results with those of healthy individuals, and to determine the value of radiological findings in the prediction of disease severity in the early period. Methods: Bilateral common carotid, internal carotid and vertebral artery Doppler ultrasound (US) imaging was performed in CCHF patients and a healthy control group between March 2016 and September 2017. Patients were grouped as mild-moderate or severe cases according to the scoring system of Bakir et al. to determine disease severity. The peak systolic and diastolic rates together with the resistive and pulsatility indexes were examined in the common carotid, internal carotid, and vertebral arteries bilaterally. The flow volumes in the internal carotid and vertebral arteries were also measured bilaterally. Results: Total 35 CCHF patients comprised 14 males and 21 females with a mean age of 52 years. 7 patients were evaluated as severe and 28 as mild-moderate. On Doppler US, the peak systolic and diastolic end flow rates in vertebral arteries bilaterally were found to be statistically significantly higher in the patient group compared to the control group (p<0.05). The internal carotid artery and vertebral artery flow volumes bilaterally were determined to be statistically significantly higher in the patient group (p=0.032). When the relationship between flow volume and disease course was examined, volume was 1.11 L/min in mild-moderate cases and 2.23 L/min in severe cases. Conclusions: Early diagnosis of CCHF is extremely important for the initiation of supportive treatment, prediction of disease severity, and precautions to be taken. The noninvasive radiological findings determined in this study can be considered to contribute to the prediction of the clinical course and severity of CCHF in the early stages.
RDL Kalıcı Kaydıİncele - ArticleYalnız künye2017MOLECULAR EPIDEMIOLOGICAL ANALYSIS OF VANCOMYCIN-RESISTANT ENTEROCOCCI
Karakeçili, Faruk; Cilo, Burcu Dalyan; Çikman, Aytekin; Akalin, Halis; Özakin, Cuneyt
Introduction: In the control of vancomycin-resistant enterococci (VRE), it is important to identify these bacteria rapidly and demonstrate their relationship with nosocomial outbreaks. In this study we aimed to investigate epidemiology of VRE strains by determination of clonal relationships of these bacteria. Material and Method: The VRE strains isolated from January 2001 to December 2009 were examined in terms of their distribution by year and by their clustering patterns into epidemic groups. Identification and antibiotic susceptibilities were tested by using the otomated system. Vancomycin resistance was confirmed by the E-test method. PFGE was used to determine the clonal relationship between the strains. Results: 664 VRE strains were isolated in periods of nine years. E. faecium was found to be the most prevalent species. Eigthy-three E. faecium strains isolated during the epidemic periods were characterized by PFGE types from 11 different clonal clusters. The largest of these clusters, F-2, contained 26 isolates which was isolated in 2009. There was a significant similarity between strains isolated in 2001 and 2002 epidemics. The F-4 clone containing five isolates was first identified in 2001, and then detected in 2003. The strains isolated in the other three epidemic periods displayed certain insignificant similarities. Discussion: E. faecium which has been increasing among the VRE species all over the world, was found to be the most common isolate. In this study, a significant similarity was observed between strains isolated in the epidemics of 2001 and 2002, which indicates that this clone survived for a long time and became prevalent in the hospital during this period. All the strains in the 2009 epidemic period were clustered in one clone, F-2. Since this clone had not previously been isolated in our hospital, it is considered that it spreaded in the hospital and was the only clone responsible for the epidemic of 2009. To prevent VRE spread that may result hospital epidemics, it is important to well informe and educate our staff concerning these infections and preventive measures.
RDL Kalıcı Kaydıİncele - ArticleAçık Erişim2017A Salmonella typhimurium Outbreak Associated With Food Served at a Wedding Reception
Karakeçili, Faruk; Çikman, Aytekin; Karagöz, Alper
Objective: We aimed to present clinical and laboratory findings of patients and the molecular analysis of strains isolated in a Salmonella typhimurium outbreak associated with food served at a wedding reception. Methods: A total of 108 patients admitted to the hospital after eating food served at a wedding reception were included in the study. The patients whose symptoms continued even after supportive care were hospitalized for further treatment. Two sets of blood and stool cultures were obtained from all the hospitalized patients, and samples were taken from the implicated food source as well. The VITEK (R) 2 Compact (bioMerieux, Marcy l'Etoile, France) automated microbiology system was used together with conventional methods to identify the isolates and determine their antibiotic susceptibility. Serotyping was performed according to the Kauffmann-White scheme using the slide agglutination method. The molecular epidemiology of the isolates was determined by pulsed-field gel electrophoresis using the XbaI enzyme. Results: All the patients presented with common complaints such as fatigue, abdominal pain, fever, diarrhea, nausea, and vomiting that had started 8 to 16 hours after the consumption of the food served. 45 patients were treated in the hospital whereas 63 patients were followed in an ambulatory setting after 4-6 hours of supportive care. Their hospitalization period varied between 1 and 5 days, and all patients were discharged with full recovery. S. typhimurium was isolated from stool cultures of 14 patients, and two of them were also blood culture-positive. All the isolates revealed a single clonal cluster in molecular analysis. All of them were susceptible to ampicillin, ceftriaxone, and ciprofloxacin, but resistant to amikacin. Conclusions: Despite the developments in the food industry in Turkey and across the world, food-borne disease outbreaks still occur. Hygiene rules should be strictly followed and appropriate inspections should be undertaken in the food sector to prevent food-borne outbreaks.
RDL Kalıcı Kaydıİncele - ArticleYalnız künye2016Measles Outbreak in the Adult Age Group: Evaluation of 28 Cases
Özçiçek, Fatih; Karakeçili, Faruk; Akin, Hicran; Kalkan, Ahmet; Çıkman, Aytekin
Nowadays, the age group affected from measles has widened and the disease has become more common among adolescents and young adults. The number of measles case reports have increased in our country, particularly from 2010-2011, and measles outbreaks occurred in various regions in 2012 and 2013. The aim of this study was to analyze the demographical and epidemiological characteristics, clinical and laboratory fi ndings, and complications of adult patients with measles who were affected during the outbreak. A total of 28 patients (25 male, 3 female; age range: 19-39 years, median age: 24) who were hospitalized and followed-up in our clinic between January 2013 and June 2013, were evaluated. In the serum sample of the index case, measles-specifi c IgM antibodies were detected by ELISA, and measles virus RNA by real-time polymerase chain reaction (RT-PCR), then genotyping was performed to detect the epidemiological relationship. In all of the other cases, measles IgM and IgG antibodies were screened by ELISA. The most common symptoms on admission included high fever (n= 28, 100%), malaise (n= 25, 89%), sore throat (n= 25, 89%), headache (n= 20, 71%) and cough (n= 18, 64%). At physical examination, rash (n= 28, 100%), lymphadenopathy (n= 11, 39%) and conjunctivitis (n= 10, 36%) were in the foreground, and Koplik spots were detected in fi ve (18%) cases. The most common laboratory fi ndings were; increased level of C-reactive protein (n= 15, 54%), leukopenia (n= 12, 43%) and increased serum levels of aminotransferases (n= 12, 43%), and thrombocytopenia was detected in fi ve (18%) patients. One or more complications (secondary bacterial pneumonia in 5, diarrhea in 4, hepatitis in 3 and otitis in 2 cases) developed in the eight (29%) patients. Measles RT-PCR and IgM tests yielded positive results for the index case, and the isolate was identifi ed as D8 strain by genotyping. Measles lgM antibodies were also positive in all of the other cases. The hospitalization period was estimated as 3-7 days (median: 5 days), while all the patients were discharged with recovery. It appeared that, our index case had come from a troop in Amasya province three days ago and he had a history of contact with suspected measles patients. In addition, the D8 strain determined in the index case was found to be related with the strain that caused the outbreak in Amasya province. Of the cases, 20 (71.4%) were military personnel, and eight (28.6%) were civilian who had histories of contact with military personnel. Regardless of immunity status in the outbreak period, all of the healthcare staff in our hospital, especially in risky departments, was recommended to be vaccinated. Personnel vaccination was provided at a high rate, however nosocomial transmission occurred in two unvaccinated cases. In conclusion, measles is an important health problem, especially in the adult age group, because of the complications and labour loss. For outbreak management; the awareness of health personnel should be increased following the identifi cation of index case, proper isolation measures should be taken for the hospitalized patients, and routine reporting should be carried out timely and accurately
RDL Kalıcı Kaydıİncele - ArticleYalnız künye2016Endemik Bir Bölgede Bruselloz ve Kırım Kongo Kanamalı Ateşi Koenfeksiyonu Olgusu
Karakeçili, Faruk; Özçiçek, Adalet; Akin, Hicran; Gülhan, Barış; Çıkman, Aytekin
Tüm dünyada, özellikle de gelişmekte olan ülkelerde yaygın olarak görülen bruselloz, halen önemini koruyan zoonotik bir hastalıktır. Bir diğer zoonotik hastalık olan Kırım-Kongo kanamalı ateşi (KKKA) ise, insanlara enfekte kene ısırığının yanı sıra, enfekte hayvanların kan ve dokuları ile temas sonucunda bulaşabilir. Her iki hastalık da, genellikle kırsal alanda yaşayanlarda ve hayvancılıkla uğraşanlarda görülmektedir. Brusellozda özgül olmayan ve birçok hastalıkla kolayca karışabilen klinik belirtilerin ortaya çıkması, bu enfeksiyonların tanısında hatalara veya gecikmelere yol açabilmektedir. Bu raporda, her iki hastalığın da birlikte görülebileceğinin vurgulanması amacıyla, bruselloz ve KKKA koenfeksiyonu tespit edilen bir olgu sunulmaktadır. Kırsal bölgede hayvancılıkla uğraşan 70 yaşında bir kadın hasta, yüksek ateş, halsizlik, yaygın vücut/eklem ağrıları ve baş ağrısı şikayetleriyle kliniğimize başvurmuştur. Son iki gündür şikayetlerinin arttığı, bulantı/kusma, karın ağrısı ve kanlı ishalinin olduğu öğrenilmiştir. Kene tutunma öyküsü olmayan olgunun fi zik muayenesinde 38.8°C ateş, bağırsak seslerinde artış ve splenomegali saptanmış; yapılan tetkiklerinde lökopeni, trombositopeni ve karaciğer enzimlerinde yükselme olduğu izlenmiştir. KKKA ön tanısıyla yatırılan hastanın serum örneği değerlendirilmek üzere, Türkiye Halk Sağlığı Kurumu (THSK) Mikrobiyoloji Referans Laboratuvarı Daire Başkanlığı'na (MRLDB) gönderilmiştir. Hastanın serviste yatışı sırasında öyküsü daha detaylı sorgulanınca, halsizlik, iştahsızlık, terleme, eklem ağrıları ve aralıklı ateş şikayetlerinin bir aydır devam ettiği ve çeşitli antibiyotik tedavileri aldığı öğrenilmiştir. Bunun üzerine bruselloz açısından yapılan tetkiklerde; Brucella Rose Bengal, tüp aglütinasyonu (1/160 titre) ve Coombs'lu immün yakalama (1/320 titre) testleri pozitif bulunmuştur. Aynı zamanda, THSK-MRLDB'de yapılan testlerde; immünofl oresan yöntemi ile KKKA virusuna özgül IgM pozitifl iği ve gerçek zamanlı polimeraz zincir reaksiyonu ile viral RNA varlığı tespit edilmiştir. Hastanın yatışında alınan iki kan kültüründe üreme olmamış, bu durumun, son bir ay içinde kullandığı antibiyotiklerden kaynaklanmış olduğu düşünülmüştür. Olguya bruselloz için doksisiklin ve rifampisin tedavisi başlanmış, KKKA için destek tedavisi uygulanarak yakın takibe alınmıştır. Yatışının ikinci gününde trombosit değerinde hızlı düşüş (37000/mm3) olması üzerine hastaya 5 ünite random trombosit ve 2 ünite taze donmuş plazma verilmiştir. Daha sonraki takiplerinde ateşi düşen ve kan tablosu düzelen olgunun bruselloz tedavisi ayaktan sekiz haftaya tamamlanmış; tedavi sonrası takiplerinde herhangi bir sorun tespit edilmemiştir. Yapılan literatür taramasında, ulaşılabildiği kadarıyla, bruselloz ve KKKA koenfeksiyonu daha önce bildirilmemiştir. Sonuç olarak, ülkemizin hem bruselloz hem de KKKA açısından endemik bir bölge olduğu göz önüne alındığında, her iki enfeksiyonun da ayırıcı tanısında bu durumun dikkate alınması önem taşımaktadır. Ayrıca bizim olgumuzda olduğu gibi koenfeksiyon olabileceği de akılda tutulmalıdır
RDL Kalıcı Kaydıİncele - ArticleAçık Erişim2016A case of brucellosis and crimean-congo hemorrhagic fever coinfection in an endemic area; [Endemik Bir Bölgede Bruselloz ve Kirim Kongo Kanamali Ateşi Koenfeksiyonu Olgusu]
Karakeçili, Faruk; Çikman, Aytekin; Akin, Hicran; Gülhan, Banş; Özçiçek, Adalet
Brucellosis, a zoonotic disease which is especially seen in developing countries is still an important public health problem worldwide. Crimean-Congo hemorrhagic fever (CCHF) is another zoonotic disease that transmits to humans by infected tick bites as well as exposure to blood or tissue from infected animals. Both of the diseases are common among persons who live in rural areas and deal with animal husbandry. Since brucellosis usually presents with non-specific clinical symptoms and may easily be confused with many other diseases, the diagnosis of those infections could be delayed or misdiagnosed. In this report, a case of coinfection of brucellosis and CCHF has been presented to emphasize the possibility of association of these infections. A 70-year-old female patient with a history of dealing with animal husbandry in a rural area admitted to our hospital with the complaints of fever, malaise, generalized body and joint pains, and headache. Her complaints had progressed within the past two days. She also reported nausea, vomiting, abdominal pain and bloody diarrhea. She denied any history of tick bites. Her physical examination was significant for the presence of 38.8°C fever, increased bowel sounds and splenomegaly. Laboratory analysis revealed leukopenia, thrombocytopenia and high levels of liver enzymes. The patient was admitted to our service with the prediagnosis of CCHF. Serum sample was sent to the Department of Microbiology Reference Laboratory at Public Health Agency of Turkey for CCHF testing. During patient's hospitalization in service, more detailed history was confronted and it was learned that she had fatigue, loss of appetite, sweating, joint pain, and intermittent fever complaints were continuing within a month and received various antibiotic treatments. The tests for brucellosis were conducted and positive results for Brucella Rose Bengal test, tube agglutination (1/160 titers) and immune capture test with Coombs (1/320 titers) were determined. The tests performed in the reference laboratory revealed CCHF virus-specific IgM positivity by immunofluorescence assay and viral RNA positivity by real-time polymerase chain reaction. Two blood cultures remained sterile during hospitalization, this situation was considered to be the cause of antibiotic usage in the last month. Doxycycline and rifampicin therapy were initiated for brucellosis, and close monitoring with supportive therapy for CCHF. On the second day of admission, the patient was transfused with 5 units random platelets and 2 units fresh frozen plasma due to dramatic decline of platelet count (37.000/mm3). Early clinical response to brucellosis therapy was confirmed with resolution of fever and improved blood counts and the treatment was completed in eight weeks on an outpatient basis. No other problems were encountered during follow-ups after completion of treatment. According to accessible literature search, coinfection of brucellosis and CCHF has not been reported previously. In conclusion, as our country is endemic for both brucellosis and CCHF, it is important to consider both infections in the differential diagnosis. Physicians should keep in mind that, likewise in our case, coinfection of brucellosis and CCHF can be detected.
RDL Kalıcı Kaydıİncele - ArticleYalnız künye2016Conventional culture and molecular screening methods for detection of vancomycin-resistant enterococci activity
Karakeçili, Faruk; Cilo, Burcu Dalyan; Akin, Hicran; Agca, Harun; Sinirtas, Melda; Özakin, Cüneyt; Yilmaz, Emel; Akalin, Halis
Introduction: Early identification of vancomycin-resistant enterococci (VRE) colonization by screening patients is necessary in terms of preventing spread and development of infection. The purpose of this study was to investigate the presence of VRE using and real time polymerase chain reaction (RT-PCR) and to compare the results and costs. Materials and methods: Patients in the risk group attending our hospital and planned for treatment with hospitalization were included. Two rectal swab specimens were taken. One swab specimen was inoculated into enterococci broth for CCSM. Resistant gene investigation was performed with the other specimen by using RT-PCR. The costs of the two methods were then compared. Results: VRE were detected in 75 (6.63%) of the 1130 patients screened using the two methods. Resistance gene was determined in 69 (6.1%) patients using RT-PCR and 32 (2.8%) with CCSM. RT-PCR results were negative in 6 patients with VRE growth determined using CCSM. VRE was detected with CCSM in all 26 patients in whom vanA genotype VRE were determined using RT-PCR, but no growth was determined with CCSM in any of the 43 patients in whom vanB genotype VRE were detected. Results obtained in 3 days using CCSM and within 4 hours using RT-PCR. Costs were 58 $ with CCSM and 46 $ with RT-PCR. Conclusion: VRE colonization being detected faster with RT-PCR than CCSM. When the costs in isolation of patients until VRE screening test results emerged were compared, VRE screening with RT-PCR was cost-effective. RT-PCR was markedly superior to CCSM in determining VanB type resistance. Due to the late results from CCSM and its failure to detect VanB type resistance, we think that RT-PCR can be an alternative to CCSM or that the two techniques can usefully be combined depending on the hospital conditions.
RDL Kalıcı Kaydıİncele - ArticleYalnız künye2016A case of brucellosis presenting with suppurative parotitis involvement; [Süpüratif parotis tutulumu ile seyreden bruselloz olgusu]
Kanmaz, Lutfi; Karakeçili, Faruk; Çıkman, Aytekin; Özçiçek, Fatih; Karavaş, Erdal
Brucellosis is a common zoonotic infection caused by Brucella bacteria. Brucella infections are usually presented with various clinical manifestations, and often accompanied by multiple organ involvements. In this article, we present a case of brucellosis with suppurative parotitis involvement accompanied by parotid abscess and fistula in a 60-year-old male patient. According to the literature review we conducted regarding complications of brucellosis, our case is the first case reported in the literature. Significant improvement in patient's suppurative parotitis and clinical findings was observed at the fifth week of combination antibiotic therapy. Patient's complaints resolved completely after eight weeks of treatment.
RDL Kalıcı Kaydıİncele - ArticleAçık Erişim2015Chronic Granulomatous Disease Diagnosed in Adulthood
Karakeçili, Faruk; Akin, Hicran; Pekgöz, Murat; Mistik, Resit; Oral, Haluk Barboros; Akalin, Halis
Chronic granulomatous disease (CGD) is a rare, genetically heterogeneous disease characterized by severe infections that can be life threatening. The disease develops due to defects in nicotinamide adenine dinucleotide phosphate (NADPH) oxidase system. It is characterized by granuloma formation depending on recurrent infections and increased inflammatory response. Lung, skin, lymph nodes, and liver are the most involved organs. Nitroblue tetrazolium test (NBT) is the most frequently used test in screening. In this article, a chronic granulomatous disease case diagnosed in adulthood and having recurrent liver and lung abscesses is reported in light of the literature. A 22-year-old male patient was admitted to our polyclinic with high fever for two weeks. Patient's family history was received in terms of CGD and NBT was carried out. Patient's NBT result was negative (0%) twice. The patient was administered empiric ceftriaxone and metronidazole treatment. Abscess drainage was planned for the patient diagnosed as CGD as a result of the analyses. The patient who developed fever response and whose laboratory values improved was discharged proposing polyclinic control with trimethoprim/ sulfamethoxazole and itraconazole prophylaxis. This case indicates that, although rarely, CGD might be diagnosed in adulthood in our country where consanguineous marriage and hereditary diseases are common.
RDL Kalıcı Kaydıİncele - ArticleYalnız künye2013Primer Uterin Hidatik Kist: Olgu Sunumu
Karakeçili, Faruk; Uluğ, Paşa; Sayar, İlyas; Naykı Aslan, Ümit; Yıldırım, Yusuf; Peker, Kemal; Naykı, Cenk
Echinococcosis, which is caused by echinococcus granulosus, is also known as cystic hydatid disease, unilocular echinococcosis or cystic echinococcosis. Cystic echinococcosis is an alarming public health problem in some countries. Although the liver and lung are the organs involved most commonly by the disease, it may appear rarely in other tissues as a primary disease. Here, we present a 66-year-old patient who is invoved in farm work work. A Uterine multiseptate hydatid cyst was found on radiological investigations and the patient underwent surgery. A total hysterectomy was carried out. There were no postoperative complications. (Turkiye Parazitol Derg 2013; 37: 302-4)
RDL Kalıcı Kaydıİncele - ArticleYalnız künye2013Salmonella serotiplerinin konvansiyonel ve moleküler yöntemler ile belirlenmesi
Karakeçili, Faruk; Gedikoğlu, Suna; Cilo Dalyan, Burcu; Güleşen, Revasiye Kayalı; Levent, Belkis; Özakın, Cüneyt
Salmonella enterica serotiplerinin belirlenmesi epidemiyolojik çalışmalar açısından önem taşımaktadır. Salmonella serotipleri, hücre duvarında yer alan somatik (O) ve flajel (H) antijenleri temel alınarak belirlenir. Bu çalışmanın amacı multipleks polimeraz zincir reaksiyonu (mPCR) yöntemi ile belirlenen moleküler serotiplendirme sonuçlarının konvansiyonel serotiplendirme sonuçları ile karşılaştırılmasıdır. Konvansiyonel serotiplendirme Ulusal Enterik Patojenler Laboratuvar Sürveyans Ağı (UEPLA) kapsamında Sağlık Bakanlığı Refik Saydam Hıfzıssıhha Merkezi Başkanlığı'nda yapılmıştır. Referans laboratuvarı tarafından 14 farklı serotipte tanımlanmış toplam 100 Salmonella suşu, Salmonella serogrupları (A, B, C1, D, E) ve Vi antijen gen bölgelerine özgü primerler kullanılarak mPCR yöntemi ile moleküler olarak serogruplandırılmıştır. H antijenleri (H: a, -b, -d, -g,m, -i, -r, -z10) ve iki antijen kompleksinde yer alan (H: 1,2, -1,5, -1,6, - 1,7 ve H: enx, enz15) antijenleri kodlayan fliC ve fliB genlerine yönelik ardışık dört mPCR yöntemi uygulanarak serotipler belirlenmiştir. Multipleks PCR sonuçları, konvansiyonel yöntem ile belirlenen serogruplar ile %100 uyum göstermiş; serogruplara yönelik mPCR’nin duyarlılık ve özgüllüğü %100 olarak bulunmuştur. Moleküler yöntemle elde edilen antijenik formüle göre belirlenen serotiplendirmede; 2 (%2) izolatta kesin sonuç, 91 (%91) izolatta muhtemel sonuç, 7 (%7) izolatta ise tamamlanamayan formül elde edilmiştir. Klinik mikrobiyoloji laboratuvarlarında en sık izole edilen Salmonella serotipleri olan S.Enteritidis, S.Typhimurium ve S.Paratyphi için moleküler serotiplendirme sonuçları muhtemel sonuç olarak değerlendiriliştir. Bu serotipler için mPCR ile elde edilen antijenik formüle göre belirlenen muhtemel sonuçlar epidemiyolojik veriler göz önünde bulundurularak yorumlandığında elde edilen sonuçların konvansiyonel serotiplendirme sonuçları ile uyumlu olduğu gözlenmiştir. Moleküler yöntem ile kesin sonuç elde edilen S.Typhi’nin serogruplandırma ve serotiplendirilmesi açısından mPCR’nin duyarlılığı %100 olarak bulunmuştur. Multipleks PCR klinik laboratuvarlarda izole edilen suşların tanımlanmasında konvansiyonel serotiplendirmeye göre daha ucuz ve daha hızlı bir yöntem olarak değerlendirilmektedir. Moleküler tiplendirme ile bütün serotiplerin kesin olarak belirlenmesi mümkün olmadığından, bugün için moleküler tiplendirme konvansiyonel serotiplendirmenin alternatifi değildir. Ancak konvansiyonel serotiplendirme sonuçları alınıncaya kadar veri sunması bakımından yararlı görünmektedir.
RDL Kalıcı Kaydıİncele - ArticleAçık Erişim2013Primary uterine hydatid cyst: a case report.
Peker, Kemal; Uluǧ, Paşa; Nayki, Ümit Aslan; Nayki, Cenk; Sayar, Ilyas; Karakeçili, Faruk; Yildirim, Yusuf
Echinococcosis, which is caused by echinococcus granulosus, is also known as cystic hydatid disease, unilocular echinococcosis or cystic echinococcosis. Cystic echinococcosis is an alarming public health problem in some countries. Although the liver and lung are the organs involved most commonly by the disease, it may appear rarely in other tissues as a primary disease. Here, we present a 66-year-old patient who is invoved in farm work work. A Uterine multiseptate hydatid cyst was found on radiological investigations and the patient underwent surgery. A total hysterectomy was carried out. There were no postoperative complications.
RDL Kalıcı Kaydıİncele - ArticleYalnız künye2013Determination of salmonella serotypes by conventional and molecular methods; [Salmonella serotiplerinin konvansiyonel ve moleküler yöntemler ile belirlenmesi]
Dalyan Cilo, Burcu; Karakeçili, Faruk; Güleşen, Revasiye; Levent, Belkis; Özakin, Cüneyt; Gedikočlu, Suna
Determination of Salmonella enterica serotypes is crutial for epidemiological studies. Salmonella serotypes are defined on the basis of somatic (O) and flagellar (H) antigens, both of which are present in the cell wall of Salmonella. The aim of this study was to compare the results of molecular serotyping obtained by multiplex polymerase chain reaction (mPCR) with conventional serotyping results. Conventional serotyping has been performed in Ministry of Health Refik Saydam Hygiene Center as part of the National Laboratory of Enteric Pathogenes Surveillance Network (UEPLA). A total of 100 Salmonella strains, thay comprise 14 different serotypes by the reference laboratory have been investigated by using specific primers for Salmonella serogroups (A, B, CI, D and E) and Vi antigen gene clusters via mPCR method. Serotypes have been determined by applying four sequential mPCR targeting the fliC and fliB genes encoding the H1 antigens (H1: a, -b, -d, -g,m, -i, -r, -z10) and H2 antigen complexes (H2: 1,2, -1,5, -1,6, -1,7 and H: enx, enz15). The results of mPCR showed 100% consistency with the serogroups determined by the conventional method. Both sensitivity and specificity of mPCR according to each serogroups were found to be 100%. Results of serotyping that have been determined with the molecular antigenic formula showed accurate results for 2 (2%), probable results for 91 (91 %) and incomplete formula for 7 (7%) isolates. Molecular serotyping results of the most common isolated Salmonella serotypes of which S. Enteritidis, S. Typhimurium and S. Paratyphi from clinical microbiology laboratories have been determined as probable results. Antigenic formula of these serotypes that detected using mPCR were considered to be consistent with the results of conventional serotyping when interpreted with epidemiologic data. The sensitivity of mPCR to identify S. Typhi which have been determined as accurate result with molecular serotyping was 100% for serogrouping and serotyping. Multiplex PCR is cheaper and faster for the serotyping of strains isolated in clinical laboratories, compared to the conventional methods. However since it is not possible to detect all serotypes by using molecular typing, this technique can not be currently considered as an alternative for conventional serotyping. Nevertheless molecular typing could be beneficial in providing the preliminary results earlier.
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