Microbiota studies are an increasingly important issue today. In the literature, there are limited studies on the antifungal resistance and biofilm formation capacity of yeasts isolated from the mouths of young individuals. For this reason, our study was carried out with 133 yeast isolates isolated from the mouths of 17 young individuals between the ages of 18-25 in 2018-2020. When the biofilm-forming capacities of 133 isolates were examined, it was determined that 99.25% were biofilm producers by tissue culture plate method and 66.92% by tube method. One hundred thirty-three yeast isolates and seven reference strains were first evaluated against fluconazole antifungal by agar disc diffusion method. The isolates were found to be susceptible to fluconazole. According to this result, 20 isolates with strong biofilm-forming capacity were selected from 133 yeast isolates. Antifungal resistance was evaluated with fluconazole, itraconazole, clotrimazole, amphotericin B and nystatin gradient test strips. It was determined that 20 isolates were resistant to amphotericin B, and 18 were resistant to nystatin antifungal. It was determined that the sensitivity of itraconazole to 14 isolates and clotrimazole to 3 isolates was dose-dependent. As a result, azole group antifungals can be used mainly in treating oral yeast infections.

OBJECTIVES:Aspergillus fumigatus causes several diseases in humans and azole resistance in A. fumigatus strains is an important issue. The aim of this multicentre epidemiological study was to investigate the prevalence of azole resistance in clinical and environmental A. fumigatus isolates in Turkey.METHODS:Twenty-one centres participated in this study from 1 May 2018 to 1 October 2019. One participant from each centre was asked to collect environmental and clinical A. fumigatus isolates. Azole resistance was screened for using EUCAST agar screening methodology (EUCAST E.DEF 10.1) and was confirmed by the EUCAST E.DEF 9.3 reference microdilution method. Isolates with a phenotypic resistance pattern were sequenced for the cyp51A gene and microsatellite genotyping was used to determine the genetic relationships between the resistant strains.RESULTS:In total, resistance was found in 1.3% of the strains that were isolated from environmental samples and 3.3% of the strains that were isolated from clinical samples. Mutations in the cyp51A gene were detected in 9 (47.4%) of the 19 azole-resistant isolates, all of which were found to be TR34/L98H mutations. Microsatellite genotyping clearly differentiated the strains with the TR34/L98H mutation in the cyp51A gene from the strains with no mutation in this gene.CONCLUSIONS:The rate of observed azole resistance of A. fumigatus isolates was low in this study, but the fact that more than half of the examined strains had the wild-type cyp51A gene supports the idea that other mechanisms of resistance are gradually increasing.

This comprehensive study aims to examine the relationships between ambient air quality (AAQ) and respiratory health of the participants residing in three different towns of Canakkale city, Turkey between August 2013 and 2014. AAQ measurements for bioaerosols, volatile organic compounds (VOCs), total particulate matter (PM) count, carbon dioxide (CO2), and carbon monoxide (CO) were performed and monthly pulmonary function test (PFT) was applied to volunteer participants residing in the study sites (n = 121) for one year. Additionally, concentrations of air pollutants for PM2.5/PM10, sulfur dioxide (SO2), nitrogen oxides, and ozone were gathered from AAQ monitoring stations. To estimate the contributions of the emission sources and their effects on human health in the region, an emission inventory was also prepared in the region and AERMOD modelling system was applied for the year of 2013. Accordingly, the industry was the most polluting sector for NOx and SO2, while road traffic and residential heating were the most polluting sectors for CO and PM10. Factor analysis revealed that organics, combustion, bioaerosol propagation, and ozone accumulation contributed to AAQ, in agreement with AQ modelling results. Can had the worst air quality (industrialized site), which affected the respiratory health indicators of the participants. Generalized linear model estimated that PF of the participants varied according to the residing district, gender, suffering from asthma, and lifelong smoking or environmental tobacco smoke exposure (p < 0.05). Also, PF of the participants were linked with VOCs levels in the Central town, total PM count in Lapseki, and ozone levels in Can (p < 0.05).

Poor indoor air quality (IAQ) can cause several respiratory diseases and symptoms. In this study, IAQ of 121 homes located in 3 different towns of Canakkale, Turkey was monitored throughout a year. Target air pollutants were particulate matter, volatile organic compounds (VOCs), bioaerosols, and Carbon dioxide (CO2), as well as air temperature and humidity. Moreover, pulmonary functions of the occupants were measured on a monthly basis. Also, occurrence of sick building syndrome (SBS) symptoms and other health related data were gathered from the occupants by a detailed questionnaire. The SBS is a situation related to indoor air pollution in which the occupants of a building experience health or comfort related adverse effects that appear to be associated directly to the time spent in the "sick" building. Results of this study showed that the highest indoor air pollutant levels were observed in Can town and the lowest levels were observed in Central town. Indoor levels of bioaerosols, particulate matter, benzene, Cladosporium spp., and Penicillium spp. as well as pulmonary functions of the occupants showed statistically significant differences between the locations of the homes (p < 0.001). Factor analysis implied that both indoor and outdoor originated sources contributed to IAQ. Even though the predominant SBS symptoms varied seasonally and spatially among the study sites, fatigue, cold-flu like symptoms, and difficulty in concentration occurred frequently. Correlations were found among the occurrence of SBS symptoms, measured IAQ parameters, and personal factors (p < 0.05). Performing more studies from the health and IAQ points of view improve public awareness.

Introduction. Colistin is a last-resort antibiotic used against carbapenem-resistant Acinetobacter baumannii (AB); however, colistin resistance has been reported recently. Methylene blue (MB) is used in microbiology for staining, and in medicine as an antidote drug.Aim. We aimed to investigate the antimicrobial effects of MB and eosin methylene blue (EMB) agar against colistin-resistant AB strains.Methodology. Firstly, a standard strain and AB clinical isolate were included in the study. After determining MICs, two strains were transformed into colistin-resistant forms, using Li's method. At each step, new MICs were determined and subcultures were inoculated onto EMB and sheep blood agar (SBA). Colistin MICs of the subcultures were also determined using Mueller-Hinton agar (MHA) containing MB. Secondly, colistin-resistant clones from 31 multidrug-resistant AB clinical isolates were screened to investigate their susceptibilities to EMB agar.Results. In the first round, MICs of both strains had risen to 64 μg ml-1. Subpopulations with high colistin resistance were inhibited by MB and EMB agar, but could grow well on SBA. In MHA plates containing MB, the MICs decreased to 0.5 μg ml-1 for colistin-susceptible or moderately resistant clones. Additionally, clones with high colistin resistance showed atypical colony morphology on SBA. In the second round, 35 % of the clinical isolates, which had gained resistance to colistin, were inhibited by EMB agar.Conclusion. MB may have inhibitory effects against colistin-resistant AB. Secondly, using only EMB agar for subculturing may cause missing of colistin-resistant strains.

Few epidemiological studies investigating the association between air pollution and health are available in Turkey. The aim of this cohort-type study is to examine the relationships between ambient air quality, respiratory diseases, and decreases in pulmonary function over a year in three different towns in Canakkale: Canakkale Central town (region I), Lapseki town center (region II), and Can town (region III). Region III had four different sub-regions, which were Can town center (region III-A), and the villages located around Can town, namely Durali (region III-B), Kulfal (region III-C), and Yuvalar (region III-D). In the first stage of the study, a detailed questionnaire was completed by the participants (n = 1152) in face-to-face interviews and pulmonary function test (PFT) was performed. In the second stage of the study, PFT measurements were repeated 1 year after the first stage. Particulate matter, SO2, NO2, and ozone were gathered from air quality monitoring stations located in the centers of the three regions. The most polluted area was region III, while region I and region II were the least polluted areas. The risk of pulmonary function decline throughout a year was 2.1 times higher in region III, 2.4 times higher both in regions III-B and III-C, and 1.6 times higher for smokers in all regions. In the present study, ambient air quality was worse in region III (industrialized region), which influenced PFT scores and the prognostics for chronic respiratory diseases. The findings of this study should be considered for future investment plans in this region related to human and environmental health needs.

Objective: In our study, we aimed to investigate the effects and duration of effect of 4 antiseptics and disinfectants frequently used in hospitals on 12 different resistant species of bacteria that cause nosocomial infections which were isolated from inpatients in our hospital. Methods: Three strains each of Acinetobacter baumannii, Pseudomonas aeruginosa, methicillinresistant Staphylococcus aureus and vancomycin-resistant Enterococcus were chosen for the study.Three American Type Culture Collection standard bacteria strains (ATCC) including P.aeruginosa ATCC 27853, Escherichia coli ATCC 25922, and Staphylococcus aureus ATCC 6538 were used as the control group.Antiseptics and disinfectants were evaluated at different concentrations and included povidone iodine (10%), sodium hypochloride (5%), ethyl alcohol and gluteraldehyde (2%) which are routinely used for disinfection in our hospital.Povidone iodine (10%) and gluteraldehyde (2%) were evaluated in 3 forms; undiluted according to the manufacturer's instructions and also in 1/2 and 1/4 diluted forms.Sodium hypochlorite (5%) was examined in undiluted form, and at 1/10 and 1/100 dilution.Ethyl alcohol was prepared at the concentrations of 95%, 70%, and 50% before use.The selected bacteria ÖZET

The more the mold species isolated on a culture medium, the more the sampling environment is represented accurately. According to the sampling purpose, it is crucial to use the best culture medium for mold. However, no study is available regarding the comparison of dichloran rose bengal chloramphenicol (DRBC) and Sabouraud dextrose agar with cycloheximide and chloramphenicol (SDA-CHX-CHL) culture media in terms of their application for airborne sampling, isolation, and identification of fungi. Airborne mold samples were impacted onto both DRBC and SDA-CHX-CHL, simultaneously using single-stage Andersen sampler. The limit of detection (LOD) value for airborne mold count was 7 CFU m−3 (1 colony growth on the Petri dish). The total mold counts (TMC) ranged between <7 and 504 CFU m−3 (med 56 CFU m−3) and <7 and 1218 CFU m−3 (med 259 CFU m−3), collected on SDA-CHX-CHL and DRBC, respectively. Significantly higher TMC were observed on DRBC than on SDA regardless of the sampling environment (i.e, indoor or outdoor) (p < 0.05). Among the most predominant mold genera, observation frequencies of Penicillium spp. and Aspergillus spp. on both culture media were found to be more than 70%. Observation frequencies of Cladosporium spp., Alternaria spp., and yeast were found to be higher in samples collected on DRBC than those on SDA-CHX-CHL. Finally, DRBC was found to be superior to SDA in terms of both number of colonies and number of genera isolated from the air.

Introduction: Colistin can be used in patients infected with carbapenem-resistant Acinetobacter baumannii complex (CR-ABC), but recently resistance to colistin and heteroresistance have been reported. In this study we aimed to investigate the colistin heteroresistance rates and the effects of colistin and its combinations on colistin heteroresistance/resistance development in CR-ABC strains in our hospital. Materials and Methods: Heteroresistance analysis was performed on CR-ABC isolates and standard ABC strain [American Type Culture Collection (ATCC) 19606)] strain. To investigate hidden heteroresistance, the isolates were exposed to colistin at sub-inhibitory concentrations. 'Time-kill' study was performed on the standard strain and a clinical strain for colistin. Serial passage test was performed to investigate the effects of drug combinations on heteroresistance/resistance development. Results: In the first heteroresistance analysis test, all strains were found to be non-heteroresistant. However, after sub-inhibitory exposure to colistin, colistin heteroresistance/resistance developed in all isolates. In serial passages, colistin-rifampicin and colistin-tigecycline (Col+Tig) combinations were found to be effective and prevented growth of colistin-resistant sub-populations even at sub-inhibitory doses. Colistin- gentamicin (Col+Gen) combination was not found to be effective against the clinical isolate while it was effective on ATCC strain. Colistin-fluconazole combination was found to be ineffective at all concentrations. Conclusion: In our study, it was shown that the strains which were detected to be non-heteroresistant could easily transform to heteroresistant/resistant forms after exposure to colistin. Colistin-rifampicin and Col+Tig combinations were found to be effective and prevented the emergence of heteroresistance/resistance to colistin even at low concentrations. At low concentrations, Col+Gen combination was ineffective against the clinical ABC isolate. Colistin- fluconazole combination failed to inhibit the emergence of resistant bacteria. Heteroresistance or resistance to colistin may easily develop because of inappropriate use of this antibiotic. To prevent this condition, colistin should be administrated at appropriate doses and in combination with the suggested antibiotics.

baumannii'lerde karbapenemazların varlığı ve bunların kromozomal veya plazmid kaynaklı

Indoor air quality (IAQ) measurements were conducted in three different towns (i.e. Centre, Lapseki, and Can) in Canakkale, Turkey (n = 121) throughout the year. All indoor environments were selected randomly among the volunteer participants of a previous health survey. Particulate matter (PM), Total Volatile Organic Compounds (TVOCs), Total Bacteria Concentration (TBC), Total Mold Concentration (TMC), and Carbon dioxide (CO2) together with temperature and relative humidity (RH) were measured monthly. Together with IAQ measurements, bronchial hyper-responsiveness indicators such as forced vital capacity (FVC) and forced expiration volume (FEV1) of the occupants of the homes were measured by monthly Pulmonary Function (PF) test. Furthermore, a comprehensive survey was given to the participants. The measured IAQ parameters showed seasonal and spatial variations (p < 0.05). Among them, the highest levels of TVOC, CO2, and PM were found in the winter, while the highest levels of both TBC and TMC were found in the summer. In general, levels of IAQ parameters and asthma prevalence were the highest in Can (i.e. industrial area). Also, IAQ adversely influenced the respiratory health of participants in Can (p < 0.05). Shortness of breath was the most prominent respiratory symptom. Negative associations between asthma and FEV1/FVC ratio, and between respiratory symptom score (RSS) and FEV1/FVC, support the idea that the PF test can be a good indicator for (early) prognosis of respiratory diseases.

AIM:This study aimed to investigate the effects of L-carnitine, with its known antioxidant properties and positive effects on wound healing, on the healing of colon anastomosis in a cecal ligation and puncture sepsis model in rats. MATERIALS AND METHODS:A total of 40 Sprague-Dawley rats were used. The rats were randomly divided into four groups of 10 (n = 10). Groups 1 and 2 had laparotomy and colon anastomosis performed. Groups 3 and 4 had cecal ligation and puncture (CLP) and colon anastomosis performed. Rats in Groups 1 and 3 were given 15 mL/kg intraperitoneal 0.9% isotonic NaCl, while the rats in Groups 2 and 4 were given 100 mg/kg intraperitoneal L-carnitine. On the postoperative fifth day, the rats were sacrificed and the burst pressure of anastomosis, histopathological effects, and tissue hydroxyproline levels were investigated. RESULTS:In Groups 2 and 4, the anastomosis burst pressure and histopathological results in both noninfected abdomen and presence of peritonitis were statistically high compared to the control group (p < 0.05). Though the hydroxyproline levels were also high, there was no statistically significant difference for this parameter (p > 0.05). CONCLUSIONS:The findings obtained from the experimental sepsis model showed that healing of anastomosis in both the presence of peritonitis and noninfected abdomen was positively affected by the systemic administration of L-carnitine and this may contribute to the safety of anastomosis.

INTRODUCTION:Methicillin-resistant Staphylococcus aureus (MRSA) is one of the most important nosocomial pathogens and is also emerging in Turkish hospitals. The aim of this study was to determine the antimicrobial susceptibility profiles of MRSA isolated from Turkish hospitals.MATERIALS AND METHODS:A total of 397 MRSA strains isolated from 12 hospitals in Turkey were included to present study. Antimicrobial susceptibilities were tested using agar dilution method. Presence of ermA, ermB, ermC, msrA, tetM, tetK, linA and aac-aph genes were studied by PCR.RESULTS:All strains were susceptible to vancomycin and linezolid. The susceptibility rates for fusidic acid, lincomycin, erythromycin, tetracyclin, gentamycin, kanamycin, and, ciprofloxacin were 91.9%, 41.1%, 27.2%, 11.8%, 8.5%, 8.3% and 6.8%, respectively. Lincomycin inactivation was positive for 3 isolates. Of 225 erythromycin resistant isolates 48 had ermA, 20 had ermC, and 128 had ermA-C. PCR was negative for 15 strains. Of 3 isolates with lincomycin inactivation one had linA and msrA. Of 358 gentamycin resistant isolates 334 had aac-aph and 24 were negatives. Among 350 tetracyclin resistant isolates 314 had tetM. Of 36 tetM negative isolates 10 had tetK.CONCLUSION:MRSA isolates from Turkish hospitals were multiresistant to antimicrobials. Quinolone and gentamycin resistance levels were high and macrolide and lincosamide resistance were relatively low. Susceptibility rates for fusidic asid were high. Linezolide and vancomycin resistance are not emerged. The most common resistance genes were ermA, tetM and aac-aph. Evolution of antimicrobial susceptibilities and resistance genes profiles of MRSA isolates should be surveyed at regional and national level for accurate treatment of patients and to control dissemination of resistance genes.

Amaç: Acinetobacter baumannii suşları normalde

We report the first case, in Medline-based literature, of conjunctivitis caused by gram negative diplococcus, Neisseria sicca. Although it is not widely accepted as such, isolation from cultures of repeated eye swab samples suggests that N. sicca may be a pathogen in conjunctival infections. Positive culture for this organism should not be readily dismissed. Such conjunctivitis responded favorably to treatment with netilmicin eye drops.

Background: There are insufficient data in the literature on the presence of Helicobacter pylori in tonsil and adenoid tissue of patients with only airway obstruction. This study examined the presence of H. pylori in surgical cases with airway obstruction or recurrent infection. Aims: To investigate the relationship between H. pylori adenotonsillar colonisation and the frequency of adenotonsillitis and to compare paediatric and adult patients according to H. pylori tonsillar colonisation. Study Design: Prospective clinical trial. Methods: Patients scheduled for adenoidectomy or tonsillectomy were classified into three groups based on indications: paediatric infection (n=29), paediatric obstruction (n=29) and adult infection (n=12). Tissue samples obtained from patients were examined for the presence of H. pylori by culture, rapid urease test and polymerase chain reaction. Results: Forty-nine tonsil tissues were examined. Positive results were found in two specimens with the rapid urease test (4.1%) and three with polymerase chain reaction examination (6.1%). Only three positive polymerase chain reaction results (5.8%) were identified in 52 adenoid tissue samples. There were no statistically significant differences in the presence of H. pylori between paediatric infection and obstruction groups or between paediatric infection and adult infection groups. Conclusion: In our study, there was a low incidence of H. pylori colonisation in tonsil and adenoid tissues. Regarding H. pylori colonisation, there was no significant difference between paediatric infection and obstruction groups. Also, no significant difference was found between adult and paediatric cases.

Staphylococcus aureus is one of the most frequent agents causing hospital infections. S.aureus has a great ability to adapt itself to variety of conditions and successful clones can be epidemic and even pandemic by its ability spread from one continent to another. The aims of this study were to detect spa types of 397 methicillin-resistant S.aureus (MRSA) strains isolated from 12 centers in different geographical regions of Turkey from 2006 to 2008, and to investigate their clonality by PFGE and MLST typing. Additionally, 91 MRSA from four of those 12 centers isolated during 2011 were also studied for their spa types. PFGE profiles indicated the presence of a major pulsotype, namely pulsotype A with a rate of 91.4% (363/397), followed by pulsotype B (n= 18, 4.5%) and pulsotype C (n= 11, 2.8%). Among isolates tested 363 (91.4%) were SCCmec type III, 30 (7.6%) were SCCmec type IV. Sequence analysis of representative isolates revealed that ST239 (85.1%) was the most common MLST type followed by two MLST types ST737 (4%), and ST97 (2.8%), both SCCmec type IV. Two isolates were ST80 with SCCmec type IV. Of 397 isolates, 338 (85.1%) were t030, followed by t005 (2.5%) and t632 (2%). Among MRSA isolated during 2011, 64 (70.3%) of 91 were t030, 4 (4.4%) were t005, 2 (2.2%) were t015, and 2 (2.2%) were t1094. Among centers the t030 prevalence of 2006-2008 isolates ranged from 59-100%. The highest t030 prevalence was found in Ankara (100%) and lowest in Trabzon (59%) provinces which are located at central and northestern Anatolia, respectively. In Istanbul province, the prevalence of t030 was 94.5% among 2006-2008 isolates which decreased to 55.5% among 2011 isolates. Also a decrease in t030 rates was observed among samples from Konya and Trabzon but not from Aydin. Our results showed that the most common MRSA clone in Turkey is ST 239-SCCmec type III, t030 which persisted during the six years of the study period. Presence of PVL toxin gene was tested by PCR and 5 (3%) isolates found to be positive, of them two were SCCmec Type IV-ST80 and three were SCCmec Type III-ST239. This study is the largest epidemiological survey ever done in Turkey which showed presence of a hospital Turkish clone TR09 (ST239-SCCmecIII-t030) and a community clone TR10 (ST737-SCCmecIV-t005) largely disseminated in Turkey.