Aim: The aim of this study was to determine the efficacy of two different disinfectant solutions (a quaternary ammonium compound used in the surface disinfection and a chlorhexidine/cetrimide product used as a mucosal antiseptic) on Stenotrophomonas maltophilia strains. Materials and methods: A total of 50 S. maltophilia strains from our stock culture collection were used in this study. Disinfectant/antiseptic susceptibilities of the strains were evaluated by the quantitative suspension test method. Results: All S. maltophilia isolates included in the study were found susceptible to the disinfectant and antiseptic agents tested. Conclusion: S. maltophilia is a prevalent opportunistic pathogen that may lead to various nosocomial infections especially in intensive care units. Because of intrinsic and acquired resistance to antimicrobial agents, treatment difficulties are encountered. S. maltophilia may also develop resistance to disinfectant agents. To prevent nosocomial infections with resistant bacteria, disinfectants used in hospitals should be replaced at regular intervals and disinfectant susceptibility tests should be performed.

ÖZGiriş: Rotavirüs (RV), çocukluk çağında görülen gastroenteritlerin ve özellikle gelişmekte olan ülkelerde gastroenterite bağlı mortalite ve morbiditenin en yaygın nedenlerindendir.Bu çalışmanın amacı, hastaneye başvuran, 0-65 yaş arasında, akut gastroenteritli, RV hızlı antijen testi pozitif hastaların dışkı örneklerinde RV'ün genotiplerinin RT-PCR yöntemi ile

Introduction: Rotavirus (RV) is the most common cause of gastroenteritis in children and is one of the most common cause of mortality and morbidity in developing countries. The aim of this study was to determine the genotypes of RV rapid test antigen positive patients between 0-65 years old with acute gastroenteritis attended to a tertiary care hospital in Ankara. Materials and Methods: This study was conducted between January 2013 and April 2018 at Gazi University Faculty of Medicine, Department of Microbiology, Stool samples were collected from 87 (40 female, 47 male) patients aged between 0-65 years who had gastroenteritis were sent to microbiology laboratory. RV VP-7 amplification was performed using Beg9 and End9 primers and specific primers for G typing G1-G4 and G9. VP-4 amplification was performed using con-2 and con-3 primers. P types were determined by specific primers for P[4], P[6], P[8] and P[9]. Access Quick RT-PCR (Promega Corporation, Madison, WI) was used for VP4 and VP7 gene amplification, and PCR Mastermix (Promega, Madison, WI) was used for genotyping. Results: No statistically significant difference was found between the gender of patients with positivity of RV antigen. RV infection was most common in children aged 12-23 months. Antigen positivity was most common in winter and autumn. Genotypes G1 (25.80%), G2 (3.22%), G3 (4.30%), G4 (6.45%), G9 (60.21%) constituted G types. P4 (1.14%), P8 (93.10%), P6 (5.74%) constituted P types. The combination of G and P types was the most prevalent for G9P[8] (56.98%) and G1P[8] (22.58%). Conclusion: It has been observed that G9 and P[8] are common genotypes in cases with RV infection in Ankara as in the whole world. Similar to various studies in Turkey, genotype G9P[8] had the highest ratio in the present study. Therefore, these data should be considered in RV vaccine strategies.

INTRODUCTION:We aimed to evaluate the effects of 7-valent pneumococcal conjugate vaccine on nasopharyngeal carriage of Streptococcus pneumoniae and antibiotic resistance in children in a well-child clinic in a tertiary children's hospital in Turkey.METHODOLOGY:We collected nasopharyngeal (NP) specimens from 557 two-month-old babies before vaccination. After the study population had received PCV7, NP samples were obtained from 135 babies. Antimicrobial susceptibility testing and serotyping were performed.RESULTS:S. pneumoniae colonized in 48 (8.6%) of the 557 two-month-old babies before vaccination. The follow-up cohort consisted of 135 subjects. The prevalence of PCV7 strain decreased from 33.3% to 19.3% after vaccination. However, non-PCV7 types increased from 66.6% to 80.6% (p = 0.02). Of PCV7 serotypes, 19F was the most frequent serotype before and after vaccination. There was an increase in 6A and 15 of non-PCV7 serotypes after vaccination. Penicillin non-susceptible increased from 56.3% to 80.6% after vaccination (p =0.03). Serotypes 14, 18C, 9V and 6B, which were identified before vaccination, never colonized afterwards. Number of siblings and having sibling with older age of five were determined to be significant effective factors for SP colonization presence after vaccination and antibiotic use was negatively associated with pneumococcal carriage but associated with penicillin non-susceptibility.CONCLUSIONS:Nasopharyngeal carriage rate of S. pneumoniae dropped after PCV7 vaccination, and replacement by NVT pneumococci were also observed. Risk factors for nasopharyngeal carriage included household crowding and having a sibling age five years or older. Penicillin non-susceptibility increased in both VT and NVT strains.

BACKGROUND/AIM:We investigated the role of body flora and chronic inflammatory infections in the etiology of allergic disorders in Turkish children.MATERIALS AND METHODS:Forty pediatric asthma patients with positive skin prick tests and 40 age-matched healthy subjects with negative skin prick tests were enrolled in this cross-sectional study. Serum H. pylori IgG, viral hepatitis serology, IL-10, and TGF-beta levels were measured. Stool and throat cultures were taken and tested for occurrence of microorganisms.RESULTS:A significantly higher percentage of nonatopic subjects tested positive for anti-H. pylori antibodies compared to atopic subjects (60% vs. 20%). Serum IL-10 levels were also significantly higher in nonatopic subjects. No significant differences in direct microscopy and culture specimens of stools were observed. Examination of throat flora showed significantly higher occurrences of Neisseria and beta-hemolytic Streptococcus in nonatopic subjects, but higher occurrences of gram-positive bacilli in atopic subjects.CONCLUSION:Higher prevalence of anti-H. pylori antibody and higher serum levels of IL-10 in nonatopic subjects suggest that chronic infection and inflammation may protect against atopic disease. Higher occurrences of Neisseria and beta-hemolytic Streptococcus in throat cultures from nonatopic subjects are novel findings that lend further support to the hygiene hypothesis.

Deniz YÜCEL1, Mehmet OĞUZ2, Osman YÜKSEL2, Güldal YILMAZ3, Özge Tuğçe PAŞAOĞLU4, Nedim SULTAN5 1 Department of General Surgery, Mersin Anamur State Hospital, Mersin, Turkey 2 Department of General Surgery, Faculty of Medicine, University of Gazi, Ankara, Turkey 3 Department of Medical Pathology, Faculty of Medicine, University of Gazi, Ankara, Turkey 4 Department of Medical Biochemistry, Faculty of Medicine, University of Gazi, Ankara, Turkey 5 Department of Microbiology, Faculty of Medicine, University of Gazi, Ankara, Turkey

The aims of this study were to investigate drug resistance rates, types of extended spectrum beta lactamases (ESBLs), and molecular epidemiological characteristics of 43 Shigella sonnei isolates. Ampicillin-sulbactam, amoxicillin-clavulanate, chloramphenicol, and ciprofloxacin were the most active antibiotics. Five isolates harbored bla SHV-12, bla(TEM-1) and bla(CTX-M-15). More than 90% of the isolates had an indistinguishable pulsotype.

The purpose of the study is to assess the effect of a novel quorum sensing inhibitor (QSI), coded as 'yd 47', against otitis media and biofilm formation on Cochlear implants (CIs). Small pieces cut from cochlear implant were implanted under the skin in the retroauricular area on both sides of four guinea pigs. The implant pieces in the study and control sides were implanted in Streptococcus pneumoniae strain solution and saline, respectively. The right and left middle ears were also instilled with a solution containing pneumococci and saline, respectively. The animals were only given an intraperitoneal 'yd 47' twice daily for three months to be assessed later with electron microscopy. Clinical examination with palpation, inspection and otoscopy did not reveal any sign of implant infection or otitis media. In the study and control implant materials, soft tissues around the implant and tympanic membranes, there was no biofilm formation by pneumococci. Contamination by various cells and some rod-shaped bacteria (not diplococcic) were seen in some of the materials. In conclusion, the novel QSI seems promising in the prevention of otitis media and biofilm formation on CIs by pneumococci.

Development of resistance to disinfectant substances in nosocomial microorganisms is an important problem encountered during disinfectant practices. Methicillin-resistant Staphylococcus aureus (MRSA) remains a significant cause of hospital-acquired infections. Besides being resistant to several antimicrobial agents, MRSA strains can also become resistant to some disinfectant substances. Resistance to disinfectant substances may develop due to the misuse of disinfectants. This may either be due to the frequent use of disinfectant substances or use in lower concentrations than recommended. MRSA strains may harbour the qacA/B disinfectant resistance genes that may cause resistance to quarternary ammonium compounds and some cationic disinfectants. These resistance genes are found in plasmids and are responsible for decreased susceptibility or resistance. In this study, a total of 69 nosocomial MRSA strains isolated from clinical specimens in our hospital were tested for disinfectant activity and the presence of qacA/B disinfectant resistance genes in these isolates was investigated by polymerase chain reaction. We determined whether the presence of these genes caused phenotypic resistance to chlorhexidine and benzalkonium chloride by the use of bactericidal and bacteriostatic tests. For this purpose, the minimum inhibitory concentration (MIC) values of these disinfectants against MRSA isolates were detected by microdilution method with the proposals of CLSI, and bactericidal effects of these disinfectants were also detected by using quantitative suspension test according to EN13727:2003 European Standard. It has been found that 11.6% (8/69) of the isolates harbored qacA/B resistance genes. MIC values for chlorhexidine and benzalkonium chloride were found in the range of 2-8 µg/ml. Although it was observed that MIC values were higher in five of the qacA/B gene positive isolates, statistically significant difference was not found between gene positive and gene negative groups. Both 1% chlorhexidine and 1% benzalkonium chloride were found bactericidal against the isolates including the ones carrying the qacA/B resistance genes. It was concluded that the presence of the qacA/B disinfectant resistance genes did not lead to resistance to the disinfectant substances at the concentrations used in clinical practices. Furthermore, tested disinfectants still exhibited bactericidal activity even with high MIC values.

Hepatitis viruses lead liver damage at different levels and may cause similar hepatitis symptoms by multiplying in hepatocytes. Nowdays, A, B, C, D, E, and G viruses are known in different terms of structures, cell proliferation patterns, transmission routes, disease processes and sequels that they may cause. It is known that billions of people are infected with one of these viruses for today. Hepatit viruses can be studied in two groups in point of transmission route. Viruses which take part in B, C, D and G groups are basically transmitted via the parenteral route, whereas A and E viruses are transmitted via the oral-fecal route. In this article, the disinfection methods which should be applied for the prevention of infections are reviewed in the light of the literature on the basis of transmission routes, and recommendations are presented.

This study aimed to identify phenotypic and genotypic resistance profiles of bacteria isolated from soil and manure samples obtained from a farm where tetracycline and tylosin were used extensively. Samples were collected from the manure and soil, before and after manure application. All of the 151 bacteria were identified based on BLAST results. Minimum inhibitory concentrations were determined by agar dilution and E-test methods. Class-specific primers were used to amplify 6 erythromycin and 7 tetracycline resistance (Tc-r) genes for 46 tetracycline-and 18 erythromycin-resistant isolates. Tcr gene sequence identity between different species of isolates was identified to investigate the dissemination of resistance genes. All of the 151 bacteria belonged to 4 different phyla: Proteobacteria, Bacteroidetes, Actinobacteria, and Firmicutes. The majority of the tetracycline-resistant isolates were present in Pseudomonadaceae. Twenty of the isolates, representing 14 different genera, were positive for Tcr genes. Only 2 isolates possessed the erm(Q) gene. This study probably is the first to describe the presence of tetracycline genes in members of the genera Simplicispira and Agrococcus. Results of the study suggest that the diversity of Tcr gene-carrying bacteria are increasing. Furthermore, tetracycline-resistant bacteria could be detected 3 months after the manure application.

The aim of this study was to investigate the effects of various extracts obtained fromPistacia eurycarpa Yalt. on the exact time of appearance of the colonies of Mycobacterium tuberculosis on solid media. For this purpose, the fatty acid compositions of the fixed oils were analyzed using Gas Chromatography – Mass Spectrometry (GC-MS) in the fruit and peels. The fixed oils and the water-soluble extracts obtained from the plant as well as the fatty acids were added either separately or together on the surfaces of the Löwenstein Jensen and Middlebrook 7H11 agar media. Their effects on growth time of 40 strains of M. tuberculosis complex were investigated. Therefore, all of water-soluble extracts accelerated the growth of the mycobacteria in a statistically significant manner in both media. It was observed that the fixed oils and the fatty acids individually did not cause any significant effect on growth duration of the M. tuberculosis strains. Finally, the water-soluble extracts of P. eurycarpa fruit and its peel significantly accelerated the growth of M. tuberculosis by shortening the growth duration of M. tuberculosis at least by one third. Key words: M. tuberculosis, Pistacia eurycarpa, gas chromatography – massspectrometry, growth time

Disinfection Methods and Applications for Hepatitis VirusesDerleme / Review 37 ABS TRACTHepatitis viruses lead liver damage at different levels and may cause similar hepatitis symptoms by multiplying in hepatocytes.Nowdays, A, B, C, D, E, and G viruses are known in different terms of structures, cell proliferation patterns, transmission routes, disease processes and sequels that they may cause.It is known that billions of people are infected with one of these viruses for today.Hepatit viruses can be studied in two groups in point of transmission route.Viruses which take part in B,C,D and G groups are basically transmitted via the parenteral route, whereas A and E viruses are transmitted via the oral-fecal route.In this article, the disinfection methods which should be applied for the prevention of infections are reviewed in the light of the literature on the basis of transmission routes, and recommendations are presented.(Viral Hepatitis

The effects of Nd:YAG laser irradiations at different power settings on several oral pathogens were evaluated. A total of 252 dentin samples were divided into seven groups consisting of 36 dentin specimens each. In each group, 9 of the 36 specimens were used as controls, thereby including a control in every group. The remaining 27 specimens were divided into three subgroups consisting of nine specimens according to different Nd:YAG laser settings (1.5, 1.8, and 2 W). Each group was inoculated on the nonpulpal side with one of the following microorganisms: Candida glabrata, Candida tropicalis, Candida krusei, Candida sake, Candida lusitaniae, Candida kefyr, and Rhodotorula mucilaginosa. The following irradiation procedure was used: the specimens were irradiated on the bacteria-free side (the side consisting of the pulpal wall) using contact mode under the constant scanning movement of the optical fiber at an angle of 10°. One lasing cycle consisted of four irradiation cycles of 10 s each, with 15-s intervals in between each irradiation cycle. The remainder of the controls and the lased specimens of each group were prepared for the microbiological investigation. After incubation for 24 h at 37 °C, the colonies were counted, and the total number of surviving microorganisms was statistically assessed. Microorganisms irradiated with Nd:YAG laser at power settings 2 W, 15 pps did not survive. Although there was a significant reduction of microorganisms at 1.5 and 1.8 W, when comparing Nd:YAG laser irradiation with the control group, sterilization did not occur.

Background/purposeThe aim of this study was to evaluate the microbiological and clinical effects of a chitosan (CH) mouth rinse on plaque inhibition.Materials and methodsThirty-six healthy participants were recruited. The following clinical data were recorded: a plaque index (PI), gingival index (GI), Quickley–Hein plaque index (QPI), and probing depth (PD). Volunteers were given oral hygiene (OH) instruction and trained on scaling and professional tooth cleaning (PTC). After the final PTC, volunteers were randomly allocated into three groups. Group A rinsed with 2% CH, group B rinsed with 0.2% chlorhexidine digluconate (CHX), and group C rinsed with 2% CH+0.2% CHX. Plaque samples were collected and assayed for Streptococcus mutans, Candida albicans, and enterococci.ResultsAfter a non-brushing period, the full-mouth PI and QPI values between the CH and CHX+CH groups differed significantly. A higher PI score at sampling sites was seen in the CH group, but no significant differences were observed between groups. The S. mutans and C. albicans levels were statistically significant in each group on Days 0 and 4. Differences of C. albicans levels between groups were found to be significant; however, no statistical differences were obtained for S. mutans or enterococci levels among the groups at the various time intervals.ConclusionWe conclude that further investigations are needed to evaluate the potential value of CH as an effective antiplaque mouth rinse.

Blastocystis sp. is now recognized as one of the most common intestinal parasite in human fecal examinations. Recently, PCR-based diagnostic methods of Blastocystis infection using direct DNA extraction from fresh fecal samples with commercially available kits are reported. Several kits have been developed, but little has been done in comparing the detective sensitivity between PCR methods using the commercial kits. In this study, we compared the detective sensitivity among five commercially available kits (MagNA Pure LC DNA Isolation Kit I, Roche; QuickGene SP Kit DNA, FujiFilm; NucleoSpin Plant II, Macherey-Nagel; QIAamp DNA Stool Mini Kit, Qiagen; ZR Fecal DNA Kit, Zymo Research) and fecal culture method. In a preliminary test, the DNA isolated with two kits (FujiFilm and Macherey-Nagel) showed negative PCR, while the other three kits showed positive PCR. Then, DNA from 50 clinical samples that was Blastocystis-positive in the examination of fecal culture method were isolated with the three kits and 1.1 kbp SSU rRNA gene was detected with PCR. The positive rates of the three kits (Roche, Qiagen, and Zymo Research) were 10, 48 and 94%, respectively. The present study indicated that there is different detective sensitivity among the commercial kits, and fecal culture method is superior in detection rate and cost performance than DNA-elution kits for diagnosis of Blastocystis sp. subtypes.

PURPOSE The purpose of this study was to compare the caries removal efficiency of polymer burs (Smartburs) and conventional carbide burs microbiologically. METHODS Twenty-four patients participated, each presenting 2 active carious lesions on the occlusal surfaces of primary molars. Sample-taking and caries-removal were done in the following order: (1) first sample (from the carious dentin); (2) caries removal (with a Smartbur or carbide bur); and (3) second sample (from the caries-free dentin), respectively. The samples were processed in a laboratory and spread on various media. The colonies on the agar plates were counted, and then numbers of CFU/ml were calculated. RESULTS There were no statistically significant differences between the numbers of CFU/ml in the carious dentin before preparation, comparing the Smartbur group and carbide bur group for all the media used (P>.05). There were statistically significant differences in the numbers of CFU/ml before and after preparation comparing both types of burs for all the media used (P<.05). There were no statistically significant differences in the reductions of the numbers of CFU/ml, comparing the 2 preparation instruments (P>.05). CONCLUSION The polymer burs were found as effective as the conventional carbide burs microbiologically in caries removal.

A total of 94 clinical isolates were collected from Gazi University Hospital, Turkey. Presence of ESBL positivity was detected using the double disk synergy test (DDST). ESBL isolates were further typed for the bla(TEM), bla(SHV), bla(CTX-M) and bla(OXA) using designed primers. ESBLs were found in 65 (69.14%) isolates using DDST. Plasmid DNAs of potentially ESBL positive strains were isolated. About 7.69% of the ESBL positive isolates did not harbour plasmid DNA. According to the PCR technique, only 2 additional isolates were found to be ESBL producers. blaTEM was the commonest genotype (73.43%), followed by blaSHV (21.87%) and blaCTX-M (17.18%), either alone or in combination. ESBL positive strains of Klebsiella pneumoniae, Escherichia coli, Acinetobacter baumannii and Pseudomonas aeruginosa are increasingly found in hospital isolates. Because these strains become resistant to available antibiotics and they can pass the gene to other clinical strains, the quick detection of these strains in clinical laboratories is very important.