Brucellosis is the most common anthropozoonosis, with more than 500,000 cases annually. While the disease was eradicated in the vast majority of industrialized regions around the world, it remains a significant public health concern, mainly in the Mediterranean littoral, the Middle East, the Arabian Peninsula, the Indian subcontinent, Asia, Africa, and Central and South America (19,26).Turkey is a relatively large country in the eastern Mediterranean region, with a geographical surface of 783,562 km 2 , and comprises seven regions. It has a population of 72 million, 70% of which lives in cities and 30% in rural areas. Brucellosis is endemic, and approximately 10,000 human brucellosis cases are reported annually. The reported incidence is 150 cases per 1 million inhabitants (24). Its prevalence varies widely from region to region due to several factors, including food habits, milk processing methods, husbandry practices, nomadism, social customs, climatic conditions, socioeconomic status, and environmental conditions. A steady increase of reported human cases was observed from 1986 (3.03/100,000 population) until 2004 (25.65/100,000). Livestock vaccination, elimination of infected animals, control of animal movements, and education induced a decline in the number of annually reported human cases, from 18,563 cases in 2004 to 9,818 cases in 2008 (17).Rapid and accurate typing procedures are crucial for epidemiologic surveillance, investigation of outbreaks, and follow-up of a control program. Many molecular typing methods commonly used for the subtyping of isolates of other bacterial species are not appropriate for routine typing of Brucella strains, and none has proven to be fully satisfactory for epidemiological trace-back investigations of brucellosis (1,9,25). Recently, a selection of 16 variable-number tandem repeats has been proposed for fingerprinting Brucella isolates (7,14,25). This multiple-locus variable-number tandem-repeat analysis (MLVA) genotyping system, MLVA-16 Orsay , comprised eight minisatellite markers (panel 1, Bruce06, Bruce08, Bruce11, Bruce12, Bruce42, Bruce43, Bruce45, and Bruce55) for species identification and eight complementary microsatellite markers (panel 2A, Bruce18, Bruce19, and Bruce21; panel

The control of Ab-BSI requires a multifaceted intervention program and complex efforts and implementations, especially if the ICU does not implement any suspension of care provision.

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R Rifampicin resistance of Brucella melitensis by rpoB gene analysis has not yet been performed in Turkey, where brucellosis is endemic. In this study, we investigated the efficacy of E-test and single nucleotide polymorphism (SNP) analysis of the B. melitensis rpoB gene, for the detection of mutations conferring rifampicin resistance, by sequencing 21 human B. melitensis strains from the Southeast and Marmara regions of Turkey. On CLSI slow-growing bacteria standards, all isolates were sensitive to rifampicin except for 6 which showed intermediate resistance to rifampicin. MIC(50) and MIC(90)values were 1 microg/ml and 1.5 microg/ml respectively (range 0.50 -1.5 microg/ml). The rifampicin-resistant phenotype was investigated at Cd 154 (GTT/TTT), Cd 526 (GAC/TAC, GAC/AAC, GAC/GGC), Cd 536 (CAC/CTC, CAC/TAC), Cd 539 (CGC/AGC), Cd 541 (TCG/TTG) and Cd 574 (CCG/CTG) of the rpoB gene in B. melitensis 16M and B115 strains, and in clinical isolates. No missense mutations were found in any of the B. melitensis isolates, which indicates that all isolates were rifampicin-susceptible. In conclusion, SNP analysis was useful as a molecular tool for rifampin resistance testing. Although resistance to rifampicin was not detected in our strains of B. melitensis; the presence of strains with intermediate resistance to rifampicin indicates that susceptibility testing should be performed periodically.

Four hundred and forty extended-spectrum β-lactamase (ESBL)-producing Escherichia coli isolates were collected from 10 different hospitals in Turkey between 2011 and 2012. Clinical specimens consisted of urine (80.45%), blood (6.59%), cerebrospinal fluid (1.13%), pleural fluid (2.95%), wound (4.31%) and sputum (4.54%). ESBL-coding genes (CTX-M1, CTX-M2, TEM, SHV) were detected by PCR. According to the PCR and sequencing results, CTX-M1 was the most prevalent β-lactamase 83.18% (366/440), followed by TEM 44.09% (194/440), CTX-M2 31.81% (140/440) and SHV 1.81% (8/440). Sequencing results showed that TEM and SHV types were TEM-1b and SHV-11, respectively. Rate of the strains harboring only CTX-M1, CTX-M2, TEM-1b and SHV-11 were 30.90%, 3.63%, 2.27% and 0.23%, respectively. Rate of the strains harboring the combinations of CTX-M1-CTX-M2, CTX-M1-CTX-M2-TEM-1b, CTX-M2-TEM-1b, CTX-M1-TEM-1b, CTX-M1-CTX-M2-TEM-1b-SHV-11, CTX-M1-TEM-1b-SHV-11, CTX-M1-SHV-11, CTX-M1-CTX-M2-SHV-11, CTX-M2-SHV-11, CTX-M2-TEM-1b-SHV-11, TEM-1b-SHV-11 were 12.95%, 11.59%, 2.95%, 26.13%, 0.45%, 0.68%, 0.22%, 0.22%, 0%, 0% and 0%, respectively. This is a nationwide study of ESBL-producing E. coli in Turkey. These results shows that CTX-M1 group is the most common type of class A β-lactamases among ESBL-producing E. coli strains in Turkey.