Objective: Urinary tract infections (UTIs) are among the most frequently seen community-acquired infections worldwide. E. coli causes 90% of urinary system infections. To guide the empirical therapy, the resistance pattern of E. coli responsible for community-acquired UTI was evaluated throughout a seven-year period in this study. Material and methods:The urine cultures of patients with urinary tract infections admitted to outpatient clinics between 1 st January 2008 and 31 st December 2014 were analyzed. Presence of ≥10 5 colony-forming units/mL in urine culture media was considered as significant for UTI. Isolated bacteria were identified by standard laboratory techniques or automated system VITEK2 (BioMerieux, France) and BD PhoenixTM 100 (BD, USA), as required. Antibiotic susceptibility testing was performed by Kirby-Bauer disk diffusion method using Clinical Laboratory Standard Institute (CLSI) criteria.Results: A total of 13281 uropathogens were isolated. Overall E. coli accounted for 8975 (67%) of all isolates. Resistance rates of E. coli to antimicrobial agents was demonstrated to be as follows: ampicillin 66.9%, cefazolin 30.9%, cefuroxime 30.9%, ceftazidime 14.9%, cefotaxime 28%, cefepime 12%, amoxicillin-clavulanic acid 36.9%, trimethoprim-sulfamethoxazole (TMP-SXT) 20%, ciprofloxacin 49.9%, amikacin 0.3%, gentamycin 24%, nitrofurantoin 0.9%, and fosfomycin 4.3%. There was no resistance to imipenem nor meropenem. The frequency of ESBL-producing E. coli strains was 24%. Conclusion:It is concluded that fosfomycin and nitrofurantoin are appropriate empirical therapy for community-acquired UTI empirical therapy, but the fluoroquinolones and the TMP-SXT shall not be used in the emprical treatment of UTI at this stage. In conclusion, as resistance rates show regional differences, it is necessary to regularly examine regional resistance rates to determine the appropriate empiric antibiotic treatment and national antibiotic usage policies must be reorganized according to data obtained from these studies.

Objectives:To determine the seroprevalence of Toxoplasma gondii (T. gondii), Rubella virus, and Cytomegalovirus (CMV) among pregnant women in Izmir, Turkey.Methods:Medical records of pregnant women attending Izmir Tepecik Training and Research Hospital, Izmir, Turkey between January 2014 and January 2016 were analyzed in this retrospective cross-sectional study. The 7513 T. gondii IgM/IgG results, 7189 Rubella IgM/IgG results, 906 CMV IgM/IgG results and 146 avidity test results were evaluated. Specific IgM and IgG antibodies were detected by an automated chemiluminescent enzyme immunoassay method. Immunoglobulin G avidity tests were performed using a multiparametric immunoassay system.Results:The rates of IgG positivity for T. gondii was 32.3%, Rubella virus 93.5%, and CMV 98.9%. Immunoglobulin M antibodies were found to be positive in 138 (1.9%) cases for T. gondii, 88 (1.2%) cases for Rubella, and 14 (1.5%) cases for CMV. Avidity tests were ordered from 146 of 218 patients who were found both IgM and IgG positive. Among 146 patients, 6 patients had a low avidity index (all for T. gondii), 11 patients showed borderline avidity, and 129 patients revealed high avidity.Conclusion:In our region, whereas the rates of IgG positivity for Rubella and CMV are high, most pregnant women were susceptible to T. gondii infections. In order to enhance the reliability of the serological diagnosis, avidity tests should be performed in all IgM positivities detected together with IgG positivity.

Candida species that show an increasing number of clinical and/or microbiological resistance to several antifungals and are the most common agents of invasive fungal infections. The aim of this study was to investigate the in vitro susceptibility of Candida blood isolates to antifungal agents (amphotericin B, fluconazole, itraconazole, and voriconazole) by comparative use of the CLSI reference microdilution method and Etest. Four hundred Candida blood isolates (215 Candida albicans, 185 non-albicans Candida strains) were included in the study. The broth microdilution test was performed according to the CLSI M27 A2 document. Etest was carried out according to the manufacturer's instructions. The MIC results obtained with reference microdilution were compared with those obtained with the Etest by using percent and categorical agreements. According to MIK(90) values, voriconazole was the most active and itraconazole was the least active drug in vitro against all Candida species. Other than voriconazole, statistically significant differences were found when the susceptibility of Candida albicans and non-albicans Candida spp. to amphotericin B, fluconazole, and itraconazole were compared. These antifungal agents were found to be more active to C. albicans. Among the non-albicans Candida species, the lowest MIC values were obtained for Candida parapsilosis isolates. When the standard method was compared with Etest, the total agreement was higher for C. albicans than for non-albicans species, especially for fluconazole and voriconazole. In view of the findings, it was concluded that itraconazole showed the lowest activity against all Candida species. Etest could be an alternative method in assessing the in vitro antifungal susceptibility of Candida spp., but it is more convenient to use the microdilution method for studying in vitro susceptibility of non-albicans species, in particular for those possessing high MIC values against azoles.

Objective: Candida infections have increased due to transplant patients, prolonged ICU stay and invasive procedures. The most common isolated strain is C. albicans. The aim of this study was to evaluate the distribution of Candida isolates at Tepecik Education and Research Hospital.Materials and Methods: Yeast like fungi were isolated between 13.01.2010 and 19.08.2011 at Mycology Laboratory. The identification was done by conventional methods and carbohydrate assimilation profile using the ID32C identification system (Biomerieux, France).Results: Yeast like fungi were isolated from 337 clinical specimens. They consisted of urine, blood culture, respiratory specimen and wound. The most isolated yeast strains were C.albicans (38.6%), C.tropicalis (13.9%), C. parapsilosis (28.4%), C.glabrata (7.4%), C.krusei (3.8%).Conclusion: Recently there is an increment in Candida infections. In this study the most common strain was C.albicans and the rate C. glabrata and C. krusei isolates were lower than expected. C. parapsilosis was the most isolated strain in blood cultures and this may be due to invasive procedures and the use of indwelling catheters.

Objectives: Data on the seroprevalence of Human papillomavirus (HPV) in Turkey are limited. The aim of this study was to characterize the high risk types of HPV in cervical cytology specimens of women in Turkey during routine cervical cancer screening. Methods:Women aged 30 years and older who had been admitted to Tepecik Education and Research Hospital in İzmir province for routine cervical cancer screening between June 2012 and December 2014 were enrolled to the study. Cervical swab samples were collected for HPV-DNA examination. For identifying HPV genotypes, cervical samples were analyzed by Cobas® 4800 HPV Test qualitative real-time PCR system (Roche Molecular Systems Inc., Alameda, CA, USA) for HPV types 16, 18 and the other 12 high risk HPV (hrHPV) types (31, 33, 35, 39, 45, 51, 52, 56, 58, 59, 66, 68). Results:In this study, the overall HPV positivity was detected in 10.07% (539/5350 samples) of women during routine cervical cancer screening. Of these; HPV type 16 was detected in 187 samples (31.59%), HPV type 18 in 46 samples (7.77%), and other hrHPV (pool of 12 genotypes) in 359 samples (60.64%), either as single or multiple infections combined. Of 539 HPV positive samples, 489 (90.72%) were single type HPV infections and the remainder (n=50, 9.28%) were multiple type infections. There was no significant difference in HPV prevalence by decades of life. Conclusions:Our results showed that hrHPV types other than type 16 or type 18 are the most detected genotypes in women undergoing routine cervical cancer screening. Data of the heterogeneity in HPV type distribution must be taken into account for the decision of vaccination and screening modalities.