BackgroundDisinfectants and antiseptics are biocides widely used in hospitals to prevent spread of pathogens. It has been reported that antiseptic resistance genes, qac’s, caused tolerance to a variety of biocidal agents, such as benzalkonium chloride (BAC) and chlorhexidine digluconate (CHDG) in Staphylococcus spp. isolates. We aimed to search the frequency of antiseptic resistance genes in clinical Staphylococcus spp. and Enterococcus spp. isolates to investigate the possible association with antiseptic tolerance and antibiotic resistance.MethodsAntiseptic resistance genes (qacA/B, smr, qacG, qacH, and qacJ) isolated from Gram-positive cocci (69 Staphylococcus spp. and 69 Enterococcus spp.) were analyzed by PCR method. The minimum inhibitory concentrations (MICs) of BAC and CHDG were determined by agar dilution method, whereas antibiotic susceptibility was analyzed by disk diffusion method according to Clinical and Laboratory Standards Institute (CLSI) criteria.ResultsThe frequency of antiseptic resistance genes was found to be high (49/69; 71.0%) in our clinical staphylococci isolates but absent (0/69; 0%) in enterococci isolates. The frequency of qacA/B and smr genes was higher (25/40; 62.5% and 7/40; 17.5%, respectively) in coagulase negative staphylococci (CNS) when compared to Staphylococcus aureus strains (3/29; 10.3%, and 4/29; 13.8%, respectively). In contrast, the frequency of qacG and qacJ genes was higher (11/29; 37.9% and 8/29; 27.5%, respectively) in S. aureus than those of CNS (5/40; 12.5%, 10/40; 25.0%) strains. qacH was not identified in none of the strains. We found an association between presence of antiseptic resistance genes and increased MIC values of BAC (>4 μg/mL) in staphylococci and it was found to be statistically statistically significant (p < 0.01). We also showed that MICs of BAC and CHDG of vancomycin-resistant enterococci (VRE) isolates were significantly higher than those of vancomycin-susceptible enterococci (VSE) isolates (p < 0.01).ConclusionsFor our knowledge, our study is the first to investigate antiseptic resistance genes in enterococci and also qacG, qacH, and qacJ genes in staphylococci isolates in Turkey. Further studies are needed to revise the biocide policy and to support infection control programs to avoid the development of new resistance mechanisms.
Aim:Intrahepatic cholestasis of pregnancy (ICP) is the most common liver disease in pregnancy. Although it was shown that multiple pregnancy and hormone therapies increase the risk of ICP, there is limited information that compared spontaneous fertilization and in vitro fertilization (IVF) from the aspect of developing ICP. In our study, we investigated the potential relationship between ICP and IVF/ spontaneous pregnancy.Materials and methods:We reviewed the records (between June 2007 and December 2014) of pregnancies with ICP who were referred to gastroenterology clinics in three different hospitals. Fifty-nine pregnancies (43 spontaneous fertilization, 16 IVF) with ICP were analyzed from the aspect of age, fertilization type, multiple/singleton pregnancy, delivery week, and biochemical results.Results:We found that serum bile acid levels were higher in the IVF group than the spontaneous fertilization group (32.8 ± 20 vs 19.6 ± 19 μmol/L; p < 0.05). There was a significant inverse correlation between serum bile acid levels and gestational age (r = -0.42, p < 0.01) in the whole group. There was no difference between IVF and spontaneous fertilization groups in term of age, onset time of symptoms, serum alanine aminotransferase (ALT), alkaline phosphatase (ALP), total and direct bilirubin levels, prothrombin time (PT), international normalized ratio (INR), and platelet count.Conclusion:Our results suggest that the serum bile acid levels are higher in IVF than in spontaneous pregnancies with ICP, but its clinical implications are not clear. Further prospective studies with large number of ICP cases are needed to clarify the effect of IVF on ICP.How to cite this article: Bolukbas FF, Bolukbas C, Balaban HY, Aygun C, Ignak S, Ergul E, Yazicioglu M, Ersahin SS. Intrahepatic Cholestasis of Pregnancy: Spontaneous vs in vitro Fertilization. Euroasian J Hepato-Gastroenterol 2017;7(2):126-129.
We present Shewanella algea infection in a chronic suppurative otitis media (CSOM) patient with cholesteatoma in terms of clinical course and treatment. This is the first time S. algea is found as solely pathogen in a CSOM patient without history of contact with seawater in Turkey. The patient admitted to the hospital several times with complaints of otorrhoea, was diagnosed as otitis media and treated. He was hospitalized to the otorhinolaryngology department for further evaluation of recurrent infections. The patient was diagnosed as cholesteatoma according to computed tomography scan findings and was operated for cholesteatoma. As a result of surgical and medical treatment he was discharged with full recovery. Physicians must be aware of rarely seen pathogens and their unexpected ways of transmission and underlying causes such as cholesteatoma when treating patients for CSOM.
Background/Aim: Presepsin is a useful biomarker for diagnosing sepsis. This study aimed to investigate the relationship between oxidative stress and presepsin levels in animal models. Materials and Methods: Sprague-Dawley rats were used for cecal ligation and puncture (CLP) and to generate massive bowel resection (MBR) models. Trunk blood was collected for analysis of presepsin. Liver and intestinal tissue samples were taken to determine oxidative stress parameters. Results: Presepsin levels in MBR and CLP sepsis models were higher than those in control groups. Reactive oxygen and nitrogen species (RONS) and malondialdehyde levels were increased in the liver and small intestine of rats in both models, whereas glutathione levels were decreased. Conclusion: Presepsin levels and RONS may be released by the same mechanism which is closely associated with the progression of sepsis and inflammation in both CLP and MBR models.
The efficiency of plateletpheresis was improved owing to new developments in automated cell separators in the past decades. Nowadays multiple units of plateletpheresis products can be taken per collection from single donor and new parameters such as immature platelet fraction (IPF), immature platelet count (IPC) can be detected practically by automated hematology analyzers. Our aim is to find out a new quality parameter for evaluation of plateletpheresis by analyzing the platelet indices of donor and also to predict platelet recovery in recipients thereby preventing unnecessary platelet transfusion. In this study 104 platelet apheresis procedures were performed on the Trima Accel cell separator. Complete blood counts of donors and recipients were analyzed by Sysmex XN-1000 automated blood cell counter by means of quality parameters such as platelet count, IPF, IPC, mean platelet volume, platelet distribution width. We analyzed these parameters in the follow up after the transfusion of plateletpheresis and evaluated them as quality markers in the assessment of plateletpheresis effectiveness. For recipients of both single and double unit apheresis platelet transfusions, the pre-apheresis donor IPC correlated significantly with 1st and 24th hour recipient IPC values (p values \ 0.05 for all comparisons). A-IPC as well as % change in IPF can be used to determine the quality of plateletpheresis in conjunction with platelet number in terms of evaluation of donors and also in the follow up of recipients undergoing platelet transfusion.
Aim: Non-alcoholic fatty liver disease (NAFLD) is the most frequent chronic liver disease. Because NAFLD is a complex disease, finding highly specific and sensitive biomarkers for diagnosis is very difficult. We investigated the possible relation between steatosis and fibrosis stages determined by Fi-broScan technique and serum vitamin B12 levels as a non-invasive biomarker in patients with NAFLD. Materials and Methods: A total of 129 patients (45.68±12.9 years of age, 29 females) with NAFLD and 50 healthy subjects (43.44±15.3 years of age, 21 females) were included in this study. FibroScan was performed in all patients for the staging of fatty liver fibrosis. Liver enzymes were also analyzed in addition to serum vitamin B12 and C-reactive protein (CRP) levels. Results: There was no difference with respect to age and gender between NAFLD and control groups. The serum alanine aminotransferase, aspartate aminotransferase, gamma-glutamyl transferase, and CRP levels were significantly higher in the patients with NAFLD than the controls (p<0.05). On the contrary, serum vitamin B12 vitamin levels were lower in the patients with NAFLD, compared to the controls (352.8±125.2pg/mL vs 435.2±134.4, p<0.01). There was a significant difference in mean serum B12 vitamin levels between the control group (435.2±134.4pg/mL) and the NAFLD subgroups with fibrozis staged F0 and F3 (366.17±129.7pg/mL, 285.22±101pg/mL, p<0.01). Discussion and Conclusion: Serum vitamin B12 levels were found to be significantly low in the patients with NAFLD in comparison to the control group. This decline in serum vitamin B12 levels was even more prominent as hepatic inflammation and fibrosis stage increased (F0-F3), but not in advanced fibrosis stage (F4).
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