Background and Objectives: Autoantibodies are immunglobulins occurred directly against autoantigens that are known as endogen antigens. Autoimmune disease is an occasion that the body begins a fight against its own cells and tissues. The antibodies that are created by the body against its own cell nuclei are called as anti-nuclear antibodies (ANA), and one of the methods used for detection and pattern of ANA is indirect immunofluorescence test (IIF). In the present study, it was aimed to determine the rate of ANA positivity and patterns of the positive specimens, and to investigate the relationship between ANA positivity and diseases in patients. Methods: ANA test results of a total of 3127 patients admitted during March 2010 to December 2012 were evaluated retrospectively. ANA test (HEp 20-10, EUROIMMUN, Germany) was used in dilution of 1:100 in IIF test. Results: A total of 494 (15.8%) resulted as ANA positive. ANA positivity rate was significantly higher in female patients than the male ones (p<0.001). The most frequent ANA patterns were coarse speckled pattern (154 patients, 31.2%), nucleolar pattern (89 patients, 18.0%), fine speckled pattern (57 patients, 11.5%), and speckled pattern (48 patients, 9.7%). ANA positivity was most commonly determined in rheumatoid arthritis (RA) (42 patients, 8.5%), systemic lupus erythematosus (SLE) (29 patients, 5.9%), and rheumatoid vasculitis (RV) (28 patients, 5.7%). The most frequent symptoms or findings were joint pain (127 patients, 26.0%) and anemia (28 patients, 5.7%). ANA positivity rates were found to be significantly higher in patients with RA (p<0.001), with SLE (p<0.001), and with Raynaud phenomenon (p=0.001) in comparison to the controls. Amongst the most frequent diseases evaluated, no significant differences were found between the control groups and the groups of RV (p=0.089), multiple sclerosis (p=0.374), and Sjögren syndrome (p=0.311) in terms of ANA positivity rates. Conclusions: The present study is the first study reporting the positivity rate and distribution of ANA in Bolu located in northwestern Turkey. Information about the pattern types and the distribution of the patterns according to the diseases and symptoms contribute in diagnosis of autoimmune diseases. It is observed that clinical diagnosis has been supported significantly by ANA test according to data of our study.
Yara yeri enfeksiyonları, hastane kaynaklı enfeksiyonlar arasında ilk üç sırada yer almaktadır. Yara enfeksiyonlarının tedavisi sırasında kültür ve antibiyogram duyarlılıklarının yapılması, tedavinin başarısını arttıracağı gibi uygunsuz antibiyotik kullanımını engelleyerek, etken olan bakterilerde direnç gelişimini de önleyecektir. Çalışmamızda, 2016-2018 yılları arasında polikliniklere ayaktan başvuran ya da servislerde yatarak tedavi gören hastaların yara yeri örneklerinden izole ettiğimiz mikroorganizmaların dağılımı ve antibiyotik duyarlılıkları belirlenerek, ampirik tedavi seçeneklerine yol gösterici olması amaçlandı. Gereç ve Yöntemler: Hastanemiz mikrobiyoloji laboratuvarına gönderilmiş olan, toplam 315 yara yeri örneği retrospektif olarak incelendi. Etken olarak kabul edilen mikroorganizmaların tür düzeyinde tanımlanmaları ve antimikrobiyal duyarlılıkları araştırıldı. Bulgular: İzole edilen mikroorganizmaların %46.4'ünü (n=146) Gram pozitif koklar, %53'ünü (n=167) Gram negatif bakteriler ve %0.6'sını (n=2) mantarlar (Candida albicans) oluşturdu. S. aureus %21 oranında en sık, Koagülaz Negatif Stafilokok %16 oranında ikinci sıklıkta, E. coli %15 oranında üçüncü sıklıkta görülen bakteri oldu (p<0.001). Gram pozitif bakterilerde, direnç durumuna bakıldığında, S. aureus suşlarının %16.7'sinin metisiline dirençli olduğu görüldü. Enterokoklar dahil Gram pozitif bakterilerde glikopeptid direncine rastlanmadı. E. coli ve K. pneumoniae suşlarında GSBL oranı (%43.8; %48.5) diğer Gram negatif bakterilere oranla daha yüksek bulundu (p=0.493). En yüksek antibiyotik direnç oranı %70.8 ile ampisiline, en az direnç oranı %2 ile imipeneme karşı görüldü. Sonuç: Yara enfeksiyonlarının sık etkenlerinden olan S. aureus ve E. coli'nin çalışmamızda, başta gastrointestinal karsinomu olan hastalarda olmak üzere oldukça yüksek oranda saptanması nedeniyle ampirik tedavide bu etkenlerin antibiyotik duyarlılıklarının göz önünde bulundurulması gerektiği düşünülmüştür.
The seropositivity of T. gondii has been found to be so large that it should not be ignored. It has come to the conclusion that the events in the risk group should be taken into consideration for this parasite, and awareness should be established. In recent years, this awareness has been observed, especially in neurology clinics.
The management of infections due to A. baumannii is difficult because of rapidly developing resistance, however, tigecycline, a glycylcycline antimicrobial, is in use for several years. In the present study, it was aimed to determine the susceptibility rates of A. baumannii to tigecycline. A total of 90 A. baumanni isolates were tested using three methods such as disk diffusion, broth microdilution, and E-test. The MIC50 and MIC90 values and the MIC range were found as 2 µg/ml, 4 µg/ml, and 0.1-8 µg/ml by microdilution; and 2 µg/ml, 6 µg/ml, and 0.1-12 µg/ml by E-test, respectively. There were a few major errors as well as the minor rates were all high as between 35.7%-46.7%. The accuracy rates between the methods were low as 53.3% (48/90) between disk diffusion and E-test, 51.1% (46/90) between disk diffusion and microdilution, and 60.0% (54/90) between E-test and microdilution. In the ROC curve analysis, an inhibition zone diameter of susceptibility breakpoint of 21.5 mm had sensitivity between 68.8%-88.9%; specificity between 81.9%-87.9%; and accuracy between 80.0%-83.33%. An analysis based on EUCAST's non-species breakpoints, the MIC tests showed higher accuracy with a rate of 96.7%, however, performance of disk diffusion got worse as lower than 25%. In conclusion, we showed that the reliability of the methods even did not remain as high as the past. Our study presented that none of three methods revealed reliable results in determination of susceptibility of A. baumanni to tigecycline, so the clinical response should be followed up carefully in such cases.
Ge liş ta ri hi/Re cei ved: 22.01.2013 Ka bul ta ri hi/Ac cep ted: 11.04.2013 © Viral Hepatit Dergisi, Ga le nos Ya y› ne vi ta ra f›n dan ba s›l m›fl t›r. / Viral Hepatitis Journal, pub lis hed by Ga le nos Pub lis hing.Objective: In this study, it is aimed to investigate the relationship between the HBV DNA positivity and serological markers such as HBsAg, HBeAg and anti-HBe in patients with acute or chronic hepatitis. Materials and Methods:Data of 574 patients whose serum specimens were processed in microbiology laboratory between march 2010 and july 2012 were retrospectively analysed. Results:In the study, HBV DNA was detected in 44.8% of HBsAg-positive, in 67.1% of HBeAg-positive and in 35.9% of anti-HBE-positive patients. HBV DNA was detected in 61.2% of the patients both of whose HBsAg and HBeAg were positive. However, HBV DNA was positive in one of 29 patients (3.4%) who had negativity of both HBsAg and HBeAg. DNA positivity was 6.3% in HBsAg-negative patients and 37.7% in HBeAg-negative ones. In the study, HBeAg was negative in 79.4% of HBV DNA-positive patients; anti-HBeAg was negative in 17.7% of DNA-positive patients. DNA levels were found significantly high in HBeAg-positive patients (p<0.001) as well as DNA levels were significantly high in anti-HBenegative ones (p<0.001).
ÖZ GİRİŞ: Q ateşi, Coxiella burnetii'nin neden olduğu bir zoonozdur. Başlıca klinik prezentasyonları pnömoni ve hepatit'tir. Bununla birlikte, birçok farklı klinik prezentasyonlar nedeniyle Q ateşini tanımak güç olabilir. Bu çalışmada, kurumumuzdaki Q ateşi olgularının klinik ve laboratuvar özelliklerini sunarak Q ateşi farkındalığını artırmayı amaçladık. GEREÇ ve YÖNTEMLER: Hastanemiz veri tabanındaki Q ateşi tanılı hastalar retrospektif olarak değerlendirilmiştir. Hastaların karakteristikleri, başvurudaki klinik ve laboratuvar değerleri kaydedilmiştir. BULGULAR: Bu çalışmaya toplam altı hasta dahil edilmiştir. En sık ateş, iştahsızlık ve bitkinlik gibi semptomlar olmak üzere çeşitli klinik prezentasyonlar gözlenmiştir. En sık laboratuvar anormalliği tüm hastalarda saptanan CRP yüksekliğiydi, LDH ve transaminaz yüksekliği bunu takip etmekteydi. Gerek LDH yüksekliği gerekse transaminaz yüksekliği dört hastada mevcuttu. SONUÇ: Q ateşini teşhis etmek için kullanılan serolojik yöntemler rutin olarak uygulanmamaktadır, bu yüzden Q ateşi olguları kolayca gözden kaçabilir. Biz inanıyoruz ki, endemik bölgelerde nonspesifik antibiyotik tedavisine yeterli yanıt vermeyen hastalarda Q ateşi daha çok araştırılmalıdır. Anahtar kelimeler: Coxiella burnetii, Q ateşi, TürkiyeABSTRACT BACKGROUND: Q fever is a zoonosis caused by Coxiella burnetii. The main clinical presentations are pneumonia and hepatitis. However, it can be difficult to recognise Q fever due to many different clinical presentations. In this study, we aimed to increase the awareness of Q fever by presenting clinical and laboratory features of Q fever cases from our institution. MATERIALS and METHODS:Patients with a diagnosis of Q fever in our hospital database were evaluated retrospectively. Patient characteristics as well as clinical and laboratory values at presentation were recorded. RESULTS:A total of six patients were included in this study. Various clinical presentation was observed such as fever, anorexia and malaise as the most common symptoms. The most common laboratory abnormality was CRP elevation as being detected in all patients followed by LDH and transaminase elevations. both were found in four patients. CONCLUSION:Serological methods used to diagnose Q fever are not routinely performed, so Q fever cases can be missed easily. We believe that Q fever should be investigated further in patients from endemic regions who did not give adequate response to nonspesific antibiotic treatment.
ÖZ Amaç: Son yıllarda geniş spektrumlu antibiyotiklerin yaygın kullanımı nedeniyle Acinetobacter baumanniii (A. baumannii)'nin ilaç direncindeki hızlı artışlar dünya çapında acil bir sorun haline gelmiştir. Bu çalışmada klinik örneklerden izole edilen A. baumannii suşlarının antimikrobiyal direnç durumlarının saptanarak ampirik tedavi ve antibiyotik kullanım politikalarına katkıda bulunulması amaçlanmıştır. Gereç ve Yöntemler: Ocak 2015-Aralık 2017 tarihleri arasında klinik örneklerden izole edilen toplam 136 A. baumannii suşu retrospektif olarak incelenmiştir. Gönderilen örnekler %5 koyun kanlı agar, EMB (Eosin Metilen Blue) agar ve çikolatamsı agar besiyerlerine, kan ve steril vücut sıvıları ise Bactec 9120 (Becton Dickinson, ABD) kan kültür sistemine ait sişelere ekilmiştir. Bakteri tanımlaması ve antimikrobiyal duyarlılık testleri için konvansiyonel yöntemler ve Phoenix (Becton Dickinson, ABD) tam otomatik bakteri tanımlama sistemi kullanılmıştır. Bulgular: A. baumannii suşları en sık yoğun bakımlardan 109 (%80.1) ve solunum yolu örneklerinden 98 (%72) izole edilmiştir. Antibiyotik direnç oranları kolistin için %5.9, amikasin için %39.7, trimetoprim/sülfametaksazol için %73.5, gentamisin için %81.6, meropenem için %82.4, imipenem, siprofloksasin için %83.1 ve seftazidim için %83.8, sefepim, piperasilin, piperasilin/tazobaktam %85.3 olarak saptanmıştır. Sonuç: Kolistin ve amikasin dışındaki antibiyotiklere direnç oranlarının yüksek oranda saptanması (>%70) özellikle yoğun bakımlarda tedavi gören ve ciddi solunum yolu enfeksiyonu olan hastalarda ampirik antibiyotik tedavi uygulamalarının çok dikkatli şekilde yapılması gerektiğini düşündürmüştür. ABSTRACTAim: Due to the widespread use of broad spectrum antibiotics in recent years, rapid increases in drug resistance of Acinetobacter baumanni (A. baumannii) have become an urgent problem worldwide. In this study, it was aimed to determine the antimicrobial resistance patterns of A. baumannii strains isolated from clinical samples and to contribute to empirical treatment and antibiotic use policies. Material and Methods: A total of 136 A. baumannii strains isolated from clinical specimens between January 2015 and December 2017 were retrospectively analyzed. The samples were inoculated in 5% sheep blood, EMB (Eosin Methylene Blue) and chocolate agar media, while blood and sterile body fluids were inoculated in Bactec 9120 blood culture system. Bacterial identification and antimicrobial susceptibility testing were performed using conventional methods and Phoenix (Becton Dickinson, USA) fully automated bacteria identification system. Results: A. baumannii strains were most frequently isolated from the intensive care units 109 isolates (80.1%) and from the respiratory tract samples 98 isolates (72%). Antibiotic resistance rates were found to be 5.9% for colistin, 39.7% for amikacin, 73.5% for trimethoprim/sulfamethoxazole, 81.6% for gentamicin, 82.4% for meropenem, 83.1% for imipenem, ciprofloxacin, 83.8% for ceftazidime and 85.3% from cefepime, piperacillin, piperacill...
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