Urine analysis is one of the most common tests for assessing urinary-tract and kidney diseases. In recent years there have been new developments in the automation of this test. The objective of the present study was to compare the performances of two urine sediment analysers, namely LabUMat with UriSed (77 Elektronika Kft, Budapest, Hungary) and iQ200 (Iris Diagnostics, Chatsworth, CA, U.S.A.), with the KOVA method for manual urine measurement by evaluating the results in terms of similar parameters (cells or particles per lower-power field or high-power field). The results obtained using the UriSed and iQ200 analysers were more reproducible (7.1-30.2 and 14.9-35.4% respectively) than those obtained using the manual technique (17.9-44.4%). Significant correlations were established among the three techniques in the evaluation of leucocytes, erythrocytes and epithelial cells. Although the UriSed, iQ200 and visual-microscopic measurements were in agreement, confirmation of the results from automated methods by manual urine analyses is significantly useful, especially for pathological cases that were close to the limits of the techniques.

The prevalence of UTI with ESBL (+) bacterial strains with multi-drug resistance is increasing in the hospitalized pediatric population, therefore rational use of antibiotics is essential.

In our study, the prevalence of nasopharyngeal Streptococcus pyogenes was 130 (14.3%) of 909 healthy children. Isolates were found to be susceptible to all antibiotics tested. Pulsed-field gel electrophoresis and arbitrarily primed PCR revealed that 34 (32.4%) of the 105 isolates and 41 (40.6%) of the 101 isolates typed, respectively, were clonally indistinguishable.Streptococcus pyogenes group A streptococcus (GAS) strains colonized in the upper respiratory tracts of children play an important role in the spread of this bacterial infection, especially among children at school, day-care centers, orphanages, and home. Study of the prevalence of healthy S. pyogenes carriers and the molecular epidemiology of the isolates may provide useful information about the origin and spread of this infectious agent, allowing for more effective control measures. Pulsed-field gel electrophoresis (PFGE) (3,4,14) has been used as a standard technique for surveying epidemiology of S. pyogenes infections. Although arbitrarily primed PCR (AP-PCR)-based fingerprinting performed with the M13 primer has been widely used for molecular epidemiology of gram-negative (1, 2, 10) and gram-positive bacteria (11), there had been no study about its efficiency in typing S. pyogenes strains.The aims of the present study were to investigate the rate of pharyngeal colonization, drug susceptibility, and the molecular epidemiology of GAS isolated from healthy children and to compare PCR-based fingerprinting with PFGE in the investigation of clonal relatedness among the GAS isolates.Study groups. The study groups included 800 primary schoolchildren and 109 children living in an orphanage in Malatya, Turkey. An otorhinology specialist rubbed sterile swabs over the posterior nasopharyngeal walls of the 909 children, who had no symptoms or signs of pharyngitis. The samples were inoculated on sheep's blood agar plates. After incubation overnight at 37°C, beta-hemolytic streptococci were identified with a bacitracin disk (0.04 U) and a latex test for the identification of streptococcal groups A, B, C, D, F, and G (streptococcal grouping kit and diagnostic reagent; Oxoid Limited, Basingstoke, England).Susceptibility testing. The antimicrobial susceptibilities of the GAS isolates were investigated by the disk diffusion method according to the criteria of the National Committee for Clinical Laboratory Standards (13). The antibiotic disks (Oxoid) used were penicillin (10 U), erythromycin (15 g), vancomycin (30 g), chloramphenicol (30 g), clindamycin (2 g), cefepime (30 g), ceftriaxone (30 g), ofloxacin (5 g), and levofloxacin (5 g).Molecular typing of the strains. Both AP-PCR and PFGE typing was performed on 101 strains which had available stocks. PFGE was also carried out on five additional strains. For AP-PCR typing, isolation of DNA by using lysozyme and proteinase K and extraction were performed by following the protocol of Welsh and McClelland (19). Then AP-PCR, which had previously been optimized (1, 2), was performed with the M13 primer (10). For PFGE, i...

We aimed to characterize carbapenem-resistant isolates in a tertiary hospital in Istanbul, Turkey, high-prevelance area for OXA-48 producers. About 76 Enterobacteriaceae clinical isolates were included. Carbapenemase production was detected by Carbapenem Inactivation Method and carbapenemase genes were investigated by PCR. The clonal relationships were evaluated by AP-PCR. Nineteen Klebsiella pneumoniae isolates were colistin resistant. About 75 isolates yielded carbapenemase by CIM. 52 OXA-48, 17 NDM-1 and 2 VIM-5 carbapenemase genes were detected. Co-production of 'OXA-48 and NDM-1' and 'OXA-48 and VIM-5' were demonstrated in two Klebsiella pneumoniae isolates. The total clustering rate was 20.2%. About 69 Klebsiella pneumoniae yielded 60 profiles and 12 isolates formed five clusters. We have demonstrated the presence of OXA-48 carbapenemases in the majority of isolates in a large collection of carbapenemase-producing isolates from a single hospital. The relatively high rates of NDM-1-producing isolates and colistin resistance is noteworthy.

Klebsiella outbreaks mainly affected premature neonates with intravenous catheters, mechanical ventilation, or both. The high mortality rate (76.7%) was notable. Resistance to multiple antibiotics, but mainly to broad-spectrum beta-lactam antibiotics, was observed, particularly in K. pneumoniae isolates. Molecular typing indicated that the three outbreaks were not related to one other.

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The gastrointestinal tract carriage of enterococci was searched in 150 hospitalized patients and 100 outpatients, and clonal relatedness of the isolates and their resistance to ampicillin, vancomycin, and high-level streptomycin and gentamicin were investigated. A stool sample or rectal swab collected from each patient was inoculated into appropriate media within an hour. Enterococcus species were identified by using conventional biochemical tests, API-20 Strep assay, and BBL crystal kit. Antibiotic susceptibility tests were performed using Kirby-Bauer disk diffusion method. A polymerase chain reaction (PCR) was used to detect vanA and vanB genes. Pulsed-field gel electrophoresis (PFGE) and arbitrarily primed-polymerase chain reaction (AP-PCR) methods were used for molecular typing of the strains. Enterococci were isolated from 90 (60%) of the specimens collected from 150 inpatients. Of these 90 isolates, 37 (41%) had high-level gentamicin resistance, 36 (40%) had high-level streptomycin resistance, and 50 (55.6%) had ampicillin resistance. Fecal colonization was found in 30% of the outpatients. Resistances to ampicillin, high-level streptomycin, and gentamicin were 13%, 10%, and 3%, in these patients' isolates, respectively. No vancomycin-resistant enterococci were detected by both agar diffusion and PCR assays in our study. Both typing procedures were applied on 78 Enterococcus strains isolated from inpatients. AP-PCR typing showed that 30 (50.8%) of the 59 E. faecium and 5 (50%) of the 10 E. faecalis strains were clonally related. These values were found to be 12 (20.3%) and two (20%) by PFGE, respectively. The typing procedures did not find any clustered strains in the six E. durans and three E. avium isolates. Neither PFGE nor AP-PCR result was significantly different among the sensitive and resistant strains. Our results indicate that the high prevalence of colonization with ampicillin and highlevel aminoglycoside-resistant enterococci is an important problem in our medical center. The high clonal diversity among the isolates indicates limited spread of antibiotic-resistant strains between patients.

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