Ali Albay

The evaluation of FASTPlaqueTBTM test for the rapid diagnosis of tuberculosis

FASTPlaqueTB (Biotec Laboratories Ltd., Ipswich, UK) is a rapid test which utilizes bacteriophage amplification technology for the detection of viable Mycobacterium tuberculosis in clinical specimens. We evaluated performance of the FASTPlaqueTB test by comparing with BACTEC 460 TB culture system (Becton Dickinson Co., Maryland, USA), polymerase chain reaction (PCR) and acid fast bacilli (AFB) smear methods. We investigated 192 sputum specimens collected from the patients suspected of having pulmonary TB by AFB smear, BACTEC 460 TB culture system, PCR and FASTPlaqueTB test. The sensitivity of AFB smear, PCR and FASTPlaqueTB test were 57.8%, 84.4% and 87.5% respectively when we accepted BACTEC 460 TB culture system as gold standard. We conclude that FASTPlaqueTB test has a good potential for rapid diagnosis of Mycobacterium tuberculosis as a result of the evaluation of these three tests by comparison to the BACTEC 460 TB culture system.

The evaluation of diagnostic methods for the detection of Helicobacter pylori in gastric biopsy specimens

PCR is a rapid, sensitive and accurate method for the specific detection of Helicobacter pylori from gastric biopsy specimens. In our study, 104 gastric tissue specimens from symptomatic adult patients were examined by staining, culture, PCR and nested PCR methods for detection of H. pylori. According to our results, positivity was achieved in 24% (25/104) with Giemsa staining, 34% (36/104) with histopathology, 36% (38/104) with PCR and 41% (43/104) with nested PCR respectively, whereas H. pylori was isolated in only 33% (35/104) of the cultures on the biopsy specimens. Both the sensitivity and the positive predictive value of the nested PCR method were 100%, and both the specificity and negative predictive value were 98%. As a conclusion, our results suggest the nested PCR as a highly valuable method in the detection of H. pylori with a reasonably high sensitivity and specificity.

Distribution of Spoligotyping Defined Genotypic Lineages among Drug-Resistant Mycobacterium tuberculosis Complex Clinical Isolates in Ankara, Turkey

Background Investigation of genetic heterogeneity and spoligotype-defined lineages of drug-resistant Mycobacterium tuberculosis clinical isolates collected during a three-year period in two university hospitals and National Tuberculosis Reference and Research Laboratory in Ankara, Turkey. Methods and Findings A total of 95 drug-resistant M. tuberculosis isolates collected from three different centers were included in this study. Susceptibility testing of the isolates to four major antituberculous drugs was performed using proportion method on Löwenstein–Jensen medium and BACTEC 460-TB system. All clinical isolates were typed by using spoligotyping and IS6110-restriction fragment length polymorphism (RFLP) methods. Seventy-three of the 95 (76.8%) drug resistant M. tuberculosis isolates were isoniazid-resistant, 45 (47.4%) were rifampicin-resistant, 32 (33.7%) were streptomycin-resistant and 31 (32.6%) were ethambutol-resistant. The proportion of multidrug-resistant isolates (MDR) was 42.1%. By using spoligotyping, 35 distinct patterns were observed; 75 clinical isolates were grouped in 15 clusters (clustering rate of 79%) and 20 isolates displayed unique patterns. Five of these 20 unique patterns corresponded to orphan patterns in the SITVIT2 database, while 4 shared types containing 8 isolates were newly created. The most prevalent M. tuberculosis lineages were: Haarlem (23/95, 24.2%), ill-defined T superfamily (22/95, 23.2%), the Turkey family (19/95, 20%; previously designated as LAM7-TUR), Beijing (6/95, 6.3%), and Latin-America & Mediterranean (LAM, 5/95 or 5.3%), followed by Manu (3/95, 3.2%) and S (1/95, 1%) lineages. Four of the six Beijing family isolates (66.7%) were MDR. A combination of IS6110-RFLP and spoligotyping reduced the clustering rate from 79% to 11.5% among the drug resistant isolates. Conclusions The results obtained showed that ill-defined T, Haarlem, the Turkey family (previously designated as LAM7-TUR family with high phylogeographical specifity for Turkey), Beijing and LAM were predominant lineages observed in almost 80% of the drug-Resistant M. tuberculosis complex clinical isolates in Ankara, Turkey.

Tuberculosis Prevalence in Forensic Autopsies

Introduction:According to the 2008 World Health Organization report, in 2006, 9.2 million new cases were determined, and 1.7 million people have lost their life due to tuberculosis (TB) in all around the world. In our country (Turkey), it is estimated that 35,000 to 40,000 people have TB disease annually. The Ministry of Health could just determine 18,500 of these cases, and only 6500 patient could be treated effectively. According to the Tuberculosis Dispensary records, the incidence for TB in Turkey is 28/100,000. Materials and Methods:It is aimed to determine the infection with Mycobacterium tuberculosis using acidoresistant bacilli microscopy, TB culture, and histopathological methods in tissue samples that were obtained from lungs of forensic cases whose autopsies had been performed in Council of Forensic Medicine Ankara Department Morgue Specialized Committee. Results:A total of 3 tissue samples that were obtained from lungs of randomized 302 cases, were positive for TB in Löwenstein-Jensen medium. Granuloma with caseating necrosis was found in histopathological examination and acidoresistant (+) bacilli (1+, 2+, and 2+, respectively) in microscopically analysis were also demonstrated in this 3 tissue samples. Discussion:For this reason, we think that autopsy workers have to be careful about tuberculosis during their autopsy working.

Short-term quinolones for successful eradication of multiply resistant vibrio cholerae in adult patients

There has been an increasing multiple drug resistance problem in Vibrio cholerae biotype Eltor, the causative agent of 7th pandemic. The aim of this study was to show in vitro and in vivo susceptibility and effectiveness of quinolones in the treatment of endemic cholera cases. Excellent results were obtained in 53 bacteriologically confirmed cholera patients treated with short-term ofloxacin and ciprofloxacin. To our knowledge, there has been no previous report on this subject in the international medical literature. Our results show that quinolones can be an alternative drug for the treatment of multiply resistant V. cholerae infections.

Multicenter evaluation of crystal violet decolorization assay (CVDA) for rapid detection of isoniazid and rifampicin resistance in Mycobacterium tuberculosis

The aim of this multicenter study was to evaluate the performance of the crystal violet decolorization assay (CVDA) for detection of multidrug resistant tuberculosis (MDR-TB). This study was performed in 11 centers in two phases. A total of 156 isolates were tested for INH and RIF resistance. In the phase I, 106 clinical isolates were tested in the Center 1–7. In the phase 2, 156 clinical isolates were tested in the center 1–6, center 8–11. Eighty six of 156 tested isolates were the same in phase I. Agreements were 96.2–96.8% for INH and 98.1–98.7% for RIF in the phase I-II, respectively. Mean time to obtain the results in the phase I was 14.3 ± 5.4 days. In the phase II, mean time to obtain the results was 11.6 ± 3.5 days. Test results were obtained within 14days for 62.3% (66/106) of isolates in the phase I and 81.4% (127/156) of isolates in the phase II. In conclusion, CVDA is rapid, reliable, inexpensive, and easy to perform for rapid detection of MDR-TB isolates. In addition, it could be adapted for drug susceptibility testing with all drugs both in developed and developing countries.

Evaluation of the BACTEC MGIT 960 SL DST Kit and the GenoType MTBDRsl Test for Detecting Extensively Drugresistant Tuberculosis Cases

Objective The present study aimed to evaluate the performances of the BACTEC MGIT 960 SL DST kit and the GenoType MTBDRsl test for detecting second-line antituberculosis drug resistance in Multidrug-resistant TB (MDR-TB) cases. Materials and Methods Forty-six MDR-TB strains were studied. Second-line antituberculosis drug resistances were detected using the BACTEC MGIT 960 SL DST kit and the GenoType MTBDRsl test. The Middlebrook 7H10 agar proportion method was used as the reference test. Results The sensitivity and specificity values for the BACTEC MGIT 960 SL DST kit were both 100% for amikacin, kanamycin, capreomycin (4 µg/mL), and ofloxacin; 100% and 95.3%, respectively, for capreomycin (10 µg/mL); and 85.7% and 100%, respectively, for moxifloxacin (0.5 µg/mL). The sensitivity and specificity values for the GenoType MTBDRsl test to detect fluoroquinolone and aminoglycoside/cyclic peptide resistance were 88.9% and 100%, respectively, for ofloxacin and 85.7% and 94.9%, respectively, for moxifloxacin (0.5 µg/mL). The accuracy of the GenoType MTBDRsl assay for kanamycin, capreomycin, ofloxacin, and moxifloxacin was lower than that of the BACTEC MGIT 960 SL DST. Conclusion The BACTEC MGIT 960 SL DST kit and the GenoType MTBDRsl were successful in detecting second-line antituberculosis drug resistance. Preliminary results of the GenoType MTBDRsl are very valuable for early treatment decisions, but we still recommend additional BACTEC MGIT 960 SL DST kit usage in the routine evaluation of drug-resistant tuberculosis.

Mycobacterium abscessus’un neden olduğu kan dolaşımı enfeksiyonu

Mycobacterium abscessus kompleksin de dahil oldugu hizli ureyen mikobakteriler, dogal ortamda bulunan ve ozellikle bagisikligi baskilanmis hastalarda firsatci patojen olabilen mikroorganizmalardir. Evre 4 noroblastoma tanisi olan 10 yasinda bir kiz hastada, M. abscessus tarafindan olusturulan kan dolasimi enfeksiyonunu bildiriyoruz. Mikroorganizmanin kan kulturu sisesinden izole edilmesini muteakip; mikroorganizma, MALDI-TOF MS ve BD Phoenix otomatize tanimlama ve ilac duyarlilik cihazi ile tanimlanmistir. Hastanin mevcut antimikrobiyal tedavisine ek olarak klaritromisin eklenmis ve hasta sifa ile taburcu edilmistir. Tuberkuloz disi mikobakteriler ciddi firsatci patojenler olarak karsimiza cikmakta ve hekimlerin ozellikle bagisikligi baskilanmis hastalarda bu mikroorganizmalari degerlendirmeye almalari gerekmektedir. Antimikrobiyal direnc profilindeki degiskenlikten dolayi, tur duzeyinde tanimlama kritik rol oynamaktadir.