Candan Çiçek

Are Human Adenovirus-5 and 36 Associated With Obesity in Children?

Objectives The aims of this study were to determine the association between adenovirus-5– and adenovirus-36–specific antibodies and obesity in children and to investigate their relationship with serum lipid and leptin levels. Methods A cross-sectional study was performed on a total of 120 children who were divided into subgroups according to body mass index percentile as obese (≥95th percentile) or nonobese (<95th percentile). The presence of adenovirus-36 and adenovirus-5–neutralizing antibodies was investigated by using the serum neutralization assay. Serum leptin levels were determined by microenzyme immonoassay; high-density lipoprotein, low-density lipoprotein, triglyceride, and cholesterol levels were measured by chemiluminescence method. Results The presence of adenovirus-5–specific antibodies was 28.3% and 6.6% in the obese children and in non–obese children, respectively (P = 0.02). The frequency of adenovirus-36–specific antibodies was significantly greater (P = 0.018) in the obese children (26.6%) than in the non–obese children (10.0%). Serum leptin level of the obese group were significantly higher than that of the non–obese group (P = 0.000). Conclusions Our data support the association between obesity and the presence of specific antibodies to adenovirus-36 and adenovirus-5 in children. Our research has the feature of being the first national study to indicate the relationship between adenovirus-36 and human obesity as well as the first international study to indicate the relationship between adenovirus-5 and human obesity.

Bacterial and viral etiology in hospitalized community acquired pneumonia with molecular methods and clinical evaluation.

INTRODUCTION Polymerase chain reaction (PCR) method has improved the diagnosis rates for patients with community-acquired pneumonia (CAP). We aimed to evaluate the bacterial and viral etiology of hospitalized CAP cases and compare clinical and laboratory findings of patients with pure bacterial and bacterial and viral (mixed) infections. METHODOLOGY A total of 55 patients hospitalized with CAP were enrolled into the prospective study between February 2010 and December 2010. Clinical and laboratory follow-up were performed on days 0, 7 and 14. Deep tracheal aspiration samples were examined for bacterial and viral pathogens by multiplex PCR, and standard bacteriological culture method. RESULTS The etiological identification rate in 50 patients for bacteria, viruses and mixed virus-bacteria combination by PCR were 62%, 4%, 32%, respectively and 60% in 55 patients by bacterial culture method. Streptococcus pneumoniae concomitant with Haemophilus influenzae (36%) and rhinovirus (16%) was very common, whereas atypical pathogens (only Mycoplasma pneumoniae) were rare (6%). Rhinovirus was the most common viral agent (20%). Recently identified viruses, human coronavirus HKU1 and human bocavirus were not detected except for human metapneumovirus (one case). There was no significant difference in terms of mean age, immune status, leukocyte count, C-reactive protein (CRP) values, hospitalization duration and CURB-65 score between bacterial and mixed viral-bacterial detections. Advanced age (p < 0.01) and higher CURB-65 score (p = 0.01) were found to be associated with increased mortality. CONCLUSION Concomitance of bacterial and viral agents is frequent and resemble with bacterial infections alone. Further studies are needed for the clinical significance of mixed detections.

Behaviour of Toxoplasma gondii RH Ankara strain tachyzoites during continuous production in various cell lines.

Toxoplasma gondii is an obligate intracellular protozoan parasite. The objective of the present study was to examine the behaviour of Toxoplasma gondii RH Ankara strain tachyzoites in a cell culture environment. The study represents the first step in determining whether T. gondii RH Ankara strain tachyzoites, grown in cell culture, are of sufficient quality to allow cessation of in vivo tachyzoite production for diagnostic assays. In the present study, T. gondii RH Ankara strain tachyzoites were continuously produced in myeloma X63.Ag8.653, HeLa, Hep-2, and Vero cell cultures for 2 months. The average size of the tachyzoites was 3 x 5.7 microm prior to the first inoculation but after continuous production, a marked decrease was noted in average tachyzoite size. The smallest tachyzoite size, was 1 x 2.1 microm after 2 months, in myeloma cell cultures even though the yield of tachyzoites increased. With other cell cultures, tachyzoite yields were not as high as myeloma cell culture although decrease in size was less. The smallest decrease in tachyzoite size, averaging 2 x 3.8 microm after 2 months, was observed in tachyzoites produced in HeLa cell cultures. A virulence assay in small groups of BALB/c mice, using tachyzoites derived from cell cultures, was also conducted. The preliminary results of the virulence assay suggest that as the size of the tachyzoites decreased, the virulence in mice decreased. Future research will focus on the effect of the size of cell culture-derived T. gondii RH Ankara strain tachyzoites on the virulence, protein expression, and the reliability of diagnostic assays. Ultimately, the behaviour of tachyzoites from various T. gondii strains will be observed in cell culture to determine if size is altered.

Chlamydia pneumoniae arthritis in a patient with common variable immunodeficiency

BACKGROUND Arthritis is an important and sometimes life-threatening complication in patients with common variable immunodeficiency (CVID). OBJECTIVE To describe a patient with CVID and arthritis due to Chlamydia pneumoniae, which is usually regarded as a respiratory tract pathogen and has not previously been detected in the synovial fluid by cell culture technique. METHODS Routine bacteriologic, virologic, mycologic, and tuberculosis cultures were performed. The patients synovial fluid was examined for fastidious organisms that might be causative pathogens of arthritis, such as chlamydiae, and special cell culture methods were used. Serologic tests were performed to determine viral and bacteriologic etiology. RESULTS The patient had a history of recurrent respiratory tract infections, and the latest exacerbation was followed by arthritis. Cytologic examination of the fluid yielded abundant lymphocytes. Chlamydia pneumoniae was detected in synovial fluid specimens by cell culture technique. Her nasopharyngeal swab and sputum culture specimens were also positive for this pathogen. She was diagnosed as having arthritis caused by C pneumoniae and was given antibiotherapy. CONCLUSION Chlamydia pneumoniae should be kept in mind as a causative pathogen in patients with CVID and arthritis, especially when effusion fluid is full of lymphocytes rather than polymorphonuclear cells and no organism is grown on routine cultures.

E-Test: An Alternative Method for Susceptibility Testing of Mycobacterium tuberculosis

Objective: The purpose of this study was to compare the agar proportion method with the E-test method for susceptibility testing of Mycobacterium tuberculosis.Materials and Methods: A total of 100 isolates were tested for isoniazid, rifampin, streptomycin and ethambutol susceptibility using an indirect-proportion method as well as the E-test method. Results:Categorical agreement between the methods was 100% for isoniazid, rifampin, streptomycin, and ethambutol. Conclusion: The E-test method appears to be an alternative method to agar proportion for testing the susceptibility of M. tuberculosis isolates to the first-line antituberculous agents.

Ten year retrospective evaluation of the seasonal distribution of agent viruses in childhood respiratory tract infections.

AIM Infections caused by respiratory viruses sometimes occur as epidemias or pandemias and are an important public health problem in the whole world. These viral agents may lead to severe respiratory diseases especially in young children and in the elderly. The aim of this study was to determine the seasonal distribution of agent viruses in childhood respiratory infections in our region. MATERIAL AND METHODS In this study, nasopharyngeal swab sample was obtained from 1 326 patients who presented to Ege University, Medical Faculty Childrens Hospital between 2002 and 2012 and who were thought to have respiratory tract infection. Influenza virus type A and B, respiratory syncytial virus, adenovirus and parainfluenza virus type 1-3 were investigated using shell-vial cell culture method and direct fluorescent antibody test and/or multiplex PCR test. Parainfluenza virus type 4, human metapneumovirus, rhinovirus, coronavirus, human bocavirus were investigated using multiplex PCR test. The seasonal distributions of the viruses were determined according to the results obtained from Ege University Medical Faculty, Department of Medical Microbiology Clinical Virology Laboratory. Approval was obtained from the ethics committee (Ege University Clinical Researches Ethics Committee, 12.02.2013, number: 13-1/46). RESULTS The majority of the patients who presented were outpatients (n:888, 67%) and the remainder were hospitalized patients (33%, n:438). Respiratory viruses were found in 503 of the nasopharyngeal swab samples (38%). Parainfluenza and respiratory syncytial virus were found most frequently in December-february (58% and 59%, respectively, influenza viruses were found most frequently in November-december (72%) and adenoviruses were found most frequently in may-september (56%). CONCLUSION Although only supportive therapies are administered generally in viral infections, viral investigations are important in terms of determining the measures to be taken by determining the causes as well as in terms of establishing a general database. Another benefit of this study would be strengthening clinical approach to patients and decreasing unnecessary antibiotic use.

In vitro activity of ciprofloxacin, ofloxacin and levofloxacin against Mycobacterium tuberculosis

BACKGROUND The increasing incidence of drug-resistant Mycobacterium tuberculosis necessitates therapeutic alternatives. The fluoroquinolones fulfill most of the criteria for an ideal class of antimycobacterial drugs. The aim of the present study was to determine to in vitro activities of ciprofloxacin, ofloxacin, and levofloxacin against M. tuberculosis strains. METHODS Susceptibility to four antituberculous drugs used in first-line treatment of tuberculosis was tested in 100 strains isolated from clinical samples. Nineteen strains (19%) were resistant to at least one of the four antituberculous drugs and 13 were multidrug resistant. The in vitro antimycobacterial activity of ciprofloxacin, ofloxacin, and levofloxacin was then determined against 100 M. tuberculosis strains using standard agar proportion dilution method. RESULTS Ciprofloxacin, ofloxacin, and levofloxacin were active against all tested strains of M. tuberculosis in vitro. CONCLUSIONS Ciprofloxacin, ofloxacin, and levofloxacin have relatively potent in vitro activity against M. tuberculosis. Further in vivo studies are needed to determine the role of these compounds in the treatment of tuberculosis, but use should be limited to special circumstances rather than first-line treatment.

Comparison of the ProDect BCS RV CHIP assay with the combination of shell vial cell culture and immunofluorescence antibody test for the detection of respiratory viruses

Abstract In the present study, a multiplex reverse transcriptase polymerase chain reaction combined with a chip hybridization assay (ProDect BCS RV CHIP) was evaluated as an alternative to the combination of immunofluorescent antibody test and shell vial cell culture considered as gold standard for the detection of respiratory viruses. Among 100 specimens, 40 were positive using the combination of immunofluorescent antibody test and shell vial cell culture assay in which 9 of them were infected by two different viruses (27 parainfluenza virus type 3, 10 adenovirus, 9 respiratory syncytial virus, 2 influenza type B, and 1 influenza type A). ProDect BCS RV CHIP detected only 10 positive specimens in which one of them was infected by two different viruses (5 respiratory syncytial virus, 3 parainfluenza virus type 3, 2 adenovirus, and 1 influenza virus type B). The sensitivity, specificity, PPV, NPV, and diagnostic accuracy of ProDect BCS RV CHIP were 25.0%, 100%, 100%, 66.6%, and 70.0%, respectively, compared to the combination of shell vial cell culture and immunofluorescent antibody test. As a result, the specificity of ProDect BCS RV CHIP is high, however, the sensitivity (25%) of the assay is not sufficient for routine laboratory use.

Parainfluenza type 3 outbreaks in Izmir children, Turkey

The present study was aimed to investigate characteristics of lower respiratory tract infections caused by parainfluenza type 3 viruses. Nasopharyngeal smears were taken from 178 patients with lower respiratory infections for the diagnosis of respiratory syncytial virus, adenovirus, influenza and parainfluenza viruses between December 2004 and April 2005. Parainfluenza type 3 was isolated from the viral specimens of 96 (53.9%) patients and it was noticeable that the parainfluenza type 3 outbreak occurs during winter. Obviously, improving the aetiological diagnosis of viral infections might avoid unnecessary therapy, antibiotics in particular, and would allow for preventive isolation of infected patients.

Assessment of Chlamydia trachomatis Prevalence by Cell Culture and Transcription-Mediated Amplification in Symptomatic Women

Objective: The frequency of Chlamydia trachomatis in women with mucopurulent discharge was determined by a cell culture technique and a transcription-mediated amplification (TMA) assay in endocervical swab specimens. Subjects and Methods: Endocervical swab specimens were obtained from 116 symptomatic patients with genitourinary complaints or abdominal pain. All of the women were married, with an age range of between 19 and 44 (median 29) years. The cell culture assay was used in all specimens. For 75 specimens the TMA assay was also performed. Results: Positive cell culture test results were obtained in 6 (5.2%) patients. Among 75 specimens, 2 were positive by both TMA and culture assays, while 1 specimen was positive only by the culture assay. Of those positive for C. trachomatis, 5 were in the 19- to 25-year age group, and 1 was in the >25-year age group. All of the patients with positive results were of low socioeconomic status. Conclusions: This study revealed a relatively low rate of C. trachomatis infections in symptomatic married women in Turkey. A commercial TMA assay failed to identfy all positive patients, in contrast to a ‘gold standard’ culture assay used in patients having such infections.