Esra Kocoglu

Mycological flora of the Hammams, traditional Turkish bath.

Traditional Turkish baths, Hammams, occupy a prominent place in public health in history and at present. It is well‐known that baths are major sources of fungal skin infections, but according to our knowledge fungal flora of Turkish Hammams was not defined yet. In Bolu, Turkey, two Hammams were open to public and for detecting fungal flora, we collected 209 samples from different part of floors, tools and screened for the fungal pathogens. From floors of the dressing rooms, Trichophyton rubrum and Candida albicans; from slippers T. rubrum, T. mentagrophytes, Epidermophyton floccosum, Candida albicans and C. tropicalis were isolated. While we could not isolate any dermatophyte species and yeasts from the vicinity of the bath windows and walls of baths, Aspergillus spp. and Penicillium spp. were isolated from the same locations. Samples taken from marble floors of baths, central massage platforms (hottest part of the Hammam) and towels did not show any fungal growth. This report reveals that components of the Turkish Hammams have low risk for fungal contamination as a result of frequent cleaning and environmental high temperature. But shared tools like slippers were found to be an important source of fungal contamination.

Efficacy of moxifloxacin compared to teicoplanin in the treatment of implant‐related chronic osteomyelitis in rats

Treatment of implant‐related chronic osteomyelitis is often difficult and usually consists of implant removal, extensive surgical debridement, and prolonged antibiotic use. This study was performed to assess the efficacy of moxifloxacin compared to a glycopeptide, teicoplanin in chronic implant‐related methicillin‐sensitive Staphylococcus aureus (MSSA) osteomyelitis. The left femoral medullar cavities of 60 Wistar male rats were contaminated with 100 µl of 108 cfu/ml methicillin‐sensitive S. aureus (ATCC 29213) and Kirschner wires were placed into the medulla of the femur. After 6 weeks, rats were randomly divided into five groups. In two groups, the Kirschner wires were removed. Experimental groups were as follows: group 1: contaminated, Kirschner wire inside, received teicoplanin; group 2: contaminated, Kirschner wire removed, received teicoplanin; group 3: contaminated, Kirschner wire inside, received moxifloxacin; group 4: contaminated, Kirschner wire removed, received moxifloxacin; group 5: contaminated, Kirschner wire inside, no antibiotics (control group). Groups 1 and 2 received teicoplanin (20 mg/kg once daily), whereas groups 3 and 4 received moxifloxacin (10 mg/kg twice daily) intraperitoneally for 28 days. At the end of the treatment, animals were sacrificed by inhalation anesthesia with ether and femora were retrieved and bacterial counts (cfu/g) were determined. Bacterial counts in all study groups were significantly reduced relative to the control. The decrease of bacterial counts was more prominent in group 4 compared to group 1 (p = 0.001) and group 2 (p = 0.003). Moxifloxacin therapy is an effective alternative to teicoplanin for chronic implant‐related MSSA osteomyelitis. Published by Wiley Periodicals, Inc. J Orthop Res 28:1368–1372, 2010

Effect of inhaled budesonide on oropharyngeal, Gram‐negative bacilli colonization in asthma patients

Background and Objective:  The effect of inhaled budesonide on oropharyngeal Gram‐negative bacilli colonization (OGNBC) in asthmatic patients was investigated.

The effect of triamcinolone acetonide aqueous nasal spray on the nasal carriage of Staphylococcus aureus.

Background In this study we aimed to investigate the effect of triamcinolone acetonide aqueous (TAA) intranasal spray that was used for 2 months to treat allergic rhinitis (AR) on the nasal carriage of Staphylococcus aureus (NCSA). Methods A total of 125 adult AR patients (study group) and 133 healthy individuals (control group) were enrolled for the study. The subjects were diagnosed with AR after a detailed history, physical examination, and prick testing. The AR subjects were administered TAA in a daily dosage of a 220-μg intranasal route. Nasal cultures were obtained on the 1st (baseline), 55th, and 60th days, and the subjects in the last two cultures of whom S. aureus was detected were accepted as NCSA. Results After all exclusion criteria were used, 110 AR and 114 control group subjects were enrolled in the study. Based on the culture results that were obtained on the 55th and 60th days, 10 (%9.1) patients from the study group and 18 (%15.7) individuals from the control group were defined to be NCSA (p > 0.05). Conclusion We conclude that the use of TAA treatment for AR does not increase the prevalence of NCSA. However, additional studies with a larger series are required to explain the effects of steroids on nasal colonization of S. aureus.

Molecular characterization of rotaviruses in mid-western Turkey, 2006–2007

Vaccines against rotaviruses are now available in numerous countries, including Turkey. As the vaccines may show various efficiencies against different type specificities and routine vaccination in infants might result in selection and immune escape of wild-type rotavirus strains, strain surveillance has been initiated before and during the vaccine introduction. We aimed to provide corresponding information on local strain prevalence in Anatolia, mid-western Turkey during the introduction of rotavirus vaccines. Stool samples positive for group A rotavirus by commercial enzyme immunoassay were subjected to reverse transcription-polymerase chain reaction based genotyping of the outer capsid antigens, VP7 and VP4, determining G and P type specificities respectively. Among 36 fully and 5 partially typeable strains we detected genotype G1, G2, and G9 VP7 specificities and genotype P[4], P[6] and P[8] VP4 specificities in 5 individual and 4 mixed combinations. The most common strain was G2P[4] (n=17), followed by G9P[8] (n=9). Other strains were G1P[8] (n=2), G2P[8] (n=2), G1+2P[8] (n=2), G9P[4] (n=1), G2+9P[8] (n=1), G4+9P[6] (n=1), and G2P[4+8] (n=1). Partially typed strains included 2 G1P[NT] and 3 G2P[NT] strains. Our data may help determine a baseline of the rotavirus genotype prevalence in Turkey and see if changes in the incidence of individual strains will be observed after routine use of vaccine.

Üçüncü basamak bir hastanedeki gebe ve/veya jinekolojik hastalıklı kadınlarda HBsAg, anti-HCV ve anti-HIV sıklığı

Objective: Hepatitis B virus (HBV), hepatitis C virus (HCV) and human immunodeficiency virus (HIV) are viruses that can be transmitted to the health care workers by infected body fluids and from mother to the baby before, during or after delivery. In the present study, we aimed to investigate the frequency of hepatitis B surface antigens (HBsAg), hepatitis C antibodies (anti-HCV), and HIV antibodies (anti-HIV) in pregnant women and/or patients with gynecologic diseases that admit to a university hospital in Bolu. Methods: HBsAg, anti-HCV, and anti-HIV results of the pregnant women and/or patients with gynecologic diseases that admitted to the obstetrics and gynecology clinics between January 2006 and June 2012 were retrospectively investigated. All markers were tested in the microbiology laboratory of our hospital by using macro ELISA method (Axsyme and Architect i2000SR systems, Abbott Diagnostics, Chicago, IL, USA). Results: The frequency of HBsAg, anti-HCV, and antiHIV positivity were 1.8%, 0.5%, and 0% in pregnant women and 1.9%, 1.1%, and 0% in patients with gynecologic diseases, respectively. Conclusion: The frequencies detected in our hospital are at low levels as seen in developed countries. Since there is no effective method of prevention especially from HCV, awareness of this serologic result before high risk procedures will enable the doctors and the health care workers to take extensive measures to prevent the transmission of the disease. J Clin Exp Invest 2013; 4 (2): 166-170

A Multicenter Evaluation of Blood Culture Practices, Contamination Rates, and the Distribution of Causative Bacteria

Background: The prognostic value of blood culture testing in the diagnosis of bacteremia is limited by contamination. Objectives: In this multicenter study, the aim was to evaluate the contamination rates of blood cultures as well as the parameters that affect the culture results. Materials and Methods: Sample collection practices and culture data obtained from 16 university/research hospitals were retrospectively evaluated. A total of 214,340 blood samples from 43,254 patients admitted to the centers in 2013 were included in this study. The blood culture results were evaluated based on the three phases of laboratory testing: the pre-analytic, the analytic, and the post-analytic phase. Results: Blood samples were obtained from the patients through either the peripheral venous route (64%) or an intravascular catheter (36%). Povidone-iodine (60%) or alcohol (40%) was applied to disinfect the skin. Of the 16 centers, 62.5% have no dedicated phlebotomy team, 68.7% employed a blood culture system, 86.7% conducted additional studies with pediatric bottles, and 43.7% with anaerobic bottles. One center maintained a blood culture quality control study. The average growth rate in the bottles of blood cultures during the defined period (1259 - 26,400/year) was 32.3%. Of the growing microorganisms, 67% were causative agents, while 33% were contaminants. The contamination rates of the centers ranged from 1% to 17%. The average growth time for the causative bacteria was 21.4 hours, while it was 36.3 hours for the contaminant bacteria. The most commonly isolated pathogens were Escherichia coli (22.45%) and coagulase-negative staphylococci (CoNS) (20.11%). Further, the most frequently identified contaminant bacteria were CoNS (44.04%). Conclusions: The high contamination rates were remarkable in this study. We suggest that the hospitals’ staff should be better trained in blood sample collection and processing. Sterile glove usage, alcohol usage for disinfection, the presence of a phlebotomy team, and quality control studies may all contribute to decreasing the contamination rates. Health policy makers should therefore provide the necessary financial support to obtain the required materials and equipment.

Determination of Susceptibility to Tigecycline in Extended Spectrum Beta-laktamase Producing Escherichia coli Isolates

İletişim Bilgisi / Correspondence 87 Yard. Doç. Dr. Fırat Zafer Mengeloğlu, Abant İzzet Baysal Üniversitesi Tıp Fakültesi Tıbbi Mikrobiyoloji AD 14280 Bolu Türkiye E-mail: mengeloglu@gmail.com Tel: +90 374 2534656/3264 Geliş tarihi / Received: 10.04.2013 Kabul tarihi / Accepted: 16.04.2013 Çıkar Çatışması / Conflict of Interest: Yok / None Genişlemiş Spektrumlu Beta-laktamaz Üreten Escherichia coli İzolatlarında