Kaya Köksalan

Auxo-, sero-, and opa-typing of Neisseria gonorrhoeae strains isolated in Istanbul, Turkey.

Background: Typing methods are essential in understanding of the transmission dynamics of Neisseria gonorrhoeae. Several typing methods were described including opa-typing. Goals: The goal of this study was to type all of the strains we isolated in the recent past by using auxo-, sero-, and opa-typing, and to compare the discriminatory power of these methods. Study: Auxotyping, serotyping, and opa-typing were performed for 56 N. gonorrhoeae strains isolated from male patients with urethritis. Results: A total of 9 auxotypes and 33 serovars were detected. Combining the 2 systems, a total of 45 distinct auxotype/serovar (A/S) classes were identified. The most common A/S class was NR/Bsty (5 strains). Fifty-five distinct patterns were detected by opa-typing. Two strains that have been isolated 16 months apart gave identical patterns with opa-typing and their A/S class was also identical (NR/Bsty). Simpson’s index of diversity was found as 0.664, 0.961, 0.987, and 0.999 for auxotyping, serotyping, A/S class, and opa-typing, respectively. Conclusions: Opa-typing is a potential useful method for typing N. gonorrhoeae as a result of its high discriminatory power, rapidity, ease and relatively lower cost.

Inherited IL-12Rβ1 Deficiency in a Child With BCG Adenitis and Oral Candidiasis: A Case Report

This is the first case report of a patient with BCG-itis and recurrent oral candidiasis with IL-12Rβ1 deficiency. Tuberculosis is a major worldwide problem, and protection from it is achieved mainly by live attenuated bacille Calmette–Guérin vaccine, which is capable of causing disease in immunocompromised host. Oral thrush is abnormal in healthy children, which suggests an underlying immunodeficiency. Mendelian susceptibility to mycobacterial disease is a rare primary immunodeficiency characterized by a selective predisposition to weakly virulent Mycobacteria and Salmonella and also predisposition to chronic mucocutaneous candidiasis. Interleukin 12 receptor β1 (IL-12Rβ1) deficiency is the most common disease of Mendelian susceptibility to mycobacterial disease, and to date only 50 IL-12Rβ1 deficient patients with clinical signs of chronic mucocutaneous candidiasis have been reported. We report a 2.5-year-old daughter of consanguineous parents with both regional bacille Calmette–Guérin lymphadenitis and recurrent oral candidiasis carrying biallelic R175W mutation in the IL12RB1 gene, resulting in complete loss of expression of IL-12Rβ1. To our knowledge, this is the first report of bacille Calmette–Guérin lymphadenitis with concurrent oral candidiasis displaying such a mutation. New mutations and wide clinical diversities are the indisputable fact of populations with a high rate of consanguineous marriages.

Comparison of tuberculin skin test and QuantiFERON®-TB Gold In-Tube for the diagnosis of childhood tuberculosis

Tuberculosis (TB) is an important worldwide ongoing health issue. To be able to control TB, one should not only cure active TB but also identify childhood TB patients who have the possibility to develop active disease in the future. The aim of this study was to compare a century‐old tuberculin skin test (TST) and QuantiFERON‐TB Gold In‐Tube (QFT‐GIT) test, developed as an alternative to TST and which has been claimed to be superior to TST in several ways, in the diagnosis of childhood TB.

Akciğerde Tüberküloz Dışı Mikobakteri Hastalığı: 42 Vakanın Retrospektif Analizi

Aim: The present study was designed to perform retrospective analysis of 42 cases with non-tuberculous mycobacterial lung infection. Materials and methods: A total of 42 patients (mean(SD) age: 46.69(14.57) years, 37(88.1%) males) diagnosed with NTM lung infection were included in this retrospective descriptive study, treated between 2004 and 2010, Istanbul. Identification was performed with Hsp65PCRREA. Data on therapeutic management, radiological and bacteriological findings, co-morbid diseases and treatment outcomes were obtained from medical records, direct phone calls to patients and tuberculosis dispensaries. Results: The most frequently identified NTM types were M.abscessus, M.avium and M.kansasii (n=14(33.3%), 9(21.4%) and 8(19.0%), respectively). Co-morbid diseases were identified in 20(47.6%) patients. Radiological evaluation revealed cavity in 27(63.4%), segmental or subsegmental homogenous opacities in 23(57.8%) and focal acinar, alveolar, micronodular opacities in 23(57.8%) patients; in 27(64.3%) lesions were bilateral. Drug sensitivity testing for first-line drugs performed in 30 (71.4%) patients revealed isoniazide+rifampicin resistance in 18(60.0%) patients, while drug sensitivity testing for second-line drugs was performed in 16(38.1%) patients. Treatment outcome was cure in 26(61.9%) patients, treatment failure in 2(4.8%), death in 3(7.1%), ongoing treatment in 5(11.9%) and follow-up without treatment in 5(11.9%) patients while treatment discontinuation in 1(2.4%) patient. Conclusion: Identification of the mycobacterium in patients with pulmonary TDM infection is essential for correct diagnosis and best treatment planning, and also to obtain real-life epidemiologic data in Turkey.