Murat Kutlu

Risk factors for occupational brucellosis among veterinary personnel in Turkey

Veterinarians and veterinary technicians are at risk for occupational brucellosis. We described the risk factors of occupational brucellosis among veterinary personnel in Turkey. A multicenter retrospective survey was performed among veterinary personnel who were actively working in the field. Of 712 veterinary personnel, 84 (11.8%) had occupational brucellosis. The median number of years since graduation was 7 (interquartile ranges [IQR], 4-11) years in the occupational brucellosis group, whereas this number was 9 (IQR, 4-16) years in the non-brucellosis group (p<0.001). In multivariable analysis, working in the private sector (odds ratio [OR], 2.8; 95% confidence interval [95% CI], 1.55-5.28, p=0.001), being male (OR, 4.5; 95% CI, 1.05-18.84, p=0.041), number of performed deliveries (OR, 1.01; 95% CI, 1.002-1.02, p=0.014), and injury during Brucella vaccine administration (OR, 5.4; 95% CI, 3.16-9.3, p<0.001) were found to be risk factors for occupational brucellosis. We suggest that all veterinary personnel should be trained on brucellosis and the importance of using personal protective equipment in order to avoid this infection.

The first report of Brucella suis biovar 1 isolation in human in Turkey

BACKGROUND Brucella melitensis and B. abortus are the species generally isolated from human samples in Turkey. Several studies have also demonstrated the presence of antibodies against B. canis. CASE REPORT AND STUDY Brucella spp. was isolated from blood culture from a 35-year-old male with clinical signs and symptoms of acute meningitis, including fever lasting for 1 week. Multiplex PCR demonstrated B. suis, and biochemical features indicated biovar 1. CONCLUSIONS This report is the first emphasizing that B. suis should be considered among the causes of brucellosis in Turkey.

Acute Brucella melitensis M16 infection model in mice treated with tumor necrosis factor-alpha inhibitors

INTRODUCTION There is limited data in the literature about brucellosis related to an intracellular pathogen and anti-tumor necrosis factor alpha (anti-TNFα) medication. The aim of this study was to evaluate acute Brucella infections in mice receiving anti-TNFα drug treatment. METHODOLOGY Anti-TNFα drugs were injected in mice on the first and fifth days of the study, after which the mice were infected with B. melitensis M16 strain. Mice were sacrificed on the fourteenth day after infection. Bacterial loads in the liver and spleen were defined, and histopathological changes were evaluated. RESULTS Neither the liver nor the spleen showed an increased bacterial load in all anti-TNFα drug groups when compared to a non-treated, infected group. The most significant histopathological findings were neutrophil infiltrations in the red pulp of the spleen and apoptotic cells with hepatocellular pleomorphism in the liver. There was no significant difference among the groups in terms of previously reported histopathological findings, such as extramedullary hematopoiesis and granuloma formation. CONCLUSIONS There were no differences in hepatic and splenic bacterial load and granuloma formation, which indicate worsening of the acute Brucella infection in mice; in other words, anti-TNFα treatment did not exacerbate the acute Brucella spp. infection in mice.

Bartonella henselae seroprevalence in cattle breeders and veterinarians in the rural areas of Aydin and Denizli, Turkey.

Bartonella henselae infections are usually detected among people who have close contact with animals. Veterinarians and cattle breeders, in particular, are considered as the risk groups for B. henselae infections. In this study, the seroprevalence of antibodies to B. henselae was investigated in these two groups of subjects in the two cities of Aydin and Denizli, which are located in the same region in the southwest of Turkey. Total antibodies to B. henselae were evaluated by indirect immunofluorescence assay in serum samples taken from 63 cattle breeders and 27 veterinarians. Twenty samples (22.2%) were found to react on 1/64 titre with B. henselae antigens. Bartonella henselae seroprevalence was found to be significantly related to age (P = 0.033) and higher in those living in Aydin (P = 0.047). Age was the only independent factor in multivariate analysis (P = 0.008). Seroprevalence was found to be 2‐fold higher in those people who had had tick contact (P = 0.093). In conclusion, the physicians in the region should consider B. henselae infection among veterinarians and breeders in their differential diagnosis list of fever of unknown origin.

Prosthetic Valve Endocarditis and Disseminated Infection Caused by Streptococcus equi

In this case report, we present a patient with meningitis, cerebral and paravertebral abscess and arthritis in addition to prosthetic valve endocarditis treated surgically and medically due to Streptococcus equi accepted as S. equi subsp. zooepidemicus with its epidemiological and clinical features despite it could not be identified to subspecies level. Klimik Dergisi 2018; 31(1): 61-3.

HIV-associated mild neurocognitive disorder (MND)

Abbreviations HIV Human immunodeficiency virus HAD HIV-associated dementia complex MND Mild neurocognitive disorder AIDS Acquired immunodeficiency syndrome HAART Highly active antiretroviral therapy HAND HIV-associated neurocognitive disorders ANI Asymptomatic neurocognitive impairment MRI Magnetic resonance imaging CSF Cerebrospinal fluid CT Computerized tomography FLAIR Fluid-attenuated inversion recovery MCMD Minor cognitive/motor disorder

Hepatocellular Carcinoma in a Chronic Hepatitis B Patient With Suppressed Viral Replication

Yazışma Adresi / Address for Correspondence: Murat Kutlu, Pamukkale Üniversitesi, Tıp Fakültesi, İnfeksiyon Hastalıkları ve Klinik Mikrobiyoloji Anabilim Dalı, Denizli, Türkiye E-posta/E-mail: muratkutlu72@yahoo.com (Geliş / Received: 20 Ekim / October 2015; Kabul / Accepted: 28 Temmuz / July 2016) DOI: 10.5152/kd.2016.31 Viral Baskılanma Sağlanan Kronik Hepatit B Hastasında Hepatoselüler Kanser Gelişimi