Nurittin Ardic

Ly6C hi inflammatory monocytes promote susceptibility to Leishmania donovani infection

Ly6Chi inflammatory monocytes (iMO) are critical for host defense against toxoplasmosis and malaria but their role in leishmaniasis is unclear. In this study, we report a detrimental role of Ly6Chi iMOs in visceral leishmaniasis (VL) caused by Leishmania donovani. We demonstrate that Ly6Chi iMOs are continuously recruited into the spleen and liver during L. donovani infection and they are preferential targets for the parasite. Using microarray-based gene expression profiling, we show that Ly6Chi iMOs isolated from the infected liver and spleen have distinct phenotypic and activation profiles. Furthermore, we demonstrate that blocking the recruitment of Ly6Chi iMOs into the liver and spleen during L. donovani infection using a CCR2 antagonist reduces the frequency of the pathogenic IFN-γ/IL10 dual producer CD4+ T cells in the spleen and leads to a significant reduction in parasite loads in the liver and spleen. Using STAT1−/− mice we show that STAT1 is critical for mediating the recruitment of Ly6Chi iMOs into organs during L. donovani infection, and adaptive transfer of wild type Ly6Chi iMOs into STAT1−/− recipients renders them susceptible to disease. Our findings reveal an unexpected pathogenic role for Ly6Chi iMOs in promoting parasite survival in VL and open the possibility of targeting this population for host-directed therapy during VL.

Pediatric Cutaneous Leishmaniasis in an Endemic Region in Turkey: A Retrospective Analysis of 8786 Cases during 1998-2014.

Background Cutaneous leishmaniasis (CL) is a major public health concern in Turkey and Sanliurfa represents the most endemic city in Turkey. Although children are most commonly affected by CL, detailed studies of pediatric CL in Turkey are lacking. Methodology/Principal Findings In this report we retrospectively evaluated clinical and epidemiological data of 8786 pediatric CL cases, and how children respond to antimonial therapy. CL was observed most frequently in children between 6–10 years old. Interestingly this group showed shorter duration of disease and smaller lesions compared to 0–5 year and 11–15 year old groups. Females were more affected in all groups. Lesion localization and types varied among groups, with 0–5 year old presenting head/neck and mucosal lesions, and more often suffered from recidivans type, this could be associated to the longest duration of the disease in this group. Eleven-15 year old group showed fewer lesions in the head/neck but more generalized lesions. Evaluation of treatment response revealed that intra-lesional treatment was preferred over intramuscular treatment. However, 0–5 year old received intramuscular treatment more often than the other groups. Furthermore, the majority of 0–5 year old group which received intra-lesional treatment did not received subsequent intra-lesional cycles, as did children in the range of 6–15 years old. Conclusions/Significance We report an increase in pediatric CL patients within the last four years. Analysis of pediatric CL patients by age revealed significant differences in CL progression. The data suggest that children between 0–5 years old responded better than other groups to intralesional treatment, since they received more often a single cycle of IL treatment, although follow up observation is required since they were more prone to develop recidivans. Eleven-15 year old patients comprise the largest percentage of patients receiving two or three cycles of intralesional treatment, suggesting that this group did not respond efficiently to intralesional treatment and highlighting the need for more effective therapeutic strategies against CL.

Meglumine antimoniate is more effective than sodium stibogluconate in the treatment of cutaneous leishmaniasis

Abstract Sodium stibogluconate (SSG, Pentostam) and meglumine antimoniate (MA, Glucantime) are two antimonials that are widely used to treat cutaneous leishmaniasis (CL), but the relative efficacies of these treatments are not clear. The aim of this study is to compare the efficacy of intralesional SSG with intralesional MA therapy in the treatment of CL. One month after completion of the therapy, 1431 of 1728 patients (82%) who received intralesional MA showed complete clinical cure compared to 1157 of 1728 patients (67%) in the SSG group. Patients who did not respond to the first round of therapy were re-administered the same treatment but with twice weekly injections. Following completion of the second course of therapy, 237 of 297 patients (80%) in the MA group and 407 of 561 patients (72%) in the SSG group healed their lesions by 1-month post-treatment. At both times, the differences in cure rates between MA and SSG groups were statistically significant (p < 0.05). Cure rates in the MA group were always significantly higher than SSG groups irrespective of other parameters including age, gender, lesion site and type of lesion. Intralesional MA is more effective than intralesional SSG in the treatment of CL.

Lip leishmaniasis: Clinical characteristics of 621 patients.

© 2015 International Journal of Critical Illness and Injury Science | Published by Wolters Kluwer Medknow Dear Editor, Old world leishmaniasis is seen in a wide geographical area including Turkey, as well. The causative agent is generally Leishmaniasis tropica, and the agent is rarely identified to be leishmaniasis major in such patients.[1] Depending on the leishmaniasis type and the person’s immune system, it may be in one of the cutaneous, mucocutaneous leishmaniasis (ML), or visceral leishmaniasis (VL) forms.[2] Mucosal involvement is rarely seen with old world leishmaniasis.[3] ML disease is an important endemic disease and public health problem in undeveloped countries, since it has a significant rate of morbidity and mortality.[4]

Rapid Identification of Klebsiella pneumoniae by Matrix-Assisted Laser Desorption/Ionization-Time of Flight Mass Spectrometry and Detection of Meropenem Resistance by Flow Cytometric Assay.

The aim of this study was to develop a rapid detection method of carbapenem‐resistant Klebsiella pneumoniae (CRKP) strains both MALDI‐TOF MS and flow cytometry (FCM).

The effect of hyperbaric oxygenation on thein vitro growth ofEscherichia coli in environments with and without blood cells

The aim of this study was to investigate whether thein vitro presence of blood cells influences the anti-microbial activity of hyperbaric oxygen (HBO) againstEscherichia coli. FiftyE. coli isolates from clinical samples were used in the study. A small number of colonies belonging to each isolate from the nutrient media were transferred into two K3EDTA tubes (the blood group) and two Mueller-Hinton broth tubes (the broth group). Then, both groups were divided into subgroups according to whether HBO was administered (HBO subgroup) or not (non-HBO subgroup). HBO treatment was applied for one hour at 2.5 absolute atmospheres. The tubes in the non-HBO subgroup were left at room temperature during this period. Subsequently, all the tubes were cultured on Mueller-Hinton and Eosin Methylene Blue agar using the quantitative counting technique. After 18 to 24 h incubation at 37 °C, the colonies formed in the plates were counted. In the blood group, compared with non-HBO subgroup samples, the number of colonies decreased in 56% of samples, increased in 32% of samples and did not change in 12% of samples in the HBO subgroup. Whereas, in the broth group the number of colonies decreased in only 32% of samples increased in 38% of samples and did not change in 30% of samples in the HBO subgroup compared with the non-HBO subgroup. The difference between the blood and the broth groups revealed a statistical significance using Pearson’s Chi-square test (P=0.025). We concluded that the antibacterial effect of HBO onE. coli increases in the cellular environment belonging to the host organism.

Helicobacter pylori isolation, serology and cagA, cagE and virB11 detection in patients with non-ulcer dyspepsia from Turkey: Correlation with histopathologic findings

Colonization with Helicobacter pylori (HP) may have major clinical consequences and HP virulence factors are associated with more severe gastroduodenal pathologies. In this study, prevalence of HP in patients with Non-Ulcer Dyspepsia (NUD) was determined by rapid urease test and culture and correlations of histopathologic changes with bacterial virulence factors and serologic profiles were investigated. Gastric biopsies from sixty-nine patients admitted to Haydarpasa Training Hospital Department of Gastroenterology were evaluated for rapid urease, HP isolation and examined histopathologically. PCR was employed for HP confirmation and detection of HP cagA, cagE and virB11 genes. For each patient, IgG and IgA antibodies and anti-cagA antibodies were also determined by ELISA tests. HP was isolated and confirmed by PCR in 74% (51/69) of the patients. Anti-HP IgG and IgA were detected in 96% (49/51) and 53% (27/51), respectively. Anti-cagA were present in 51% (26/51). cagA, cagE and virB11 were positive in 56.8% (29/51), 60.7% (31/51) and 58.8% (30/51) of the patients, respectively. Statistically significant correlation was observed between cagA PCR and inflammation/activity scores. Detection of cagA by molecular assays can be an alternative test that can be employed for individual patient assessment.

Cross-resistance and associated resistance in Escherichia coli isolates from nosocomial urinary tract infections between 2004–2006 in a Turkish Hospital

In this study, antimicrobial resistance profiles were determined for 748 isolates of Escherichia coli from patients with acute nosocomial urinary tract infections (UTIs) at a Turkish Training Hospital. Thirteen antibiotics were included. Resistance to ampicillin alone (45.1%) and ciprofloxacin alone (20.6%) were the most commonly identified ‘single resistances’. Multiple resistance was found in 49.7% of the strains. The most common multiple antibiotic resistance profiles included ampicillin-sulbactam/amoxycilline-clavulonate (4.0%) and ampicillin-sulbactam/trimethoprim-sulfamethoxazole/amoxycilline-clavulonate (2.8%). From 2004 to 2006, ampicillin, trimethoprim-sulfamethoxazole and ciprofloxacin resistant strains increased to 76% from 57%, 53% from 43% and 55% from 41%, respectively. The percentage of extended-spectrum β-lactamase (ESBL) producing strains was 7.8% and imipenem resistance was seen in 5.2% of ESBL positive strains. We conclude that clinically important E.coli strains have now emerged with broader multidrug resistance. Periodical evaluation of laboratory results and clinical surveillance are crucially important for optimal antibiotic management of UTIs and infection control policies.