Sedat Kaygusuz

A case of brucellar septic arthritis of the knee with a prolonged clinical course.

Brucellosis is a systemic infectious disease with a broad spectrum of clinical manifestations. Arthritis is frequently observed in its course and may be one of the main presenting clinical features of the disease. We report a case of brucellar monoarthritis of the knee with a prolonged clinical course despite efficient antibiotic treatment.

Seroprevalence of tetanus immunity among noninsulin-dependent diabetes mellitus patients

Tetanus is a preventable disease that continues to affect people in both developing and developed countries. The aim of the present study was to evaluate the immunity profile to tetanus in patients with Type II diabetes mellitus (DM) and to compare them with healthy controls. The tetanus antitoxin levels in 310 diabetic patients (104 males and 206 females) and in 200 healthy controls (72 males and 128 females) were measured by ELISA (Virotech, Germany). The mean antitoxin concentration in patient and control groups were 0.8238+/-1.61 and 0.9978+/-1.49 IU/ml, respectively. There was a statistically significant difference between the two groups (z=-3.520, P=.0001 and odds ratio was 2.367). There was a definitive inverse correlation between the duration of diabetes and tetanus antibody titers (Spearmans correlation analysis, r=-.155, P=.006). A gender-dependent difference in the susceptibility to tetanus was present in the diabetic group with antibody titers being significantly higher in males compared with females (z=-2.267, P=.023). For both of control (chi(2)=20.207, P=.003) and patient (chi(2)=43.532, P=.0001) groups, there was a significant inverse correlation between the tetanus immunity levels and age. Statistically, a significant drop in antibody titers of both groups was found as the period past from the last immunization increased (Pearson correlation analysis: for patient group r=-.364, P=.0001; for control group r=-.143, P=.044). The tetanus antitoxin levels were significantly increased in individuals who had primary immunization during childhood (for patient group chi(2)=17.191, P=.0001; for control group chi(2)=9.911, P=.007). A significant reduction in the level of antitoxin immunity to tetanus in association with an increased susceptibility to infections in patients with diabetes may implicate the need for improving vaccination rates in this patient group.

Tetanus Antitoxin Seroprevalence in Patients with Behçet's Disease

Anti-tetanus antibody status was evaluated by enzyme-linked immunosorbent assay in 82 patients with Behçets disease and 79 healthy individuals. 76 patients with Behçets disease (92.7%) and 74 healthy controls (93.7%) had protective antibody titres against tetanus, with geometric mean levels of 1. 0194±1.2755 and 1.3899±1.6533 IU/ml, respectively. The difference between the 2 groups was not statistically significant. There was a significant inverse correlation between antitoxin titres and age in patient and control groups. These findings imply that patients with Behçets disease have intact overall immunity against tetanus.

Afebrile Convulsion in an Adult after Recombinant Hepatitis B Vaccination

Vaccination against HBV is important in order to reduce the incidence of HBV infection. Although the HBV vaccine is among the safest of all vaccines, vaccination against HBV has been associated with side-effects. Herein we present a case of afebrile convulsion after recombinant HBV vaccination.

A study of the chikungunya virus in humans in Turkey

Background/aim: The chikungunya virus (CHIKV) is a mosquito-borne disease and has recently been causing explosive outbreaks. The CHIKV has spread throughout all continents. Although the first chikungunya case imported from India to Turkey was reported in 2012, there is no detailed epidemiologic study in Turkey yet. The aim of this study was to investigate the seroprevalence of the CHIKV in Turkey. Materials and methods: ELISA was used to screen 500 random serum samples of healthy people collected from Kırıkkale, which is located in central Anatolia in Turkey. The results were verified by indirect immunofluorescence test (IIFT). Results: The results showed that 0.4% samples were positive for CHIKV. In the verification study with IIFT, CHIKV IgG type antibodies were defined as negative. To the best of our knowledge, this is the first serological study on the CHIKV in Turkey. Conclusion: Further studies are needed to elucidate the epidemiological situation in patients that have fever and arthritis.

Üçüncü basamak bir referans hastanesinde izole edilen metisilin dirençli stafilokok suşlarında duyarlılık

Objectives: Methicillin resistant Staphylococcus strains still remain as an important reason of hospital acquired infections. The aim of this study to see the antimicrobial sensitivity patterns of these strains for effective empirical therapy Material and methods: Antibiotic susceptibility results of staphylococcus strains were investigated retrospectively from tertiary reference hospital. 276 methicillin resistant staphylococcus species, which were isolated from

Echinococcosis: A Possible Etiology in Psoriatic Disease

We aimed to investigate seroprevalence of Echinococcus granulosus in patients with psoriasis to determine a possible etiologic role, since both echinococcosis and psoriasis are defined as T cell-mediated diseases. Forty psoriatic patients and 50 age- and sex-matched control subjects were included in the study. IgG-specific ELISA was used to determine seropositivity. E. granulosus-specific IgG antibodies were found to be positive in 17/40 (42.5%) of the patients with psoriasis and in 11/50 (22%) of the control subjects (p = 0.008). Our results suggest thatechinococcosis might be one of the causative pathogens in the etiopathogenesis of psoriasis in highly endemic regions.

Neopterin levels in nonreplicative HBV carriers

The aim of this study was to determine the existence of immune activation by measuring neopterin in HBV (Hepatitis B virus) carriers with viral load (HBV DNA) less than 5 pg/ml. Forty-three subjects and 56 healthy controls were included in the study. Neopterin levels of were compared. ALT and ALP levels in one patient and AST levels in two patients were found minimally higher than upper limit, and GGT levels were within the reference range in all patients. Neopterin levels in the patient group and in the controls were 159.97+/-13.39 and 84.10+/-11.45 nmol/l, respectively (P<0.0001). The difference between the two groups was statistically significant (P<0.0001). In conclusion, the increased neopterin levels of HBV carriers might be the indicators of the effect of cellular immunity. This increase might also implicate a background inflammation based on mainly cellular immunity that exists within the liver.

Evaluation of the approaches and knowledge level of tuberculosis diagnosis and treatment of infectious disease research assistants and specialist physicians

Introduction This study aims to evaluate approaches and knowledge level for tuberculosis (TB) diagnosis and treatment among infectious diseases and clinical microbiology research assistants and specialist physicians. Materials and Methods This was a descriptive study on the research assistants and specialist physicians. A questionnaire consisting of 24 questions prepared by the researchers was used. Data were analyzed using SPSS, version 22.0. Result In this study, 116 physicians participated. The average age of participants was 41.07 ± 8.65 years, and 64.7% were female. The proportion of physicians with no pulmonary and non-pulmonary TB experience was calculated as 6.9% and 3.4%, respectively. Acid-fast-bacilli (AFB) tests were most frequently used in the diagnosis of pulmonary TB. On the other hand, the tuberculin skin test (TST) + chest radiography (CR) was most frequently used for latent TB in immunosuppressed subjects (91.4% and 69%, respectively). The most common non-pulmonary TB clinic form encountered was lymphadenitis (88.8%); the most common treatment problem was drug side effects (75%); and the most common drug resistance was to isoniazid (25.9%). It was determined that physicians encountered HIV and TB coinfection in 62.9% of patients, and standard TB treatment was applied for most patients (48.3%). The most frequent yearly TST + CR + AFB trials (69%) were performed in the screenings of health workers who were in contact with TB patients. It was observed that 44% of physicians used a negative pressurized chamber and/or isolation chamber in the institution, and 72.4% used a N95/FFP3 mask during examination. It was determined that the participants were mostly correct about TB. Conclusions Infectious diseases and clinical microbiology physicians continue to encounter TB patients. This group of physicians often has a good level of knowledge and experience with TB, although special training for this disease is low.

İdrar Kültürlerinden İzole Edilen Bakteriler ve Antibiyotik Duyarlılıkları

Uriner sistem enfeksiyonlari, toplum kokenli ve saglik bakimi ile iliskili enfeksiyonlar arasinda en sik gorulen enfeksiyondur. Uriner enfeksiyonlarda tedavi genellikle ampirik olarak baslandigi icin etkenlerin ve antibiyotik duyarlilik paternlerinin bilinmesi tedavi basarisi icin onemlidir. Bu calismada Kirikkale Universitesi Tip Fakultesi Hastanesi Enfeksiyon Hastaliklari ve Klinik Mikrobiyoloji Laboratuarinda Şubat 2013 –Şubat 2014 tarihleri arasinda idrar kulturlerinden izole edilen bakteriler ve bu bakterilerin antibiyotik duyarliliklari degerlendirilmistir. Idrar kulturunde ureme saptanan hastalar antibiyotik kullanimi ve/veya hastanede yatis oykusune gore iki gruba ayrilmistir. Grup 1, antibiyotik kullanimi olmayan ve/veya hastanede yatis oykusu bulunmayan; grup 2, antibiyotik kullanimi olan ve/veya hastanede yatis oykusu bulunan hastalardan olusturulmustur. Bakteri tanimlanmasinda ve antibiyotik duyarliliklarinin saptanmasinda Vitek 2 otomatize sistem kullanilmistir. Toplam 118 bakteri calismaya alinmistir. Birinci grup 45 ve ikinci grup 73 bakteri mevcuttu. Sonuc olarak; her iki grupta da en sik izole edilen bakteri Escherichia coli olmakla birlikte iki grup arasinda etken ve duyarlilik sonuclari bakimindan anlamli farkliliklar saptanmistir.