Selçuk Kiliç

Higher prevalence of toxoplasmosis in victims of traffic accidents suggest increased risk of traffic accident in Toxoplasma-infected inhabitants of Istanbul and its suburbs ☆

Reflexes of drivers who have toxoplasmosis have been shown to deteriorate from the actions of the parasitic cysts. The cysts can change the level of the neurotransmitters such as dopamine in the brain and by doing so extend the muscle response time and change personality profiles. In this study, we aimed to determine the frequency of the latent toxoplasmosis (LT) in the driver population who were either injured or died in traffic accidents reported in Istanbul and its suburbs. We compared the results with a control group and discussed the relationship between the LT and the traffic accidents. We included 218 (89.7%) non-fatal, 25 (10.3%) fatal cases in our study as study groups. A total 243 subjects, 234 (96%) male, 9 (4%) female (who were alcohol negative) compared with 191 (95.5%) male and 9 (4.5%) female subjects (control group) who had a traffic accident before but no history of toxoplasmosis were studied. Serologic tests, enzyme immunoassay (EIA) for IgG and IgM, and microimmunoflorescence (MIF) for IgG were used as the reference test, the Sabin-Feldman Dye test (SFDT) was used. According to serologic test results, LT seroprevalence in the study groups was 130 (53.5%) and in the control group 56 (28%) (p<0.0001). A LT was present in 126 out of 234 (53.8%) males in the study groups, and 54 out of 191 (28.3%) males in the control group (p<0.0001). In the 31-44 year age group, there was a significant difference with regard to toxoplasmosis between the study subjects and control groups (p<0.0001). This difference was statistically very significant in (recent and former) cases with middle-aged men (31-44 years old). The results of this retrospective study suggest that LT in drivers, especially those who are between 31 and 44 years might increase the risk for getting involved in a car accident. In a prospective study, Toxoplasma positive and negative subjects can be monitored before they are involved in a traffic accident to clarify the cause and result relationship.

Seroprevalence of Neospora caninum in dairy cattle ranches with high abortion rate: special emphasis to serologic co-existence with Toxoplasma gondii, Brucella abortus and Listeria monocytogenes.

The aim of this study was to determine seroprevalence of Neospora caninum in dairy cattle ranches with higher abortion rates and co-existence of Neospora caninum, Toxoplasma gondii, Brucella abortus, and Listeria monocytogenes antibodies. The blood samples were collected from dairy cows with history of abortion (n=234) as well as from pregnant cows that were (n=323) kept in the same ranches. N. caninum seroprevalence was 10.77% (60/557). The co-existence rate of N. caninum seropositivity with T. gondii, B. abortus and L. monocytogenes was 24.77% (138/557), 13.82% (77/557) and 42.85% (162/378), respectively. Only one animal had significant antibody titers for all analyzed infectious agents. The seroprevalence of N. caninum and T. gondii were significantly higher in pregnant cows than aborted cows (p<0.05 and p<0.001, respectively). As a result, the comprehensive data generated through this study can significantly contribute to understanding of serologic association of N. caninum with T. gondii, B. abortus and L. monocytogenes in pregnant and aborted dairy cows.

Antimicrobial susceptibilities of Francisella tularensis subsp. holarctica strains isolated from humans in the Central Anatolia region of Turkey

OBJECTIVES To assess the in vitro susceptibility of Francisella tularensis subsp. holarctica biovar II strains to 24 antimicrobial agents. METHODS Thirty-nine F. tularensis strains isolated from humans in the Central Anatolia region of Turkey were examined. Each isolate was identified by conventional and molecular techniques. MICs of aminoglycosides, tetracyclines, fluoroquinolones, macrolides, penicillins, cephalosporins, imipenem, clindamycin, linezolid, chloramphenicol and rifampicin were determined using the Etest method on glucose/cysteine blood agar plates. Interpretation of results was made according to CLSI clinical breakpoints. RESULTS All strains were susceptible to aminoglycosides, tetracyclines, chloramphenicol, rifampicin and three fluoroquinolones. In contrast, resistance to penicillins, cephalosporins, carbapenems, macrolides and clindamycin was observed for all isolates. Fluoroquinolones had the lowest MIC(50) and MIC(90). CONCLUSIONS All strains were susceptible to the antibiotics traditionally used to treat tularaemia, such as streptomycin (MIC(90) 1.5 mg/L), gentamicin (MIC(90) 0.25 mg/L), tetracycline (MIC(90) 0.38 mg/L) and chloramphenicol (MIC(90) 0.25 mg/L). Since fluoroquinolones showed the lowest MIC values, and have important advantages over aminoglycosides, including ease of oral administration and lower toxicities, quinolones have the potential for being effective first-line therapy for tularaemia.

Urogenital myiasis caused by Psychoda albipennis (Diptera: Nematocera) in Turkey

We report a 21-year-old female patient from Sakarya, Turkey, who visited our hospital with pain in the right costo-lumbar region. She also complained of irritation in the vagina, dysuria, polyuria, hematuria, vomiting and diarrhea. Physical examination of the patient did not reveal any abnormalities. Biochemical examination revealed a slight decrease in hemoglobin (10.8 g/ l) and hematocrit (34%) levels. Microscopic examination of the urine showed the presence of 6–7 leukocytes and 8–10 erythrocytes. Radiological and ultrasonographic examinations showed that the patient was suffering from kidney stones (nephrolithiasis), and a 2-cm diameter stone was seen in the right kidney. The patient was treated with the extracorporeal shockwave lithotripsy. During her stay in the hospital five grayishbrown larvae, approximately 3 mm in length, were isolated from her urine. They were killed in boiling water and placed in 5% glycerin in 70% ethyl alcohol. The larvae were identified as the fourth stage of the moth fly Psychoda albipennis (Fig. 1). No more larvae were collected from the patient and the urogenital and gastrointestinal symptoms ceased within a month.

In vitro susceptibility of isolates of Francisella tularensis from Turkey.

Abstract Background: Tularemia is an infection caused by Francisella tularensis, which has a wide distribution in the northern hemisphere and diverse clinical manifestations. For decades, the drug of choice for the treatment of tularemia has been streptomycin, with tetracycline and chloramphenicol being used as alternatives. The purpose of the present study was to determine the in vitro antimicrobial susceptibility of a large panel of geographically diverse F. tularensis isolates from Turkey against traditional and newer antimicrobial agents. Methods: The antibiotic susceptibilities of 250 F. tularensis strains were examined using the Epsilometer test for 9 antimicrobial agents. Each isolate was identified by conventional and molecular techniques. Results: All the strains were confirmed biochemically and using a combination of species- and subspecies-specific polymerase chain reaction (PCR) assays to be F. tularensis subsp. holarctica. One isolate was assigned to F. tularensis subsp. holarctica biovar japonica based on erythromycin susceptibility, an ability to ferment glycerol, and the nucleotide sequence of the region of difference 1 (RD1). All strains were susceptible to aminoglycosides (streptomycin and gentamicin), tetracyclines (tetracycline and doxycycline), chloramphenicol, 2 fluoroquinolones (ciprofloxacin and levofloxacin), and rifampicin. In addition, all isolates except 1 had a minimal inhibitory concentration (MIC) for erythromycin of > 256 μg/ml. Conclusions: Since the fluoroquinolones showed the lowest MIC values and have advantages such as excellent bioavailability and activity, availability of oral formulations, and lower toxicities, they represent candidate therapeutic options in the first-line treatment of tularemia. To the best of our knowledge, this is the first report of the presence of F. tularensis subsp. holarctica biovar japonica outside Japan.

Evaluation of a commercial immunochromatographic assay for the serologic diagnosis of tularemia.

Tularemia is an infection caused by Francisella tularensis with a worldwide distribution in the northern hemisphere and diverse clinical manifestations. Serology plays an important role in the diagnosis of tularemia. A commercially available immunochromatographic assay (ICA) for the serologic diagnosis of tularemia (VIRapid Tularemia, Vircell, Granada, Spain) was evaluated, and the performance was compared with that of the current standard, the microagglutination test (MA). A panel of 221 sera from 109 cases of tularemia was tested as well as 236 sera from normal individuals or individuals with other infectious or autoimmune diseases. The ICA demonstrated 91.5% (κ = 0.91) agreement with the reference method (MA) and gave an overall sensitivity of 99.3% and a specificity of 94.6%. No cross-reactivity was observed in the ICA with serum samples from normal individuals and patients with autoimmune diseases and bacterial, viral, and parasitic infections, although 4 of 50 patients with brucellosis demonstrated positive results in the ICA. The performance of ICA was simple, and it requires no specialized equipment. The ease of use and significantly high sensitivity and specificity of ICA make it a good choice for diagnostic testing and a valuable field test to support a presumptive diagnosis of tularemia in remote areas.

Water as Source of Francisella tularensis Infection in Humans, Turkey.

Francisella tularensis DNA extractions and isolates from the environment and humans were genetically characterized to elucidate environmental sources that cause human tularemia in Turkey. Extensive genetic diversity consistent with genotypes from human outbreaks was identified in environmental samples and confirmed water as a source of human tularemia in Turkey.

Prevalence of Toxoplasma gondii antibodies in domestic (Columba livia domestica) and wild (Columba livia livia) pigeons in Niğde region, Turkey.

OBJECTIVE The present study was conducted to investigate the prevalence of Toxoplasma gondii specific antibodies in domestic (Columba livia domestica) and wild (Columba livia livia) pigeons between October 2003-June 2004. METHODS Blood samples were collected from 216 pigeons, consisting of 105 (55 female, 50 male) domestic pigeons and 111 (53 female, 58 male) wild pigeons. The sera were tested for T. gondii antibodies using the Sabin Feldman Dye Test (SFDT). RESULTS One of the 105 (0.95%) domestic pigeon and one of the 111 (0.90%) wild pigeon were found to be seropositive for T. gondii antibodies at the titer of 1:16. CONCLUSION This is the first serological study on toxoplasmosis in the domestic and wild pigeon in the Niğde region of Turkey.

Antimicrobial susceptibility and molecular subtyping of 55 Turkish Bacillus anthracis strains using 25-loci multiple-locus VNTR analysis

Anthrax, which is caused by the bacterium Bacillus anthracis, is one of the oldest documented infectious diseases in both livestock and humans. The differentiation of B. anthracis strains is difficult because of their highly homogeneous genomes. We used multiple-locus variable-number tandem repeat analysis (MLVA) with 25 markers to genotype 55 B. anthracis isolates from 16 distinct regions of Turkey. The antimicrobial susceptibility of the isolates was investigated using the agar dilution method. An eight-loci MLVA assay revealed six unique genotypes (G(K)13, G(K)27, G(K)35, G(K)43, G(K)44, and G(K)61). However, the 25-loci MLVA was more discriminatory, revealing the presence of ten genotypes instead of six. The additional genotypes resulted from the split of four subtypes: G(K)35 (b and c), G(K)43 (a and f), G(K)44 (d and e), and G(K)61 (i and j). All of the Turkish B. anthracis isolates were susceptible to ciprofloxacin, levofloxacin, tigecycline, linezolid, and vancomycin. One isolate was resistant to penicillin and to doxycycline. A total of 34 isolates were susceptible, 20 isolates were partially susceptible, and one isolate was resistant to erythromycin. None of the isolates exhibited susceptibility to cefotaxime. A total of 53 isolates were susceptible to gentamicin, and two were resistant. The genotypes G(K)35 (n=24), G(K)44 (n=13), and G(K)43 (n=10) were the most prevalent in 10, 6, and 5 regions, respectively, of the total 16 provinces. The B. anthracis isolates collected from these regions implied that the movement of B. anthracis is a result of the increased transportation of livestock and the resultant cross contamination.

Prevalence of Toxoplasma gondii antibodies and intestinal parasites in stray cats from Nigde, Turkey

Abstract The prevalence of antibodies to Toxoplasma gondii was investigated by the Sabin-Feldman Dye test (SFDT) in 72 stray cats from Nigde, Turkey. A total of 55 (76.4%) of the analysed sera had antibodies to T. gondii. The seropositivity of T. gondii was 77.1% in male and 75.7% in female cats (P>0.05). Faeces of these cats were also examined by zinc sulphate flotation method for the presence of parasite oocysts and eggs of other parasites. Two protozoan parasites were identified as Isospora spp. (12.5%) and Eimeria spp. (4.1%) in cats. Toxoplasma gondii oocysts were not found in any faecal samples analysed. Two parasitic helminth species were observed: Toxocara cati (15.2%) and Toxascaris leonina (20.8%). These common ascarids were recorded for the first time in cats from Nigde.