Fatma Esenkaya Taşbent

A significant portion of women encounter vaginal infections at some point in their lives. These infections have many effects such as infertility, pelvic inflammatory disease (PID), severe disseminated infections, and complications affecting fetal health during pregnancy. Vaginal infections can be symptomatic or asymptomatic, thereby concealing their presence. This study aimed to determine the frequency and causative agents of vaginal infections in symptomatic and asymptomatic women in Konya. The study included 200 patients aged > 18 years who visited the gynecology clinic for any reason and provided informed consent. Patients who reported at least one of the symptoms of vaginal discharge, burning, or itching were categorized into the symptomatic group, while those without any of these complaints were categorized into the asymptomatic group. Vaginal swab samples collected from the patients were evaluated for bacterial vaginosis (BV) using the Nugent scoring method on Gram-stained smears. Trichomonas vaginalis was investigated through Giemsa-stained microscopic examination and polymerase chain reaction (PCR) analysis. Samples were also cultured on routine media to analyze fungal and bacterial growth. A total of 74% of the patients were symptomatic, and 26% were asymptomatic and were admitted to the gynecology outpatient clinic for reasons other than vaginitis. According to the Nugent scoring system, BV was observed in 21.6% of the symptomatic group and 13.5% of the asymptomatic group. T. vaginalis was detected in only seven patients (3.5%) through microscopic examination and PCR. Among the patients with T. vaginalis, five were in the symptomatic group, and two were in the asymptomatic group. The rate of vaginal candidiasis was found to be 34.5% in the symptomatic group and 21.2% in the asymptomatic group. Aerobic vaginitis was observed in 12.8% of the symptomatic group and 7.7% of the asymptomatic group. The positivity rates for BV, vaginal candidiasis, and trichomoniasis in asymptomatic patients are concerning. Considering the fetal complications and chronic effects of vaginal infections, the decision to establish screening programs in the asymptomatic patient group should be based on national data, considering the prevalence of the pathogen in the region and its outcomes.

Objective: The study aimed to evaluate E.histolytica-specific ELISA adhesin antigen test results in stool samples sent to the medical microbiology laboratory with suspicion of amebiasis. Materials and Methods: A total of 1120 stool samples were included in the study, which were sent to the medical microbiology laboratory with suspicion of amebiasis in the two-year period between January 2022 and December 2023. The results of ELISA adhesin antigen test studied on stool samples were evaluated retrospectively. Results: Of the 1120 samples in the study, 578 (51.6%) were obtained from male and 542 (48.4%) from female patients. The mean age of the patients was 33.92±24.33 (0-94) years. There were 335 (30%) samples from pediatric patients, and the mean age was determined as 4.48 ±4.78. The positivity rate of E.histolytica specific ELISA adhesin antigen test was 14.3% (n=161). Of the positive patients, 77 (47.8%) were male and 84 (52.2%) were female. There were 55 (34.1%) positive samples from pediatric patients. While there was no statistically significant difference between the positivity status and age of the patients, or between the positivity status and gender (p>0.05), the seasonal difference was considered significant (p<0.05). Conclusion: With the E.histolytica-specific ELISA adhesin antigen test, E.histolytica and non-pathogenic E.dispar can be differentiated and patients can be prevented from receiving unnecessary treatment.

Pseudomonas aeruginosa, yüksek mortaliteyle seyreden enfeksiyonlara yol açan fırsatçı bir patojendir. Bu çalışmada üniversite hastanesinde yatan hastaların kan kültürlerinde tespit edilen P. aeruginosa izolatlarının çeşitli antibiyotiklere karşı direnç profilinin belirlenmesi amaçlanmıştır. Bu çalışmada Ocak 2018-Aralık 2023 tarihleri arasında kan örneklerinden izole edilen P. aeruginosa izolatlarının antibiyotik direnç profilleri retrospektif olarak incelenmiştir. Klinik izolatlar konvansiyonel yöntemler, VITEK 2 Compact (bioMérieux, Fransa) veya Phoenix (BD Diagnostic Systems, ABD) otomatize sistemleri ile tanımlanmıştır. Antibiyotik duyarlılıkları otomatize sistemleri ile test edilmiş ve European Committee on Antimicrobial Susceptibility Testing (EUCAST) önerileri dikkate alınarak değerlendirilmiştir. En yüksek direnç imipenem (n=162, %39.4), meropenem (n=134, %32.6) ve piperasilin/tazobaktama (n=130, %31.6) karşı tespit edilmiştir. En etkili antibiyotiklerin ise amikasin (n=15, %3.6) ve tobramisin (n=17, %4.1) olduğu belirlenmiştir. Antibiyotiklerin direnç oranları yıllara göre incelendiğinde piperasilin/tazobaktam, seftazidim, sefepim, imipenem, meropenem ve levofloksasin direnç oranlarında istatiksel olarak anlamlı fark saptanırken (p0.05). Antibiyotik duyarlılık test sonuçlarına göre uygulanan tedavi protokolü ve akılcı antibiyotik kullanımı ile direnç oranlarının azalacağı düşünülmektedir. Bu nedenle düzenli sürveyans takibi yapılmalı ve tedavide uygun antibiyotik kombinasyonları seçilmelidir.

Background/Aim: Tuberculosis remains a major global health problem with a high morbidity and mortality rate, approximately a quarter of the population is infected with tuberculosis. Drug susceptibility testing is an essential tool for identifying and managing drug-resistant tuberculosis. This study was conducted to evaluate the drug susceptibility pattern of Mycobacterium tuberculosis complex strains isolated from a university hospital. Methods: A total of 10900 samples sent to the microbiology laboratory with the suspicion of tuberculosis clinically between January 2018 and January 2022 were analyzed retrospectively. The automated BACTEC MGIT 960 (Becton Dickinson, USA) was used for sample culture and susceptibility testing. The obtained data were statistically analyzed with the Statistical Package for Social Sciences (SPSS version 20). Results: Out of the 154 isolated positive samples, males and females constituted equal parts of the study population (50%). The majority of tuberculosis cases were in the age group 56–75 years (42.2%), Pulmonary TB was detected in (90.3%) of the patients, while extrapulmonary TB cases were observed in (9.7%). As a result of susceptibility studies on positive samples, isoniazid resistance was 5.2%; streptomycin resistance 1.3%; ethambutol resistance was detected at a rate of 0.6%, while no rifampicin resistant sample was found. Both streptomycin and isoniazid resistance were seen together in 1.3% of the samples. Conclusion: A similar resistance pattern of the first-line antituberculosis drugs was observed in other studies conducted in different provinces of Turkey. The absence of multi-drug resistant and extensively drug-resistant tuberculosis in our study indicates that the tuberculosis surveillance program implemented in our region was successful.

Amaç: Vulvovajinal kandidiyazis, kadınların yaklaşık %75’inde yaşamları boyunca en az bir kez görülen yüzeysel mantar enfeksiyonudur. Bazı genler, Candida türlerinin vajina mukozasına ve epitel hücrelerine yapışmasında ve patogenezinde rol oynamaktadır. Bu çalışmanın amacı, vulvovajinal kandidiyazisli hastalardan izole edilen Candida suşlarındaki HWP1 (hifal duvar proteini), ALS1 (agglutinin benzeri sekans), SAP1 (sekrete aspartil proteaz), PLB1 (fosfolipaz B), INT1 (integrin A) genlerinin sıklığının araştırılmasıdır. Gereç ve Yöntemler: Çalışmaya moleküler teknik kullanılarak tanımlanan 100 vajinal Candida izolatı dahil edildi. İzole edilen tüm Candida suşlarında, enfeksiyon da önemli rol oynayan INT1, HWP1, PLB1, SAP1 ve ALS1 genlerinin varlığı PCR yöntemi kullanılarak araştırıldı. Bulgular: SAP1, INT1 ve HWP1 virülans genleri Candida suşları arasında en yaygın, PLB geni en az tespit edilen gen olmuştur. Candida albicans suşlarında SAP1 (%93.0) geni en çok saptanan virülans geni olurken, bunu HWP1 geni (%86) takip etmiştir. Benzer şekilde non-albicans Candida türlerinde saptanan virülans genleri arasında SAP1 geni (%86) en fazla saptanan virülans geni olmuştur. Farklı Candida türlerinin %95’inde VVK’ya neden olabilecek en az iki virülans faktörü tanımlanmıştır. Sonuç: Bu çalışmada elde edilen sonuçlar, vulvovajinal kandidiyazis enfeksiyonu sırasında eksprese edilen INT, HWP, PLB, SAP ve ALS genlerinin, Candida suşlarının vajinaya adezyonuna ve biyofilm oluşumuna katkıda bulunmuş olabileceğini düşündürmektedir.

Aims: In this study, we aimed to determine mutations in the gene sequence of this virus, by performing whole genome sequence analysis from patient samples found positive by actual RT-PCR (PCR) for SARS-CoV-2. Methods: The study included six adult patient samples with different clinical manifestations with positive PCR tests for SARS-CoV-2, between June 01, 2020, and March 12, 2021. Sequence knowledge of all samples/testers has been loaded into the GISEAD (Global Initiative on Sharing All Influenza Data) data system. Clade Analysis, Genome Analysis, Variant Analysis, and Phylogenetic Tree Analysis were conducted. Results: 3 of the patients were women (female), and three were men(male), with the mean age of 42.5 years old (between 20 - 61). Totally 71 mutations were specified in 6 adult patients. By the Pangolin lineage, three of the patients were B.1.177, two were B.1, one was of B1.36 lineage. By the Pango lineage, two of the patients were B.1.609, one was B.177, one was B.1.36. By the Nexstrain Clade, four of the patients were 20A and two were of 19A lineage. No D614G mutation was detected in any of the patients. While five patients recovered, one patient with metastatic lung adenocarcinoma died. Conclusion; The patients were detected in the commonly found 'Non-VOC' group. Therefore, variants could not be associated with the clinical status and prognosis of the patients. However, it is thought that the data obtained contribute to both global and national SARS-CoV-2 data.

Amaç: Çoklu ilaca dirençli (MDR) bakteriler ile oluşan enfeksiyonları kontrol etmek, klinisyenler için büyük bir zorluk haline geldi. Bu nedenle, ana yaklaşım alternatif tedavilerin de gözden geçirilmesidir. Bu çalışmada, gaz formundaki medikal ozonun MDR patojenler üzerindeki antibakteriyel etkisini zamana bağlı olarak değerlendirilmesi hedeflenmiştir. Gereçler ve Yöntem: Çalışma 21 Mart-15 Nisan 2021 tarihleri arasında Necmettin Erbakan Üniversitesi Meram Tıp Fakültesi Hastanesi Tıbbi Mikrobiyoloji laboratuvarı’nda gerçekleştirildi. On MDR bakteri, yedi farklı bakteriyel konsantrasyonunda (102-108 bakteri/petri) petri kaplarında in vitro olarak değerlendirildi. 10, 20 ve 40 dakikalık 40 ug/ml dozda ozon maruziyeti ve kontrol grubunun MDR bakterileri üzerinde etkinliğini araştırıldı. Plakların 24 saatlik inkübasyonundan sonra, ozonun her maruz kalma süresi için ortalama koloni sayıları belirlendi ve Log10'a dönüştürüldü. Bulgular: Ortalama bakteriyel azalma (log10) dikkate alındığında, ozonun bakterisidal etkisi 10 dakikaklık maruziyette sadece metisiline dirençli Staphylococcus aureus, VIM-1 üreten Klebsiella pneumoniae ve Karbapenem dirençli Acinetobacter baumannii üzerinde saptandı. Optimum etki, test edilen izolatlarda genellikle 20 dakika içinde gözlendi. Bununla birlikte, MDR-Pseudomonas aeruginosa, ozon maruziyetinden nispeten daha az etkilendi. Ancak 40 dakikalık maruziyet sonunda tüm bakteriler %99'luk seviyenin üzerinde inaktive edildi. Sonuçlar: Ozon gazı, MDR patojenleri üzerinde etkili bakterisidal aktivite gösterdi ve etkisinin, maruz kalma süresine ve bakteri tipine bağlı olduğu tespit edildi. Pandemi dünyasında mikrobiyal enfeksiyonların kontrolü için yeni yaklaşımlara duyulan ihtiyaç dikkate alındığında, ozon tedavisinin optimizasyonu yüksek öncelikli olarak gerçekleştirilmelidir ve ozonun MDR-bakterilerin inaktivasyonu üzerindeki etkisinin derinlemesine anlaşılmasını desteklemek için daha fazla in vivo çalışmaya ihtiyaç vardır.

Toxoplasma gondii (T. gondii) is an obligate intracellular parasite. It is regarded as an important cause of morbidity and mortality in congenital contamination and immunosuppressive patients. This study aimed to determine the seropositivity of T. gondii in various ages and patient groups, as well as to reveal the current immune status, especially in risk groups. Results of T. gondii serology conducted between 2015 and 2019 in the medical microbiology laboratory in a university hospital were retrospectively analyzed. In the study, anti-T. gondii IgM, anti-T. gondii IgG antibodies, and anti-T. gondii IgG avidity test results were investigated by the enzyme-linked fluorescent assay method. Additionally, seropositivity rates among immunosuppressed patients and pregnant women, which are risk groups for toxoplasmosis, were revealed. In the identification of the immunosuppressed patients, groups with significant immunosuppression were retrospectively determined by examining their files. The serology of T. gondii was investigated in serum samples of a total of 20.875 individuals, among which 6.220 (29.8%) are males and 14.655 (70.2%) are females. Anti-T. gondii IgM and IgG positivity rates were significantly higher in women than in men. When all years are evaluated, IgM positivity in 16.448 patients and IgG positivity in 4.427 patients were investigated. In the 5-year period, T. gondii IgM seropositivity and T. gondii IgG seropositivity was among all the patients was 2.4% and 24.1%, respectively. While the rate of T. gondii IgG seropositivity in women of childbearing age was 36.1%, it was 42.4% in pregnant women and 14.6% in immunosuppressed patients. T. gondii serology follow-up of pregnant women and immunosuppressed patients in terms of reactivity of latent infection should be advised and toxoplasmosis should be considered in suspicious clinical cases.

Objective Genome sequencing is useful for following the change in mutation and variants in viral agent during pandemics. In this study, we performed next-generation sequencing of severe acute respiratory syndrome-coronavirus-2 (SARS-CoV-2) complete genomes on pediatric patients. Methods Six pediatric patients aged 0 to 18 years who were positive for SARS-CoV-2 by reverse transcription polymerase chain reaction were included in this study. SARS-CoV-2 genome sequencing was performed using Oxford Nanopore Technologies MinION, following the ARTIC Network protocols. Sequencing data were obtained using the FASTQ program and quality assessment was evaluated. The sequence information of all samples was uploaded to the Global Initiative on Sharing All Influenza Data (GISAID) database. Genome, variant, clade, and phylogenetic tree analyses were performed with bioinformatic analysis. Results Two of these six samples were at 20A, two were at 20B, and two were at 19A in the nextstrain clade. According to Pango lineages, B.1.36, B.1.218, B.1, and B.1.260 lineages were detected. A total of 84 mutations were observed in all samples. None of the variants were classified as variants of concern (VOC) nor variants of interest (VOI) according to the Pango database. Conclusion This study is the first comprehensively sequence analysis registered in the GISAID database reported from the Konya region in Turkey. Similar studies will be informative to track changes in the virus genome, obtain epidemiological data, guide studies on diagnosis and treatment, and evaluate vaccine efficacy.