Drug resistance in Mycobacterium tuberculosis: a retrospective study from a 2000-bed teaching hospital in Ankara, Turkey.
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Adolescent↗
Biomedical subjects
Levent Doganci
Publications and source records attributed to Levent Doganci.
Resistance patterns of Mycobacterium tuberculosis complex isolates in the Turkish Army from 1998 to 2000.
The aim of this retrospective study was to investigate susceptibility rates of Mycobacterium tuberculosis complex (MTBC) isolates against streptomycin, rifampicin, isoniazid, and ethambutol between January 1998 and December 2000 in the Turkish Army. Specimens collected from patients were cultured both conventionally and radiometrically. Differentiation of MTBC bacteria from Mycobacteria other than tuberculosis bacilli was made by the BACTEC p-nitro-alpha-acetyl-amino-beta-hydroxypropiophenone test. Susceptibility testing of MTBC isolates was performed using the BACTEC radiometric susceptibility assay for mycobacteria. Most of the specimens originated from respiratory system. A total of 98 isolates in 1998, 123 isolates in 1999, and 84 isolates in 2000 were obtained and identified as MTBC using the radiometric BACTEC TB460 system. Initial resistance was most frequent to isoniazid followed by ethambutol, streptomycin , and rifampicin in this study period. The differences between resistance rates were not statistically significant on an annual basis. None of these isolates was resistant to all four antimycobacterial agents. Although resistance rates of our isolates were not as high as previously reported by some authors from Turkey and there was no significant difference between the annual susceptibility rates, routine screening of antituberculosis drug susceptibility should be continued to control the resistance development and its spread.
Antitubercular Agents↗
The evaluation of diagnostic methods for the detection of Helicobacter pylori in gastric biopsy specimens.
PCR is a rapid, sensitive and accurate method for the specific detection of Helicobacter pylori from gastric biopsy specimens. In our study, 104 gastric tissue specimens from symptomatic adult patients were examined by staining, culture, PCR and nested PCR methods for detection of H. pylori. According to our results, positivity was achieved in 24% (25/104) with Giemsa staining, 34% (36/104) with histopathology, 36% (38/104) with PCR and 41% (43/104) with nested PCR respectively, whereas H. pylori was isolated in only 33% (35/104) of the cultures on the biopsy specimens. Both the sensitivity and the positive predictive value of the nested PCR method were 100%, and both the specificity and negative predictive value were 98%. As a conclusion, our results suggest the nested PCR as a highly valuable method in the detection of H. pylori with a reasonably high sensitivity and specificity.
Adolescent↗
Acute pyelonephritis causing acute renal allograft dysfunction.
In renal transplant recipients, acute pyelonephritis may cause acute deterioration of renal function. We report a case with acute allograft failure due to acute pyelonephritis, which was confirmed by graft biopsy. After appropriate antimicrobial therapy, allograft function recovered.
Acute Disease↗
Detection of Cryptosporidium parvum infection in childhood using various techniques.
BACKGROUND: The protozoan parasite Cryptosporidium parvum, which causes acute gastroenteritis in both humans and animals, has become an important pathogen all over the world. C. parvum may cause asymptomatic or symptomatic acute infections of the digestive system in immunocompetent subjects, but life-threatening disease in immunocompromised hosts. The aim of this study was to determine the usefulness of conventional microscopic staining techniques in the detection of C. parvum. For this purpose, 50 unselected immunocompetent asymptomatic children were evaluated for C. parvum during routine upper endoscopy. MATERIAL/METHODS: Duodenal aspirates and duodenal biopsy samples from 37 girls and 13 boys, between the ages of 2 and 18 years, obtained by gastrointestinal upper endoscopy and concomitant stool samples were examined with different staining techniques. RESULTS: Two stool samples and one duodenal aspirate were positive for C. parvum, but we could not demonstrate C. parvum in any duodenal biopsy samples. Dyspepsia was the primary indication for upper endoscopy in the patient with positive duodenal aspirate sample. CONCLUSIONS: These findings indicate that there is a low asymptomatic carrier rate in immunocompetent subjects with no involvement of intestinal villius attachment in the duodenum. We also conclude that C. parvum is an infrequent parasite in asymptomatic subjects, most probably due to a very low prevalence of HIV positivity in Turkey.
Adolescent↗
Increased antibacterial activity of zinc polycarboxylate cement by the addition of chlorhexidine gluconate in fixed prosthodontics.
PURPOSE: This study evaluated the antibacterial activity of water-activated zinc polycarboxylate cement with adjunctive 0.12% chlorhexidine gluconate on the subgingival microbiota in fixed partial dentures. MATERIALS AND METHODS: Thirty-six teeth prepared as fixed partial denture abutments in 9 patients were cemented randomly using water-activated zinc polycarboxylate cement (control group) or water-activated zinc polycarboxylate cement, including 0.12% chlorhexidine gluconate (test group). A total of 108 subgingival plaque samples were analyzed at baseline, immediately before permanent cementation (5 weeks), and 8 weeks later (at 13 weeks). RESULTS: In the control group, the subgingival microbiota altered to closely resemble the flora of chronic gingivitis (increased proportions of gram-negative anaerobes such as Prevotella intermedia, Fusobacterium nucleatum) by 13 weeks. In contrast, the microflora at test sites comprised predominantly gram-positive facultative cocci and rods at 13 weeks. CONCLUSION: This study demonstrated that the addition of 0.12% chlorhexidine gluconate may enhance the antimicrobial action of polycarboxylate cements to ensure the maintenance of a microflora compatible with periodontal health, at least up to 13 weeks post-cementation.
Adult↗