Mikrobiyol Bul
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The aim of this study was to investigate a small tularemia outbreak in a village of Karamürsel county of Kocaeli province (located in North-west part of Turkey), between 22 January - 8 March 2005 and to present the anti-epidemic measures implemented. Following diagnosis of oropharyngeal tularemia in two patients living in the same village, a field investigation was performed at this region. All patients have undergone physical examination. ⋯ F. tularensis could not be grown in the cultures, however F. tularensis DNA was detected in the samples of the natural spring water by real time PCR. The patients were treated with streptomycin, ciprofloxacin, or doxycycline, and all the patients have recovered. The outbreak was taken under control after cleaning the spring water tank and chlorination of the water.
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Listeria monocytogenes may lead to intrauterine infections which can be treated if diagnosed promptly. However, there is not a rapid routine screening test with high specificity and sensitivity for the diagnosis of listeriosis during pregnancy. We investigated the presence of different L. monocytogenes O antibodies for diagnosis of listeriosis in 275 paired maternal-cord sera using the agglutination test, and aimed to evaluate the correlation between poor pregnancy outcomes, level of L. monocytogenes serotype O antibodies and risk factors for listeriosis. ⋯ Risk factors such as non-specific febrile illness during pregnancy (p < 0.001), consumption of ready-made food (p = 0.008), consumption of raw milk and milk products (p < 0.001) were found to be related to the presence of > or = 1/320 titers of L. monocytogenes antibodies. The major limiting factor in this study was the inability to obtain second serum samples from the mothers and newborns following delivery, to confirm the diagnosis by seroconversion. These results emphasize the need for the development of rapid, simple and reliable tests, alternative to culture methods, for the early and proper diagnosis of Listeria infections during pregnancy.
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Case Reports
[A herpes simplex virus encephalitis case with no clinical response to acyclovir treatment].
In spite of high rates of morbidity and mortality in herpes simplex virus (HSV) encephalitis, however, it is one of the exceptional viral infections with specific and effective therapy. In this report a HSV encephalitis case who was clinically unresponsive to acyclovir treatment, has been presented. An 11 months old girl patient has been brought to our clinic with the complaints of high fever and focal convulsions. ⋯ Valproic acid and haloperidol were given to the patient for the treatment of permanent partial paroxysms and orofacial dyskinesis, developing in the follow-up period, respectively. After getting these complications under control, the patient was discharged and taken into follow-up. As a result, although it could not be possible to confirm the drug resistance by molecular methods, it was thought that this might be both a clinical and virological resistance phenomenon, because of the detection of HSV-DNA in the CSF sample during the period of severity of the illness.
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Panton-Valentin leucocidin (PVL) is a cytotoxin which causes tissue necrosis by degradating leucocytes and other cell types. PVL has recently become very up to date as it has been shown to be the major virulance factor of community acquired methicillin resistant Staphylococcus aureus strains. In this study, the presence of PVL was investigated in methicillin sensitive and resistant S. aureus (MSSA and MRSA, respectively) strains which were isolated from clinical samples between January 2005-May 2006 at Dokuz Eylul University Hospital, Izmir. ⋯ None of the MRSA isolates had pvl gene. Although this cytotoxin was rarely detected among MSSA isolates, it was interesting to note that the prevalence of PVL was twice more in the year 2006 compared to 2005. It was also worth to notify that four of six (66.7%) PVL positive strains had been isolated from the patients of general surgery inpatient or outpatient clinics.
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The first published tularemia epidemic in Turkey had been reported in 1936 from Luleburgaz (located in European part-Thrace region-of Turkey), and the second was in 1945 again in the same province. Following a long period of time without any tularemia report from Thrace region, in 2005 another epidemic occurred in a village of Edirne, another province located in the same region. Since there is presumptive evidence of circulation of the infectious agent, Francisella tularensis in Thrace region of Turkey, a large scale seroepidemiological study is needed. ⋯ Rose Bengal test was also found positive in three of the seropositive subjects, and with the thought of a probable cross reaction they were taken into an advanced investigation for brucellosis. The risk evaluation revealed that male gender, being together with livestock and exposure to ticks were the major risk factors. Since the data of this study indicated that F. tularensis is in circulation in Thrace Region, the educational programmes for both the healthcare workers and inhabitants of this region should be attempted for the prevention of a possible epidemic.