[Investigation of Polymerase Chain Reaction Method in Patients with Suspected Chronic Cutaneous Leishmania of Negative Microscopy]

Leishmaniasis is a parasitic disease that is transmitted to humans by the bites of infected female phlebotomine sandflies. In the diagnosis of cutaneous leishmaniasis (CL), in the smear samples, the demonstration of the parasite by microscope remains a gold standard method. However, it becomes difficult to diagnose the parasite since the number of amastigotes in chronic cases with a lesion of one year or longer is very low. Due to many factor such as patients primarily do not to take any notice these lesions in their bodies, do not apply to health institutions or late applied, receive wrong treatment; the diagnosis and treatment are delayed. In addition, it is been worse prognosis by add secondary infection to lesions and wounds become chronic. For this reason, molecular methods are used in addition to microscopic examination in chronic suspected CL cases. It was aimed to reveal of the molecular diagnostic value in chronic suspected CL cases by polymerase chain reaction (PCR) in the smear belonging to Turkish patients that reported to be evaluated clinically because it can not be seen Leishmania amastigotes in microscopic examination. Smear of 50 Turkish patients who were clinically reported of the evaluation of chronic CL were selected. These samples were smears belonging to suspected CL patients that applied Hatay Mustafa Kemal University, Faculty of Medicine, Parasitology laboratory from different polyclinics and were decided to be evaluated clinically as a result of microscopic examination because they came from endemic regions (such as Hassa, Altınözü, Yayladağı). DNA was isolated from selected samples and PCR was performed using 13A, 13B primers targeting the kinetoplastid DNA (kDNA) region. The samples found positive by PCR were typed by polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) analysis using LITSR and L5.8S primers targeting internal transcribed spacer (ITS-1) region. Of the 50 smear samples, 17 (34%) were determined positive with 13A, 13B primers targeting the kinetoplastid DNA (kDNA) region. Positive samples were also found to be positive with LITSR and L5.8S primers targeting ITS-1 region. The PCR products obtained from PCR with ITS-1 gene region were digested with the restriction endonucleases BsuRI (HaeIII). As a result of PCR-RFLP analysis, it was determined that 11 of Leishmania tropica, one of Leishmania major and five of Leishmania infantum/donovani out of 17 samples. Chronic CL can be confused with skin diseases such as sarcoidosis, tuberculosis, malignant tumors. In particular, chronic CL cases can be escaped the attention for many reasons such as failure to diagnose correctly, insufficient microscope experience, fail to see due to low number of parasites. For this reason, it was concluded that PCR, which is a molecular method, should be used in chronic suspected CL samples which are negative for the parasite by microscopic examination.

Identification of medically important Candida species by polymerase chain reaction-restriction fragment length polymorphism analysis of the rDNA ITS1 and ITS2 regions

AIM

We aimed to identify the distribution of species in candidal strains isolated from clinical samples and restriction fragment length polymorphism (RFLP) method based on Msp I and Bln I restrictive enzyme cuts of polymerase chain reaction (PCR) products after the amplification of ITS1 and ITS2 regions of rDNA genotypically.

MATERIALS AND METHODS

One hundred and fifty candidal strains isolated from various clinical samples were studies/ included. Phenotypic species assessment was performed using automated VITEK-2 system and kit used with the biochemical tests. Common genomic region amplification peculiar to candidal strains was carried out using ITS1 and ITS2 primer pairs. After the amplification, PCR products were cut with Msp I and Bln I restriction enzymes for species identification.

RESULTS

The majority of Candida isolates were isolated from urine (78.6%) while other isolates were composed of strains isolated from swab, wound, blood and other samples by 11.3%, 3.3%, 2% and 4.7%, respectively. The result of RFLP analysis carried out with Msp I and Bln I restriction enzymes showed that candidal strains were Candida albicans by 45.3%, Candida glabrata by 19.3%, Candida tropicalis by 14.6%, Candida parapsilosis by 5.3%, Candida krusei by 5.3%, Candida lusitaniae by 0.6% and other candidal strains by 9.3%.

CONCLUSION

When the ability to identify Candida to species level of phenotypic and PCR-RFLP methods was assessed, a great difference was found between these two methods. It may be argued that Msp I and Bln I restriction enzyme fragments can be used in the identification of medically important Candida species. Further studies are needed to develop this kind of restriction profile to be used in the identification of candidal strains.

Relationship between the resistance genes to quaternary ammonium compounds and antibiotic resistance in staphylococci isolated from surgical site infections

BACKGROUND

We aimed to investigate the prevalence of disinfectant resistance genes (qacA/qacB,qacC) and the aminoglycosides resistance genes [(aac(6')aph(2''),aph(3')-IIIa,ant(4')-Ia)] in both S. aureus and coagulase-negative staphylococcal strains (CoNS) isolated from surgical site infections.

MATERIAL AND METHODS

Totally, 130 staphylococcal strains isolated from surgical site infections between January 2012 and February 2013 were included in the study. The PCR technique was employed to verify any presence of methicillin resistance gene (mecA), aminoglycoside resistance genes [(aac(6')/aph (2''), aph(3)-III a ant (4')-1a)], and disinfectant resistance genes (qacA/qacB,qacC) in staphylococci.

RESULTS

MecA gene was determined in 58 (44.6%) of 130 staphylococcal isolates. A total of 28 (73.7%) of 38 S. aureus isolates were found to be positive for the mecA gene, and 4 (12.9%) of 31 isolates sensitive to amikacin were sensitive to methicillin. Eighteen (47.4%) of 38 amikacin-resistant S. aureus isolates were found to be positive for qacA/qacB genes and 11 (8.9%) of them were positive for qacC gene. Both mecA and qacA/qacB genes were found to be positive at the same time in 19 amikacin-resistant S. aureus strains. Seven (18.4%) S. aureus isolates were determined to be positive for qacA/qacB and qacC genes. Frequency of qacA/B genes was found to be 47.4% among amikacin-resistant S. aureus strains, while qacC gene was found to be 28.9% (p<0.05). The ratio of qacA/B and qacC genes in CoNS was found to be 37.9% and 20.7%, respectively (p<0.05).

CONCLUSIONS

Quaternary ammonium resistance genes were found to be positive at a remarkable ratio in the staphylococcal isolates from surgical wounds. Especially, the high rates of aminoglycosides and methicillin-resistance gene was remarkable in S. aureus isolates. Quaternary ammonium resistance genes were found to be positive.

[The distribution of intestinal parasites in students of the Mustafa Kemal University School of Health.]

Intestinal parasites are an important national health problem in our country as in the rest of the world. In our study, the prevalence of intestinal parasites in female students (aged from 16-18 years) in the Mustafa Kemal University School of Health was investigated. Fecal samples and cellophane tape preparations were used for diagnosis. For this reason 142 fecal samples and 136 cellophane tape preparations were examined. One or more parasites were found in 65 (45.77%). fecal samples. The prevalence of parasites that found in fecal samples is as follows: Blastocystis hominis in 63 samples (96.92%) and Giardia intestinalis in 2 samples (3.08 %). Enterobius vermicularis was found in 9 (6.61%) out of 136 cellophane tape preparations.