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Öğe Assessment of Evidence for Positive Association and Seroprevalence of Hepatitis B and C in Diabetic Patients in a Developing Country(BMJ PUBLISHING GROUP, 2015) Korkmaz, Huseyin; Kesli, Recep; Pamuk, Bans Onder; Ipekci, Suleyman Hilmi; Terzi, Yuksel; Kebapcilar, LeventBackground and Aim: The data related to the association between hepatitis virus infections and diabetes mellitus (DM) are conflicting. The aim of this study was to investigate the seroprevalence of hepatitis B virus (HBV) and hepatitis C virus (HCV) and to determine the risk factors affecting the prevalence in Turkish patients with type 1 DM and type 2 DM. Methods: The study consisted of 736 diabetic and 505 nondiabetic patients. Serological investigation for the hepatitis B surface antigen (HBsAg) and the HCV antibody (anti-HCV) was performed with a third-generation commercial chemiluminescence assay. The presence of HBsAg was considered as indicator of HBV infection. The HCV infection in the patients with positive anti-HCV was confirmed by a real-time polymerase chain reaction assay. The patients were divided according to their HBV and HCV infection status, and their demographic features, diabetes properties, general risk factors, and aminotransferase levels were analyzed. Results: There was no significant difference in the seropositivity rate for the HBsAg (3.8% vs 3.0%, P > 0.43; odds ratio, 1.292; 95% confidence interval, 0.683-2.444). However, anti-HCV seropositivity was significantly increased in the DM group (3.3% vs 1.8%, P < 0.03; odds ratio, 2.398; 95% confidence interval, 1.025-5.609). Increased aminotransferase levels and a history of blood transfusions were positively correlated with both HBV and HCV infection. Moreover, a history of surgical procedures and high glycated hemoglobin A1c levels were positively associated with HBsAg antigen seropositivity. Conclusions: Although no significant difference in the seropositivity of the HBsAg was determined, a high prevalence of HCV infection was detected in the DM patients compared to healthy controls.Öğe Comparison of a Newly Developed Automated and Quantitative Hepatitis C Virus (HCV) Core Antigen Test with the HCV RNA Assay for Clinical Usefulness in Confirming Anti-HCV Results(AMER SOC MICROBIOLOGY, 2011) Kesli, Recep; Polat, Hakki; Terzi, Yuksel; Kurtoglu, Muhammet Guzel; Uyar, YavuzHepatitis C virus (HCV) is a global health care problem. Diagnosis of HCV infection is mainly based on the detection of anti-HCV antibodies as a screening test with serum samples. Recombinant immunoblot assays are used as supplemental tests and for the final detection and quantification of HCV RNA in confirmatory tests. In this study, we aimed to compare the HCV core antigen test with the HCV RNA assay for confirming anti-HCV results to determine whether the HCV core antigen test may be used as an alternative confirmatory test to the HCV RNA test and to assess the diagnostic values of the total HCV core antigen test by determining the diagnostic specificity and sensitivity rates compared with the HCV RNA test. Sera from a total of 212 treatment-naive patients were analyzed for anti-HCV and HCV core antigen both with the Abbott Architect test and with the molecular HCV RNA assay consisting of a reverse transcription-PCR method as a confirmatory test. The diagnostic sensitivity, specificity, and positive and negative predictive values of the HCV core antigen assay compared to the HCV RNA test were 96.3%, 100%, 100%, and 89.7%, respectively. The levels of HCV core antigen showed a good correlation with those from the HCV RNA quantification (r = 0.907). In conclusion, the Architect HCV antigen assay is highly specific, sensitive, reliable, easy to perform, reproducible, cost-effective, and applicable as a screening, supplemental, and preconfirmatory test for anti-HCV assays used in laboratory procedures for the diagnosis of hepatitis C virus infection.Öğe A Comparison of Immuncapture Agglutination and ELISA Methods in Sero-logical Diagnosis of Brucellosis(IVYSPRING INT PUBL, 2011) Ozdemir, Mehmet; Feyzioglu, Bahadir; Kurtoglu, Muhammed Guzel; Dogan, Metin; Dagi, Hatice Turk; Yuksekkaya, Serife; Kesli, RecepBackground: Different serological tests are used in serologic diagnosis of brucellosis. The most widely used of these are Standard Tube Agglutination and Coombs anti-brucella tests. Whereas ELISA Ig M and Ig G tests have been in use for a long time, immuncapture agglutination test has been recently introduced and used in serological diagnosis. The aim of this study was to compare diagnostic values of ELISA Ig M and Ig G and im-muncapture agglutination tests with Coombs anti-brucella test. Methods: Sera from 200 patients with presumptive diagnosis of brucellosis were in-cluded into the study. Coombs anti-brucella test, ELISA Ig M and Ig G tests and Im-muncapture test were investigated in these sera. Then, sensitivity, specificity, negative predictive and positive predictive values were calculated. Results: Sensitivity, specificity, negative predictive and positive predictive values were found to be 90,6 %, 76,3 %, 94,2 %, and 65,9 % respectively for the Immuncapture test, whereas they were found to be 73,7 %, 58,9 %, 84,2 %, and 42,8 % for Ig G and 72,2 %, 67,8 %, 85,2 %, and 48,7 % for Ig M. The Immuncapture test was found to be compatible with ELISA Ig M and Ig G tests but it was statistically incompatible with Coombs anti-brucella test. Conclusions: Immuncapture agglutination test yields similar results to those of Coombs anti-brucella test. This test is a useful test by virtue of the fact that it determines blocking antibodies in the diagnosis and follow-up of brucellosis.Öğe Comparison of the Diagnostic Accuracy of Five Different Stool Antigen Tests for the Diagnosis of Helicobacter pylori Infection(WILEY, 2013) Korkmaz, Huseyin; Kesli, Recep; Karabagli, Pinar; Terzi, YukselBackground: Several noninvasive diagnostic tests based on the detection of Helicobacter pylori stool antigen (HpSA) have been developed. The aim of the study was to compare the diagnostic accuracy of 5 HpSA tests-2 monoclonal enzyme immunoassay tests (EIAs: the Premier Platinum HpSA Plus test and Helicobacter pylori Antigen (Hp Ag) test) and 3 rapid immunochromatographic assay (ICA) tests (the ImmunoCard STAT! HpSA test, one step HpSA test, and H. pylori fecal antigen test)-for diagnosing H. pylori infection in adult patients with dyspeptic symptoms before eradication therapy. Materials and Methods: A total of 198 patients with dyspeptic symptoms were included in the study. A gastric biopsy was collected for histopathology and rapid urease testing. Stool specimens for HpSA testing were also collected. Patients were considered H. pylori positive if two invasive tests (histological and rapid urease tests) were positive. Results: The sensitivity and specificity were 92.2% and 94.4%, respectively, for the Premier Platinum HpSA Plus test; 48.9% and 88.9%, respectively, for the HP Ag test; 86.7% and 88.9, respectively, for the One Step HpSA test; 68.9% and 92.6%, respectively, for the ImmunoCard STAT! HpSA test; and 78.9% and 87%, respectively, for the H. Pylori fecal antigen test. Conclusions: The Premier Platinum HpSA Plus EIA test was determined to be the most accurate stool test for diagnosing H. pylori infections in adult dyspeptic patients. The currently available ICA-based tests are fast and easy to use but provide less reliable results.Öğe Distribution of ıntestinal parasites for age and gender in the 13 to 18 years age group at the Nigde Orphanage(KAFKAS UNIV, VETERINER FAKULTESI DERGISI, 2010) Ozkalp, Birol; Celik, Battal; Kurtoglu, Muhammet Guzel; Kesli, RecepThe present study was aimed at the determination of the rate of infection with intestinal parasites in children cared for at the Nigde Orphanage, and the demonstration of the distribution of infection in these children for age and gender. Faecal samples collected from 110 children, aged 13 to 18 years, were examined by the native method using physiological saline. Of the 110 faecal samples examined, 41 (37.3%) contained intestinal parasites, and of the samples containing parasites, 25 (61%) contained helminths and 16 (39%) contained protozoa. The number of faecal samples identified to contain a single parasite species was 39 (95%), while 2 (5%) samples contained more than one parasite species. As regards the distribution of the intestinal parasites for gender, it was ascertained that of the 75 females 30 (40%) individuals and of the 35 males 11 (31.5%) individuals were infected with intestinal parasites. The difference between the two sexes was considered to be insignificant. Faecal examination revealed the presence of the following parasite species at the indicated rates: Ascaris lumbricoides (34.1%), Entamoeba histolytica (29.3%), Taenia saginata (17.1%), Giardia intestinalis (9.8%), Enterobius vermicularis (7.3%) Trichuris trichiura (2.4%). The present study demonstrated that the environment of the orphanage was favourable for autoinfection and the spread of infection by direct contact. Furthermore, it was determined that the rate of parasitic infection was higher in the age group of 13 to 14 years, compared to the age group of 15 to 18 years.Öğe The Effect of Telithromycin on Inflammatory Markers in Chronic Obstructive Pulmonary Diseases(2009) Bekçi, Taha; Kurtipek, Ercan; Kesli, Recep; Maden, Emin; Teke, TurgutAim: To evaluate the anti-inflammatory effect of telithromycin on sputum interleukin-8 (IL-8), tumor necrosis factor-? (TNF-?), myeloperoxidase (MPO) levels in patient with chronic obstructive pulmonary diseases (COPD). Methods: Thirty four patients with mild to moderate COPD were enrolled in this prospective, single center, double-blind, placebo controlled study. Subjects received either telithromycin or placebo for 10 days. Before and after treatment period spirometric tests, arterial blood gas analyses were performed, sputum samples were taken for measurement of sputum inflammatory markers, and sputum was induced. Results: There was no statistical difference in baseline clinical or laboratory parameters between groups. After the treatment, the induced sputum IL-8, TNF-?, MPO levels is similar compared with pretreatment levels. Conclusion: In this study, anti-inflammatory effects of telithromycin in stable COPD patients were not demonstrated. Further studies are needed to determine the clinical significance of these findings.Öğe Epidemiology, Clinical and Microbiological Characteristics of Invasive Streptococcal Infections in Turkey, 2010-2011(ANKARA MICROBIOLOGY SOC, 2014) Topkaya, Aynur Eren; Balikci, Ahmet; Aydin, Faruk; Hascelik, Gulsen; Kayman, Tuba; Kesli, Recep; Aydemir, SohretA one-year active surveillance study was conducted to investigate the epidemiological and microbiological characteristics of invasive group A streptococci (GAS) infections in Turkey and to provide data for the establishment of national preventive strategies related to invasive GAS infections. A total of 46 clinical microbiology laboratories from 12 different regions of Turkey (Istanbul; Eastern and Western Marmara; Eastern and Western Blacksea; Aegean; Mediterranean; Western, Central, Northeastern, Middle-eastern and Southeastern Anatolia) participated in the study. Accordingly, GAS strains isolated from sterile body sites (blood, cerebrospinal, synovial, pleural, peritoneal, pericardial fluids) in the study centers between June 2010-June 2011, were sent to Maltepe University Hospital Clinical Microbiology Laboratory for microbiological confirmation and further analysis. The isolates were identified by conventional methods, and for serotyping, opacity factor (OF) and T protein types were investigated. For genotyping GAS lysate preparation, emm gene amplification and sequencing were performed by using the protocols recommended by Centers for Disease Control and Prevention. A total of 65 invasive GAS strains were isolated in 15 of the participant centers, during the study period. The rate of invasive GAS isolation exhibited regional variation, with the highest rates in the Eastern Blacksea (Trabzon, n=19), followed by Istanbul (n=17) and Western Anatolia (Ankara, Konya, n=14). Of the patients with invasive GAS infection 33 were female, 32 were male, with the age range of 0-89 years. GAS strains were most commonly isolated from soft tissue specimens (n=18), followed by abscess material (n=10), sterile body fluids (n=8) and blood (n=7) samples. Serotyping revealed that 55% (36/65) of the strains were OF positive, and the majority of T protein was polygroup T (n=20), followed by U (n=14), B (n=5), X (n=3) and Y (n=2). T protein was not detected in 22 isolates. The strains were found to have 17 different emm types; emm1 (n=13), emm4 (n=6), emm6 (n=6), emm12 (n=6), emm24 (n=4), emm14 (n=3) and emm28 (n=3). Nine of the strains could not be typed by sequencing. The correlation between emm typing and serotyping was detected as 58%. It was observed that 26-valent vaccines included 70.5% of the invasive GAS strains included in this study. Our study provided initial data concerning the epidemiological properties of invasive GAS infections and characterization of GAS strains in Turkey. The incidence of invasive GAS infections is low in our country. Although immunization programme by 26-valent GAS vaccine is not currently an urgent public health issue for our country, the results of this study indicated that emm types 4 and 24 should better be included in such a vaccine to be used in Turkey. Additionally, since epidemiological features of GAS infections and the microbiological characteristics of the strains can vary by time, for the diagnosis of invasive streptococcal infections and to take the necessary preventive measures, epidemiological studies should be conducted repeatedly.Öğe Evaluation of performance of quantiferon assay and tuberculin skin test in end stage renal disease patients receiving hemodialysis(EDIZIONI INT SRL, 2011) Maden, Emin; Bekci, T. Taha; Kesli, Recep; Atalay, Huseyin; Teke, Turgut; Solak, Yalcin; Turk, SuleymanPurpose: End stage renal disease (ESRD) cases are associated with increased risk of tuberculosis. There is no gold standard method for detecting latent tuberculosis infection (LTBI) in ESRD. The aim of the present study was to analyze the performance of the tuberculin skin test (TST) and QuantiFERON-TB Gold in tube (QFT-G) in cases receiving hemodialysis (HD). Methods: The TST and QFT-G were prospectively performed in 96 ESRD cases undergoing HD. The agreement of the QFT-G and TST was assessed in two TST cut off values (10 mm and 5 mm) in Bacille Calmette Guerin (BCG) vaccinated and non-vaccinated cases. Results: Of 96 cases 67 were BCG vaccinated and 29 were BCG non-vaccinated. QFT-G was positive in 39.6% cases and indeterminate in 3.1%. TST was positive in 43.8% of cases in cut off value of 10 mm and positive in 58.3% of cases in cut off value of 5 mm. Agreement between TST and QFT-G results was fair in both BCG vaccinated and non-vaccinated cases in either cut off values, except in cut off value of 10 mm in BCG vaccinated cases in which the agreement was moderate. Conclusion: The agreement between QFT-G and TST test is fair and there is no significant difference in both cut off values of TST in screening of LTBI in ESRD cases receiving HD.Öğe HPV TYPES AND THE RELATION OF HPV PREVALENCE TO RISK FACTORS AND CERVICAL SMEAR IN WOMEN AT RISK FOR CERVICAL CANCER(NOBEL ILAC, 2011) Eroglu, Celalettin; Kesli, Recep; Eryilmaz, Mehmet Ali; Unlu, Yasar; Gonenc, Oguzhan; Celik, CetinObjective: In this study, the aim was to determine HPV prevalence, types of HPV and the relationship between HPV positivity and the risk factors for developing cervical cancer and cervical smear in women at risk for cervical. cancer Material and Method: Four hundred and four healthy women who applied for the screening of cervical cancer and who were at risk were enrolled in the study All subjects were retrospectively investigated in terms of the risk factors for cervical cancer The presence of HPV was determined and the most frequently encountered 16 types of HPV were identified, using Reverse Hybridization Method. Cervical smear samples were obtained via conventional method and assessed with 2001 Bethesda system. Results: The median age of the subjects was 37 (27-62) and HPV frequency 32.5% (n=131). The most frequent types of HPV were HPV 18 in 60 cases (45.8%) and HPV 16 in 22 cases (16.8%). According to HPV types, high risk rate for cervical cancer was found to be 78.7% (n=103). Of the variables of the risk factors, the presence of genital condyloma was observed as the most important risk factor Conclusion: It was found that the women at risk for cervical cancer showed high positivity rate, especially in oncogenic HPV types.Öğe INVESTIGATION OF THE SUSCEPTIBILITIES OF MYCOBACTERIUM TUBERCULOSIS COMPLEX STRAINS TO MAJOR ANTITUBERCULOSIS DRUGS WITH BACTEC MGIT 960 SYSTEM(NOBEL ILAC, 2011) Kurtoglu, Muhammet Guzel; Kesli, Recep; Terzi, Yuksel; Baykan, MahmutObjective: The study was designed to investigate retrospectively the resistance rates of tuberculosis-causing mycobacteria, isolated in the microbiology and clinical microbiology laboratories of Konya Research and Education Hospital. Material and Method: Mycobacterium tuberculosis complex strains were isolated from various clinical samples of 1666 patients applying to Konya Research and Education Hospital between May 2007 and December 2009, and the resistance rates of Mycobacterium tuberculosis complex strains against first generation anti tuberculosis drugs were investigated. After homogenization and decontamination, the samples investigated were cultured using BACTEC Mycobacteria Growth Indicator Tube-960 (MGIT-960) system. Susceptibility rates of the strains determined with production were investigated with the same system versus streptomycin (SM), Isoniazid (INH), Rifampin (RIF) and Ethambutol (ETB) (SIRE). Results: From 1666 patients prediagnosed with tuberculosis, 70 Mycobacterium tuberculosis complex strains were isolated. While no drug resistance was found in 17 (24%) of them, resistance to one or two drugs was found in 26 (37%) strains (24% to INH, 20% to SM, 6% to ETB and 4% to RIF). While resistance was found to be only against one drugs in 15 of these (21%), two drugs in 11 of these (16%), no resistant strains could be determined against three or four drugs together Among the patients with resistance, 81% (57/70) displayed primary and 18% (13/70) secondary tuberculosis, and 2 patients were found to display resistance to isoniazid and rifampin together (MDR-TB). Conclosion: It was seen that the findings in the study were consistent with those determined by other studies in our country. Preventing the resistance to antituberculosis drugs is possible by enlightening the distribution rates of drug resistant strains in public, defining appropriate drug regimes and increasing the quality of tuberculosis control programs. Therefore, it is essential that regular and continuous scanning of antituberculosis drugs should be performed.Öğe Isolation Rate of Mycobacterium tuberculosis Complex from Patients with Suspected Tuberculosis and Identification of the Strains with BACTEC (TM) NAP and Immunochromatographic TB Ag MPT64 Rapid (TM) Tests(ANKARA MICROBIOLOGY SOC, 2011) Kurtoglu, Muhammet Guzel; Ozdemir, Mehmet; Kesli, Recep; Ozkalp, Birol; Baysal, BulentTuberculosis (TB) which is still one of the important infectious diseases in the world as well as Turkey, results in high morbidity and mortality. Clinical mycobacteriology laboratories have crucial roles in the identification, typing and susceptibility testing of Mycobacterium tuberculosis. The aims of this study were the investigation of the isolation rate of M.tuberculosis complex (MTC) from the clinical specimens of TB-suspected patients and to compare identification of mycobacteria isolated from solid and/or liquid media by using BACTEC NAP and immunochromatographic TB Ag MPT64 rapid test. A total of 1670 patients who were admitted to outpatients clinics of our hospital and prediagnosed as TB, have been included in the study. All the patients were anti-HIV seronegative. NALC-NaOH method were used for decontamination/homogenization, and preparations from samples were stained with Erlich-Ziehl-Neelsen method to detect acid-resistant bacilli (ARB) in direct microscopy. All of the samples were inoculated into BACTEC (TM) MGIT-960 (Becton Dickinson, USA) and Lowenstein-Jensen (14) media for cultivation and incubated at 37 degrees C for 6-8 weeks. Mycobacteria that were grown in the media have been identified by BACTEC (TM) NAP (Becton Dickinson, USA) and TB Ag MPT64 rapid test (SD Bioline Ag MPT64 Rapid (TM); Standard Diagnostics, Korea). The culture positivity in the samples of TB-suspected patients was found to be 3.7% (63/1670) with LJ and/or MGIT-960 methods, whereas ARB positivity rate was 1.6% (28/1670). Fifty-three (84%) out of culture positive 63 samples have been identified as MTC by BACTEC NAP test, while 61(97%) were found as MTC by TB MPT64 test. Considering BACTEC NAP test as the reference method, TB MPT64 test identified all the MTC strains correctly (sensitivity: 100%), however the false positivity rate was estimated as 12.7% (specificity: 87%). Of 53 MTC positive samples, 36 were sputum, four were bronchoalveolar lavage, four were urine, three were gastric fluid, three were pleural fluid, and one of each were abscess, peritoneal fluid and cerebrospinal fluid samples. ARB positivity rate was detected as 41.5% (22/53) among MTC culture positive samples. Of the patients who were infected with MTC, 72% (38/53) were male and 98% (52/53) were adults (age range: 20-85 years). Our data indicating 3.1% (53/1670) isolation rate of MTC from TB-suspected patients in our region were in concordance with the other results reported from Turkey. In conclusion, immunochromatographic TB Ag MPT64 test which seemed to be useful for the rapid identification of mycobacteria grown on solid and/or liquid, was practical to perform and had high sensitivity, however further larger-scaled studies are needed to support our data in our country.Öğe Plasma-soluble urokinase plasminogen activator receptor (suPAR) levels in Behcet's disease and correlation with disease activity(WILEY, 2018) Kurtipek, Gülcan Saylam; Kesli, Recep; Akyürek, Fatma Tunçez; Akyürek, Fikret; Ataseven, Arzu; Terzi, YükselBackgroundSoluble urokinase plasminogen activator receptor (suPAR), a new biomarker, is a soluble form of membrane-bound receptors secreted from different immune cells. The aim of the present study is to determine plasma suPAR levels in Behcet's disease and their correlation with disease activity. MethodsThirty Behcet's disease patients determined according to the International Study Group criteria for Behcet's disease diagnosis and 41 healthy subjects were included in the present study. Micro-enzyme-linked immunosorbent assay was employed to obtain quantitative data. Data of both groups were statistically analyzed. ResultsThe comparison of C-reactive protein and suPAR plasma levels of the control and Behcet's disease group revealed statistically significant differences (respectively, P = 0.003 < 0.05 and P = 0.020 < 0.05). However, plasma suPAR levels related with disease activity revealed no statistically significant differences (P > 0.05). ConclusionThe present study is the first study analyzing suPAR levels in Behcet's disease patients and their correlation with disease activity. However, further prospective studies with larger patient series using suPAR as a new plasma biomarker are required to diagnose and monitor Behcet's disease and to support the findings of the present study.Öğe Plasma-soluble urokinase plasminogen activator receptor (suPAR) levels in psoriasis patients and correlation with disease severity(DERMATOVENEROLOGICAL SOC SLOVENIA, 2015) Kurtipek, Gülcan Saylam; Kesli, Recep; Akyürek, Fatma Tunçez; Akyürek, Fikret; Terzi, YükselObjective: Psoriasis is a chronic, relapsing, inflammatory, hyper-proliferative skin disease. Plasma-soluble urokinase plasminogen activator receptor (suPAR) is released from the cell membrane-bound plasminogen activator and is a new biomarker of systemic inflammation. The aim of this study is to investigate plasma levels in psoriasis patients and determine their correlation with the Psoriasis Area and Severity Index (PASI) score. Materials and methods: The plasma suPAR levels of 50 healthy individuals and 65 psoriasis patients were measured using the Micro-ELISA method and the relation with PASI was investigated. Results: On comparing plasma suPAR levels of the psoriasis patients with the control group consisting of healthy individuals, no statistically significant difference was determined (5.29 ng/ml +/- 2.12 and 6.03 ng/ml +/- 2.42, respectively, p = 0.326; Table 1). Likewise, there was no significant correlation between the suPAR levels and PASI score (r = 0.147, p = 0.243 > 0.05). Conclusions: There was no statistically significant difference in the plasma SuPAR levels of psoriasis patients compared to the control group. Nevertheless, we firmly believe that plasma SuPAR, a new biomarker, could indicate disease severity if conducted with larger patient series and with moderate to severe psoriasis patients.Öğe Türkiye’de invazif streptokok enfeksiyonlarının epidemiyolojisi, klinik ve mikrobiyolojik özellikleri, 2010-2011(2014) Topkaya, Aynur Eren; Balıkcı, Ahmet; Aydın, Faruk; Hasçelik, Gülşen; Kayman, Tuba; Kesli, Recep; Aydemir, ŞöhretBu çalışmada, ülkemizdeki invazif A grubu streptokok (AGS) enfeksiyonlarının epidemiyolojik ve mikrobiyolojik özelliklerinin belirlenmesi ve bu hastalıkların önlenmesinde uygulanacak olan ulusal stratejilere veri sağlanması amacıyla bir yıllık aktif sürveyans yapılması planlanmıştır. Çalışmaya, Türkiye’nin 12 farklı bölgesinden (İstanbul; Doğu ve Batı Marmara; Doğu ve Batı Karadeniz; Ege; Akdeniz; Batı, Orta, Kuzeydoğu, Ortadoğu ve Güneydoğu Anadolu) toplam 46 klinik mikrobiyoloji laboratuvarı katılmıştır. Katılımcı merkezlerde, Haziran 2010-Haziran 2011 tarihleri arasında steril vücut bölgelerinden (kan, beyin omurilik sıvısı, eklem, plevra, periton, perikard sıvıları) izole edilen AGS’ler, doğrulama ve ileri çalışmalar için Maltepe Üniversitesi Tıp Fakültesi, Tıbbi Mikrobiyoloji Anabilim Dalı Laboratuvarına gönderilmiştir. Bakterilerin tanımlanması konvansiyonel yöntemlerle yapılmış; serotiplendirme için opasite faktörü (OF) ve T protein tipleri araştırılmış, genotiplendirme için AGS lizatı hazırlama, emm geni amplifikasyonu ve dizilenmesi, “Centers for Disease Control and Prevention” protokolüne göre uygulanmıştır. Çalışma dönemi içinde katılımcı merkezlerin 15’inden, 65 invazif AGS suşu izole edilmiştir. İnvazif AGS izolasyon oranının bölgesel farklılıklar gösterdiği belirlenmiş, en yüksek izolasyonun Doğu Karadeniz (Trabzon; n 19) bölgesinde olduğu, bunu İstanbul (n 17) ve Batı Anadolu (Ankara, Konya; n 14) bölgelerinin izlediği görülmüştür. İnvazif AGS enfeksiyonu tanısı konulan hastaların 33’ü kadın, 32’si erkek olup, yaş aralığı 0-89 yıl arasındadır. AGS suşlarının en fazla yumuşak doku (n 18), apse (n 10), steril vücut sıvısı (n 8) ve kan (n 7) örneklerinden izole edildiği gözlenmiştir. Serotiplendirme sonucunda 36 (%55) izolatın OF pozitif olduğu saptanmış; en sık saptanan T protein tipleri poligrup T (n 20) ve U (n 14) olmuş, bunları B (n 5), X (n 3) ve Y (n 2) izlemiştir. Yirmi iki izolatta T proteini tespit edilememiştir. Genotiplendirme sonucunda izolatların 17 farklı emm tipine sahip olduğu saptanmış; en sık rastlanan tipler; emm1 (n 13), emm4 (n 6), emm6 (n 6), emm12 (n 6), emm24 (n 4), emm14 (n 3) ve emm28 6 (n 3) olarak belirlenmiş, dokuz suş dizileme ile tiplendirilememiştir. İzolatların emm tipleri ile serotipleri arasındaki korelasyon %58 olarak bulunmuştur. Kullanımdaki 26 değerli aşının invazif AGS suşlarının %70.5’ini kapsadığı tespit edilmiştir. Sonuç olarak bu çalışmayla Türkiye’de invaziv AGS enfeksiyonlarının epidemiyolojik ve mikrobiyolojik özellikleriyle ilgili ilk veriler elde edilmiştir. İnvazif AGS enfeksiyon sıklığının ülkemizde düşük olduğu, 26 değerli ASG aşısının aşı programına dahil edilmesinin ülkemiz için şu anda acil halk sağlığı sorunu olmadığı ve eğer ülkemizde kullanılacaksa aşıya emm4 ve emm24 tiplerinin de eklenmesi gerektiği ortaya çıkmıştır.
