It is extremely important to identify the predominant infecting organisms and antibiotic resistance profiles in hospitals primarily departments at risk for infection such as intensive care units in terms of rational use of antibiotics and hospital infection control measures. In this study, it was aimed to determine the antibiotic resistance rates of microorganisms isolated from various clinical specimens of intensive care unit patients in our hospital between February 2010 and February 2011. Microorganisms were identified by conventional methods, antibiotic susceptibilities were determined by using Kirby-Bauer disk diffusion method and evaluated according to the Clinical and Laboratory Standards Institute (CLSI) recommendations. Growth was detected in 33 % out of 897 samples and 297 microorganisms consisting of 152 (51 %) Gram positive, 102 (34 %) Gram negative bacteria and 43 (14 %) Candida species were isolated. One hundred and thirty seven microorganisms were isolated from respiratory specimens, 87 from blood, 54 from urine and 19 from wound samples. The most frequently isolated Gram-negative bacteria  was Pseudomonas spp. (n=58, 38 %), followed by Escherichia coli (n=29; 19 %), Acinetobacter spp. (n=25; 16 %), Klebsiella spp. (n=22; 14 %), and other Gram-negative bacteria [(n=18; 12 %); 8 Citrobacter spp., 7 Enterobacter spp., 2 Proteus spp., 1 Serratia spp.]. The most effective antibiotics were amikacin and imipenem for E.coli, Klebsiella and other Enterobacteriaceae and cefepime for Pseudomonas and Acinetobacter spp. Among Gram positive bacteria 68 (67 %) were coagulase negative Staphylococcus (CNS), 19 were Staphylococcus aureus, 12 were Enterococcus spp. and 3 were Streptococcus pneumoniae. Methicillin resistance rate was 74 % in CNS and S.aureus. These data may contribute to making the appropriate empirical treatments and the measures for the intensive care unit infections.

Zerife ORHAN1, Mustafa GÜL2, Murat ARAL2, Ali ÖZER3, Arzu KAYIŞ1
1Kahramanmaraş Sütçü İmam Üniversitesi, Sağlık Hizmetleri Meslek Yüksekokulu, KAHRAMANMARAŞ
2Kahramanmaraş Sütçü İmam Üniversitesi Tıp Fakültesi, Tıbbi Mikrobiyoloji Anabilim Dalı, KAHRAMANMARAŞ
3İnönü Üniversitesi Tıp Fakültesi, Halk Sağlığı Anabilim Dalı, MALATYA

In this study, we aimed to determine the prevalence of H. pylori antigens and distribution according to age and gender groups in fresh stool samples sent to our laboratory with stool antigen test request.
Results of 8402 stool specimens obtained from different patients and sent to the laboratory with H.pylori stool antigen test request between January 2006 and December 2010, were retrospectively evaluated. For each patient, only the first result was included in the study. Statistical differences between H.pylori stool antigen positivity rates in different age, gender and child-adult groups were determined using Z proportion test. 4304 (51 %) of examined stool samples belonged to children and 4098 (49 %) to adult patients. Positivity rates of H.pylori antigen in children, adults group and in total were 20.7 %, 25.5 % and 23 %, respectively. Higher rate seen in adult patients compared to children group was found statistically significant (p<0.001). Whereas statistically significant difference between genders in children group was not observed, in adult group women’s H.pylori positivity rate was found significantly higher (p<0.05). H.pylori antigen frequencies distribution by age groups showed increase in H. pylori antigen prevalence parallel to age increase, with the highest values in 26-35 age group, drawing a plateau in the subsequent age groups and showing decrease in group above 56 years.
As a result, the high prevalence of H. pylori and increase of prevalence parallel to age are significant facts. Commonly seen bacterium H.pylori with its well known relationship with gastric cancer and required eradication after diagnosis, is a major public health problem in our region.

Keywords: age, Helicobacter pylori, prevalence, stool antigen test

The prevalence of autoantibodies positivity in serum samples of patients with chronic hepatitis C infection, and the relationship between the presence of autoantibodies and HCV RNA positivity were investigated. Serum samples of 121 anti-HCV positive and 68 anti-HCV negative patients were included in this study. Serum ANA, ASMA, AMA, LKM were detected by indirect immunofluorescence assay. HCV RNAs were detected by using quantitative real-time polymerase chain reaction.
There was no significant differences in positivite for at least one autoantibodies between anti-HCV positive and anti-HCV negative samples. The positivity of ANA was found to be higher among anti-HCV negative samples compared to the anti-HCV positive samples. A significantly higher incidence of AMA were seen in HCV RNA positive samples. The HCV viral load was significantly lower in the autoantibody positive samples with HCV RNA positive.
In conclusion, although autoantibodies are commonly found among patients with chronic hepatitis C infection, the relationship between autoantibodies production and HCV infection is still controversial. More studies are required to understand the autoimmune mechanisms in chronic hepatitis C infection.

Aspergillus spp., which is widely distributed throughout the earth is an important opportunistic mold. Aspergillus fumigatus is the most common cause of invasive aspergillosis. It is a rare cause of spondylitis in the immunocompromised host. In this paper, we report a case of A. fumigatus spondylodiscitis, which developed in a patient with amyloidosis, nephrotic syndrome and history of steroid consumption, treated with voriconazole.

Keywords: Aspergillus fumigatus, discitis, spondylitis, spondylodiscitis, voriconazole

Although influenza vaccination is announced to be the most effective prevention method for the outbreak of 2009 pandemic influenza A H1N1 virus, especially the speculations for vaccine ingredient squalene and its adverse effects have suppressed its effectiveness and caused controversy. Squalene, a natural organic lipid which belongs to triterpene class of terpenoids, is used for medical purposes, besides dietary supplement and in cosmetics industry, as oil-in-water emulsion vaccine adjuvant because of being degradable oil and its biological origin.
Formulations of squalene with tween 80 and span 85 which are ingredients of influenza vaccines, have proved to induce potent humoral responses as well as cellular immune responses and their effectiveness to be more potent and long lasting than alum which is an adjuvant used in vaccines for more than 70 years. In a series of studies on adverse effects of squalene, although local and short term adverse effects were detected to be more frequent compared to non-adjuvanted vaccines, there were no significant differences in terms of unexpected or serious adverse effects.
After it was reported that squalene was included in multi-vaccination program and there was a significant correlation with anti-squalene antibodies and chronic multisymptomatic illnesses (Gulf war syndrome) in American veterans during the Gulf war, the adequacy of these reports and validations of the performed methods were extensively questioned. As a result of recent reports using validated methods and control groups, the claimed correlation between squalene antibodies and the illness could not be confirmed.
In this review, squalene which has a bright future in drug and gene transfer as well as vaccine applications is examined into with the light of recent publications.

Keywords: influenza A virus H1N1, influenza vaccines, MF59 oil emulsion, Persian gulf syndrome, squalene