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Antifungal activity of organic and organometallic derivatives of benzimidazole and benzothiazole
(Ecv-Editio Cantor Verlag Medizin Naturwissenschaften, 1997) Kucukbay, H; Durmaz, B
Forty organic or organometallic derivatives of benzimidazole and benzothiazole and five rhodium(I) and ruthenium(Ir) complexes were evaluated for their in vitro antifungal activity against Candida albicans. Four of the tested compounds, the rhodium containing compounds 30, 31, 32 and 33, were found effective at the minimum inhibitory concentrations(MICs) between 400-600 mu g/ml.
Aqueous humor penetration of topically applied ciprofloxacin, ofloxacin and tobramycin
(Ecv-Editio Cantor Verlag Medizin Naturwissenschaften, 1997) Durmaz, B; Marol, S; Durmaz, R; Oram, O; Hepsen, IF; Gunal, S
The purpose of this study was to determine the aqueous humor concentrations of topically applied ciprofloxacin (GAS 86393-32-0), ofloxacin (GAS 82419-36-1) and tobramycin (GAS 79645-27-5). Thirty patients undergoing cataract extraction or trabeculectomy were randomly divided into three groups and each of the group received either 0.3 % ciprofloxacin, ofloxacin or tobramycin topical drops preoperatively. Eyedrops were instilled for six times at a frequency of one drop every 15 minutes, beginning 90 minutes before initiation of the surgery. At the time of surgery, 0.1 mi aqueous fluid was aspirated from the anterior chamber. Concentrations of the antimicrobial agents were determined using the microbroth dilution procedure outlined by the National Committee for Clinical Laboratory Standards. Escherichia coli (ATCC 25922) was used as a standard strain for determination of minimal inhibitory concentrations (MICs). The mean aqueous levels of ciprofloxacin and ofloxacin were found to be 0.092 +/- 0.077 mu g/ml, 0.964 +/- 0.693 mu g/ml, respectively. Tobramycin did not reach the concentration that could be detected by applied method. Conclusion: The mean aqueous humor levels of ofloxacin and ciprofloxacin were more than the MICs levels for most of the ocular pathogens which may cause postoperative endophthalmitis.
Bacteriological, clinical and epidemiological characteristics of hospital-acquired Acinetobacter baumannii infection in a teaching hospital
(W B Saunders Co Ltd, 2003) Ayan, M; Durmaz, R; Aktas, E; Durmaz, B
Over an 18 month period, the bacteriological, clinical and epidemiological characteristics of nosocomial Acinetobacter baumannii infections in a teaching hospital were studied. Typing studies were performed on 38 strains isolated from 36 patients. Twenty-two of the strains were isolated during the three outbreaks. Surgery, catheterization, mechanical ventilation, and antibiotic therapy for adult patients and respiratory distress syndrome, mechanical ventilation, and prematurity for paediatric patients were the main risk factors identified. All isolates were resistant to penicillins (except ampicillin-sulbactam), cephalosporins, gentamicin, and aztreonam but susceptible to carbapenems and colistin. Resistance to tobramycin, ciprofloxacin, ampicillin-sulbactam, trimethoprim-sulfamethoxazole, and amikacin was variable. Antibiotyping, arbitrarily-primed polymerase chain reaction (AP-PCR) and the pulse-field get electrophoresis (PFGE) indicated the epidemiological relationship. The outbreak strains, demonstrated genetic distinction between our three outbreaks and isolates from specific areas in the hospital. (C) 2003 The Hospital Infection Society. Published by Elsevier Science Ltd. All rights reserved.
Bacteriology of chronic maxillary sinusitis and normal maxillary sinuses: Using culture and multiplex polymerase chain reaction
(Ocean Side Publications Inc, 2003) Kalcioglu, MT; Durmaz, B; Aktas, E; Ozturan, O; Durmaz, R
Background: Although many investigations have been performed on bacteriology of chronic sinusitis and normal sinuses, there still is much discussion. Also a new bacterial agent, Alloiococcus otitidis determined in the nasopharynx and middle ear specimens can be thought as a causative agent of sinusitis. Methods: The bacteriology of chronic maxillary sinusitis and maxillary sinuses with normal radiogram and endoscopic findings were studied by culture methods for aerobic and anaerobic bacteria. Multiplex polymerase chain reaction (PCR) was used to investigate four bacteria in study and control groups. There were 27 specimens in the study group and 28 specimens in the control group. Results: In the study group, the bacteria commonly isolated were Staphylococcus aureus (11.1%), alpha-hemolytic streptococci (11.1%), Streptococcus pneumoniae (11.1%), Haemophilus influenzae (7.4%), coagulase-negative staphylococci (7.4%), and anaerobes (33.3%). Coagulase-negative staphylococci (14.3%), alpha-hemolytic streptococci (10.7%), and anaerobes (35.7%) were isolated also in the control group. PCR was used to investigate S. pneumoniae, H. influenzae, Moraxella catarrhalis, and A. otitidis in the study and control groups. None of these bacteria was determined in the control group whereas detection rates of these bacteria in the study group were 11.1, 11.1, 3.7, and 7.4%, respectively. It should be considered that PCR yielded faint amplification band for A. otitidis. Conclusion: Using multiplex PCR can help to increase detection rates of bacterial etiology. Healthy sinuses are not sterile. A. otitidis may be one of the pathogens causing sinusitis.
Concentration of total serum IgE in parasitized children and the effects of the antiparasitic therapy on IgE levels
(Oxford Univ Press, 1998) Durmaz, B; Yakinci, C; Köroglu, M; Rafiq, M; Durmaz, R
[Abstract Not Available]
Detection and typing of extended-spectrum ?-lactamases in clinical isolates of the family Enterobacteriaceae in a medical center in Turkey
(Mary Ann Liebert, Inc, 2001) Durmaz, R; Durmaz, B; Koroglu, M; Tekerekoglu, MS
To determine and type the extended-spectrum beta -lactamases (ESBLs) among the family Enterobacteriaceae in a medical center, a total of 668 clinical isolates were screened. Of the 668 isolates, the 80 strains were presumptively defined as ESBL producers according to the result of disk method using ESBL marker antibiotics (aztreonam, ceftazidime, and cefoxitin). These 80 strains were retested with the double-disk synergy test (DDST), the E-test ESBL strip, a 5-mug ceftazidime disk, and agar dilution MICs of ceftazidime with and without clavulonic acid. Isoelectric focusing was performed to confirm ESBL production and type the beta -lactamases. By evaluation of the results of all tests used for ESBL detection together with isoelectric focusing, 33 (4.9%) of the 668 isolates were described as ESBL producer. The positive results of the agar dilution test, DDST, the E-test strip, and 5-mug ceftazidime disk were 32, 26, 27, and 26 of the 33 strains, respectively. ESBL positivity was 48.8% in Klebsiella species, 15.4% in Citrobacter species, 4.9% in Enterobacter species and 1.1% in Escherichia coli strains. The ESBL enzymes frequently determined were SHV-2/6-like (pI 7.6), SHV-5-like (pI 8.2), SHV-4-like (pI 7.8), and SHV-3-like (pI 7). SHV-derived enzymes were commonly observed in Klebsiella spp whereas TEM-related enzymes were seen in E. coli strains. The results of this study indicated that SHV-2/6-derived (pI 7.6) ESBL expression among the isolates of the family Enterobacteriaceae is an important problem in our medical center.
Effect of abdominal insufflation on bacterial growth in experimental peritonitis
(Mary Ann Liebert Inc Publ, 2001) Sare, M; Demirkiran, AE; Alibey, E; Durmaz, B
Background: Perforated appendicitis can be treated laparoscopically, but this approach is associated with a higher rate of intra-abdominal abscess. Pneumoperitoneum impairs the clearance of bacteria from the peritoneal cavity in experimental models of peritonitis. The aim of this study was to investigate the effects of intra-abdominal gas insufflation on bacterial growth in a rat model. Materials and Methods: The effects of intraperitoneal insufflation with different gases and a gasless model on bacterial proliferation in a setting of Escherichia coli-induced experimental peritonitis were studied in a rat model. Saline (0.25 mL) was given intraperitoneally to six Wistar male rats as the sham group. Escherichia coli (1.5 x 10(9) cfu/mL per kilogram) was injected intraperitoneally into to 24 rats. Microorganism counts were taken after 8 hours, and rats were divided into three groups: group 1, CO2 insufflation; group 2, N2O insufflation; and group 3, no insufflation. Microorganism counts were repeated 8 hours after the procedure (at 16 hours postinjection). Results: The difference in microorganism counts between 8 and 16 hours were significant in the CO2 and N2O insufflation groups (P < 0.05) but not in the group without pneumoperitoneum. Conclusions: Abdominal insufflation may promote intra-abdominal bacterial growth or decrease intra-abdominal bacterial clearance.
Effects of laparoscopic models on anaerobic bacterial growth with Bacteroides fragilis in experimentally induced peritonitis
(Mary Ann Liebert Inc Publ, 2003) Sare, M; Demirkiran, AE; Tastekin, N; Durmaz, B
Background: Previous reports of recurrent intra-abdominal abcess formation after the laparoscopic treatment of perforated acute appendicitis led us to investigate the possible effects of gas insufflation on the spread of infection. We previously showed that Escherichia coli counts were significantly higher in a laparoscopy group that underwent carbon dioxide (CO2) insufflation than in control and laparotomy groups. The aim of this study is to investigate the effects of intra-abdominal CO2 and nitrous oxide (N2O) insufflation on anaerobic bacterial growth in a rat model. Methods: A standard strain of Bacteroides fragilis (ATCC 25285) was injected intraperitoneally (1 x 10(6) cfu/mL per kilogram) in 40 Wistar rats under sterile conditions. Forty rats with induced peritonitis were randomly divided into five groups: control, laparotomy, CO2 insufflation, N2O insufflation, and one group without pneumoperitoneum. Eight hours after the intraperitoneal injection of B. fragilis, peritoneal aspirates were obtained and inoculated onto Brucella agar. At the sixteenth hour of induced peritoneal infection (corresponding to hour 8 in the laparoscopy groups) all animals underwent laparotomy; peritoneal aspirates were obtained and inoculated into Brucella agar for bacterial counts. The colonies of B. fragilis were counted manually, and the results were expressed as the mean number of colony-forming units per milliliter. Results: No significant differences in microorganism counts were noted between the study groups before the procedure (p >.05 for all comparisons). We observed a significant increase in the number of bacteria (mean +/- SD) in the CO2 insufflation group between hour 8 and hour 16 of peritoneal contamination. Conclusion: The results suggest that CO2 insufflation may promote the growth of intra-abdominal anaerobic bacteria. Such bacterial growth may lead to intra-abdominal abcess formation or cause localized peritonitis to develop into generalized peritonitis. We suggest that laparoscopy without pneumoperitonemn may be preferred in patients with peritonitis.
Evaluation of culture results of specimens from patients with suspected anaerobic infection
(Luigi Ponzio E Figlio, 1999) Durmaz, B; Durmaz, R; Tastekin, N
In order to establish the etiological agents of anaerobic infections, 154 clinical specimens collected from patients with suspected anaerobic infection were cultured under both aerobic and anaerobic conditions. Bacteria were isolated from 111 (72%) of these specimens. Only aerobes were recovered from 48 (43%), only anaerobes from 31 (28%) and both aerobes and anaerobes from 32 (29%) of the 111 specimens. A total 83 anaerobic bacteria including Bacteroides fragilis group (28%), Porphyromonas (19%), Peptostreptococci (10%), Prevotella (17%), Clostridia (12%), Fusobacteria (10%), Veillonella (2%) and Eubacteria (2%) were identified. Anaerobes were most commonly isolated from peritoneal fluid followed by joint fluid, abscess and endometrial materials, blood, soft-tissue biopsy and draining material.
Infective endocarditis due to Clostridium histolyticum
(Blackwell Science Ltd, 2000) Durmaz, B; Agel, HE; Sönmez, E; Türköz, R; Aydin, E
[Abstract Not Available]
Investigation of the relationship between Epstein-Barr virus and ordinary gastric carcinoma using the nested polymerase chain reaction
(Slovak Academic Press Ltd, 1998) Durmaz, R; Aydin, A; Köroglu, M; Durmaz, B; Çiralik, H
To investigate whether Epstein-Barr virus (EBV) is associated with ordinary gastric carcinoma and to determine its genotype, samples from ordinary gastric carcinoma from 65 patients (40 males, 20 females) and 21 endoscopic biopsies from 7 individuals with non-neoplastic mucosa were analysed using one-stage and nested (two-stage) polymerase chain reaction (PCR) assays. The nested PCR assay yielded 56.9% (37/65) and 52.3% (11/21) positivity for the ordinary gastric carcinoma and control cases, respectively; these results were significantly than those of the one-stage PCR assay(13.5% and 0%, respectively). The EBV positivity showed similar rate in male and female patients (60% versus 52%, P > 0.05). The dominant genotype of EBV was 1 (92%) followed by mixture of 1+2 (5.4%) and 2 (2.6%). In conclusion, similar positivity rates of EBV in neoplastic and non-neoplastic tissues suggest that the relationship of this virus to the ordinary gastric carcinoma is not clear.
Methicillin-resistance among Turkish isolates of Staphylococcus aureus strains from nosocomial and community infections and their resistance patterns using various antimicrobial agents
(W B Saunders Co Ltd, 1997) Durmaz, B; Durmaz, R; Sahin, K
The purposes of this study were to determine the prevalence of Turkish isolates of methicillin-resistant Staphylococcus aureus (MRSA) in nosocomial and community infections and their antibiotic resistant patterns. The oxacillin disk diffusion method for the detection of methicillin resistance and the Kirby-Bauer disk diffusion for antibiotic susceptibility tests were used. A total 383 S. aureus strains were identified from different patients. The prevalence of methicillin resistance among S. aureus strains was 31.3% (120/383). The proportions of MRSA isolated from nosocomial and community infections were 26.4% (46/174) and 35.4% (74/209), respectively. The resistance rates of MRSA to other antibiotics were as follows: 71% resistant to erythromycin, 54% to clindamycin, 52% to gentamicin, 44.5% to trimethoprim-sulfamethoxazole and 36% to ciprofloxacin. No strain resistant to vancomycin was recorded in this study.
Nasopharyngeal carriage, antimicrobial susceptibility, serotype distribution and clonal relatedness of Streptococcus pneumoniae isolates in healthy children in Malatya, Turkey
(Elsevier Science Bv, 2005) Bayraktar, MR; Durmaz, B; Kalcioglu, MT; Durmaz, R; Cizmeci, Z; Aktas, E
The aims of this study were to assess the nasopharyngeal colonisation rate, serogroup and antibiotic susceptibility patterns of Strepto-coccus pneumoniae strains isolated from healthy children. Of 848 children, 162 (19.1 %) were found to be carriers. The carrier rate was significantly higher in the 7-year-old age group. Children from the slums of the city had higher carriage rate (23.7%) than those in the centre of the city (17.7%), but this was not statistically significant. The number of intermediate penicillin-resistant strains was 17 (10.5%). No high-level penicillin-resistant S. pneumoniae strain was found. The rates of resistance to co-trimoxazole, erythromycin, tetracycline and clindamycin were 11.7%, 4.9%, 4.3% and 3.7%, respectively. All isolates were uniformly susceptible to rifampicin, moxifloxacin, levofloxacin and vancomycin. Fourteen different serogroups were identified. The most prevalent serogroups in descending order were 9, 19, 23, 10, 6 and 18, accounting for 76.3% of the isolates. Arbitrarily primed polymerase chain reaction typing of 105 isolates revealed that 25 (23.8%) of the isolates were clonally indistinguishable. This value was 20.9% in children from the central area and 36.8% in those from the slum of the city. There was no relationship between serogroups and genotypes, i.e. strains within the same serogroup yielded the same or different genotypes, and vice versa. In conclusion, serogrouping results give a preliminary idea about the possible coverage of a future pneumococcal vaccine. Penicillin G is still a suitable agent for the empirical treatment of pneumococcal infections in our population. Living in the slum of the city may lead to both increased carriage and clustering rates of S. pneumoniae among healthy children. (c) 2005 Elsevier B.V. and the International Society of Chemotherapy. All rights reserved.
Nosocomial infections and risk factors in intensive care units
(Luigi Ponzio E Figlio, 2003) Yologlu, S; Durmaz, B; Bayindir, Y
The present study was performed to describe the incidence and risk factors for nosocomial infections (NIs) in the intensive care units of a University hospital. From January to July 2002, 454 patients from Medical and Surgical Intensive Care Unit (MICU and SICU) were observed in the active, targeted, prospective surveillance study. Risk factors for NIs were found by logistic regression analysis. Two hundred and eighteen NIs were recorded in 149 of 454 screened patients. The overall incidence rate was calculated as 33% in the ICUs. The incidence was 39% in MICU and 29% in SICU. The most frequent nosocomial infection observed in MICU, and SICU was pneumonia (42%), and surgical wound infection (31%), respectively. Extrinsic risk factors were urinary catheter, mechanical ventilation, total parenteral nutrition, entubation, antimicrobial treatment prior to the NI, nasogastric cathater and central catheter. The highest intrinsic risk factor was unconsciousness in MICU, respiratory failure in ICU's. This high NI rates may be reduced by timely feedback of data for infection control activities. The recognition of risk factors for NIs is an important tool for the identification and development of interventions to minimize such risks in the ICU's.
Nosocomial infections in a new medical center, Turkey
(Slack Inc, 2000) Durmaz, B; Durmaz, R; Otlu, B; Sönmez, E
Nosocomial infection was found in 255 (2.5%) of 10,164 inpatients in a new medical center with a 310-bed capacity. The infection rate was 12.5% in the intensive care unit, 9.5% in neurology, 5.5% in general surgery, and 4.0% in orthopedics. Rates in the other services were lower. Hospital-acquired infections in our medical center frequently involved multiply resistant Enterobacteriaceae and staphylococci (Infect Control Hosp Epidemiol 2000;21:534-536).
Porphyromonas somerae sp nov., a pathogen isolated from humans and distinct from Porphyromonas levii
(Amer Soc Microbiology, 2005) Summanen, PH; Durmaz, B; Väisänen, ML; Liu, CX; Molitoris, D; Eerola, E; Helander, IM
Porphyromonas levii is an anaerobic, pigmented gram-negative bacillus originally isolated from bovine rumen. We describe 58 human clinical strains of P. levii-like organisms, isolated from various human clinical specimens that are phenotypically similar to the type strain of P. levii, a rumen isolate (ATCC 29147). Our biochemical, comparative 16S rRNA sequence analyses, and DNA-DNA relatedness studies indicate that the human P. levii-like organisms are similar to each other but genetically different from the P. levii type strain isolated from bovine rumen. We therefore propose the name Porphyromonas somerae to encompass the human P. levii-like organisms. P. somerae was predominantly isolated from patients with chronic skin and soft tissue or bone infections, especially in the lower extremities.
Prevalence of enterotoxigenic Bacteroides fragilis in patients with diarrhea
(Academic Press Ltd Elsevier Science Ltd, 2005) Durmaz, B; Dalgalar, M; Durmaz, R
In this age matched controlled study performed in Malatya, a city in east region of Turkey, Enterotoxigenic Bacteroides fragilis (ETBF) was investigated in stool specimens obtained from children and adults with and without diarrhea. A nested polymerase chain reaction (PCR) method was used to detect the enterotoxin gene of B. fragilis in a total of 418 stool samples, including 221 samples from 117 children (aged 0-16 years) and 104 adults (aged > 16 years) with diarrhea, and 197 samples from 102 children and 95 adults as control group that was the same age group with those having diarrhea. ETBF was detected in 13 of 117 diarrheal children (11.1%) and 8 of 102 control children (7.8%) (P > 0.05). In children aged 1-5 years, the rate of ETBF was significantly higher in patients than in controls (25% versus 9.5%, respectively; P < 0.05). On the other hand ETBF was detected similar rates (2.2% and 2.4%, respectively) in children younger than 1 year in both patients and controls. ETBF positivity was not significantly difference between patient and control groups who were older than 5 years of age and adults. The frequency of ETBF in the controls was slightly higher in older persons than in younger ones; however, it was not significant. The rate of ETBF as the only enteropathogen in the patients with ETBF was significantly higher than in controls with ETBF (88% versus 39%, respectively; P < 0.02). We found that in east region of Turkey, the prevalence of ETBF was higher in the childhood diarrhea, particularly in aged 1-5. As the only enteropathogen, ETBF may play an important role in diarrheal diseases. Persons after 6 years old can be carrier for ETBF regardless diarrhea. (c) 2005 Elsevier Ltd. All rights reserved.
Prevalence of group A streptococcal carriers in asymptomatic children and clonal relatedness among isolates in Malatya, Turkey
(Amer Soc Microbiology, 2003) Durmaz, R; Durmaz, B; Bayraktar, M; Ozerol, IH; Kalcioglu, MT; Aktas, E; Cizmeci, Z
In our study, the prevalence of nasopharyngeal Streptococcus pyogenes was 130 (14.3%) of 909 healthy children. Isolates were found to be susceptible to all antibiotics tested. Pulsed-field gel electrophoresis and arbitrarily primed PCR revealed that 34 (32.4%) of the 105 isolates and 41 (40.6%) of the 101 isolates typed, respectively, were clonally indistinguishable.
Primary drug resistance and molecular epidemiology of Mycobacterium tuberculosis isolates from patients in a population with high tuberculosis incidence in Turkey
(Mary Ann Liebert, Inc, 2003) Durmaz, R; Ozerol, IH; Durmaz, B; Gunal, S; Senoglu, A; Evliyaoglu, E
To determine the rate of primary drug resistance and compare the fingerprint pattern diversity of the resistant and sensitive Mycobacterium tuberculosis isolates, antituberculosis susceptibility testing and restriction fragment length polymorphism (RFLP) analysis were performed on 88 M. tuberculosis isolates of the patients who were diagnosed as new tuberculosis cases in 2000. Primary resistance to isoniazid, rifampicin, ethambutol, and streptomycin were determined by the BACTEC method. IS6110 and pTBN12 were used as molecular markers. The frequency of resistance to at least one drug was 32.95%, whereas 10.23% of the isolates were resistant to more than one drug. Single-drug resistance to isoniazid, streptomycin, ethambutol, and rifampicin was found in 9 (10.22 %), 7 (7.95 %), 4 (4.54 %), and 0 (0.0 %) strains, respectively. Two M. tuberculosis strains (2.26%) showed multiple drug resistance. The combination of two fingerprinting procedures on a total of 88 isolates identified 58 (65.9%) strains as unique and clustered 30 strains in 11 clusters (clustering = 34.1%). The clustering rate for resistant and sensitive isolates was 13.8% and 40.1%, respectively. In conclusion; drug susceptibility testing showed that the majority of the drug-resistant infections involved either isoniazid or streptomycin alone. In addition to the high tuberculosis incidence, elevated primary drug resistance and high clustering rate indicate problems in the present control programs. New control strategies supported by molecular typing might be more effective to reduce tuberculosis.
Sensitivity of two-stage PCR amplification for detection of Mycobacterium tuberculosis in paraffin-embedded tissues
(Elsevier Science Bv, 1997) Durmaz, R; Aydin, A; Durmaz, B; Aydin, NE; Akbasak, BS; Gunal, S
In order to improve the sensitivity of polymerase chain reaction (PCR) for the detection of mycobacterial DNA in paraffin-embedded tissues, a new approach with two sets of specific primers in two-stage PCR was employed in specimens obtained from tuberculosis patients and controls. Thirty-nine paraffin blocks selected from patients who had been diagnosed as having tuberculosis by radiological evaluations, histopathological findings,land clinical symptoms and signs including response to antituberculous treatment were examined. The control group consisted of 10 specimens from individuals that were proved to be negative for tuberculosis. After deparaffinization, lysis, phenol-chloroform extraction, and ethanol precipitation, the isolated DNA was amplified by PCR. Initially, all specimens were examined by the one-stage PCR using specific primers for 123-base pair (bp) fragment in IS6110 of mycobacterial DNA which yielded positive results only in 3 out of 39 (7.7%). In the two-stage PCR technique, 245-bp fragment of mycobacterial DNA was amplified at the first-step, then the PCR products were reamplified using the second specific primer pairs for 123-bp fragment. The true positivity of the two-stage PCR was 84.6% (33/39). The results indicate that two-stage PCR is more sensitive than one-stage (84.6% vs. 7.7%). All control specimens were negative by both PCR amplification methods, indicating that specificity of both methods was high. When the two-stage amplification was used, PCR positivity in the specimens obtained from different tissues was as follows: peritoneal and omental biopsies, 4/4; bone biopsies, 3/3; lymph node biopsies, 12/14; genito-urinary biopsies, 7/9; skin biopsies, 4/6; and one from each lung, breast, and pleural biopsies. PCR showed a good correlation with the granulomatous tissue reaction resulting in a 83.8% (31/37) positivity. The results indicate that the two-stage PCR amplification can be used for detection of M. tuberculosis in paraffin-embedded tissues and is a useful technique in confirming tuberculosis in patients with clinically suspected disease who have acid-fast stain-negative. (C) 1997 Elsevier Science B.V.

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