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  • Küçük Resim
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    Acute otitis media and respiratory viruses
    (European Journal of Pediatrics, 2007) Bulut, Yunus; Güven, Mehmet; Otlu, Barış; Yenişehirli, Gülgün; Aladağ, İbrahim; Eyibilen, Ahmet; Doğru, Salim
    Abstract The present study was performed to elucidate the clinical outcome, and etiology of acute otitis media (AOM) in children based on virologic and bacteriologic tests. The study group consisted of 120 children aged 6 to 144 months with AOM. Middle ear fluid (MEF) was tested for viral pathogens by reverse transcriptase polymerase chain reaction (RT-PCR) and for bacteria by gram-staining and culture. Clinical response was assessed on day 2 to 4, 11 to 13, 26 to 28. Respiratory viruses were isolated in 39 patients (32.5%). Respiratory syncytial virus (RSV) (46.5%) was the most common virus identified in MEF samples, followed by human rhinovirus (HRV) (25.6%), human coronavirus (HCV) (11.6%), influenza (IV) type A (9.3%), adenovirus type sub type A (AV) (4%), and parainfluenza (PIV) type -3 (2%) by RT-PCR. In total 69 bacterial species were isolated from 65 (54.8%) of 120 patients. Streptococcus pneumoniae (S. pneumoniae) was the most frequently isolated bacteria. Viral RNA was detected in 31 (56.3%) of 55 bacteria-negative specimens and in 8 (12.3%) of 65 bacteria-positive MEF samples. No significant differences were found between children representing viral infection alone, combined viral and bacterial infection, bacterial infection alone, and neither viral nor bacterial infection, regarding clinical cure, relapse and reinfection rates. A significantly higher rate of secretory otitis media (SOM) was observed in alone or combined RSV infection with S. pneumonia or Haemophilus influenzae (H. influenzae) than in other viruses infection. Conclusion. This study provides information about etiologic agents and diagnosis of AOM in Turkish children. The findings highlight the importance of common respiratory viruses and bacterial pathogens, particularly RSV, HRV, S. pneumoniae and H. influenzae, in predisposing to and causing AOM in children.
  • Küçük Resim
    Öğe
    Primary drug resistance and molecular epidemiology of the Mycobacterium tuberculosis strains isolated in the Kelkit valley
    (Turkish Journal of Medical Sciences, 2009) Bulut, Yunus; Yenişehirli, Gülgün; Otlu, Barış; Seyfikli, Zehra; Çelikel, Serhat; Yılmaz, Ayşe; İnönü, Handan
    Öz: Amaç: Bu çalışmada; Kelkit vadisinden izole edilen Mycobacterium tuberculosis izolatlarında primer ilaç direncinin ve direnç genotiplerinin belirlenmesi amaçlanmıştır. Yöntem ve Gereç: İzolatların, izoniazid, rifampisin, etambutol ve streptomisin dirençleri BACTEC metoduyla belirlendi. Kırk sekiz dirençli Mycobacterium tuberculosis suşu spoligotiplendirme yöntemiyle genotiplendirildi. Bulgular: En az bir ilaca direnç % 11.6, birden fazla ilaca direnç % 8.25 olarak belirlendi. Tek ilaç direnci sırası ile izoniazid (INH), etambutol (ETB), streptomisin (SM) ve rifampisin (RIF) için % 5.8, % 2.07, % 3.73 ve % 0 bulundu. İki veya daha fazla ilaca direnç oranları; streptomisin + etambutol, streptomisin + izoniazid, izoniazid + rifampisin, rifampisin + etambutol, izoniazid + etambutol + rifampisin, streptomisin + etambutol + izoniazid ve izoniazid + etambutol + rifampisin + streptomisin için sırasıyla; % 0.82, % 1.65, % 0.41, % 0.82, % 2.90, % 0.41 ve % 1.24 olarak belirlendi. Spoligotiplendirme sonuçlarına göre 15 farklı genotip paterni elde edildi. Bu yöntemle 4 izolat tiplendirilemedi. Çalışmamızda en sık rastlanan spoligotip kümeleri sırası ile ST4 (n = 10, % 20.8), ST53 (n = 6, % 12.5), ST7 (n = 4, % 8.3), ST41 (n = 4, % 8.3), ST31 (n = 4, % 8.3); ve familyaları TI (n = 18, % 37.5), S (n = 12, % 25) ve LAM-7 TUR (n = 4, % 8.3) olarak saptandı. Sonuç: Kelkit vadisinde yapılan bu ilk çalışmada; major anti tüberküloz ilaçlara karşı yüksek oranda direnç varlığı gözlendi.