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Shigella, a member of enterobacteriaceae, is endemic over the world and causes infections with high mortality rates especially in developing countries. Disease is more common among children under 5 years old and is an important cause of children death in world. World health organisation (WHO) consider the researches of a protective vaccine developement for shigellosis as a priority. Protective vaccines for Shigella infections are focused on conjugate vaccines based on bacterial O polysaccharide linked to a carrier protein administered by parenteral, oral or intranasal; live attenued vaccines conferring protection without causing disease; live oral vaccines obtained by genetic process following the discover of genes involved in pathogenesis; hybrid live vector Shigella vaccines; wide spectrum vaccines and invazin-complex vaccines. Last years, since virulance factors and pathogenesis of Shigella are discovered, promising vaccines for future are developed. In this review, vaccine developement strategies for obtaining protective and safe vaccines from past to now are investigated.

Enterobacteriaceae ailesinin bir üyesi olan Shigella cinsi tüm dünyada endemik olarak görülmek- te, özellikle gelișmekte olan ülkelerde yüksek mortalite ile seyreden infeksiyonlara neden ol- maktadır. Hastalık çoğunlukla 5 yașın altındaki çocuklarda görülmekte ve dünyada çocuk ölümü nedenlerinin arasında önemli bir yer tutmaktadır. Dünya Sağlık Örgütü (WHO) șigelloza karșı koruyucu așı geliștirme çalıșmalarını öncelikleri arasına almıștır. Shigella infeksiyonları için koru- yucu așılar, bakteri O polisakkariti tașıyıcı bir protein ile bağlanarak parenteral, oral veya intranazal uygulanan konjuge așılar; hastalık olușturmadan koruyucu etki sağlamayı hedefleyen canlı attenue așılar; patogenezde rol oynayan genlerin aydınlatılması ile genetik yoldan elde edilecek canlı oral așılar; hibrit canlı vektör Shigella așıları; geniș spektrumlu așılar ve invazin kompleks așısı üzerinde yoğunlașmıștır. Son yıllarda Shigella virülans faktörlerinin ve patogenezinin iyice aydınlatılması ile gelecekte umut vaad eden așılar elde edilmiștir. Bu der- lemede, koruyucu ve güvenilir așı elde etmek için geçmișten günümüze yapılan așı geliștirme stratejileri incelenmiștir

Fifty-three Salmonella enterica group C isolates obtained from various human samples (47 stool, 4 blood and 2 urine) in ten provinces of Turkey between 1 July 2000 and 30 June 2002 were serotyped and resistance to antimicrobials was investigated by agar dilution tests. The isolates were identified as S. Choleraesuis (11), S. Hadar (7), S. Irumu (4), S. Virchow (3), S. Tallahassee (3), S. Paratyphi C (2), S. Braenderup (2), S. Othmarschen (2), S. Menston (2), S. Concord (2), S. Infantis (2), S. Kottbus (2), S. Edinburg (1), S. Oranienburg (1), S. Muenchen (1) and S. Malmoe (1). Antimicrobial resistance rates of S. enterica groups C1 and C2 were high for ampicillin (26% and 60%, respectively), amoxicillin/clavulanic acid (11% and 40%), chloramphenicol (16% and 27%) and tetracycline (3% and 40%). The percentages of strains sensitive to all antimicrobials were 58% and 33%, respectively. Multiresistance was not observed in group C1 isolates, but the rate of multiresistant isolates was 13% in group C2. The rate of decreased ciprofloxacin susceptibility (CipL) was 61% in serogroup C1 and 20% in serogroup C2. These results indicated that S. enterica group C infections in humans were not infrequent in Turkey and that multiple antimicrobial resistance was common within these strains.

Bacteria in Salmonella genus are separated into more than 2600 serovars. It is important that the isolated serovars and their sources are known in a certain country. This will help the identification of new Salmonella serovars that will be isolated later on. Since there is no Salmonella reference center in Turkey, Salmonella serovars isolated in Turkey were mainly reported by the articles of Aksoycan's manuscripts in various years, and in the list of Toreci and Ang in 1991. The aim of this meta-analysis was to detect and prepare a list for all the Salmonella serovars isolated from human and non-human samples in Turkey up to the end of 2011. In creating this serovar list, libraries, personal and institutional archives, theses, publication lists, books published after scientific meetings and congresses, and international and local periodicals have been explored, and members of Turkish Microbiology Society are communicated via the web site of the society and personal e-mail addresses, and their publications regarding Salmonella serovars were requested. The list also includes the modifications on the names and antigenic formulae of the serovars that were carried out in recent years. The number of serovars isolated in Turkey up to the end of 2011 is 129. Fifty three of them were isolated from humans, 38 from humans and non-human samples, and 38 from non-human samples. The total number of serovars isolated from humans is 91. Twenty seven serovars from serogrup 0:4 (B); 23 serovars from serogrup 0:7 (C1); 25 serovars from serogrup 0:8 (C2-C3); 16 serovars from serogrup 0:9 (D1); 8 serovars from serogrup 0:3,10 (E1) and 5 serovars from serogrup 0:28 (M) have been reported. Only two of the more than 2600 serovars known were isolated firstly in Turkey: S. Istanbul (8:z10: e,n,x) in 1969 and S. Adana (43:z10:1,5) in 1977. Previously, serovars containing 1 and 25 O antigen of S. Boecker ([1],6,14,[25]) were isolated in 1967 and 1971 for the first time in Turkey. In 1967, a serovar containing T1 antigen that appears during S-R alteration in Salmonella, with (T1: b: e,n,x) antigen formula has been isolated from non-human samples and was reported to be a probable S-R alteration of Salmonella Benfica. Furthermore, non-motile isolates of Salmonella enterica subsp enterica serogrup 0:7 (C1) and serogrup 0:9 (D) were reported as well. While reporting a new Salmonella isolation in a country one should not be content with only giving the name of the serovar, but also emphasize the antigenic structure and the identification method clearly.

In this study a total of 122 Salmonella serotype Enteritidis stock strains selected from the culture collection of Enterobacteriaceae Laboratory of Ankara University Faculty of Medicine, Department of Medical Microbiology, were investigated by plasmid profile analysis with the method defined by Kado and Liu and pulsed field gel electrophoresis (PFGE) according to World Health Organization protocols using SpeI and XbaI macrorestriction enzymes, for better understanding of the molecular epidemiology of S. Enteritidis. The study strains were selected from a collection of previously isolated epidemic (n= 13) and sporadic (n= 109) strains (103 stool, 16 blood and one each bile, urine and cerebrospinal fluid) obtained from 10 different cities after the year 2000. PFGE patterns were analyzed with Gene Directory software (Syngene, UK) and a similarity index was determined by using Dice coefficient and the unweighted pair group method with mathematical averaging (UPGMA). Plasmid-carrying 110 (90%) strains that harbored 1-4 plasmids with sizes ranging from 2.0 to 100 kb were separated into patterns more than 14 (p1-p14). A total of 85 (69.7%) isolates harbored the 57 kb plasmid solely or in combination with other plasmids. By PFGE, 11 distinct patterns were shown with each enzyme SpeI and XbaI. S. Enteritidis strains after digestion with macrorestriction enzyme SpeI generated 11 different PFGE patterns (A to K), whereas XbaI generated also 11 different PFGE patterns (a to k). PFGE pattern A consisted of 93 strains (76.2%) after digestion with macrorestriction enzyme SpeI, while PFGE pattern a consisted 53 (43.4%) and PFGE pattern b 42 strains (34.4%) after digestion with macrorestriction enzyme XbaI. Using two macrorestriction enzymes two PFGE cluster profiles Aa (50 strains, 40.9%) and Ab (42 strains, 34.4%) were found to be predominating among 17 different PFGE clusters. Our results confirmed the clonal nature of S. Enteritidis strains in Turkey. The use of two enzymes in PFGE analysis appeared to increase the discriminatory power of PFGE, leading to greater diversity among strains. PFGE analysis performed by SpeI and XbaI enzymes combined with plasmid profiling could be established as a useful tool for detection of genetic relationship between isolates.

160 Salmonella strains were isolated from children at the paediatrics department of Ankara University. 48.1% of the isolates were Salmonella enteritidis, 41.9% Salmonella typhimurium and 10% other serotypes. For the analysis of data, the study period was divided into 2 periods: 1993-95 and 1996-99. A decline in the isolation rate of S. typhimurium (from 63.1% to 30.1%) and rapid rise in S. enteritidis (from 31.6% to 57.3) was observed during the review period. However, for S. typhimurium isolates, the 5-drug (ampicillin, chloramphenicol, streptomycin, tetracycline and sulfonamides) pattern of resistance was increased from 13.5% to 38.7% in the second period. Since S. enteritidis and 5-drug-resistant S. typhimurium have also increased in other countries, their pandemic spread in humans indicates the continuing importation and exportation of these pathogens.

To investigate the characteristics of Salmonella serotype Typhi and Salmonella serotype Paratyphi B, which still remain significant in Turkey. Materials and methods: Eighteen S. Typhi and 42 S. Paratyphi B strains isolated from clinical samples were investigated by plasmid profile analysis, enterobacterial repetitive intergenic consensus-polymerase chain reaction (ERIC-PCR), and pulsed field gel electrophoresis (PFGE) methods. Results: Plasmid profile analysis showed that 10 out of 18 (56%) S. Typhi isolates harbored 1 to 3 plasmids, and 11 out of 42 (26.2%) S. Paratyphi B isolates harbored 1 to 4 plasmids. PFGE performed with restriction enzyme AvrII grouped both S. Typhi and S. Paratyphi B isolates into 14 clusters; with restriction enzyme XbaI, S. Typhi and S. Paratyphi B isolates were grouped into 13 and 12 clusters, respectively. Conclusion: These results showed that plasmid profile analysis and PFGE are reliable and discriminative methods complementing the phenotypic characters of S. Typhi and S. Paratyphi B isolates, and may contribute to the epidemiologic investigation of typhoid or paratyphoid diseases. The study presented here is the first report on S. Typhi and S. Paratyphi B isolates from Turkey investigated by plasmid profile analysis, ERIC-PCR, and PFGE methods.

Eleven Salmonella Choleraesuis and seven Salmonella Hadar strains isolated from various clinical humand samples were investigated by plasmid profile analysis, enterobacterial repetitive intergenic consensus-polymerase chain reaction (ERIC-PCR) and pulsed-field gel electrophoresis (PFGE) in order to obtain information at a molecular level on the epidemiology of S. Choleraesuis and S. Hadar, which are significantly present in Turkey. Plasmid profile analysis showed that 10 (90.9%) of 11 S. Choleraesuis isolates harbored one to two plasmids with sizes of 2.0, 5.0 or 6.5 kb; and 5 (71.4%) of 7 S. Hadar isolates harbored one to three plasmids ranging from 2.5 to 70 kb. ERIC-PCR was performed using ERIC-2 primers; since isolates within each serotype showed similar band models, we concluded that ERIC-PCR is not suitable for differentiating isolates within the same serotype and for grouping into clusters. In PFGE using the AvrII enzyme, S. Choleraesuis isolates formed three clusters, and S. Hadar isolates formed three clusters; using the XbaI enzyme, S. Choleraesuis isolates formed two clusters, and S. Hadar isolates formed four clusters. These results showed that plasmid profile analysis and PFGE are reliable and discriminative methods that would complement antibiograms, and could contribute to the investigation of outbreak epidemiology. This is the first report on S. Choleraesuis and S. Hadar isolates from Turkey investigated by plasmid profile analysis, ERIC-PCR and PFGE methods.

In this study, a plasmid, carrying ampicillin resistance (ampR) gene, isolated from a clinical isolate of Salmonella enterica serotype Typhimurium presenting ACSSuT (ampicilin, chloramphenicol, streptomycin, sulphonamide, tetracycline) resistance phenotype, was defined. The length of complete sequence of this plasmid was 8271 base pairs (bp), and it was named as pAnkS owing to its isolation place (plasmid-Ankara- Salmonella). The plasmid was analyzed for potential reading frames and structural features indicative of transposons and transposon relics. The Xmnl enzyme restriction fragments of pAnkS were cloned into E. coli plasmid vectors (pBSK), sequenced and analyzed with the BLAST programs. Plasmid pAnkS has contained a previously defined enterohemorrhagic E. coli (EHEC) plasmid p4821 as a core region and also contained a complete Tn3-like transposon of 4950 bp consisting of the left terminal repeat, Tn3-related tnpR and tnpA genes for transposition functions, ampicillin resistance gene bla(TEM), and the right terminal repeats, pAnkS showed strong homology with another Salmonella plasmid, pNTP16, for sequences that belong to p4821 and partial Tn3 segments. It was found that pNTP16 also carries kanamycin resistance gene (kanR) in addition to ampR gene. Plasmid pAnkS is one of the few completely sequenced plasmids from Salmonella Typhimurium and is in the middle of the pathway of evolution of plasmid from p4821 to pNTP16. The identification of pAnkS might help better understanding of plasmid evolution.

The aim of this study was to evaluate the value of nalidixic acid resistance as an indicator of decreased susceptibility to ciprofloxacin (MIC = 0.125 - 1 mg/L) in Salmonella isolates from humans (n = 620) in Turkey. One isolate was found to be resistant, and the remaining isolates were susceptible to ciprofloxacin with the Clinical and Laboratory Standards Institute breakpoints; however, 75 isolates (12.1%) had decreased susceptibility. Resistance to nalidixic acid was observed in 76 (12.3%) isolates in the disk diffusion test. Seventy-four of these isolates had decreased susceptibility, one was fully resistant, and one isolate was susceptible to ciprofloxacin. One isolate with decreased susceptibility to ciprofloxacin was intermediate to nalidixic acid. Screening with 30-microg nalidixic acid disks had a sensitivity of 98.6% and a specificity of 99.8% for determination of decreased susceptibility to ciprofloxacin.

Since Turkey currently lacks a national reference center for Salmonella infections, the present study was conducted to document the distribution of serotypes and antimicrobial resistance patterns among Salmonella enterica isolates recovered from clinical samples in ten Turkish provinces over a 2-year period. Among the 620 Salmonella enterica isolates recovered between 1 July 2000 and 30 June 2002, strains belonging to the serotypes Enteritidis (47.7%), Typhimurium (34.7%), Paratyphi B (6.0%), Typhi (2.9%), Paratyphi A (0.2%) and serogroup C (8.5%) were found. Resistance to multiple antimicrobial agents was particularly high among Salmonella Typhimurium isolates (76.7%), and resistance or decreased susceptibility to ciprofloxacin (MIC >= 0.125 mg/l) was demonstrated in Salmonella Paratyphi B, Salmonella Typhimurium and Salmonella Enteritidis strains. All of the Salmonella Typhi isolates were susceptible to ciprofloxacin. The results indicate that decreased susceptibility to ciprofloxacin is an emerging problem in Salmonella enterica in Turkey, particularly in multiresistant strains.

In order to find the distinctive features of Salmonellae and Salmonella infections in Turkey, 620 Salmonellae strains, isolated from various clinical samples (481 stool, 108 blood, 12 urine, 3 bone marrow, 3 cerebrospinal fluid, 9 pus, and one from each of the bile, pleural fluid, wound, catheter samples) in 13 clinical microbiology laboratories of 10 provinces in Turkey (Ankara, Antalya, Bursa, Edirne, Eskişehir, Istanbul, Izmir, Kayseri, Konya and Trabzon) between July 1, 2000 and June 30, 2002, were serotyped. Among the patients 43% were female, 57% were male, 63.2% were from outpatient clinics and 36.8% were hospitalized patients. Seventy eight percent of the patients had gastroenteritis, 10.7% had septicemia/local infection, 9.8% had typhoid/paratyphoid fever and 1.5% were carriers. Incidence of gastroenteritis was higher in 0-5 years age group (p0.001). Of the 620 Salmonella enterica isolates, 47.7% were S. Enteritidis, 34.7% S. Typhimurium, 6% S. Paratyphi B, 2.9% S. Typhi, 0.2% S. paratyphi A, 6.1% serogroup C1, and 2.4% serogroup C2. S. Enteritidis was the most common serotype in all provinces except for Kayseri, where S. Typhimurium was found to be the most common serotype (68.2%). Overall, the most frequently isolated serotype was S. Enteritidis, also being the most common serotype in stool and blood cultures. During the surveillance period two outbreaks have occurred, the first one by S. Enteritidis strains in Edirne, and the second one by S. Typhimurium strains in Kayseri. As a result, Salmonella infections are still a common health problem in Turkey, and active surveillance of Salmonella infections has vital importance.

The aim of the study was to evaluate the clinical pattern of Salmonella bacteraemia in Turkish children. From 1993 to 2002, all children with a blood culture positive for Salmonella were retrospectively evaluated in the Division of Paediatric Infectious Diseases in Ankara University School of Medicine. All Salmonella isolates were serotyped and investigated for antimicrobial susceptibility. During the 10-year study period, 40 patients with Salmonella bacteraemia were identified. Of 37 eligible children, eight had enteric fever and 29 had non-typhoidal salmonellosis. Salmonella typhimurium was the most common serotype in the group with non-typhoidal salmonellosis. No significant differences were found between the enteric fever and non-typhoidal salmonellosis groups with regard to clinical features, laboratory findings and outcome, except in mean platelet counts and mean serum alanine aminotransferase (ALT) levels. In vitro resistance rates of Salmonella strains were low. Outcome was excellent in all but one child with hydrocephalus and gross neurological sequelae owing to meningitis. Salmonella bacteraemia is relatively uncommon in Turkish children. Differentiating between enteric fever and non-typhoidal Salmonella bacteraemia on clinical grounds is difficult.

Salmonella enfeksiyonlarının ve Salmonella' ların Türkiye'ye özgü özelliklerini ortaya koymak üzere, 1 Temmuz 2000 ile 30 Haziran 2002 tarihleri arasındaki iki yıllık sürede 10 ildeki (Ankara, Antalya, Bursa, Edirne, Eskişehir, İstanbul, İzmir, Kayseri, Konya ve Trabzon) 13 klinik mikrobiyoloji laboratuvarında, insanların çeşitli klinik örneklerinden (481 dışkı, 108 kan, 12 idrar, 9 püy, 3 kemik iliği, 3 beyin omurilik sıvısı ve birer adet olmak üzere safra, plevra sıvı, yara, kateter örnekleri) izole edilen 620 Salmonella susu serotiplendirilmiştir. Hastaların %43'ü kadın, %57'si erkek, %36.8'i hastanede yatan hasta ve %63.2'si poliklinik hastasıdır.Hastaların %78'i gastroenteritis %10.7'si septisemi/lokal enfeksiyonlu, %9.8'i tifo/ paratifolu hastalar olup %1.5'i taşıyıcıdır. Gastroenterit 0-5 yaş grubunda daha fazla görülmüştür (p, In order to find the distinctive features of Salmonellae and Salmonella infections in Turkey, 620 Salmonellae strains, isolated from various clinical samples (481 stool, 108 blood, 12 urine, 3 bone marrow, 3 cerebrospinal fluid, 9 pus, and one from each of the bile, pleural fluid, wound, catheter samples) in 13 clinical microbiology laboratories of 10 provinces in Turkey (Ankara, Antalya, Bursa, Edirne, Eskişehir, Istanbul, izmir, Kayseri, Konya and Trabzon) between July 1, 2000 and June 30, 2002, were serotyped. Among the patients 43% were female, 57% were male, 63.2% were from outpatient clinics and 36.8% were hospitalized patients. Seventy eight percent of the patients had gastroenteritis, 10.7% had septicemia/local infection, 9.8% had typhoid/paratyphoid fever and 1.5% were carriers. Incidence of gastroenteritis was higher in 0-5 years age group (p

The authors describe the antigenic relationship between Salmonella cholerae suis (211) and Salmonella aberdeen, Escherichia coli (0 75, 0 163) 0 antigens.

A case of Salmonella typhimurium pericarditis is reported. The diagnosis was based on blood and pericardial effusion cultures.

Shigella is one of the most important causative agents of diarrhea especially in childhood. Since man is the main reservoir of Shigella and human to human transmission is possible, Shigella can easily spread in public and cause outbreaks. In this study, a total of 60 Shigella strains isolated in Ankara, Turkey by years 2001, 2008 and 2009 were investigated by their antimicrobial susceptibility profiles, plasmid profile analysis (PPA) and pulsed-field gel electrophoresis (PFGE). For epidemiological investigation, the results obtained by antibiotic resistance typing (ART) which was the phenotyping method, was compared to the results of the genotyping methods which were PPA and PFGE. Of the isolates 49 (81.6%) were S.sonnei, 10 (16.6%) were S.flexneri and one was (1.6%) S.dysenteriae. Antimicrobial susceptibilities were evaluated by disc diffusion method and the highest resistance rates were found against trimethoprim/sulfamethoxazole (91.6%), followed by tetracycline (68.3%) and ampicillin (26.6%). Resistance against ampicillin, chloramphenicol and amoxycillin/clavulanic acid were found higher in S.flexneri isolates than S.sonnei (p< 0.001). All isolates were found to be susceptible to ciprofloxacin, gentamicin and ceftazidime. S.sonnei demonstrated 12 and S.flexneri demonstrated 4 antibiotic resistance models. All isolates were carrying plasmids with varying sizes and varying numbers between 1 to 7. S.sonnei isolates demonstrated 27 and S.flexneri isolates demonstrated 8 plasmid profiles. S.sonnei isolates were clustered in 4 patterns and S.flexneri were clustered in 5 patterns by PFGE. This method demonstrated obvious clonal similarity among S.sonnei strains isolated in Ankara and discriminative power (DP) was calculated as 0.26. PPA and ART demonstrated higher DP among S.sonnei strains (0.97 and 0.75, respectively). In this study gain or loss of instable genetic mobile elements were thought to be responsible for higher discriminative powers of PPA and ART methods. These typing methods were found to be appropriate for the epidemiological investigation of strains collected in a short time period. PFGE was found to be convenient for the evaluation of clonal relatedness of the strains, however, in such geographical areas where the same clone was in circulation, use of ART and/or PPA together with PFGE would be useful for precise discrimination of Shigella strains.

The authors described antigenic relationship between C. glabrata and E. coli (0:75, 0:163), S. aberdeen O antigens.