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Background/aim: The aim of this study was to investigate the effects of PhiKZ phage therapy and meropenem alone or combined treatments in a pneumonia mouse model induced by the Pseudomonas aeruginosa PAO1 strain. The cross-talk between lungs and kidneys was also determined. Materials and methods: The systemic, lung-specific, and kidney-specific inflammation levels and the bacterial load in lung tissue and biochemical parameters were investigated after PhiKZ phage therapy and meropenem alone or combined treatments in a pneumonia mouse model induced by the P. aeruginosa PAO1 strain. The cross-talk between lungs and kidneys was also determined by measuring plasma levels of glycocalyx components. Results: The greatest reduction in lung bacterial load was obtained with the combined use of the PhiKZ phage and meropenem. The C-reactive protein level in the patient group was significantly higher than in the treatment groups and decreased after treatment. Serum interleukin IL-6 levels were statistically significantly higher than in the phage serum and phage + meropenem groups. Pulmonary infection can trigger proinflammatory cytokines such as IL-6, TNF-α, and IL-1ß. Increased cytokines trigger insulin resistance in the liver. Lung infection triggers liver inflammation because there is communication between the lungs and liver. Conclusion: Elevated proinflammatory cytokines due to infection were decreased because of the reduced burden of bacterial load after treatment. This study might have proved communication between lungs and kidneys related to proinflammatory cytokines.

Despite the effectiveness of nucleoside/nucleotide analogues in the treatment of chronic hepatitis B (CHB), their long-term administration is associated with the emergence of resistant hepatitis B virus (HBV) mutants. In this study, mutations resulting in antiviral resistance in HBV DNA samples isolated from 23 CHB patients (nine treatment naïve and 14 treated previously) were studied using a line probe assay (INNO-LiPA HBV DR; Innogenetics) and ultradeep pyrosequencing (UDPS) methods. Whilst the INNO-LiPA HBV DR showed no resistance mutations in HBV DNA samples from treatment-naive patients, mutations mediating lamivudine resistance were detected in three samples by UDPS. Among patients who were treated previously, 19 mutations were detected in eight samples using the INNO-LiPA HBV DR and 29 mutations were detected in 12 samples using UDPS. All mutations detected by the INNO-LiPA HBV DR were also detected by UDPS. There were no mutations that could be detected by INNO-LiPA HBV DR but not by UDPS. A total of ten mutations were detected by UDPS but not by INNO-LiPA HBV DR, and the mean frequency of these mutations was 14.7 %. It was concluded that, although INNO-LiPA HBV DR is a sensitive and practical method commonly used for the detection of resistance mutations in HBV infection, UDPS may significantly increase the detection rate of genotypic resistance in HBV at an early stage.

Flu caused by influenza viruses, is a serious public health problem all over the world with its high morbidity and mortality. Therefore World Health Organization (WHO) regularly collects the results of national influenza surveillance, evaluates the results and shares them on international portal. Thus, it provides the possibility of rapid prevention and preparation of countries that needs to be taken on the fight against the epidemic flu. Starting from 2004-2005 season until today the current flu activity in our country is also followed in accordance with sentinel surveillance. The aim of this study was to evaluate the results of sentinel surveillance data obtained by National Influenza Reference Laboratory in Istanbul University Faculty of Medicine, in 2013-2014 and 2014-2015 seasons. For this purpose, nasal/nasopharyngeal swab samples taken from the patients diagnosed as influenza-like illness by the volunteer family physicians in Izmir, Istanbul, Antalya, Edirne and Bursa were included in the study. A total of 1240 samples were delivered to our laboratory in three days, in Virocult® transport culture medium according to cold chain rules. All the samples were studied by real-time polymerase chain reaction (Rt-PCR) according to the protocols of Centers for Disease Control and Prevention (CDC). In our study, the positivity rates of influenza viruses in 2013-2014 and 2014-2015 seasons were detected as 31.4% (202/641) and 44.4% (289/650), respectively. In 2013-2014 season, influenza A(H3N2) virus was the predominant type with a rate of 93.1% (188/202), and the rest was influenza B virus (14/202; 6.9%). In 2014-2015 season, influenza B virus has been dominated with a rate of 60.2% (174/289), and the rates of influenza A(H1N1)pdm09 and influenza A(H3N2) were 30.4% (88/289) and 9.3% (27/289), respectively. The flu season in 2013-2014 has started at 48th week and peaked at 52nd week, while it was started later in the second week in 2014-2015 season and peaked at 10th-13th week. The lineage of the influenza B viruses isolated in both seasons were identified as B/Yamagata. Antigenic characterization of influenza A viruses isolated in our laboratory was found compatible with the vaccine strains. In conclusion, surveillance studies are highly important for the determination of the effects of flu on public health and identification of the approaches for fighting with flu. In this sense, influenza surveillance of the countries are required to implement more effectively in an expanded field of scale.

Aim Serologic tests having high sensitivity and specificity are used in order to prevent contamination with infectious agents from blood and blood products for transfusion safety. The present serologic tests have problems such as low sensitivity and weak detection capacity of infectious agents in the “window period”. We aimed to test the use of NAT (Nucleic Acid Amplification Test) in routine blood screening in the Blood Bank. Method We used the Procleix Ultrio (Chiron Ltd., USA) test kit based TMA (Transcription Mediated Amplification) for the NAT study of serum samples from 18,200 donors who came to the Turkish Red Crescent between February 2007 and September 2008. The NAT positive samples were studied twice. The discrimination of HIV, HCV and HBV NAT positive samples was performed by the Procleix Discrimination (Chiron Ltd., USA) test. Otherwise, Micro ELISA were used in parallel for routine serological screening of Anti-HIV, Anti-HCV, and HBsAg with Vironoste HIV Uni-form, AG/Ab innotest HCV Ab and Hepanostika Ultra HBsAg test kits. Results The results of serum samples with serology (+) and NAT (+) (13/18,200 and 0.05%) for anti-HIV, anti-HCV and HBsAg were higher than in other NAT studies; we also detected that a transfusion risk can occur in every 1400 transfusions.

A case of dirofilariasis is presented. The disease showed in our case subcutaneous location and was identified 9 years after the initial admittance of the patient. The mass was finally removed surgically.

Malaria is still a major health problem in Turkey, where Plasmodium vivax malaria is endemic. Spontaneous rupture of the spleen is an important and life-threatening complication and occurs in up to an estimated 2 % of cases. Hence the small number of case reports suggests under-reporting or underdiagnosis. Review articles have reported only 18 malaria cases with spontaneous splenic rupture in the English language literature since 1960. Two cases of P. vivax malaria with splenic complications are reported here. One of them showed signs and symptoms of acute abdominal pain, then splenic rupture occurred.

Four hundred and four coagulase-negative staphylococci were isolated from 4905 urine specimens obtained from 4192 inpatients and outpatients. The distribution of the strains was as follows: 193 Staphylococcus epidermidis (47.8%), 171 Staphylococcus saprophyticus (42.3%), 29 Staphylococcus haemolyticus (7.2%), 5 Staphylococcus warneri (1.2%), 3 Staphylococcus schleiferi (0.7%), 2 Staphylococcus hominis (0.5%) and 1 Staphylococcus simulans (0.2%). All three Staphylococcus schleiferi strains were isolated from inpatients: a 64-year-old female, a 68-year-old male and a 3-month-old male with colony counts of 468,000 cfu/ml, 324,000 cfu/ml and 764,000 cfu/ml respectively. These findings show that among coagulase-negative staphylococci, Staphylococcus schleiferi, a newly described species of coagulase-negative staphylococci not previously reported as a uropathogen, may also cause hospital acquired urinary tract infection.

Sera from 18 haemodialysis patients with anti-HCV positive by a second generation enzyme-linked immunosorbent assay (ELISA) test (Abbott) have been tested for hepatitis C virus (HCV) antibodies by UBI and Innotest ELISA, RIBA-2, LIA-TEK, Abbott supplementary test and HCV-RNA polymerase chain reaction (PCR) in order to evaluate the correlation between the results of PCR, antibody status and alanine aminotransferase (ALT) levels. None of the ELISA tests or confirmatory tests were able to identify HCV infectious sera, and increased ALT levels in combination with anti-HCV positivity is a significant marker for HCV viraemia. Secondly, no correlation between the evolution of the immunoblotting assay profile and the presence of HCV RNA was present.

Aim Hepatitis B virus (HBV) can be transmitted by blood transfusions even so using serological tests having high sensitivity and specificity. We aimed to detect HBV DNA in isolated Anti-HBc donors and show if they have transfusion risk or not. Method We investigated Anti-Hbc and Anti-HBs in serum samples of 12858 HBs-Ag negative blood donors who were applied to the Turkish Redcrescent between June 2007 and October 2008 by the Micro ELISA kit (Hepanostica ultra HBsAg, Bio Meriux, France). Anti-HBc and Anti-Hbs positive cases were omitted. We used Procleix ultrio (Chiro, USA) test kit (Chiron Tigris automated instrument was used) based TMA (Transcription-Mediated Amplification) for NAT study in Anti-HBc positive and Anti-HBs negative plasma samples. The discrimination of HBV in NAT positive samples were performed by Procleix Discrimination (Chiro, USA) test. Results 2748 (21.4%) Anti-HBc seropositivity were detected in 12852 HBsAg(−) serum samples. 23.5% Anti-HBs negativity was detected in 2748 Anti-HBc positive serum samples. On the other hand, 5.1% isolated Anti-Hbc positivity [HBsAg(−), Anti-HBc(+), Anti-HBs(−)] were detected in 12852 HBsAg(−) serum samples. 0.091% and 0.047% HBV-DNA positivity were detected in isolated Anti-HBc positive plasma samples and HBsAg(−) plasma samples, respectively. Conclusion As a result, even we have detected one HBV transmission in every 2142 blood transfusion by HBsAg screening tests; we suggest that it is not necessary to add additional tests to detect isolated Anti-HBc for routine purposes in Blood Banking. The reasons are higher negativity rates (99%) of isolated Anti-HBc serum samples and the rejection of blood donors with Anti-HBc positivity.

We report mutations in influenza A virus (H5N1) strains associated with 2 outbreaks in Turkey. Four novel amino acid changes (Q447L, N556K, and R46K in RNA polymerase and S133A in hemagglutinin) were detected in virus isolates from 2 siblings who died.

Istanbul and Ankara connections in the history of smallpox. During the 600years of Ottoman history smallpox was ever-present alongside other epidemics such as plague and cholera. The prox- imityoftheAnatolianplateautoSouth-westernAsiaandmajortrade routeswhereitisbelievedtohaveoriginatedfromwasprobablythe reason for its presence in Asia Minor since ancient times. Written recordsbeforethe15thCenturyarescarceanddetailsofthedisease in the Empire remain under-documented. Even after the 15th Century, record-keeping was inadequate due to a lack of under- standing of infectious disease control and its importance in public health. The Ottoman Empire was represented at the First Interna- tional Sanitary Conference in Paris (1851), which ended without any successful resolution to disease control. At the 13th Interna- tionalSanitaryConference(1926),smallpoxandtyphuswererecog- nised as diseases to be controlled with quarantine measures 1 . Most documents related to the disease in the empire date back to 19th Century. While disease prevention and Jenner type vaccination started during the collapse of the empire, full eradication occurred only after the foundation of the Republic of Turkey.

1473-0502/$ see front matter 2010 Elsevier Ltd doi:10.1016/j.transci.2010.09.013 q This study was presented in 19th ECCMID, Helsi 19, 2010. ⇑ Corresponding author. Address: Cerrahpas a Me biology and Clinical Microbiology Department, Koc _ Istanbul, Turkey. Tel.: +90 532 6168150; fax: +90 2 E-mail addresses: bzeybek@istanbul.edu.tr (B. Ko suatsaribas@hotmail.com (S. Saribas). Aim: Serologic tests having high sensitivity and specificity are used in order to prevent contamination with infectious agents from blood and blood products for transfusion safety. The present serologic tests have problems such as low sensitivity and weak detection capacity of infectious agents in the ‘‘window period”. We aimed to test the use of NAT (Nucleic Acid Amplification Test) in routine blood screening in the Blood Bank. Method: We used the Procleix Ultrio (Chiron Ltd., USA) test kit based TMA (Transcription Mediated Amplification) for the NAT study of serum samples from 18,200 donors who came to the Turkish Red Crescent between February 2007 and September 2008. The NAT positive samples were studied twice. The discrimination of HIV, HCV and HBV NAT positive samples was performed by the Procleix Discrimination (Chiron Ltd., USA) test. Otherwise, Micro ELISA were used in parallel for routine serological screening of Anti-HIV, Anti-HCV, and HBsAg with Vironoste HIV Uni-form, AG/Ab innotest HCV Ab and Hepanostika Ultra HBsAg test kits. Results: The results of serum samples with serology (+) and NAT (+) (13/18,200 and 0.05%) for anti-HIV, anti-HCV and HBsAg were higher than in other NAT studies; we also detected that a transfusion risk can occur in every 1400 transfusions. 2010 Elsevier Ltd. All rights reserved.