INTRODUCTION: It was aimed to investigate clinical
characteristics and incidence of bacterial and viral
pathogens in patients who were hospitalized with the
clinical diagnosis of community acquired pneumonia
(CAP).
METHODS: In this study 91 patients at the ages between
one month and six years who required hospitalization
and were admitted to pediatrics clinics and pediatric
emergency services of the Selçuk University Meram
Medical Faculty, and also who did not use antibiotics for
48 hours before hospital admission and had the clinical
diagnosis of CAP were investigated from October 2008 to
February 2010. Demographic and clinic characteristics
of the patients were recorded. Blood samples for
complete blood count, erytrocyte sedimentation rate,
C-reactive protein, procalcitonin, blood culture and
nasopharyngeal aspirate samples for detection of the
viral etiologies by real time polymerase chain reaction
(RT-PCR) were taken at the time of hospital admission.
Initial posteroanterior (PA) chest X-rays of all patients
were checked.
RESULTS: The agents of pneumonia were detected
in 24.2% (22/91) but not in 75.8% (69/91) of our
patients. Of 91 patients, 11 (12.1%) were positive for
viral infections, 9 (9.9%) were positive for only bacterial
infections, 3 (3.3%) had viral coenfection, 2 (2.2%) were
positive for both viral and bacterial infections. Out of
11 viral positive patients, 7, 2, 1, 2, and 1 patients were detected to have parainfluenza virus (PIV) 2,
PIV 3, adenovirus, both PIV 3 and adenovirus, both
PIV 2 and PIV 3, respectively. RSV, PIV 1 and human
metapneumovirus (hMPV) were not detected in any of
cases. Out of 11 bacteria positive patients, 5, 2, 1, 1, 1,
and 1 patients were detected to have Staphylococcus
epidermidis, S. saprophyticus, S. hominis, S. capitis,
S. sobrinus and S. mitis. Also mixed viral-bacterial
agent presence were detected in 2 (2.2%) of our patients.
Out of ninety one pneumonia patients those having their
diagnosis clinically, 59 (64.7%) had radiological signs.
DISCUSSION AND CONCLUSION: Our study demonstrated the etiological
influence of viral agents in CAP. Parainfluenza virus 2
was the most common viral agent among detected
viruses in all age groups. Improving the etiological
diagnosis of viral infections may avoid unnecessary
the use of antibiotic. Further comprehensive and
randomized controlled studies are needed to confirm
our results.

INTRODUCTION: Formic acid is an ubiquitous chemical
constituent in the environment, being produced by
sources as diverse as vegetation, ants, soil, vehicles,
biomass burning, and photochemical reactions. The
present work is focused on in vitro analysis of cytotoxic
and genotoxic effects of formic acid, using cytogenetic
tests such as the cytokinesis-block micronucleus assay
(CBMN) and chromosomal aberration analysis, in human
lymphocytes.
METHODS: This study was carried out using blood
samples from healthy, non-smoking adults aged 18–22
years, of whom 10 were male and 6 were famale.
Different concentrations (0.07, 0.1, 0.2, 0.3, 0.4, 0.5,
0.8 mM) of formic acid was added to the lymphocyte
culture test for chromosomal aberration (CA) analysis.
Mitomycin-C (0.3 mg/ml) was used as the positive
control. Human peripheral blood lymphocyte cells
were treated with 20, 40, 60, 80 mM concentrations of
formic acid for 48 h. for the CBMN test. Mitomycin-C
(0.5 mg/ml) was added to the Lymphocyte culture as a
positive control. The present research was carried out
to assess the cytotoxic and genotoxic effects of formic
acid on human peripheral lymphocytes in vitro using the
cytokinesis-block micronucleus assay (CBMN), as well as
chromosomal aberration (CA) analysis.
RESULTS: A significant increase was observed for
induction of micronucleus frequency in all treatments
of formic acid concentrations for 48 h. comparing with
the negative control and mitomycin C (MMC, 0.5 μg/
ml) which was used as positive control. When compared
with negative control and with mitomycin C (MMC, 0.3
μg/ml) which is used as positive control, it is observed
that formic acid is rising the frequency of chromosomal
aberration significantly at all appliance concantrations
in 24 h. The frequency of micronuclei and chromosomal
aberrations increased in a dose dependent manner. The
results showed that there were significant correlations
between formic acid concentration and micronuclei
frequency (r= 0.92), numbers of necrotic cells (r= 0.95),
and apoptotic cells (r= 0.91).
DISCUSSION AND CONCLUSION: Our data provided evidence that there
is a significant correlation between the concentration of
formic acid and the following chromosomal aberrations:
frequency of micronuclei, apoptotic cells, and necrotic
cells in vitro.

INTRODUCTION: In this study it was aimed to
characterize the Vibrio species isolated from anchovy
and garfish samples obtained from fishermen and to
determine the antibiotic resistances, plasmide DNA and
SDS-PAGE (sodium dodecyl sulphate polyacrylamide gel
electrophoresis) whole cell protein profiles of these
isolates.
METHODS: The fish samples were taken as fresh,
kept in ice during transport to the laboratory and
immediately taken for analysis. The fish samples
weighed as 25 grams were added into 225 mL of sterile
alkaline peptone water supplemented with 3% NaCl
broth for enrichment purpose and incubated at 37 OC
for 18 to 24 hours. After incubation, yellow, green or
blue-green colonies growing on Thiosulphate Citrate
Bile Salt Sucrose (TCBS) agar were subcultured on
Triptone Soya Agar (TSA) and incubated overnight for
further identification of the isolates. The isolates were
identified according to morphological, physiological
and biochemical tests. Moreover, the resistances
against seven different antibiotics of isolates were
determined by disk-diffusion method. In addition,
the SDS-PAGE cell protein and plazmid DNA profiles of
isolates were determined.
RESULTS: Totallly 44 fish samples were tested
for determining Vibrio species and were analyzed
according to their morphological, biochemical properties. At the end of the analysis; 12 Vibrio species
were determined. The isolates were resistant against
to ceftazidime 66.6%, gentamisine 25%, tetracycline
16.6%, ceftriaxone 91.6%, amikacine 16.6%, ofloxacine
25% and penicillin G 58.3%. In addition, The MARI
(Multiple Antibiotic Resistance Index) values of tested
strains were found at the rate of 0.41. The numerical
analysis of SDS-PAGE whole-cell protein profiles of
Vibrio spp. isolates revealed two major clusters at
similarity levels of 80% and above. The 1-4 plasmide
(range 1590 - 27000 bp) in all of the isolates were
determined.
DISCUSSION AND CONCLUSION: As a result, it is possible to say that
microbial infections can be prevented by adequate
freezing and cooking, proper storage and processing
after harvesting and avoidance of cross-contamination
during fish handling. In addition, the coastal
contamination due to bacteria leads to decline in the
quality of seawater resources and so leads to risks
to human health and economic losses. Furthermore,
our study indicated that the presence of antibiotic
resistant Vibrio spp. strains isolated from fishes might
be potential risk for health.

INTRODUCTION: On 23rd of December, 2013, 116
patients including students of two schools, and
workers of 17 work places who consumed lunch and
dinner from the same catering company, applied to
Marmaris State Hospital, Muğla province suffering from
nausea, vomiting, abdominal pain, and diarrhea. This
study was conducted to identify the cause, and mode
of transmission, and to implement control measures.
METHODS: The suspected case was defined as
“individuals working in 17 work places and two schools
and having at least one of the following symptoms onset
on 23 December 2013: nausea, vomiting, stomach ache,
diarrhea, and fever”. Probable case was accepted as
“suspected case having vomiting or diarrhea”. Controls
were selected from the same school/workplace among
persons who didn’t have these symptoms. In the study,
face to face interviews were conducted for 213 (100
cases, 113 controls) people. Seventy seven probable
cases, 100 suspected cases and 113 controls were
included in the analysis. Samples from stool, swabs
of the kitchenwares and untensils, samples from food
and water were taken. Moreover, samples from food
handlers were tested for S. aureus.
RESULTS: Cases started to increase after lunch
on Monday at 23 December 2013. The menu of the
company included chicken doner, rice, mushroom
soup, salad and buttermilk. The first case attended
Muğla, Marmaris District Public Hospital during the
same day with nausea and vomiting complaints at
12: 30. Most common symptoms seen in the cases,
were nausea, abdominal pain, vomiting, diarrhea
and high fever. The attack rate was determined
as 16%. The epidemic curve revealed a point
source outbreak. Cases and controls had similar
characteristics for age and sex. It was determined
that 96% (74/77) of cases and 32% (37/113) of
controls ate chicken doner (OR – odds ratio: 50 95%
CI: 14-171). After controlling for mushroom soup and
salad, odds of being ill was 34 (ORadj – adjusted odds
ratio = 34, 95% CI-confidence interval= 8.8-129.7).
In the analysis done by the Provincial Agriculture
- Food Laboratory on the food samples S. aureus
enterotoxin was identified in chicken doner sample.
DISCUSSION AND CONCLUSION: It was found that the poisoning seen
in the Marmaris district was caused by S. aureus
enterotoxin in the chicken doner. In the research
the source of contamination was not shown.
Recommendations were given to the food company
to implement control and protection measures; and
to provide training on good hygiene practices for
company workers.

INTRODUCTION: The aim of this study was to determine
the knowledge and practice of workers of a catering
company in Izmir on food and personal hygiene, and
to investigate factors which influence their knowledge
and behaviour.
METHODS: The cross-sectionally planned study was
implemented in the central kitchen of a catering firm
having the ISO 22000 Food Safety Management System
and in the hospital kitchens served by the firm. It was
planned to include all workers (n: 73) of the catering
firm to the study however the study was completed with
59 people. The data were collected through the method
of the questionnaire and observation by the researcher.
Observation was done only with the kitchen workers.
The food hygiene knowledge of the workers were scored
as sufficient and insufficient while their behaviours
were evaluated as appropriate or inappropriate. Data
were analyzed with the SPSS 15.O package program
and in comparing the socio-demographic properties and
working period with the hygiene knowledge level and
behaviour condition chi-square test was used. p value
<0.05 was noted statistically significant.
RESULTS: The mean age of the workers were 35.4±7.6
and 86.4% of them were working in the kitchen while
13.6% were food engineer, food technician, secretary,
and driver who were not often in the kitchen. It was
determined that all workers participating in the study
underwent regular medical check-upsafter entering the work and majority of them have had hygiene training
courses at their current workplace or before, and more
than half of the workers have been working in the food
business for 7 years or less. In this study, it was shown
that more than half of workers (52.5%) had insufficient
the level of knowledge of hygiene and inappropriate
behaviour (58.8%) regarding food hygiene. Educational
status is a factor which significantly affects the level of
food hygiene knowledge (p=0,029). It was determined
that socio-demographic characteristics do not have a
significant effect on behaviour concerning food hygiene.
DISCUSSION AND CONCLUSION: In this study, despite the majority of
employees having received hygiene training, it was
determined that their knowledge on food hygiene and
safety was inadequate and it was observed that these
knowledge was not transformed to their behaviours.

INTRODUCTION: In the study the impact of the Bacillus
species bacteria used in the fight against larvae of
Culex pipiens which constitute mosquito fauna of
Istanbul was evaluated.
METHODS: In the study, 501 samples were
taken from the sources of mosquito larvae before
disinfection, in 39 towns of Istanbul, from 15 April
to the end of June, in 2013. Samples were brought
to the laboratory, by maintaining at 24 oC to ensure
larvae come to stages III and IV, and some of them
to adult mosquitoes. Lyophilized preparations of
Bacillus sphaericus (200 g/ha, 300 g/ha and 400 g/
ha); Bacillus thuringiensis H-14 (200 g/ha, 300 g/ha
and 400 g/ha); Bacillus sphaericus (H5a5b, Strain
2362) + Bacillus thuringiensis israelensis (H-14,
Strain AM65-52) (5000 g/ha) species which are used
as larvacide by Istanbul Metropolitan Municipality
agaist C. pipiens III and IV stage larvae, were used.
The cultures (6,1x108 CFU/ml and 12,6x108 CFU/ml)
which prepared from these lyophilized preparations
in the medium Unat’s fish broth were used. Remaining
mosquito larvae and adult mosquitoes were examined
under stereo and light microscope to identify the
species of mosquitoes.
RESULTS: The larvae of C. pipiens species were observed in all samples taken from 39 towns of
Istanbul. In samples from Buyukcekmece, Silivri
and Umraniye districts, beside densely presented
C. pipiens larvae, a small amount of Anopheline
and Aedes species larvae were also observed.
The first larval mortality began in 50th minutes in
the experiment with lyophilized preparations and
cultures prepared in Unat’s fish broth (12,6x108
CFU/ml density). In the experiments used culture
concentration of 6.1x108 CFU/ml, the first larvae
mortality was observed in 60th minute.
DISCUSSION AND CONCLUSION: In all experiments, it was observed
that all of the larvae died in 6th hours. Cultures
prepared in Unat’s fish broth were determined to
be more effective than lyophilized preparations. It
was determined that the reduced density of cultures
caused a delay in starting time of mortality but
overall time for all larvae deaths was unchanged.

Fascioliasis is a liver and biliary tract disease, which
is rare in human. It is transmitted by consuming water
plants containing Fasciola hepatica metacercariae or
drinking contaminated water. Detection of parasite
eggs in stool and serological/radiological tests are
significant in fascioliasis diagnosis. A female patient
who is 75-years-old applied to our clinic with one month
duration of abdominal pain, nausea, vomit and anorexia.
Routine biochemistry parameters of the patients with
cholecystectomy were normal except her 8% eosinophilia.
Endoscopic ultrasonography was planned in order to
determine abdominal pain etiology and if there was a
stone in ductus choledochus. Endoscopic retrograde
cholangiopancreatography (ERCP) was applied for
diagnosis and treatment purpose after the view of parasitecompatible
view in ductus choledochus of the patient.
Two parasites compatible with F. hepatica were taken
out of ductus choledochus by ERCP. It was observed that
the complaints of the patient, who was postoperatively
treated with two doses of 10 mg/kg triclabendazole,
was completely passed in control examination after two
weeks. We present an acute cholangitis case depends on
fascioliasis that we interventional diagnosed and treated,
and the review of literatures on this case.

Protection level against a disease of interest by
application of a licenced vaccine whose effectiveness
has been proved in a population is measured by “vaccine
effectiveness” which is determined with observational
epidemiological studies conducted under non-ideal field
conditions. For determination of whether decrease in
incidence of related disease in a population is due to
vaccination or other reasons rather than vaccination,
vaccine effectiveness should be monitored as a routine part
of the surveillance. Therefore, vaccine effectiveness studies
play an important role in public health actions. Various
other study designs that are developed as an alternative
to classical observational epidemiological studies such
as cohort and case-control studies can also be used in
determination of vaccine effectiveness. In accordance with
related vaccine and disease and current facilities, vaccine
effectiveness can be determined by using appropriate one
of the alternative designs such as indirect cohort method,
test-negative case-control design, case-case study, the
screening method, household contact study, as well as
cohort and case-control studies. Additionally, study designs
which are used in other fields such as case-cohort study,
nested case-control study, incidence density case-control
design are among the designs that can be chosen for
determination of vaccine effectiveness. However, it should
be remembered that none of them is perfect and they
should be performed under different assumptions related
with each design, as well as various general assumptions.
How necessary assumptions are not fulfilled, estimation of
vaccine effectiveness will go far from its actual value. Any factor that shows attack rate in vaccinated or unvaccinated groups less or more than its actual value leads to bias in
estimating vaccine effectiveness. These factors should be
controlled as much as possible in phase of design or during
analysis. For vaccine effectiveness estimation not to be
misleading; an appropriate study design should be selected
and necessary assumptions in accordance with the selected
design, potential bias sources and confounders should be
taken into account in planning phase of the study and while
study results are being interpreted.

Difficulties are being faced in the diagnosis of
invasive fungal diseases due to the lack of sensitivity
and specificity of the current diagnostic methods or
taking too long time to get a result having clinical
importance. Rapid diagnosis is the key point in
patient outcomes. Excluding the culture tests,
because of its rapid application and no need for
invasive sampling, was making the serological tests
based on the measurement of response of specific
host antibody became attractive. However especially
due to immunosuppressive conditions, these tests
are not always the indicator of invasive disease in
the patients who have no ability to produce specific
antibody response. Detection of microbial antigens
generally requiring a relatively large microbial
burden, limits the assay sensitivity. Nonetheless,
several examples of successful antigen detection
systems have been developed, and some of these
are widely used. To detect circulating Aspergillus
galactomannans enyzme immunoassay (Platelia)
method utilizing the rat monoclonal antibody EB-A2
is commercially in use. This test is able to detect
galactomannan in the level of 0.5-1.0 ng/ml.
Furthermore, galactomannan could be detected in
the serum at a early stage of invasive aspergillosis
before clinical signs and symptoms occured. However,
this test has some disavantages like false positive or
negative results. (1-3)-β-D-glucan is a characteristic
cell-wall component of fungi except for Zygomycetes.
A broad range of fungi including Aspergillus, During
invasive infections (1-3)-β-D-glucan is released to
the blood by some fungi containing Aspergillus,
Candida, Fusarium, Trichosporon, Saccharomyces, Acremonium and Pneumocyctis jirovecii. The
method used for determination of (1-3)-β-D-glucan
concentration depends on activation of glucan
by factor G, a horsecrab shoe coagulation factor.
There are some commercial test kits available for
(1-3)-β-D-glucan both in Europe and USA.Mannan is
the major circulating antigen in patients who have
invasive candidiasis. There are several serological
tests for the detection of antibodies formed against
mannan. However, these tests are usually failed in
discriminating between colonization and invasive
infection. When combination with mannan antigen
test was performed, it gave sensivity of 80% and
specifity of 93%. In the diagnosis of cryptococcal
infections detection of capsular antigen in the both
cerebro-spinal fluid or serum, is used. Both latex
aglutination and enzymeimmunoassay tests are found
to detection of capsular antigen. The diagnosis of
fungal infections has moved forward in the past few
years and there are many newly developed methods
that are likely to provide early detection of fungal
infections. However, it seems that best approach is
combining both traditional methods like culture or
microscopy with serological methods.

Polymerase chain reaction (PCR), is a simple,
effective and widely used enzymatic technic especially
in the field of molecular biology which provides the
opportunity to amplify a specific DNA fragment from
DNA complex pool. Several PCR techniques such as realtime
PCR, quantitative and qualitative PCR, Reverse
Transcriptase PCR, Nested PCR and multiplex PCR have
been developed since the first invention of PCR. Due to
the various difficulties of the PCR techniques developed
so far, widening the application fields and finding out
more advanced level of PCR techniques have become
the first priority of the researchers. Digital PCR (dPCR)
technology has been developed as a new method to
permit the evaluation of the small changes in the copy
number variations of the rare mutations, differences
between the gene expression changes or state of
methylation. Digital PCR is a PCR based new technique
for the sensitive measurement of number of DNA copies,
it provides opportunity to do large number of PCR with
a few number of sample dilution and it has so many
small compartments where seperate PCRs are executed
in each. At the same time, dPCR leaves some of the
quantitative methods behind with the performance of
determining the quantity of small amount of genetic
material within seconds. This method shows high sensitivity with the strategy of counting single molecule. It also attracks the attention as a method having quite a
high reliability and repeatability level. This review aims
to give insight for dPCR development history and the
possible difficulties came across in its application.