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    Comparison of mycobacteria growth indicator tube with BACTEC 460 for detection and recovery of mycobacteria from clinical specimens
    (1996) Badak F.Z.; Kiska D.L.; Setterquist S.; Hartley C.; O'Connell M.A.; Hopfer R.L.
    We compared the Mycobacteria Growth Indicator Tube (MGIT) system with the BACTEC 460 (B460) and Lowenstein Jensen (LJ) systems for the recovery of mycobacteria (acid-fast bacteria [AFB]) from 1,441 clinical specimens. Excluding 13 isolates of Mycobacterium gordonae, 178 significant AFB isolates were recovered from 113 patients. Isolates (119) of the Mycobacterium avium complex (MAC) accounted for 67% of all isolates, while isolates (30) of the Mycobacterium tuberculosis complex (MTB) accounted for 17% of isolates. The MGIT system recovered 98 (82%) MAC and 27 (90%) MTB isolates, while the B460 system recovered 101 (85%) MAC and 28 (93%) MTB isolates and the LJ system recovered 91 (76%) MAC and 25 (83%) MTB isolates. Overall, the MGIT system recovered 152 isolates of AFB (85.4% sensitivity), and the B460 and LJ systems recovered 151 (84.8% sensitivity) and 137 (76.9% sensitivity) AFB isolates, respectively. The recoveries of AFB with combinations of media were as follows: MGIT + LJ, 93.2%; B460 + LJ, 92.1%; and MGIT + B460, 96.6%. Although the sensitivity of MGIT was equivalent to that of B460, MGIT required a longer incubation (median, 11 days) than did B460 (median, 8 days) to become positive (P < 0.05).
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    Confirmation of the presence of Mycobacterium tuberculosis and other mycobacteria in mycobacterial growth indicator tubes (MGIT) by multiplex strand displacement amplification
    (1997) Badak F.Z.; Kiska D.L.; O'Connell M.; Nycz C.M.; Hartley C.; Setterquist S.; Hopfer R.L.
    Multiplex strand displacement amplification (mSDA) is capable of amplifying three distinct DNA sequences simultaneously. These include sequences present in most genera of mycobacteria, a sequence specific for Mycobacterium tuberculosis, and an internal control. mSDA was used to detect the presence of these target sequences in 154 (72 positive, 76 negative, and 6 failed) clinical specimens cultured in the mycobacterial growth indicator tube (MGIT) system. A wide variety of specimen types were processed and cultured. Once these cultures were deemed positive by MGIT fluorescence or were deemed negative after 8 weeks of incubation, MGIT culture aliquots were processed for mSDA analyses. A chemiluminescent microwell assay was used to detect the amplified products. The procedure was relatively simple and took less than 6 h to complete. The sensitivity of mSDA for detecting acid-fast bacilli was 96.4% compared to that of MGIT culture. Sensitivity and specificity were 97.2 and 96.1%, respectively, when all clinical criteria were considered. mSDA was shown to be a rapid and effective method for confirming the presence of M. tuberculosis and other mycobacteria in positive MGIT cultures.
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    Susceptibility of Mycobacterium tuberculosis strains to first-line and second-line antituberculosis drugs in Ege University Hospital
    (2001) Çiçek Saydam C.; Çavuşoglu C.; Burhanoglu D.; Özkalay N.; Badak F.Z.; Bilgiç A.
    Recently tuberculosis has shown a speedy worldwide spread. The incidence of drug-resistant Mycobacterium tuberculosis is increasing in almost all industrialized and developing countries. The epidemiology of multiple drug resistance varies in different regions and countries. The aim of this study was to determine the activities of first-line (isoniazid, rifampin, ethambutol and streptomycin) and second-line (kanamycin, para-aminosalicylic acid, ethionamide and capreomycin) antituberculosis drugs on 100 various clinical isolates of M. tuberculosis. Mycobacterium tuberculosis ATCC 27294, ATCC 35838, ATCC 35825 and ATCC 35837 were used for internal quality control. First-line drug resistant strains were isolated from 10 clinical specimens. Six of them showed resistance to a single drug and four to more than one first-line drug. All of the single-drug resistant strains were resistant to isoniazid. Of 100 isolates, 56 were resistant to capreomycin, 41 to kanamycin, 12 to para-aminosalicylic acid and four to ethionamide. All of the first-line drug-resistant strains were found to be susceptible to para-aminosalicylic acid and ethionamide. In view of the above findings, we suggest that clinicians should be well-informed about the current local epidemiology of tuberculosis, and health care institutions should maintain up-to-date drug susceptibility data on the local isolates of M. tuberculosis.