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    Comparative evaluation of automated chemiluminescence tests and RIBA assay used in HCV diagnosis
    (Scientific Publishers India, 2016) Kalem, Fatma; Yuksekkaya, Serife; Dagi, Hatice Turk; Ertugrul, Omur; Dogan, Metin
    Introduction: Hepatitis C, caused by hepatitis C virus (HCV) can be a mild illness lasting a few weeks or can cause lifelong liver cirrhosis and cancer. Today although the sensitivity of diagnostic tests is increasing; it has often been associated with decreased specificity so the rate of false-positive test results is increasing. The aim of this study was to compare the false-positive rates of anti-HCV results. Methods: During the period of 18.07.2011 to 18.12.2013; blood samples of patients admitted to Konya Numune Hospital were screened for anti-HCV using chemiluminescence immunoassay (CIA). After 2012; the new version of same anti-HCV test was used. Borderline and reactive results were retested and tests which were reactive in repeated CIA were confirmed by a recombinant immunoblot-assay (RIBA). Subjects with a positive RIBA test were considered to have been as true positive anti-HCV. Results: A total of 54178 sera were tested for anti-HCV during the period of 18.07.2011 to 18.12.2013 and 649 sera were positive with chemiluminescence method. 374 of reactive cases were confirmed by RIBA. The RIBA results showed 171 (45.7 %) negative, 163 (43.5 %) positive, and 40 (10.7 %) indeterminate results. By using the new version of the test; the rate of false positive and indeterminate anti-HCV test results decreased from 75.1% to 35.5 %. Conclusions: In this study it was observed that lower false positive rates of newly developed test. Lowering the false positive rate of ELISA tests will provide more confidence to use these tests in the diagnosis of HCV. There is a need for further studies on this issue.
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    Comparison of a New and Rapid Method: Brucella Coombs Gel Test With Other Diagnostic Tests
    (Wiley, 2016) Kalem, Fatma; Ergun, Ayse Gul; Durmaz, Suleyman; Dogan, Metin; Ertugrul, Omur; Gundem, Seval
    Background: The aim of this study was to detect reliability of Brucella Coombs gel test (BCGT) by comparing with with ELISA (IgG IgM), Standard agglutination test, and Brucella immunocapture agglutination methods in serological diagnosis of brucellosis. Methods: Brucella Coombs gel test (BCGT), Brucella ELISA (IgG IgM), Standard agglutination test, and Brucella immunocapture agglutination tests of 78 patients with presumptive diagnosis of brucellosis which were sent to Microbiology Laboratory of Konya Numune Hospital from various regions of Konya were studied. Results: Results: Of 78 patients with ELISA IgG and IgM, STA, BICA and BCGT; 26, 21, 10, 12 and 12 were positive. When compared with BICA, the sensitivity and specifity of BCGT were 100% and 100%, respectively. Conclusion: According to results BCGT can be used as a diagnostic test in routine laboratories after more comprehensive studies in control groups and patients. J. Clin. Lab. Anal. 30:756-759,2016. (C) 2016 Wiley Periodicals, Inc.
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    Dispeptik hastalarda farklı yöntemlerle helıcobacter pylorı varlığının araştırılması
    (2008) Kalem, Fatma; Baysal, Bülent
    H.pylori infeksiyonu; dünyada en sık görülen infeksiyonlarından bir tanesidir. H. pylori infeksiyonu; gastrit, gastrik ve peptik ülser, gastrik adenokarsinom ve MALT lenfoma için risk faktörüdür. Tanısında invaziv (endoskopi gerektiren) kültür, histoloji ve üreaz testleriyle birlikte noninvaziv (endoskopi gerektirmeyen) üre soluk testi, HpSA ve serolojik metotlar kullanılmaktadır. PZR ile farklı klinik örneklerde bakteri varlığı gösterilebilmektedir. Bu infeksiyonun tedavisi gelişen ilaç direnci sebebiyle gittikçe zorlaşmaktadır. Tedavide en çok kullanılan ilaç olan klaritromisinin diğer bazı hastalıkların tedavisinde de yaygın kullanımı ile direnç oranları artmaktadır. Çalışmada üreaz testi, gaita antijen testi, histopatolojik inceleme ve kültür yöntemleri ile H.pylori varlığı ve üreyen suşlarda klaritromisin, amoksisilin, metronidazol duyarlılığının araştırılması amaçlanmıştır.Gereç ve Yöntem: Bu çalışmada S. Ü. Meram Tıp Fakültesi İç Hastalıkları Anabilim Dalı Gastroenteroloji Kliniği endoskopi ünitesine, dispeptik şikayetlerle 2005-2006 tarihleri arasında başvurarak gastroduodenoskopi yapılan 103 vakadan alınan biyopsi örneklerinde H. pylori varlığı; üreaz testi, gaita antijen testi, histopatolojik inceleme ve kültür yöntemleri ile araştırıldı. Üreyen suşlarda klaritromisin, amoksisilin, metronidazol direnci incelendi. Ayrıca bu hastalarda HpSA'nin tanı değeri diğer yöntemlerle kıyaslanarak araştırıldı.Bulgular: 103 örnekten kültür ortamında 40 örnekte H.pylori üremiştir (%38.8). Elde edilen 40 suştan 28 tanesinde antibiyotik duyarlılığı yapılabilmiştir. Bunlardan 8 tanesinde klaritromisine E-test metoduyla direnç saptanmıştır (%28.5). Bu suşların 11(%39.2) tanesinde de metronidazole direnç saptanmıştır. Suşlardan hiçbirinde amoksisiline direnç saptanmamıştır. Kullanılan testlerin sensitivite, spesifite, pozitif prediktif (PPD), negatif prediktif (NPD) değerleri sırasıyla kültür için;%76, 98, 97, 83, üreaz için; %97.9, 24.4, 56.4, 92, HpSA için; %74, 80, 76, 79, histopatoloji için; %75, 95, 93, 80 olarak bulunmuştur.Sonuç: Toplum sağlığı açısından H.pylori tanı ve tedavisi oldukça önemlidir. Tedavide başarısızlığı durumunda H.pylori suşlarının antimikrobiyal duyarlılığının araştırılması faydalı olacaktır. Ayrıca yeni ilaç kombinasyonları denenebilir.
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    INVESTIGATION OF THE PRESENCE OF HELICOBACTER PYLORI BY DIFFERENT METHODS IN PATIENTS WITH DYSPEPTIC COMPLAINTS
    (Ankara Microbiology Soc, 2010) Kalem, Fatma; Ozdemir, Mehmet; Baysal, Buelent
    Helicobacter pylori infections which are common worldwide may be a risk factor for gastritis, gastric and duodenal ulcers, gastric adenocarcinoma and mucosa-associated lymphoid tissue (MALT) lymphomas. For the detection of H.pylori, invasive methods such as culture, histopathology and rapid urease tests which require endoscopy and gastric biopsy specimen and non-invasive methods (not requiring endoscopy) such as urea breath test, stool antigen test (H.pylori stool antigen; HpSA) and serology are used. The aim of this study was to investigate the presence of H.pylori in patients with dyspeptic complaints, by rapid urease test, HpSA test, culture and histopathology and to evaluate the diagnostic performance of HpSA test. A total of 103 dyspeptic patients who were admitted to Selcuk University Meram Medical Faculty Gastroenterology Clinic and undergone gastroduodenal endoscopy between January 2005 and December 2006, were included to the study. All the specimens were cultivated, however, urease activity was tested in 98 of the patients, histopathological examination in 76 and HpSA test in 86 of the patients. H.pylori was isolated in 38.8% (40/103) of the specimens by culture. H.pylori was positive in 38.2% (29/76) of the specimens by histopathology, in 86.7% (85/98) by urease test, and in 44.2% (38/86) by HpSA test. The sensitivity and specificity values of the tests when culture was taken as the gold standard, were; 97.5% and 20.7% for urease test, 75% and 82.6% for HpSA test and 72.5% and 100% for histopathology, respectively. In conclusion, HpSA method could be applied as a screening test for H.pylori diagnosis in case endoscopy could not be performed. However, if invasive methods were to be performed, the diagnosis should be confirmed by a more sensitive and specific test such as culture and histopathology.