INTRODUCTION: Antimicrobial resistance is a growing problem worldwide, and to combat with this problem some measures should be taken. Analysis of current situation is one of them and National Antimicrobial Resistance Surveillance System (NAMRSS) was established for this purpose. The quality of the data depends on the participating laboratories performance, so there was need for an assessment of the laboratories in the system. This study was aimed to analyse the status of the participating laboratories for antimicrobial susceptibility testing requirements.
METHODS: There were 77 participating laboratories selected for NAMRSS throughout the country. Twenty-five of them were included in for capacity analysis study. A Laboratory Assessment Tool (LAT) was used for the evaluation of laboratories with ‘checklist’ features, and face-to-face interviews were used. LAT was a programmeme containing 677 questions in 10 modules that have been developed by World Health Organization (WHO). It was used with additional queries for antimicrobial susceptibility tests (AST). Teams were formed from a total of 33 volunteer experts who received training prior to laboratory visits in a workshop, and there were at least two people in each team. They have visited the laboratories for implementing the LAT. Data were transferred to a database and analysed for both general conditions, and AST capacity.
RESULTS: Laboratories were distributed institutionally as university hospital (n=17), training and research hospital (n = 4), state hospital (n = 2) and military hospital (n = 2). NAMRSS laboratories performed identification and AST by automated systems as well as disc diffusion and minimum inhibitory concentration (MIC) tests except for one laboratory. Also, the laboratories were generally in 'good standing' (approx. > 85 %) for three of the modules, where the other modules suggest that there are issues that 'need some improvements' at different degrees. When focused on AST tests, other than internal quality control applications, it was observed that availability for AST testing culture media and reagents, identification and AST testing capacity are in between 84-95 %. The fulfilment of total quality requirements was 67%.
DISCUSSION AND CONCLUSION: NAMRSS laboratories seem to be able to support reliable results in AST, which is essential for both surveillance system and evidence based decisions of efficient treatment of patients. On the other hand, improvement in some other issues is necessary.

INTRODUCTION: Human papillomavirus (HPV) is the most detected viral pathogen of reproductive system and almost all servical carsinomas are related to HPV. The incidance and mortality rate of cervical carsinomas are significantly on the decrease by means of early diagnosis and treatment as a result of screening programmes. The aim of the study is to evaluate the results of HPV DNA and cervical cytology specimens simultaneously in a three year period.
METHODS: The test results of 328 patients that were send to Molecular Microbiology Laboratory for HPV DNA and genotype between 2012-2014 were retrospectively analysed. The cytology results of the patients were reviewed simultaneously by pathology laboratory and reexamined if necessary. The relationship between cervical anomalies and the presence of HPV DNA and genotypes were evaluated. Cervical samples were collected in DigeneHC2 DNA Collection Device and DNA was isolated using QIAamp DNA Mini Kit. DNA samples were tested for high risk HPV infection by the Genotyping Kit HPV GP. Conventional (Papanicolau) smears were evaluated cytologically according to 2001 Bethesda System.
RESULTS: The median age of the patients was found 36 and there was no significant difference between the median ages of the HPV DNA negative and positive women. High risk HPV DNA was determined 110 out of 328 patients (33.5%) and multiple types were detected 22.7% of the cases. The most determined types were HPV-16/51/18/56. Abnormal cytology was detected from 21.5% of the 270 patients that were evaluated by pathologist simultaneously. The abnormal cytologic signs of the patients were reported as 48.3% ASCUS, 34.5% LSIL, 7% ASC-H, 7% HSIL and 3.5% AGUS. The HPV DNA positivity of the patients with abnormal cytologic results (50%) were found high significantly comparing the patients with normal cytology (28.3%) (p=0.002). The type 16 was determined 38% and 44% from the patients with abnormal and normal cytology, respectively.
DISCUSSION AND CONCLUSION: The genotyping of HPV plays an important role as the cervical cancer screening programmes are gaining importance globally. The determination of high rates of type 16 from patients with normal cytology proves that cytologic tests results should be supported by DNA typing and those patients should be followed up closely.

INTRODUCTION: In the recent years, the epidemiology of nosocomial Candida infections and antifungals used in the treatment have changed significantly. Although Candida albicans is the most frequently identified species but, incidence of non-albicans Candida species are increased. In this study, we aimed to contribute to the epidemiological database of our hospital and country by valuating the distribution of Candida species isolated from nosocomial Candida infections.
METHODS: Agents isolated from 3840 nosocomial infections that detected in patients hospitalized in intensive care units and clinical departments of Ankara Research and Training Hospital during January 2010 and December 2015 were evaluated. Candida species isolated from various clinical specimens were evaluated by Infection Control Committee according to the "Centers for Disease Control and Prevention (CDC)" criteria. Distrubition of 350 Candida species isolated from nosocomial infections were investigated.
RESULTS: During the study period, the number of nosocomial infections determined among the patients hospitalized at the intensive care units and clinical departments were 2559 and 1281 respectively. The rate of Candida species detected from nosocomial infections in intensive care units and clinical departments were 11.2%, 3.7% respectively. The most common Candida species identified as agent of nosocomial Candida infections was Candida albicans (39.7%). Among the non-albicans Candida group, C. parapsilosis (20.9%) was the most common agent followed by C. glabrata (17.4%) and C. tropicalis (15.1%). Urinary tract infections were detected as the most common nosocomial Candida infections.
DISCUSSION AND CONCLUSION: Epidemiology of nosocomial Candida infections can be change between years and hospital to hospital. Epidemiological studies should be performed at regular intervals in all hospitals in order to appropriate control of nosocomial Candida infections.

INTRODUCTION: Infections of the urinary tract are included among the most common infections globally, and the most frequently seen pathogen is Escherichia coli. Nitrofurantoin, trimethoprim-sulfamethoxasole and fosfomycin are recommended as the first choice antibiotics for urinary system infections according to the guideline prepared by Infectious Diseases Society of America (IDSA). Ciprofloxacin is recommended in case of treatment failure. The aim of the study was to investigate the in vitro efficacy of nitrofurantoin, fosfomycin, trimethoprim sulfamethoxazole and ciprofloxacin on isolates obtained as the agent of UTI. Additionally it was aimed to compare MIC results with disk diffusion (DD) results evaluated according to Clinical and Laboratory Standards Institute (CLSI) for want of FOS DD zone diameter limits in EUCAST.
METHODS: 302 E. coli isolates obtained from urine specimens of outpatients who applied with UTI complaint between May 2014 and September 2014. The antibiotic susceptibility of isolates were determined according to the recommendations of European Committee on Antimicrobial Susceptibility Testing (EUCAST) using the disc diffusion method for nitrofurantoin, trimethoprim sulfamethoxazole and ciprofloxacin and minimum inhibitor concentration (MIC) was determined with broth microdilution method forfosfomycin.
RESULTS: The susceptibility rates tested with disc diffusion method for nitrofurantoin, trimethoprim sulfamethoxazole and ciprofloxacin were 1.66%, 45.36% and 42.38%, respectively. The entire portion of test isolates were found susceptible against fosfomycin based on the MIC values. The rate of resistance of the isolates against both ciprofloxacin and trimethoprim sulfamethoxazole was found to be 29.14%. The MIC50/MIC90 values against fosfomycin were found 2 µg/ml and / 8 µg/ml respectively. Fosfomycin MIC values of isolates were detected as consistent with EUCAST epidemiologic cutoff (ECOFF) data. The Pearson correlation analysis was carried out for zone diameters measured for fosfomycin as a result of disc diffusion test and MIC values showed a weak reverse correlation (r=-0,5238, p=0,00).
DISCUSSION AND CONCLUSION: We have the opinion that ciprofloxacin and trimethoprim sulfamethoxazole are not suitable choices for empirical treatment for our country based on this evaluation and fosfomycin can be the antibiotic that could be preferred in empirical treatment since its MIC values have not increased much yet. The data of the antibiotic consumption surveillance carried out on the outpatients in our country together with the results of the present study clearly show the relationship between the use of antibiotics and development of resistance. Accordingly, we want to emphasize the importance of starting therapy according to the results of cultures and antibiotics susceptibility results based on the UTI treatment protocols.

INTRODUCTION: Malaria is a mosquito-borne infectious disease that is transmitted most commonly by an infected female Anopheles mosquito to humans. This study intended to investigate the malaria epidemiology in Bursa Province using the data provided by the Malaria Control Unit of Public Health Directory, from January 2013 through December 2014.
METHODS: The cases were evaluated according to age groups, gender, parasite species, the month in which the infection was detected and the origin of district (indigenous or imported cases).
RESULTS: During a period of two years, a total of 7853 blood smears were examined and malaria parasite was found in 12 cases (0,15%). Among the group, 11 (91,7%) were male and 1 (8,3%) was female. The mean age was 35,5±14,92 years, while the age range varied between 20 and 61 years. P. falciparum was observed in 11 cases (91,7%) and one case (8,3%) was P. vivax. All P. falciparum cases were found to be imported cases coming to Bursa from African counteries (Ghana, Tanzania, Niger, Guinea, Cameroon, Gabon, Gambia).
DISCUSSION AND CONCLUSION: This study can contribute to the malaria prevalence studies to be conducted in this area and Turkey in future.

INTRODUCTION: In this study, the incidence of Trichomonas vaginalis was investigated in samples taken from patients with pre-vaginitis using different culture methods and it was tried to determine which culture method is more suitable for isolation of parasitic pathway from the clinical material
METHODS: The patients who applied to Cumhuriyet University Research and Application Hospital, Outpatient Polyclinic of Gynecology and Obstetrics between the dates of November 2015 – June 2016 with the pre-diagnosis of vaginitis were examined. The vaginal swab samples of 100 female patients the 30 age of whom varied between 18 and 68 were examined with InPouch TV system, Cysteine Pepton Liver Maltose (CPLM) and Trichomonas Broth (TB) culture methods.
RESULTS: At the end of the study, T. vaginalis was determined in 4 (4.0%) of 100 patients in all the media used in the study. However, while T. vaginalis sustained its vitality in CPLM and TB media until the sixth and seventh day, it was determined that it was able to continue its life until the twelfth day in 35 InPouch TB medium. It was determined that the parasite reproduced in the InPouch TV and TB media more intensely and rapidly and followed a normal course in the CPLM medium.
DISCUSSION AND CONCLUSION: As a result,In our study, four (4%) of 100 patients with vaginitis who were admitted to the outpatient clinic were found positive in three different culture media. The most suitable culture for the isolation and identification of T. vaginalis was evaluated as InPouch TV in terms of the length of life of the trophozoites in culture and as short as the isolation period should be considered

INTRODUCTION: The objective of this study is to know the food safety and to express our efficiency in food literacy and obtaining healthy foods. Assessing consumer’s knowledge of obtaining safe foods and food literacy and interfering in this field will be an important step to enhance the health of the society. In this study, the knowledge of university students of food literacy and food safety was and their behaviours regarding the subject were determined.
METHODS: This study was conducted on the individuals aged 18 and older studying at Amasya University, Health Services Vocational High School in May-June 2016. The questionnaire form, prepared based on the literature by the face-to-face interview method, was used in collecting the data. The questions in the questionnaire form were addressed to the students regarding food safety, food literacy, monthly average expenses on food and factors affecting food preferences. The data were evaluated in the computer environment using SPSS 21 software. The chi-square test was conducted to evaluate the frequency tables and categorical data.
RESULTS: 470 students participated in the study and the average age of the study group was 20,05±2,61. The rates of the students answering the concept of food safety and food literacy right are 15,3% and 14,7%, respectively. Only 8,7% of the students who participated in the study stated that they knew Alo 174 line right. The most reliable sources for food safety were identified as university (56,2%), scientific journals and books (48,3%), and the medical personnel (47,9%). When the factors affecting the food preferences of the consumers were analyzed, the demands and economic conditions of the family were determinative and it was observed that they mostly purchased foods from the markets and preferred packaged products.
DISCUSSION AND CONCLUSION: It was determined that students did not know the concepts of food literacy and food safety at a sufficient level. Moreover, it was revealed in the analysis performed that the departments at which students study, age, gender, economic conditions and the monthly expenses on foods criteria were not effective factors in the identification of the food safety concept.

INTRODUCTION: Although pesticides are mostly used on agricultural grounds, non-agricultural pesticide applications have important health implications since individuals of either sex and all ages can be affected. Municipalities in Turkey make widespread use of pesticide applications in order to combat undesirable organisms in public spaces. This study was intended to elicit information from municipal officials concerning pesticide applications across Turkey and to assess their knowledge of pesticides.
METHODS: This was a descriptive study. Data were collected using a supervised questionnaire administered to officials from 431 municipalities in Turkey in June-July 2015. The interviewees comprised officials responsible for pesticides. Information about the study was given and verbal approvals were taken.
RESULTS: 41,3% of respondents stated that pesticides were not their main responsibility, and 61.8% had received no relevant training. Additionally, 75.2% reported that pesticide application was performed by municipal employees, while 60.1% of municipalities had no manager in charge of applications. The most common personal protective equipment provided was a cloth mask (78.8%). The least well-known correct proposition was that ‘Clothing worn during pesticide application should be washed in the workplace’ (61.5%). The false proposition with the lowest level of recognition as inaccurate was ‘Clothing worn during one application should not be used again in the next (36.2%).
DISCUSSION AND CONCLUSION: While non-agricultural pesticide application is regulated by law in Turkey, there are deficiencies in practice. Pesticide applications performed by municipalities must be properly supervised. In addition, workers employed in the field of pesticides in municipalities and one in three of those in decision-making positions are insufficiently informed on the subject. Both represent a risk to both community health and to that of the operative concerned.

INTRODUCTION: Being a complex and multifactorial disease, obsesity is characterized by hormonal and metabolic changes and occurs depending on an increase in fat rate of the body. It is a crucial problem for both developed and developing countries. In the last 20 years, there has been an increase in obesity frequency all over the world. It is known that obesity which comes into being in adolescence may continue in older ages. For this reason, it is useful to detect it in early ages and take necessary measures. The evaluation of the risk factors and obesity level in the 14-17 age group adolescents who are students in high schools in Kayseri and its central districts.
METHODS: This descriptive study has been conducted with 1072 adolescents in 14-17 age group. Body Mass Index has been calculated in kg/m2 unit by using the formula ‘body weight/height’, and the adolescents have been regarded as “overweight” or “obese” according to the cut-points determined for the 2-18 age group in the International Obesity Task Force study. In addition, the relationship between BMI and the variables that might affect obesity (age, gender, siblings, smoking status, parental education status, obesity in the family, duration of internet and TV use, the number and pattern of meals, work out status, the frequency of food consumption) has been evaluated.
RESULTS: 16.7% of the adolescents were overweight, and 3.9% were obese. While 18.9% of the boys were overweight and 4.6% were obese, these ratios are 15.0% and 3.5% among the girls, respectively. Of the adolescents who have an obese individual in their family, 20.8% were overweight and 6.9% were obese. The rate of obesity and overweight was lower in the adolescents who consume snacks compared to those who do not. Age, gender, number of siblings, parental education status, smoking and skipping meals do not affect the body weight.
DISCUSSION AND CONCLUSION: Overweight and obesity in adolescent is an important problem. Approximately one of five adolescents attending high school in Kayseri are overweight.The presence of obesity in the family, not consuming snacks are determined to be the most significant risk factors of obesity.

Infections are the most important causes of chorioamnionitis. Causative bacteria are usually genital mycobacteria, anaerobes, enteric Gram-negative bacilli and group B streptococci. Also Staphylococcus aureus can rarely be the causative agent. In this study a case of chorioamnionitis caused by Staphylococcus aureus was reported. A ten weeks pregnant woman was admitted to our hospital with fever, physical examination revealed lower quadrant tenderness. As the fetal heart sounds can not be heard by ultrasound therapeutic abortion was planned. The meropenem treatment was administered to the patient with the pre-diagnosis of chorioamnionitis after obtainined cultures. Then Staphylococcus aureus was growed in the blood cultures and in the cultures of amniotic membranes obtained during operation. The histopathologic examination of the amniotic membranes was reported as acute funisit and acute chorioamnionitis. The therapy was continued with cefazoline and completed in 14 days. As a result Staphylococcus aureus should also be considered as a causative agent in chorioamnionitis cases and the empirical therapy should be administered accordingly.

Bioterrorism is defined as the unlawful use of pathogen materials for political, social and/or economic objectives. There are numerous examples of bioterrorist attacks in history. Bioterrorism agents are categorized by parameters as toxicity, morbidity and mortality. This categorization is very important to assess the effects of each biological agent on public health. Food is the most vulnerable agent for contamination by toxic materials. Food chain can be broken at any stage through intentional or unintentional contaminations. Food safety means to protect foods from intentionally inserted biological agents, toxins, chemicals, radiation and physical substances. Intentional or unintentional food contamination can occur by biological, chemical or physical agents. Food safety management systems like food quality assurance, food quality control, good manufacturing practices, HACCP (Hazard Analysis Critical Control Points), and ISO (Internatiıonal Organization for Standardization) 22000 are needed in order to ensure food safety in national and international levels. HACCP has proven to be effective against accidental contamination, however its implementation for determine or decrease intentional attacks is very rare. PAS 96: 2014 (Guide to Protecting and Defending Food and Drink) is a guideline that is published for protect and defense food business from deliberate attacks. This guideline describes TACCP (Threat Assessment Critical Control Points) as a systematic management of risk through the evaluation of threats, identification of vulnerabilities, and implementation of controls of products, purchasing, processes, premises, distribution networks and business systems by a knowledgeable and trusted team with the authority to implement changes to procedures. In addition to this, there is a new system that called VACCP (Vulnerability Assessment Critical Control Points) is being used to protect against food fraud. Since food safety management systems are dynamic systems, it is necessary to determine new hazards and threats, to update methodologies against each circumstances, and develop new methodologies where necessary.