Alicja Nowak-Zaleska, PhD, dissertation in the field of genetic differentiation of the genus Acinetobacter, a microbiologist, an assistant in the 1Department of Biology, Ecology and Sport Medicene. Roman Kotłowski, PhD, chemistry, an assistant in the Department of Molecular Biotechnology and Microbiology. Agnieszka Mikucka, MD, microbiologist, deputy head of Dept. of Microbiology, Nicolaus Copernicus University in Toruń, Collegium Medicum of L. Rydygier in Bydgoszcz. Eugenia Gospodarek, MD, microbiology, prof. NCU in Toruń, head of Dept. of of Microbiology Nicolaus Copernicus University in Toruń, Collegium Medicum of L. Rydygier in Bydgoszcz
The occurrence of multidrug resistant (MDR) strains of A. baumannii is a growing problem especially when concerning patients in intensive care units. One of the causes of antibiotic resistance is the presence of transporter proteins responsible for their removal. So far, for strains of the species A. baumannii, a system of transporting antibiotics composed of three proteins, AdeA, AdeB and AdeC responsible for resistance to gentamicin, ofloxacin, cefotaxime, and tetracycline has been described. Multiple alignment revealed a 39% similarity of CAP01997 protein of A. baumannii containing Pro-Ala repeats to EmrA that is part of the EmrA/EmrB/TolC transportation system of E. coli responsible for mutlidrag resistance. We took tryin to check whether there is a correlation between the number of Pro-Ala repeats in the EmrA homologue of A. baumannii and the resistance to antibiotics. In this study 79 MDR A. baumannii strains isolated from patients were analyzed. Resistance to antibiotics was determined on Mueller–Hinton agar plates using a Kirby–Bauer disk diffusion test. The number of CCTGCA repeats encoding Pro-Ala repeats in EmrA-homologue of A. baumannii was determined using PCR method and capillary electrophoresis. The results of this research showed significant correlation between resistance to tobramycin and netilmicin, susceptibility to imipenem and the numbers of repeated Pro-Ala sequences in the CAP01997 protein, a homologue of EmrA. Based on presented results (p<0.0001) we can conclude that EmrA-homologue of A. baumannii confers resistance to Imipenem and Netilmicin depending on the presence of 7 and 5 Pro-Ala repeats in CAP01997 protein, respectively.
Persia D. Dadgardoust graduated with a Bachelor of Science degree in Medical Technology in 2007 from the University of Santo Tomas and is likewise a registered Medical Technologist in her country, the Philippines. She graduated from Medicine from the same institution in 2011 and is currently an Otorhinolaryngology – Head and Neck Surgery resident at the University of Santo Tomas Hospital. Her interests include Otology/Neuro-Otology, Audiology and Head and Neck diseases.
This case is set at a clinical division of a tertiary hospital and aims to present a case of tuberculosis of the thyroid gland in a female who presented with a left lateral neck mass, to discuss the incidence of tuberculosis of the thyroid gland in patients with the same profile as our patient and to discuss the diagnostic modalities and treatment for patients with the said disease. Patient is a 55-year old female who presented with a 1 year history of a gradually enlarging left lateral neck mass accompanied by cough, hoarseness, weight loss and intermittent fever. Tuberculosis work-up was negative and was ruled out. Nasal endoscopy revealed nasopharyngeal mass. Ultrasound of the neck was consistent with an evolving follicular neoplasm and fine needle aspiration biopsy was inconclusive. Due to risk factors in the patient, total thyroidectomy with bilateral selective neck dissection and nasopharyngeal biopsy were done. Final histopathology results were consistent with a tuberculous process. Patient was then started on anti-Koch’s regimen. Few have been available in current literature regarding the incidence of tuberculosis in the thyroid gland. According to these reports, diagnosis was often made post-operatively or postmortem. Some advocate the use of ancillary procedures such as ultrasound and CT scan to aid in the diagnosis. Repeated aspirations with bacteriological studies and staining methods can be recommended to avert a more radical management. A course of anti-Koch’s regimen would suffice to treat this disease masquerader.