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    A case of meningitis caused by Streptococcus pyogenes in a previously healthy woman
    (2009) Uluğ M.; Ulug N.C.; Celen M.K.; Geyik M.F.; Ayaz C.
    Background: Streptococcus pyogenes is a well-known cause of a variety of clinical infections including local symptoms such as tonsillopharyngitis, cervical lymphadenitis, otitis media, cellulites, erysipelas, as well as more severe diseases such as scarlet fever, osteomyelitis, necrotizing fasciitis, sepsis, and toxic shock syndrome. However, acute bacterial meningitis caused by this pathogen is unusual. Objective: We report a case of group A streptococcus (GAS) meningitis in a previously healthy woman with a dramatically rapid course and fatal outcome. Case: A 41-year-old previously healthy woman presented a history of fever, headache, vomiting, and sore throat of three days' duration. Neurological examination revealed diminished consciousness and neck rigidity. The cerebrospinal fluid (CSF) was turbid with 10,000 leukocytes/mm3. Direct examination of CSF showed Gram-positive cocci in chains, and cultures yielded S. pyogenes. Blood cultures yielded growth of S. pyogenes. The patient was treated initially with ceftriaxone (4 g/day) and the control CSF examination was not changed on the third day, so vancomycin (2 g/day) was added to the treatment; however, she died on the fourth day of the treatment. Conclusion: S. pyogenes meningitis is uncommon and the incidence seems to be persistently low; nevertheless, clinicians should be aware that sporadic cases may occur and may have a fulminant course with a relevant neurological sequel. Copyright © 2009 Ulug et al.
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    Characteristics of acute bacterial meningitis in Southeast Turkey
    (2004) Ayaz C.; Geyik M.F.; Hosoglu S.; Celen M.K.; Akalin S.; Kokoglu O.F.
    BACKGROUND: Acute bacterial meningitis (ABM) remains a significant worldwide cause of death in adults. Even in the antibiotic era, the mortality rate in ABM remains significant and has been reported in the range of 8-40%. AIM: The aim of this study was to assess the characteristics of epidemiology, clinical manifestations, treatment modalities and outcome of patients with ABM in Southeast Turkey. SETTINGS AND DESIGN: This retrospective study included all cases of community-acquired ABM diagnosed and treated in Dicle University Hospital between June 1996 and December 2002. METHODS AND PATIENTS: The study group consisted of 186 adult patients (110 male, 76 female) with ABM, those patients who are older than 14 years, followed up at Dicle University Hospital from June 1996 to December 2002. Patients' charts were retrospectively reviewed, clinical characteristics were recorded and final data were analyzed. STATISTICAL ANALYSIS: In statistical analyses, the Chi-square test was used for binary variables and Student's t-test for continuous variables. RESULTS: The patients' mean age was 30.2 ± 15.3 years (range 74 to 90 years). On admission, typical symptoms of meningitis were found in most of the patients: headache in 92.5%, fever in 88.2%, and nuchal rigidity in 80.1%. The main predisposing factor for ABM was otitis media (40 patients, 21.5%) and closed head trauma (12 patients, 6.5%). Streptococcus pneumonia was the most common identified pathogen. Twenty-nine patients (15.6%) died during hospitalization period. In multivariate analyses, the significant mortality factor was found as initial level of consciousness, low cerebrospinal fluid/blood glucose ratio, high erythrocyte sedimentation rate and initial treatment by penicillin G. CONCLUSIONS: Although still remains as a serious infection, early diagnosis and effective treatment may reduce fatal outcome and improve the course of the disease in patients with ABM. Ceftriaxone should be considered as the drug of choice for initial empirical therapy, while waiting culture results and vancomycin must be withheld for patients having increased risk of penicillin resistant pneumococci strains.
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    Comparison of lamivudine and alpha-interferon combination with alpha-interferon alone in the treatment of HBeAg-positive chronic hepatitis B
    (2006) Ayaz C.; Celen M.K.; Colak H.; Hosoglu S.; Geyik M.F.
    Aim: To compare the efficacy of a combination of a-interferon (IFN-a) and lamivudine with IFN-a alone in the treatment of patients with HBeAg-positive chronic hepatitis B (CHB). Methods: Sixty-eight treatment-naove patients with HBeAg-positive CHB were randomized to receive either 9 MU of IFN-a2a three times a week and lamivudine 100 mg daily (Group 1), or IFN-a2a alone in the same dosage (Group 2), for 12 months. Serum ALT, HBeAg, anti-HBe and HBV DNA were tested at the end of treatment and 6 months later. Complete response was defined as normal ALT, negative HBeAg and negative HBV DNA, six months after stopping treatment. Results: Of the 68 patients, 64 completed the study. In Group 1 (n=31), mean (SD) ALT levels decreased from 124 (59) IU/L to 39 (18) IU/L at 12 months; corresponding values in Group 2 (n=33) were 128 (57) and 56 (11) IU/L (p<0.05). Absence of HBV DNA at the end of treatment was more common in Group 1 (28/31) than in Group 2 (22/33; p<0.022). The number of patients with seroconversion to anti-HBe (4/31 [13%] vs. 4/33 [12%], respectively; p>0.05), as also those with complete response (4/31 [13%] and 4/33 [12%], respectively; p>0.05) six months after completion of treatment was similar in Group 1 and Group 2 . Conclusion: Combination treatment with IFN-a and lamivudine was better than IFN-a monotherapy in normalization of ALT and clearance of HBV DNA; however, it did not have a better sustained response rate than IFN-a alone. © 2004 Indian Journal of Gastroenterology.
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    The effects of alfa-tocopherol, ascorbic acid and pentoxifylline on bacterial translocation in common bile duct ligated rats
    (AVES, 2004) Aldemr M.; Geyik M.F.; Akalin Ş.; Hoşo?lu S.; Taçyildiz I.
    This study was conducted to investigate the effects of alfa-tocopherol, ascorbic acid and pentoxifylline on the bacterial translocation in an animal model of obstructive jaundice. Prolonged biliary obstruction gives rise to numerous changes in the liver and the host defense system. The increased biliary duct pressure may induce translocation of bacteria from the biliary tract into bloodstream and lymphatic system. Fifty rats were randomized into 5 groups containing 10 rats each. All rats were initially anaesthetized by intramuscularly injection of Ketamine (25 mg/kg). The abdomen was opened and the common bile duct was identified and divided after ligation using 5-0 silk. Sham operated rats (group 1) had a similar incision followed by mobilization of the common bile duct, without ligation or division. In group 2 rats, only common bile duct ligation was performed. In group 3, 4 and 5 rats common bile duct ligation was performed and alfa-tocopherol, ascorbic acid and pentoxifylline were administered for 21 days. The animals were sacrificed at the end of the 21st day, and serum levels of total bilirubin, ALT, AST, ALP and GGT were measured. Mesenteric lymph nodes, liver, spleen and blood were cultured. The bacterial translocations of rats in groups 1-5 were 0%, 82.5%, 25%, 30% and 20%, respectively. Bacterial translocation significantly increased in the mesenteric lymph nodes, liver, spleen and blood of rats in group 2 compared to group 1 (p<0.001). Bacterial translocations of the mesenteric lymph nodes, liver, spleen and blood in group 2 was significantly higher than those of group 3-5 (p<0.05). There was no significant difference between treatment groups (p>0.05). The predominant pathogens obtained from the mesenteric lymph nodes, liver, spleen and blood were Esherichia coli (42.9%), Klebsiella spp. (23.8%) and Proteus spp. (19%). The bacterial counts, colony-forming units per gram tissue (cfu/g), were found significantly higher in mesenteric lymph nodes, liver, spleen and blood of rats in group 2 than those of group 3, 4 and 5 (p=0.001). The present experimental study has demonstrated that, during obstructive jaundice, administration of alfa-tocopherol, ascorbic acid and pentoxifylline reduce the incidence of bacterial translocation.
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    The effects of levofloxacin and intravenous immunoglobulins on sepsis due to Streptococcus pneumoniae in splenectomized rats
    (Turkish Surgical Society, 2003) Aldemir M.; Geyik M.F.; Akalin Ş.; Hoşo?lu S.; Taçyildiz I.; Ayaz C.
    This experimental study was conducted to investigate the effects of levofloxacin and intravenous immunoglobulins (IVIG) on sepsis due to Streptococcus pneumonia in splenectomized rats. Splenectomy impairs the immune response to bacterial infections. Postsplenectomy sepsis is a serious complication that can result in fulminant bacteriemia and even death. Sixty infant Sprague-Dawley rats were randomized into 5 groups containing 12 rats each. All rats were initially anaesthetized by intramuscularly injection of Ketamine (5 mg/kg). In the group 1, after the abdomen was opened, spleen was mobilized. In the other groups, splenectomy was performed. All of this animals (in the groups 2-5) were inoculated with Streptococcus pneumonia seven days after splenectomy. Fifteen hours after inoculation, blood (0.1 cc) was obtained for bacterial counts (cfu) and immediately drug therapy was given. The saline solution, levofloxacin, IVIG, levofloxacin plus IVIG were given in group 2-5 rats respectively. Twenty-four, 48 and 72 hours after initial therapy, blood samples were obtained from all rats for bacterial counts and biochemical examination (Ig G,A,M) and during 72nd hours rats were sacrificed. After inoculation in the groups 2-5 rats positive cultures were obtained. During 48th and 72nd hours, positive cultures (41.7% and 25%) of rats in groups 3 were significantly lower than (100% and 100%) those of group 2 (p<0.05 and p=0.001, respectively). Positive culture ratio (41.7%) in the group 4 was significantly lower than (100%) that of group 2 (p<0.05). During 24th, 48th and 72nd hours, positive cultures (41.7%, 16.7% and 0%) in the group 5 were significantly lower than those of group 2 (p<0.05, p<0.001 and p<0.001). During 24th, 48th and 72nd hours, bacterial counts in the groups 3-5 were significantly lower than those of group 2 (p<0.001). The IgG levels of groups 4 and 5 were significantly higher than those of groups 2 and 3 (p<0.001). The present experimental study has demonstrated that levofloxacin and IVIG, both alone and combine, are useful on sepsis due to S. pneumonia in splenectomized rats.
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    Effects of nimodipine on the cerebrovascular and neuronal changes during pneumococcal meningitis in the rat
    (Akademiai Kiado Rt., 1997) Hoşoglu S.; Ceviz A.; Serdar Kemaloglu M.; Sari I.; Inalöz S.; Geyik M.F.; Kökoglu Ö.F.
    It was investigated whether treatment with the calcium channels blocker Nimodipine, a 1,4-dihydropyridine derivative, influences vasculopathy and neuronal injury in experimental pneumococcal meningitis. Rats were randomly assigned to one of three experimental groups. The first group (Control group, n=20) was given saline (0.4 ml/day) intraperitoneally (ip), whereas the second group (group C, n=22) was treated only with ceftriaxone in a dosage of 30 mg/day/ip. The third group (group C-N, n=22) was treated with the combination of ceftriaxone 30 mg/day/ip, and nimodipine 0.6 mg/day/ip. Treatment was begun at the time of inoculation in all three groups. The control group was compared clinically and histopathologically with groups C and C-N at 24 h, three and six days after inoculation. Six rats in the control group and eight rats in group C and group C-N were sacrificed at 24 hours and seven rats in each group were sacrificed on the third and sixth day after inoculation. Clinically, there were no significant differences between group C and group C-N (p>0.05). There were significant differences between group C and group C-N for vasculopathy and neuronal injury (p<0.0001 and p<0.005, respectively). © 1997 Akadémiai Kiadó.
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    The effects of prophylactic antibiotics on the bacterial translocation due to pringle maneuver
    (Turkish Surgical Society, 2002) Girgin S.; Aldemir M.; Taçyildiz I.-B.; Geyik M.F.
    This study was undertaken to investigate the effectiveness of prophylactic antibiotics (Cefotaxime and Ceftazidime) on the bacterial translocation related to PM in rats. Bacterial translocation may occur in humans and is associated with an increased incidence of septic morbidity. It has been consistently demonstrated in a number of experimental models, including burns, trauma, shock, and surgery. It has been previously determined that the PM causes bacterial translocation. The prophylactic antibiotics may reduce this translocation. Thirty male Sprague-Dawley rats weighed in at 250-300 gr were divided into 3 groups each were containing 10 rats. After being anaesthetized by intramuscularly injection of Ketamine, midline laparotomy was performed to all rats under sterile conditions. In group 1 (Control), the hepatoduodenal ligament was clamped for 40 min. In group 2 (Cefotaxime), following intramuscularly application of Cefotaxime (30 mg/kg) 30 minutes before the surgical procedures, the PM was performed for 40 min. In group 3 (Ceftazidime), Ceftazidime (30 mg/kg) was applied instead of Cefotaxime before the PM. 1 ml of blood sample was obtained from the portal vein for blood culture. The MLN biopsy and splenectomy were performed for culture. The positive bacterial cultures, obtained from MLN, spleen and blood, were determined most frequently in group 1. It was found that the positive cultures of group 1 (56.7%) were significantly higher than those of group 2 (6.7%) and group 3 (6.7%) (p=0.006, p=0.006, p=0.001, respectively). Microorganisms, obtained from MLN and spleen,were E. coli, C.pneumonia, Mikst, Candida and E.fecalis (respectively, 61.9%, 14.3%, 9.5%, 9.5%, 4.8%). In both cultures of MLN and spleen, the CFU of the group 1 was significantly higher than CFU of group 2 and 3 (p=0.001, p=0.003). In our study, we determined that PM significantly increased bacterial translocation in MLNs, spleen and blood, and prophylactic application of Cefotaxime and Ceftazidime had preventive effect on this translocation.
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    The epidemiology and control of nosocomial infections in pediatric surgery
    (2002) Önen A.; Çi?dem M.K.; Geyik M.F.; Otçu S.; Öztürk H.; Dokucu A.I.
    Purpose: To investigale the epidemiology and control methods of nosocomial infection (NCI) in pediatric surgery. Method: We retrospectively reviewed 2844 hospitalized children in the pediatric surgical clinic between January 1997 and December 2000. The diagnosis of NCI was made based on criteria proposed by "Centers for Disease Control and Prevention (CDC)". The incidence of NCIs, type of microorganisms and infections, age, sex and risk factors were determined. The mortality rate and hospitalization period of patients with NCI were compared with 78 control patients whose age, sex and primary disease were identical and free of NCI. Results: There were 78 children with NCI; the overall incidence was 2.74% (4.99% in 1997, 3.89% in 1998, 1.33% in 1999, 1.44% in 2000). The meanage was 28 months the most frequent infections were surgical wound and urinary tract infection, in the NCI and 26 months in the control group. The most frequent risk factors were urethral catheter (10.26%), trauma (9.25%), and parenteral nutrition (8.70%). The mean hospitalization period was 16 days (range 4-28 days) in patients with NCI, while it was 9 days (range 2-22 days) in control group. There was a significant difference in mortality rate and hospitalization period (p<0.05, p<0.001, respectively) between the patients with NCI and those of controls. Conclusion: Surgical wound infection was the most common NCI in Pediatric Surgery. Urethral catheterization, trauma and parenteral nutrition were the most frequent risk factors. NCIs caused high mortality, prolonged hospitalization period and increased cost. Close relationship between the pediatric surgical team and the infection disease team; the education of medical staff; handwashing and disinfetion; limited antibiotics; close follow-up for risk factors; minimized invasive interventions and catheterizations; isolation; and early enteral nutrition resulted in significant decrease in the incidence of NCIs in our clinic in the last two years.
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    The evaluation of geriatric infections: Dicle experience
    (2010) Ulu? M.; Çelen M.K.; Geyik M.F.; Hoşo?lu S.; Ayaz C.
    • Objective: Although successes have been achieved in the treatment of the infectious diseases with antibiotics in nowadays, infectious diseases are still serious problem in the elderly. This study was conducted in order to determine the pattern of clinical infectious diseases in hospitalized elderly patients. • Material and Method: In this study, the data of all elderly patients aged 65 and older, were hospitalized to our clinic between May 2000 and May 2005 were evaluated retrospectively. We reviewed 301 patients for diagnostic studies, risk factors, isolated microorganisms and morbidity and mortality rates. • Results: Infections as a cause of hospitalization were identified as the following frequency; sepsis (19.2%), pneumonia (17.9%), acute gastroenteritis (16.9%), acute bacterial meningitis (5.3%) and urinary tract infection (3.6%), respectively. E. coli was the most isolated microorganism in these patients. Hypertension, chronic obstructive pulmonary disease and diabetes were seen as risk factors in our patients. Seventy-three patients died during hospital stay due to their infection and chronic diseases. • Conclusion: Under diagnosis of the elderly diseases is very common due to many factors related to elderly, family members and health workers. Prognosis is rather worse especially in sepsis due to pneumonia and urinary tract infections.
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    The evaluation of gram negative bacilli isolated from inpatiens and its antibiotic resistance
    (2010) Özmen E.; Geyik M.F.; Ulu? M.; Çelen M.K.; Hoşo?lu S.; Ayaz C.
    Aim: Resistance to gram negative bacilli is increasing all over the world. In this study, the resistance of gram negative bacilli, which were isolated from inpatients, was evaluated for selected antibiotics. The aim of this study was to acquire the significant results for empiric therapy. Material and Method: Eight hundered ninety eight strains which were isolated from inpatients were investigated between May 2003 and April 2005 from clinical speciments at Dicle University Hospital, Diyarbakir. The microdiluation test was used to determine for antibiotics resistance. Findings: Escherichia coli (n=282), Enterobacter spp. (n=215), Pseudomonas aeruginosa (n=101), Klebsiella spp. (n=95), Stenotrophomanas maltophilia (n=69) and Acinetobacter spp. (n=52) were the most frequent isolates. The resistance ratio among whole isolates against ceftriaxone was 73%, cefotaxime 68%, ceftazidime 63%, trimetoprim/sulfamethoxazole 60%, ciprofloksasin 51%, amikasin 20%, imipenem 3% and meropenem 2%. The resistance to the third generation cephalosporins, trimetoprim/sulfamethoxazole and ciprofloxacin was found higher than other antibiotics in this study. Results: In conclusion, antimicrobial resistance must be monitored for each hospital for a reasonable empirical antibiotic therapy. Surveillance studies might be useful for empirical treatment approach. © 2010 Düzce Medical Journal.
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    Intestinal ischemia, bacterial translocation, and oxygen free-radical production in abdominal compartment syndrome
    (2009) Yagmur Y.; Ozturk H.; Guloglu C.; Geyik M.F.; Ozturk H.; Mete F.
    Objectives. The aim of this experimental study was to evaluate the consequences of increased intra-abdominal pressure on the small bowel and whether this pressure creates intestinal ischemia leading to oxygen free-radical production and bacterial translocation. Material and Methods. Twenty Sprague-Dawley rats weighing 275-300 g were used. Group 1 rats (n = 10) were subjected to 20-mm Hg pneumoperitoneum pressure for 60 minutes. In group 2 rats (n = 10, controls) the intra-abdominal pressure was not increased. In all rats the following parameters were investigated: mean arterial pressure after carotid catheterization, histopathological examination of the intestinal mucosa evaluated with a scoring system, malondialdehyde production in the liver and small bowel, and bacterial translocation towards the mesenteric lymph nodes, liver, and spleen 24 hours after pneumoperitoneum deflation. Results. The mean arterial pressure exhibited no alterations. Histological analysis mainly showed extensive epithelial separations from the lamina propria down the sides of the villi and ulceration at the villus tips in the rats with increased intra-abdominal pressure. Bacterial translocation occurred to the mesenteric lymph nodes, spleen, and liver after 60 minutes of increased intra-abdominal pressure of 20 mm Hg (p < 0.05). Malondialdehyde increased in the liver and small bowel mucosa (p < 0.05 for both). Conclusions. Increased intra-abdominal pressure in rats leads to intestinal ischemia and mild histological changes in the small bowel and to oxygen free-radical production and bacterial translocation. © Copyright by Wroclaw Medical University.
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    Musculoskeletal involvement in brucellosis in different age groups: A study of 195 cases
    (SMW supporting association, 2002) Geyik M.F.; Gür A.; Nas K.; Çevik R.; Saraç J.; Dikici, Bünyamin; Ayaz C.
    Objective: The aim of the present study was to determine the distribution and characteristics of arthritis in 195 patients with musculoskeletal involvement due to brucellosis in different age groups in the southeastern region of Turkey. Patients and methods: We carried out a retrospective analysis of 283 patients with brucellosis records and identified 195 with musculoskeletal involvement. Patients were classified into acute-subacute (<12 months) and chronic (>12 months) brucellosis. Patients were also classified into three age groups: <15 years old (group A), 15-45 years (group B), and over 45 years (group C). In addition, patients were classified into five subgroups according to type of arthritis: peripheral arthritis, polyarthritis, spondylitis, sacroiliitis, and spondylitis/sacroiliitis. Results: 195 (69%) of the 283 patients [138 female (49%), 145 male (51%)] had musculoskeletal involvement. Of the patients with musculoskeletal involvement 113 (58%) were female and 82 (42 %) were male, ranging in age from 3 to 71 years (mean age 33.14 ± 15.03). Of 195 patients studied, 39 (14%) were <15 years old (group A), 122 (43%) were aged 15-45 (group B), and 34 (12%) were over 45 (group C). The most commonly affected joints were the sacroiliac joint in 108 patients (55%), peripheral joints in 106 (54%), and spondylitis in 60 (31%). Of 108 patients with sacroiliitis, 19 were in group A, 76 in group B, and 13 in group C. Bilateral sacroiliitis was less common in group B (23 patients) than in groups A (3) and C (3) (p <0.05). Spondylitis was more common in group B (18%). Sacroiliitis and polyarthritis were more common than other types of musculoskeletal involvement in females, whereas in males the distribution of all types was similar. In patients aged under 15 and 15-45, sacroiliitis and polyarthritis were common compared with other types of arthritis, but the distribution was similar in patients over 45. Conclusion: In southeastern Anatolia musculoskeletal involvement in brucellosis is frequent. The series presented suggests that musculoskeletal involvement in group A is higher than groups A and C. The prevalence of musculoskeletal involvement appears to differ according to age, sex and clinical type.
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    Nasopharyngeal carcinoma in the etiology of fever of unknown origin
    (2010) Ulu? M.; Çelen M.K.; Geyik M.F.; Tekin R.; Ayaz C.
    Fever of unknown origin is defined as a temperature higher than 38.3°C lasting three weeks or longer and not beind diagnosed even after one week of study in-hospital settings. Infections and malignancies had been the most common causes of fever of unknown origin overall. Nasopharyngeal carcinoma, constituting less than 0.03% of all malignant tumors and only 2% of all head and neck cancer. Ebstein Barr virus infection consumption of smoked and salted fish and vitamin-C deficient diet have been blamed in its etiology. In this study,we present two cases who were admitted to our clinic with fever of unknown origin initially and later diagnosed with nasopharyngeal carcinoma atypically progressing.
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    An outbreak due to multidrug-resistant Klebsiella pneumoniae in Neonatal Intensive Care Unit
    (1997) Hosoglu S.; Ayaz C.; Devecioglu C.; Boşnak Mehmet; Geyik M.F.
    An outbreak of neonatal septicemia due to Klebsiella pneumonias have been detected in Neonatal Care Unit, Dicle University Hospital, between the period of October 1996-March 1997. Septicemia was diagnosed in 105 cases by clinical features and routine laboratory findings but only 68 (64.8%) of them were included to the study by at least one blood culture positivity. Cultivation of the blood samples was performed in PEDS Plus/F Medium BACTEC 9240 system. The beta lactamase production and the antibiotic susceptibilities were tested on Sceptor panel and MIC Identification panel respectively, and all the 30 K. pneumoniae strains were found beta lactamase positive and multidrug resistant. K. pneumoniae (44.1%) was followed by coagulase-negative Staphylococci (22%) and Enterobacter spp. (11.8%) those isolated from blood cultures. As the identical strain of K. pneumoniae was isolated from the environmental cultures of nursery in Obstetrics Department as well, it is concluded that the source of the infection was the environment. The majority of K. pneumoniae strains showed high sensitivity to ciprofloxacin (100%) and imipenem (96.6%) but they were resistant to ceftazidime, tobramicin, mezlocillin, ticarcillin, cefazolin, gentamycin and ampicillin. After an education programme given to the personnel, only one case was detected in March 1997.
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    The role of trace elements in Helicobacter pylori infected patients
    (2011) Bozkurt F.; Gulsun S.; Ustun C.; Geyik M.F.; Hosoglu S.
    Objective: To evaluate the effect of trace elements in patients with Helicobacter pylori associated chronic gastritis Design: Prospective study Settings: Clinical services of the clinical microbiology and infectious diseases and gastroenterology clinics at Dicle University, Turkey Subjects: A total of 92 patients with variable severity of chronic gastritis (45 Helicobacter pylori positive and 47 Helicobacter pylori negative gastritis) and 90 age and sex matched healthy subjects were included in the study conducted between October 2006 and November 2008. Intervention: Histopathologic examination, culture of Helicobacter pylori and urease tests were performed for each patient. The atomic absorption spectrophotometer was used in the measurement of trace elements in the serum. Main Outcome Measures: Serum copper and zinc levels were significantlyelevatedinpatientswithHelicobacter pylori associated gastritis compared to Helicobacter pylori negative gastritis and healthy controls (p < 0.0001). Serum copper, zinc and Cu/Zn levels in patients with Helicobacter pylori negative chronic gastritis was not significantlydifferentfromthe serum levels in healthy controls (p > 0.05). Conclusions: Our results suggest a relationship between Helicobacter pylori associated chronic gastritis and the elevation of trace element levels in serum. This study confirmsthattheelevation of trace element levels in serum (Cu and Zn levels) will be helpful in the diagnosis of Helicobacter pylori associated chronic gastritis in the abscence of invasive procedures, and is useful in predicting the severity of infection in patients with chronic gastritis.