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Article Citation - WoS: 1Citation - Scopus: 1Detection of Sexually Transmitted Infection Agents in Pregnant Women Using Multiplex Polymerase Chain Reaction Method(BMC, 2025) Bakir, Ayfer; Cendek, Busra Demir; Usluca, Selma; Aral, Murat; Korkut, Gizem; Morkoc, Mehmet; Keskin, Huseyin LeventBackgroundSexually transmitted infections (STIs) are a significant public health concern that can lead to serious outcomes such as infertility, pregnancy complications, and neonatal infections. This study aimed to evaluate the prevalence of STI and their associated risk factors in symptomatic and asymptomatic pregnant women.MethodsBetween July and October 2024, a total of 300 pregnant women in their third trimester, including 113 symptomatic and 187 asymptomatic individuals aged 18 to 45 years, who sought antenatal care at the Gynecology and Obstetrics Clinic of Ankara Etlik City Hospital, were included in the study. The detection of STIs agents in vaginal swab samples was performed using multiplex polymerase chain reaction in the Molecular Diagnosis Laboratory of the Department of Microbiology.ResultsThe overall prevalence of STIs was 34.3% (103/300), with single and multiple infections accounting for 28.3% and 6.0% of cases, respectively. The most frequently detected pathogens were Ureaplasma parvum/urealiticum (29.0%), Mycoplasma hominis (4.6%), and Chlamydia trachomatis (2.3%). Co-infections were commonly observed between Ureaplasma parvum/urealiticum and Mycoplasma hominis. No significant difference in STI prevalence was observed between the symptomatic (35.4%) and asymptomatic (33.7%) groups. Co-infection with non-STI bacterial agents, such as Gardnerella vaginalis and Streptococcus agalactiae, increased the risk of STIs by 1.96 times (p = 0.006).ConclusionsThis study revealed that STIs occur at similar rates among symptomatic and asymptomatic pregnant women. This finding highlights the critical importance of detecting asymptomatic cases to prevent the spread of silent infections and to safeguard maternal and neonatal health. Ureaplasma parvum/urealiticum were identified as the most common pathogens. Given that co-infections with non-STI bacterial agents significantly increase the risk of STIs, multiplex PCR-based multicenter and prospective studies are essential to refine screening strategies for pregnant women.Article Investigation of Human Herpesvirus 8 & Leishmania Species in Malignant Skin Tumours, Psoriasis, Actinic Keratoses, & Seborrheic Keratoses: a Single-Center Experience From Ankara, Turkey(Scientific Scholar Llc, 2025) Bakir, Ayfer; Usluca, Selma; Kartal, Selda Pelin; Alper, MuratBackground & objectives: The role of human herpesvirus-8 (HHV-8) and Leishmania species in the aetiology of malignant skin tumours and proliferative skin diseases remains a topic of debate. This study aims to analyse formalin-fixed, paraffin-embedded (FFPE) skin biopsy samples using polymerase chain reaction (PCR) to determine whether skin lesions caused by HHV-8 and Leishmania spp. resemble malignant and proliferative skin diseases and assess the role of these pathogens in disease aetiology. Methods: In this retrospective, single-center observational study, skin biopsies were collected from 275 individuals diagnosed with malignant skin tumours, psoriasis, actinic keratoses, seborrheic keratoses, and chronic dermatitis. The presence of HHV-8 and Leishmania spp. in biopsy samples was evaluated Results: HHV-8 DNA was not detected in any of the samples using PCR. However, Leishmania spp. DNA was identified in 8.4 per cent of all samples (n=23). No positivity was observed in the control group (P=0.387). Leishmania spp. DNA PCR positivity was most frequently detected in psoriasis cases (32.4%), followed by actinic keratosis (AK) (8.7%), malignant skin tumours (4.2%), and seborrheic keratosis (SK) (3.8%). When the Leishmania positivity rate in individuals diagnosed with psoriasis was compared with that of the control group, the difference was found to be significant (P=0.002). The positivity rate in squamous cell carcinoma (SCC) (7.3%) was higher than in basal cell carcinoma (1.6%). Interpretation & conclusions: The findings in this study suggests that there is no relationship between malignant and proliferative skin diseases and HHV-8. However, Leishmania spp. DNA was detected in 8.4 per cent of all samples. Biopsy-archived samples may be preferred for the differential diagnosis of Leishmania in diseases that do not respond to treatment and in atypical clinical presentations.Article Toxoplasma gondii Coinfection in HIV-Positive Patients at a Tertiary Care Hospital(Bentham Science Publ Ltd, 2025) Kurkcu, Muhammed Furkan; Bakir, Ayfer; Kaba, Semiha Berra Topsakal; Kusabbi, Ilknur Alkan; Usluca, SelmaIntroduction: Toxoplasma gondii (T. gondii) can cause serious complications in both immunocompetent and immunosuppressed individuals. This study aims to assess the seroprevalence of T. gondii among HIV-positive individuals and to investigate its association with age, sex, CD4+ T cell count, HIV RNA levels, and hematological parameters. Methods: This study included 247 HIV-positive individuals followed up at a tertiary care hospital between November 1, 2022, and November 30, 2024. We analyzed serum samples for T. gondii IgG antibodies using electrochemiluminescent microparticle immunoassay. Results: The prevalence of T. gondii IgG seropositivity was found to be 32.8% (n=81; 95% CI: 26.9-39). The median age of seropositive individuals was 52 years (IQR: 42-61), which was significantly higher compared to seronegative individuals (p<0.001). The highest IgG seropositivity rate (66.7%) was observed in the 61-80 age group. Hemoglobin levels were significantly lower in IgG seropositive individuals (p=0.040). Logistic regression analysis indicated an increased risk of T. gondii infection with advancing age. The odds ratio for the 41-60 age group was 13.3 (95% CI: 1.6-106, p=0.02), while for the 61-80 age group, it was 28 (95% CI: 3.3-240, p=0.002). Discussion: The seroprevalence of T. gondii in HIV-positive individuals was lower than both global and regional averages. Age was identified as an independent risk factor for T. gondii seropositivity. Additionally, hematological alterations associated with anemia were observed in seropositive individuals. Further large-scale, multi-center, and regionally representative studies are required to optimize T. gondii infection management and screening strategies in people living with HIV. Conclusion: These findings suggest that T. gondii infection in HIV-positive individuals increases with age and may be associated with anemia, highlighting the need for age-focused screening and management strategies.Article Citation - Scopus: 1Detection of Toxoplasma Gondii and High-Risk Human Papillomaviruses in FFPE Malignant and Benign Breast Lesions Using Real-Time Pcr(Dove Medical Press Ltd, 2025) Usluca, Selma; Bakir, Ayfer; Arikok, Ata Turker; Korkut, Gizem; Yagiz, Gulsah Ceylan; Alper, MuratObjective: Breast cancer is the most prevalent malignancy among women. In recent years, it has been suggested that various pathogens such as Toxoplasma gondii (T. gondii) and human papillomavirus (HPV) may play a potential role in the development of breast cancer. This study aimed to determine the prevalence of T. gondii and HPV infections in formalin-fixed paraffin-embedded tissue samples of breast cancer patients using real-time PCR. Methods: The study included 136 paraffin-embedded biopsy samples with w confirmed malignant breast tumor diagnosis and 50 breast tissue samples diagnosed as benign breast lesions, serving as controls. The presence of T. gondii DNA and high-, medium-, and low-risk HPV genotype DNAs were investigated using the real-time PCR method. First, deparaffinization was performed using xylene and alcohol, followed by DNA extraction and real-time PCR amplification. Results: The most common histopathological types of malignant breast carcinoma were invasive carcinoma (n=82; 60.3%), invasive lobular carcinoma (n=26; 19.1%), invasive ductal carcinoma (n=8; 5.9%), and mixed invasive carcinoma (n=8; 5.9%). According to the Modified Bloom-Richardson classification, 55.15% of malignant breast tumor samples were grade 2, 32.4% were grade 3, and 12.5% were grade 1. Real-time PCR analysis did not detect T. gondii DNA or HPV DNA in any of these samples. Conclusion: Our findings do not support a role of T. gondii and HPV in breast cancer development. To better understand the possible relationship between breast cancer and these pathogens, further studies with larger sample sizes, diverse diagnostic methods, and broder geographical coverage are necessary.Article Prevalence of Toxoplasma Gondii in Patients with Schizophrenia and Its Association with Clinical Symptoms(Pergamon-Elsevier Science Ltd, 2025) Kurkcu, Muhammed Furkan; Korkut, Gizem; Varli, Mehmet Ridvan; Yilmaz, Gulsum; Usluca, Selma; Bakir, AyferBackground: Schizophrenia is a multifactorial neuropsychiatric disorder influenced by both genetic predisposition and environmental factors. Recent evidence suggests a possible link between latent Toxoplasma gondii infection and schizophrenia, though the underlying mechanisms remain unclear. Objective: To compare the seroprevalence of T. gondii in patients with schizophrenia and healthy individuals, and to evaluate the relationship between seropositivity and clinical parameters. Methods: A total of 265 participants (155 schizophrenia patients and 110 healthy controls) were enrolled. IgG and IgM antibodies were detected using electrochemiluminescence immunoassay (ECLIA), avidity was assessed using ELISA, and DNA presence was tested with real-time PCR. Clinical symptoms were evaluated using the Brief Psychiatric Rating Scale (BPRS). Statistical analysis included logistic regression and non-parametric tests (p < 0.05). Results: T. gondii IgG seropositivity was significantly higher in schizophrenia patients (29 %) than in controls (18.2 %) (p = 0.044, OR = 1.84; 95 % CI: 1.01-3.34). IgM positivity and DNA detection did not differ significantly. All seropositive participants showed high IgG avidity, indicating latent infection. BPRS scores and illness duration were higher in IgG-positive individuals, but the differences were not significant. Conclusion: Latent T. gondii infection may be associated with schizophrenia. However, further multicenter studies integrating molecular and serological approaches are needed to clarify its role in disease pathogenesis.Book Part Malaria and Molecular Diagnosis(NOBEL TIP KİTABEVLERİ, 2024) Usluca, SelmaMalaria is named after the Italian term “mal’aria”, which means “bad air” to represent the association of the disease with mar shy areas (Fikadu and Ashenafi, 2023; Tuteja, 2007). Towards the end of the 19th century, Charles Louis Alphonse Laveran, a French army surgeon, noticed parasites in the blood of a patient suffering from malaria, and Ronald Ross, a British medical offi cer in Hyderabad, India, discovered that mosquitoes transmitted malaria. The Italian professor Giovanni Battista Grassi subsequ ently showed that human malaria could only be transmitted by Anopheles mosquitoes (Tuteja, 2007).Article Investigation of Toxoplasma Gondii and Human Papillomavirus in Paraffin-Embedded Spontaneous Abortus Materials(Oxford Univ Press inc, 2026) Usluca, Selma; Bakir, Ayfer; Kurkcu, Muhammed Furkan; Caglar, Melike; Duran, Firdevs SahinObjective Toxoplasma gondii and human papillomavirus (HPV) can cause spontaneous abortus. This study aimed to investigate the prevalence of these pathogens in formalin-fixed, paraffin-embedded placenta samples from women diagnosed with spontaneous abortus.Methods A total of 288 formalin-fixed, paraffin-embedded placenta tissue blocks stored in the archives of Etlik City Hospital Pathology Laboratory were included in the study between October 1, 2022, and June 23, 2023. The presence of T gondii and HPV in formalin-fixed, paraffin-embedded placenta samples was investigated using real-time polymerase chain reaction.Results The T gondii DNA was not detected in the samples. However, anti-T gondii IgG antibody was positive in 10.4% (11/106) of the patients. Human papillomavirus DNA was positive in 5.4% of the samples, with HPV 18 and HPV 31/58/66 being the most frequently detected HPV types.Conclusions Our study revealed that HPV could infect the placenta by detecting high-risk HPV in placental samples. However, no relationship was found between HPV positivity and previous stillbirth or spontaneous abortus. Prospective studies with larger populations are needed to further understand the role of these factors in the cause of spontaneous abortus.Book Human Microbiota: Molecular Foundations, Systemic Interactions, and Clinical Perspectives(Ortadoğu Reklam Tanıtım Yayıncılık Turizm Eğitim İnşaat Sanayi ve Ticaret A.Ş., 2026) Aral, Murat; Usluca, Selma; Bakır, AyferDear Readers, Over the past two decades, the rapid progress achieved in the field of the human microbiota has led to the emergence of a new biological framework that extends beyond the classical “commensal–pathogen” dichotomy. It is now supported by strong molecular and clinical evidence that microbial communities residing in different anatomical sites, particularly the gut, play a decisive role in immune system development, metabolic balance, neurodevelopment, and disease progression. Thanks to highthroughput sequencing technologies, multiomics approaches, and advanced bioinformatic analyses, the composition and functional potential of the microbiota can be characterized in detail, opening new windows for understanding the delicate balance between health and disease. Nevertheless, a significant gap still remains between the rapidly expanding body of knowledge in microbiota science and its translation into clinical practice. Although numerous studies have identified strong associations between microbial alterations and various diseases, interpreting these relationships within a causal framework and integrating them reliably into clinical decisionmaking processes involve substantial methodological and biological challenges. Differences in sampling strategies, diversity of analytical platforms, interpopulation heterogeneity, and the lack of standardized reference ranges are among the main factors limiting the generalizability of current findings. Therefore, the translation of microbiotarelated knowledge into clinical practice requires not only technical accuracy but also conceptual caution. This book aims to address the human microbiota not merely as a descriptive ecosystem, but as a dynamic biological system that changes throughout life and remains in continuous interaction with environmental and clinical factors. The physiological foundations of microbiota development from infancy to old age, the conceptual boundaries of dysbiosis, associations with different disease groups, and the current level of evidence regarding microbiotabased interventions are presented through a holistic approach grounded in the contemporary literature. In particular, attention is drawn to issues frequently encountered in clinical translation, such as overgeneralization, methodological uncertainty, and limitations in evidence level, with the aim of providing readers with a critical framework for evaluation. The fundamental approach of this book is not to present the microbiota as the “key to every disease,” but to evaluate it in a manner that remains faithful to biological reality and the limits of existing evidence. Clearly defining diagnostic and therapeutic methods, explicitly stating what the applied technologies can and cannot measure, and shaping clinical expectations in alignment with scientific data constitute the core of this approach. Within this framework, the book aims to serve as a robust, balanced, and uptodate reference source for both researchers and clinicians in the field of microbiota science. The future of microbiota research will be shaped by interdisciplinary collaboration, standardized methodologies, and studies focusing on clinically meaningful outcome measures. This book seeks not only to compile existing knowledge, but also to contribute to this process by encouraging critical thinking and promoting progress guided by scientific prudence. During the preparation of this book, the scientific guidance and critical evaluations provided by the section editors played a decisive role in shaping its academic framework. The meticulous contributions of the associate editors regarding content coherence, terminological consistency, and adherence to publication standards strengthened the integrity and readability of the work. The dedicated efforts of the contributing authors, who combined current literature with a clinical perspective, formed the fundamental scientific basis of this volume. We would also like to extend our sincere thanks to Türkiye Klinikleri Publishing House, whose constructive approach and experience in academic publishing supported the process at every stage. The coordination and editorial support provided by the publishing team made a significant contribution to maintaining the scientific quality of the book. Sincerely,
