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Öğe Catheter-Related Bacteremia due to Enterobacter ludwigii in a Hemodialysis Patient: First Report in the Literature(TURK NEFROLOJI DIYALIZ TRANSPLANTASYON DERGISI, 2018) Koz, Suleyman; Oguz, Esin; Timucin, Meryem; Buyuktuna, Seyit Ali; Bakici, Mustafa Zahir; Candan, Ferhan; Kayatas, MansurThe Enterobacter cloacae complex, a member of the genus Enterobacter, consists of a group of bacteria that are responsible for serious infections in human beings. A recently identified member of the group, Enterobacter ludwigii sp, is an emerging source of clinically important infections, but, up until now, there has been no report of catheter related bacteremia due to Enterobacter ludwigii sp. in hemodialysis patients. We report a hemodialysis patient with catheter related bacteremia due to Enterobacter ludwigii sp. whose infection improved only partially by antibiotics that were expected to be fully effective, based on antibiotic susceptibility testing; the infection could be cured only after removal of the catheter.Öğe Cutaneous Anthrax in the Central Anatolia Region of Turkey: A Review of 39 Adults Cases(ORTADOGU AD PRES & PUBL CO, 2010) Engin, Aynur; Elaldi, Nazif; Dokmetas, Ilyas; Bakici, Mustafa Zahir; Kaya, Safak; Bakir, MehmetObjective: Anthrax is a zoonotic infectious disease that caused by Bacillus anthracis. Sporadic anthrax is still present world-wide, particularly in animal raising countries including Turkey. The aim of this study was to evaluate the epidemiological, clinical, and laboratory findings and treatment protocols of adult patients with cutaneous anthrax retrospectively. Material and Methods: A retrospective review of 39 adult patients with cutaneous anthrax presented between 1983 and 2005, in Cumhuriyet University Hospital in Sivas, a city located in the central Anatolia region of Turkey was carried out. Results: Of the 39 cases with the diagnosis of cutaneous anthrax, 27 (69.2%) were males and 12 (30.8%) were females. The mean age was 44 (range, 1674) years. The clinical presentations were severe edema due to anthrax in 10 (26%) and typical pustuler lesion in 29 (74%) patients. The lesions were mostly located on the hand and forearm. Twenty-five cases (64.1%) had a history of recent animal slaughtering activity. Culturing of 39 wound specimens yielded 17 (43.6%) B. anthracis strains. Thirty-six (92.3%) patients were treated with penicillin G. A patient with severe cutaneous anthrax and extensive edema died on the first admission day. Mortality rate was 2.6%. Conclusion: Although the incidence of anthrax is decreasing world-wide, it is still encountered in Turkey. Preventive measures such as education of the risk population and vaccinaton of animals against anthrax would reduce the incidence of the disease. We suppose that penicillin is still the antibiotic of choice for the treatment of cutaneous anthrax in endemic regions.Öğe Diagnostic value of autoantibodies against citrullinated peptide antigens in rheumatoid arthritis: Comparison of different commercial kits(Turkish League Against Rheumatism (TLAR), 2011) Şahin, Özlem; Kaptano?lu, Ece; Bakici, Mustafa Zahir; Sezer, Hafize; Elden, Hasan; Hizmetli, SamiObjectives: In this study we tested the diagnostic values of rheumatoid factor (RF), anti-cyclic citrullinated peptide (anti-CCP) and two different commercial anti-mutated citrullinated vimentin (anti-MCV) kits in the differential diagnosis of rheumatoid arthritis (RA) considering that there might also be substantial differences between the performances of the commercial kits. Patients and methods: Thirty-four RA patients, admitted to our rheumatology outpatient clinics between October 2008 and February 2009, and 24 healthy controls were included in this study. Sera of RA patients and healthy controls were analyzed for RF, anti-CCP-2, anti-MCV-548 and anti-MCV-248 autoantibodies with two different commercial kits. Disease activity was determined by disease activity score 28 (DAS-28) in RA patients. Extra-articular involvement was evaluated in RA patients. Results: In the receiver operating characteristic (ROC) curve analysis perfomed to determine the diagnostic sensitivity, anti-CCP-2 had the highest value of area under ROC curve. Sensitivity and specificity was 88% and 90%, 84% and 100%, 80% and 90%, and 84% and 100% for RF, anti-CCP-2, anti-MCV-548, and anti-MCV-248 respectively. DAS-28 had a weak correlation with anti-CCP-2 (r=0.623), anti-MCV-548 (r=0.481), and Anti-MCV-248 (r=0.408). There was no statistically significant difference in RF, anti-CCP-2, anti-MCV-548, and anti-MCV-248 values between patients with or without extra-articular involvement or between patients with low or moderate disease activity according to DAS-28 score. Conclusion: Anti-CCP, RF and anti-MCV autoantibodies are all useful in the differential diagnosis of RA. However, the anti-CCP antibody has a superior diagnostic value compared to the other auto antibodies. The anti-MCV antibodies detected by the anti-MCV-248 kit seem more reliable than the anti-MCV antibodies detected by the anti-MCV-548 kit in differential diagnosis of RA due to their high sensitivity and specificity. These findings suggest that different commercial kits may exhibit different performances. Nevertheless, our results need to be confirmed by future studies which should include more patients. © 2011 Turkish League Against Rheumatism. All rights reserved.Öğe Did MALDI-TOF MS Increase Anaerobe Identification in the Microbiology Laboratory? A University Hospital Experience(Turkiye Klinikleri, 2020) Taşkin Kafa, Ayşe Hümeyra; Çelik, Cem; Hasbek, Mürşit; Bakici, Mustafa ZahirObjective: This study aimed to investigate how the number of species identified in various clinical samples sent with the anaerobic culture request changed with Matrix Assisted Laser Desorption and Ionization Time-Of-Flight Mass Spectrometry (MALDI-TOF MS). Material and Methods: A total of 602 samples were included in the study, consisting of 419 different clinical samples sent from various polyclinics and services to the Microbiology Laboratory of Sivas Cumhuriyet University Medical Faculty with the anaerobic culture request, and 183 stool samples sent with the Clostridioides difficile request between 2015 and 2018. The results of the anaerobic culture requests within the mentioned years were analyzed retrospectively from the BD EpiCenter™ (Becton Dickin-son, USA) data analysis system. In the study, MALDI-TOF MS measurements were performed using a Bruker Microflex™ LT MALDI-TOF MS device and flexControl 3.0 software (Bruker Daltonics, USA), and MALDI Biotyper® 3.0 software and database were used for typing. Results: In the anaerobic cultures of 419 specimens sent from different clinical materials, 46 different anaerobic bacteria species were identified by MALDI-TOF MS method and 10 different anaerobic bacteria species were identified in stool samples. Among the identified anaerobic bacterial isolates, the most common genus was found to be Prevotella with 26.4%, followed by Cutibacterium acnes with 17.6%, Bacteroides with 12%, and Fusobac-terium with 8.8%, respectively. C. perfringens (47.3%) was identified as the most frequently identified species among 183 stool samples sent with the C. difficile request. Conclusion: When the results of our study were compared with the results of conventional methods, it was observed that there was an increase in the identification of anaerobic bacteria with MALDI-TOF MS system. We believe that the MALDI-TOF MS system can contribute to the identification of anaerobic bacteria. © 2020 by Türkiye Klinikleri.Öğe Evaluation of 2015-2016 MOTAKK HBV DNA and HCV RNA External Quality Assessment National Program Results(ANKARA MICROBIOLOGY SOC, 2018) Karatayli, Ersin; Soydemir, Ege; Aksoy, Zeynep Busra; Kizilpinar, Mehtap; Altay Kocak, Aylin; Karatayli, Senem Ceren; Yurdcu, Esra; Yildirim, Umut; Guriz, Haluk; Bozdayi, Gulendam; Yurdaydin, Cihan; Ilhan, Osman; Yildirim, Yasin; Bozdayi, A. Mithat; Oguz, Acelya Yalcintas; Baris, Ahmet; Alp, Alpaslan; Aksozek, Alper; Sayiner, Arzu; Karagul, Aydan; Ordu, Aylin; Istanbullu, Aye; Otlu, Baris; Aridogan, Buket; Aksu, Burak; Buruk, C. Kurtulus; Karahan, Ceren; Guney, Cakir; Toksoz, Devrim; Yildirim, Dilara; Colak, Dilek; Daglar, Duygu Eren; Findik, Duygu; Kas, Elif; Caliskan, Emel; Zeyrek, Fadile Yildiz; Arslan, Fatma; Demir, Feyza; Milletli, Fikriye; Kibar, Filiz; Ozdincer, Furkan; Dundar, Gulnur; Arslan, Hande; Agca, Harun; Aliskan, Hikmet Eda; Guducuoglu, Huseyin; Fidan, Isil; Akyar, Isin; Afsar, Ilhan; Kaleli, Ilknur; Donmez, Ismail; Yanik, Kemalettin; Midilli, Kenan; Cubukcu, Kivanc; Ozdemir, Mehmet; Acar, Melek; Yalinay, Meltem; Kuskucu, Mert Ahmet; Bakici, Mustafa Zahir; Aydin, Neriman; Yilmaz, Neziha; Ceken, Nihan; Ziyade, Nihan; Yilmaz, Nisel; Ozgumus, Osman Birol; Gitmisoglu, Ozlem; Demirgan, Recep; Kesli, Recep; Guckan, Ridvan; Sertoz, Ruchan; Akgun, Sadik; Aksaray, Sebahat; Tezcan, Seda; Kaygusuz, Sedat; Gokahmetoglu, Selma; Mese, Sevim; Bayik, Seyit Ahmet; Akcali, Sinem; Gurcan, Saban; Karsligil, Tekin; Us, Tercan; Ozekinci, Tuncer; Pilgir, Tulin; Aslan, Ugur; Dinc, Ugur; Coskun, Umut Safiye Say; Cetinkol, Yeliz; Keskin, Yusuf; Ayaydin, Zeynep; Toraman, Zulal AsciMOTAKK, as a national external quality control program has been launched to evaluate the molecular detection of viral infections including HBV DNA and HCV RNA in molecular microbiology diagnostic laboratories in Turkey. This program is prepared in compliance with ISO 17043:2010 (Conformity assessment general requirements for proficiency testing) standards, and aims to take the place of external quality control programs from abroad, contributing to standardization and accuracy of molecular diagnostic tests in our country. The aim of this study was to evaluate 2015 and 2016 results of the MOTAKK External Quality Control Program for HBV DNA and HCV RNA viral load. The calls were announced on the web page of MOTAKK (www.motakk.org). The quality control samples were sent to participating laboratories in 2015 and 2016. Main stocks were prepared from patients with chronic hepatitis B and C who had viral load detection with reference methods according to WHO reference materials for viral load studies to improve quality control sera. From these main stocks, samples with different viral loads were prepared from dilutions of plasma with HBV, HCV, HAV, HIV, Parvovirus B19 and CMV negative serologic markers. Quality control samples were sent to the participating laboratories along with the negative samples in the cold chain. The laboratories accomplished the related tests within 2-3 weeks and entered their results on the MOTAKK web page. These results were analysed according to ISO 13528 (Statistical methods for use in proficiency testing by interlaboratory comparison) and scoring reports were created by a software developed by MOTAKK and sent to participating labs. Each laboratory evaluated their own results in comparison with the other laboratory results, reassessed the tests via observing the distance from the mean result and the reference values. The number of laboratories participating in the HBV DNA and HCV RNA external quality control program was 70-73 in 2015-2016. Participants were able to comply with the program tools, registering, entering results and receiving the results reports problem. In HBV panel, 72.6-89.1% and 84.7-90.3% of the participant laboratories were in 1 standard deviation (SD) in 2015-2016, respectively. In HCV panel, 70.8-89.1% and 84.7-90.3% of the participant laboratories were in 1 SD in 2015-2016, respectively. A national external quality control program for HBV DNA and HCV RNA in Turkey has been prepared for the first time with this project and implemented successfully. All the data provided in the MOTAKK external quality control program final report, compensate all the data provided by the quality control program final reports from abroad; additionally, the report allows comparison of used technologies and commercial products.Öğe Evaluation of the compatibility of Phoenix 100 and Microflex LT MALDI-TOF MS systems in the identification of routinely isolated microorganisms in the clinic microbiology laboratory(WALTER DE GRUYTER GMBH, 2016) Celik, Cem; Uysal, Elif Bilge; Tutar, Ugur; Erturk, Rahsan; Bakici, Mustafa Zahir; Gozel, Mustafa GokhanBackground: Matrix-assisted laser desorption/ionization time-of flight mass spectrometry (MALDI-TOF MS) is a quick, reliable, and efficient system for identifying microorganisms. Many centers that use the Phoenix 100 system today may adopt aMALDI-TOF MS system in the future. Our laboratory recently undertook this pivot. The present study evaluates the reproducibility of species identifications made by the Phoenix 100 and MALDI-TOF MS systems, during a period of transitioning laboratory instrumentation. Methods: Eight hundred and twelve microbial isolates, from aerobic cultures of different clinical samples, were identified simultaneously with Phoenix 100 (Becton Dick-inson, Sparks, MD, USA) and a Microflex LT MALDI-TOF MS (Bruker Daltonics, Bremen, Germany) devices. Results: Both systems made identical species assignments for 98.9%, 92.1%, 95.1%, and 93.1% of Gram-negative isolates, catalase-positive Gram-positive cocci isolates, cat-alase-negative Gram-positive cocci isolates, and Candida isolates, respectively. Conclusions: Identifications made by two instruments commonly used in microbiology laboratories, the Phoenix 100 and the Microflex LT MALDI-TOF MS, are highly consistent.Öğe Is sustained release of vancomycin from fibrin glue effective to prevent methicillin-resistant Staphylococcus aureus graft infection?(ACADEMIC JOURNALS, 2012) Katrancioglu, Nurkay; Karahan, Oguz; Kilic, Ahmet Turhan; Katrancioglu, Ozgur; Celik, Cem; Bakici, Mustafa Zahir; Atahan, ErhanProsthetic vascular graft infection remains one of the most serious complications seen after vascular surgery. Recently, fibrin glue has gained attention as a possible means to deliver drug therapies. In this study, the efficacy of vancomycin incorporated fibrin glue for preventing methicillin-resistant Staphylococcus aureus (MRSA) infection of prosthetic grafts was investigated. The vascular grafts were implanted into subcutaneous pockets in the backs of 32 rats. Group 1: no graft contamination; Group 2: MRSA contamination; Group 3: vancomycin incorporated fibrin glue graft and MRSA contamination; and Group 4: vancomycin soaked graft and MRSA contamination. The grafts were removed after 7 days and evaluated by a quantitative culture analysis. The quantitative culture values for Groups 2, 3, and 4 were 1.8x10(11) +/- 1.4x10(11), 1.1x10(7) +/- 2.4x10(7), and 2.6x10(8) +/- 3.9x10(8), respectively. The culture values of the Group 2 was significantly higher than those of the Group 3 and Group 4 (p=0.014 and p=0.016, respectively), however, Groups 3 and 4 were comparable (p=0.161). In our study, efficacies of vancomycin-incorporated fibrin and vancomycin alone were comparable. The finding of the current study indicated that a fibrin-based delivery system might not be as effective an option as a vancomycin delivery.Öğe Mortality predictors of Staphylococcus aureus bacteremia: a prospective multicenter study(BMC, 2016) Yilmaz, Mesut; Elaldi, Nazif; Balkan, Ilker Inanc; Arslan, Ferhat; Batirel, Ayse Alga; Bakici, Mustafa Zahir; Gozel, Mustafa Gokhan; Alkan, Sevil; Celik, Aygul Dogan; Yetkin, Meltem Arzu; Bodur, Hurrem; Sinirtas, Melda; Akalin, Halis; Altay, Fatma Aybala; Sencan, Irfan; Azak, Emel; Gundes, Sibel; Ceylan, Bahadir; Ozturk, Recep; Leblebicioglu, Hakan; Vahaboglu, Haluk; Mert, AliBackground: Staphylococcus aureus is one of the causes of both community and healthcare-associated bacteremia. The attributable mortality of S. aureus bacteremia (SAB) is still higher and predictors for mortality and clinical outcomes of this condition are need to be clarified. In this prospective observational study, we aimed to examine the predictive factors for mortality in patients with SAB in eight Turkish tertiary care hospitals. Methods: Adult patients with signs and symptoms of bacteremia with positive blood cultures for S. aureus were included. All data for episodes of SAB including demographics, clinical and laboratory findings, antibiotics, and outcome were recorded for a 3-year (2010-2012) period. Cox proportional hazard model with forward selection was used to assess the independent effect of risk factors on mortality. A 28-day mortality was the dependent variable in the Cox regression analysis. Results: A total of 255 episodes of SAB were enrolled. The median age of the patients was 59 years. Fifty-five percent of the episodes were considered as primary SAB and vascular catheter was the source of 42.1 %. Healthcare associated SAB was defined in 55.7 %. Blood cultures yielded methicillin-resistant S. aureus (MRSA) as a cause of SAB in 39.2 %. Initial empirical therapy was inappropriate in 28.2 %. Although overall mortality was observed in 52 (20.4 %), 28-day mortality rate was 15.3 %. Both the numbers of initial inappropriate empirical antibiotic treatment and the median hours to start an appropriate antibiotic between the cases of fatal outcome and survivors after fever onset were found to be similar (12/39 vs 60/216 and 6 vs 12 h, respectively; p > 0.05). High Charlson comorbidity index (CCI) score (p = 0.002), MRSA (p = 0.017), intensive care unit (ICU) admission (p < 0.001) and prior exposure to antibiotics (p = 0.002) all were significantly associated with mortality. The Cox analysis defined age [Hazard Ratio (HR) 1.03; p = 0.023], ICU admission (HR 6.9; p = 0.002), and high CCI score (HR 1.32; p = 0.002) as the independent predictive factors mortality. Conclusions: The results of this prospective study showed that age, ICU stay and high CCI score of a patient were the independent predictors of mortality and MRSA was also significantly associated with mortality in SAB.Öğe Occult Hepatitis B Prevalence in Hepatitis B Vaccinated Dialysis Patients(TURK NEFROLOJI DIYALIZ TRANSPLANTASYON DERGISI, 2018) Huzmeli, Can; Seker, Ayse; Candan, Ferhan; Bagci, Gokhan; Akkaya, Lale; Bakici, Mustafa Zahir; Kayatas, MansurOBJECTIVE: Occult hepatitis B (OHB) virus infection is defined as the presence of hepatitis B virus (HBV) DNA in the liver tissue or serum of subjects seronegative for hepatitis B surface antigen. OHB leads to the potential risk of transmission in dialysis service. Routine HBV vaccine in dialysis patients is recommended. However, HBV vaccine response rates are lower than the community. The aim of this study was to determine the prevalence of OHB in hepatitis B vaccinated dialysis patients. MATERIAL and METHODS: This study was performed at the Nephrology Department, Faculty of Medicine, Cumhuriyet University, between 1st January -31st December 2014. Sera from 200 dialysis patients with negative HbsAg were investigated for HBV DNA using the polymerase chain reaction (PCR). RESULTS: The mean age of the patients was 59.57 +/- 14.89 (18-91) years; 179 of them were on hemodialysis and 21 were on peritoneal dialysis. Of the patients included in the study, anti-HBs positivity was present in 135 (67.5%) and anti-HBs negativity in 65 (32.5%). The OHB prevalence was 1.5% (n=3). CONCLUSION: In our study, the OHB prevalence was 1.5%. We assume that HBV infection would be reduced further by routinely applying HBV PCR tests for all patients who start dialysis and by taking precautions against transmission.Öğe Production, purification, and characterization of metalloprotease from Candida kefyr 41 PSB(ELSEVIER SCIENCE BV, 2017) Yavuz, Sevgi; Kocabay, Samet; Cetinkaya, Serap; Akkaya, Birnur; Akkaya, Recep; Yenidunya, Ali Fazil; Bakici, Mustafa ZahirA thermostable metalloprotease, produced from an environmental strain of Candida kefyr 41 PSB, was purified 16 fold with a 60% yield by cold ethanol precipitation and affinity chromatography (bentoniteacrylamide-cysteine microcomposite). The purified enzyme appeared as a single protein band at 43 kDa. Its optimum pH and temperature points were found to be 7.0 and 105 degrees C, respectively. K-m and V-max values of the enzyme were determined to be 3.5 mg/mL and 4.4 mu mol mL(-1) min(-1), 1.65 mg/mL and 6.1 mu mol mL(-1) min(-1), using casein and gelatine as the substrates, respectively. The activity was inhibited by using ethylenediamine tetraacetic acid (EDTA), indicating that the enzyme was a metalloprotease. Stability of the enzyme was investigated by using thermodynamic and kinetic parameters. The thermal inactivation profile of the enzyme conformed to the first order kinetics. The half life of the enzyme at 95, 105, 115, 125 and 135 degrees C was 1310, 610, 220, 150, and 86 min, respectively. (C) 2016 Elsevier B.V. All rights reserved.Öğe Pseudomonas aeruginosa: Evaluation of Antimicrobial Resistance Patterns in Strains Isolated from Blood Culture in a University Hospital(Bilimsel Tip Yayinevi, 2020) Taskin Kafa, Ayse Humeyra; Celik, Cem; Hasbek, Mursit; Bakici, Mustafa ZahirIntroduction: The aim of this study was to contribute to the establishment of appropriate empirical treatment protocols by determining antibiotic susceptibility profiles of Pseudomonas aeruginosa strains isolated from bacteremia patients in intensive care units and various clinics. Materials and Methods: Antibiotic susceptibility of a total of 111 P. aeruginosa isolates isolated from the blood of inpatients in intensive care units and other services between January 2014 and July 2018 in Cumhuriyet University, Faculty of Medicine were evaluated retrospectively. In the study, the susceptibility profiles of amikacin, piperacillin-tazobactam, ceftazidime, cefepim, gentamicin, ciprofloxacin, levofloxacin, imipenem and meropenem were investigated using the automated system of Phoenix 100 (Becton Dickinson Co., Sparks, MD, USA). The results were evaluated based on the criteria of the Clinical and Laboratory Standards Institute (CLSI) for 2014 and the European Committee on Antimicrobial Susceptibility Testing (EUCAST) from 2015 onwards. Results: One hundred and eleven P. aeruginosa were isolated from blood samples, 77 from intensive care units and 34 from various services of the hospital. P. aeruginosa strains isolated from cultures have a high rate of resistance against antimicrobial agents. The highest resistance was determined for imipenem with 20.7% and the lowest resistance was determined for amikacin with 1.8%. Piperacillin-tazobactam, ceftazidim, cefepim, ciprofloxacin, levofloxacin, and meropenem resistance rates were 18%, 17.1%, 17.8%, 18.9%, 13.9%, 19.8% respectively. Multidrug-resistant was found to be 10.8%. This ratio was determined as 13% in intensive care units. Conclusion: Considering the current antibiotic susceptibility profiles while determining empirical treatment protocols is rather important to prevent resistance. In addition, putting forward the bacterial resistance status periodically through this type of studies, to determine the strength of existing drugs and to guide therapy, presents valuable data. Within this context, we propose that the data of our study will contribute to the current literature.Öğe Resistance rates to antituberculosis drugs in Sivas province(ANKARA MICROBIOLOGY SOC, 2007) Goenlueguer, Ugur; Bakici, Mustafa Zahir; E., Tanseli Goenlueguer; Hasbek, MuersitInfections caused by drug-resistant Mycobacterium tuberculosis strains represent a serious public health problem in recent years. The aim of this retrospective study was to investigate the resistance rates of M.tuberculosis complex strains isolated from clinical specimens in the laboratories of Cumhuriyet University and Numune State Hospitals in Sivas province (located in the middle Anatolia), between May 2004-May 2006 period, to the major antituberculous drugs. A total of 158 M.tuberculosis complex strains which were isolated from sputum, bronchial lavage fluid, stomach fluid, urine, pus, peritoneal fluid and cerebrospinal fluid samples, each of which from different patients were included to the study. The identification of the isolates and antituberculosis drug susceptibility testing were performed by MGIT (Mycobacteria Growth Indicator Tube) 960 system in both of the laboratories. Of 158 isolates 42 (26.6%) were found resistant to at least one of the drugs, while 116 (73.4%) were susceptible to all of the tested antimycobacterials. The overall resistance rates were found as 17.7% (28/153) for isoniazid, 11.4% (18/153) for streptomycin, 4.4% (7/153) for rifampicin, and 5.1% (8/153) for ethambutol. The rate of multidrug resistant isolates characterized with resistance to isoniazid+rifampicin were 3.8% (6/158). As a result, the most common resistance patterns observed in our region were found as single isoniazid resistance (13/158; 8.2%), single streptomycin resistance (8/158; 5.1%) and combined isoniazid+streptomycin resistance (8/158; 5.1%), respectively, with lower resistance rate to rifampicin (4.4%) in comparison to the previous results reported from Turkey.Öğe Results of a Multicenter Study Investigating Plasmid Mediated Colistin Resistance Genes (mcr-1 and mcr-2) in Clinical Enterobacteriaceae Isolates from Turkey(ANKARA MICROBIOLOGY SOC, 2017) Sari, Ayse Nur; Suzuk, Serap; Karatuna, Onur; Ogunc, Dilara; Karakoc, Ayse Esra; Cizmeci, Zeynep; Aliskan, Hikmet Eda; Comert, Fsun; Bakici, Mustafa Zahir; Akpolat, Nezahat; Cilli, Fatma Feriha; Zer, Yasemin; Karatas, Aysel; Karapinar, Bahar Akgun; Bayramoglu, Gulcin; Ozdamar, Melda; Kalem, Fatma; Delialioglu, Nuran; Aktas, Elif; Yilmaz, Nisel; Gurcan, Saban; Gulay, ZeynepColistin is a polymyxin antibiotic which is considered as one of the last line agents against infections due to multidrug resistant or carbapenem resistant gram-negative pathogens. Colistin resistance is associated with chromosomal alterations which can usually cause mutations in genes coding specific two component regulator systems. The first plasmid-mediated colistin resistance gene, mcr-1 was described in Escherichia coli and Klebsiella pneumoniae isolates in December 2015 and followed by another plasmid-mediated colistin resistance gene mcr-2 in 2016. The rapid and interspecies dissemination of plasmid-mediated resistance mechanisms through horizontal gene transfer, have made these genes considerably threatening. After the first reports, although mcr-1/mcr-2 producing Enterobacteriaceae isolates have been reported from many countries, there have been no reports from Turkey. Thus, the aim of this study was to investigate the presence of mcr-1/mcr-2 in clinical Enterobacteriaceae isolates from different parts of our country. A total of 329 Enterobacteriaceae isolates from 22 laboratories were collected which were isolated between March, 2015 and February, 2016. mcr-1/mcr-2 were investigated by polymerase chain reaction during February-March, 2016. Two hundred and seventeen of Klebsiella pneumoniae (66%), 75 of Salmonella spp. (22.8%), 31 of Esherichia coli (9.4%), 3 of Enterobacter cloacae (0.9%), 2 of Klebsiella oxytoca (0.6%) and 1 of Enterobacter aerogenes (0.3%) isolates were included to the study. Agarose gel electrophoresis results of PCR studies have shown expected band sizes for positive control isolates as 309 bp for mcr-1 and 567 bp for mcr-2. However, the presence of mcr-1/mcr-2 genes was not detected among the tested study isolates of Enterobacteriaceae. Although mcr-1/mcr-2 were not detected in our study isolates, it is highly important to understand the mechanism of resistance dissemination and determine the resistant isolates by considering that colistin is a last-line antibiotic against infections of multidrug or carbapenem resistant gram-negative bacteria. Thus, it is suggested that these mechanisms should be followed-up in both clinical and non-clinical (e.g. isolates from food animals, raw meats and environment) isolates of special populations.Öğe Rotavirus and adenovirus gastroenteritis: time series analysis(WILEY, 2015) Celik, Cem; Gozel, Mustafa Gokhan; Turkay, Hakan; Bakici, Mustafa Zahir; Guven, Ahmet Sami; Elaldi, NazifBackgroundThis study investigated the effects of changes in weather conditions (monthly average temperature, monthly minimum temperature, monthly average humidity) on rotavirus and adenovirus gastroenteritis frequency and whether there was a seasonal correlation. MethodsBetween 2006 and 2012, 4702 fecal samples were taken from patients 5 years of age with acute gastroenteritis; these samples were analyzed in terms of rotavirus group A and adenovirus serotype 40-41 antigens using time-series and negative binomial regression analysis. ResultsRotavirus antigens were found in 797 samples (17.0%), adenovirus antigens in 113 samples (2.4%), and rotavirus and adenovirus antigens together in 16 samples (0.3%). There was a seasonal change in rotavirus gastroenteritis (P < 0.001), and a 1 degrees C decrease in average temperature increased the ratio of rotavirus cases in those with diarrhea by 0.523%. In addition, compared with data from other years, the number of patients was lower in the first month of 2008 and in the second month of 2012, when the temperature was below -20 degrees C (monthly minimum temperature). There was no statistically significant relationship between adenovirus infection and change in weather conditions. ConclusionVarious factors such as change in weather conditions, as well as the population's sensitivity and associated changes in activity, play a role in the spread of rotavirus infection.Öğe The seropositivity of HBsAg and HCV of the Patients from Cumhuriyet University Research and Practice Hospital Hemodialysis Unit(Galenos Yayincilik, 2013) Kaplan, Ozlem; Bakici, Mustafa Zahir; Celik, Cem; Kayatas, Mansur; Candan, FerhanObjective: The aim of this study is to examine and determine the positive distributions of HBsAg and Anti-HCV test results of the patients who applied to Cumhuriyet University Training and Application Hospital Haemodialysis Unit. We evaluated these results in terms of the factors such as age, gender, settlement and sickness table to make a contribution to the literature. Materials and Methods: The HBsAg and Anti-HCV test results of 3023 patients applying to haemodialysis unit of our hospital between 01.01.2002 and 31.12.2011 were examined retrospectively by evaluating the test results of haemodialysis unit and clinical microbiology laboratory. Results: In our study, total 3023 patient applying to our unit, 1696 male (56%) and 1327 female (44%), were evaluated in terms of the HBsAg and Anti-HCV test results. Seropositivity was 3.5% for HBsAg and 5.1% for Anti-HCV. The proportion of subjects with both HBsAg and Anti-HCV was 0.2%. Anti-HCV positivity was frequently seen in the patients with chronic renal failure and HBsAg was frequently seen in the patients with acute renal failure. While anti-HCV positivity was seen more in in chronic renal failure patients, HBsAg positivity was more frequent in acute renal failure patients. Anti-HCV was frequently seen in the patients living in downtown and HBsAg was frequently seen in the patients living in uptown. In our study, no statistically significant difference was found among the distribution of HBsAg and Anti-HCV positivity by age groups; however, the frequency increased in 60-69 age range. Conclusion: We determined that HBsAg and Anti-HCV positivity obtained from the haemodialysis unit of our hospital were below the country average. We believe that lower HBsAg and Anti-HCV results could be achieved by controls of infection control commitees in haemodialysis centres. Also informing the medical staff, personnel, haemodialysis patients and their relatives about these topics with regular trainings and separating the staff who give care to the seropositive patients and equipment from the others and showing the necessary sensitivity in serologic follow-up and vaccination of the patients can decrease the rate.
