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Öğe Brucellosis Seroprevalence and Diagnostic Challenges: A Comprehensive Review from 2017-2021(Erciyes Univ Sch Medicine, 2025) Topcu, Kubra Firtina; Hasbek, MursitObjective:This study aimed to evaluate the performance of the Rose Bengal test (RB), serum agglutination test (SAT), and Coombs test (CT) in samples suspected of brucellosis, analyze the seasonal distribution, examine the relationship with Crimean-Congo hemorrhagic fever (CCHF), which is frequently observed in our region, and determine the seroprevalence of brucellosis in the area. Materials and Methods: A retrospective analysis was conducted on 12,279 brucellosis- suspected samples submitted from various clinics between 2017 and 2021. RB, SAT, and CT tests were performed, and results were analyzed concerning seasonal and yearly distributions as well as factors such as age and gender differences. Results: Among the 12,279 RB tests conducted, 281 (2.3%) were positive, and 11,998 (97.7%) were negative. Of the positive results, 96 samples were positive for both RB and SAT, while 185 were RB positive but SAT negative. CT provided positive results in 101 out of 185 cases with discordant RB and SAT results. The seroprevalence rate was 1.5%, with higher rates observed among males and during the spring and summer seasons. A notable increase in seropositivity was observed during the pandemic. Conclusion: This study highlights the annual and seasonal distribution of brucellosis and differences across age and gender groups.The Coombs test played a crucial role in resolving cases with discordant RB and SAT results. A rise in brucellosis cases during the pandemic was noted, with significant co-infections involving CCHF.Öğe Investigation of the Agents Isolated From the Blood Cultures of a University Hospital Neonatal Intensive Care Unit and Their Antimicrobial Susceptibility(Galenos Publ House, 2023) Topcu, Kubra Firtina; Hasbek, Mursit; Cabuk, AsliIntroduction: Neonatal sepsis is a clinical syndrome characterized by non-specific signs and symptoms caused by various pathogens. The diagnosis is based on a combination of clinical and laboratory findings. Gram-positive and Gram-negative bacteria are the predominant etiologic agents. In our study,we aimed to evaluate the types of microorganisms grown in neonatal blood cultures and antimicrobial susceptibilities of Gram-negative agents. Materials and Methods: We retrospectively analyzed 2566 blood culture results. Samples from blood culture bottles with growth were passaged on blood agar. The growing colonies were identified by MALDI-TOF MS. Antibiotic susceptibility tests were performed on a fully automated device. The results were evaluated according to EUCAST standards. Results: Growth was detected in 12.1% of the samples. 59.5% of the patients with growth were male. 66% of the patients were at term and 53.7% had early-onset sepsis. 74.6% of the cases were cesarean section and 59.5% were above 2500 grams. Coagulase-negative staphylococci (CNS) were the most common organisms grown in early and late-onset sepsis. 73.9% CNS, 9% Gram-negative enteric and nonfermentary bacilli, 2.9% Gram-positive bacilli and 0.1% fungi were grown. 40% of S.aureus were methicillin resistant. The most antimicrobial-resistant Gram-negative agent was Klebsiella spp. Klebsiella spp. isolates were resistant to amikacin 9%, ampicillin 100%, cefepime 72.7%, ceftazidime 81.8%, gentamicin 81.8%, meropenem 9.1%. Extended spectrum beta lactamase was positive in 90.9%. Acinetobacter spp. isolates were resistant to amikacin 42.8%, ampicillin 42.8%, gentamicin 42.8%, meropenem 42.8%. Conclusion: Microorganism species and antibiotic susceptibilities in intensive care units vary over time and between clinics. Broad-spectrum antimicrobials started early with suspicion of sepsis without culture confirmation can be replaced with agent-specific narrow-spectrum antimicrobials when growth is detected in culture,monotherapy can be switched or treatment can be terminated early. This may contribute to the prevention of resistance development.Öğe Klebsiella pneumoniae Infections in the Intensive Care Unit: Risk Factors Related to Carbapenem Resistance and Patient Mortality(Ankara Microbiology Soc, 2020) Buyuktuna, Seyit Ali; Hasbek, Mursit; Celik, Cem; Unlusavuran, Meltem; Avci, Onur; Baltaci, Sevgi; Topcu, Kubra FirtinaKlebsiella pneumoniae is the cause of complicated and difficult-to-treat nosocomial infections such as sepsis, urinary tract infection, catheter related infections, pneumonia and surgical site infections in intensive care units. The biggest problem in infections with K.pneumoniae is that treatment options are limited due to multiple antibiotic resistance and consequently the increased morbidity and mortality. The widespread and improper use of carbapenems can lead to epidemics that are difficult to control, especially in intensive care units because of the acquired resistance to this group of antibiotics. Outbreaks and sporadic cases caused by carbapenem resistant K.pneumoniae (CRKP) species have been reported all over the world in recent years with increased frequency. The aim of this study was to determine the risk factors related to carbepenem resistance and mortality caused by K.pneumoniae infections in a university hospital anesthesia intensive care unit. The study was conducted between January 1st, 2016, and December 31st, 2018. Retrospective data were obtained from the patient and laboratory-based surveillance records. Adult patients (>= 18 years) with K.pneumoniae growth in the blood, urine, abscess and tracheal aspirate samples collected 48 hours after admission to the intensive care unit were considered as the relevant infection locus-related agent and treated with antibacterial therapy. Clinical samples collected from patients were inoculated onto 5% sheep blood and eosin-methylene-blue (EMB) agar except the blood samples. Blood samples were cultured in blood culture bottles and incubated in an automated system. Gram staining was performed for the samples showing growth signal within five days and then inoculated onto 5% sheep blood and EMB agar media and were incubated for 18-24 hours at 35.5-37 degrees C. Identification of the isolates was performed using Bruker IVD MALDI Biotyper 2.3 (Bruker Daltonik GmbH, Bremen, Almanya) based on matrix-assisted laser desorption/ionization time-of-mass spectrometry (MALDI-TOF MS). K.pneumoniae isolates were identified by obtaining reliability scores of 2.0 and above in the study. Antibiotic susceptibility tests were performed with Phoenix 100 (BD, New Jersey, ABD) automated system. Interpretations were made according to the European Committee on Antimicrobial Susceptibility Testing (EUCAST) guidelines. Combination disk diffusion test and polymerase chain reaction based tests were used to show the presence of carbapenemase in CRKP isolates. A total of 88 patients with K.pneumoniae infection were included in the study. The mean age of the patients was 74 +/- 15 (range= 21-93) years and 60.2% were female. CRKP was detected in 32 patients (36.4%) and carbapenem-sensitive K.pneumoniae (CSKP) was detected in 56 patients. The presence of OXA-48 was found to be 68.8% in the carbapenem screening test performed by combination disc method in patients with CRKP. Multivariate logistic regression analysis showed that previous use of colistin [Odds ratio (OR)= 19.108; 95% confidence interval (CI). 2.027-180.133; p= 0.010] and aminoglycoside (OR= 12.189; 95% CI= 1.256-118.334; p= 0.031) was an independent risk factor in terms of CRCP among the patients with K.pneumoniae infection. The 28-day mortality rates were 71.9% in the CRKP group (23/32) and 37.5% in the CSKP group (21/56). Presence of CRKP in terms of 28-day mortality (OR= 5.146; 95% CI= 1.839-14.398; p= 0.002) was an independent risk factor. The data obtained in this study will guide for conducting effective and continuous surveillance studies and implementing rational antibiotic programs to prevent the increase in CRKP.
