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Öğe Antibiotic Susceptibilities of Escherichia coli Strains Isolated From Urine Samples in a Tertiary Hospital in Eastern Turkey(2021) Erdoğan, Esra; Akbulut, Ahmet LeventAbstract: Objective: Escherichia coli is the most common cause of urinary tract infections. The increase and spread of resistance to antibiotics is a serious problem in our country as well as in the world. The aim of this study was to determine the antimicrobial susceptibility profiles of E. coli strains that cause urinary tract infection.Methods: The antibiotic susceptibilities of 1850 E. coli strains isolated from urine samples of patients who applied to Urology service and outpatient clinics of Malatya Education and Research Hospital, which is a tertiary care hospital in eastern part of Turkey, over the 3 years between July 2016 and July 2019, were evaluated retrospectively from computer records using the Vitek 2.0 Compact automated system (BioMérieux, France). Antibiogram results were classified as susceptible, moderately susceptible and resistant.Result: Of the total 1850 samples, 1300 (70.3%) were female and 550 (29.7%) were male, with a mean age of 52 (18-104) years. 73 (3.9%) of the patients were inpatients and 1777 were outpatients. All the isolated E. coli strains were found to be susceptible to ampicillin 39.2%, amoxicillin-clavulanic acid 67.9%, piperacillin-tazobactam 80.8%, cefuroxime 67.1%, cefotaxime 68.8%, cefixime 67.7%, ceftazidime 71.2%, cefepime 73.9%, ertapeneme 97.9%, imipeneme 99.5%, meropeneme 99.7%, amikacin 89.7%, gentamicin 78.4%, norfloxacine 65.8%, ciprofloxacine 65.9%, nitrofurantoin 94.2% and fosfomycin 96.5%. Resistance rates were higher in inpatients as compared to outpatients. Antibiotic susceptibilities were found to be decreased in different age ranges with increasing age. Conclusion: When selecting the antimicrobial treatment in community-acquired urinary tract infections, considering the antimicrobial resistance data in the region, the choice of cost-effectivetreatment with high patient compliance and low resistance rates will increase treatment success. It is thought that antibiotic treatment should be determined according to the results of culture antibiograms, especially in nosocomial infections due to high resistance rates.Öğe Association between blood groups and COVID-19 susceptibility(2022) Erdoğan, Esra; Delen, Leman AcunCOVID-19, become one of the biggest global problems in human history since the final days of 2019. Fever, dry cough, dyspnea, myalgia and fatigue are frequently encountered among the clinical symptoms of the patients. Although COVID-19 causes mild to moderate symptoms in most infected individuals, people with comorbid illness or people over the age of 60 have a higher risk of developing severe illness as well as death. In more severe cases, the infection causes pneumonia, severe acute respiratory failure, multiple organ failure, and even death. In this study, we aimed to examine the effects of ABO and Rh blood groups on the severity of COVID-19 infection (admission to intensive care units, intubation and death) among patients hospitalized in COVID-19 pandemic wards. Of the patients who were hospitalized in COVID-19 pandemic inpatient services in Malatya Training and Research Hospital; a tertiary health care facility serving as 1040-bed situated in Eastern Turkey, 300 adult patients with known blood groups, and the patients who had applied to the hospital’s blood bank during the same dates (control group=21911) were included in the study. Intensive care unit admission and mortality rates were found to be significantly higher in B blood group as compared to other blood groups, while intubation and death rates were found to be significantly lower in O blood group when compared to other groups. When the blood groups of the population (control group=21991) and COVID-19 patients were compared, it was seen that there was no significant difference between the blood groups, and the distribution was observed to be similar to that of the population. As a result, more research is needed in order to clarify the relationship between COVID-19 and the ABO and Rh blood groups to better understand the COVID-19 infection, which has affected the whole world.Öğe Candidemia in adult intensive care units: Analysis of a 4 year process in a tertiary hospital in Turkey(2020) Erdoğan, Esra; Erdoğan, Mehmet Mustafa; Delen, Leman AcunAim: Candidemia are one of the most important causes of mortality and morbidity in inpatients, and their importance is increasingwith the increasing number of immunosuppressive patients and the widespread use of invasive procedures and broad spectrumantibiotics in recent years. In our study, we aimed to identify Candida species isolated from blood cultures and to determine theantifungal susceptibility rates of adult patients who were hospitalized in Malatya Education and Research Hospital Intensive CareUnits between July 2015 and July 2019, and had Candida growth in at least one of their blood cultures.Materials and Methods: The blood cultures isolated from adult intensive care units patients and sent to the Microbiology Laboratoryof our hospital over the four years, were examined retrospectively. Species distribution and antifungal susceptibility were determinedusing VITEK 2 Compact System (BioMerieux, France).Results: Of the 123 clinical samples, 59 (48%) were C. albicans, 21 (17.1%) were C. parapsilosis, 18 (14.6%) were C. tropicalis, 12(9.8%) were C. glabrata, 5 (4.1%) were C. kefyr, 2 (1.6%) were C. krusei, 2 (1.6%) were C. lipoliytica, 2 (1.6%) were C. lusitaniae, 1 (0.8%)was C. dubliniensis and 1 (0.8%) was C. pelliculosa. 96.5% of C. glabrata strains were found to be susceptible to amphotericin-B,93.1% to fluconazole, 98.3% to voriconazole, 93.5% to caspofungin, 91.4% to micafungin and 96.7% to flucytosine. 98.1% of nonalbicansCandida (NAC) strains were found to be susceptible to amphotericin-B, 74.6% to fluconazole, 90.7% to voriconazole, 78.4%to caspofungin, 80% to micafungin and 100% to flucytosine.Conclusion: The highest resistance to antifungals was found in C. glabrata and the highest susceptibility was observed in C. tropicalis.In order to develop effective and accurate infection control strategies and reduce mortality and morbidity, it is important to know thedistribution and susceptibility of infectious agents, especially in critical patients in intensive care units.Öğe Kronik hastalıklarda kullanılan ilaçlar ile antibiyotiklerinin vitro etkileşimleri(İnönü Üniversitesi, 2020) Erdoğan, EsraAmaç: Yaşadığımız yüzyılda beklenen yaşam süresinin uzamasıyla dünyada ve ülkemizde kronik hastalıklar en önemli mortalite ve morbidite nedeni haline gelmiştir. Antibiyotik tüketiminde ilk sıralarda oluşumuz antibiyotiklere direnç gelişmesini tetiklemiştir. Çoklu ilaç kullanımında ilaç ilaç etkileşimleri ile sıklıkla karşılaşılması ilaçların dozlarını güncellemeyi gerekli kılmıştır. Çalışmamızda hekimler tarafından kronik ve enfeksiyon hastalıklarının tedavisinde sıklıkla reçete edilen ilaçları; in vitro ortamda enfeksiyon etkenimizle bir araya getirerek birbirlerinin etkilerini nasıl değiştirdiklerini görmeyi amaçladık. Materyal ve Metot: İn vitro ortamda besiyerinde antibiyotik disklerimiz ile kronik hastalıklarda sıklıkla kullanılan ilaçları (aspirin, amlodipin, atorvastatin, varfarin, metoprolol, metformin ve klopidogrel) bir araya getirerek ilaç etkileşimlerini (sinerji/antagonizma) Kirby Bauer disk difüzyon yöntemi ile minimal inhibitör konsantrasyonlarındaki (MİK) değişikliğini de mikrodilüsyon yöntemi ile belirledik. Bulgular: İlaç emdirerek Candida albicans ekimi üzerine yerleştirdiğimiz disklerin büyük kısmı ITR ve FLU ile potansiyalizasyon sinerjizmi gösterirken, diğer mikroorganizmalar farklı ilaç ve antibiyotikler ile bazen sinerjistik bazen de antagonistik etkileşime girdi. Bazı ilaçlarımız ise antibiyotik diskleri ile hiçbir etkileşim göstermedi. Mikrodilüsyon yöntemi uyguladığımız kombine kullanımların MİK değerlerini düşürdüğünü bulduk. Sonuç: İleri yaş ve reçete edilen ilaçların sayısı ile olası ilaç ilaç etkileşimlerinin sıklığı arasındaki güçlü ilişkiden dolayı özellikle yaşlılarımız bu duruma daha duyarlıdır. Dirençli bakterilerin yol açtığı enfeksiyonlar, hastalık/ölüm oranları ile tedavi maliyetlerinde artışa sebep olmaktadır. İlaç ile zehir arasındaki tek farkın doz olduğu bilinciyle başta doktor ve eczacılar olmak üzere tüm sağlık çalışanları ve hastalar akılcı ilaç kullanımı hususunda görev ve sorumluluklarını yerine getirmelidir.Öğe M. tuberculosis etkenine karşı birinci kuşak antibiyotik izoniyazid (INH)'in antibakteriyel etkisi üzerine NAD, H2O2 ve zayıf manyetik alan etkisinin incelenmesi(İnönü Üniversitesi, 2015) Erdoğan, EsraM. tuberculosis Etkenine Karşı Birinci Kuşak Antibiyotik İzoniyazidin Antibakteriyel Etkisi Üzerine NAD, H2O2 ve Zayıf Manyetik Alan Etkisinin İncelenmesi Amaç: Dünya nüfusunun yaklaşık üçte biri Mycobacterium tuberculosis basili ile enfektedir. Her yıl yaklaşık 2 milyon insan hastalık sebebi ile hayatını kaybetmektedir. İzoniyazid, tedavide en yaygın ve etkin kullanılan ilaç olmasına rağmen etki mekanizması tam olarak aydınlatılamamıştır. Öte yandan elektromanyetik alan kaynakları sağlık üzerine olumlu olumsuz pek çok etkiye sahiptir. DSÖ düşük frekanslı elektromanyetik alanları "2B sınıfı olası kanserojen etken" olarak kabul etmiştir. Çalışmamızda zayıf manyetik alan uygulaması ile NAD ve H2O2 ilavesinin izoniyazidin etki mekanizması üzerine etkilerini araştırmayı amaçladık. Materyal ve Metod: Bu çalışmada farklı gruplara tek tek ve birlikte, değişen konsantrasyonlarda NAD ile H2O2 ilave edilerek ilacın etki mekanizması üzerinde yaptığı değişim değerlendirildi. Bir deney grubu günlük 4,5 saat (10 günde toplam 45 saat) 5 mT , 50 Hz manyetik alana maruz bırakıldı. Sonuçları değerlendirmek üzere agar proporsiyon yöntemi kullanıldı. PZR-RFLP metoduyla dirençli suşlar gösterildi. Bulgular: Manyetik alan uygulaması deney sonunda kontrol grubuyla karşılaştırıldığında hem duyarlı hem dirençli suşların koloni sayılarında herhangi bir değişikliğe neden olmamıştır (p>0,05) . 10'ar µM NAD ve H2O2'nin tek tek ve birlikte izoniyazid içeren besiyerlerine 10 gün boyunca ilavesi bu maddelerin birlikte ilave edildiği grupta ilacın etkinliğini artırarak koloni sayılarını azaltmıştır (p<0,05). Bundan hareketle değişen konsantrasyonlarda NAD ve H2O2 'nin beraber ilave edildiği gruplarda en çok etki 100'er µM eklenen grupta ölçülmüştür. Sonuç: Özellikle 100'er µM NAD ve H2O2 'nin birlikte ilavesinin izoniyazidin etkinliğini bir miktar artırdığı ancak zayıf manyetik alan uygulamasının ilacın etkinliğini değiştirmediği tespit edildi.Öğe Seroprevalence of toxoplasmosis in women admitted to an education and research hospital in eastern anatolia after the syrian crisis(2020) Erdoğan, Esra; Erdoğan, Mehmet Mustafa; Altındağ, Mehmet MuratAbstract: Aim: Toxoplasmosis caused by Toxoplasma gondii, is a zoonotic disease which is generally asymptomatic. However, it causes serious symptoms in pregnant women and immunocompromised individuals. About one third of the people worldwide are seropositive. Due to the civil war in Syria, Turkey has been home to more than 4 million refugees. This unexpected increase in the Syrian population in particular increases the risk of infectious diseases. The aim of this study was to evaluate the prevalence of Toxoplasma gondii, antitoxoplasma IgG and IgM antibodies in local and Syrian women, who were admitted to Obstetrics and Gynecology Clinic of Malatya Education and Research Hospital, which is a tertiary care hospital in eastern part of Turkey, between January 2015 and July 2019. Material and Methods: The anti-toxoplasma IgG and anti-toxoplasma IgM antibody values of women who were admitted to our hospital and evaluated in terms of toxoplasma, determined by using “Chemiluminescence Immunoassay (CLIA)” method, were investigated retrospectively. Results: According to the results analyzed in a total of 11.025 women, including 743 Syrian refugees, the seropositivity of antitoxoplasma IgG and IgM were found to be 25.8% (2.819/10.932) and 1.6% (180/11.025), respectively. Among these patients, the seropositivity of anti-toxoplasma IgG was found to be 25.3% (190/750) and the seropositivity of anti-toxoplasma IgM was found to be 2.5% (20/797) in pregnant women. Anti-toxoplasma IgG and IgM seropositivity were found to be 27.9% and 0.5%, respectively, in Syrian women. In Malatya, a city located in eastern Turkey, Toxoplasma gondii seropositivity was found to be common to the extent that it could not be neglected in both local women and Syrian refugees. No statistically significant difference could be found in Syrian female refugees living in Malatya in terms of carrying toxoplasma antibodies when compared with the local women. More than 70% of pregnant women were observed to be seronegative and they were at serious risk for toxoplasmosis. In particular, it was concluded that women at childbearing age, who constitute the risk group, should be made aware of the disease and serological tests should be performed routinely for toxoplasma.Öğe YOĞUN BAKIM ÜNİTELERİNDEN İZOLE EDİLEN PSEUDOMONAS AERUGİNOSA SUŞLARININ ANTİBİYOTİKLERE DUYARLILIKLARI(2021) Erdoğan, Mehmet Mustafa; Delen, Leman Acun; Erdoğan, EsraÖz: Pseudomonas aeruginosastrains are frequently isolated, especially from inpatient samples in intensive care units. These strains lead to infections that are difficult to treat due to antibiotic resistance, thus increasing morbidity and mortality. The aim of this study is to determine the resistance of P. aeruginosaisolates, isolated from intensive care patients of Malatya Training and Research Hospital, to various antibiotics. P. aeruginosastrains isolated from various clinical samples of patients who were followed up in intensive care units of Malatya Training and Research Hospital between July 2016 and July 2019, were included in the study. Identification and in vitro antibiotic susceptibility of the strains were determined using Vitek 2 automated system (bioMérieux, France). Of the 468 P. aeruginosastrains included in the study, 51.7% were isolated from respiratory tract samples, followed by urine samples with 31.2% and, abscess and wound samples with 9%. Colistin and norfloxacin were determined to be the most effective antibiotics for P. aeruginosastrains, while the lowest susceptibility was determined for aztreonam among the studied antibiotics. Susceptibility rates were determined to be; 76.5% for amikacin, 8.1% for aztreonam, 74.4% for gentamicin, 62.2% for imipenem, 97.1% for colistin, 57.5% for levofloxacin, 61.4% for meropenem, 57.4% for netilmisin, 89.9% for norfloxacin, 48.7% for piperacillin/tazobactam, 35.7% for piperacillin, 57.7% for cefepime, 62.7% for ceftazidime, 66% for ciprofloxacin, and 80.9% for tobramycin. In order to develop effective and accurate infection control strategies and reduce morbidity and mortality, it is important to know the distribution and susceptibility of infectious agents, especially in critical patients in intensive care units.
