Yazar "Kuskucu, Mert Ahmet" seçeneğine göre listele

Listeleniyor 1 - 2 / 2
  • Küçük Resim Yok
    Öğe
    Investigation of carbapenem resistance and the first identification of Klebsiella pneumoniae carbapenemase (KPC) enzyme among Escherichia coli isolates in Turkey: A prospective study
    (Elsevier Sci Ltd, 2016) Kuskucu, Mert Ahmet; Karakullukcu, Asiye; Ailiken, Mailihaba; Otlu, Bans; Mete, Bilgul; Aygun, Gokhan
    Background: The aim of this study was to determine the presence of carbapenem resistance and carbapenemase production in Escherichia coil isolates from clinical samples in Turkey. Methods: The prospective study included a total of 4.052 Escherichia coli isolates collected from patients admitted to a hospital from March 2011 to May 2012. We used ertapenem disc for screening carbapenemase production, and the confirmation was performed by using Etest. The resistance mechanisms and genetic relatedness of the carbapenem resistant strains were investigated by using PCR (polymerase chain reaction) and pulsed -field gel electrophoresis (PFGE), respectively. Results: Among the 4.052 E coli isolates, 24 (0.59%) were found to be carbapenem resistant. Of these, only 5 isolates were positive for OXA-48 and 2 isolates were positive for ICIebsiella pneumoniae carbapenemase (KPC)-2. The KPC-2 producing E. coil strains (n = 2) were both isolated from the same patient. The bla(KPC) genes were confirmed using DNA sequence analysis. The genetic relationship between the 24 E. coil strains studied by PFGE revealed that the strains were genetically unrelated. Conclusions: This article confirms, to our knowledge for the first time, the detection of KPC-2-producing E. coil in Turkey, with OXA-48 being the most frequent carbapenemase in the study. (C) 2016 Elsevier Ltd. All rights reserved.
  • Küçük Resim Yok
    Öğe
    Resistance Genes and Mortality in Carbapenem-resistant Klebsiella pneumoniae Bacteremias: Effects of the COVID-19 Pandemic
    (Galenos Publ House, 2024) Kurt, Ahmet Furkan; Tanriverdi, Elif Seren; Yalcin, Metin; Bayramlar, Osman Faruk; Kaya, Sibel Yildiz; Karaali, Ridvan; Kuskucu, Mert Ahmet
    Background: Emerging carbapenem-resistant Klebsiella pneumoniae (K. pneumoniae) (CRKP) bacteremias are presenting significant public health risks due to limited treatment options and increased mortality. K. pneumoniae isolates exhibit carbapenem resistance rates that vary from 25% to 50% throughout the European continent, including our country. Aims: To assess the characteristics of CRKP bacteremia, a condition that has recently demonstrated an increasing prevalence in our center. We sought to ascertain the resistance rates of isolated strains to antibiotics other than carbapenems, identify the responsible carbapenemase genes, evaluate the efficacy of antibiotics, determine mortality rates, explore clonality among strains, and investigate the influence of the COVID-19 pandemic on all these factors. Study Design: Retrospective observational study. Methods: This study included patients aged 18 and older who had experienced meropenem-resistant K. pneumoniae bacteremia. Meropenem resistance was confirmed by employing the Kirby-Bauer disk diffusion method. Meropenem minimum inhibitory concentration (MIC) levels were determined using the gradient test, while colistin MIC levels were ascertained using the disk elution technique. Carbapenemase genes were evaluated via colony polymerase chain reaction (PCR), and clonality analysis was performed using the arbitrarily primed PCR technique. Results: The study comprised 230 patients, with a mean age of 63.1 +/- 15.9 years, of whom 58.7% were male. Oxacillinase-48 (OXA-48) was detected in 74.8% of the patients, New Delhi metallo-beta-lactamase (NDM) in 12.6%, OXA-48 + NDM in 7.8%, and KPC in 4.8%. The 14-day and 30-day mortality rates were 57% and 69.6%, respectively. Multivariate analysis of the 30-day mortality revealed several crucial factors, including bacteremia development in the intensive care unit, the occurrence of bacteremia during the COVID-19 pandemic, polymicrobial bacteremia, the use of indwelling intravenous catheters, a platelet count of <= 140,000/ mu l, procalcitonin levels of >= 6 mu g/l, and a Charlson comorbidity score >= 3. Notably, the OXA-48 and KPC genes were upregulated significantly during the COVID-19 pandemic, while the NDM gene groups were downregulated. Additionally, both 14-day and 30-day mortality rates increased significantly. Conclusion: In this study, the most prevalent carbapenemase gene was OXA-48; however, there has been a recent increase in KPC genes. No dominant epidemic strain was identified through clonality analysis. The clustering rate was 68% before the pandemic, increasing to 85.7% during the pandemic. The significance of infection control measures is underscored by the rise in both clustering and mortality rates during the COVID-19 pandemic.