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    Bacteria isolated from blood cultures and their antimicrobial susceptibility
    (AVES, 2011) Duman Y.; Kuzucu C.; Çu?lan S.S.
    Purpose: The aim of this study was to analyse the distrubution and antimicrobial susceptibility stream infections in 2009. Material and Methods: The samples were incubated in BACT / ALERT 3D automated systems for five days. Microorganisms were identified by using conventional methods. Antibiotic susceptibility was determined by Kirby-Bauer disk diffusion method according to the recommentations of Clinical Laboratory Standards Institute (CLSI) criteria. Results: The microorganisms isolated were 31.5% Gram-negative and 68.5% Gram-positive bacteria. The most frequently isolated bacteria were Escherichia coli and coagulase negative staphylococcus (CNS). All of the E.coli and Klebsiella were susceptible to imipenem, meropenem and amikacin. Imipenem was the most effective antibiotic against Pseudomonas aerugiosa, and tigecycline was the most effective antibiotic against Acinetobacter spp. In this study 30.8% of Staphylococcus aureus isolates were resistant to methicillin, no glycopeptide resistant Staphylococci was encountered. One enterecoccus strain was resistant to glycopeptides. Conclusion: Identification of microorganisms from blood cultures and its antibiotic susceptibility pattern will guide to clinician during the treatment.
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    The effect of sodium dichloroisocyanurate dihydrate to prevent the environmental transmission of multidrug-resistant acinetobacter Baumanniiin hospital settings
    (Parlar Scientific Publications, 2020) Duman Y.; Kuzucu C.; Ersoy Y.; Otlu B.
    Nosocomial infections are a substantial concern as the major cause of morbidity and mortality of hospitalized patients' in the world. Disinfection of inanimate environment, equipment and hospital setting is important to prevent nosocomial infections. Sodium dichloroisocyanurate dihydrate (NaDCC) can be used for disinfection of environment and medical devices. The aims of this study were to determine the efficacy of NaDCC at various concentrations and times against multi-drug resistant Acinetobacter strains. In the first phase of the study, the bactericidal activity of NaDCC to A. baumannii was investigated by quantitative suspension test. In the second phase, the surface activity of NaDCC was tested by surface disinfection application test. In the third phase, before the cleaning of randomly selected patient's room A. baumannii contamination on the inanimate environment objects and equipment was investigated. After the cleaning of the room the effect of NaDCC was tested. As a result of the quantitative suspension test; NaDCC was inhibited the all A. baumannii and ATCC strains. In the surface disinfection application test, it was determined that at the concentration of 1000 ppm and 500 ppm, the activity of NaDCC; at 5th, 30th and 60th minutes was effective to microorganisms at 5 log level, respectively. But at 100 ppm concentration it was effective to at 5th minutes three, at 30th and 60th minutes seven A. baumannii strains at 5 log levels, while it was effective at log 1 level to other A. baumannii strains and S. aureus, E. coli and P. aeruginosa ATCC. As a result of investigation the A. baumannii contamination in patient's room; before the cleaning, we determined A. baumannii contamination on the inanimate objects of room (such as bed surface, bed edges, control device, nightstand, chair) and on equipment (such as stethoscope, steam appliance, blood pressure device, aspirator heads, ventilator surfaces). After the cleaning it was determined that at 1000 ppm concentration at 5th, 30th and 60thminutes NaDCC was effective to A. baumannii at 5 log levels. However, at 500 ppm concentration at 5th minute it was effective at log 5 level except control device. At 30th and 60th minutes of 500 ppm concentration of NaDCC was effective at log 5 level to A. baumannii. At 100 ppm concentration at 5th, 30th and 60th minutes it was effective to A. baumannii strains at log 1 level on inanimate objects and equipment. In low concentration, NaDCC efficacy was reduced against A. baumannii. The application concentration and time of the disinfectant to clean up the equipment and the environment is very important for preventing nosocomial infections and the spread of A. baumannii. Thus, it is necessary to check and follow up the staff and to create clean and disinfection training programs for educating staff. © by PSP
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    Investigation of beta-lactamase genes and clonal relationship among the extended-spectrum beta-lactamase producing nosocomial escherichia coli isolates
    (Ankara Microbiology Society, 2015) Görgeç S.; Kuzucu C.; Otlu B.; Yetkin F.; Ersoy Y.
    Extended-spectrum beta-lactamase (ESBL) producing microorganisms currently cause a major problem. Among theseCTX-M beta-lactamase producing Escherichia coli has also disseminated worldwide as an important cause of both nosocomial and community-acquired infections. The aims of this study were to determine the prevalence of the beta-lactamase genes, antibiotic susceptibilities and clonal relationships of ESBL-producing nosocomial E.coli isolates. A total of 76 ESBL-producing E.coli strains isolated from urine (n= 26), blood (n= 25) and wound (n= 25) specimens of hospitalized patients identified as nosocomial infection agents according to the CDC criteria between June 2010-]une 2011 were included in the study. Antibiotic susceptibilities of the isolates were detected by Kirby-Bauer disc diffusion method according to CLSI recommendations. ESBL production was tested by double disc diffusion method, and cefotaxime/cefotaxime-clavulanic acid E-test strips (AB Biodisk, Sweden) were used for indeterminate results. Presence of TEM, SHV, CTX-M, OXA-2 group, 0XA-10 group, PER, VEB and CES beta-lactamase genes were investigated by polymerase chain reaction (PCR) using specific primers. Pulsed-field gel elec-trophoresis (PFCE) method was used for the detection of clonal relationships among the strains. Most of the ESBL-producing E.coli strains were isolated from samples of inpatients in intensive care (35%), internal medicine (16%) and general surgery (13%) units. All of the 76 strains were found susceptible to imipenem, meropenem and amikacin; however all were resistant to cefotaxime and ceftriaxone. The susceptibility rates of the isolates to cefoxitin, ertapenem, cefoperazone/sulbactam, piperacillin-tazo- bactam, gentamicin, ciprofloxacin, cefepime, amoxicillin-davulanic acid, aztreonam and ceftazidime were 96%, 83%, 63%, 61%, 50%, 41%, 25%, 21%, 20% and 18%, respectively. Among E.coli isolates, the frequency of CTX-M, TEM, OXA-2 group, PER, SHV and OXA-10 group beta-lactamase genes were found as 89.5%, 59.2%, 15.8%, 14.5%, 11.8% and 3.9%, respectively, while none of the isolates were positive for VEB and CES beta-lactamase genes. In 1 (1.3%) strain none of the investigated genes were detected. PCR analyses of the isolates revealed that 25 harbored CTX-M and TEM genes together, while 20 harbored only CTX-M and two harbored only TEM genes. Single SHV gene was not detected in any of the isolates. PFCE demonstrated no major clonal relationship between ESBL-producing isolates. This study indicated that CTX-M type enzymes were highly endemic among ESBL-producing nosocomial E.coli strains in our hospital, with the polyclonal spread of ESBL-producing bacteria without any dominant epidemic clone. In conclusion, it was considered that further studies are needed to explain the relationship between epidemic clones and plasmids with the use of plasmid analysis and multilocus sequence typing methods.