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    Investigation of EDTA-CarbaNP-direct test for the detection of metallo-β-lactamases in Pseudomonas aeruginosa
    (Elsevier Science Inc, 2025) Tutan, Hanife; Mazlumoglu, Bilge; Cizmeci, Zeynep; Cekin, Zuhal Kalayci; Comert, Fusun; Tanriverdi, Elif Seren; Aktas, Elif
    Background: WHO has included carbapenem-resistant Pseudomonas aeruginosa (CR-Pa) in the high priority pathogens list. Ceftazidime-avibactam (CZA) is one of the limited treatment options in CR-Pa infections. Early detection of metallo-beta-lactamases (MBL) is important because CZA is not effective against MBL-producing isolates. Aim: To modify the CarbaNP-direct test (CNPdt) with EDTA and evaluate its use in MBL detection and prediction of CZA resistance CR-Pa isolates. Methods: 398 CR-Pa isolates from five centres in T & uuml;rkiye were included. Susceptibility tests were done using EUCAST criteria. The isolates were tested for blaVIM, blaIMP, blaNDM, blaOXA-48, blaKPC and blaGES genes using Biospeedy Carbapenem-Resistance qPCR kit and GES Antibiotic-Resistance kit (Bioeksen, T & uuml;rkiye). We modified CNPdt described by Pasteran et al. by adding a third tube with ethylenediaminetetraacetic acid (EDTA). The isolates with carbapenemase genes were subjected to CNPdt and EDTA-CNPdt. EDTA-CNPdt was considered positive if the tube without EDTA turned yellow while the tube with EDTA remained red and negative if both tubes turned yellow (Fig. 1). Results: Carbapenemase genes were detected in 55 (13.8 %) of the isolates. CNPdt was positive in 31 of the isolates. Of the 31 isolates, 23 were positive for EDTA-CNPdt. All of these 23 isolates were MBL producers and resistant to CZA. PCR, CNPdt, EDTA-CNPdt and CZA susceptibility test results are shown in Table 2. Conclusion: The positivity of CNPdt in CR-Pa is limited, but EDTA-CNPdt detected 100 % of MBL-producing isolates when CNPdt was positive. This test can be used for MBL detection and prediction of CZA resistance in CNPdt positive isolates.
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    Investigation of Streptococcus agalactiae Colonisation in pregnant women using culture and a novel qPCR Kit
    (Elsevier Science Inc, 2026) Mazlumoglu, Bilge; Genc, Leyla; Ince, Sule Ule Birol; Pelit, Suleyman; Tanriverdi, Elif Seren; Aktas, Elif
    Background: Maternal colonisation with Streptococcus agalactiae (GBS) is the most important risk factor for earlyonset sepsis in newborns. We aimed to determine the rate of GBS colonisation in pregnant women evaluate the concordance between culture and a novel commercial polymerase chain reaction (PCR) test for screening. We also aimed to investigate the presence of the hypervirulent ST-17 clone and the potential risk factors that may affect colonisation. Material and Methods: A total of 365 rectovaginal samples from pregnant women >= 36 weeks were investigated. Lim Broth was used for culture. PCR was done by the Bio-Speedy GBS (Group B Streptococcus) qPCR kit. The presence of the hypervirulent ST-17 clone was evaluated by PCR. Potential risk factors were evaluated via a survey. Results: GBS was detected in 12.3 % (95 % CI: 9.3-16.1) of pregnant women by culture, in 15.3 % (95 % CI: 11.9-19.5) by direct qPCR and in 19.5 % (95 % CI: 15.6-23.9) by enrichment qPCR. Cohen's Kappa analysis revealed an 'almost perfect' level of agreement between culture and direct qPCR (kappa = 0.85; 95 % CI: 0.74-0.97). Discordant results were observed in 13 cases (12 qPCR positive / culture negative, and one qPCR-negative / culture-positive). All isolates were susceptible to penicillin, while resistance to erythromycin and clindamycin were 37.8 % (95 % CI 25.1-52.4) and 33.3 % (95 % CI 21.4-47.9), respectively. ST-17 clone constituted 7 % (95 % CI:1.9-17.0) of the positive samples. GBS colonisation showed an association with sexual activity that approached the statistical significance threshold, and a significant association with education level. Conclusion: Using a novel PCR test, almost perfect agreement was found between qPCR and culture, while the detection of colonisation was higher by qPCR. This study highlights the diagnostic contribution of molecular methods in GBS screening, even providing results after the onset of labor. The high prevalence of GBS, along with the circulation of hypervirulent clones underscores the critical importance of routine screening in pregnant women.