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    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.
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    Oral colonization of Acinetobacter baumannii in intensive care units: Risk factors, incidence, molecular epidemiology, association with the occur of pneumonia and sepsis, and infection control measures
    (Mashhad Univ Med Sciences, 2022) Duman, Yucel; Ersoy, Yasemin; Tanriverdi, Elif Seren; Otlu, Bans; Toplu, Sibel Altunisik; Goziikara, GOzde; Tekerekoglu, Mehmet Sait
    Objective(s): Oral colonization of Acinetobacter baumannii can lead to infections such as pneumonia and sepsis. We aimed to evaluate oral colonization of hospitalized patients in ICUs and to examine risk factors for oral colonization, molecular epidemiology, and incidence of pneumonia and sepsis. Materials and Methods: The study began in February 2021. Oral cultures were taken. The microorganisms were identified by a Maldi-tof MS mass spectrometry device. Colistin resistance genes were investigated by polymerase chain reaction. Clonal relationships were determined by pulsed-field gel electrophoresis. Results: A. baumannii was found in 21 of 96 patients' oral cultures. Pneumonia and sepsis due to A. baumannii were detected in 14 and 5 patients, respectively. The mean growth time of A. baumannii from oral cultures was 11.8 days, and the meantime for the occurrence of pneumonia after oral growth was 5.2 days. We determined a plasmid mediated mcr-2 colistin resistance gene in a colistin susceptible A. baumannii strain. It is the first report of the plasmid mediated mcr-2 colistin resistance gene in our country. In total, fourteen different A. baumannii genotypes were determined in PFGE. It was determined that the effects of antibiotic use, oral motor dysfunction, mechanical ventilation, intubation, orogastric tube use, and total parenteral nutrition intake on oral colonization were statistically significant. Conclusion: Oral colonization of A. baumannii is a significant concern in ICUs. We believe that it is important to take oral cultures and follow the risk factors and take infection control measures to prevent oral colonization of resistant isolates in ICUs.