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Öğe Bir Üniversite Hastanesi’nde 2018-2019 Yıllarında İzole Edilen Staphylococcus Aureus İzolatlarının İncelenmesi(2020) Tanriverdi, Elif Seren; Duman, Yucel; Tekerekoglu, MehmetAmaç: Staphylococcus aureus toplum ve sağlık bakım ilişkili cilt ve yumuşak doku enfeksiyonları, üriner sistem enfeksiyonu, endokardit, pnömoni,septik artrit, osteomyelit, sepsis gibi morbidite ve mortalitesi yüksek enfeksiyonlara neden olan en önemli mikroorganizmalardan biridir. Çalışmamızda hastanemiz Tıbbi Mikrobiyoloji laboratuvarına gelen çeşitli klinik örneklerden izole ettiğimiz metisiline dirençli S. aureus (MRSA) ve metisilineduyarlı S. aureus (MSSA) izolatlarının antimikrobiyallere direnç oranlarının belirlenmesi ve hastanemize ait direnç profilinin incelenmesi amaçlandı.Gereç ve Yöntem: 2018- 2019 yılları arasında izole edilen 879 S. aureus izolatı çalışmaya dahil edildi. İzolatlar konvensiyonel yöntemlerle veMALDI-TOF MS (Bio Merieux, Fransa) ile identifiye edildi. İzolatların antimikrobiyal duyarlılık testleri European Committee on AntimicrobialSusceptibility Testing (EUCAST) kriterlerine göre Kirby-Bauer disk düffüzyon ve Gradient düffüzyon methodu ile belirlendi.Bulgular: 2018 yılında %24.2, 2019 yılında ise %22.3 olmak üzere iki yıllık sürede MRSA oranı %23.3 olarak belirlendi. S. aureus izolatlarınındağılımına bakıldığında yara kültürlerinin en sık S. aureus izole edilen klinik örnek olduğu tespit edildi. MRSA ve MSSA izolatlarında vankomisin velinezolide direnç belirlenmedi. En yüksek direnç oranı MRSA ve MSSA izolatlarında sırasıyla %98 ve %82.8 ile penisiline karşı tespit edildi.Sonuç: Hastanemizdeki S. aureus izolatlarının direnç profillerinin bilinmesi; ampirik tedavide yol gösterici olacaktır. Ayrıca etkili enfeksiyon kontrolönlemlerinin alınması, el hijyenine dikkat edilmesi ve kısıtlı antibiyogram uygulaması MRSA enfeksiyonlarının kontrolüne katkı sağlayacaktır.Öğe Carbapenem-resistant Klebsiella pneumoniae outbreak with monoclonal spread: Evaluation of resistance genes and ceftazidime-avibactam susceptibility(Elsevier, 2023) Arici, Neslihan; Tanriverdi, Elif Seren; Calik, Seyma; Kansak, Nilgun; Adaleti, Riza; Otlu, Baris; Aksaray, SebahatPurpose: The aim of this study was to investigate ceftazidime-avibactam (CAZ-AVI) susceptibility, carbapenemase genes, and clonal relationship in carbapenem-resistant Klebsiella pneumoniae (CrKp) isolates.Methods: A total of 28 non-repetitive CrKp isolates with positive carbapenemase production determined by the modified carbapenem inactivation method (mCIM), were included in the study. Identification of the isolates was performed with MALDI-TOF MS (VITEK-MS, bioMerieux, France). The automated system (VITEK-2, bioMerieux) and gradient diffusion test (Etest, bioMerieux) were used to determine antibiotic susceptibility. The mCIM was performed according to CLSI (2021) recommendations. CAZ-AVI susceptibility was carried out using the standard disc diffusion method. Results were evaluated according to EUCAST 2022 criteria. The blaOXA-48, blaNDM, blaKPC, blaIMP and blaVIM genes were investigated by multiplex PCR. The clonal relationship between isolates was determined by both AP-PCR and PFGE methods.Results: Of the total 28 isolates, 89.3% were susceptible to CAZ-AVI. blaOXA-48 gene was found in 85.7% of the isolates, blaOXA-48 thorn blaNDM gene in 10.7%, and blaNDM gene in 3.6%. blaKPC, blaIMP and blaVIM genes were not detected. Three clusters with three different genotypes were determined by the PFGE method. The largest cluster was Genotype A (n:24), followed by Genotype B (n:3), and Genotype C (n:1). AP-PCR was highly compatible with PFGE. The isolates of Genotype A, mostly from the intensive care unit (ICU), were evaluated as outbreak strains with monoclonal dissemination. Conclusions: OXA-48 remains the most frequently detected enzyme in CrKp strains in our country. The ceftazidime-avibactam susceptibility rate of 89.3% indicates that this antibiotic is still effective against CrKp isolates. The unnoticed outbreak detected in our study revealed the severity of intra-hospital cross-contamination affecting different wards, including the ICU. Therefore, in order to limit the spread of CrKp isolates, it is of great importance to implement strict infection control measures, and molecular surveillance programs, especially in the ICU.Öğe A Case of Infective Endocarditis Due to Abiotrophia defectiva, and Treatment with Ertapenem(Galenos Publ House, 2021) Duman, Yucel; Altunisik Toplu, Sibel; Tanriverdi, Elif Seren; Bayindir, YasarThe most frequently reported infections due to Abiotrophia defectiva worldwide are bacteraemia and endocarditis. It is estimated that A. defectiva causes approximately 5-6% of microbiologically proven endocarditis and plays a role in the etiology of culture negative endocarditis. In this article we reported a patient with infective endocarditis (IE) due to penicillin resistant A defectiva, which caused vegetation in the mitral valve, embolism in the spleen and successfully treated with ertapenem. A 70-year-old female patient was admitted to the emergency service with fever and abdominal pain. The patient had a pronounced widespread abdominal tenderness in the left quadrant. The body temperature was 38.9 degrees C, C-reactive protein (CRP) level was 12.7 mg/dl and white blood cell count was 13.3x10(3) mm(3). The patient was hospitalized to investigate fever's reason. It was learned in the anamnesis that she used warfarin. Considering the pre-diagnosis of urinary tract infection, empirical treatment with ceftriaxone 2x1 g/day was started. However, due to the increase in International Normalized Ratio value on the second day of ceftriaxone treatment, ertapenem 1x1 g/day was started by considering drug interaction between warfarin and ceftriaxone. Transesophageal echocardiography of the patient revealed a 1.2x1.2 cm vegetation on the posterior leaflet surface of the mitral valve, and ischemia due to embolism in the spleen was detected on abdominal computer tomography. Penicillin resistant A defectiva grew in the blood culture. The patient was diagnosed as having IE on the seventh day of her admission. Ertapenem treatment was completed in six weeks due to the patient's absence of fever, decreased CRP level, and the absence of A. defectiva in the seventh day control blood culture. After treatment, vegetation was not observed in the transthoracic echocardiography of the patient and no signs of ischemia was detected in the spleen. Detection of A. defectiva shaped the follow-up process of our patient by bringing the diagnosis of IE to mind. In treatment of A defectiva-related IE, guidelines suggest long-term combination of aminoglycosides with beta-lactams or vancomycin. However, in our patient, treatment was provided by using ertapenem alone for six weeks. In addition, we believed that early diagnosis and treatment in our patient prevented serious complications.Öğe A Case of Intra-abdominal Tuberculosis Due to Mycobacterium bovis Mimicking Ovarian Cancer: Importance of Microbiological Diagnosis(Ankara Microbiology Soc, 2022) Dalgic, Bahise Cagla Taskin; Yenisehirli, Gulgun; Tanriverdi, Elif Seren; Akkan, Murat; Otlu, Baris; Sezer, Oznur; Koseoglu, Handan inonuMycobacterium bovis causes gastrointestinal tuberculosis by being transmitted through consumption of infected milk and dairy products, mostly in developing countries, and can spread to the other neighbourhood intra-abdominal tissues and organs. In addition to the symptoms such as weight loss, weakness, abdominal pain, and chronic diarrhea in female patients with abdominal tuberculosis, findings such as pelvic mass, ascites and CA-125 elevation may be encountered. Patients with these symptoms usually preliminary diagnosed as having ovarian cancer. It is very important to distinguish between these two diseases quickly, which have different treatment protocols. In this case report, a case of intra-abdominal tuberculosis caused by M.bovis, whose diagnosis was confirmed by microbiological methods with the findings mimicking ovarian cancer such as weight loss, ascites, pelvic mass and increased CA-125 was presented. Tuberculosis was considered in the differential diagnosis of a 23-year old female patient with abdominal pain, weight loss, ascites, pelvic mass, and elevated CA-125 (643.9 U/ml) findings and a mass in the left tubaovarian region on abdominal CT. The ileum biopsy sample taken during colonoscopy and ascitic fluid sample taken with paracentesis were sent to our laboratory for acid-fast bacilli (AFB) staining and tuberculosis culture. In our laboratory, samples were incubated in both liquid culture system [BACTEC MGIT 320 Mycobacteria Culture System (Becton Dickinson,USA)] and solid culture medium [Lowenstein-Jensen Medium (Becton Dickinson,USA)] and AFB smears were performed. While AFB smears were negative, ileum biopsy material showed growth on day 14 and ascitic fluid sample on day 11 in liquid culture medium. AFB smear was prepared from broth and red bacilli were seen on a blue background that formed cord factor. The bacillus was identified as Mycobacterium tuberculosis complex by the immunochromatographic rapid test [BD MGIT TBc Identification Test (BD,USA)]. The anti-tuberculosis drug treatment was initiated with the diagnosis of intra-abdominal tuberculosis. The isolated bacillus was found to be sensitive to isoniazid, rifampicin, ethambutol and resistant to streptomycin, according the drug susceptibility test results. Subspecies identification of M.tuberculosis complex was investigated by matrix-assisted laser desorption ionization-time of flight mass spectrometry (MALDI-TOF MS) but could not be determined by this method. Genotyping was performed with the GenoType MTBC VER 1.X (Hain Lifescience, HardwiesenstraBe, Germany) kit. The isolate was identified as M.bovis. In the follow-up of the patient three months later, it was determined that tumor markers, ascitic fluid and intra-abdominal lymph nodes regressed significantly and the mass in the left ovary completely disappeared. In this report, we presented a case with intra-abdominal tuberculosis whose clinical, radiological and laboratory findings mimic ovarian cancer to imply the importance of microbiological diagnosis.Öğe Cessation of Rectal Screening for Vancomycin-Resistant Enterococci: Experience from a Tertiary Care Hospital from Turkiye(Mdpi, 2023) Dizman, Guelcin Telli; Metan, Goekhan; Zarakolu, Pinar; Tanriverdi, Elif Seren; Hazirolan, Guelsen; Aytac Ak, Hanife; Kilincarslan, DilekObjective:Here, we compared the impact of different polices on the epidemiology of Vancomycin-resistant Enterococcus faecium bloodstream infections (VRE-BSIs) in a tertiary care hospital including two hospital buildings (oncology and adult hospitals) in the same campus. Material and Methods:All patients who were hospitalized in high-risk units were screened weekly for VRE colonization via rectal swab between January 2006 and January 2013. After January 2013, VRE screening was only performed in cases of suspicion of VRE outbreak and during point prevalence studies to evaluate the epidemiology of VRE colonization. Contact precautions were in place for all VRE-positive patients. The incidence density rates of hospital-acquired (HA)-VRE-BSIs were compared between two periods. Results:While the rate of VRE colonization was higher in the second period (5% vs. 9.5% (p < 0.01) for the adult hospital, and 6.4% vs. 12% (p = 0.02 for the oncology hospital), there was no increase in the incidence rate HA-VRE BSIs after the cessation of routine rectal screening in either of the hospitals. Conclusion:Screening policies should be dynamic and individualized according to the epidemiology of VRE as well as the workforce and cost. Periodical rectal screening of VRE can be discontinued if suspicion of an outbreak can be carefully monitored.Öğe Chemical composition, antimicrobial activities, and molecular docking studies of Turkish propolis ethanol extract(Czech Academy Agricultural Sciences, 2023) Ozbey, Gokben; Muz, Mustafa Necati; Tanriverdi, Elif Seren; Erkan, Sultan; Bulut, Niyazi; Otlu, Baris; Zigo, FrantisekThe purpose of the present study was to investigate the antimicrobial effect of propolis ethanol extract col-lected from the Tarsus district of Mersin province, Kilis province, Yayladagi district of Hatay province in southern Turkiye and Sarkoy district of Tekirdag province of northwestern Turkiye against Escherichia coli (ATCC 25922), Helicobacter pylori (ATCC 43504), Pseudomonas aeruginosa (ATCC 27853), and Staphylococcus aureus (ATCC 29213). Their chemical constituents were detected via liquid chromatography-mass spectrometry/mass spectrometry (LC-MS/MS). They were used in a molecular docking approach to search the interactions between the propolis compounds. A total of 24 phenolic compounds were detected in all samples. 3-4 dimethoxycinnamic acid, caffeic acid and genistein were indicated to be the predominant phenolic compounds in propolis extracts by LC-MS/MS, while rutin was found in the lowest concentra-tion. Phenolic compounds were detected in a high concentration of the propolis samples collected from the Tarsus dis-trict of Mersin province. The broth microdilution method determined minimum inhibition concentration (MIC) values. MIC values ranged from 0.02 to 14 mg center dot mL-1. E. coli and S. aureus examined were as susceptible to the propolis extracts ex-cept for Mersin and Tekirdag propolis samples. The propolis sample collected from the Tarsus district of Mersin province presented the highest antibacterial activity on P aeruginosa with MIC values of 1 mg center dot mL-1. Active substances in propolis were docked to the relevant target proteins (5LMM, 4NX9, 5YHG, and 5FXT) representing E. coli (ATCC 25922), H. py-lori (ATCC 43504), P aeruginosa (ATCC 27853), and S. aureus (ATCC 29213), and with the help of molecular simulation. With this study, we indicated that the ethanol extract of propolis had a stronger antibacterial activity on S. aureus isolates than that of E. coli, H. pylori, and P aeruginosa. Although each component of propolis contributed to the antibacterial activity, the contribution of the vitexin component to the antibacterial activity was found to be quite significant.Öğe Clinical Properties of COVID-19 Developed in the Patients with Tuberculosis(Ankara Microbiology Soc, 2022) Otlu, Baris; Yakupogullari, Yusuf; Tanriverdi, Elif Seren; Bentli, RecepThere are limited publications about the Coronavirus disease 19 (COVID-19) clinic developing in the patients with active tuberculosis (TB). In this study, it was aimed to determine some clinical features of patients diagnosed with TB who also had COVID-19. In this retrospective cross-sectional study, 71 pa- tients with COVID-19 were evaluated out of a total of 595 patients diagnosed with TB in our province between 2015 and 2021. After contracting COVID-19, a total of nine (12.6%) TB patients were hospital- ized, five (7%) patients were admitted to the intensive care unit, three (4.2%) were intubated, and one (1.4%) died due to severe COVID-19. The frequency of such health problems was found to be higher than the normal population living in the same province. None of these complications were observed in a total of 40 female TB patients, and the hospital and intensive care unit admission rates for men were significantly higher than for women. The results of this study showed that men with active TB had more health problems due to COVID-19 than the normal population. Comprehensive studies are needed to detail the resilience of female TB patients against COVID-19.Öğe Comparison the serologic tests used in the diagnosis of brucellosis; brucellacapt, brucella coombs gel, and brucella coombs tube agglutination tests(2021) Tanriverdi, Elif Seren; Duman, Yucel; Gozukara Bag, Harika Gozde; Tekerekoglu, MehmetAim: Brucellosis is the most common bacterial zoonosis in the world and in our country. The definitive diagnosis of the disease is the isolation of the agent in culture, but in routine diagnosis serologic tests are mostly used. In the routine serological diagnosis of brucellosis, rose bengal, standard tube agglutination (STA) and coombs tube agglutination (CTA) tests were used. The aim of this study was to determine the effectiveness of Brucellacapt (BCAP) and Coombs Gel (CJ) tests by comparing with STA and CTA tests. Materials and Methods: A total of 100 samples (47 positive and 53 negative by CTA test) were included in the study between June 2018 and July 2019. Titters detected as ≥1 / 160 in STA, CTA, BCAP (METSER Brucella test with Coombs, Savas Medical, Istanbul), CJ (ODAK Brucella Coombs Gel test, Toprak Medical, Istanbul) tests were accepted as positive. Cohen kappa (κ) analysis was used to evaluate the consistency between the tests. Results: Out of 100 samples included in the study were found positive, 20 with STA, 48 with CAP and 53 with CJ tests, respectively. Among the 47 patients who were positive with CTA test, 44 were positive with BCAP and CJ tests, also 2 of them were negative with BCAP and 1 with CJ test. Among the samples found negative with the CTA test, 3 were found positive with BCAP and 7 with the CJ test. STA test was negative in 27 samples that were positive by CTA test. κ = 0.900 for CTA and BCAP, κ = 0.841 for CTA and CJ, κ = 0.860 for BCAP and CJ; showed a high level of agreement. The STA test showed a very low level of agreement with all three methods (κ = 0.440 for CTA with STA, κ = 0.426 for BCAP with STA, κ = 0.363 for CJ with STA). Conclusion: Compared to CTA testing, the applicability of BCAP and CJ tests is easier. Among the three tests, the CJ test gives the fastest results. In the serologic diagnosis of brucellosis, BCAP and CJ test can be used because of high compatibility with CTA test, and it is thought that the compatibility between the tests should be evaluated with more comprehensive studies.Öğe Detection of SARS-CoV-2 RNA in the Serum Samples of Healthy Blood Donors(Galenos Publ House, 2023) Dalgic, Bahise Cagla Taskin; Yenisehirli, Gulgun; Tanriverdi, Elif Seren; Alici, Ayse; Otlu, BarisIntroduction: The transmission rate of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) by blood transfusion is thought to be low; however, it has not yet been proven whether the virus is transmitted by blood transfusion. Published studies have reported that SARS-CoV-2 RNA has been detected in the blood, plasma, or serum of infected individuals. This study aimed to investigate the presence of SARS-CoV-2 RNA in the serum of blood donors and evaluate the risk of transmission of SARS-CoV-2 by transfusion. Materials and Methods: In this study, 200 blood samples were taken from volunteer blood donors. In all serum samples, SARS-CoV-2 RNA was detected by reverse-transcription quantitative polymerase chain reaction assay. Medical records of the donors and recipients were retrospectively reviewed. Results: SARS-CoV-2 RNA was detected in seven (3.5%) of the donor serum samples. None of the positive donors had symptoms of coronavirus disease 2019 (COVID-19), and none had been admitted to the hospital after donation. Seven SARS-CoV-2 RNA-positive donor blood components were given to 12 recipients. No medical records indicated that COVID-19 occurred after the transfusion of blood components for recipients. Conclusion: This study demonstrated the presence of SARS-CoV-2 RNA in the serum of asymptomatic donors. Although our data suggest that the transfusion of blood products from asymptomatic donors to recipients with SARS-CoV-2 RNA in their serum may not result in COVID-19, further studies are needed to prove that SARS-CoV-2 is not transmitted by blood transfusion.Öğe Determination of safety status and probiotic properties of Enterococcus strains isolated from traditional cheeses in Turkey(Oxford Univ Press, 2023) Kanak, Eda Kilic; Yilmaz, Suzan Ozturk; Altindis, Mustafa; Tanriverdi, Elif Seren; Otlu, BarisAims This study aimed to evaluate the probiotic properties of Enterococcus strains isolated from Turkish traditional cheeses. Methods and results Fifty-two Enterococcus spp. were taxonomically determined as follows: Enterococcus faecium (26), Enterococcus faecalis (18), Enterococcus durans (6), and Enterococcus italicus (2). The ability of isolates/strains to survive the harsh conditions (acidity and in-vitro gastric solution) of the gastrointestinal tract was established. They also showed auto-aggregation, hydrophobicity, and co-aggregation ability. Hydrophobicities of the strains were found between 0.8%-21%, 0.7%-56%, and 2%-63% for xylene, chloroform, and ethyl acetate, respectively. Autoaggregation values of the Enterococcus strains were 4%-20%, 7%-30%, and 36%-98% after 2, 4, and 24-h incubation, respectively. In this study, the Enterococcus strains tested showed co-aggregation ability with the Escherichia coli ATCC 25922, Salmonella Typhimurium ATCC 14028, and Staphylococcus aureus ATCC 25923. The results of PCR amplification revealed that only five strains possess virulence factor genes (gelE,asa1,cyl A,esp). We determined antibiotic resistance, biofilm forming abilities, and hemolytic activity for safety evaluation of strains. Conclusions In this large and comprehensive study, we found that only few of Enterococcus strains have promising probiotic potential, among which E. faecalis ES1 and E. faecium EM1 showed the best probiotic properties (are the most promising probiotic candidates).Öğe Does marking as sterile mean really sterile? Stenotrophomonas maltophilia outbreak caused by a blood-gas injector containing liquid heparin(Cambridge Univ Press, 2023) Dizman, Guelcin Telli; Metan, Gokhan; Karahan, Gizem; Tanriverdi, Elif Seren; Hazirolan, Gulsen; Otlu, Baris; Sonmezer, Meliha CaglaAn outbreak investigation was initiated after detecting an increase in the number of patients with Stenotrophomonas maltophilia bloodstream infections (SM-BSIs) througout the hospital. S. maltophilia was isolated from the cultures of blood-gas injectors containing liquid heparin. The incidence density of SM-BSIs decreased significantly after prohibiting the use of those injectors.Öğe The Effects of Antiperspirant Aluminum Chlorohydrate on the Development of Antibiotic Resistance in Staphylococcus epidermidis(Mdpi, 2023) Aras, Ayse; Rizvanoglu, Suna Sibel; Tanriverdi, Elif Seren; Karaca, Basar; Eryilmaz, MujdeThis study investigates the effects of the antiperspirant aluminum chlorohydrate on the development of antibiotic resistance in commensal Staphylococcus epidermidis isolates. The isolates were exposed to aluminum chlorohydrate for 30 days. The bacteria that developed resistance to oxacillin and ciprofloxacin were isolated, and the expression levels of some antibiotic resistance genes were determined using quantitative reverse transcriptase PCR. Before and after exposure, the minimum inhibitory concentration (MIC) values of the bacteria were determined using the microdilution method. A time-dependent increase was observed in the number of bacteria that developed resistance and increased MIC values. Consistent with the ciprofloxacin resistance observed after exposure, an increase in norA, norB/C, gyrA, gyrB, parC, and parE gene expression was observed. In addition to aluminum chlorohydrate exposure, oxacillin resistance was observed in all test bacteria in the group only subcultured in the medium, suggesting that phenotypic resistance cannot be correlated with chemical exposure in light of these data. The increase in mecA gene expression in selected test bacteria that acquired resistance to oxacillin after exposure compared with control groups suggests that the observed resistance may have been related to aluminum chlorohydrate exposure. To our knowledge, this is the first time in the literature that the effects of aluminum chlorohydrate as an antiperspirant on the development of antibiotic resistance in Staphylococcus epidermidis have been reported.Öğe Effects of Different Progesterone Doses on the Concentrations of Proinflammatory and Anti-inflammatory Cytokines in Pregnant Women With Threatened Abortion(Springernature, 2021) Kirici, Pinar; Tanriverdi, Elif SerenBackground and objective This study aimed to investigate how different doses of progesterone influence the concentrations of interleukin-6 (IL-6) and tumor necrotizing factor-alpha (TNF-alpha), which are proinflammatory cytokines, as well as that of IL-10, which is an anti-inflammatory cytokine, in pregnant women with threatened abortion. Materials and methods This is a prospective, single-center, randomized controlled trial conducted with 221 patients with a threatened abortion diagnosis. Group 1 consisted of IL-6, IL-10, and TNF-alpha values in pre-treatment blood samples from 221 patients diagnosed with imminent abortion. Group 2 included 81 patients who received natural oral 100 mg micronized progesterone MP twice a day for two weeks. Group 3 included 83 patients who were administered oral 200 mg of natural micronized progesterone MP twice a day for two weeks. Group 4 included 57 patients who received oral 200 mg of natural micronized progesterone MP twice a day for two weeks, and one depot progesterone was added to the treatment by administering it at a dosage of 500 mg/day intramuscularly. Results IL-6 values between groups were lower in group 4 compared to group 3 (p=0.007). When IL-10 values were compared between the groups, the IL-10 ratio was highest in group 4 and lowest in group 2 (p<0.001, p=0.003, p<0.001). When the TNF-alpha values between the groups were compared, the value in group 4 was decreased compared to groups 1 and 2 (p=0.031, p<0.001). In the logistic regression analysis, the IL-6 value above 12.01 increased the abortion imminens rate 1.01 times, and a TNF-alpha value above 11.04 increased the abortion imminens rate 1.21 times. Conclusion Progesterone used to treat imminent abortion reduces the levels of proinflammatory cytokines, such as IL-6 and TNF-alpha, while increasing those of anti-inflammatory cytokine IL-10 in proportion to the dose administered. Progesterone can prevent imminent abortion by generating an anti-inflammatory environment.Öğe Emerging Tuberculosis Among Patients with Previous COVID-19(Bilimsel Tip Yayinevi, 2022) Yakupogullari, Yusuf; Tanriverdi, Elif Seren; Ermis, Hilal; Otlu, BarisCOVID-19 patients have a higher incidence of opportunistic infections, but there is little information on tuberculosis (TB). In this study, it was aimed to determine any possible contribution of COVID-19 in TB emergence among patients diagnosed with TB during the pandemic. A retrospective screening of the regional TB laboratory's records identified TB patients diagnosed in the Malatya region between April 1, 2020, and December 31, 2021. Medical data of TB patients with a prior COVID-19 were evaluated. During the study period, 171 TB patients were diagnosed in the region, with 26 also infected with SARS-CoV-2. Patients' histories revealed that 10 (38.5%) of these 26 patients developed TB symptoms in a median 68.5 days after COVID-19. Four patients had one-week to two-month corticosteroid treatment due to severe COVID-19, and one had a hematological malignancy history. However, the remaining five patients had no significant predisposing factor for TB relapse. Four out of 10 patients were free of any finding for active TB before COVID-19. Severe COVID-19 may have some obvious implications for TB reactivation, but there was no conclusive evidence of such an effect in mild to moderate COVID-19. Nonetheless, inquiring about COVID-19 histories from TB patients in large-scale studies may provide high-quality evidence about the interactions between the two pathogens.Öğe The impact of COVID-19 pandemic on nosocomial multidrug-resistant bacterial bloodstream infections and antibiotic consumption in a tertiary care hospital(German Medical Science-Gms, 2022) Metan, Gokhan; Cuha, Mervenur Demir; Hazirolan, Gulsen; Dizman, Gulcin Telli; Tanriverdi, Elif Seren; Otlu, Baris; Tas, ZahitWe investigated the change in the epidemiology of nosocomial blood-stream infections (BSIs) caused by multidrug-resistant bacteria during Coronavirus Disease (COVID-19) and antibiotic consumption rates at a pandemic hospital and at the Oncology Hospital which operated as COVID-19-free on the same university campus. Significant increases in the infection density rate (IDRs) of BSIs caused by carbapenem-resistant Acinetobacter baumannii (CRAB) and ampicillin-resistant Enterococcus faecium (ARE) were detected at the pandemic hospital, whereas car-bapenem-resistant Klebsiella pneumoniae BSIs were increased at the non-pandemic Oncology Hospital. Pulsed field gel electrophoresis showed a polyclonal outbreak of CRAB in COVID-19 intensive care units. Antibiotic consumption rates were increased for almost all antibiotics, and was most significant for meropenem at both of the hospitals. In-creased IDRs of CRAB and ARE BSIs as well as an increased consump-tion rate of broad-spectrum antibiotics emphasize the importance of a multimodal infection prevention strategy combined with an active anti-biotic stewardship program.Öğe Infective endocarditis caused by Chaetomium globosum(Elsevier Science Inc, 2023) Demir, Tolga; Baris, Ayse; Sigirci, Serhat; Sigirci, Buket Bambul; Tanriverdi, Elif Seren; Koramaz, IsmailChaetomium globosum is a dematiaceous, filamentous fungus belonging to the large genus saprobic as-comycetes and is rarely involved in human infection. We present the case of a 25-year-old man undergo-ing tricuspid valve replacement due to recurrent prosthetic ring endocarditis. Initially, it was considered culture-negative endocarditis; however, the diagnosis of Chaetomium globosum could only be provided by DNA isolation of the mold isolate grown in culture and the valve tissue samples taken from the pa-tient. This report describes the first documented tricuspid endocarditis caused by Chaetomium species and discusses the importance of molecular tools to enhance the diagnostic process in culture-negative endocarditis, especially for fastidious and nonculturable microorganisms. (c) 2022 Elsevier Inc. All rights reserved.Öğe Investigation for the presence of bacteria and antimicrobial resistance genes in sea snails (Rapana venosa)(Inst Rural Health Lublin, Poland, 2023) Ozbey, Gokben; Tanriverdi, Elif Seren; Basusta, Asiye; Lakshmanappa, Yashvanth Shaan; Otlu, Baris; Zigo, FrantisekIntroduction and Objective. The aims of this study were to search for the presence of bacteria in sea snails (Rapana venosa) by using culturomics and Matrix-assisted laser desorption/ionization time-of-flight mass spectrometry (MALDI-TOF MS), and the antibiotic resistance/susceptibility of the sea snails.Materials and method. The anti-microbial susceptibilities of Gram-negative bacteriawas assessed by the Kirby-Bauer disk diffusion method, the presence of the mcr genes (mcr-1 to-5), the major carbapenemase and 13-lactamase resistant genes in Gram-negative bacteria, using mPCR method and 16S rRNA sequence analysis of A. hydrophila isolates.Results. Bacterial growth accounted for 100% and 94.2% in the samples of intestine and meat, respectively, in the snails. The main organisms identified by MALDI-TOF MS were A. salmonicida subsp. salmonicida at 33.7%, followed by Raoultella ornithinolytica at 9.6% (10/104) and Staphylococcus warneri at 7.7% in meat and intestine samples. Aeromonas hydrophila/ punctata (caviae), Aeromonas sobria, Klebsiella aerogenes, Klebsiella oxytoca, Raoultella planticola, Shewanella putrefaciens and Vibrio vulnificus are intrinsic or chromosomally-mediated resistant against ampicillin. No mcr genes (mcr-1 to-5), the major carbapenemase and 13-lactamase resistant genes were found. Aeromonas salmonicida subsp. salmonicida showed very low levofloxacin and meropenem resistance levels at 2.9%. When the sequence was searched in the Blast database, the genome of A. hydrophila/punctata (caviae) isolate showed high similarity with the A. hydrophila sequences. Conclusions. The findings obtained not only provide data about the proportion of bacteria in the gut and meat of the sea snails and their antibiotic resistance/susceptibility, but also show the absence of carbapenemase, colistin, and 13-lactamase resistant genes among bacterial isolates from sea snail gut microbes.Öğe Investigation of bacterial pathogens in milk from mastitic dairy cattle by matrix-assisted laser desorption ionization-time of flight mass spectrometry(Chulalongkorn Univ, 2022) Ozbey, Gokben; Otlu, Baris; Yakupogullari, Yusuf; Celik, Betul; Tanriverdi, Elif Seren; Kelestemur, Neslihan; Safak, TarikThe scope of the present study was to assess the use of Matrix-Assisted Laser Desorption/Ionization-Time of Flight (MALDI-TOF) Mass Spectrometry (MS) as a quick technique for the identification of bacterial species in mastitis. In this study, milk samples from each udder quarter from a total of 250 dairy cattle were aseptically collected and tested. The samples were grouped into California Mastitis Test (CMT) positive, CMT negative and clinical mastitis. The samples were streaked on blood agar and the bacterial isolates were analysed using MALDI-TOF MS. Using MALDI-TOF MS, certain species such as Staphylococcus chromogenes (44/188, 23.4%), Aerococcus viridans (40/188, 21.3%) and Staphylococcus haemolyticus (19/188, 10.1%) were identified at a higher proportion in milk samples from cattle that were CMT positive. Moreover, the most common bacteria isolated from CMT negative milk samples were A. viridans (56/161, 34.8%), S. haemolyticus (24/161, 14.9%) and S. chromogenes (17/161, 10.6%). Only one isolate of S. chromogenes (1/4, 25%), A. viridans (1/4, 25%), S. haemolyticus (1/4, 25%) and Enterococcus faecium (1/4, 25%) was detected from milk samples with clinical mastitis using MALDI-TOF MS. There was a concurrence between the MALDI-TOF and biochemical bacterial identification method in 325 of 353 samples (92.06%). This study concludes that MALDI-TOF can be applied for quick determination of bacterial isolates once the bacterial colony has been isolated in milk samples.Öğe Investigation of the VISA and hVISA Presence in Methicillin- Resistant Staphylococcus aureus Isolates by Various Methods(Ankara Microbiology Soc, 2022) Ucar, Serife; Duman, Yucel; Tanriverdi, Elif Seren; Tekerekoglu, Mehmet Sait; Otlu, BarisStaphylococcus aureus is an important human pathogen that causes community and hospital-acquired infections. The role of vancomycin in the treatment of methicillin-resistant S.aureus infections is indisput- able. However, vancomycin intermediate susceptible S.aureus (VISA) and heterogeneously VISA (hVISA) isolates, that cause treatment failures during the use of vancomycin, cannot be detected by routine labo-ratory methods. The gold standard method for the detection of these isolates is the population profile analysis-area under the curve (PAP-AUC) method. In this study, it was aimed to determine the presence of mecA and mecC gene regions that cause methicillin resistance, the clonal relationship between iso- lates, and the presence of VISA and hVISA. A total 68 methicillin-resistant S.aureus (MRSA) strains were included in this study which were isolated in the microbiology laboratory of the hospital between 2015-2020. Identification of the isolates were determined by matrix assisted laser desorption ionization-time of flight mass spectrophotometry (VITEK MS, BioMerieux, France). Methicillin resistance was investigated by disk diffusion method using cefoxitin (30 mu g, Bioanalyse, Turkiye) disk and vancomycin MIC values were determined by broth microdilution method. mecA and mecC gene regions were investigated by polymerase chain reaction (PCR) method. The presence of VISA and hVISA were investigated by modi- fied agar screening, macro gradient diffusion test and confirmated by PAP-AUC methods, and the clonal relationship between isolates were investigated by pulsed field gel electrophoresis method. The mecA gene region was determined in all isolates, but the mecC gene region was not found in any of the iso- lates. The MIC50 value of the isolates was determined as 1 mu g/mL and the MIC90 value was determined as 2 mu g/mL by broth microdilution method. Six VISA and four hVISA suspected strains were detected by a modified agar screening method. Among the isolates identified as suspicious by the modified agar screening method, one isolate was evaluated as VISA and one isolate was evaluated as hVISA by the gold standard PAP-AUC method. No dominant epidemic isolate has been identified by PFGE. As a result, VISA and hVISA were determined in the hospital. The increase in these isolates is a serious concern. For this reason, it is believed that it would be beneficial to investigate the VISA/hVISA ratios in MRSA isolates at certain periods, and to take necessary infection control measures to implement measures and practices to prevent the spread of these isolates in the community and hospital environment.Öğe A long-lasting Sphingomonas paucimobilis outbreak: A potential for pathogens to persist on environmental devices despite disinfection measures(Mosby-Elsevier, 2023) Menekse, Sirin; Tanriverdi, Elif Seren; Altinay, Ece; Ogus, Halide; Aydogan, Arzu Atesoglu; Saglam, Duygu; Celik, OzgeBackground: Sphingomonas paucimobilis, an aerobic, non-fermentative, Gram-negative opportunistic bacillus, can colonize everywhere in hospital settings where water is used. We reported a hospital S paucimobilis outbreak that persisted for nearly 2 years despite all necessary preventive measures.Methods: Over a period from February 13, 2020 to December 3, 2021, 67 patients were identified to have S paucimobilis as documented by positive cultures from clinical samples, along with 19 positive environmental samples.Results: Bacterial regrowth for molecular analysis could be obtained in 49 isolates (39 clinical, 4 extracorporeal membrane oxygenation (ECMO) water heater devices, 1 unused mouthwash solution, 5 water samples from thoracic drainage aspirators). Two distinct clonally indistinguishable genotypes were detected in APPCR and PFGE analyses, with 100% consistency. The main cluster was obtained consistently throughout the outbreak from 30 samples (61.2%: 24 clinical, 4 ECMO, 1 unused mouthwash solution, 1 water sample from the thoracic drainage aspirator). The other cluster involved 15 clinical samples and 4 water samples from the thoracic drainage aspirators.Conclusions: Given that waterborne pathogens can spread to a wide range of equipment used in healthcare environments, the pathogens can persist on the surfaces of environmental devices even after recommended disinfection measures have been applied. Therefore, individual tracking of all devices used in critical care settings, such as thoracic drainage aspirators and ECMO water heater devices, with records of pre- and post-disinfection procedures is of paramount importance for complete elimination of the source of infection. & COPY; 2022 Association for Professionals in Infection Control and Epidemiology, Inc. Published by Elsevier Inc. All rights reserved.
