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    Analysis of an outbreak due to Chryseobacterium meningosepticum in a neonatal intensive care unit
    (Luigi Ponzio E Figlio, 2003) Tekerekoglu, MS; Durmaz, R; Ayan, M; Cizmeci, Z; Akinci, A
    The aim of this study was to describe the epidemiological and clinical features of an outbreak due to Chryseobacterium meningosepticum. During a 11-day period, the outbreak was observed among four newborns in a neonatal intensive care unit (NICU) in a teaching hospital. All patients yielded C. meningosepticum in their blood cultures, in addition one was colonised in the throat. Antimicrobial susceptibility assay showed complete resistance to penicillins, cephalosporins, aminoglycosides, imipenem, aztreonam, and tetracycline, sensitivity to ciprofloxacin and trimethoprim-sulfamethoxazole. All patients were empirically treated with amikacin and meropenem. The neonate who was the first to develop sepsis died before the culture result. When C. meningosepticum was identified, antimicrobial therapy was changed to a combination of ciprofloxacin, rifampicin and vancomycin, and three neonates were treated successfully. Environmental screening recovered C. meningosepticum from two venous catheter lines and one nutritional solution that was opened by health care staff and used for two neonates. Arbitrary primed polymerase chain reaction and antibiogram typing indicated that all isolates were epidemiologically related. This study demonstrates that rapid selection of appropriate antibiotics is critical for clinical cure and standard precautions should be reconsidered to limit the spread of this bacterium on the NICU in our hospital.
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    Detection and typing of extended-spectrum ?-lactamases in clinical isolates of the family Enterobacteriaceae in a medical center in Turkey
    (Mary Ann Liebert, Inc, 2001) Durmaz, R; Durmaz, B; Koroglu, M; Tekerekoglu, MS
    To determine and type the extended-spectrum beta -lactamases (ESBLs) among the family Enterobacteriaceae in a medical center, a total of 668 clinical isolates were screened. Of the 668 isolates, the 80 strains were presumptively defined as ESBL producers according to the result of disk method using ESBL marker antibiotics (aztreonam, ceftazidime, and cefoxitin). These 80 strains were retested with the double-disk synergy test (DDST), the E-test ESBL strip, a 5-mug ceftazidime disk, and agar dilution MICs of ceftazidime with and without clavulonic acid. Isoelectric focusing was performed to confirm ESBL production and type the beta -lactamases. By evaluation of the results of all tests used for ESBL detection together with isoelectric focusing, 33 (4.9%) of the 668 isolates were described as ESBL producer. The positive results of the agar dilution test, DDST, the E-test strip, and 5-mug ceftazidime disk were 32, 26, 27, and 26 of the 33 strains, respectively. ESBL positivity was 48.8% in Klebsiella species, 15.4% in Citrobacter species, 4.9% in Enterobacter species and 1.1% in Escherichia coli strains. The ESBL enzymes frequently determined were SHV-2/6-like (pI 7.6), SHV-5-like (pI 8.2), SHV-4-like (pI 7.8), and SHV-3-like (pI 7). SHV-derived enzymes were commonly observed in Klebsiella spp whereas TEM-related enzymes were seen in E. coli strains. The results of this study indicated that SHV-2/6-derived (pI 7.6) ESBL expression among the isolates of the family Enterobacteriaceae is an important problem in our medical center.
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    Epidemiologic and clinical clinical features of a sepsis caused by methicillin-resistant Staphylococcus epidermidis (MRSE) in a pediatric intensive care unit
    (Mosby-Elsevier, 2004) Tekerekoglu, MS; Durmaz, R; Ay, S; Çiçek, A; Kutlu, O
    [Abstract Not Available]
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    Immunological response to primary and secondary measles vaccination among school-age children in Malatya, Turkey
    (Oxford Univ Press, 1998) Durmaz, R; Yakinci, C; Köroglu, M; Tekerekoglu, MS
    [Abstract Not Available]
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    Nasal carriage of methicillin-resistant Staphylococcus aureus among smokers and cigarette factory workers
    (Luigi Ponzio E Figlio, 2001) Durmaz, R; Tekerekoglu, MS; Kalcioglu, T; Özturan, O
    Effects of smoking and tobacco on nasal carriage and colonisation rates of Staphylococcus aureus were investigated on 368 healthy males aged between 30 and 40 years old. The study group comprised 100 non-smokers (control group), 91 smokers, and 177 cigarette factory workers (42 smokers, 135 non-smokers). Quantitative cultures were done from the nasal swabs of all participants. After identification and determination of colony counts, S. aureus strains were tested for methicillin resistance using the oxacillin disk diffusion method. The rates of nasal carriage of S. aureus were found to be 30% in the control group, 33% in smokers, and 41% in cigarette factory workers. Overall, S. aureus colonisation (greater than or equal to 500 cfu/ml) was detected in 72% of the carriers (55/76). Colonisation rates were 43%, 63%, and 85% in the carriers of the study groups, respectively. An increasing colonisation rate was detected in accordance with the increasing number of cigarettes smoked per day, and smoking period. While methicillin-resistant Staphylococcus aureus was only found in 3% of the 30 S. aureus strains isolated from the control group, its isolation rate was 20% in the 30 S. aureus isolates of the smokers, and 33% in the 72 S, aureus isolates of the cigarette factory workers. These results indicate that cigarette and/or tobacco appear to have noticeable effects on the ecology of the nose.