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Öğe Anti-HAV IgG seropositivity in children aged between 2-16 years who were admitted to Turgut Ozal Medical Center(Aves, 2006) Ozen, Metehan; Yologlu, Saim; Isik, Yuksel; Tekerekoglu, Mehmet SaitObjective: We aimed to determine the seropositivity of hepatitis A infection in patients aged between 2-16 years who were admitted to the Department of Pediatrics of a university hospital in Eastern Anatolia. Material and Method: We studied 685 subjects, aged between 2-16 years, who were admitted to our Department between 2004 January and 2005 July. We used chi(2) test to evaluate serological results. Results: There is statistically significant increase of hepatitis A seropositivity in subjects attending school when compared with subjects before primary school (chi(2): 18,46, p< 0,00001). There is no significant difference of serological results between subjects of rural and urban origin (.2: 0,82, p= 0,365). Conclusions: Age of exposure to hepatitis A infection for children is increasing towards puberty. Hepatitis A vaccination should be recommended for susceptible children before attending primary school.Öğe Association of Helicobacter pylori infection with systemic inflammation in preeclampsia(Taylor & Francis Ltd, 2010) Ustun, Yusuf; Engin-Ustun, Yaprak; Ozkaplan, Esra; Otlu, Baris; Tekerekoglu, Mehmet SaitMethods. Forty patients with preeclampsia and 40 normotensive pregnant women of similar age and body mass index at the third trimester of gestation were selected for the study. Chlamydia pneumonia IgM and IgGs, Helicobacter pylori IgAs and concentrations of CRP and TNF-alpha were measured. Results. Concentrations of CRP and TNF-alpha were significantly higher in patients with preeclampsia than in control subjects. In the preeclamptic group, positivity rate for Helicobacter pylori IgA was significantly higher as compared to controls (p = 0.034). CRP and TNF-alpha levels were higher in Helicobacter pylori seropositive subjects. Conclusion. We demonstrated high levels of serum CRP and TNF-alpha in preeclamptic women who were seropositive to Helicobacter pylori in comparison with those in seronegative subjects.Öğe Comparison of an automated system with four phenotypic methods for the detection of methicillin-resistant Staphylococcus aureus(Academic Journals, 2012) Iraz, Meryem; Tekerekoglu, Mehmet Sait; Otlu, Baris; Ay, SelmaCorrect and rapid detection of methicillin resistance in Staphylococcus aureus is very important for treatment of infected patients. Detection of the mecA gene or PBP2a by polymerase chain reaction (PCR) is considered the gold standard for determination of methicillin resistance in staphylococci. In most clinical laboratories, phenotypic methods are used for the detection of methicillin resistance in S. aureus because PCR is not suitable for routine usage. In this study, we aimed to compare different phenotypic methods: disk diffusion, agar screening, latex agglutination and an automated system employed to establish the presence of methicillin-resistant S. aureus (MRSA). Presence of the mecA gene via PCR was used as the marker for MRSA positivity. Afterward, 214 samples were analyzed for methicillin resistance via oxacillin or cefoxitin disk diffusions, oxacillin agar screening, MRSA latex agglutination and the automated BD Phoenix system. Sensitivity, specificity, negative and positive predictive values of these phenotypic methods were evaluated. In the detection of MRSA, the cefoxitin disk-diffusion method was found to be more useful than oxacillin disk diffusion. The automated MRSA strain-detection system was found to be more successful than the other phenotypic methods. These results showed that the automated system could be used safely for routine MRSA detection.Öğe Do mobile phones of patients, companions and visitors carry multidrug-resistant hospital pathogens?(Mosby-Elsevier, 2011) Tekerekoglu, Mehmet Sait; Duman, Yucel; Serindag, Ayfer; Cuglan, Serpil Semiha; Kaysadu, Halim; Tunc, Emine; Yakupogullari, YusufA cross-sectional study was conducted to determine bacterial colonization on the mobile phones (MPs) used by patients, patients' companions, visitors, and health care workers (HCWs). Significantly higher rates of pathogens (39.6% vs 20.6%, respectively; P = .02) were found in MPs of patients' (n = 48) versus the HCWs' (n = 12). There were also more multidrug pathogens in the patents' MPs including methicillin-resistant Staphylococcus aureus, extended-spectrum beta-lactamase-producing Escherichia coli, and Klebsiella spp, high-level aminoglycoside-resistant Enterococcus spp, and carabepenem-resistant Acinetobacter baumanii. Our findings suggest that mobile phones of patients, patients' companions, and visitors represent higher risk for nosocomial pathogen colonization than those of HCWs. Specific infection control measures may be required for this threat.Öğe The Effects of Colistin on Imipenem MICs in OXA-48 Producing Klebsiella pneumoniae Isolates: An In Vitro Study(Galenos Publ House, 2021) Duman, Yucel; Tekerekoglu, Mehmet Sait; Kuzucu, Cigdem; Yakupogullari, YusufIntroduction: A new approach to carbapenem resistance-K. pneumoniae infections is to use combination drug therapies. However, little data are available about the effectiveness of the in vitro carbapenem plus colistin combination against oxacillinase-48 (OXA-48) producing K. pneumoniae. Therefore, the aim of this study is to assess the potential synergistic activity of imipenem plus colistin in OXA-48-producing K. pneumoniae strains and investigate the changes in the imipenem minimal inhibitory concentrations (MICs) to varying MICs of colistin. Materials and Methods: Carbapenem and colistin resistance (CoIR) genes were investigated by polymerase chain reaction. In the first stage, synergistic properties were determined by the checkerboard combination method. In the second step, at varying colistin concentrations, changes in the imipenem MICs were investigated. Results: Colistin MIC50 2 mu g/ml, MIC90 16 mu g/ml, and imipenem MIC50 32 mu g/ml, MIC90 128 mu g/ml were found, respectively. According to the fractional inhibitor concentration (FIC) formula, 62.2% of the isolates were synergistic, and 37.8% were indifference. When the colistin was fixed at 0.125 mu g/ml, 0.25 mu g/ml, 0.5 mu g/ml, 1 mu g/ml, and 2 mu g/ml, respectively. Significant decreases were observed in the imipenem Mies, especially of colistin-sensitive isolates. However, imipenem MICs of CoIR isolates did not decrease to susceptible levels. Conclusion: This information will facilitate the design of antibiotic regimens that are more suitable for treating infections due to such pathogens producing OXA-48 and prolong these antibiotics' efficacy. Further in vitro research is required to determine which treatment combination is best and its optimal use as combination therapy to treat these infections.Öğe Evaluation of the Diagnostic Performance of Xpert MTB/RIF Test for the Detection of Mycobacterium tuberculosis and Rifampin Resistance in Clinical Samples(Ankara mıcrobıology soc, hacetlepe unıv faculty medıcıne dept mıcrobıology, 06100 ankara, turkey, 2016) Gursoy, Nafia Canan; Yakupogullari, Yusuf; Tekerekoglu, Mehmet Sait; Otlu, BarisRapid and accurate detection of active tuberculosis (TB) cases is one of the most important goal of tuberculosis control programme. For this purpose, new methods are being developed to isolate, serotype and determine the drug resistance of the agent. Xpert MTB/RIF test (CepheidGeneXpert (R) System, USA) that has been recently developed, is a real-time polymerase chain reaction-based method which detects Mycobacterium tuberculosis complex and resistance of the strain to rifampicin (RIF) from the clinical sample directly within a couple of hours. However, there are not sufficient data about the performance of that test for extrapulmonary samples and pulmonary samples other than sputum. The aims of this study were to investigate the sensitivity, specificity, positive and negative predictive values of Xpert MTB/RIF test in detection of M. tuberculosis and the performance in the determination of rifampicin resistance of the isolates from pulmonary and extrapulmonary clinical samples. A total of 2160 clinical samples, in which 1141 (52.8%) were pulmonary and 1019 (47.2%) were extrapulmonary samples, sent to our laboratory between July 2013 to December 2014, were included in the study. Sixty seven of the evaluated samples (3.1%) were positive with microscopy (acid-fast stain; AFS), 116 samples (5.1%) were positive with culture and 98 samples (4.5%) were positive with Xpert MTB/RIF test. When the culture was considered as the reference method, the sensitivity and specificity of Xpert MTB/RIF test were determined as 73.3% and 99.3%, respectively for all samples; 77.5% and 99.5%, respectively for pulmonary samples and 63.9% and 99.2%, respectively for extrapulmonary samples. Among AFS positive samples, the sensitivity was 100% and specificity was 66.7%; whereas among AFS negative samples those values were 40.4% and 99.4%, respectively. Among all the samples involved in the study, RIF resistance was determined only in three samples with Xpert MTB/RIF test and that was also proved phenotypically (100% concordance). According to mycobacterial culture results, positive and negative predictive values of Xpert MTB/RIF test were determined as 86.7% and 98.5%, respectively for all samples. Those were determined as 92.5% and 98.3%, respectively for extrapulmonary samples and were determined as 74.2 and 98.7%, respectively for pulmonary samples. According to the results obtained in our study, sensitivity of Xpert MTB/RIF test for extrapulmonary samples was found to be at moderate level; sensitivity of the test was found to be decreased especially in AFS negative samples with less bacilli load. Nonetheless, specificity of Xpert MTB/RIF test to the agent in all samples was found to be extremely high. In our study, although RIF-resistant strains were detected in few of the samples, Xpert MTB/RIF test could differentiate all resistant and sensitive strains. Additionally, detection of M. tuberculosis and RIF resistance in our laboratory takes approximately 20.96 days with culture, this period decreases to a couple of hours with Xpert MTB/RIF test. Because of the advantages such as being practical, rapid and requiring minimal safety measures, it was concluded that Xpert MTB/RIF test may contribute to rapid diagnosis of TB also in extrapulmonary samples, with the confirmation of culture method.Öğe Evaluation of the Diagnostic Performance of Xpert MTB/RIF Test for the Detection of Mycobacterium tuberculosis and Rifampin Resistance in Clinical Samples(Ankara Microbiology Soc, 2016) Gursoy, Nafia Canan; Yakupogullari, Yusuf; Tekerekoglu, Mehmet Sait; Otlu, BarisRapid and accurate detection of active tuberculosis (TB) cases is one of the most important goal of tuberculosis control programme. For this purpose, new methods are being developed to isolate, serotype and determine the drug resistance of the agent. Xpert MTB/RIF test (CepheidGeneXpert (R) System, USA) that has been recently developed, is a real-time polymerase chain reaction-based method which detects Mycobacterium tuberculosis complex and resistance of the strain to rifampicin (RIF) from the clinical sample directly within a couple of hours. However, there are not sufficient data about the performance of that test for extrapulmonary samples and pulmonary samples other than sputum. The aims of this study were to investigate the sensitivity, specificity, positive and negative predictive values of Xpert MTB/RIF test in detection of M. tuberculosis and the performance in the determination of rifampicin resistance of the isolates from pulmonary and extrapulmonary clinical samples. A total of 2160 clinical samples, in which 1141 (52.8%) were pulmonary and 1019 (47.2%) were extrapulmonary samples, sent to our laboratory between July 2013 to December 2014, were included in the study. Sixty seven of the evaluated samples (3.1%) were positive with microscopy (acid-fast stain; AFS), 116 samples (5.1%) were positive with culture and 98 samples (4.5%) were positive with Xpert MTB/RIF test. When the culture was considered as the reference method, the sensitivity and specificity of Xpert MTB/RIF test were determined as 73.3% and 99.3%, respectively for all samples; 77.5% and 99.5%, respectively for pulmonary samples and 63.9% and 99.2%, respectively for extrapulmonary samples. Among AFS positive samples, the sensitivity was 100% and specificity was 66.7%; whereas among AFS negative samples those values were 40.4% and 99.4%, respectively. Among all the samples involved in the study, RIF resistance was determined only in three samples with Xpert MTB/RIF test and that was also proved phenotypically (100% concordance). According to mycobacterial culture results, positive and negative predictive values of Xpert MTB/RIF test were determined as 86.7% and 98.5%, respectively for all samples. Those were determined as 92.5% and 98.3%, respectively for extrapulmonary samples and were determined as 74.2 and 98.7%, respectively for pulmonary samples. According to the results obtained in our study, sensitivity of Xpert MTB/RIF test for extrapulmonary samples was found to be at moderate level; sensitivity of the test was found to be decreased especially in AFS negative samples with less bacilli load. Nonetheless, specificity of Xpert MTB/RIF test to the agent in all samples was found to be extremely high. In our study, although RIF-resistant strains were detected in few of the samples, Xpert MTB/RIF test could differentiate all resistant and sensitive strains. Additionally, detection of M. tuberculosis and RIF resistance in our laboratory takes approximately 20.96 days with culture, this period decreases to a couple of hours with Xpert MTB/RIF test. Because of the advantages such as being practical, rapid and requiring minimal safety measures, it was concluded that Xpert MTB/RIF test may contribute to rapid diagnosis of TB also in extrapulmonary samples, with the confirmation of culture method.Öğe INVESTIGATION OF HYDROPHOBIC CHARACTERISTICS OF BIOFILM PRODUCER AND NON-PRODUCER STAPHYLOCOCCUS AUREUS CLINICAL ISOLATES(Ankara Microbiology Soc, 2010) Ay, Selma; Guldur, Tayfun; Tekerekoglu, Mehmet Sait; Otlu, BarisThe ability of staphylococcus to adhere certain structures and to form biofilm (slime) layer plays an important role in the pathogenesis of staphylococcal infections. Hydrophobic interactions and hydrogen bonds are important factors that play role in adherence This study was designed to compare the hydrophobic properties of slime positive and negative Staphylococcus aureus strains isolated from blood cultures. Ten methicillin-resistant S.aureus isolates (five of them being slime positive) obtained from blood cultures of patients at intensive care unit of a university hospital, between May 2006 and June 2007, were included in the study. Slime production of the isolates was determined by Christensen's method. Methicillin resistance was determined by cefoxitin disc test and oxacillin salt agar test It was determined that the test strains did not exhibit any autoaggregation The adherence of strains to the three different hydrocarbons as solid phases (butyl-sepharose, octyl-sepharose and phenyl-sepharose; Amersham Bioscience, Sweden) were studied by using hydrophobic interaction chromatography (HIC) method After butyl- and octyl-sepharose chromatography, it was determined that slime negative S aureus strains were separated into three fractions eluted with phosphate buffered saline (PBS), 40% and 96% ethanol, while slime positive strains were separated into two fractions eluted with 40% and 96% ethanol, respectively. By phenyl-sepharose chromatography analysis, both slime negative and positive strains were separated into two fractions eluted in 40% and 96% ethanol. Hydrophobicity tests were repeated at 4 C and pH 6-9 to evaluate the effect of changing conditions on hydrophobicity However, no changes were observed at these temperature and pH values. According to these analysis it was concluded that; (a) S aureus strains consist heterogeneous fractions with distinct hydrophobic binding strengths, (b) hydrophobic surface protein secretion may be different in heterogeneous groups, and (c) slime positive S aureus strains were more hydrophobic than non-slime producing strains Further research is required in order to characterise the eluted fractions and to evaluate their pathogenic capacities.Öğe Investigation of the Presence of Panton-Valentine Leukocidin and Clonal Relationship of Community- and Hospital-Acquired Clinical Isolates of Staphylococcus aureus(Ankara Microbiology Soc, 2013) Duman, Yucel; Tekerekoglu, Mehmet Sait; Otlu, BarisStaphylococcus aureus is one of the most important pathogens that cause community- and hospitalacquired infections by its toxins and enzymes. Panton-Valentine leukocidin (PVL), a cytotoxin which is especially produced by community-acquired S.aureus strains that cause soft tissue and skin infections and pneumonia. PVL leads to the destruction on polymorphonuclear cells by necrosis or induce apoptosis, so that it has great importance in the virulence of the organism. PVL can also exacerbate the clinical course of S.aureus infections and may lead to severe complications. Studies show that communityacquired PVL-positive S.aureus strains have become prevalent in hospital environments. In this study, we aimed to investigate the presence of PVL from hospital- and community-acquired S.aureus strains and to determine the clonal relationship between the PVL-positive strains. A total of 265 S.aureus strains isolated from different clinical samples (wound, blood, tracheal aspirate, urine, drainaige, catheter, parasynthesis fluid) of which 88 were community-acquired and 177 were hospital-acquired according to the CDC criteria were included in the study. Methicillin resistance of the strains were investigated by conventional methods, the presence of PVL and mecA gene regions by polymerase chain reaction, and clonal relationship among the PVL positive S.aureus strains by pulsed-field gel electrophoresis (PFGE). Community-acquired 12.5% (11/88) and hospital-acquired 43% (76/177) of the strains were found resistant to methicillin. Community-acquired (CA) strains were most commonly isolated from wound samples (86%), while 34% of hospital-acquired (HA) strains were isolated from wound, and 33% were from blood samples. The rate of PVL positivity among CA- and HA-strains were found as 15% and 3%, respectively. Hospital-acquired PVL-positive strains were isolated from the samples originating from pediatric (n= 1) and neurology inpatient clinics and intensive care unit (n= 3). Thirty nine percent of PVL-positive CAS.aureus strains were isolated from samples originated from internal medicine, 23% from general surgery, 15% from dermatology, 15% from orthopedic surgery and 8% from pediatrics outpatient clinics. Ninety two percent of PVL-positive CA-S.aureus strains have been isolated from wound samples, while 67% of HA-S.aureus strains from wound and 33% from blood samples. Five PVL-positive HA- methicillin-sensitive S.aureus strains were found clonally-related with each other by PFGE. When the macrorestriction patterns were evaluated according to Tenover criteria; three of those isolates were indistinguishable, and two were clonally unrelated. There was no clonal relationship between community-acquired strains. In conclusion we observed that PVL could be detected not only in community-acquired strains but also in hospital-acquired strains. The spread of PVL-positive strains in the hospital environment and even create epidemics, increases the risk of mortality and morbidity. Epidemiological studies will help us to understand the clonal spread of CA and HA-S.aureus strains.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 Laboratory-acquired skin infections in a clinical microbiologist: Is wearing only gloves really safe?(Mosby-Elsevier, 2016) Duman, Yucel; Yakupogullari, Yusuf; Otlu, Baris; Tekerekoglu, Mehmet SaitLaboratory-acquired infection is one of the leading occupational health hazards. On a laboratory worker's hands, carbuncles occurred. Staphylococcus aureus was isolated from pus samples of the carbuncles, with the same pulsed field gel electrophoresis band pattern with one of the recently studied strains in the laboratory. Incorrect or inadequate application of infection control measures may result in pathogen acquisition from the clinical samples, and wearing only gloves is not sufficient for the biosafety of laboratory workers in clinical diagnostic laboratories. (C) 2016 Published by Elsevier Inc. on behalf of Association for Professionals in Infection Control and Epidemiology, Inc.Öğe Molecular epidemiology of methicillin-resistant Staphylococcus aureus isolates from clinical specimens of patients with nosocomial infection(Edizioni Int Srl, 2007) Tekerekoglu, Mehmet Sait; Ay, Selma; Otlu, Baris; Cicek, Aysegul; Kayabas, Uener; Durmaz, RizaBacteriological and epidemiological studies were carried out on 90 isolates of methicillin-resistant Staphylococcus aureus (MRSA) at Turgut Ozal Medical Center of Inonu University, (Malatya/Turkey). MRSA isolates were obtained from patients with nosocomial infections. Staphylococcus aureus clinical isolates were collected between May 2004-May 2005. Isolates were tested for resistance to methicillin. Antimicrobial susceptibility testing and slime production evaluation was performed. Genotype studies were carried out by arbitrarily primed polymerase chain reaction (APPCR) and consequent cluster analysis. All of the isolates were mecA-positive in a PCR-based assay; all exhibited resistance to oxacillin, by agar dilution (MICs >= 4mg/L) and disc diffusion methods, and multiple antibiotics. Most MRSA isolates were collected in intensive care units. Of 90 samples, 53 were found to be unrelated to the others while the remaining 37 strains were either identical or closely related, Dendrogram analysis identified nine major clusters. These data support the opinion that MRSA are significant nosocomial pathogens in intensive care units and that resistant clones may be transmitted between patients. Molecular epidemiological tools are helpful for understanding transmission patterns and sources of infection, and are useful for measuring outcomes of intervention strategies implemented to reduce nosocomial MRSA.Öğe Mycobacterıum Tuberculosıs İn Laboratuvar Tanısı(Turgut Özal Tıp Merkezi Dergisi, 2000) Tekerekoglu, Mehmet Sait; Durmaz, Rıza; Özerol, İ.HalilTüberküloz basilinin kısa sürede tanımlanması, Haç direncinin saptanması ve infeksiyon kaynağının belirlenmesi etkin bir tedavi için çok önemlidir. Bu nedenle klasik laboratuvar tam metodları yanında hızlı sonuç veren, duyarlılığı ve özgüllüğü yüksek, kolay uygulanabilir yeni kültür yöntemleri ve molekül er biyoloji teknikleri geliştirilmiştir.Öğe 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 SaitObjective(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.Öğe Yoğun Bakım Ünitelerinde İzole Edilen Acinetobacter Baumannii İzolatlarının Kolistin MİK Değerlerinin ve Direnç Genlerinin İrdelenmesi(2021) Duman, Yucel; Tekerekoglu, Mehmet SaitAmaç: Acinetobacter baumannii yoğun bakım ünitelerinde yatan hastalarda sağlık bakımı ilişkili enfeksiyonlara neden olan fırsatçı bir patojendir. A. baumannii farklı mekanizmalarla hızlı bir şekilde antimikrobiyallere karşı direnç geliştirebilmektedir. Çoklu ilaç dirençli (ÇİD) izolatlarının oluşturduğu enfeksiyonlar; morbidite ve mortalitesi yüksek, uzun süreli hospitalizasyon gerektiren enfeksiyonlardır. Kolistin, ÇİD A. baumannii izolatlarına karşı kullanılabilen son antimikrobiyallerden biridir. Bu izolatlarının artmasına bağlı olarak kolistin kullanımı tüm dünyada artmıştır. Çalışmamızda yoğun bakım ünitelerinde yatan hastaların kan kültürlerinden izole edilen ÇİD A. baumannii izolatlarında kolistin direnç oranlarının, minimum inhibitör konsantrasyon (MİK) değerlerinin ve kolistin direncine neden olan plazmid aracılı yayılım gösteren direnç genlerinin araştırılması amaçlanmıştır. Gereç ve Yöntem: Çalışmamıza Ocak 2017-Aralık 2018 tarihleri arasında laboratuvarımızda kan kültür örneklerinden izole edilen 97 A. baumannii izolatı alındı. İzolatların MİK değerleri Avrupa Antimikrobiyal Duyarlılık Testi Komitesi önerileri doğrultusunda broth mikrodilüsyon yöntemiyle araştırıldı. Polimeraz zincir reaksiyonu ile kolistin direnç gen bölgeleri mcr 1-5 çalışıldı. Bulgular: Çalışılan A. baumannii izolatlarının 8’i (%8,2) dirençli, 89’u (%91,8) duyarlı saptandı. Kolistin MİK50 değeri 0,5 µg/mL, MİK90 değeri 2 µg/mL olarak bulundu. Kolistin direncinin horizontal yayılım tehlikesi açısından araştırılan plazmid aracılı mcr gen bölgeleri (1-5 mcr genleri) belirlenemedi. Sonuç: Kolistin hastanemiz yoğun bakım ünitelerinde yatan hastaların, A. baumannii izolatlarına bağlı enfeksiyonlarının tedavisinde hala etkin olarak kullanılabilecek önemli bir antimikrobiyaldir. Ancak kolistine karşı direnç gelişimini önlemek için, irrasyonel antibiyotik kullanımı engellenerek antimikrobiyal duyarlılık testi sonuçlarına göre tedavi uygulanması gerekmektedir. Ayrıca dirençli izolatların hastanelerde kolonizasyonunun önlemesi için gerekli enfeksiyon kontrol önlemlerinin alınmasının önemli olduğu kanısındayız
