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Öğe Anti-tuberculosis drug resistance in southeast of turkey(Acta Medica Mediterranea, 2013) Dal T.; Özcan N.; Tekin R.; Tekin A.; Çelen M.K.; Özekinci T.Objective: Tuberculosis is a globally prevalent life-threatening infectious disease. In this study we aimed to evaluate antibiotic suscebtibility rates of Mycobacterium tuberculosis complex strains. Materials and methods: A total of 150 culture-positive samples were included in. Among culture positive samples 86 were Mycobacterium tuberculosis complex and 64 were non-tuberculous mycobacterium. Of Mycobacterium tuberculosis complex isolated samples 45 were Ziehl-Neelsen positive. Of 64 non-tuberculous mycobacterium isolated samples 15 were Ziehl-Neelsen positive. Mean age of the patients with tuberculosis was 37.74±20.53 and non-tuberculous mycobacterium isolated patients was 46.80±23.32. Antibiotic susceptibility testing was performed for the four first-line anti-tuberculosis drugs by BACTEC MGIT-960 instrument (Becton Dickinson). Of M. tuberculosis strains 41 % was resistant to at least one or more of the drugs (isoniasid 27.9%, ethambutol 8.13%, streptomycin 12.79 %, rifampicine 9.3 %). Of the strains 5.8 % was resistant to two, 3.4 % to three and 3.4 % to four drugs. Conclusion: Mycobacterium tuberculosis complex and drug resistance of this microorganism continued to be a problem for our country and non-tuberculous mycobacterium species may become a problem in the future. We thought that a strong and costeffective tuberculosis control programme contributes to reduce the incidence of drug resistance in the community.Öğe Brucellosis seroprevalence in southeast Turkey (Diyarbakir)(2004) Atmaca S.; Özekinci T.; Akpolat N.; Elçi S.; Suay A.; Arikan E.This study was conducted to determine brucellosis seropositivity in patients suspected of having brucellosis who sought treatment at the Central Laboratory of Dicle University Medical Faculty Hospital in southeast Turkey (Diyarbakir). 20,663 serum samples were collected during the study (1 August 2001-31 December 2002), and 14,480 sera were tested in a 12-month period on a seasonal basis by Rose-Bengal slide agglutination (RBSA), and positive sera were titrated by standard tube agglutination (STA). Titration values of 1/160 and above were considered positive. Of the 20663 sera, 463 (2.2%) tested positive on RBSA. Of these 463 sera, 267 (57.6%) tested positive on STA, with titers of 1/160 and higher. Seasonally, hospital attendance was highest in the summer and lowest in the winter. On STA tests done on RBSA-positive samples, the highest concentration of titers of 1/160+ was in the spring. In order to eliminate brucellosis in southeast Turkey, an endemic region for the disease, precautions must be increased, the unregulated slaughtering and consumption of animals must be prevented, and the consumption of raw, unpasteurized milk and of dairy products made from such milk must be halted.Öğe The distribution according to the species of Gram-negative bacteria isolated from hospitalized patients's urine specimens and their antimicrobial susceptibility(2012) Dal T.; Tekin A.; Tekin R.; Deveci O.; Can S.; Özekinci T.; Dayan S.Objective: In this retrospective study, we aimed to determine the distribution according to the species of Gram-negative bacteria in isolates obtained from urine cultures of hospitalized patients with urinary tract infections and to detect their antimicrobial susceptibility pattern for contribute to empirical treatment approach to urinary tract infections in our hospital. Methods: Between the dates of January 2006 and September 2011, a total of 3,548 Gram-negative isolates obtained from urine cultures of hospitalized patients with urinary tract infection were identified by conventional methods and the BD PhoenixTM 100 (Becton Dickinson, MD, USA) fully automated microbiology system. Antimicrobial susceptibility testing of isolates was performed by Kirby- Bauer's disk diffusion method according to the Clinical and Laboratory Standarts Institute (CLSI) criteria. In addition, extended-spectrum beta-lactamase (ESBL) production of predominant urinary pathogenic bacteria was detected by the double-disk synergy method. Results: In this study, a significantly higher incidence of urinary tract infection was observed in females compared with males; 2,245 (63.3%) and 1,303 (36.7%), respectively. Escherichia coli was the predominant pathogenic bacterium and accounted for 2,341 (65.8%) of 3,548 hospitalized patients with urinary tract infections. In addition, Klebsiella pneumoniae accounted for 679 (19.1%), Acinetobacter spp. for 177 (5%), Enterobacter spp. for 176 (5%), Pseudomonas aeruginosa for 142 (4%), and other Gram-negative bacteria for 38 (1.1%). Antimicrobial susceptibility rates of Gram-negative bacteria isolated from urine cultures for ceftazidime, trimethoprim-sulfamethoxazole, ciprofloxacin, piperacillin-tazobactam, cefoperazonesulbactam, amikacin, imipenem, meropenem were detected as 34.5%, 38%, 42%, 50%, 70%, 87%, 90%, and 92%, respectively. In addition, the rates of ESBLproducing Escherichia coli and Klebsiella pneumoniae were detected as 38% and 36%, respectively. Conclusion: The present study and the other studies show that in the near future it is possible our therapeutic options may become more limited than ever due to the development of high-level resistance against broad-spectrum antibiotics such as cephalosporins, carbapenems and fluoroquinolones. Due to the highlevel resistance to ceftazidime, ciprofloxacin and trimethoprim-sulfamethoxazole, we recommend that these antibiotics should not be used for the empirical treatment of urinary tract infections.Öğe Effect of EDTA on the Susceptibility of Pseudomonas aeruginosa to Imipenem, Ceftazidime and Cefepime in Mueller-Hinton Agar(2003) Akpolat N.; Özekinci T.; Aktar G.; Karaşahin Ö.; Suay A.[No abstract available]Öğe Effect of Mg+2 concentration in Mueller-Hinton agar on the susceptibility of pseudomonas aeruginosa to levofloxacin(2001) Akpolat N.; Özekinci T.; Atmaca S.[No abstract available]Öğe Evaluation of clinical and microbiological features of deep carious lesions in primary molars(2003) Ayna B.; Çelenk S.; Atakul F.; Sezgin B.; Özekinci T.Purpose: Concern about the survival of microorganisms in deep carious lesions may often lead to unnecessary exposure of the pulp during excavation. This study evaluated the relationship between microbiological and clinical results of deep carious lesions in primary molars. Methods: Clinical evaluation was performed on 72 deep carious lesions considered to have pulp perforation after traditional excavation. The dentin color and consistency were assessed by means of standardized scales using the technique of Bjorndal et al before restoration. For microbiological examination, dentin samples were taken by a sterile bur and transferred to transport fluid, then plated on tryptic soy agar for growth of total colony forming units. Samples were then transferred on Rogosa SL agar for growth of oral lactobacilli and on mitis salivarius agar for growth of mutans streptococci. Results: The proportion of mutans streptococci, lactobacilli, and total colony forming units increased when the dentin color and consistency increased. However, the proportion of lactobacilli was smaller than diat of mutans streptococci in carious dentin samples. Conclusions: Contrary to expectations, the findings showed that the number of bacteria in carious dentin of primary molars was not significantly excessive. (J Dent Child. 2003;70:15-18).Öğe Evaluation of the Ehrlich-Ziehl-Neelsen (EZN) and amplified Mycobacterium tuberculosis direct test according to the BACTEC method in respiratory and nonrespiratory samples(2007) Özekinci T.; Meşe S.; Atmaca S.; Akpolat N.; Gül K.Aim: Tuberculosis remains a significant and threatening disease, particularly in developing countries. Mycobacterium tuberculosis should be detected and identified as soon as possible to ensure the prevention of the spread of the disease. For this purpose, use of fast and reliable laboratory diagnostic methods with high sensitivity and specificity was initiated in recent years. Materials and Methods: In this study, 107 respiratory and 198 nonrespiratory (305 in total) samples submitted to Dicle University Faculty of Medicine Clinical Microbiology Laboratory were examined using the Ehrlich-Ziehl-Neelsen (EZN), BACTEC 460 TB (Becton and Dickinson Diagnostic Instrument System, Towson, MD), and MTD (Amplified Mycobacterium tuberculosis Direct Test, Gen-Probe, USA) methods. Results: In respiratory samples, sensitivity of EZN was found as 83.33%, specificity as 95.04%, positive predictive value as 50%, and negative predictive value as 98.96%, whereas in nonrespiratory samples these values were 18.18%, 98.39%, 40%, and 95.37%, respectively. In respiratory samples, sensitivity of MTD was found as 83.33%, specificity as 94.05%, positive predictive value as 45.45%, and negative predictive value as 98.95%, whereas in nonrespiratory samples these values were 54.54%, 88.23%, 21.42%, and 97.05%, respectively. Conclusions: In view of the above, the pre-diagnostic EZN test and the MTD method based on nucleic acid amplification should be applied together with the BACTEC 460 system, which is considered as a gold standard, and the evaluation should be made accordingly. Furthermore, MTD should not be used as a screening test due to its high cost, and should rather be preferred in smear-positive samples. © TÜBİTAK.Öğe Fusidic acid susceptibilities of methicillin-sensitive and methicillin-resistant staphylococcus aureus strains(2001) Atmaca S.; Özekinci T.; Özerdem N.In this study, the activity of fusidic acid to methicillin-sensitive and methicillin-resistant Staphylococcus aureus strains was investigated by disk diffusion method. For methicillin susceptibility testing, 1 ?g oxacillin disks were used, and of 103 S.aureus strains isolated from clinical samples (pus, urine, blood, throat, ear, sputum), 53 (51.4%) were found to be methicillin resistant whereas 48 (46.6%) were methicillin sensitive. Resistance to fusidic acid was detected in 10 (18.9%) of methicillin-resistant and in 2 (4.2%) of methicillin-sensitive S.aureus isolates.Öğe Hbsag, anti-HCV and anti-HIV seroprevalence among blood donors in southeastern anatolia, Turkey, 2011-2015(EDIMES Edizioni Medico Scientifiche, 2019) Dayan S.; Özekinci T.; Bekçibaşi M.; Deveci Ö.Transmission of infections through blood and blood product transfusion is a serious healthcare problem. There are insufficient up-to-date data about seroprevalence of HBsAg, anti-HCV and anti-HIV 1/2 among healthy blood donors in Turkey. We aimed to investigate the seroprevalence of HBsAg, anti-HCV and anti-HIV 1/2 in Southeastern Anatolia, Turkey. HBsAg, anti-HCV, and anti-HIV 1/2 analysis results among blood donors who applied to Dicle University Faculty of Medicine, Diyarbakir District Blood Centre, between January 1, 2011 and December 31, 2015 were retrospectively evaluated. HBsAg, anti-HCV, and anti-HIV 1/2 screenings were performed using a fully automated device with the microparticle enzyme immunoassay method (MEIA). The chi-square (?²) test was applied to variables. Among the donors, 1607 (1.73%) were HBsAg-positive, 255 (0.27%) were anti-HCV-positive and two (0.0021%) were positive for anti-HIV 1/2. HBsAg positivity rates by years were 2.50% in 2011, 1.92% in 2012, 1.74% in 2013, 1.53% in 2014 and 1.27% in 2015 (p<0.001). HBsAg-positivity was 0.78% for the donors between 18-24 years of age, 1.90% for those between 25-49 years of age and 3.92% for donors over the age of 49 (p<0.001). Anti-HCV positivity rates were as follows: 0.35% in 2011, 0.34% in 2012, 0.29% in 2013, 0.23% in 2014 and 0.16% in 2015 (p<0.001). Verified anti-HIV 1/2 positivity was observed for only two donors (0.0021%) within five years. HBsAg and anti-HCV positivity were observed to decrease significantly over the years and were significantly lower among younger donors. © 2019, EDIMES Edizioni Medico Scientifiche. All rights reserved.Öğe Investigation of autoantibody, anti-HCV and anti-HIV seropositivities in "anti-HBc alone" positive samples(2006) Meşe S.; Özekinci T.; Yilmaz Ş.; Atmaca S.; Arikan E."Anti-HBc alone" which is an unusual serologic pattern of hepatitis B virus (HBV) infections, may be detected in the seropositive samples for hepatitis C virus (HCV), human immunodeficiency virus (HIV) infections and in the presence of autoantibodies due to cross reactions. In this study, 20 serum samples with isolated antibody to hepatitis B core antigen, which were detected in May 2005, have been investigated by means of the presence of some autoantibodies (anti-nuclear antibody; ANA and rheumatoid factor; RF), anti-HCV and anti-HIV, in the Central Laboratory of Dicle University Medical School. All of the "anti-HBc alone" samples were negative for HBV-DNA by real-time polymerase chain reaction (PCR), and liver enzyme (ALT and AST) levels were normal except for three patients. As a result, a total of six (30%) samples were found positive. Four of them were positive for ANA and two were positive for anti-HCV, while one serum yielded positivity for both ANA and anti-HCV. Anti-HCV positive samples were searched for the presence of HCV-RNA by real-time PCR, and none were found positive. Of three patients with increased AST and ALT levels, one was anti-HCV positive, one was ANA positive, while the other was negative for all parameters. In conclusion, possible presence of autoantibodies and anti-HCV should be taken into consideration during the evaluation of isolated anti-HBc IgG positive test results.Öğe Lamivudine and Adefovir Motif Variants Detected in chronic Hepatitis B patients(2014) Özekinci T.; Mese S.; Ozbek E.; Atmaca S.Background and Aims: Chronic hepatitis B is an important health problem worldwide. Lamivudine, adefovir, entecavir and telbivudine are the oral drugs licensed for the treatment of patients with chronic hepatitis B. Implementation of antiviral therapy leads to the emergence of mutant strains during the treatment in chronic hepatitis B. Primary antiviral resistance may be rarely encountered. The aims of this study were to detect the resistance patterns of Hepatit B Virus strains in treatment-naive chronic hepatitis B patients Materials and Methods: A total of 147 CHB patients were included to this study which was carried on between January 2007-December 2010. HBV DNA levels were detected by using the Real time PCR (COBAS Ampli-Prep/COBAS TaqMan HBV Test). HBV-DNA was extracted from the sera of the patients by using extraction kit (Invisorb, Instant Spin DNA/RNA Virus Mini Kit, Germany). A line prob assay (Inno-Lipa HBV DR v2, Innogenetics N.V, Ghent, Belgium) was used to determine motif variants at viral polymerase gene fragment in HBVDNA samples of these patients and evaluated colorimetrically. Results. In 147 patients antiviral resistance rate was found 17% (25/147) for lamivudin, 5.44% (8/147) adefovir, 0.68%(1/147) lamivudin and adefovir. Various mutations were detected. This mutations; responsible for lamivudine resistance YMDD+YVDD (n=10), YMDD+YIDD (n=12), YIDD (n=2), YVDD (=1); responsible for adefovir resistance N236T (n=3), A181T (n=5); responsible for lamivudine and adefovir resistance YMDD+YIDD+N236T (n=1). Conclusions: As a conclusion, it is thought that drug resistance should be followed up regularly, the determination of HBV drug resistance as immediate as possible period may be instructive for the treatment and follow-up in CHB patients. Although determination of known mutations with Inno Lipa DR v2 method is disadvantage, because of ease of application and the determination of both lamivudinadefovir resistance in a short time, it can be used for the treatment and follow-up in CHB patients. © Societá Editrice Universo (SEU).Öğe Molecular typing of nosocomial enterococci by pulsed-field gel electrophoresis(Refik Saydam National Public Health Agency (RSNPHA), 2015) Güldemir D.; Karagöz A.; Dal T.; Tekin A.; Özekinci T.; Durmaz R.Objective: Enterococci are the second most common cause of nosocomial urinary tract and wound infections, also third most common cause of nosocomial bacteremia. Currently, especially vancomycin-resistant enterococci (VRE) are one of the significant pathogens that cause nosocomial infections and increase mortality, morbidity, and healthcare costs. Therefore prevention and control of the nosocomial VRE outbreaks and epidemiological analysis of the infection are important. Pulsed-Field Gel Electrophoresis (PFGE) is accepted as a "gold standard" method in the molecular epidemiological analysis of enterococcal infections. The aims of this study are to determine the clonal relationship among the nosocomial enterococcal isolates and the rate of cross-contamination between them. Method: Thirty-six Enterococcus strains isolated from hospitalized patients with nosocomial infection in different clinics of Dicle University Hospital between November 2010 and June 2012 were included in this study. A total of 36 isolates were obtained from various clinical samples including urine (n=18), blood (n=6), bronchoalveolar lavage (BAL) fluid (n=5), wound biopsy sample (n=5), vaginal smear (n=1) and catheter tip (n=1). Nine of the thirty-six isolates were VRE. Isolation and identification of the isolates were conducted in the bacteriology laboratories of Dicle University Medical Faculty, Department of Medical Microbiology. The conventional methods and BD PhoenixTM 100 (Becton Dickinson, MD, USA) fully automated microbiology system were used for the identification. Antimicrobial susceptibilities of enterococcal strains were determined by a fully automated microbiology system according to the Clinical and Laboratory Standards Institute (CLSI). In addition, vancomycin susceptibilities of the isolates were performed by E-test method. Staphylococcus aureus ATCC 25923 strain was used for quality control. PFGE was studied for determining of rate of cross-contamination. PFGE was performed in National Molecular Microbiology Referance Laboratory, Public Health Institution of Turkey (PHIT). DNA restriction fragments were obtained by cutting bacterial DNA with the SmaI enzyme. DNA restriction fragments were used by CHEF DR II (Bio-Rad Laboratories, Nazareth, Belgium) system. PFGE results were evaluated by Bionumerics software system (version 6.01; Applied Maths, Sint-Martens-Latem, Belgium). Results: DNA patterns of the isolates were obtained by PFGE, and dendrogram of DNA patterns were made. Comparison of DNA patterns obtained by PFGE showed that 26 E. faecium strains were divided into four different clusters and one major group, 10 E. faecalis strains were three clusters and one major group. Twenty-six Enterococcus faecium isolates were involved in a joint cluster (97% similarity). The cluster rate was found to be 77% (20/26), number of E. faecium strains in each cluster ranged from 2 to 14 strains. Conclusion: In this study, cross-contamination was highlighted among enterococcal strains causing nosocomial infections in Dicle University Hospital between November 2010 and June 2012. Our data revealed that more effective infection control programs should be implemented to prevent cross-transmission.Öğe Seroprevalence of hepatitis b and tetanus among ezidian (Yazidi) women fleeing war(Bulgarian Society for Microbiology (Union of Scientists in Bulgaria), 2018) Özcan N.; Bulut Z.K.; Evinç E.; Yiğitalp G.; Özekinci T.; Ceylan A.Women suffer much from wars and forced migrations. In 2014, Ezidians (Yazidis) living in Iraq migrated to Syria and then to Turkey due to civil war. Tetanus is a bacterial infection caused by Clostridium tetani spores getting into the body. Hepatitis B is an infection caused by the hepatitis B virus. Both hepatitis B and tetanus are vaccine-preventable diseases. We aimed to evaluate the seroprevalence of tetanus and hepatitis B among Yazidi women who had fled to our country and have been living in a tent city. This study was conducted in Diyarbakır province, located in Southeastern Turkey, between July 2015 and February 2016. A total of 245 Yazidi women aged between 15 and 49 years, living in a tent city, were included. HBsAg, anti-HBs and anti-HBcIgG were studied by ELISA method with Cobas e 601 (Roche Diagnostics, Switzerland) system autoanalyzer. Antibodies to tetanus toxin were tested by ELISA method with the Virotech ELISA tetanus (Virotech, Germany). Of the 245 women, 38 (15.5%) had vaccine-induced immunity, while 11 (4.5%) had antibodies against hepatitis B due to previous exposure. Two women (0.8%) had isolated anti-HBcIgG positivity. Among 245 women, 96 (39.2%) had anti-tetanus antibodies. This population was notably susceptible to both tetanus and hepatitis B. Vaccination of this sensitive population was important for the well-being of the women, their spouses and children to be born. © 2018, Bulgarian Society for Microbiology (Union of Scientists in Bulgaria). All rights reserved.Öğe Short communication: Evaluation of the correlation between hepatitis D virus (HDV) RNA positivity and HDV antibodies(2005) Özekinci T.; Atmaca S.; Akpolat N.; Temiz H.; Arikan E.The objective of this study was to evaluate the correlation between serum hepatitis D -delta- virus (HDV) RNA detection and anti-HDV IgG and IgM antibodies, in the serodiagnosis of delta hepatitis. A total of 153 HBsAg positive sera were screened for the presence of anti-HBc IgM, anti-HDV IgG and anti-HDV IgM by commercial enzyme immunoassays and HDV-RNA by real time polymerase chain reaction (PCR). Of 153 sera, 86 (56.2%) were found positive for HDV antibodies. Although isolated anti-HDV IgG was present in 35 and isolated anti-HDV IgM was present in 11 patients, IgG and IgM were present concurrently in 40 additional patients. HDV-RNA was detected in 21.5% (33/153) of the patients. Four of the 33 HDV-RNA positive patients were positive only for anti-HDV IgG, 8 were positive only for anti-HDV IgM, and 19 were positive for both anti-HDV IgG and IgM antibodies. Twenty seven of 51 (53%) anti-HDV IgM positive patients were also found positive for HDV-RNA, while 27 of 33 (82%) HDV-RNA positive patients exhibited anti-HDV IgM positivity. Increased serum ALT levels were detected approximately in 85% (28/33) of viremic patients. As all of the HDV-RNA positive patients were found negative for anti-HBc IgM, superinfection with delta virus were considered. In conclusion, PCR is a sensitive and useful method for the detection of viremic patients as well as for the monitorization of antiviral therapy, anti-HDV IgM positivity together with increased ALT levels appear to be good markers for the prediction of hepatitis delta viremia, especially in the countries with limited economical sources as Turkey.
