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Öğe Assessment of methicillin and clindamycin resistance patterns in staphylococcus aureus isolated from a tertiary hospital in Turkey(2013) Tekin A.; Dal T.; Deveci O.; Tekin R.; Atmaca S.; Dayan S.In order to detect the methicillin susceptibility and determine the prevalence of constitutive and inducible clindamycin resistance in Staphylococcus aureus strains, a total of 254 S. aureus isolates, including 139 (54.7%) methicillin-sensitive and 115 (45.3%) methicillin-resistant, were tested for clindamycin and erythromycin by Kirby-Bauer's disk diffusion method. The disk diffusion induction test or D-test was performed on erythromycin-resistant and clindamycin-sensitive strains using the disk diffusion method. The erythromycin-resistant and clindamycin-sensitive strains with a D-shaped zone around the clindamycin disk were considered positive for inducible clindamycin resistance. If a strain was found to be both erythromycin-resistant and clindamycin-resistant, it was considered to have constitutive clindamycin resistance. Overall, ten (3.9%) strains, including two methicillin-resistant S. aureus and eight methicillin-sensitive S. aureus, were found to be erythromycin-resistant and clindamycin-sensitive according to the disk diffusion method and all of these strains showed inducible clindamycin resistance by the D-test method. Constitutive clindamycin resistance was detected in 100 of all MRSA strains. In conclusion, the presence of inducible clindamycin-resistant strains may lead to clindamycin treatment failure in patients with S. aureus infection. The D-test method should be used for antimicrobial susceptibility testing of clindamycin.Öğe Assessment of the laboratory transmission of brucellosis in an endemic region(Acta Medica Mediterranea, 2014) Deveci O.; Tekin R.; Aslan E.; Hosoglu S.; Bozkurt F.; Dayan S.; Demirpence O.Objectives: Laboratory-acquired brucellosis (LB) has been one of the most commonly reported laboratory-associated bacterial infections in both endemic and non-endemic countries. Brucellosis is endemic in Turkey. The aim of this study is to describe the risk factors of LB among laboratory healthcare workers. Material and method: A regional survey study was conducted by face-to-face interview in 7 hospitals from Diyarbakir, Mardin and Batman province, in southeaster Anatolia in Turkey. A structured survey questionnaire was administered to the Laboratory healthcare workers, employed in infectious diseases clinics and microbiology departments, who were at risk of Brucella infection. Result: Of the 136 laboratory workers, 13 (9.5%) had a history of laboratory-acquired brucellosis. Logistic regression analysis identified factors independently associated with an increased risk of LB including lack of biosafety cabinet (P<0.005) and a lack of compliance in the use of the same (P<0.005). Using a biosafety cabinet (P<0.005), existence of biosafety cabinet (P<0.005), full adherence to glove use (P<0.005) and male gender(P<0.005) were found to be protective factors. Conclusion: Increased adherence to personal protective equipment and use of biosafety cabinets should be priority targets to prevent LB.Öğe Carbapenem resistance in Acinetobacter baumannii: Where is it heading?(2013) Deveci O.; Dal T.; Tekin R.; Bozkurt F.; Tekin A.; Dayan S.In the context of the substantial increase in antibiotic resistance rates of Acinetobacter baumannii, we aimed to evaluate the susceptibility rate changes of A. baumannii strains for carbapenems. A. baumannii strains isolated from patients diagnosed with healthcare-associated infections between 2007-2010 were included. A total of 127 A. baumannii strains [53 (42%) from the intensive care unit and 74 (58%) from the non-intensive care unit] were isolated. Conventional methods and an automated microbiology system were used for identification. Susceptibility testing was studied by Kirby-Bauer disk diffusion method. In 2007, five of 26 strains, in 2008, 18 of 31, in 2009, 10 of 35, in 2010, and 20 of 35 were obtained from intensive care unit patients. The susceptibility rate for imipenem was 50% in 2007 but 20% in 2010, while for meropenem it was 55% in 2007 but 12% in 2010. Prevention and control of antibiotic resistance among Acinetobacter species needs antibiotic usage restrictions and infection control precautions.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 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 In vitro antimicrobial susceptibility pattern among stenotrophomonas maltophilia strains isolated from clinical specimens(Duzce University Medical School, 2014) Tekin A.; Dal T.; Tekin R.; Deveci Ö.; Demirkaya S.; Mete M.; Dayan S.Aim: In this study, the determination of in vitro antimicrobial susceptibility rates among Stenotrophomonas maltophilia strains isolated from clinical specimens was aimed. Method: A total of 60 S. maltophilia strains isolated from various clinical specimens sent to Dicle University Hospital clinical microbiology laboratory between January 2006 and September 2011 were included retrospectively in this study. Urine samples were inoculated onto 5% sheep blood agar and Eosin-Methylene Blue (EMB) agar media, quantitatively; other clinical samples were inoculated, qualitatively. Identification of S. maltophilia isolates was performed by conventional methods and fully automated microbiology system. Antimicrobial susceptibility tests were performed by Kirby-Bauer’s disk diffusion method and by broth dilution. Results: A total of 60 S. maltophilia strains isolated from clinical specimens as 24 urine, 15 blood, 11 sputum, four synovial fluids, three cerebrospinal fluids, two wound swabs and one middle ear materials. The resistance rates against antibiotics were detected as 85% (n=51) for piperacillin-tazobactam, 75% (n=45) for levofloxacin, 73% (n=44) for ciprofloxacin, 57% (n=34) for trimethoprim-sulfamethoxazole, 5% (n=3) for meropenem and imipenem, and 0% (n=0) for amikacin. Conclusion: In this study, it was detected that piperacillin-tazobactam can be used as an alternative option other than trimethoprim-sulfamethoxazole, for the treatment of infections due to S. maltophilia at least in our region. © 2012 Düzce Medical Journal.Öğe Non-invasive parameters in the assessment of liver fibrosis(Scientific Publishers of India, 2017) Dayan S.; Dal T.; Tekin R.; Deveci O.; Ipek D.; Ozcan N.; Bozkurt F.Liver biopsy and histopathological evaluation are the main methods to assess liver pathology. However, liver biopsy is not widely used due to implementation challenge. We aimed to investigate non-invasive parameters for evaluation of liver fibrosis in chronic Hepatitis B patients. A total of 65 patients who admitted to outpatient clinic and diagnosed as chronic hepatitis were included in this study. Liver puncture biopsy was performed for all patients and was evaluated according to the Modified Ishak Fibrosis Score. The patients without fibrosis or with mild and moderate fibrosis were evaluated as Group I (Stage O, I, II), the patients with advanced fibrosis were evaluated as Group II (stage III, IV, V, VI). Among 65 patients, 42 were male and 23 were female; 48 of the patients were in group I while 17 patients belonged to group II. Gamma-Glutamyl Transferase (GGT), Alkaline Phosphatase (ALP), Aspartat Transaminaz (AST) and Alanin Aminotransferaz (ALT) levels were significantly higher in Group II patients. In the assessment of liver fibrosis, liver biopsy remains the gold standard diagnostic method but AST, ALT, GGT, ALP parameters have contribution to this evaluation. Non-invasive testing may be useful in cases which biopsy cannot be performed or repeat biopsy required. © 2017, Scientific Publishers of India. All rights reserved.Öğe Risk factors for central venous catheter-related bloodstream infections(EDIMES Edizioni Medico Scientifiche, 2019) Bekçibaşi M.; Dayan S.; Aslan E.; Kortak M.Z.; Hoşoğlu S.Our study aimed to identify the risk factors playing a role in central venous catheter-related bloodstream infections (CR-BSI) in a tertiary large volume university hospital. The current prospective clinical trial was conducted in a university hospital with 1400 beds. All demographic data, length of hospital stay, coexisting diseases, features of catheters used, invasive diagnostic and therapeutic procedures and all antibiotics used in patients with CVCs were recorded. A total of 356 CVCs inserted in 281 patients were followed up for 5667 catheter days. The mean duration of catheterization was recorded as 15.9±12.7days. CR-BSI was detected in 46 (12.9%) patients. The incidence of CR-BSI was found to be 8.12 in 1000 catheter days. Advanced age and longer duration of catheterization were found to be independent risk factors for the development of CR-BSI in multivariate analysis. Coagulase-negative staphylococci (15.2%), Candida spp (13%) and Klebsiella pneumoniae (13%) were the agents most frequently isolated. © 2019, EDIMES Edizioni Medico Scientifiche. All rights reserved.
