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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 A case of acute hemorrhagic cystitis caused by salmonella paratyphi a in a pediatric patient(2012) Yula E.; Deveci O.; Toka-Ozer T.; Tekin A.; Inci M.; Karakus A.It is a very rare medical condition that Urinary tract infection (UTI) caused by Salmonella species. Seven-year-old boy admitted to our hospital with complaint of lower abdominal pain, burning and pain during urination (dysuria), nausea and increased fever. The patient had normal vital signs but abdominal examination revealed bilateral suprapubic tenderness. In the laboratory, it was found the amount of hemoglobin 12.9 g/dL, red blood cell count 4.8 million/mm3, white blood cell count 11.800/mm3, platelet count 275.000/mm3, level of C-reactive protein 30.2 mg/L, serologically S. paratyphi A "O" antibody (1/160) and S. paratyphi A "H" antibody (1/320) positivity. Urine examination showed gross hematuria and leukocyte esterase was positive. Urine culture was performed and isolate obtained urine culture was identified with conventional methods. Result of urine culture was reported as Salmonella species and isolate was determined as Salmonella paratyphi A by using anti-sera during the advanced identification. Results of radiological imaging were found normal. The patient was diagnosed as acute hemorrhagic cystitis caused by S. paratyphi A and received ceftriaxone treatment for seven days and had a full recovery. We conclude that in case of acute hemorrhagic cystitis, S. paratyphi A should be considered as causative agent in endemic areas.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 [Fascioliasis and brucellosis in same patient].(2014) Deveci O.; Aslan E.; Tekin A.; Toka Özer T.; Tekin R.; Bozkurt F.; Çetinçakmak M.G.Brucellosis is a zoonotic infectious disease that can affect many organs and systems and leads to very different clinical circumstances. Brucellosis is rare in association with various infectious agents. Fascioliasis is a zoonotic disease caused by Fasciola hepatica, popularly referred to as a large leaf-shaped liver fluke. This case is a 39-year-old male patient, and his complaints began a week ago, which were chills, fever, abdominal pain, nausea, vomiting, weakness, sweating, and widespread pain. The patient was considered brucellosis in the preliminary diagnosis. Rose Bengal test and Wright test (1/640) were detected as positive. Due to patients having elevated liver enzymes, abdominal ultrasound was taken. A liver lesion was seen with abdominal ultrasound. So, abdominal computed tomography (CT) was taken. The CT result report came in the form that at the left lobe of the liver segment 2, largely necrosis that showed no contrast enhancement, approximately 61x63 mm in size (compatible with fascioliasis) is viewed. The patient's IHA test results, required for fascioliasis, were detected as 1/320 positive. Especially for zoonotic diseases in areas with high endemicity, it should be considered that more than one infectious agent can be present together in high-risk patients.Öğe Four-year study of entecavir efficacy and safety in nucleos (T)ide-naïve HBeAg positive chronic hepatitis B patients(Klinicka Bolnica Sestre Milosrdnice, 2014) Celen M.K.; Dal T.; Ayaz C.; Bayan K.; Mert D.; Deveci O.; Oruc E.K.Entecavir is a guanosine analogue with activity against hepatitis B virus. The aim of this 4-year trial was to evaluate entecavir treatment in nucleos(t)ide-naïve HBeAg-positive chronic hepatitis B patients. Forty-nine patients received entecavir and nine of them withdrew from the trial at the end of week 96. The initial mean value of alanine aminotransferase was 79.4±41.5 IU/L, and at the end of the 4-year study period, 90% of patients had alanine aminotransferase values within the normal range. At week 96, 91.7% of patients had HBV DNA <300 copies; at month 48, 90% of patients had HBV DNA <50 IU/mL. HBeAg loss was recorded in 7.1% of patients at week 96 and in 12.5% at month 48. The rate of HBeAg seroconversion was 4.8% at week 96 and 7.5% at month 48. The rate of HBsAg seroconversion was 2.1% at week 96 and 2.5% at month 48. Entecavir as a potent and safe agent leading to continuous viral suppression proved to be safe and well tolerated therapy.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.
