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    Ağız sürüntüsü ve dışkı örneklerinden soyutulan candida albicans suşlarının klotrimazol, ketokonazol, mikonazol, ekonazol ve 5-florositozin'e in vitro duyarlılığı
    (1998) Gül, Kadri; Suay, Adnan; Mete, Ömer; Mete, Mahmut
    Ağız sürüntüsü ve dışkı örneklerinden soyutulan 50 Candida albicans susunun İmidazol türevlerinden klotrimazol, ketakonazol, mikonazol ve ekonazol ile 5-florositozin'e duyarlılığı disk difüzyon yöntemi ile araştırılmıştır. Candida albicans suşları klotrimazol'e % 32, ketokonazol'e % 26, mikonazol'e % 34, ekonazol'e % 98 ve 5-fluorositozin'e % 36 duyarlı bulunmuştur.
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    Assessment of the results of erlich ziehlneelsen and fluorochrome staining procedures, bactec 460 and löwenstein-jensen culturing procedures in the diagnosis of tuberculosis
    (2004) Mete, Mahmut; Özekinci, Tuncer; Suay, Adnan; Akpolat, Nezahat; Atmaca, Selahattin
    The Ziehl-Neelsen (ZN) and fluorochrome (FC) staining procedures and the Bactec and Löwenstein-Jensen (L-J) culturing procedures were used to test 340 clinical specimens for tuberculosis, and the diagnostic value of the fluorochrome procedure was investigated. Positive cultures were obtained from 34 specimens (10%), of which 13 (3.8%) tested positive in ZN, and 18 (5.3%) in FC. Sensitivity of the ZN and FC staining results was found to be 38.2% and 52.9%, respectively. NAP (p-nitro-?-acetylamino-?-hidroxypropiophenone) identified 32 (94.1%) of the 34 strains as M. tuberculosis complex, and 2 (5.9%) as Mycobacteria other than tuberculosis (MOTT) bacilli. Twenty-one (61.7%) of the 34 culture-positive specimens grew only in Bactec 12 B medium, 2 (5.9%) grew only in L-J medium, and 11 (32.3%) grew in both Bactec and L-J media. The 32 M. tuberculosis complex strains' sensitivities to streptomycin (STR), isoniazid (INH), rifampin (RIF), and ethambutol were assessed with the Bactec system. Four (12.5%) of these strains were resistant to streptomycin, 9 (28.1%) to isoniazid, 7 (21.8%) to rifampin, and 6 (18.7%) to ethambutol. Total drug resistance was 43.7%. Six strains (18.7%) were resistant to 1 drug, 5 (15.6%) to 2 drugs, 2 (6.2%) to 3 drugs, and 1 (3.1%) to all 4 drugs, isoniazid plus rifampin resistance was seen in 18.7%.
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    Brucellosis seroprevalence in southeast Turkey (Diyarbakır)
    (2004) Atmaca, Selahattin; Elçi, Saffet; Özekinci, Tuncer; Suay, Adnan; Arıkan, Eralp; Akpolat, Nezahat
    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 (Diyarbakır). 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.
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    Evaluation of Rapid Genotype Assay for the Identification of Gram-Positive Cocci from Blood Cultures and Detection of mecA and van Genes
    (Ankara Microbiology Soc, 2011) Gulhan, Baris; Atmaca, Selahattin; Ozekinci, Tuncer; Suay, Adnan
    Rapid and accurate identification of bacterial pathogens grown in blood cultures of patients with sepsis is crucial for prompt initiation of appropriate therapy in order to decrease related morbidity and mortality rates. Although current automated blood culture systems led to a significant improvement in bacterial detection time, more rapid identification systems are still needed to optimise the establishment of treatment. Novel genotype technology which is developed for the rapid diagnosis of sepsis, is a molecular genetic assay based on DNA multiplex amplification with biotinylated primers followed by hybridization to membrane bound probes. The aim of this study was to evaluate the performance of Genotype (R) BC gram-positive test for the identification of gram-positive cocci grown in blood cultures and rapid detection of mecA and van genes. This test uses DNA.STRIP (R) technology which includes a panel of probes for identification of 17 gram-positive bacterial species and is able to determinate the methicillin and vancomycin resistance mediating genes (mecA and vanA, vanB, vanC1, vanC2/C3) simultaneously, in a single test run. A total of 55 positive blood cultures from BACTEC (TM) Plus/F (Becton Dickinson, USA) aerobic and pediatric blood culture vials were included in the study. The isolates which exhibit gram-positive coccus morphology by Gram staining were identified by Genotype (R) BC gram-positive test (Hain Life Science, Germany). All of the samples were also identified with the use of Phoenix PMIC/ID Panel (Becton Dickinson, USA) and antibiotic susceptibilities were determined. Of the 55 blood culture isolates, 17 were identified as Staphylococcus epidermidis [all were methicillin-resistant (MR)], 9 were S.aureus (one was MR), 18 were S.hominis (10 were MR), 4 were E.faecalis, 3 were E. faecium (one was vanconycin-resistant), 2 were S.saprophyticus (one was MR), 1 was S.warneri and 1 was S.haemolyticus, by Phoenix automated system. Genotype (R) BC gram-positive test results revealed consistency with Phoenix system regarding bacterial identification in 46 (83.6%) of the samples. The two bacteria identified as S.saprophyticus by the Phoenix system could not be identified by the Genotype (R) BC test since this species were not included in the identification panel of the system, however, mecA gene were detected in these two samples by Genotype (R) BC test. Genotype (R) BC test detected mecA gene in five samples which were not detected as methicillin resistant by the Phoenix system. Besides polymicrobial growth was determined in five samples by Genotype (R) BC test, but not by the automated system. One E.faecium isolate with vanA gene was correctly identified by Genotype (R) BC test. In conclusion, Genotype (R) BC gram-positive test is a fast and reliable test for the identification of the most important gram-positive pathogens and mecA and van genes directly from positive blood culture bottles. This test was also found superior than the automated Phoenix system regarding the detection of polymicrobial growth. These data indicated that, routine use of DNA strip technology-based assay would be useful for clinical diagnosis in patients with sepsis.
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    Giardiasisin tanısında enzym immun assay (EIA) ve direkt inceleme yöntemlerinin karşılaştırılması
    (2005) Suay, Adnan; Elçi, Saffet; Özekinci, Tuncer; Akpoat, Nezahat; Atmaca, Selahattin; Uzun, Aslıhan
    Bu çalışmada, çeşitli gastrointestinal şikayetlerle hastanemiz polikliniklerine başvuru yapan hastaların dışkı örneklerinin incelenmesinde, rutin mikroskobik yöntem ve EIA testi karşılaştırılmıştır. Toplanan 188 dışkı örneğinde, nativ-lugol ile direkt mikroskobik inceleme yapılmış, 141 örnekte Giardia intestinalis kist ve/veya trofozoiti bulunurken, 47 dışkı örneğinde herhangi bir parazit tespit edilememiştir. Tüm örneklere, RIDASCREEN EIA kit prosedürü uygulanmıştır. Direkt mikroskobisi pozitif bulunan 141 örneğin 136 'sı EIA testi ile pozitif; 5'i negatif olarak saptanmıştır. Direkt mikroskobide parazit saptanmayan 47 dışkı örneğinin 38'i EIA ile negatif; 9'u pozitif olarak belirlenmiş, iki yöntem hasta ve kontrol grupları göz önüne alınarak karşılaştırıldığında istatiksel olarak anlamlı fark bulunmuştur (p<0.05). Dışkıda Giardia intestinalis antijenini belirlemeye yönelik kullanılan EIA yönteminin duyarlılığı %96,4, özgüllüğü %80,8 olarak belirlenmiştir.
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    Kan kültürlerinde üreyen gram-pozitif kokların tanımlanması ve mecA ve van genlerinin saptanmasında hızlı Genotip testinin değerlendirilmesi
    (2011) Özekinci, Tuncer; Atmaca, Selahattin; Gülhan, Barış; Suay, Adnan
    Sepsisli hastaların kan kültürlerinde üreyen bakteriyel patojenlerin hızlı ve doğru olarak tanımlanması, uygun tedaviye erken dönemde başlanması ve dolayısıyla morbidite ve mortalitenin azalması açısından büyük önem taşımaktadır. Günümüzde kullanılan otomatize kan kültür sistemleri, bakterilerin tespit edilme zamanını kısaltmış olsa da, optimum tedaviye yönlenmek için daha hızlı tanımlama sistemlerine gereksinim duyulmaktadır. Son yıllarda geliştirilen “genotip teknolojisi”, biyotinlenmiş primerlerle DNA’nın multipleks amplifikasyonunu takiben membrana bağlı problar kullanılarak hibridizasyona dayalı, sepsisin hızlı tanısı için kullanılan genetik bir testtir. Bu çalışmada, kan kültürlerinde üreyen gram-pozitif kokların tanımlanması ve mecA ve van gen varlığının hızlı tespitinde “Genotype® BC grampositive” testinin değerlendirilmesi amaçlanmıştır. DNA•STRIP® teknolojisine dayalı olan bu test, 17 gram-pozitif bakteri türünü tanımlayabilmekte ve eş zamanlı olarak metisilin ve vankomisin direncinde etkin olan genleri de (mecA ve vanA, vanB, vanC1, vanC2/C3) aynı aşamada belirleyebilmektedir. Çalışmaya, BACTECTM Plus/F (Becton Dickinson, ABD) aerobik ve pediatrik kan kültür şişelerinde üreme saptanan 55 kan kültürü dahil edilmiştir. Gram-pozitif kok morfolojisi görülen şişelerde üreyen bakterilerin tanımlanmasında “Genotype® BC grampositive” (Hain Life Science, Almanya) test kiti kullanılmıştır. İzolatlar aynı zamanda Phoenix PMIC/ID Panel (Becton Dickinson, ABD) ile de tanımlanmış ve antibiyotik duyarlılıkları belirlenmiştir. Çalışmamızda, Phoenix ile 55 kan kültürü izolatının 17’si Staphylococcus epidermidis [tümü metisiline dirençli (MR)], dokuzu S.aureus (biri MR),18’i S.hominis (10’u MR), dördü E.faecalis, üçü E.faecium (biri vankomisine dirençli), ikisi S.saprophyticus (biri MR), biri S. warneri ve biri S.haemolyticus olarak tanımlanmıştır. Genotype® BC testi ile elde edilen sonuçlara göre, 46 (%83.6) örneğin Phoenix sistemi ile tam uyumlu olarak tanımlandığı izlenmiştir. Phoenix ile S.saprophyticus olarak tanımlanan iki örnekte Genotype® BC testi sadece mecA genini saptamış, kit panelinde yer almadığından bu suş tür düzeyinde tanımlanamamıştır. Buna karşın Genotype® BC, Phoenix ile metisilin direncinin tespit edilemediği beş örnekte mecA genini tespit etmiş; beş örnekte ise otomatize sistemle saptanamayan karışık üremeleri saptayabilmiştir. Ayrıca vanA geni taşıyan bir E.faecium izolatı Genotype® BC ile doğru bir şekilde ayırt edilebilmiştir. Sonuç olarak “Genotype® BC gram-positive” kan kültür testinin, pozitif kan kültür şişelerinden direkt olarak önemli gram-pozitif sepsis patojenlerini ve mecA ve van genlerini hızlı ve güvenilir bir şekilde saptayabildiği; polimikrobiyal enfeksiyonların belirlenmesinde üstünlük gösterdiği belirlenmiştir. Elde edilen sonuçlar doğrultusunda sepsis düşünülen hastalarda DNA strip teknolojisine dayalı bu hızlı testin rutin olarak kullanılmasının klinik tanıya katkı sağlayacağı düşünülmüştür.
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    Koagulaz-negatif stafilokoklarda makro ve mikro yöntemle "slime" oluşumunun saptanması ve antibiyotik direncinin araştırılması
    (1996) Elçi, Saffet; Özel, Ferruh; Gül, Kadri; Mete, Ömer; Suay, Adnan
    Çeşitli klinik örneklerden izole edilen 92 koagülaz-negatif stafilokok susu "slime" oluşumu ve antibiyotik direnci açısından araştırıldı. "Slime" oluşumu hem makro-tüp yöntemiyle hem de kantitatif mikro-yöntemle incelendi. Mikro-test optik yoğunluk ölçümleri makro-test pozitif suşlar için (ortalama ± SS) 0.440 ± 0.141, negatifler için ise 0.171 ± 0.049 olarak belirlendi (p < 0.0001). Slime pozitiflerde metisilin direnci % 33.7, beta-laktamaz yapımı % 50 olarak saptandı. Slime pozitiflerin antibiyotiklere slime negatiflere oranla daha dirençli olduğu gözlendi (p < 0.02).
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    Malaria status in diyarbakir and its districts between 1995–2000 years on basis of the malaria eradication institute's data
    (2005) Suay, Adnan; Mete, Mahmut; Kaya, N. A.; Akdeniz, Sedat
    The records for malarial patients were detected by malaria surveillance studies and by research of Malaria Eradication Instıtute, Diyarbakır branch between the years of 1995 - 2000 were examined in this study. According to the records, a total of 751.312 blood samples were investigated for active surveillance, passive surveillance and check studies and a total of 80.330 malaria cases were detected. All the cases were Malaria tertiana caused by Plasmodium vivax. Of the malarial donors, 44.033 were male (54.8%) and 36.297 were female (45.2 %). According to the years in which the experimental data were collected, the number of cases, which was 26.912 in 1995, fell down to 2.581 in 2000. In the total, July, in which 12.361 symptoms were detected, and August, in which 10.572 symptoms were found were the months in which the highest numbers were seen. In addition, the most prevalent age groups for malaria infection were 15 - 24 years-old with 17.387 patienst, and 25 - 44 years-old with 17.757 patients. Furthermore, Ergani with 10.686 and Silvan with 13.774 symptoms occupied the first places for the intensity of infection.
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    Natural ovine dermatophilosis:Clinical aspects and efficacy of penicillin/streptomycin treatment
    (2002) Elitok, Bülent; Suay, Adnan; Elitok, Özgül M.; Sekın, Servet
    This is the first report about natural Dermatophilus congolensis infection in Turkey. Presumptive and confirmatory diagnoses were made based on clinical signs and the demonstration of the bacteria frorn scab material by direct microscopic examination and by culturing the organism on bacteriological media and identifying it by conventional methods such as biochemical reactions. The study was carried out using two groups of animals. Seventy sheep and 20 goats, 8-11 months old were included in group 1 and 155, 1-4 weeks old lambs in group 2. Ten sheep and five goats in the first group and 10 lambs in the second group were allocated as control groups. In group 1, the animals were treated daily with 20.000 IU Benzilpenicillin procaine and 20 mg Dihydrostreptomycin mixture per kg body weight for 5 days. Antibiotic sprays were applied locally. In the second group, lambs were treated daily with intramusculer injection of the same antibiotic for 3 days at the same dose. Differences between treated and untreated sheep in terms of recovery were highly significant (p < 0.01) in week 5 and (p < 0.001) in weeks 6, 7 and 8. Compared to untreated lambs, a statistically significant difference (p < 0.001) was found in treated lambs in weeks 2 and 3 after treatment.
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    Torch group antibody distribution in patients' blood sent to central laboratories from various departments, in dicle university hospital
    (2004) Suay, Adnan; Özekinci, Tuncer; Mete, Mahmut; Elçi, Saffet
    In this study, 3.664 suspected blood samples were examined in a manner of TORCH during one year period—January 1999 to January 2000. There were 1034 male donors and 2630 females ages at 0–41 and over. In the light of the investigation of the blood samples, antitoxoplasmosis gondii was found as 56.3% IgG positive in females and 41.1% IgG positive in males, whereas it was detected as 7.6% and 4.5% positive for IgM values, respectively. At the same time, rubella case was found out as 90.8% positive for female and 90.3% positive for male donors for IgG values, while it was 9.7% and 9.2% positive for IgM values, respectively. Cytomegalovirus (CMV) was discovered as 83.8% positive in females and 81.2% positive in males for IgG and as 12.9% positive in female and 14.9% positive in male donors. Moreover, Herpes simplex virus type I (HSV - 1) was found out as 89.7% positive in females and 87.2% positive in males for IgG values whereas IgM values were detected as 6.9% positive for female and 8.5% positive for male donors. Herpes simplex virus type II (HSV-2) IgG positivity was discovered as 90.6% in females and 87.8% in males while rates for IgM positivity were 8.6% and 10.5%, respectively.
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    The value of cmv and rubella igg avidity tests in the diagnosis of cytomegalovirus (cmv) and rubella infections in pregnant women
    (2005) Özekinci, Tuncer; Suay, Adnan; Karaşahin, Özge; Akpolat, Nezahat
    IgG avidity tests, which came on the scene recently with regard to most efficient use of time and early onset to the therapy, are considered in this study, and compared with Enzyme immunoassay(EIA). Serums of a total of 879 women in the first trimester of their gestations who referred to Dicle University, Faculty Hospital, Department of Gynaecology and Obstetrics in between the dates of 09 April 2002–09 May 2003 were evaluated with the classical method ELISA (Cobas Core II, Roche, USA), in terms of Rubella and HCMV IgG and IgM. Avidity tests were performed with (IgG avidity EIA. Well; Radim, Italy) commercial kits. 4 samples among the 8 that were positive for HCMV IgM and IgG were found to have low AIs (AI<35%), 2 samples to have intermediate AIs (AI 35–45%), and the other 2 to have high AIs (AI >45%). One of the 156 IgG positive serum samples had an intermediate AI (AI 35–45%), and 155 had high AIs. In the Rubella IgG avidity tests, 9 of the 13 IgM and IgG positive samples had low AIs (AI <50%), 1 had an intermediate AI (AI 50–60%), and 3 had high AIs (AI >60%). Only one of the 151 IgG positive samples had a low AI, whereas the remaining 150 had high AIs. If only avidity test is taken into consideration, gray region or low avidity test results especially negative for IgM with ELISA and showing a clear chronical pattern will be falsely interpreted in accord with an infection, if the results for these serums are new. IgG avidity test is useful in serums revealing suspected results in IgM ELISA test. Follow-up of patients with intermediate and low AIs and repeating tests in certain intervals, and examination of the amniotic fluid by PCR will be appropriate. As only IgG avidity test taken into consideration will cause unnecessary abortus and anxiety, use of single confirmation tests in such cases is not right. IgG avidity tests should only be used as confirmation tests in pregnant women.