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    Acinetobacter baumannii: Derin boyun enfeksiyonunun nadir bir nedeni
    (2012) Tekin, Alicem; Kınış, Vefa; Topçu, İsmail; Yorgancılar, Ediz; Bakır, Salih; Özbay, Musa
    Derin boyun enfeksiyonları, üst solunum yollarından kaynaklanan ve boynun derin yapılarını etkileyen bakteriyel enfeksiyonlardır. Bu enfeksiyonlar uygun zamanda ve şekilde tanı konulup tedavi edilmezlerse, hızla ilerleyip ciddi morbidite ve mortaliteye neden olurlar. Acinetobacter baumannii birçok hastane kaynaklı enfeksiyonda rol almakla birlikte, kulak burun boğaz hekimlerinin yabancı olduğu ve boyun enfeksiyonlarda nadiren izole edilen bir bakteridir. Bu makalede apse kültüründe Acinetobacter baumannii’nin izole edildiği, ciddi bir derin boyun enfeksiyonu olgusu sunuldu. Hasta antibiyotik tedavisi ve cerrahi drenaj uygulanarak başarıyla tedavi edildi.
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    Anterior chest wall musculoskeletal tuberculosis
    (2010) Kapan, Murat; Önder, Akın; Keleş, Ayşe Nur; Tekin, Alicem; Arıkanoğlu, Zülfü
    Kas-iskelet tüberkülozları, tüm tüberküloz vakalarının %1-3’ünü oluştururlar ve bunlardan yalnızca %1-5’i toraks ön duvarında yerleşir. Toraks ön duvarında en sık tutulan yapılar ise sternum kenarı ve kosta gövdesidir. Bilgisayarlı tomografi lezyonların tanımlanmasında ve genişliğinin belirlenmesinde etkilidir. Eğer yüksek klinik şüphe varsa uygun histopatolojik ve mikrobiyolojik örnekler alındıktan sonra, derhal cerrahi eksizyon yapılmalı ve antitüberküloz ilaç tedavisi başlanmalıdır. Bu yazımızda, toraks ön duvarında tüberküloz tanısı alan 49 yaşında kadın hastanın güncel literatür eşliğinde irdelenmesi amaçlanmıştır. Klin Den Ar Derg 2010; 1(2): 122-124
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    ANTI-TUBERCULOSIS DRUG RESISTANCE IN SOUTHEAST OF TURKEY
    (Carbone Editore, 2013) Dal, Tuba; Ozcan, Nida; Tekin, Recep; Tekin, Alicem; Celen, Mustafa Kemal; Ozekinci, Tuncer; Dal, 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 cost-effective tuberculosis control programme contributes to reduce the incidence of drug resistance in the community.
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    Aynı Hastada Fascioliazis ve Bruselloz
    (2014) Deveci, Özcan; Tekin, Recep; Çetinçakmak, Mehmet Güli; Aslan, Emel; Tekin, Alicem; Bozkurt, Fatma; Toka-Özer, Türkan
    Bruselloz birçok organı ve sistemi etkileyebilen çok farklı klinik tablolara yol açan zoonotik bir enfeksiyon hastalığıdır. Brusellozun farklı enfeksiyon etkenleri ile birlikteliği nadirdir. Fascioliazis; halk arasında büyük karaciğer kelebeği olarak adlandırılan yaprak şeklindeki Fasciola hepatica'nın neden olduğu zoonotik bir hastalıktır. Olgumuz 39 yaşında erkek hasta bir hafta önce başlayan üşüme, titreme, ateş, karın ağrısı, bulantı, kusma, halsizlik, terleme ve yaygın vücut ağrısı şikâyetleri olmuştu. Hastanın ön tanısında bruselloz düşünüldü. Buna yönelik olarak istenen tetkiklerde rose bengal testi pozitif, Wright testi (1/640) pozitif saptandı. Karaciğer enzim yüksekliği olması üzerine batın ultrasonografisi (USG) yapılan hastada karaciğerde lezyon görülmesi nedeniyle batın bilgisayarlı tomografi (BT) çekildi. BT sonucu karaciğer sol lob segment 2'de büyük oranda nekrotik görünümde yaklaşık olarak 61x63 mm boyutlarında kontrast tutulum göstermeyen (fascioliazis ile uyumlu) alan izlendi şeklinde sonuç geldi. Fascioliazise yönelik olarak IHA testi istenen hastanın sonucu 1/320 pozitif saptandı. Zoonotik hastalıklar için yüksek endemisiteye sahip olan bölgelerde, risk grubunda olan hastalarda birden fazla enfeksiyon etkeninin bir arada olabileceği göz önünde bulundurulmalıdır.
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    Öğe
    Bir Devlet Hastanesinde intestinal parazit dağılımı ve etiyolojik analiz raporu
    (2011) Tekin, Alicem; Yula, Erkan; Deveci, Özcan; İnci, Melek
    Amaç: İntestinal parazitler, özellikle gelişmekte olan ülkeler başta olmak üzere küresel olarak yaklaşık dört milyar insanı etkileyen önemli bir halk sağlığı sorunudur. Bu çalışma; çoklu (mikst) intestinal parazit prevalansını ve potansiyel infeksiyon kaynağını belirlemek amacıyla yapılmıştır.Gereç ve yöntem: Çalışmaya 4 aylık periyotta, Kızıltepe Devlet Hastanesi Mikrobiyoloji Laboratuvarına paraziter etken varlığının araştırılması amacıyla gönderilen 1620 dışkı örneği prospektif olarak dahil edildi. Makroskobik inceleme sonrası dışkı örnekleri, dışkı konsantratör tüpü ile çöktürülüp kopro-parazitolojik yöntemlerden nativ-lugol yöntemi uygulanarak intestinal parazitler yönünden incelendi. Dışkı örneklerinin tamamı Entamoeba histolytica/dispar taraması için ticari test kiti kullanılarak Mikro-ELISA yöntemi ile adhezin antijen varlığı yönünden araştırıldı.Bulgular: Çalışmada, toplam 1620 insan dışkı örneği incelendi ve 447’si (% 27.6) intestinal parazitler yönünden olumlu bulundu. Enfekte dışkı örnekleri arasında; 63’ünün (% 14.1) iki parazit ve 18’inin (% 4.0) üç parazit ile çoklu infekte olduğu görüldü. Giardia intestinalis (% 43.3), Taenia spp. (% 36.4) ve Trichomonas hominis (% 5.4) en sık tespit edilen parazitlerdi. Çoklu parazitle (G. intestinalis & Taenia spp.) infekte dışkı örneklerinde kadın ve erkekler arasında cinsiyet açısından istatistiksel olarak anlamlı bir fark bulunmadı (p>0.05).Sonuç: Bulgularımız bölgemizde parazitik infeksiyonların endemik kalmaya devam ettiğini göstermektedir.
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    Boğmacanın moleküler tanısı için laboratuvar yapımı Bir PCR yönteminin geliştirilmesi ve optimizasyonu
    (2011) Tekin, Alicem; Esen, Berrin; Güldemir, Dilek; Akbaş, Efsun; Ötgün, Nar Selin
    Bordetella pertussis’in etken olduğu boğmaca, her yaştan duyarlı bireyi, özellikle de çocukları etkileyen, akut, bulaşıcı bir solunum sistemi enfeksiyonu olup, ağır bir klinik tablo ile karakterizedir. Tanıda kullanılan geleneksel kültür yönteminin özgüllüğü yüksek olmasına rağmen, duyarlılığı düşüktür. Bu nedenle boğmaca tanısında duyarlı, özgül ve hızlı bir tanı yöntemine gereksinim vardır. Polimeraz zincir reaksiyonu (PCR), boğmaca tanısında son yıllarda kullanılmaya başlanan yeni bir yaklaşımdır ve kültür yönteminden daha duyarlı olduğu gösterilmiştir. Çeşitli çalışmalarda PCR için seçilen hedef gen bölgeleri arasında; pertusis toksin geni (ptxA-Pr), insersiyon sekans genleri (IS481 ve IS1001), adenilat siklaz geni, yapısal genlerden porin ve flajellin geni yer almaktadır. Bu araştırmada, ptxA-Pr ve IS481 gen bölgelerine özgül primerlerin kullanıldığı bir “in-house” PCR tanı yönteminin geliştirilmesi ve optimizasyonu amaçlanmıştır. Çalışmada, ptxA-Pr genine özgül PTp1/PTp2 primerleri ve IS481 genine özgül PIp1/PIp2 primerleri ve çeşitli standart bakteri suşlarının DNA’ları kullanılarak bir “in-house” PCR yöntemi geliştirilmiştir. Sağlıklı 45 bireyden alınan boğaz sürüntüsü ile azalan konsantrasyonlarda B.pertussis standart bakteri suşu karıştırılmak suretiyle oluşturulan “temsili nitelikte klinik örnekler” ile yöntemin duyarlılığı ve özgüllüğü test edilmiş ve optimizasyon yapılmıştır. PTp1/PTp2 primerlerinin kullanıldığı “in-house” PCR yönteminin özgüllüğünün yüksek, duyarlılığının ise düşük [34.4 cfu/Rm (koloni oluşturan ünite/reaksiyon karışımı)] olduğu görülmüştür. PIp1/PIp2 primerlerinin kullanıldığı “in-house” PCR yönteminin ise B.pertussis ile B.bronchiseptica arasında çapraz reaksiyon vermesi nedeniyle özgüllüğünün düşük olmasına rağmen, yüksek duyarlılık (1.12 cfu/Rm) gösterdiği tespit edilmiştir. Temsili nitelikteki klinik örnekler ile yapılan “in-house” PCR denemelerinden de benzer sonuçlar elde edilmiştir. Ayrıca yaptığımız eş zamanlı kültür çalışmasında, yöntemin B.pertussis saptama duyarlılığı 2 x $10^ 3$ cfu/ml olarak saptanmıştır. Çalışmamızda, IS481 genini hedef alan PCR’nin duyarlılığı yüksek bulunurken, ptxA-Pr genini hedef alan PCR’nin özgüllüğü yüksek bulunmuş; bu nedenle boğmacanın moleküler tanısında, IS481’i hedef alan PCR ile ön tanı konulması, ptxA-Pr’yi hedef alan PCR’nin de konfirmasyon amaçlı kullanılmasının uygun olacağı kanısına varılmıştır.
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    Comparison of the antibacterial effect of silver sulfadiazine 1%, mupirocin 2%, Acticoat and octenidine dihydrochloride in a full-thickness rat burn model contaminated with multi drug resistant Acinetobacter baumannii
    (Elsevier Sci Ltd, 2012) Selcuk, Caferi Tayyar; Durgun, Mustafa; Ozalp, Burhan; Tekin, Alicem; Tekin, Recep; Akcay, Cemal; Alabalik, Ula
    In this study, our aim is to compare the efficacy of different topical antibacterial agents in a rat model contaminated with a multi drug resistant (MDR) standard Acinetobacter baumannii strain. The study was carried out on 40 Sprague-Dawley rats of 250-300 g each. For the purposes of this study, the rats were divided into 5 groups, with 8 rats in each group: Group 1 control; Group 2 silver sulfadiazine; Group 3 mupirocin; Group 4 Acticoat group; and Group 5 octenidine dihydrochloride group. Following to the formation of the full-thickness burn areas in rats, the MDR A. baumannii standard strain was inoculated into the burned area. The rats in all the groups were sacrificed at the end of the 10th day and subjected to histopathological and microbiological evaluation. In the histopathological evaluation, the lowest inflammatory cell response and bacterial density in the eschar and muscle tissues were observed in the Acticoat group. While these results were found to be statistically significant compared to the silver sulfadiazine group, only the bacterial density in the muscle tissue was found as significant in comparison to the mupirocin and octenidine groups. In the microbiological evaluation, the lowest growth in the muscle tissue culture among all the groups was observed in the Acticoat group. The growth in the eschar tissue culture was significantly lower in the Acticoat and octenidine groups in comparison to the silver sulfadiazine group. At the end of the study, it has been observed that Acticoat was effective both in eschar and muscle, while octenidine was effective in eschar tissues in a rat burn model contaminated with MDR A. baumannii. (C) 2012 Elsevier Ltd and ISBI. All rights reserved.
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    Cutaneous anthrax in Southeast Anatolia of Turkey
    (Taylor & Francis Ltd, 2015) Tekin, Recep; Sula, Bilal; Deveci, Ozcan; Tekin, Alicem; Bozkurt, Fatma; Ucmak, Derya; Kaya, Safak
    Context: Anthrax is a rare disease cause by Bacillus anthracis, a Gram-positive, rod-shaped endospore-forming capsuled bacterium. Anthrax is manifest in three primary forms: cutaneous, respiratory, and gastrointestinal. Cutaneous anthrax accounts for approximately 95% of all cases of anthrax in humans. Objective: In the present study, we evaluated the clinical diagnosis and treatment of cutaneous anthrax, a rare disease that nonetheless remains a serious healthcare problem in developing countries. Methods: The complete medical records of patients diagnosed with cutaneous anthrax between January 2001 and December 2012 were examined in a retrospective manner. Cutaneous anthrax was diagnosed by the identification of typical antrax lesions and/or the presence of Gram-positive-capsuled bacillus after staining with Gram stain and methylen blue in pathology samples obtained from these lesions and the presence of characteristic scarring with a history of severe swelling, black eschar, and positive response to treatment form the basis of diagnosis in cases where cultures were negative for the presence of bacillus. Results: A total of 58 patients were admitted to the hospital with cutaneous anthrax between January 2001 and December 2012. This included 32 (55.2%) males and 26 (44.8%) females, with an age range of 15-82 years and a mean age of 38 +/- 13.8 years. The incubation period for the infection ranged between 1 and 20 d (mean 3.7 +/- 1.4 d). The most common symptoms at the time of hospital referral were swelling, redness, and black eschar of the skin. The most common lesion site was the hand and fingers (41.3%). Isolated of bacteria was used to diagnose the disease in six cases (23.8%), detection of Gram-positive bacillus in samples of characteristic lesion material was used in seven (28.5%) cases, and the presence of a characteristic lesion was the sole diagnositc criteria in 45 (77.6%) cases. Treatment consisted of penicillin G (12 cases), ampicillin-sulbactam (30 cases), Cefazolin (12 cases), or ciprofloxacin (4 cases). Conclusion: Although the prevalence of anthrax is a decreasing worldwide, it remains a significant problem in developing countries. Rapid identification of the signs and symptoms of cutaneous anthrax is essential for effective treatment. Early supportive treatment and appropriate antimicrobial measures are necessary to address this potentially life-threatening disease.
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    Development and Optimization of an In-House PCR Method for Molecular Diagnosis of Pertussis
    (Ankara Microbiology Soc, 2011) Guldemir, Dilek; Akbas, Efsun; Otgun, Selin Nar; Tekin, Alicem; Esen, Berrin
    Pertussis (whooping cough), caused by Bordetella pertussis is a severe, acute contagious disease of the respiratory system and it affects mostly children and also susceptible individuals of all ages. Although the conventional culture method used for diagnosis is highly specific, it has a lower sensitivity. Therefore, there is a need for a sensitive, specific and rapid method for diagnosis of pertussis. Polymerase chain reaction (PCR), introduced recently as a new approach for diagnosis of pertussis, has been shown to be more sensitive than culture method. Pertussis toxin gene (ptxA-Pr), insertion sequence genes (IS481 and IS1001), adenylate cyclase genes and structural porin and flagellin genes were chosen as targets for PCR, in different studies. This study aimed to develop and optimize a diagnostic in-house PCR method by using primers specific for ptxA-Pr and IS481 gene regions. An in-house PCR method was developed by using primer pairs of PTp1/PTp2 specific for ptxA-Pr gene and PIp1/PIp2 specific for IS481 gene and DNAs of various bacterial reference strains. Throat samples obtained from 45 healthy individuals and B.pertussis reference strain with decreasing concentrations were mixed to constitute a group of representative clinical samples and used to test and optimize sensitivity and specificity of the method. The in-house PCR with PTp1/PTp2 primers showed a very high specificity but a low sensitivity with a value of 34.4 cfu/Rm (colony forming unit/reaction mixture). Whereas, the in-house PCR with PIp1/PIp2 primers exhibited a low specificity due to cross-reactivity with B. pertussis and B.bronchiseptica but much higher sensitivity with a value of 1.12 cfu/Rm. The experiments performed with the representative clinical samples yielded similar results. Simultaneously applied cultivation studies indicated the detection limit of the PCR method as 2 x 10(3) cfu/ml. Based on our results, the PCR targeting IS481 gene had high sensitivity while the PCR targeting ptxA-Pr gene had high specificity. It was concluded that, PCR method targeting the IS481 gene might be used for pre-diagnosis and then PCR for ptxA-Pr gene might be applied for the confirmation of B.pertussis in the molecular diagnosis of pertussis.
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    The Effect of Hyperbaric Oxygen Treatment on the Healing of Burn Wounds in Nicotinized and Nonnicotinized Rats
    (Oxford Univ Press, 2013) Selcuk, Caferi Tayyar; Ozalp, Burhan; Durgun, Mustafa; Tekin, Alicem; Akkoc, Mehmet Fatih; Alabalik, Ulas; Ilgezdi, Savas
    The importance of oxygen in wound healing and the negative effects of cigarette smoking have been demonstrated in various studies. In this study, our aim was to investigate the effect of hyperbaric oxygen (HBO2) treatment on wound healing in nicotinized and nonnicotinized rats. The study was conducted on 32 Sprague Dawley rats. The rats were divided into four groups, with eight rats in each: group 1, nonnicotinized rats; group 2, nonnicotinized rats treated with HBO2; group 3, nicotinized rats; and group 4, nicotinized rats treated with HBO2. To prepare the nicotinized groups, the rats were given nicotine for 28 days. At the end of day 28, standard, deep, second-degree to third-degree burns were created on the rats. The HBO2-treated groups underwent HBO2 treatment once a day for 7 days after the creation of the burn damage. All rats were killed 21 days after injury, and the burns were subjected to macroscopic, histopathological, and microbiological evaluation. During this evaluation, the smallest necrotic areas and the lowest rate of fibrosis were observed in group 2. The largest necrotic areas and the highest inflammation and fibrosis rates were observed in the nicotine-treated group 3. When the nicotinized and nonnicotinized groups were compared separately, there was a significant difference in favor of the groups treated with HBO2. Bacterial growth was the highest in the nicotinized group 3, whereas no statistically significant difference was observed among the other groups. We conclude that HBO treatment accelerates the recovery of burn wounds and provides more effective healing by reducing the development of scars both in nicotinized and nonnicotinized rats.
  • Küçük Resim
    Öğe
    Effect of pneumatic tube delivery system rate and distance on hemolysis of blood specimens.
    (Wiley-Blackwell, 2012) Evliyaoğlu, Osman; Toprak, Gülten; Tekin, Alicem; Başarali, Mustafa Kemal; Kılınç, Cumhur; Çolpan, Leyla
    Background: We evaluated the effects of pneumatic tube system (PTS) transport rates and distances on routine hematology and coagulation analysis. PTS effects on centrifuged blood samples were also examined. Method: The study was completed at Dicle University Hospital, which has the longest pneumatic tube system in Turkey. Blood samples were collected at three different locations within the hospital and an emergency department, and delivered to the central laboratory by the PTS or a human carrier. Samples were transported at different rates and over varying distances. Each specimen's potassium (K) and lactic dehydrogenase (LDH) levels, in both the serum and plasma, were tracked to monitor hemolysis. Measurements of LDH and K were obtained using heparin or citrate. Result: A positive correlation was observed between distance and hemolysis in serum samples transported at 4.2 m/sec, and at 3.1 m/sec for more than 2200 m (r = 0.774 and r = 0.766, respectively). Distance and hemolysis were also correlated in non-centrifuged samples (r = 0.871). The alterations in plasma LDH and K levels at different rates and PTS lengths were not statistically significant. Conclusion: The rate of hemolysis in PTS transported samples, dependent on PTS length and rate, may seriously affect routine tests of non-centrifuged samples.
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    Evlilik öncesi yapılan tarama testi sonuçlarının değerlendirilmesi
    (2011) Deveci, Özcan; Tekin, Alicem; Durmaz, Süleyman; Toka, Türkan Özer; Yanık, Keramettin; Yula, Erkan
    Amaç: İnsan bağışık yetmezlik virüsü (HIV), Hepatit B ve Hepatit C virüsleri ile Treponema pallidum, parenteral ve cinsel yolla bulaşan enfeksiyon etkenleridir. Ülkemizde evlenecek çiftlere yasal prosedür ve ilgili mevzuat kapsamında evlilik öncesi tarama testi yapılarak, başvuranların cinsel yolla bulaşan hastalıklar yönünden tetkikleri değerlendirilmektedir. Bu çalışmanın amacı; evlilik öncesi tarama amaçlı yapılan HBsAg, anti-HCV, anti-HIV I/II ve Treponema pallidum antikorları (anti-Treponema pallidum IgG, IgA ve IgM) test sonuçlarının değerlendirilmesidir. Gereç ve yöntem: Kızıltepe Devlet Hastanesi Enfeksiyon Hastalıkları ve Klinik Mikrobiyoloji Polikliniğine Ocak 2011- Mart 2011 tarihleri arasında evlilik öncesi tarama testi yaptırmak için gelen 117 hasta randomize olarak çalışmaya dahil edildi. Bu hastaların 64’ü bayan (yaş ortalaması 24.7±5.7), 55’i erkekti (yaş ortalaması 24.7±4.7). Hastaların HBsAg, anti-HCV ve anti-HIV I/II testleri makro-ELISA cihazında (Vitros ECIQ, Ortho Clinical Diagnostics, USA), anti-Treponema pallidum IgG, IgA ve IgM antikorlarının taranması ise immünokromatografik hızlı testle (Syphilis Syphilis 3.0, Standard Diagnostic, Inc. Korea) çalışıldı. Bulgular: Çalışmaya alınan 119 hastanın 5’inde (%4.2) HBsAg pozitifliği belirlendi. Bu 5 hastanın 3’ü erkek ve 2’si bayandı. Anti-HCV, anti-HIV I/II ve anti-Treponema pallidum IgG, IgA ve IgM antikor testleri ise bütün hastalarda negatif olarak bulundu. Sonuç: Çalışmada elde edilen HBsAg test sonucunun, bölgemizdeki HBsAg pozitiflik oranı ile uyumlu olduğu bulundu. Sonuç olarak evlilik öncesi yapılan tarama testlerinin cinsel yolla bulaşan hastalıkların önlenmesindeki öneminin artarak devam edeceği kanaatindeyiz. Klin Deney Ar Derg 2011; 2 (3): 292-294.
  • Küçük Resim
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    Fusidic acid resistance among staphylococci strains isolated from clinical specimens in a general hospital
    (Dicle Üniversitesi Tıp Fakültesi, 2012) Özer, Türkan Toka; Yula, Erkan; Tekin, Alicem; Deveci, Özcan
    Objectives: The aim of this study was to investigate in vitro susceptibility of fusidic acid to clinic isolates of staphylococci. Materials and methods: The forty-one coagulase negative staphylococci (CNS) and 18 Staphylococcus aureus strains isolated from various clinical specimens were included in this study. Staphylococci isolates were identified by conventional methods such as colony morphology onto medium, gram staining, catalase and coagulase tests. According to “Clinical and Laboratory Standards Institute (CLSI)” criteria, antimicrobial susceptibility testing of isolates was performed by Kirby-Bauer’s disk diffusion method. Results: The seventy-two percent of the isolated S.aureus were defined as methicillin sensitive-S.aureus (MSSA), 28% of the isolated S.aureus were defined as methicillin resistant-S.aureus (MRSA). The difference among fusidic acid susceptibility rates of MSSA and MRSA strains was not statistically significant (p=0.305). The twenty-nine percent of the isolated CNS were defined as methicillin sensitive-CNS (MS-CNS), 71% of the isolated CNS were defined as methicillin resistant-CNS (MR-CNS). There was no statistically significant difference between MS-CNS and MR-CNS strains for fusidic acid susceptibility rates (p=0.490). But the difference among fusidic acid susceptibility rates of CNS and S.aureus strains was statistically significant (p<0.001). CNS strains were found more resistance than S.aureus strains for fusidic acid. Conclusion: In this study, the resistance rates were detected to increase for fusidic acid along with methicillin resistance. Among CNS isolates, fusidic acid resistance rates were significantly more elevated than that for S.aureus. Fusidic acid remains as an alternative in the treatment of infections due to staphylococci.
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    Öğe
    Fusidic Acid Resistance in Staphylococcus aureus Strains in an Interval of Ten Years (2001-2011)
    (Ortadogu Ad Pres & Publ Co, 2012) Nergiz, Sebnem; Atmaca, Selahattin; Ozekinci, Tuncer; Tekin, Alicem
    Objective: Fusidic acid is a steroid-like antibiotic which is used alone or consecutively in combination with other antimicrobial drugs in the treatment of staphylococcal infections, including the strains resistant to methicillin. In this study, we aimed to compare fusidic acid resistance rates in Staphylococcus aureus [methicillin susceptible Staphylococcus aureus (MSSA) and methicillin resistant Staphylococcus aureus (MRSA)] strains isolated in our hospital's clinical microbiology laboratory at an interval of ten years. Material and Methods: Bacterial strains were identified by conventional methods and BD PhoenixTM Automated Microbiology System (BD Diagnostic Systems, Sparks, MD). Methicillin and fusidic acid susceptibilities of the identified S. aureus strains were determined according to Clinical and Laboratory Standards Institute (CLSI) criteria. In order to determine methicillin and fusidic acid susceptibilities, 1 mu g oxacillin and 10 mu g fusidic acid disks (Oxoid Ltd., Basingstoke, United Kingdom) were used. Oxacillin susceptibility was detected according to the criteria of CLSI, and inhibition zone of >= 13 mm was considered as sensitive, 11-12 mm as intermediate, <= 10 mm as resistant. Fusidic acid susceptibility was detected according to the criteria of Comite de L'antibiogramme de la Societe Francaise de Microbiologie, and inhibition zone of 22 mm was considered as sensitive, 16-21 mm as intermediate, <= 15 mm as resistant. Results: In a study carried out ten years ago, fusidic acid resistance rate in S. aureus strains was reported as 11.6%, whereas in our study it was found as 14.6%. There was not any significant difference between the two resistance rates (p=0.695). Fusidic acid resistance rates were found to be 4.2% and 5.7%, respectively in the years 2001 and 2011 for MSSA strains. In MRSA strains, however, the rates were found as 18.9% and 22.2%, respectively. No significant difference was noted between fusidic acid resistances of MSSA and MASA strains, studied at the two different periods (p=1.00, p=0.906). Conclusion: In the light of these findings, it has been concluded that fusidic acid is still a good alternative drug in the treatment of all staphylococcal infections, including methicillin resistant strains.
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    HBsAg, anti-HCV, anti-HIV 1/2 and syphilis seroprevalence in healthy volunteer blood donors in southeastern Anatolia
    (J Infection Developing Countries, 2013) Dayan, Saim; Tekin, Alicem; Tekin, Recep; Dal, Tuba; Hosoglu, Salih; Yazgan, Umit Can; Bekcibasi, Muhammed
    Introduction: This study investigated the seroprevalence of hepatitis B virus surface antigen (HBsAg), antibody against hepatitis C virus (anti-HCV), antibody against human immunodeficiency virus type 1/2 (anti-HIV 1/2), and antibody against Treponema pallidum (anti-Treponemal or syphilis antibody) in healthy volunteer blood donors, and assessed their distribution according to the years and genders. Methodology: HBsAg, anti-HCV, anti-HIV, and syphilis screening results of a total of 266,035 healthy volunteer blood donors who had been admitted for blood donation to the Regional Blood Center of Dicle University Hospital between January 2000 and December 2010 were evaluated, retrospectively. HBsAg, anti-HCV, and anti-HIV 1/2 screening were performed using a fully automated device with the microparticle enzyme immunoassay method (MEIA). Syphilis screening was performed by Rapid Plasma Reagin (RPR) carbon test between January 2000 and December 2009, and by using a fully automated device with the MEIA method between January 2010 and December 2010. Results: Of 266,035 healthy volunteer blood donors, 259,384 (97.5%) were male and 6,651 (2.5%) were female. Statistically, there was not any significant difference between male and female genders for HBsAg, anti-HCV and syphilis seropositivities (P = 0.729, P = 0.748, and P = 0.861, respectively). HBsAg was found to be positive in 8,422 (3.17%), anti-HCV in 1,703 (0.64%), anti-HIV 1/2 in one (0.0004%) of 266,035 healthy volunteer blood donors, and syphilis antibody with RPR in 166 (0.07%) of 246,341 healthy volunteer blood donors. Conclusion: Blood donor forms should be carefully tailored to improve the identification of possible risks of transfusion-transmitted infections.
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    HBV, HCV and HIV seroprevalence in soldiers tested for carriership
    (Society of TURAZ BİLİM, 2014) Deveci, Özcan; Uysal, Cem; Tekin, Recep; Tekin, Alicem; Ay, Müzeyyen; Bozkurt, Fatma; Dayan, Saim
    Individuals employed or recruited to work in tourism, cleaning and food sectors and the men performing their military service in the food and cleaning services in the military are requested to undergo scans for the hepatitis B (HBV), hepatitis C (HCV) and human immunodeficiency (HIV) viruses as part of the carrier testing. The aim of the present study is to evaluate the seroprevalence of HBV, HCV and HIV in the soldiers scanned in terms of carriership. The study was conducted in the Kiziltepe State Hospital through the retrospective evaluation of the records of the soldiers who presented to the infectious diseases clinic between March 2010 and December 2012 for carriership scans. The HBV, HCV, and HIV tests were carried out in the central laboratory of the Kiziltepe State Hospital through the micro particle enzyme immunoassay (MEIA) method using the Axsym Plus Immunoassay Auto Analyzer (Abbott Laboratories, Abbott Park, Illinois, USA). The records of 367 soldiers between the ages of 20-22 were included in the study. Among these, 5 (1.36%) were HBsAg and 2 (0.55%) were anti-HCV positive, while none of them were positive for HIV. In order to reduce the risk of HBV, HCV and HIV infections, which are mainly transmitted through blood and sexual intercourse, preventive measures should be taken, education should be given and awareness should be increased. Especially individuals who are employed in sectors where the transmission risk is high should be periodically scanned and monitored for infection and diseases caused by these viruses.
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    In vitro activity of quinupristin-dalfopristin, methicillin and vancomycin against staphylococcus strains isolated from clinical samples
    (Erciyes Üniversitesi Sağlık Bilimleri Enstitüsü, 2012) Yula, Erkan; Toka, Türkan Özer; Deveci, Özcan; Tekin, Alicem; Yanık, Keramettin; Durmaz, Süleyman
    Summary: The aim of the study is to investigate susceptibility of staphylococci strains isolated from various clinical samples to quinupristin-dalfopristin. The ninety-eight strains of staphylococci [74 coagulase-negative staphylococci (CNSs) and 24 S. aureus] isolated from various clinical samples were included the study which had been sent to microbiology laboratory. Staphylococci strains were identified by using conventional methods. Methicillin and quinupristin-dalfopristin susceptibility of staphylococci strains were performed by Kirby-Bauer’s disc diffusion method according to the Clinical and Laboratory Standards Institute criteria. Also, vancomycin susceptibility of strains was investigated by E-test method. Strain of S. aureus ATCC 25923 was used as the quality control strain. The fifty-three (72%) strains of the CNSs were defined as methicillinresistant CNS (MR-CNS), three (13%) strains of S. aureus was defined as methicillin-resistant S. aureus (MRSA). The eight (15%) strains of MR-CNS were found resistant to quinupristin-dalfopristin, one (5%) strain of MS-CNS were found resistant to quinupristin-dalfopristin. None of MSSA or MRSA strains were resistant to quinupristin-dalfopristin. All of the strains were found as susceptible to vancomycin. Strains of staphylococci were found susceptible to quinupristin-dalfopristin at high rates. Consequently we think that quinupristin-dalfopristin combination may be an alternative option for treatment of resistant Gram-positive cocci infections like vancomycin.
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    IN VITRO ACTIVITY OF QUINUPRISTIN-DALFOPRISTIN, METHICILLIN AND VANCOMYCIN AGAINST STAPHYLOCOCCUS STRAINS ISOLATED FROM CLINICAL SAMPLES
    (Erciyes Üniversitesi, 2012) Yula, Erkan; Özer, Turkan TOKA; Deveci, Ozcan; Tekin, Alicem; Yanık, Keramettin; Durmaz, Suleyman
    Bu çalışmada, çeşitli klinik örneklerden izole edilen stafilokok suşlarında kinupristin-dalfopristin duyarlılık oranlarının araştırılması amaçlanmıştır. Çalışmaya, mikrobiyoloji laboratuvarına gönderilen çeşitli klinik örneklerden izole edilen 98 stafilokok suşu [74'ü koagülaz negatif stafilokok (KNS) ve 24'ü S. aureus] dahil edildi. Stafilokok suşları konvansiyonel yöntemler ile tanımlandı. Stafilokok suşlarının metisilin ve kinupristin-dalfopristin duyarlılığı Clinical and Laboratory Standards Institute (CLSI) önerileri doğrultusunda Kirby-Bauer disk difüzyon yöntemiyle çalışıldı. Ayrıca suşların vankomisin duyarlılığı E-test yöntemi ile araştırıldı. Çalışmada kalite kontrol suşu olarak S. aureus ATCC 25923 kullanıldı. İzole edilen KNS’lerin 53(% 72)’ü metisiline dirençli KNS (MR-KNS) ve S. aureus’ların ise 3(%13)’ü metisiline dirençli (MRSA) olarak tanımlandı. MRKNS’lerin 8(% 15)’i kinupristin-dalfopristine dirençli iken, metisiline duyarlı KNS'lerde (MS-KNS) kinupristindalfopristin direnci 1(%5) suşta tespit edildi. MSSA ve MRSA suşlarının hiçbirinde kinupristin-dalfopristin direnci tespit edilmedi. Suşların tamamının vankomisine duyarlı olduğu bulundu. Stafilokok suşlarının kinupristindalfopristine yüksek oranda duyarlı oldukları bulundu. Sonuç olarak vankomisin gibi kinupristin-dalfopristin kombinasyonun da özellikle dirençli Gram-pozitif kok enfeksiyonlarının tedavisinde alternatif olabileceğini düşünmekteyiz
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    In Vitro Antimicrobial Susceptibility Pattern Among Stenotrophomonas Maltophilia Strains Isolated From Clinical Specimens
    (Düzce Üniversitesi, 2014) Dal, Tuba; Tekin, Recep; Deveci, Özcan; Demirkaya, Safinaz; Mete, Mahmut; Dayan, Saim; Tekin, Alicem
    Aim: In this study, the determination of in vitro antimicrobial susceptibility rates amongStenotrophomonas maltophilia strains isolated from clinical specimens was aimed.Method: A total of 60 S. maltophilia strains isolated from various clinical specimens sent toDicle University Hospital clinical microbiology laboratory between January 2006 and September2011 were included retrospectively in this study. Urine samples were inoculated onto 5% sheepblood agar and Eosin-Methylene Blue (EMB) agar media, quantitatively; other clinical sampleswere inoculated, qualitatively. Identification of S. maltophilia isolates was performed byconventional methods and fully automated microbiology system. Antimicrobial susceptibilitytests 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, 15blood, 11 sputum, four synovial fluids, three cerebrospinal fluids, two wound swabs and onemiddle ear materials. The resistance rates against antibiotics were detected as 85% (n=51) forpiperacillin-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 analternative option other than trimethoprim-sulfamethoxazole, for the treatment of infections dueto S. maltophilia at least in our region
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    In vitro efficacy of nitrofurantoin and some antibiotics in Escherichia coli strains isolated from urine cultures
    (2012) Özekinci, Tuncer; Dal, Tuba; Tekin, Alicem; Tekin, Recep; Bozdağ, Hasan; Deveci, Özcan
    Amaç: Bu retrospektif çalışmada, Escherichia coli’nin neden olduğu üriner sistem enfeksiyonlarının (ÜSE) tedavisinde yaygın olarak kullanılan bazı antibiyotikler ile nitrofurantoinin in vitro etkinliğini saptamayı amaçladık. Materyal ve metot: Toplam 3279 E.coli izolatı [2157’si (%65,8) ayakta tedavi edilen ve 1122’si (%34,2) yatan hasta olmak üzere] çalışma kapsamına alındı. E.coli izolatlarının identifikasyonları geleneksel yöntemler ve BD PhoenixTM 100 (Becton Dickinson, MD, USA) tam otomatik mikrobiyoloji sistemi ile yapıldı. Antimikrobik duyarlılık testleri Kirby-Bauer disk difüzyon yöntemi ile çalışıldı. Genişlemiş-spektrumlu beta-laktamaz (GSBL) aktivitesi ise çift-disk sinerji yöntemi kullanılarak belirlendi. Bulgular: Amosisilin-klavulanat, trimetoprim-sulfametoksazol ve siprofloksasin için duyarlılık oranları; sırasıyla %22,2, %39,8 ve %41,1 bulundu. Nitrofurantoin duyarlılık oranı ayakta tedavi edilen hastalar için %93,1 (n=2009) ve yatan hastalar için %89,2 (n=1001) olarak belirlendi. Ayakta tedavi edilen ve yatan hastaların nitrofurantoin duyarlılık oranları arasındaki fark istatistiksel olarak anlamlıydı (p<0,001). Ancak, nitrofurantoin duyarlılığı ile duyarlılık oranlarının yıllara göre dağılımı arasında anlamlı bir ilişki yoktu (p=0,755). GSBL üreten E.coli izolatlarının oranı %38 (n=1246) olarak saptandı. GSBL üreten ve üretmeyen izolatlar için nitrofurantoin duyarlılık oranları arasında da istatistiksel olarak anlamlı fark vardı (p<0,001). Sonuç: Bu çalışmanın ışığı altında, en azından hastanemizde ÜSE’nin tedavisi için nitrofurantoinin güvenli bir şekilde kullanılabileceğini düşünmekteyiz.