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Öğe Clinical characteristics and incidence of bacterial and viral pathogens in patients hospitalized with community acquired pneumonia in childhood in Konya between October 2008 and February 2010(Refik Saydam National Public Health Agency (RSNPHA), 2016) Sert S.; Emiroğlu M.; Arslan U.; Koç O.; Örs R.Objective: It was aimed to investigate clinical characteristics and incidence of bacterial and viral pathogens in patients who were hospitalized with the clinical diagnosis of community acquired pneumonia (CAP). Method: In this study 91 patients at the ages between one month and six years who required hospitalization and were admitted to pediatrics clinics and pediatric emergency services of the Selçuk University Meram Medical Faculty, and also who did not use antibiotics for 48 hours before hospital admission and had the clinical diagnosis of CAP were investigated from October 2008 to February 2010. Demographic and clinic characteristics of the patients were recorded. Blood samples for complete blood count, erytrocyte sedimentation rate, C-reactive protein, procalcitonin, blood culture and nasopharyngeal aspirate samples for detection of the viral etiologies by real time polymerase chain reaction (RT-PCR) were taken at the time of hospital admission. Initial posteroanterior (PA) chest X-rays of all patients were checked. Results: The agents of pneumonia were detected in 24.2% (22/91) but not in 75.8% (69/91) of our patients. Of 91 patients, 11 (12.1%) were positive for viral infections, 9 (9.9%) were positive for only bacterial infections, 3 (3.3%) had viral coenfection, 2 (2.2%) were positive for both viral and bacterial infections. Out of 11 viral positive patients, 7, 2, 1, 2, and 1 patients were detected to have parainfluenza virus (PIV) 2, PIV 3, adenovirus, both PIV 3 and adenovirus, both PIV 2 and PIV 3, respectively. RSV, PIV 1 and human metapneumovirus (hMPV) were not detected in any of cases. Out of 11 bacteria positive patients, 5, 2, 1, 1, 1, and 1 patients were detected to have Staphylococcus epidermidis, S. saprophyticus, S. hominis, S. capitis, S. sobrinus and S. mitis. Also mixed viral-bacterial agent presence were detected in 2 (2.2%) of our patients. Out of ninety one pneumonia patients those having their diagnosis clinically, 59 (64.7%) had radiological signs. Conclusion: Our study demonstrated the etiological influence of viral agents in CAP. Parainfluenza virus 2 was the most common viral agent among detected viruses in all age groups. Improving the etiological diagnosis of viral infections may avoid unnecessary the use of antibiotic. Further comprehensive and randomized controlled studies are needed to confirm our results.Öğe Detection of PER-1 type extended spectrum beta lactamase in the acinetobacter baumannii species isolated from blood cultures and investigation of clonal relationship [Kan kültürlerinden soyutlanan acinetobacter baumannii suşlarında PER-1 tipi beta laktamaz varlı?ı ve klonal yakınlı?ının araştırılması](Turkiye Klinikleri, 2013) Coşar M.; Tuncer E.I.; Arslan U.; Mansur A.; Otlu B.; Türk Da?i H.; Findik D.Objective: In this study, the presence of PER-1 type extended spectrum beta lactamases (ESBL) was investigated in ceftazidime-resistant Acinetobacter baumannii strains isolated from bloodstream infections by polymerase chain reaction (PCR), and the clonal relation of the isolates was investigated by random amplified polymorphic DNA (RAPD) PCR and pulse-field gel electrophoresis (PFGE) in all PER-1 producing A. baumannii strains. Material and Methods: The isolates were identified as A. baumannii by conventional methods and Phoenix 100BD automated system (Becton Dickinson Diagnostic Systems, Sparks). Ceftazidime resistance was determined by E test method and PER-1 genes were screened by PCR in ceftazidime resistant strains. Genetic relation of PER producing A. baumannii was investigated with RAPD and PFGE, and the similarity of the bands were calculated according to "dice similarity coefficients". Colistin susceptibility test was studied by E-test, and other antibiotic susceptibility tests were performed by the Kirby-Bauer disk-diffusion method according to the standards of Clinical and Laboratory Standards Institute. Results: Of the 100 A. baumannii isolates; 78 were determined as ceftazidime-resistant. The PER-1 gene was identified in 18 (23%) isolates of these strains. The clonal relation of the 18 PER-1 positive isolates were investigated by RAPD and PFGE. All PER-1 positive isolates were found to be clonally related. The resistance rates of the A. baumannii strains were found as follows: 67% to amikacin, 71% to imipenem, 85% to ciprofloxacin, 83% to tetracycline, 83% to trimethoprime-sulfamethoxazole, 87% to cefepim, 99% to piperacillin-tazobactam and 100% ceftriaxone. Colistin resistance was not determined. Conclusion: In our study, the prevalence of PER-1 was lower than the previous studies. However, presence of the high ceftazidime resistance rates among these isolates may indicate the presence of other beta-lactamases. Detection of clonally-related isolates with RAPD and PFGE in different clinics may be due to treatment of these patients in the same clinic before, and this may explain the spread of PER-1 positive strains. © 2013 by Türkiye Klinikleri.Öğe Evaluation of antibacterial effects of pulp capping agents with direct contact test method(2014) Yalcin M.; Arslan U.; Dundar A.Objectives: Calcium hydroxide has been used in dentistry as a major capping material having the capacity to introduce the formation of a mineralized dentin bridge, but it has no direct inducing effect to the pulp cells. The purpose of this study was to evaluate the antibacterial properties of three different pulp capping agents using a direct contact test (DCT). Materials and Methods: The antibacterial properties of three pulp capping agents were evaluated a DCT. For the DCT, wells (n = 12) of 96-microtiter plates were coated with the tested cements (Dycal, Dentsply, USA; DiaRoot BioAggregate, Diadent, Holland; Calcimol LC, Voco, Germany) and Kalzinol (zinc oxide/eugenol cement, Dentsply, USA) was used as control material. A Lactobacillus casei suspension was placed on the surface of each specimen for 1 h at 37°C. Bacterial growth was monitored for 16 h with a temperature-controlled microplate spectrophotometer. The kinetics of the outgrowth in each well were recorded continuously at 650 nm every 30 min. The data were analyzed by one-way ANOVA, and Tamhane's T2 multiple comparison test. The level of significance was determined as P < 0.05. Results: All pulp capping agents showed an increase in the logarithmic growth rate of L. casei when compared with the control group (P < 0.05). Therefore, all pulp capping agents did not show antibacterial activity. Conclusions: The tested pulp capping agents haven't got antibacterial properties. Therefore, they should be used carefully when pulp is exposed or only very thin dentin remained over the pulp to avoid bacterial contamination. © 2014 Dental Investigations Society.Öğe First case of peritonitis due to Ablotrophia defectiva [9](2006) Arslan U.; Guney I.; Yuksekkaya S.; Atalay H.; Turk Dag? H.[Abstract not Available]Öğe Genotype distribution of extended spectrum ?-lactamase producing Escherichia coli and Klebsiella pneumoniae(Scientific Publishers of India, 2015) Dagi H.T.; Al Dulaimi, Dhay Ali Azeez; Kuş, H.; Seyhan T.; Fındık, D.; Tuncer I.; Arslan U.Extended-spectrum beta-lactamase (ESBL) production is the most important cause of betalactam resistance in Gram-negative bacteria. Although it may also be found in other Gramnegative bacteria, ESBL is most commonly produced by Escherichia coli and Klebsiella pneumoniae strains. In this study, we aimed to investigate the distribution of ?-lactamase genes in ESBL-producing E. coli and K. pneumoniae strains. One hundred and twenty isolates of E. coli and K. pneumoniae isolated from clinical samples were used in this study. The identification and the antibiotic susceptibility tests were performed by VITEK 2 system in accordance with the manufacturer’s instructions. ESBL production was determined accoring to Clinical and Laboratory Standards Institute guidelines. The DNA isolation was performed with a commercial kit following company recommendations.blaTEM,blaSHV andblaCTX-M genes were amplified by multiplex PCR with specific primers. Of the 120 isolates collected, 84 isolates were of E. coli and 36 isolates were of K. pneumoniae.blaTEM gene was the most prevalent type (85.8%) followed byblaCTX-M (83.3%) andblaSHV (24.2%). NoblaSHV gene was detected in the E. coli strains. Among 120 ESBL-producing strains, 10.8% were susceptible to cefepime, 10.0% to ceftazidime, while 5.0% to ceftriaxone. In conclusion,blaTEM gene was the most frequently encountered ESBL of E. coli and K. pneumonia in our hospital. Further molecular surveillance and epidemiological studies of such resistant bacteria are recommended for monitoring and controlling the spread of ESBL producing strains. © 2015, Scientific Publishers of India. All rights reserved.Öğe The importance of sonication in the diagnosis of prosthetic joint infections [Prostetik eklem enfeksiyonlarinin tanisinda sonikasyonun önemi](Nobelmedicus, 2017) Sümer Ş.; Erkoçak Ö.F.; Arslan U.; Fındık D.; Dağı H.T.; Aydın B.K.; Demir N.A.Objective: The objective of this study is to investigate the efficacy of sonication method used to determine the cause in the diagnosis of prosthetic joint infections (PJI). Material and Method: This study included 30 patients who were operated due to prosthesis infection and as a control group 10 patients whose prostheses were removed due to mechanical reasons and who had no sign of infection. Cultures were prepared from these tissue samples through gram staining and conventional methods. The prostheses removed from the patients were put into the sonication device in sterile water with ringer lactate. After sonication, Gram staining, cultures and polymerase chain reaction (PCR) were made. Results: During the Gram staining done prior to the sonication, microorganisms were found in six patients (20%); after the sonication, microorganisms were seen in nine patients (30%), but this difference was not statistically significant (p>0.05). While agents were found in the cultures of 11 patients (36.7%) that were prepared using the conventional method, agents were found in 20 patients (66.7%) with the sonication method. The rate of detecting the agent in the culture prepared after sonication was statistical significantly higher than in the culture prepared with conventional methods (p=0.004). The sensitivity of PCR was found 63.3%. Conclusion: The sonication method of PJI is basically a procedure performed to increase the detectability of microorganisms. We found in the present study that the sonication method was obviously more precise than conventional methods in the microbiological diagnosis of PJI. © 2017, Nobelmedicus. All rights reserved.Öğe MLST types of vancomycin-resistant enterococcus faecium strains isolated from blood cultures [Kan Kültürlerinden ízole Edilen Vankomisine Dirençli Enterococcus faecium Suşlarinin MLST Tipien](Ankara Microbiology Society, 2013) Arslan U.; DEMlR E.; ORYAŞlN E.; Da?i H.T.; Tuncer I.; Findik D.; Bozdo?an B.Enterococci, particularly vancomycin-resistant enterococci (VRE), are important nosocomial pathogens with limited treatment options. Enterococci have low-level resistance to penicillins and aminoglycosides and are intrinsically resistant to cephalosporins. In addition, they can acquire high-level resistance to beta-lactam antibiotics, aminoglycosides and glycopeptides. The aim of this study was to determine glycopeptide resistance mechanisms and genetic relationships of vancomycin-resistant EJaecium strains isolated from blood cultures between 2003-2009 years by molecular epidemiologic methods. A total of 38 VRE strains isolated from blood cultures were included in this study. The isolates were identified by conventional methods and Phoenix 100 BD automated system (Becton Dickinson Diagnostic Systems, USA) and confirmed by sequence analysis of 16S rRNA amplicons. Antibiotic susceptibility tests were performed by the Kirby-Bauer disk diffusion method accor-ding to the CLSI standards. MIC values of vancomycin were determined in vancomycin resistant strains by E-test (AB Biodisk, Sweden) method. Vancomycin resistance genes included vanA, vanB, vanC, and vanD were investigated by polymerase chain reaction (PCR) method. Clonal relationship between strains was determined by pulsed-field gel electrophoresis (PFGE). Sequence analysis was performed for examples selected for multilocus sequence typing (MLST) of each pulsotype and subtype. Thirty eight strains of enterococci isolated from blood cultures were defined as EJaecium by phenotypic methods and confirmed by 16S rRNA sequence analysis. Vancomycin MIC values of strains were determined as > 256 ?g/ml by E test. The vanA gene was detected in all isolates. Clonal relationship of 38 isolates E.Faecium carrying the vanA gene was determined by PFGE and MLST methods. PFGE detected four pulsotypes (A-D) and one sporadic isolate. Twenty nine strains belonged to A pulsotype, three strains belonged to B pulsotype, two strains belonged to C pulsotype and three strains belonged to D pulsotype. Out of 29 isolates, eight strains were type Al, nine strains were type A2, six strains were type A3, two strains were type A4 and four strains were type A5. MLST identified four different sequence types (STs). Twenty nine A pulsotype and its subtypes belonged to ST117 (76.3%), three B pulsotype belonged to ST280 (7.9%), two C pulsotype belonged to ST18 (5.2%) and three D pulsotype belonged to STI7 (7.9%). In conclusion, bloodstream infections caused by VRE in our hospital arose from a dominant strain belonged to ST117. However, presence of different pulsotypes of this strain indicated that the strain had been present in the hospital for a long time and had accumulated genetic variations. In addition, infections caused by minor pulsotypes were also detected. Therefore for prevention and control of the spread of nosocomial infections caused by VRE, it is crucial to identify resistance patterns and clonal relationship of these organisms.Öğe Quantitative analysis of various virulance genes (PVL, LukED, ?-hemoliz) by real-time PCR of Staphylococcus aureus strains isolated from bovine mastitis(University of Punjab (new Campus), 2016) Arslan E.; Ladikli S.; Arslan U.In 98 Staphylococcus aureus (S. aureus) strains isolated from bovine mastitis, presence/absence of virulence genes such as Panton-Valentine leukocidin (PVL), ?-hemolysis and LukED and quantitative analysis were conducted by Real-Time PCR. According to Real-Time PCR PVL, ?-hemolysis and LukED genes of 98 S. aureus strains were found as 70.40%, 90.81% and 66.32%, respectively. As a result of the quantitative analysis of virulence genes according to strains, they are grouped into 3 groups as 40<-10,000, 10,000-100,000 and 100,000< IU/ml considering viral gene amount. The amount of PVL gene among these groups was determined as 27.55%, 9.18% and 32.65% respectively, and ?-hemolysis as 48.97%, 39.79% and 2.04% and LukED as 45.91%, 14.28% and 6.12%. As a result, in S. aureus strains isolated from bovine mastitis the prevalence of these virulence genes were higher. Therefore it is deduced that PVL, ?-hemolysis and LukED may be important virulence factors in the pathogenesis of S. aureus. Copyright 2016 Zoological Society of Pakistan.Öğe Short communication: Extended-spectrum beta-lactamase production in Klebsiella pneumoniae strains isolated from bloodcultures and their antibiotic susceptibilities [Kisa bildiri: Kan kültürlerinden izole edilen Klebsiella pneumoniae suşlar?nda genişlemiş spektrumlu beta-laktamaz varl??? ve antibiyotik duyarl?l?klar?](2008) Işik F.; Arslan U.; Tuncer I.This study was carried out to detect the extended-spectrum beta-lactamase (ESBL)-producing Klebsiella pneumoniae strains isolated from blood cultures of hospitalized patients, and to determine their antimicrobial susceptibilities. A total of 102 K.pneumoniae strains isolated from blood samples were taken in the study, and ESBL production and susceptibilities to amikacin, gentamicin, imipenem, ciprofloxacin, amoxicillin/clavulonate (AMY/CA), ceftazidime, ceftriaxone, trimethoprim/ sulphametoxazole (TMP-SMX), piperacilin-tazobactam (PIP/TAZ) and chloramphenicol were investigated by using E-test (AB Biodisk, Sweden). ESBL positivity was observed in 65 (63.7%) of the isolates, and all of the strains were found susceptible to imipenem. The resistance rates of ESBL-producing isolates were detected as 27.7% for amikacin, 41.5% for chloramphenicol, 49.2% for TMP-SMX, 55.4% for ciprofloxacin and 60% for PIP/TAZ; whereas these rates for ESBL non-producers were 2.7%, 5.4%, 5.4%, 2.7%, and 13.5%, respectively. Both the resistance rates and MIC values (MIC50 and MIC90) of the tested antimicrobial agents except imipenem, were found higher in ESBL positive strains than the ESBL negative strains (p<0.05). The results of this study, in accordance with the previous national and international reports, indicated high rate of ESBL positive K.pneumoniae and also increased rate of antimicrobial resistance in such strains. Clinical microbiology laboratories should put ESBL detection tests into practice and each hospital should determine their antibiotic treatment policies according to their data.
