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Öğe Assessment of In vitro Antibacterial Activity and Cytotoxicity Effect of Nigella sativa Oil(MEDKNOW PUBLICATIONS & MEDIA PVT LTD, 2016) Ugur, Ayse Ruveyda; Dagi, Hatice Turk; Ozturk, Bahadir; Tekin, Gulsum; Findik, DuyguBackground: Methicillin resistance is a serious health concern since it has spread among Staphylococcus aureus and coagulase-negative Staphylococci (CoNS) that are frequent community and nosocomial pathogens worldwide. Methicillin-resistant strains are often resistant to other classes of antibiotics, making their treatment difficult. Nigella sativa oil is known to be active against Gram-positive cocci, yet its in vitro cytotoxicity is rarely investigated, is a proper and powerful candidate for treatment of methicillin-resistant isolates. Objectives: The aim of this study is to evaluate the in vitro antibacterial activity and cytotoxicity effect of N. sativa oil. Materials and Methods: The minimal inhibitory concentrations (MICs) of N. sativa oil were determined by broth microdilution method against four different American Type Culture Collection strains, 45 clinical isolates of methicillin-resistant S. aureus (MRSA), and 77 methicillin-resistant CoNS (MRCoNS). The effects of different dilutions (0.25 mu g/mL, 0.5 mu g/mL, and 1 mu g/mL) of N. sativa oil on the proliferation of gingival fibroblasts were evaluated. Results: The MIC values of N. sativa oil against clinical isolates of Staphylococci were between < 0.25 mu g/mL and 1.0 mu g/mL. Compared to the control group, there was no cytotoxic effect on the proliferation of the gingival fibroblasts. Conclusion: In the present study, the oil of N. sativa was very active against MRSA and MRCoNS and had no in vitro cytotoxicity at relevant concentrations. These findings emphasize that there is a requirement for further clinical trials on N. sativa oil for "safe" medical management of infections caused by methicillin-resistant Staphylococci.Öğe Bacteremia after piezocision(MOSBY-ELSEVIER, 2014) Ileri, Zehra; Akin, Mehmet; Erdur, Emire Aybuke; Dagi, Hatice Turk; Findik, DuyguIntroduction: The aim of this study was to investigate the presence of transient bacteremia after a piezocision procedure. Methods: The sample consisted of 30 subjects (24 women, 6 men; mean age, 19.6 +/- 0.7 years; range, 18.1-22.4 years) with the American Society of Anesthesiologists' physical status I. All patients had Class I skeletal and dental relationships and had fixed orthodontic treatment with the Damon system. The piezocision surgery was performed 1 week after the placement of the orthodontic appliances in all patients. Two 20-mL venous blood samples were collected before and 30 to 60 seconds after the first microincision using an aseptic technique. The samples were inoculated into BACTEC Plus aerobic and anaerobic blood culture bottles and were assessed in the BACTEC blood culture analyzer (Becton Dickinson Diagnostic Instrument Systems, Sparks, Md). The results were analyzed statistically using the McNemar test, with P = 0.05 indicating statistical significance. Results: No significant difference between the preoperative and postoperative samples was determined with respect to transient bacteremia (P < 0.250). No bacteremia was detected in the pretreatment samples, although Gemella sanguinis, Streptococcus pluranimalium, and Streptococcus mitis/oralis were detected in 3 postoperative blood samples. Conclusions: The piezocision procedure might be related to transitory bacteremia. Hence, orthodontists should consider the possibility of bacterial endocarditis in at-risk patients when piezocision is part of the treatment plan.Öğe COMMUNITY-ACQUIRED METHICILLIN-RESISTANT STAPHYLOCOCCUS AUREUS AND GENOTYPES AMONG UNIVERSITY STUDENTS IN TURKEY(SOUTHEAST ASIAN MINISTERS EDUC ORGANIZATION, 2014) Demirel, Gamze; Findik, Duygu; Dagi, Hatice Turk; Arslan, Ugur; Lan, ArsNasal carriage of Staphylococcus aureus is an important risk factor for nosocomial and community-acquired staphylococcal infections. We investigate the prevalence of community-acquired methicillin-sensitive (CA-MSSA) and -resistant (CA-MRSA), including inducible dormant (ID)-MRSA S. aureus, and genotypes of MRSA strains of nasal cultures from 1,108 university students attending Selcuk University, Turkey. Risk factors were based on replies to a questionnaire. S. aureus was identified using conventional culture methods and a Stapyloslide (R) latex test. Antibiotic susceptibility and methicillin resistance were determined by a disk diffusion method, and vancomycin susceptibility was performed using an E-test. Identification of mecA and SCCmec types were conducted by PCR and genotypes by pulse field gel-electrophoresis (PFGE). Prevalence of S. aureus was 17%, with 9% being MRSA. Two isolates were SCCmec type III, 11 were SCCmec variant IIIA and one SCCmec type IV. No ID-MRSA was detected. The majority of the isolates were resistant to penicillin and no strain was resistant to vancomycin. Two MRSA strains were PFGE pulsotype A, 9 pulsotype B, 2 pulsotype C,1 pulsotype D and 3 pulsotype E. Presence of permanent catheter and use of antibiotics in the previous month were risk factors for MSSA colonization and association with medical facilities were risk factors for MRSA carriers. There is a need for multicenter studies in Turkey to investigate CA- and ID-MRSA prevalence and nosocomial infections.Öğe Comparative evaluation of automated chemiluminescence tests and RIBA assay used in HCV diagnosis(SCIENTIFIC PUBLISHERS INDIA, 2016) Kalem, Fatma; Yuksekkaya, Serife; Dagi, Hatice Turk; Ertugrul, Omur; Dogan, MetinIntroduction: Hepatitis C, caused by hepatitis C virus (HCV) can be a mild illness lasting a few weeks or can cause lifelong liver cirrhosis and cancer. Today although the sensitivity of diagnostic tests is increasing; it has often been associated with decreased specificity so the rate of false-positive test results is increasing. The aim of this study was to compare the false-positive rates of anti-HCV results. Methods: During the period of 18.07.2011 to 18.12.2013; blood samples of patients admitted to Konya Numune Hospital were screened for anti-HCV using chemiluminescence immunoassay (CIA). After 2012; the new version of same anti-HCV test was used. Borderline and reactive results were retested and tests which were reactive in repeated CIA were confirmed by a recombinant immunoblot-assay (RIBA). Subjects with a positive RIBA test were considered to have been as true positive anti-HCV. Results: A total of 54178 sera were tested for anti-HCV during the period of 18.07.2011 to 18.12.2013 and 649 sera were positive with chemiluminescence method. 374 of reactive cases were confirmed by RIBA. The RIBA results showed 171 (45.7 %) negative, 163 (43.5 %) positive, and 40 (10.7 %) indeterminate results. By using the new version of the test; the rate of false positive and indeterminate anti-HCV test results decreased from 75.1% to 35.5 %. Conclusions: In this study it was observed that lower false positive rates of newly developed test. Lowering the false positive rate of ELISA tests will provide more confidence to use these tests in the diagnosis of HCV. There is a need for further studies on this issue.Öğe A Comparison of Immuncapture Agglutination and ELISA Methods in Sero-logical Diagnosis of Brucellosis(IVYSPRING INT PUBL, 2011) Ozdemir, Mehmet; Feyzioglu, Bahadir; Kurtoglu, Muhammed Guzel; Dogan, Metin; Dagi, Hatice Turk; Yuksekkaya, Serife; Kesli, RecepBackground: Different serological tests are used in serologic diagnosis of brucellosis. The most widely used of these are Standard Tube Agglutination and Coombs anti-brucella tests. Whereas ELISA Ig M and Ig G tests have been in use for a long time, immuncapture agglutination test has been recently introduced and used in serological diagnosis. The aim of this study was to compare diagnostic values of ELISA Ig M and Ig G and im-muncapture agglutination tests with Coombs anti-brucella test. Methods: Sera from 200 patients with presumptive diagnosis of brucellosis were in-cluded into the study. Coombs anti-brucella test, ELISA Ig M and Ig G tests and Im-muncapture test were investigated in these sera. Then, sensitivity, specificity, negative predictive and positive predictive values were calculated. Results: Sensitivity, specificity, negative predictive and positive predictive values were found to be 90,6 %, 76,3 %, 94,2 %, and 65,9 % respectively for the Immuncapture test, whereas they were found to be 73,7 %, 58,9 %, 84,2 %, and 42,8 % for Ig G and 72,2 %, 67,8 %, 85,2 %, and 48,7 % for Ig M. The Immuncapture test was found to be compatible with ELISA Ig M and Ig G tests but it was statistically incompatible with Coombs anti-brucella test. Conclusions: Immuncapture agglutination test yields similar results to those of Coombs anti-brucella test. This test is a useful test by virtue of the fact that it determines blocking antibodies in the diagnosis and follow-up of brucellosis.Öğe Determination of Hemolytic Activity and In Vitro Antifungal Susceptibility of Trichophyton rubrum Clinical Strains(ANKARA MICROBIOLOGY SOC, 2011) Solgun, Gulkan; Findik, Duygu; Dagi, Hatice Turk; Arslan, UgurTrichophyton spp. which are among the agents of dermatophytosis with high morbidity, produce many virulence factors including hemolysins that exhibit toxic activity on immune system cells. Since relapses and chronicity are common problems related to dermatophytosis, prompt and appropriate treatment is of crucial importance. However, treatment is getting difficult due to the choice of inappropriate antifungals and increasing rates of cross-resistance among antifungal agents. The aims of this study were to investigate the hemolytic activities of Trichophyton rubrum strains isolated from patients with dermatophytosis and to detect the in vitro susceptibilities of those strains to ketoconazole, itraconazole, sulconazole, econazole and terbinaphine. Hair, skin and nail samples of patients were examined with direct microscopy using potassium hydroxide and cultivated on mycobiotic agar and Sabouraud dextrose agar. To determine hemolytic activities of T.rubrum strains, they were subcultured in Columbia Agar with 5% sheep blood and incubated for 7-14 days at 25 degrees C in aerobic conditions. Media which displayed hemolysis were further incubated for 1-5 days at 37 degrees C to increase hemolytic activity. Antifungal susceptibility testing was done with broth microdilution method guided by Clinical and Laboratory Standards Institute (CLSI) M38-A document. A total of 79 T.rubrum strains which exhibited negative urease and hair perforation tests, yielded pigmentation in potato-dextrose agar, were evaluated in the study. Hemolytic activity was detected in 71 strains (89.9%). Fifty strains showed incomplete (alpha) hemolysis and 21 strains showed complete (beta) hemolysis, whereas hemolysis was absent in eight of the isolates. Larger colonies created a larger zone of hemolysis and the smaller ones created a smaller zone. However, alpha-hemolysis did not turn to beta-hemolysis following further enlargement of the colony. According to antifungal susceptibility testing, the minimum inhibitory concentration (MIC) ranges, MIC50 and MIC90 values were found 0.0125-4 mu g/ml, 0.5 and 2 mu g/ml for ketoconazole; 0.0625-2 mu g/ml, 0.5 and 1 mu g/ml for itraconazole; 0.0313-4 mu g/ml, 0.25 and 1 mu g/ml for sulconazole; 0.0313-0.125 mu g/ml, 0.0313 and 0.0625 mu g/ml for econazole; 0.0313-0.0313 mu g/ml, 0.0313 and 0.0313 mu g/ml for terbinaphine, respectively. When the MIC values of hemolytic and non-hemolytic T.rubrum strains were compared, it was detected that hemolytic activity had no effect on MIC values. Our data have indicated that terbinaphine was the most effective antifungal agent against T.rubrum, while MIC values for itraconazole which is in common clinical use, were higher than expected and MIC values for econazole were lower than expected.Öğe Enterococcus avium Peritonitis in a Child on Continuous Ambulatory Peritoneal Dialysis(MULTIMED INC, 2014) Ugur, Ayse Ruveyda; Findik, Duygu; Dagi, Hatice Turk; Tuncer, Inci; Peru, Harun[Abstract not Available]Öğe Genotype distribution of extended Spectrum beta-Lactamase producing Escherichia coli and Klebsiella pneumoniae.(ALLIED ACAD, 2015) Dagi, Hatice Turk; Al Dulaimi, Dhay Ali Azeez; Kus, Halit; Seyhan, Tuba; Findik, Duygu; Tuncer, Inci; Arslan, UgurExtended-spectrum beta-lactamase (ESBL) production is the most important cause of beta-lactam resistance in Gram-negative bacteria. Although it may also be found in other Gram-negative bacteria, ESBL is most commonly produced by Escherichia coli and Klebsiella pneumoniae strains. In this study, we aimed to investigate the distribution of beta-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. (TEM)-T-bla, (SHV)-S-bla and (CTX)-C-bla-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. (TEM)-T-bla gene was the most prevalent type (85.8%) followed by (CTX)-C-bla-M (83.3%) and (SHV)-S-bla (24.2%). No blaSHV 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, (TEM)-T-bla 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.Öğe Identification and antifungal susceptibility of Candida species isolated from bloodstream infections in Konya, Turkey(BMC, 2016) Dagi, Hatice Turk; Findik, Duygu; Senkeles, Cigdem; Arslan, UgurBackground: In this study, our aim was to identify Candida species isolated from bloodstream infections and to determine their susceptibilities to various antifungal agents to demonstrate the local resistance profiles and to guide empirical treatment for clinicians. Methods: Two hundred Candida isolates (95 Candida albicans, 105 non-albicans Candida strains) were included in the study. Candida species were identified by conventional, biochemical and molecular methods. Antifungal susceptibility tests for amphotericin B, fluconazole, voriconazole, posaconazole, caspofungin and anidulafungin were performed with broth microdilution method according to the Clinical and Laboratory Standards Institute M27-A3 document. Results: Of the 200 Candida strains, the most prevalent species were C. albicans (47.5 %), Candida glabrata (18.0 %) and Candida parapsilosis complex (14.0 %). All Candida species except for three (1.5 %) Candida kefyr strains were susceptible to amphotericin B. Only one (2.8 %) C. glabrata was resistant to fluconazole (MIC >= 64 mu g/ml), and the others (97.2 %) exhibited dose-dependent susceptibility. All species, but C. glabrata strains, were susceptible to fluconazole. Resistance to voriconazole, posaconazole, caspofungin and anidulafungin was not detected in any strain. Conclusion: Candida albicans were susceptible to all antifungal drugs. Three C. kefyr strains were resistant to amphotericin B. Only one C. glabrata was resistant to fluconazole. All the strains were susceptible to voriconazole, posaconazole, caspofungin and anidulafungin. In vitro antifungal susceptibility tests should be performed to select of appropriate and effective antifungal therapy, and monitor the development of resistance.Öğe THE IMPORTANCE OF SOLUBLE UROKINASE PLASMINOGEN ACTIVATOR RECEPTOR IN PATIENTS WITH ACUTE BRUCELLOSIS(NOBEL ILAC, 2015) Demir, Nazlim Aktug; Dagi, Hatice Turk; Findik, Duygu; Sumer, Sua; Ural, Onur; Kolgelier, ServetObjective: Brucellosis is a common zoonotic infectious disease especially in Mediterranean countries. Inflammatory markers are elevated during the course of acute brucellosis. C-reactive protein (CRP) is the most commonly used biochemical marker in clinical practice. Soluble urokinase type plasminogen activator receptor (suPAR) is an interesting biomarker which has drawn attention recently. Purpose o f this study is to examine correlation between suPAR and CRP levels as markers o f infectious disease in patients diagnosed with acute brucellosis. Material and Method: This study included 125 acute brucellosis patients and 50 healthy controls. Pretreatment blood samples were taken from the patients. suPAR levels were measured using ELISA and CRP levels were measured with nephelometry. Results: There was a positive correlation between suPAR levels and CRP, alanine aminotransferase (ALT) and aspartate aminotransferase (AST) (p=0.045, 0.039, 0.040; respectively). When we compared patient and control groups, CRP and suPAR levels were significantly higher than controls (p=0.001, 0.001; respectively). Growth in blood culture was detected in 14 (11.2%) patients. Tlrere was not a significant difference between patients who have or did not have growth in blood cultures (p=0.117). In the ROC curve analysis performed for suPAR, area under the curve (AUC) was 93.6% (p=0.001). Sensitivity and specificity were calculated as 84.8% and 86.0%, respectively, when suPAR's cut-off value was taken as 3.85 ng/mL according to the ROC curve. Conclusion: Results of this study suggest that suPAR, like CRP, is a promising biomarker in acute brucellosis.Öğe THE IMPORTANCE OF SONICATION IN THE DIAGNOSIS OF PROSTHETIC JOINT INFECTIONS(NOBEL ILAC, 2017) Sumer, Sua; Erkocak, Omer Faruk; Arslan, Ugur; Findik, Duygu; Dagi, Hatice Turk; Aydin, Bahattin Kerem; Demir, Nazlim AktugObjective: 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.Öğe In Vitro Synergistic Activity of Sulbactam in Combination with Imipenem, Meropenem and Cefoperazone Against Carbapenem-Resistant Acinetobacter baumannii Isolates(ANKARA MICROBIOLOGY SOC, 2014) Dagi, Hatice Turk; Kus, Halit; Arslan, Ugur; Tuncer, InciAcinetobacter baumannii which is an opportunistic pathogen leading to nosocomial epidemics, exhibit high rates of antimicrobial resistance. Treatment of Acinetobacter infections is a challenge since most of the isolates are multiple antibiotic resistant. The aim of this study was to investigate minimum inhibitory concentrations (MICs) of sulbactam, imipenem, meropenem, and cefoperazone and in vitro synergistic activity of sulbactam in combination with imipenem, meropenem and cefoperazone against A.baumannii isolates of hospitalized patients. Forty A.baumannii strains isolated from various clinical specimens and found to be resistant to carbapenems by disc diffusion method, were included in the study. The isolates were identified by conventional methods and VITEK 2 (bioMerieux, France) automated identification system. MICs of sulbactam, imipenem, meropenem, and cefoperazone were determined by the broth nnicrodilution method according to the standards of CLS1 and in vitro synergy test was performed using the checkerboard microdilution method. Synergistic, partial synergistic, additive, indifferent and antagonistic effects of drug combinations were evaluated with the fractional inhibitory concentration index (FICI). Interpretation of the FICI was as follows: 0.5 synergy; <= 0.5 to < 1 partial synergy; 1 additive; > 1 to < 4 indifference; and >= 4 antagonism. Forty A.baumannii isolates were resistant to imipenem and cefoperazone, but two were susceptible, seven were moderately susceptible and 31 were resistant to meropenem with the microdilution method. MIC values of the isolates for sulbactam were found to be 4 mu g/ml in two, 8 mu g/ml in five, 16 mu\g/ml in three, 32 mu g/ml in 13, 64 pg/ml in three, 128 pg/ml in six and > 128 pg/ml in eight isolates. According to the FICI; imipenem/sulbactam combination exhibited synergy in 18 (45%), partial synergy in 4 (10%) and indifferent effect in 2 (5%) isolates, the combination of meropenem and sulbactam showed synergy in 19 (48%), partial synergy in 3 (7.5%), and indifferent effect in 3 (7.5%) isolates, the combination of cefoperazone/sulbactam demonstrated synergy in 18 (45%), partial synergy in 2 (5%), and indifferent effect in 2 (5%) isolates. There was no antagonistic effect with the tested combinations. In conclusion, MIC values of sulbactam were generally high in carbapenem-resistant A.baumannii strains. However, synergistic effect was detected in approximately half of the strains with the sulbactam/carbapenem combinations. The data obtained in this study should be supported by further advanced in vitro and clinical studies to predict the accurate clinical efficacy of sulbactam containing combinations on A.baumannii infections.Öğe Investigation of OXA Type Beta-Lactamases and PFGE Patterns in Acinetobacter baumannii Strains Resistant to Carbapenems(ANKARA MICROBIOLOGY SOC, 2014) Keyik, Serafettin; Arslan, Ugur; Dagi, Hatice Turk; Seyhan, Tuba; Findik, DuyguAcinetobacter baumannii is an important opportunistic and multidrug-resistant pathogen leading to nosocomial infections. Over the last 10 years, a significant and threatening increase in resistance to carbapenems, mainly due to the dissemination of class D beta-lactamases, has been reported in A.baumannii worldwide. The most common types of beta-lactamases causing carbapenem resistance in A.baumannii are the OXA-23, OXA-24, OXA-40, OXA-58 and OXA-143 type serine beta-lactamases. The aim of this study was to investigate the presence of OXA type beta-lactamases in carbapenem-resistant A.baumannii strains and the clonal relationship between the strains. A total of 105 non-duplicate carbapenem-resistant A.baumannii strains isolated from various clinical samples (68 blood, 18 bronchoalveolar lavage, 13 drainage, 3 urine, 2 cerebrospinal fluid and 1 catheter samples) in the Microbiology Laboratories of Selcuk University, Meram (2009-2012) and Selcuklu (2007-2008) Medical School Hospitals, were included in the study. The isolates were identified by conventional methods and Phoenix 100 BD (BD Diagnostic, USA) and Vitek II (bioMerieux, France) automated systems. Carbapenem susceptibility test was performed by Kirby-Bauer disk diffusion method according to the CLSI standards. bla(OXA 23-like), bla(OXA 24-like), bla(OXA 58-like) and bla(OXA 51-like) genes were amplified by multiplex PCR assay and clonal relatedness was investigated by pulsed-field gel electrophoresis (PFGE) using Apal enzyme. The bla(OXA 51-like) gene was determined in all carbapenem-resistant A.baumannii isolates, while the bla(OXA 23-like) and bla(OXA 58-like) genes were detected in 46.6% and 53.3% of isolates, respectively. However biG(OXA) (24-like) gene was not demonstrated in any isolates. bla(OXA 23-like) gene was determined in both Meram and Selcuklu Medical School hospitals, but bla(OXA 58-like) gene was detected only in Meram Medical School hospital. PFGE analysis of the isolates revealed 32 different groups in bla(OXA 23-like) producing A.baumannii strains and 23 different groups determined in bla(OXA 58-like) producing strains. No common epidemic isolates were detected in the two hospitals, however it was noted that some clones produced small outbreaks in Meram MS hospital. In this study it was shown that bla(OXA 23-like) and bla(OXA 58-like) genes together with bla(OXA 51-like) gene had significant roles in the carbapenem-resistance of A.baumanniistrains. Carbapenem-resistant A.baumannii strains producing bla(OXA 23-like) and bla(OXA 58-like) enzymes showed the epidemic potential of this nosocomial pathogen and the requirement of molecular typing methods to identify the epidemiologic relationship of the isolates.Öğe MLST Types of Vancomycin-Resistant Enterococcus faecium Strains Isolated from Blood Cultures(ANKARA MICROBIOLOGY SOC, 2013) Arslan, Ugur; Demir, Esra; Oryasin, Erman; Dagi, Hatice Turk; Tuncer, Inci; Findik, Duygu; Bozdogan, BulentEnterococci, 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 E.faecium 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 E.faecium by phenotypic methods and confirmed by 16S rRNA sequence analysis. Vancomycin MIC values of strains were determined as > 256 mu 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 A1, 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 ST17 (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 New tridentate azo-azomethines and their copper(II) complexes: Synthesis, solvent effect on tautomerism, electrochemical and biological studies(ELSEVIER, 2015) Sarigul, Munire; Deveci, Pervin; Kose, Muhammet; Arslan, Ugur; Dagi, Hatice Turk; Kurtoglu, MukerremIn this study, three azo-azomethines and their copper(II) complexes were prepared and characterized by analytical and spectroscopic methods. The complexes prepared were found to be mononuclear and the chelation of the ligands to the copper(II) ions occurs through two phenolic oxygens and a nitrogen atom of the azomethine group of the ligand. The tautomeric behaviors of the azo-azomethines in solution were studied by UV-Vis. spectra in three organic solvents with different polarity (CHCl3, DMSO and DMF) at room temperature. The redox behaviors of the azo-azomethines and their Cu(II) complexes were investigated by cyclic voltammetry (CV) in DMSO solution containing 0.1 M tetrabutylammonium tetrafluoroborate (TBATFB) as supporting electrolyte. Additionally, the antibacterial activity was also evaluated by the broth microdilution methods against Staphylococcus aureus, Enterococcus faecalis, Escherichia coli, Klebsiella pneumoniae and Pseudomonas aeruginosa. The compounds were found to be less effective against all bacteria tested than two reference antibiotics (ampicillin and gentamicin). (C) 2015 Elsevier B.V. All rights reservedÖğe Plasmid-mediated fluoroquinolone resistance in clinical isolates of escherichia coli in Konya, Turkey(CUKUROVA UNIV, FAC MEDICINE, 2018) Azeez, Dhay Ali; Findik, Duygu; Dagi, Hatice Turk; Arslan, UgurPurpose: Resistance to quinolones usually results from mutations in the topoisomerase genes encoded chromosomally and also the expression of efflux pumps, loss of porines and the transfer of plasmid-mediated genes. The aim of this study was to investigate the presence of plasmid-mediated quinolones resistance genes (qnrA, qnrB, qnrC, qnrS, qepA, and aac(6')-1b-cr) in clinical isolates of Esherichia coli from Selcuk University, Konya, Turkey. Materials and Methods: In this study 115 quinolone-resistant isolates were screened for qnrA, qnrB, qnrC, qnrS, qepA, and aac(6')-1b-cr genes by polymerase chain reaction (PCR). All aac(6')-1b positive amplicons were analyzed by digestion with BseGI restriction enzyme to identify aac(6')-1b-cr variant. Results: Of the 115 quinolone-resistant E. coli strains, three (2.6%) carried qnrB, nine (7.8%) carried qnrS and 50 (43.5%) carried aac(6')-1b-cr genes. None of them harboured qnrA, qnrC and qepA genes. Conclusion: We determined that aac(6')-1b-cr gene was responsible for most of the quinolone-resistant E. coli strains from Konya, Turkey. The prevalence of qnrB and qnrS genes was low and qnrA, qnrC and qepA genes were not detected. The surveillance of quinolone resistance genes is important, especially plasmid mediated ones are rapidly spreading all over the world.Öğe Postoperative fungal endophthalmitis caused by Trichosporon asahii treated with voriconazole(CONSEL BRASIL OFTALMOLOGIA, 2015) Gonul, Saban; Gedik, Sansal; Ozturk, Banu Turgut; Bakbak, Berker; Koktekir, Bengu Ekinci; Okudan, Suleyman; Dagi, Hatice TurkPostoperative fungal endophthalmitis is a rare but devastating complication of cataract surgery. Vitrectomy and intravitreal amphotericin B injection as well as administration of systemic antifungal agents have been suggested as optimal treatments for fungal endophthalmitis. However, this therapy may fail to eliminate fungal species resistant to current antifungal agents. The saprophytic fungus Trichosporon asahii is frequently observed as a cause of endogenous endophthalmitis in immunosuppressed patients. We report a case of postoperative endophthalmitis caused by T. asahii, resistant to amphotericin B. To the best of our knowledge, this is the first report of T. asahii endophthalmitis successfully treated with intravitreal and systemic voriconazole, pars plana vitrectomy, and removal of the intraocular lens and entire lens capsule.Öğe Reference ranges for serum immunoglobulin (IgG, IgA, and IgM) and IgG subclass levels in healthy children(TUBITAK SCIENTIFIC & TECHNICAL RESEARCH COUNCIL TURKEY, 2019) Bayram, Rumeysa Olcay; Ozdemir, Hulya; Emsen, Ayca; Dagi, Hatice Turk; Artac, HasibeBackground/aim: The serum immunoglobulin levels are used routinely in clinical practice because they provide key information on the humoral immune status. This study aimed to determine the age-related reference values of serum immunoglobulin levels in healthy children. Materials and methods: A total of 330 healthy children, aged between 0 and 18 years, were included in this study. The serum immunoglobulin levels were measured using a nephelometric method in a total of 11 groups, each group consisting of 30 individuals, and IgG subclasses in 6 groups of children aged more than 2 years. Results: The serum IgG levels were high during the newborn period, decreased until the sixth month, and again increased to a maximum level at the age of 18 years. The level of IgA was found to be extremely low in the newborn period and then increased with age. While the lowest value was in the newborn period for serum IgM level, the highest value was in the 16- to 18-year-old period. The IgG subclasses varied depending on the age groups. Conclusion: The updated reference intervals of immunoglobulin levels in children may be used for the accurate diagnosis of immune deficiencies.Öğe Screening and genotyping of group B streptococcus in pregnant and nonpregnant women in Turkey(J INFECTION DEVELOPING COUNTRIES, 2016) Alp, Feyza; Findik, Duygu; Dagi, Hatice Turk; Arslan, Ugur; Pekin, Aybike Tazegul; Yilmaz, Setenay ArzuIntroduction: The purpose of this study was to investigate group B streptococcus (GBS) colonization, to compare the methods, to determine the relationship between GBS carriage and risk factors, and to genotype the GBS isolates. Methodology: Recto-vaginal swab specimens were obtained from 500 women, and a questionnaire was administered to each to assess their risk factors for GBS carriage. A culture, GBS antigen test, and polymerase chain reaction (PCR) were performed on all samples. Antibiotic susceptibility testing was performed, and the clonal relationship was determined by pulsed-field gel electrophoresis (PFGE) on all viable isolates. Results: Of the 500 women, sixty-eight (13.6%) women were GBS carriers, of whom 9.8% were pregnant and 16.5% not. There was a significant difference between GBS carriage and history of premature rupture of membrane (PROM). GBS was isolated from 65 (13%) samples. GBS was positive in 70 (14%) samples by antigen test and in 62 (12.4%) by PCR. Sixty-eight of the 70 positive antigen tests were confirmed by PCR or culture. Fifty-five isolates were resistant to tetracycline, 16 to erythromycin and clindamycin, and 13 to levofloxacin. Thirteen different pulsotypes and 17 sporadic strains were determined by PFGE. Conclusions: GBS carriage rate in non-pregnant women was higher than in pregnant women. The GBS antigen test was more sensitive than culture and PCR. GBS isolates did not originate from a single clone and contained sporadic strains. There was a significant difference between GBS carriage and history of PROM. Epidemiologic data obtained in this study will help future studies.Öğe Two outbreaks of ESBL-producing Klebsiella pneumoniae in a neonatal intensive care unit(WILEY-BLACKWELL, 2014) Sumer, Sua; Dagi, Hatice Turk; Findik, Duygu; Arslan, Ugur; Demir, Nazlim Aktug; Ural, Onur; Tuncer, InciBackgroundIn the present study, two epidemic episodes of extended spectrum beta-lactamase (ESBL)-producing Klebsiella pneumoniae in the neonatal intensive care unit (NICU) were evaluated. MethodsRoutine and surveillance culture samples were taken from seven neonates with signs of infection in the NICU of Selcuk University Faculty of Medicine between 10 March and 25 April 2011, and between 11 June and 30 September 2011. ResultsESBL-producing K.pneumoniae strains were isolated in six different samples (one wound, one blood, and four cerebrospinal fluid cultures) of the three neonates in the first episode and in 11 different samples (seven blood and four cerebrospinal fluid cultures) of the four neonates in the second episode. ESBL-producing K.pneumoniae was isolated from inguinal, axillar region, and stool samples of the nine colonized neonates in the second episode. It was determined on pulse field gel electrophoresis that all strains originated from two clones. ConclusionsThe deficiencies in the infection control measures in an NICU may transform into an epidemic rapidly. Therefore, periodic training, observation, and monitoring of compliance are important.
