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    Colistin resistance in Carbapenem-resistant Klebsiella pneumoniae strains.
    (ALLIED ACAD, 2016) Kalem, Fatma; Ergun, Ayse Gul; Ertugrul, Omur; Ozcimen, Serap; Simsek, Husniye; Suzuk, Serap; Unaldi, Ozlem
    Objective: Because of the increase in the infections caused by carbapenem-resistant Klebsiella pneumoniae carbapenemase (KPC)-producing K. pneumoniae; nowadays colistin is used more frequently. In this study, the firstly detected colistin resistance in carbapenem-resistant KPC-producing K. pneumoniae strains were evaluated. Material and methods: For identification and susceptibility testing; VITEK 2 Compact (bioMerieux, France) have been used. Because of resistance; MICs were studied with gradient test method in Microbiology Reference Laboratory, Public Health Institution of Turkey, Ministry of Health, Ankara, Turkey for confirmation. The presence of carbapenem resistance genes (OXA23, NDM1, OXA48, KPC, VIM ve IMP) was investigated by Polymerase Chain Reaction (PCR) method. Pulsed Field Gel Electrophoresis (PFGE) method was used to determine the clonal relationships between strains. PCR and PFGE tests have been studied in Molecular Microbiology Research and Application Laboratory Department of Microbiology Reference Laboratories, Public Health Institution of Turkey, Ministry of Health, Ankara, Turkey. Results: All strains were resistance for carbapenems and colistin Two of four strains were isolated from patients hospitalized in intensive care and two of them were isolated from patients hospitalized in clinics. Resistance to carbapenems were confirmed genotypically. Two strains isolated from patients in clinics were positive for NDM1 and OX-48, and isolates from patients in intensive care unit were positive for only OXA-48 carbapenem genes. PFGE typing method described two clones that have a relationship with each other. The strains in which NDM1 and OXA-48 were together positive were in one clone and OXA-48-positive strains were in other clone. Conclusion: The emergence of colistin resistant strains is a very important problem due to decrease of treatment options for infections caused by carbapenem-resistant KPC producing K. pneumoniae. Colistin should not be used alone, combination therapy should be preferred.
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    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, Metin
    Introduction: 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.