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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 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 Determination of hepatitis B virus DNA incidence, viral load, and mutations in blood donors with HBsAg and anti-HBs-negative serology and antibodies to hepatitis B core antigen(ELSEVIER, 2007) Findik, Duygu; Arslan, Ugur; Baykan, MahmutBackground: The aim of the present study was to determine hepatitis B virus DNA incidence, viral load, and mutations in blood donors with HBsAG and anti-HBs negative serology and antibodies to hepatitis B core antigen. Methods: Blood samples were collected from 1000 blood donors with HBsAg-negative test results. Anti-HBc total screening was performed using the ELISA method. HBsAg-negative/anti-HBc total-positive samples were tested for anti-HBs, anti-HBc IgM, HBeAg, and anti-HBc. Samples with isolated anti-HBc were determined for viral load of HBV DNA using real-time PCR. Results: Anti-HBc total was established as positive in 200 (20%) of the 1000 blood donors. While anti-HBs was negative in 59 (29.5%) of the 200anti-HBc-positive samples, it was found to be positive in 141 (70.5%) of them. All of the other hepatitis B markers were negative in all of the anti-HBs-negative samples. HBV DNA was not detected in the sera of the isolated anti-HBc-positive blood donors with real-time PCR. Conclusion: Although we could not detect HBV DNA in the sera of the isolated anti-HBc-positive blood donors, findings in the literature suggest that anti-HBc testing should be used in combination with HBsAg for the screening of blood donors to reduce risk. After that, the most appropriate algorithm to follow can be HBV DNA screening of donors. (c) 2007 European Federation of Internal Medicine. Published by Elsevier B.V All rights reserved.Öğe Distribution of emm Genotypes and Antibiotic Susceptibility of Streptococcus pyogenes Strains: Analogy with the Vaccine in Development(ANKARA MICROBIOLOGY SOC, 2013) Arslan, Ugur; Oryasin, Erman; Eskin, Zeynep; Turk Dagi, Hatice; Findik, Duygu; Tuncer, Inci; Bozdogan, BulentStreptococcus pyogenes is the most common bacterial pathogen causing pharyngotonsillitis, and also can lead to diseases such as otitis media, impetigo, necrotizing fasciitis, bacteremia, sepsis and toxic shock-like syndrome. M protein encoded by emm gene is an important virulence factor of S.pyogenes and it is used for genotyping in epidemiological studies. The aims of this study were to determine the M protein types of group A streptococci (GAS) by using emm gene sequence analysis method, to compare the M types in terms of analogy with the vaccine in development and to determine the antibiotic susceptibilities of the isolates. A total of 35 GAS strains isolated from various clinical specimens in our laboratory were included in the study. Strains growing in blood culture were considered as invasive, strains growing in throat and abscess cultures were considered as non-invasive. The isolates have been identified by conventional methods and 16S rRNA sequence analysis at species level. emm genotyping of strains identified as S.pyogenes, was performed by PCR method as proposed by the CDC. Amplicons were obtained and sequenced in 23 out of 35 isolates. The results were compared with CDC emm sequence database. Antibiotic susceptibility of the isolates was performed by agar dilution method and evaluated as recommended by CLSI. Twenty-three out of 35 isolates could be typed and 15 different emm genotypes were detected. The most common emm types were emm1 (22%), emm89 (13%), emm18 (9%) and emm19 (9%). The detection rate of other emm types (emm5, 12, 14, 17, 26, 29, 37, 74, 78, 92, 99) was 47%. Types emm1, 12, 19, 74, 89 and 99 were observed in strains isolated from blood cultures. It was detected that nine of the 15 (60%) emm types are within the contents of 26 valent vaccine (emm 1, 5, 12, 14, 18, 19, 29, 89, 92). It was also observed that 17 (74%) of the 23 cases were infected by vaccine types and the four emm types (emm1, 12, 19, 89) identified in blood samples were among the vaccine types. All of the strains were found susceptible to penicillin, ampicillin, erythromycin, lincomycin, gentamicin, chloramphenicol, vancomycin and linezolid, however six isolates were resistant to levofloxacin (MIC=4 and 16 mu g/ml) and one isolate was resistant to tetracycline (MIC= 16 mu g/ml). In conclusion, this preliminary local study with limited number of invasive and non-invasive S.pyogenes isolates, emphasized the need for larger scale multi-center studies to determine the analogy and efficacy of the vaccine in development.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 Familial brucellosis: A report of four patients(ELSEVIER SCI LTD, 2006) Findik, Duygu; Ural, Onur; Arslan, Ugur; Dikici, Nebahat[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 Identification of bacterial vaginosis-associated bacteria in male urethra: Co-occurrence of Atopobium vaginae and Gardnerella vaginalis(MALAYSIAN SOC MICROBIOLOGY, 2019) Ugur, Ayse Ruveyda; Tuncer, Emine Inci; Findik, DuyguAims: Bacterial vaginosis (BV) is characterized by a transition in vaginal microflora from lactobacilli to anaerobic bacteria. Gardnerella vaginalis and Atopobium vaginae are considered the most responsible pathogens for the etiology of BV. Colonization of male urethra with BV-associated bacteria has been rarely investigated. The aim of this study was to investigate the differences in the presence of BV-associated bacteria in the healthy male urethra in regard to sexual exposure. Methodology and results: The first-catch urine specimens, representative of urethral swabs, from 114 healthy male volunteers, were included in this study. Lactobacillus spp., L. crispatus, L. jensenii, L. gasseri, L. iners, G. vaginalis, A. vaginae, Peptoniphilus spp., P. lacrimalis, BVAB2, Mageeibacillus indolicus, Megasphaera type I, Mobiluncus mulieris, Leptotrichia/Sneathia, Corynebacterium spp., and Prevotella spp. were investigated using a PCR assay. The most frequently identified BV-associated bacteria were Lactobacillus spp., Peptoniphilus spp., and G. vaginalis. There was no association between any BV-associated bacteria and sexual exposure. There was statistically significant co-occurrence of A. vaginae and G. vaginalis in the MU of subjects independently of sexual exposure (p = 0.025). Also, there was a significant association between G. vaginalis and smoking (p = 0.023). Conclusion, significance and impact of study: To the best of our knowledge, this is the first study reporting the co-occurrence of G. vaginalis and A. vaginae in the male urethra independently of sexual exposure.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 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 INVESTIGATION OF THE CLONALITY AND PANTON-VALENTINE LEUKOCIDIN TOXIN AMONG NOSOCOMIAL METHICILLIN-RESISTANT STAPHYLOCOCCUS AUREUS STRAINS(ANKARA MICROBIOLOGY SOC, 2009) Kirdar, Sevin; Arslan, Ugur; Tuncer, Inci; Findik, Duygu; Bozdogan, BuelentMethicillin-resistant Stapyhlococcus aureus (MRSA) is one of the major causes of morbidity and mortality in hospitalized patients. This study was aimed to investigate the clonality of the MRSA strains isolated from patients with nosocomial infection and also to determine the presence of Panton-Valentine leukocidin (PVL) toxin in these isolates. A total of 37 samples (31 isolated from surgical wound samples, 2 them from abscess and 4 from drainage samples) obtained from patients hospitalized at surgery, internal medicine and intensive care units, were included to the study. The clonality among MRSA strains was demonstrated by pulsed-field gel electrophoresis (PFGE) and the presence of PVL by polymerase chain reaction using luk-PV-1 and luk-PV-2 primers. PFGE revealed that 31 of 37 strains were A pulsotype and subtypes, 3 strains were B pulsotype and the last 3 were C pulsotype. Pulsotype A has been isolated especially from cardiovascular surgery and other surgery departments and intensive care units, pulsotype B from orthopedic and pulsotype C from neurology and neurosurgery wards. PVL gene was not identified in any of the isolates. These results indicated the presence of a dominant clone among MRSA strains in our hospital, however, different pulsotypes may also be present in different surgery units. Continuous molecular epidemiological surveillance of nosocomial MRSA strains and their PVL positivity supply valuable clinical and epidemiological data for infection control and patient follow-up.Öğe Investigation of Various Virulence Factors of Klebsiella pneumoniae strains Isolated from Nosocomial Infections(ANKARA MICROBIOLOGY SOC, 2017) Kus, Halit; Arslan, Ugur; Turk Dagi, Hatice; Findik, DuyguKlebsiella pneumoniae is an opportunistic pathogen that commonly affects immunosuppressed patients and causes nosocomial infections. K. pneumoniae has a variety of virulence factors, especially capsule polysaccharide, hypermucoviscosity (HV), fimbriae, toxins and determinants for iron acquisition. The aim of this study was to detect the virulence factors in K. pneumoniae strains isolated from nosocomial infections in two years. Fifty three K. pneumoniae strains isolated from the samples of patients with nosocomial infections in the Medical Microbiology Laboratory of Selcuk University Faculty of Medicine Hospital between 2011 and 2013 were included in the study. Identification and antimicrobial susceptibilities of the isolates were performed by VITEK 2 automatic system. Biofilm formation, alpha-hemolysin, capsule and HV were investigated by phenotypic methods. Polymerase chain reaction (PCR) was used to detect virulence genes encoding adhesins (fimH-1, mrkD, kpn, ycfM), siderophores (entB: enterobactin, iutA: aerobactin, irp-1, irp-2, ybtS, fyuA: yersiniabactin, iroN: catechols receptor), protectines or invasins (rmpA, magA, traT) and toxins (hlyA, cnf-1). Of the 53 K. pneumoniae isolates, 12 (22.6%) were isolated from in patients of reanimation intensive care unit, 8 (15.1%) medical oncology, 7 (13.2%) newborn intensive care unit and 26 (49%) other clinics. The distribution of the isolates according to the samples was as follows: urine (n=14), blood (n=13), wound (n=8), drainage fluid (n=10), broncho-alveolar lavage (n=7), and cerebrospinal fluid (n=1). Isolates which were resistant to meropenem were 5.7% and production of extended spectrum beta-lactamase (ESBL) was 71.7%. The capsule, biofilm formation, and HV were observed in 100%, 79.2%, and 1.9% of the isolates, respectively. Production of alpha-hemolysin was not detected in any of the isolates. The genes; entB (96.2%), ycfM (86.8%), and mrkD (83.0%) showed high prevalence. The other genes were detected in different ratios: fimH-1 (64.2%), fyuA (54.7%), kpn (49.1%), ybtS (41.5%), irp-1(41.5%), irp-2 (37.7%), traT (11.3%) and iutA (5.7%). Virulence genes; iroN, rmpA, magA, hlyA and cnf-1 were not detected in any of the isolates. Enterobactin had the highest rate among siderophores, and ycfM and mrkD in adhesins. The capsule and biofilm formation were commonly found in the isolates. Hypermucoviscosity was only found in one isolate but associated genes were not detected. Alfa hemolysin production and hlyA gene were not determined. As a result, it seems that the basis of the pathogenicity of K. pneumoniae strains isolated from nosocomial infections are capsule, adhesins, enterobactin and ability of biofilm formation. There is a need for new studies for the continuous monitoring of toxin and invasion ability as well as antibiotic resistance in the control of hospital infection caused by K. pneumoniae.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 Molecular Epidemiology and Antifungal Susceptibility of Candida Species Isolated from Urine Samples of Patients in Intensive Care Unit(ANKARA MICROBIOLOGY SOC, 2011) Yuksekkaya, Serife; Findik, Duygu; Arslan, UgurThe aims of this study were to analyse the amphotericin B and fluconazole susceptibility and molecular epidemiology of Candida strains (Candida albicans, Candida tropicalis and Candida glabrata) isolated from the urine samples of patients hospitalized in the intensive care unit. Identification of the isolates was done according to microscopic morphology (chlamydospor, blastospor, pseudohyphae and true hyphae) on cornmeal agar, germ tube formation and carbohydrate assimilation patterns (API ID 32C bioMerieux, France). Antifungal susceptibilities of the isolates were determined by in vitro broth microdilution method recommended by Clinical and Laboratory Standards Institute (CLSI). To investigate the clonal relationship of the isolates, randomly amplified polymorphic DNA (RAPD) analysis was performed by using Cnd3 primer. Of the 56 Candida isolates minimum inhibitory concentration (MIC) ranges, MIC50 and MIC90 values for amphotericin B were 0.125-1 mu g/ml, 0.125 and 0.5 mu g/ml for C.albicans, 0.125-1 mu g/ml, 0.25 and 1 mu g/ml for C.tropicalis and 0.125-1 mu g/ml, 0.25 and 1 mu g/ml for C.glabrata, respectively. Fluconazole MIC ranges, MIC50 and MIC90 values were 0.25-4 mu g/ml, 0.25 and 0.5 mu g/ml for C.albicans, 0.25-16 mu g/ml, 0.5 and 1 mu g/ml for C.tropicalis and 0.5-64 mu g/ml, 8 and 16 mu g/ml for C.glabrata, respectively. For amphotericin B, none of the isolates had high MIC values (MIC > 1 mu g/ml). While one of the C.glabrata isolates was resistant to fluconazole (MIC >= 64 mu g/ml), one C.tropicalis and two C.glabrata isolates were dose-dependent susceptible (MIC: 16-32 mu g/ml). The results of RAPD analysis indicated an exogenous spread from two clones for C.albicans, one clone for C.glabrata and one clone for C.tropicalis. This study underlines the importance of molecular epidemiological analysis of clinical samples together with hospital environmental samples in terms of Candida spp. to determine the exogenous origin for the related strains and to prevent nosocomial Candida infections.Öğe Nail digital dermoscopy in onychomycosis: a correlation with clinical type, gender, and culture examination(ERCIYES UNIV SCH MEDICINE, 2019) Islamoglu, Zeynep Gizem Kaya; Demirbas, Abdullah; Unal, Mehmet; Findik, DuyguObjective: Onychomycosis (OM) is a common disease that covers both tinea unguium and those remaining cases caused by yeasts, mainly of the Candida and various non-dermatophyte molds. Diagnosis is usually confirmed with direct microscopy and fungal culture. Nail dermoscopy is a non-invasive tool to diagnose various nail disorders and also to avoid time-consuming investigations. The aim of the present study was to determine the dermoscoping findings in OM and to correlate this with clinical type, gender, and culture results. Materials and Methods: This was a cross-sectional study of 100 patients diagnosed with OM according to clinical findings and direct microscopic examination. Nail dermoscopy was performed using a FotoFinder Digital Dermoscope, and images were recorded. A part of the samples was cultured in all patients. Results: The most frequent clinical type was distal lateral subungual onychomycosis (80.0%). The culture was negative in 72.0% of the samples. In the positive group, 48% of Trichophyton rubrum was cultured. The most common dermoscopic findings were longitudinal stria, ruin appearance, and longitudinal leukonychia. In culture-negative samples, irregular termination was most commonly seen. Ruin appearance, brown discoloration, hematoma, and transverse leukonychia, such as brushing, were compatible with total dystrophic OM. Conclusion: Determinative dermoscopic findings for OM, clinical types, and fungus forms were identified. These signs can avoid unnecessary mycology in selected cases.Öğe 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.
