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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 Microorganisms and their antibiotic resistances that isolated from the urine of urinary infection suspected patients(1988) Tuncer I.; Sengil A.Z.; Findik D.; Ergun H.; Gunaydin M.[Abstract not Available]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 Reliability of stool antigen tests: Investigation of the diagnostic value of a new immunochromatographic Helicobacter pylori approach in dyspeptic patients(Asian Pacific Organization for Cancer Prevention, 2015) Korkmaz H.; Findik D.; Ugurluoglu C.; Terzi Y.Background: A diagnosis of H. pylori infection can be made by invasive or non-invasive methods. Several noninvasive diagnostic tests based on the detection of H. pylori stool antigen (HpSA) have been developed. The Genx H. pylori stool antigen card test is a new rapid, non-invasive test that is based on monoclonal immunochromatographic assay. The aim of this study was to determine its sensitivity, specificity, and diagnostic accuracy for diagnosing H. pylori infection in adult patients. Materials and Methods: A total of 162 patients were included in the study. A gastric biopsy was collected for histopathology and rapid urease testing. Stool specimens for HpSA testing were also collected. Patients were considered H. pylori positive if two invasive tests (histological and rapid urease tests) were positive. Results: Using the reference test, 50.6% of the samples were positive for H. pylori infection. The Genx H. pylori antigen test was positive in 19.7% of patients. The sensitivity, specificity, positive predictive value, negative predictive value, and diagnostic accuracy of the Genx H. pylori antigen test were 51.6%, 96.0%, 88.8%, 76.1%, and 79.0%, respectively. Conclusions: The Genx H. pylori stool antigen card test is a new non-invasive method that is fast and simple to perform but provides less reliable results.
