Browsing by Author "Gazi H."
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Item Prevalence of anti-HCV positivity in hemodialysis patients [4](2000) Sivrel Arisoy A.; Kursat S.; Gazi H.; Kurutepe S.; Ozbakkaloglu B.[No abstract available]Item Oropharyngeal carriage and penicillin resistance of Neisseria meningitidis in primary school children in Manisa, Turkey(Academy of Medicine Singapore, 2004) Gazi H.; Surucuoglu S.; Ozbakkaloglu B.; Alkcali S.; Ozkutuk N.; Degerli K.; Kurutepe S.Introduction: To determine the oropharyngeal carriage rates and serogroups of Neisseria meningitidis in primary school children in Manisa, Turkey as well as the prevalence and penicillin resistance of AC meningitidis. Materials and Methods: Throat swabs obtained from 1128 children were cultured and recovered organisms were tested by disk diffusion method and the E-test for antimicrobial susceptibilities. Results: The carriage rate of N. meningitidis in our region was 6.2% (71 strains) and the serogroups identified were serogroups A (28.1%), B (22.5%), C (35.2%), D (2.8%) and W-135 (11.2%). Penicillin resistance was found in 16 strains (22.5%), while beta-lactamase activity was found in none. Conclusions: The carriage rate of N. meningitidis and serogroups are similar to the rates reported in other countries. Continued surveillance of meningococci for antimicrobial resistance will allow early detection of changes in susceptibility patterns that might affect recommendations for chemoprophylaxis as well as for treatment.Item Antimicrobial susceptibility of bacterial pathogens in the oropharynx of healthy school children in Turkey(2004) Gazi H.; Kurutepe S.; Sürüoǧlu S.; Teker A.; Özbakkaloglǔ B.Background & objectives: Information on oropharyngeal carriage rates of Streplococcus pneumoniae, Haemophilus influenzae, Streptococcus pyogenes and Moraxella catarrhalis and their resistance pattern in healthy school children in Turkey is lacking. The present study was undertaken to determine the carriage rates and antimicrobial resistance of these bacterial pathogens in such children aged 6-14 yr in Manisa, Turkey. Methods: A total of 1022 children were included from nine schools selected randomly from 32 schools. Throat swabs were cultured for bacteria which were identified using standard microbiological methods. Antimicrobial susceptibility was determined as per National Committee for Clinical Laboratory Standards guidelines. Results: Of the 1022 children 240 (23.4%) harboured S. pneumoniae, 162 (15.8%) H. influenzae, 30 (2.9%) S. pyogenes and 82 (8%) M. catarrhalis in their oropharynx. For S. pneumoniae overall 17.9 per cent of the isolates were intermediately and 7 per cent were resistant to penicillin and resistance to erythromycin trimethoprim-sulphamethoxasole (TMP/SMX), and chloramphenicol was 13.7, 9.1 and 1.6 per cent, respectively. Ampicillin resistance observed in 20.9 per cent of H. influenzae isolates was associated with the presence of β-lactamase, except two isolates interpreted as β-lactamase-negative ampicillin resistant strains. Resistance of H. influenzae to TMP/SMX, chloramphenicol, azithromycin, cefaclor and amoxicillin/clavulanic acid was 14.2, 2.4, 1.8, 1.2 and 1.2 per cent, respectively. M.catarrhalis isolates produced β-lactamase in 80.5 per cent of the cases and all were susceptible to macrolides and clavulanic acid/amoxicillin combination; the highest rate of resistance of 17 per cent was for TMP/SMX. One (3.3%) isolate of S. pyogenes was resistant to macrolides tested. Interpretation & conclusion: Our data shows that upper respiratory tract of about 50 per cent children was colonized with respiratory pathogens. There is a need for surveillance of nasopharyngeal carriage of resistant strains in healthy school children.Item Increasing antimicrobial resistance in Escherichia coli isolates from community-acquired urinary tract infections during 1998-2003 in Manisa, Turkey(National Institute of Health, 2005) Kurutepe S.; Surucuoglu S.; Sezgin C.; Gazi H.; Gulay M.; Ozbakkaloglu B.Urinary tract infections are among the most common infections with an increasing resistance to antimicrobials. The aim of this study was to determine the change in antimicrobial susceptibility of Escherichia coli isolates from patients with community-acquired urinary tract infection (UTI) for the years 1998 through 2003 and to suggest that the current empirical antibiotic therapy used for these patients is inappropriate. During the study period, 7,335 community urine samples of which 1,203 (16.4%) grew bacterial isolates were analyzed. Among the total of 1,203 isolates, 880 (73.2%) were E. coli. The range of resistance of E. coli to ampicillin was 47.8 to 64.6% and that to trimethoprim-sulfamethoxazole was 37.1 to 44.6% during the study period. The susceptibility pattern of E. coli to nitrofurantoin and cefuroxime did not vary significantly over the 6-year period. There was a significant increase in the susceptibility of E. coli to ciprofloxacin (11.3-26.7%), amoxicillin-clavulanate (18.4-29.2%) and gentamicin (7.0-25.6%) (P < 0.05). Empirical initial treatment with ampicillin and trimethoprim-sulfamethoxazole was thus inadequate in approximately half of UTI cases in our region.Item Drug-resistant pulmonary tuberculosis in western Turkey: Prevalence, clinical characteristics and treatment outcome(King Faisal Specialist Hospital and Research Centre, 2005) Surucuoglu S.; Ozkutuk N.; Celik P.; Gazi H.; Dinc G.; Kurutepe S.; Koroglu G.; Havlucu Y.; Tuncay G.Background: Although high antituberculosis (anti-TB) drug resistance rates have been reported in Turkey, the clinical characteristics and implications for the outcome of anti-TB treatment have not been fully investigated. We determined the prevalence of anti-TB drug resistance and examined demographic data, clinical characteristics and treatment outcome in relation to patterns of resistance. Methods: From the TB case registry of a university hospital and the two largest dispensaries in Manisa city, we identified all pulmonary TB cases with a culture-proven definitive diagnosis and antimicrobial susceptibility results for a 7-year period. We collected and analyzed demographic and clinical data and information on treatment outcome for those cases in relationship to anti-TB drug resistance. Results: Of 355 M. tuberculosis strains, 71.5% were susceptible to streptomycin, isoniazid, rifampicin and ethambutol. Any drug resistance and multi-drug resistance (MDR) rates were 21.1% and 7.3% and were higher in males (53% and 9%, respectively) than in females (22% and 1%, respectively). Drug resistance was significantly higher in old cases (acquired drug resistance) vs new cases (primary drug resistance), and was associated with treatment failure (P<0.001). The prevalence of MDR was significantly higher in the old cases (22.4%) than in the new cases (4.4%) (P<0.001). Symptoms, radiographic findings, associated diseases, and sputum smear positivity were unrelated to the development of resistance. The prevalence of any drug resistance and MDR was significantly higher in those with treatment failure than in patients with treatment success. Conclusion: High resistance rates, particularly for acquired MDR, indicate a need for improvement in the TB control programme in our region.Item Subcutaneous administration of live lactobacillus prevents sepsis-induced lung organ failure in rats(2005) Ilkgul O.; Aydede H.; Erhan Y.; Surucuoglu S.; Gazi H.; Vatansever S.; Taneli F.; Ulman C.; Kose C.; Bengmark S.The leading cause of death in intensive care units around the world is the syndrome of exaggerated and prolonged systemic inflammation response (SIRS), which if not controlled will lead to irreversible, often multiple, organ dysfunction and organ failure syndrome (MODS). Host phagocytic cells, predominantly macrophages and neutrophils, and their soluble products, play a central role. Accumulation of neutrophils is often observed, especially in the lungs, intestines, liver and kidneys. Neutrophilic infiltration of distant organs, and especially of the lungs, has been a characteristic finding of patients dying from sepsis. However, the mechanisms responsible for the exuberant inflammation and neutrophil infiltration are not yet fully understood. It has recently been demonstrated that this, at least in part, is due to an inhibition of neutrophil apoptosis, and there is a suggested association with activation of nuclear factor - κB (NF-κB), reduced activity of caspases-9 and -3 and maintenance of mitochondrial transmembrane potential.Item Bacteriology of surgical wound infections in a tertiary care hospital in Turkey(2005) Surucuoglu S.; Gazi H.; Kurutepe S.; Ozkutuk N.; Ozbakkaloglu B.Objective: To determine the spectrum of the pathogens cultured from surgical wound infections and assess their antimicrobial drug resistances. Design: Laboratory-based retrospective study for the five year period. Setting: A four hundred bed, tertiary-care university hospital in Turkey. Results: Overall 621 pathogens were identified from January 1999 to January 2004. Of these isolates, 431 (69%) were gram-positive, 178 (29%) were gram-negative bacteria and also 12 (2%) were identified as Candida albicans. The most common organism was Staphylococcus aureus (50%), followed by Escherichia coli (8%), Streptococcus pyogenes (7%), Pseudomonas aeruginosa (7%), coagulase-negative staphylococci (6%), Enterococcus faecalis (4%), Enterobacter spp. (4%), Klebsiella pneumoniae (3%), Acinetobacter spp. (3%), Proteus spp. (3%), group B. B-haemolytic streptococci (2%), Candida albicans (2%), and Citrobacter spp. (1%). The rate of resistance to methicillin in staphylococci and multidrug resistance in S. aureus were 31% and 12%, respectively. There was no increase in resistance to methicillin by years. Piperacillin/tazobactam, sefoperazone/ sulbactam, carbapenems, ofloxacin and amikacin were the most active agents against gram-negative isolates. The rates of extended spectrum beta-lactamase production in K. pneumoniae and E. coli strains were determined as 14%, and 6%, respectively. Conclusion: Methicillin resistant Staphylococcus aureus (MRSA) is emerging as a major pathogen in surgical wound infections. We concluded that antimicrobial treatment of surgical wound infections should include empiric coverage for MRSA. The surveillance of resistance in pathogens causing surgical wound infections is necessary to promote the appropriate therapeutic choices for these infections.Item Comparison of antimicrobial effects of dexmedetomidine and etomidate-lipuro with those of propofol and midazolam(2006) Keleş G.T.; Kurutepe S.; Tok D.; Gazi H.; Dinç G.Background and objectives: The aim of our study was to investigate the antimicrobial effects of dexmedetomidine and etomidate-lipuro, and to compare these effects with those of midazolam and propofol on Staphylococcus aureus, Escherichia coli, Pseudomonas aeroginosa, Acinetobacter baumannii and extended-spectrum beta-lactamase Escherichia coli ( E. coli ESBL). Methods: All hypnotic dilutions were exposed to micro-organisms for 0, 30, 60, 120 and 240 min at room temperature in vitro. The inoculums taken from diluted suspensions were re-inoculated on blood agar and incubated for 18-24 h at 35°C after which a count of the colonies was compared. Results: Midazolam reduced the viable cells of S. aureus at 30, 60, 120 and 240 min, and also completely inhibited the growth of E. coli, P. aeroginosa, A. baumannii and E. coli ESBL. Dexmedetomidine, etomidate-lipuro and propofol, however, did not inhibit any of the micro-organisms tested. Conclusion: In vitro, midazolam had an antimicrobial effect on E. coli, P. aeroginosa, A. baumannii and E. coli ESBL. Like propofol and dexmedetomidine, etomidate-lipuro had no antimicrobial effect on any of the micro-organisms tested. © 2006 Copyright European Society of Anaesthesiology.Item Use of DNA hybridization test for diagnosing bacterial vaginosis in women with symptoms suggestive of infection(2006) Gazi H.; Degerli K.; Kurt O.; Teker A.; Uyar Y.; Caglar H.; Kurutepe S.; Surucuoglu S.The purpose of this study was to evaluate a DNA hybridization test (Affirm VPIII) as an alternative to Gram stain for the rapid diagnosis of bacterial vaginosis in women with clinical signs of vaginal infection. Vaginal specimens were collected from 321 symptomatic women, and analyzed for bacterial vaginosis by both Gram stain using Nugent criteria and DNA hybridization test. Sensitivity, specificity, positive predictive value, and negative predictive value of the DNA hybridization test were determined using the Gram staining as the standard for diagnosis of bacterial vaginosis. Of the 321 patients, 115 (35.8%) were Gram positive for bacterial vaginosis and 126 (39.2%) were negative. 80 patients (25.0%) demonstrated intermediate Gram staining that was also considered negative. The Affirm system detected G. vaginalis in 107 (93.0%) of 115 vaginal specimens positive for bacterial vaginosis diagnosed by Gram stain. Compared to the Gram stain, DNA hybridization test had a sensitivity of 87.7% and a specificity of 96.0%. Positive and negative predictive values of the DNA hybridization test were 93.0% and 92.7%, respectively. In conclusion, Affirm VPIII hybridization test correlated well with Gram stain and may be used as a rapid diagnostic tool to exclude bacterial vaginosis in women with genital complaints. Copyright © Apmis 2006.Item Characterization of rpoB mutations by line probe assay in rifampicin-resistant Mycobacterium tuberculosis clinical isolates from the Aegean region in Turkey(National Institute of Health, 2007) Ozkutuk N.; Gazi H.; Surucuoglu S.; Gunduz A.; Ozbakkaloglu B.The nature and frequency of mutations in the rpoB gene of rifampicin (RIF)-resistant Mycobacterium tuberculosis clinical isolates vary considerably according to the geographical location, and very little information is available regarding specific mutational patterns in our country. The main objective of this study was to determine the frequency of mutations in the hypervariable region of the rpoB gene in RIF-resistant M. tuberculosis isolates recovered from tuberculosis patients in our region by using the INNO-LiPA Rif. TB kit and to evaluate the performance of the kit for the detection of RIF-resistance. Mutations associated with RIF resistance were studied by line probe assay (LiPA) in 65 RIF-resistant and 56 RIF-susceptible M. tuberculosis strains isolated from different patients in the Aegean region of Turkey. The LiPA identified all susceptible strains (100%) as RIF-sensitive and 63 of 65 (96.9%) phenotypically documented RIF-resistant M. tuberculosis isolates as RIF-resistant, with specific detection of mutation in 44 (67.7%) isolates, whilst 2 strains were identified as RIF-susceptible. The R5-pattern (Ser-531-Leu mutation) was the most frequently observed (35 of 65, 53.8%), followed by the ΔS2-pattern (7.7%) and ΔS4-pattern (7.7%).Item Assessment of performance of "amplified Mycobacterium tuberculosis direct test" in pulmonary and extrapulmonary specimens; [Akci̇ǧer ve akci̇ǧer dişi örneklerde "ampli̇fi̇ye Mycobacterium tuberculosis di̇rek test" i̇n güveni̇li̇rli̇ǧi̇ni̇n deǧerlendi̇ri̇lmesi̇](2007) Sürücüoǧlu S.; Özkütük N.; Gazi H.; Çelik P.Since rapid diagnosis is critical in control of tuberculosis, nucleic acid amplification techniques have been widely used. The purpose of the present study was to assess the performance of Amplified Mycobacterium tuberculosis Direct Test (Amplified MTD Test, Gen-Probe) for the diagnosis of pulmonary and extrapulmonary tuberculosis in our laboratory. A total of 267 specimens (170 pulmonary and 97 extrapulmonary) were tested in the Clinical Mycobacteriology Laboratory of Manisa (a province located in Aegean part of Turkey) University Hospital from September 2001 to March 2005. When Amplified MTD (AMTD) test results were compared to the culture results taken as the gold standard, the sensitivity, specificity, positive and negative predictive values (PPV, NPV) for pulmonary specimens were found to be 84%, 96%, 73%, and 98%, respectively. When AMTD test positive, culture negative discrepant results were evaluated against the clinical history of the patients, these rates were detected as; 88%, 100%, 100%, and 98%, respectively. For 97 extrapulmonary specimens, sensitivity, specificity, PPV and NPV of AMTD test were 60%, 100%, 100%, and 98%, respectively. In conclusion, the results of the AMTD assay were reliable for the rapid diagnosis of pulmonary tuberculosis; if the results were evaluated together with the clinical status of patients, the performance of the test would be increased. However, even though the culture positive extrapulmonary specimens were sparse in our study (5%), the sensitivity of the AMTD test in extrapulmonary specimens was found less than that in pulmonary specimens. Therefore it is thought that AMTD test results should be evaluated carefully for the diagnosis of extrapulmonary tuberculosis.Item Comparison of interferon-gamma whole blood assay with tuberculin skin test for the diagnosis of tuberculosis infection in tuberculosis contacts; [Temaslιlarda tüberküloz enfeksiyonunun tanιsι için interferon-gama tam kan testi ile tüberkülin deri testinin karşιlaştιrιlmasι](2007) Öztürk N.; Sürücüoǧlu S.; Özkütük N.; Gazi H.; Akçali S.; Köroǧlu G.; Çiçek C.Tuberculin skin test which is used for the detection of latent tuberculosis (TB), has many disadvantages such as false positivities due to cross reactions between environmental mycobacteria and BCG strain, false negativities due to immunosuppression and malpractice, and also difficulties in application and evaluation. Recently a new diagnostic test which measures the production of interferon (IFN)-gamma in whole blood upon stimulation with specific ESAT-6 and CFP-10 antigens of Mycobacterium tuberculosis has been introduced. Since most of the mycobacteria other than tuberculosis and BCG strain do not contain these antigens, the detection of IFN-gamma levels indicates the specific T-cell response against M.tuberculosis. The aim of the study was to compare the tuberculin skin test and whole blood IFN-gamma assay (QuantiFERON®-TB Gold, Cellestis Ltd, Carnegie, Victoria, Australia) for the identification of latent TB infection in the contacts with active TB patients. The tests results were evaluated by using Kappa (K) analysis, and K coefficients of <0.4, 0.4-0.75 and >0.75 were accepted as poor, moderate and excellent agreements, respectively. A total of 233 subjects from three risk groups were included to the study. Group 1 included the household members (n=133) who had contact with smear positive index cases, Group 2 included the subjects from community (n=46) who had contact with smear positive index cases, and Group 3 included health care workers (n=74) who had contact with TB patients or their specimens. The positivity rates of tuberculin skin test and IFN-gamma assay in the cases were found as 37% and 42%, respectively. There were no significant differences among the three patient groups with regard to the results of the tuberculin skin test (p>0.05). However, the positive result of the IFN-gamma assay in Group 1 was found statistically higher than the other groups (51.3%, p=0.013). A poor agreement between the two tests was detected in the results taken from 233 subjects (65.7%, K=0.28), while agreement was moderate in unvaccinated group (72.7%, K=0.44). Evaluation of agreement rates of the tests according to the risk groups yielded 64.6% (K=0.3) for Group 1, 71.7% (K=0.32) for Group 2, and 63.5% (K=0.21) for Group 3, which all coefficients showed poor agreement. Although IFN-gamma blood assay has many advantages such as objective and quantitative results, no interference with vaccination due to the use of specific antigens and being practical, the high cost and the need for well-equipped laboratory are its disadvantages. As a result it was concluded that, IFN-gamma blood assay has limited value for the detection of latent TB infection in our country, since the prevalence of TB infection and BCG vaccination rates are high in Turkey.Item Clinical aspects and risk factors of nosocomial Stenotrophomonas maltophilia bacteremia episodes in a Turkish intensive care unit(E.S.I.F.T. srl, 2007) Tunger O.; Vural S.; Cetin C.B.; Keles G.; Borand H.; Gazi H.Stenotrophomonas maltophilia is an important nosocomial pathogen with increasing frequency in recent years, especially in immunocompromised and clinically debilitated patients. The aim of this study is to describe the characteristics of 35 episodes of S. maltophilia bacteremia at Celal Bayar University hospital in Turkey over a 3-year period from January 2003 to December 2005. Cases were identified with microbiology laboratory records and clinical data were collected from the medical record of each patient. The source of bacteremia was central venous catheter (CVC) in 65.7% (23) and respiratory tract infection in 2.9% (1) of episodes while the source of bacteremia was unknown in 11 (31.4%) episodes of bacteremia. Factors significantly associated with mortality were age of ≥65 years, APACHE score of ≥16, the presence of the total parenteral nutrition, anemia, low creatinine clearance level and shock. The most sensitive antibiotic was found as trimethoprim-sulfamethoxazole (91.4%) in antibiotic susceptibility testing of the isolates. Susceptibilities of piperacillin-tazobactam and netilmicin which frequently used antibiotics as an empirical therapy were 62.8% and 68.6%, respectively. © E.S.I.F.T. srl.Item Second-line drug susceptibilities of multidrug-resistant Mycobacterium tuberculosis isolates in Aegean Region - Turkey(2008) Özkütük N.; Sürücüoǧlu S.; Gazi H.; Coşkun M.; Özkütük A.; Özbakkaloǧlu B.Aim: The emergence of multidrug-resistant tuberculosis (MDR-TB) is increasing, and the standard shortcourse regimen used for the treatment of TB is likely to be ineffective against MDR-TB, leading to the need for second-line drugs. In such situations, drug susceptibility testing is necessary to select an appropriate treatment regimen. Unfortunately, there are few studies showing the pattern of the second-line drug resistance in Turkey. We aimed to analyze the resistance to second-line anti-tuberculosis drugs of MDR strains of Mycobacterium tuberculosis isolated from the Aegean region of Turkey. Materials and Methods: In this study, drug susceptibility testing of 40 MDR-TB strains isolated from the Aegean region of Turkey was performed using the BACTEC 460 TB radiometric system. Capreomycin, ethionamide, kanamycin, amikacin, clofazimine and ofloxacin were tested in 1.25 μg/ml, 1.25 μg/ml, 5.0 μg/ml, 1.0 μg/ml, 0.5 μg/ml, and 2.0 μg/ml concentrations, respectively. Results: The results showed that 37.5% of the strains were resistant to ethionamide, 25% to capreomycin, 5% to kanamycin, amikacin and ofloxacin, and 2.5% to clofazimine. One (2.5%) of the 40 MDR-TB cases was defined as extensively drug-resistant tuberculosis (XDR-TB). Conclusions: The results of the study indicate that the high rates of resistance to ethionamide and capreomycin may be a problem in the treatment of patients with MDR-TB; XDR-TB is not yet a serious problem in our region. © TÜBİTAK.Item Evaluation of real-time PCR method for rapid diagnosis of brucellosis with different clinical manifestations(2009) Surucuoglu S.; El S.; Ural S.; Gazi H.; Kurutepe S.; Taskiran P.; Yurtsever S.G.In this study, we tested the advantages of TaqMan real time PCR technique and compare it to conventional methods using serum samples from patients with different clinical forms of brucellosis. A total of 50 patients were included in the study. Blood culture using BACTEC 9240 system, Standard Wright's tube agglutination, and real time PCR methods were used. Control blood samples from 30 people with no history of brucellosis or exposure to Brucella spp. were examined too. Serological assay was positive for 49 patients (98%). Forty-four (88%) of the 50 patients had a positive PCR result, whereas Brucella spp were isolated from blood cultures of 18 patients (36%). STA test was all positive for focal brucellosis. Real time PCR test was positive in 9 patients with focal disease (90%), whereas blood culture was positive only in 4 patients (40%). The sensitivity, specificity, positive and negative predictive values of the real time PCR method were calculated as 88%, 100%, 100%, and 83%, respectively. Our results suggest that the high sensitivity and specificity of real time PCR method make it a useful tool for diagnosis of brucellosis with different clinical manifestations.Item Antimicrobial resistance of gram-negative bacteria isolated from lower respiratory tract specimens of hospitalized patients; [Hastanede yatan hastaların alt solunum yolu örneklerinden izole edilen gram-negatif bakterilerde antimikrobiyal direnç](AVES, 2011) Gazi H.; Ecemiş T.; Kurutepe S.; Gürsev N.; Sürücüoǧlu S.Objective: In this study, we aimed to determine the distribution of the genera of Gram-negative bacteria isolated from lower respiratory tracts of patients treated as in-patients and to calculate the antibiotic resistance rates to guide empirical antibiotic therapy. Methods: Samples taken from the lower respiratory tract and sent to the Bacteriology Laboratory at the Celal Bayar University Faculty of Medicine from January 2008 to December 2010 were retrospectively analyzed. Results: A total of 853 Gram-negative bacteria were isolated from specimens of in-patients. The rates of carbapenem (85%) and multidrug resistance (47%) among A. baumannii were higher than those observed for P. aeruginosa (30% and 19.2%). Carbapenem resistance was not found among the bacteria of the family Enterobacteriaceae, while the highest rates of resistance were detected for ciprofloxacin and trimethoprim-sulfamethoxazole. Conclusions: Implementation of effective treatment protocols based on sensitivity test results can be useful in preventing nosocomial lower respiratory infections caused by resistant Gram-negative bacteria.Item Molecular diversity of drug resistant Mycobacterium tuberculosis strains in Western Turkey(Galenos Publishing House, 2012) Sürücüoǧlu S.; Günal S.; Özkütük N.; Biçmen C.; Özsöz A.; Gazi H.; Durmaz R.Objective: The aim of this study was to investigate the molecular diversity and clonal relationship of drug resistant Mycobacterium tuberculosis strains isolated in Western Turkey. Materials and Methods: A total of 87 strains isolated between 2006 and 2009, eight of which were rifampicin monoresistant and 79 were multidrug resistant, were analyzed with IS6110 RFLP and spoligotyping methods. Results: The results of spoligotyping showed that 7% of the strains were orphans, and 8% were undefined for family in the SpolDB4 database. Major families of the strains were LAM (38%), T (35%), Haarlem (7%), Beijing (2%), S (2%) and U (1%) families. The clustering rate by spoligotyping was calculated as 75%. The most predominant SIT cluster was SIT41 (29%). According to the results of IS6110 RFLP, 71 different patterns of IS6110 were observed. Low copy number was found in 26% of the strains. When the results of two methods were combined, the final clustering rate was calculated as 26%. Conclusions: The genotypical distribution of drug resistant tuberculosis isolates in our region indicates genetic diversity and the clustering rate was found low in our region. However, more comprehensive and long-term molecular epidemiological studies are needed to control the drug resistant strains. © Trakya University Faculty of Medicine.Item Seroprevalance of measles, rubella, mumps, varicella, diphtheria, tetanus and hepatitis b in healthcare workers; [Saǧli{dotless}k çali{dotless}şanlari{dotless}nda ki{dotless}zami{dotless}k, ki{dotless}zami{dotless}kçi{dotless}k, kabakulak, suçiçeǧi, difteri, tetanos ve hepatit b seroprevalansi{dotless}](AVES Ibrahim Kara, 2013) Ciliz N.; Gazi H.; Ecemiş T.; Şenol S.; Akçali S.; Kurutepe S.Objective: We aimed to determine the antibody levels of healthcare workers of Celal Bayar University Hospital against vaccinepreventable diseases such as measles, rubella, mumps, diphtheria, tetanus, varicella and hepatitis B, and encourage compliance to recommended vaccinations for non-immune staff. Methods: The antibody levels were tested by enzyme-linked immunosorbent assay (ELISA). Demographic characteristics were collected by a questionnaire, and the history of the diseases, immunization and the sharps-related injuries were queried. Results: 44% percent of 309 healthcare personnel were exposed to occupational injury at least once, and 78.3% of the injuries were needle-stick injuries. Injuries were found to be more common among doctors and nurses, and pediatric and surgical departments, respectively. Frequency of anti-HBs positivity among healthcare workers was 84.1%, while 71.5% of healthcare workers were immunized with HBV vaccine before starting to work, and the immunization status directly correlated with the level of education. In general, high seropositivity was noted for measles (99.7%), rubella (97.0%), mumps (99.7%) and varicella (99.7%), while diphtheria (60.8%) and tetanus (93.5%) antibody levels significantly decreased with age. Histories of the disease and vaccination were not reliable while verifying the immunity status. Conclusions: It is necessary to increase adherence to universal protective measures in healthcare workers and to take corrective and protective measures for sharps-related injuries. It is also essential to increase hepatitis B vaccination rates and to confirm the immune status of medical staff working in high risk departments and diphtheria and tetanus vaccinations should be repeated once every ten years.Item In-vitro effects of various antimicrobial combinations against multidrugresistant Acinetobacter baumannii strains(Scientific Publishers of India, 2016) Güçkan R.; Kurutepe S.; Gazi H.; Kilinç Ç.In recent years, Acinetobacter strains have emerged as one of the most important nosocomial pathogens, especially in patients admitted to an intensive care unit (ICU). The progressively increasing antibiotic resistance against A. baumannii is now a major problem in our country as it is throughout the world. This resistance against A.baumannii has increased and led clinicians to find alternative antibiotics or antibiotic combinations. In the present study, it is aimed to evaluate the interaction between colistinrifampicin, colistin-imipenem, tigecycline-rifampicin and tigecycline-imipenem antibiotic combinations using microdilution checkerboard and E-test methods against ten multidrug resistant A. baumannii strains. Since A. baumannii strains have become frequently observed as an infection factor and since antimicrobial resistance rates have increased, there should be newly developed drugs for better treatments. In this study, 50 A. baumannii strains were isolated from various clinical specimens between June 2005 and September 2009 in Celal Bayar University, Faculty of Medicine, Department of Microbiology and Clinical Microbiology, and in Bacteriology Laboratory. Isolation and identification procedures were performed by using conventional biochemical tests as well as by BBL Crystal GN; N/F ID (Becton Dickinson, USA) or Phoenix 100 BD systems (Becton Dickinson, USA). The antibiotic susceptibilities of strains were investigated by using the disk diffusion method according to the recommendations of the Clinical and Laboratory Standards Institute. According to our in vitro study results, the checkerboard method, which was used to examine the synergy between colistin-rifampicin and colistin-imipenem, showed 80% synergistic activity. Tigecycline-imipenem combination had lowest synergetic (10%) efficiency and highest antagonistic effect (30%). The consistency between checkerboard and E-test methods was 52,5% (range 10-70%). Further comparison studies of the E-test synergy technique with the checkerboard and time-kill methods are warranted. © 2016, Scientific Publishers of India. All rights reserved.Item Seroprevalence of west nile virus, crimean-congo hemorrhagic fever virus, francisella tularensis and borrelia burgdorferi in rural population of Manisa, Western Turkey(Malaria Research Center, 2016) Gazi H.; Özkütük N.; Ecemis T.; Atasoylu G.; Köroglu G.; Kurutepe S.; Horasan G.D.Background & objectives: Zoonotic diseases are well recognised threat to public health globally. The information of regional prevalence and associated risk factors allow the national programmes to determine and frame better strategies for their control, as they also provide the actual status of zoonosis in the region. The aim of this study was to determine the seroprevalence of West Nile virus (WNV), Crimean-Congo hemorrhagic fever virus (CCHFV), Francisella tularensis and Borrelia burgdorferi among the rural residents of Manisa region, Turkey and to identify the associated risk factors. Methods: Cross sectional study was conducted in rural parts of Manisa, Aegean region of western Turkey in 2012. Blood samples from 324 randomly selected subjects were screened for the presence of IgG antibodies to WNV, CCHFV, F. tularensis and B. burgdorferi with commercially available kits. The demographic structure of the rural residents and risk factors related to lifestyle such as outdoor agriculture activities, animal husbandry, hunting and history of tick bite were questioned and their relationships with positive results were analyzed statistically. Results: It was observed that 49 subjects (15%) had IgG antibodies to at least one of the zoonotic agents studied. The seroprevalence of F. tularensis was highest with a percentage of 7.1% (n = 23). Distribution of the positive results for WNV, CCHFV and B. burgdorferi were 4.3% (n = 14), 3.7% (n = 12) and 0.9% (n = 3), respectively. Older age and uncompleted secondary education were the statistically significant risk factors for seropositivity to at least one zoonotic agent investigated. Logistic regression analyses confirmed that older age (over 50) increased the risk of WNV and CCHFV seropositivity. Interpretation & conclusion: Seropositivity rates were not found to be higher than the expected rates. Further, studies are needed to evaluate the threat of vector borne zoonoses and associated risk factors in the study area. © 2016, Malaria Research Center. All rights reserved.