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Öğe Colistin administration for extensive drug-resistant Pseudomonas aeruginosa pneumonia in intensive care unit: case report(Cukurova Univ, Fac Medicine, 2016) Kilinc, Cetin; Ulutas, Kemal Turker; Akcimen, Beril; Celik, Levent; Duran, NizamiPseudomonas aeruginosa strains may develop the resistance to antibiotics via different mechanisms such as, alteration of protein binders of penicillin, porin mutations, DNA-gyrase mutation and active expulsion pumps. Especially, multi-drug resistant P. aeruginosa strains, are known to be most important cause of mortality in the intensive care units. Special antibiotic therapy is required, because of having the multiple antibiotic resistances. The case reports a 67-year-old male patient who had a history of 6 years paraplegia. He admitted to the emergency department with impaired general condition, including a week ongoing nausea, chest pain, cough, phlegm, wheezing and fatigue. Widespread crepitant rales were detected up to the middle and lower zones of both lungs. Besides, there was CRP elevation, hyperuricemia, a consolidated infiltration compatible with increased opacity at lower zone of right lung and reticulonodular style increased opacity at upper zone of right lung on chest. On disk diffusion, there was resistance to all antibiotics except colistin. Although colistin treatment was initiated, the patient was lost due to cardiac arrest at the 3rd day of treatment. This case is reported to be observed for the first time of P. aeruginosa infection that was extensively drug-resistant to antibiotics except colistin in our hospital, and to highlight importance of true treatment arrangements according to antibiotic susceptibility.Öğe COMPARISON OF ANTIBIOTIC RESISTANCE OF ACINETOBACTER AND PSEUDOMONAS AERUGINOSA STRAINS ISOLATED FROM INTENSIVE CARE UNITS WITH OTHER CLINICS(Carbone Editore, 2016) Ozer, Burcin; Inci, Melek; Duran, Nizami; Kurtgoz, Seyda; Alagoz, Gulcan; Pasa, Ozgur; Kilinc, CetinIntroduction: Acinetobacter and Pseudomonas strains lead to serious and nosocomial infections in intensive care units (ICUs) and the other clinics. Resistance of these bacteria against to antibiotics, in particular is emerging as a very significant in intensive care units. The factors which affect the increase in resistance to antimicrobial drugs are the high probability of encountering antimicrobial resistant microorganisms and empiric antimicrobial treatment. Materials and methods: The bacterial culture results of clinical specimens sent to Microbiology Laboratory of Mustafa Kemal University Hospital in five year period were examined retrospectively. Antimicrobial susceptibility of the bacteria of genus Acinetobacter and Pseudomonas aeruginosa isolated from these specimens were analyzed. The antibiotic resistance of P. aeruginosa and Acinetobacter strains isolated from ICUs and those isolated from other clinics was compared. Results: In five-year period, 772 P. aeruginosa and 971 Acinetobacter spp. were isolated from the specimens. Twenty-three percent of P. aeruginosa strains and 49.3% of Acinetobacter spp. were isolated from the patients in intensive care units. 628 (64.7%) of Acinetobacter and 92 (11.9%) of P. aeruginosa strains were found to be Multidrug Resistant (MDR). The ratios of multidrug-resistance in Acinetobacter strains isolated from the patients in ICUs were found to be higher than those in P. aeruginosa strains isolated from the patients in intensive care units. MDR ratio of these bacteria isolated in ICUs was higher than that isolated in the other clinics. Conclusion: Acinetobacter strains isolated from the patients in ICUs were determined to be more resistant than those isolated from the patients in other clinics while Pseudomonas strains isolated from the other clinics, were more resistant than those isolated from the patients hospitalized in ICUs. The ratio of MDR bacteria was higher in ICUs than that in other clinics.Öğe Comparison of antibiotic resistance of acinetobacter and pseudomonas aeruginosa strains isolated from intensive care units with other clinics(A. CARBONE Editore, 2016) Ozer, Burcin; Inci, Melek; Duran, Nizami; Kurtgoz, Seyda; Alagoz, Gulcan; Pasa, Ozgur; Kilinc, CetinIntroduction: Acinetobacter and Pseudomonas strains lead to serious and nosocomial infections in intensive care units (ICUs) and the other clinics. Resistance of these bacteria against to antibiotics, in particular is emerging as a very significant in intensive care units. The factors which affect the increase in resistance to antimicrobial drugs are the high probability of encountering antimicrobial resistant microorganisms and empiric antimicrobial treatment. Materials and methods: The bacterial culture results of clinical specimens sent to Microbiology Laboratory of Mustafa Kemal University Hospital in five year period were examined retrospectively. Antimicrobial susceptibility of the bacteria of genus Acinetobacter and Pseudomonas aeruginosa isolated from these specimens were analyzed. The antibiotic resistance of P. aeruginosa and Acinetobacter strains isolated from ICUs and those isolated from other clinics was compared. Results: In five-year period, 772 P. aeruginosa and 971 Acinetobacter spp. were isolated from the specimens. Twenty-three percent of P. aeruginosa strains and 49.3% of Acinetobacter spp. were isolated from the patients in intensive care units. 628 (64.7%) of Acinetobacter and 92 (11.9%) of P. aeruginosa strains were found to be Multidrug Resistant (MDR). The ratios of multidrug-resistance in Acinetobacter strains isolated from the patients in ICUs were found to be higher than those in P. aeruginosa strains isolated from the patients in intensive care units. MDR ratio of these bacteria isolated in ICUs was higher than that isolated in the other clinics. Conclusion: Acinetobacter strains isolated from the patients in ICUs were determined to be more resistant than those isolated from the patients in other clinics while Pseudomonas strains isolated from the other clinics, were more resistant than those isolated from the patients hospitalized in ICUs. The ratio of MDR bacteria was higher in ICUs than that in other clinics.Öğe Molecular epidemiology and risk factors in extended-spectrum beta lactamase positive and quinolone-resistant Escherichia coli strains isolated from urinary tract infections(A. CARBONE Editore, 2015) Kilinc, Cetin; Inci, Melek; Yula, Erkan; Ozer, Burcin; Duran, Nizami; Durmaz, Suleyman; Kaya, Yusuf SelimIntroduction: The study was designed to investigate the epidemiology, risk factors, and clonal relationships in extended-spectrum beta lactamase (ESBL)-positive and quinolone resistant Escherichia coli strains isolated from urinary tract infections. Materials and methods: The study included 96 E. coli strains isolated from urine samples and identified as the infection agent. All the strains were ESBL positive and quinolone resistant. ESBL production was evaluated by the double disc synergy test. The clonal proximity of the isolates was determined with Rep-PCR method. Results: Fifty-two (54.2%) of the 96 isolates were isolated from nosocomial infections, and 44 (45.8%) were isolated from community- acquired infections. Three common risk factors for ESBL-positive E.coli infections were identified. The most common risk factor was hospitalization in the last 6 months. The Rep-PCR technique detected 29 clones, of which nine were major clones and 20 were sporadic. Conclusion: The identification of clonal relationships using Rep-PCR can reveal the source of infections and means of dissemination. Community-acquired isolates that cause infections may be associated with hospitalization. Strains colonized in hospital for along time can increase infections in various departments. An increase in the resistance to any drug in any unit of a hospital may be the harbinger of a pandemic. The source of infection and ways of spread can be identified most accurately by the demonstration of clonal relationships.Öğe MOLECULAR EPIDEMIOLOGY AND RISK FACTORS IN EXTENDED-SPECTRUM BETA LACTAMASE POSITIVE AND QUINOLONE-RESISTANT ESCHERICHIA COLI STRAINS ISOLATED FROM URINARY TRACT INFECTIONS(Carbone Editore, 2015) Kilinc, Cetin; Inci, Melek; Yula, Erkan; Ozer, Burcin; Duran, Nizami; Durmaz, Suleyman; Kaya, Yusuf SelimIntroduction: The study was designed to investigate the epidemiology, risk factors, and clonal relationships in extended-spectrum beta lactamase (ESBL)-positive and quinolone resistant Escherichia coli strains isolated from urinary tract infections. Materials and methods: The study included 96 E. coli strains isolated from urine samples and identified as the infection agent. All the strains were ESBL positive and quinolone resistant. ESBL production was evaluated by the double disc synergy test. The clonal proximity of the isolates was determined with Rep-PCR method. Results: Fifty-two (54.2%) of the 96 isolates were isolated from nosocomial infections, and 44 (45.8%) were isolated from community-acquired infections. Three common risk factors for ESBL-positive E.coli infections were identified. The most common risk factor was hospitalization in the last 6 months. The Rep-PCR technique detected 29 clones, of which nine were major clones and 20 were sporadic. Conclusion: The identification of clonal relationships using Rep-PCR can reveal the source of infections and means of dissemination. Community-acquired isolates that cause infections may be associated with hospitalization. Strains colonized in hospital for along time can increase infections in various departments. An increase in the resistance to any drug in any unit of a hospital may be the harbinger of a pandemic. The source of infection and ways of spread can be identified most accurately by the demonstration of clonal relationships.Öğe Sociodemographic characteristics of patients with Demodex brevis and Demodex folliculorum infestation and its association with rosacea and Behcet's disease.(Allied Acad, 2015) Durmaz, Suleyman; Yula, Erkan; Kaya, Ozlem Aycan; Gokmen, Aysegul Aksoy; Kilinc, Cetin; Atambay, Metin; Ekiz, OzlemDemodex mites are ectoparasites often found in the skin thought to be associated with the development of some skin diseases. Demodex positivity may be affected by several factors. In order to determine the relationship between Demodex infestation and rosacea disease (RD), Behcet's disease (BD) and various individual parameters such as gender, personal hygiene and skin type. A total of 238 individuals (61 with RD, 46 with BD, and 131 healthy subjects) were investigated for the presence of Demodex folliculorum and D. brevis using the standardized skin surface biopsy technique and a questionnaire. The incidence of Demodex mites in RD patients was significantly higher when compared to the control group (p=0.010 and p=0.001, respectively). However, there was no difference between those with BD and the control group. There was a significant difference between ages of groups, skin types, use of moisturizer, and itching, without taking into account the presence of Demodex among the disease groups (p<0.05). On the other hand, there was no significant difference between disease groups in terms of data of gender, skin care, epilation, and face washing. Our study reveals that the positivity rates of Demodex mites in rosacea patients were significantly higher. Mean ages of groups, skin types, use of moisturizer, and the presence of itching of the ear and face may be associated with higher density of Demodex mites.Öğe Sociodemographic characteristics of patients with demodex brevis and demodex folliculorum infestation and its association with rosacea and behçet’s disease(Scientific Publishers of India, 2015) Durmaz, Suleyman; Yula, Erkan; Aycan Kaya, Ozlem; Aksoy Gokmen, Aysegul; Kilinc, Cetin; Atambay, Metin; Ekiz, OzlemDemodex mites are ectoparasites often found in the skin thought to be associated with the development of some skin diseases. Demodex positivity may be affected by several factors. In order to determine the relationship between Demodex infestation and rosacea disease (RD), Behçet’s disease (BD) and various individual parameters such as gender, personal hygiene and skin type. A total of 238 individuals (61 with RD, 46 with BD, and 131 healthy subjects) were investigated for the presence of Demodex folliculorum and D. brevis using the standardized skin surface biopsy technique and a questionnaire. The incidence of Demodex mites in RD patients was significantly higher when compared to the control group (p=0.010 and p=0.001, respectively). However, there was no difference between those with BD and the control group. There was a significant difference between ages of groups, skin types, use of moisturizer, and itching, without taking into account the presence of Demodex among the disease groups (p<0.05). On the other hand, there was no significant difference between disease groups in terms of data of gender, skin care, epilation, and face washing. Our study reveals that the positivity rates of Demodex mites in rosacea patients were significantly higher. Mean ages of groups, skin types, use of moisturizer, and the presence of itching of the ear and face may be associated with higher density of Demodex mites. © 2015, Scientific Publishers of India. All rights reserved.Öğe Virulence Factors in Staphylococci Isolated From Nasal Cavities of Footballers(Elsevier Science Inc, 2016) Duran, Nizami; Yildirim, Yunus; Duran, Gulay Gulbol; Pasa, Ozgur; Kilinc, Cetin; Yildirim, Irfan; Eryilmaz, NaciyeAim: This study aimed to investigate the rate of Panton-Valentine Leukocidin producing Staphylococcus aureus and methicillin (mecA) and slime (icaA/icaD) genes in staphylococcal strains isolated from nasal cavities of footballers. Materials and Methods: Nasal swab samples were taken from each footballers and a healthy control group for the isolation of staphylococcal strains. The polymerase chain reaction technique was used to determine Panton-Valentine Leukocidin, mecA and icaA/icaD genes in staphylococcal isolates. Results: Among 91 S. aureus strains, the presence of mecA gene was detected as 9.9%. This ratio was 17.9% (27 of 151) among the coagulase-negative staphylococci. A significant difference was found between coagulase-negative staphylococci and S. aureus isolates regarding the presence of mecA gene (P < 0.001). As for the genes of the slime, icaA/icaD genes were detected in 198 of 242 (81.8%) strains. The occurrence of slime genes was 91.2% and 89.4% among the S. aureus coagulase and negative staphylococci, respectively (P > 0.05). There was a statistically significant difference between the frequency of the mecA and slime genes when compared with the healthy control group and the football players (P < 0.01). Of 91 isolates, 22 were found to be methicillin resistant by the oxacillin disc diffusion method, whereas the remaining (220) were methicillin susceptible. Methicillin resistance was detected as 14.9% by the polymerase chain reaction method, whereas it was found as 9.1% by phenotypic methods. Conclusions: Early and accurate diagnosis of virulent staphylococcal strains is crucial because the virulent coagulase-negative and coagulase-positive staphylococcal strains in the nasal floras of footballers may be major potential sources of superficial and deep tissue infections.
