26 research outputs found
Investigation of bla(OXA-48)-Like Genes in Carbapenemase Producing Klebsiella spp. Isolates
No full textThe emergence and spread of multi-drug-resistant (MDR), extended-spectrum beta-lactamase (ESBL) producing carbapenem-resistant members of Enterobacteriaceae family has become a worldwide health problem. Carbapenem resistance caused by bla(KPC), bla(NDM) gene regions are sporadic and bla(OXA-48) gene region is endemic in our country. The aim of this study was to determine the presence of bla(OXA-232), bla(OXA-181), bla(OXA-162), bla(OXA-204), bla(OXA-244), bla(OXA-163), bla(OXA-245) genes in OXA-48 like carbapenemase producing Klebsiella pneumoniae isolates. The isolates used in this study were provided from the Medical Microbiology Laboratory collection of Sakarya University Sakarya Training and Research Hospital. Identification and antibiotic susceptibility tests were determined by the VITEK 2 (R) automated system (biomerieux, France) and the carbapenemase production of isolates was determined by the modified Hodge test. Minimal inhibitor concentration (MIC) values were determined with broth microdilution method. The isolates containing the bla(OXA-48)-like gene region were identified by real-time polymerase chain reaction (Rt-PCR) method using consensus primers. In "High Resolution Melting Analysis (HRMA)" method carried out by using "Type-it HRM PCR" (Qiagen, Hilden, Germany) kit, isolates which showed a deviation in melting temperatures (Tm) were selected with the suspicion of OXA-48 variant. The sequence analysis (ABI 3500, Applied Biosystems, USA) was carried out to determine which variants were present in these isolates. Compatibility of MIC values was determined between VITEK 2 (R) and the microdilution method with the rate of 82% for imipenem, 77% for meropenem and 90% for ertapenem in carbapenemase-producing K. pneumoniae isolates. In 45 of 100 K. pneumoniae isolates, the bla(OXA-48)-like gene region was found to be positive by the Rt-PCR method. For the determination of OXA-48 variants, these 45 isolates were evaluated by HRMA method. The sequence analysis revealed that 41 (91.2%) isolates contained bla(OXA-48)/bla(OXA-245) gene regions, while 2 (4.4%) isolates were found to contain bla(OXA-181) gene regions and 2 (4.4%) isolates were found to contain bla(OXA-244) gene regions. This is the first study to determine OXA-48 and OXA-244 positivity in bla(OXA-48)-like gene regions in Turkey. As a result of this study, the OXA-48-like gene region was found to be 45%, of which 4.4% had bla(OXA-181) and 4.4% had bla(OXA-244) gene regions. The detection of bla(OXA-48)-like gene regions will guide for the selection of antibiotics in critical patient groups
Detection of the Presence of Extended-Spectrum Beta-Lactamase Enzyme in Gram-negative Bacteria According to CLSI and EUCAST Criteria
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Seroprevalence of TORCH Viral Agents in Pregnant Women in Turkey: Systematic Review and Meta-Analysis
No full textRubella Virus, Cytomegalovirus (CMV), Herpes Simplex Virus-2 (HSV-2), Hepatitis B (HBV) and Hepatitis C virus (HCV) can cause serious fetal disease. The seropositivity rates of these agents vary among countries and geographic regions. This study aimed to analyze the prevalence rates and diagnostic methods used in studies investigating the seroprevalence of viral pathogens in the TORCH group among pregnant women in Turkey between 2005 and 2024. A systematic search was conducted using electronic databases between January 2005 and January 2024. A total of 60 studies meeting the inclusion criteria were included. Data quality control was assessed using the Joanna Briggs Institute guideline prevalence studies checklist. Heterogeneity was measured using the I-squared (I2) statistic in the Comprehensive Meta Analysis (CMA) program. The average seropositivity rates for Rubella, CMV, HSV-2, HBV and HCV in Turkey were determined as 91.18%, 94.81%, 35.52%, 1.66% and 0.25%, respectively. When the diagnostic methods were examined, it was determined that ELISA and ECLIA methods were used most frequently. The seropositivity of the agents did not show statistically significant differences according to the year periods, geographical regions and age of the patients (p > 0.05). The highest prevalence rates of Rubella and HSV-2 in pregnant women were reported in the Mediterranean region, the highest prevalence rates of CMV and HCV in the Southeastern Anatolia region and the highest seroprevalence of Anti HBs in the Marmara region. The results of this study support the necessity of increasing public awareness in the control of fetal infection caused by TORCH viral agents, prenatal screening, vaccination for Rubella and HBV and compliance with hygiene conditions for agents such as CMV, HSV-2 and HCV. The results of this study highlight the need to increase public awareness on prenatal screening for the control of fetal infection caused by all TORCH viral agents, vaccination for Rubella and HBV and compliance with hygiene conditions for agents such as CMV, HSV-2 and HCV
The prevalence of mixed genotype infections in Turkish patients with hepatitis C: A multicentered assessment
No full textBackground: HCV virus infections are one of the major health problems in the world that can cause cirrhosis and liver cancer at a higher rate than other hepatitis data. The aim of this study was to determine the prevalence of mixed infections with different HCV genotypes in Turkey and also to evaluate the current HCV genotype and subtype distributions by a multicentered assessment. Methods: The HCV genotype data of 17,578 hepatitis C patients collected from 23 centers from different geographic regions covering all Turkey were collected. The data included information about the HCV genotypes in the last 10 years (between 2007 and 2016), demographic properties of the patients and the methods/systems used to determine the genotypes. Results: Two hundred twenty-eight of the patients (1.3%) had mixed genotype. The most common mixed genotype combination was 1b + 4 (0.83%) followed by 1a + 1b (0.26%). Genotype distribution varies according to geographical regions. However, genotype 1 (82.92%) was the most common genotype in all regions and all years. This was followed by genotype 3 (7.07%) and genotype 4 (5.43%). A variety of methods were used by the centers including sequencing, pyrosequencing, real-time PCR, in-house RFLP, reverse hybridization (LIPA), and hybridization. Conclusions: Infection with mixed HCV genotypes in Turkey is uncommon. Genotype distribution varies according to geographic regions; the most common genotype 1 is encountered all over the country, while genotypes 3 and 4 are only in some of the centers. Since there is limited information about mixed HCV infection, further investigations are needed to determine the clinical importance of mixed HCV infection. © 2019 Verlag Klinisches Labor GmbH. All rights reserved
Investigation of Programmed death-1 Expression Levels in Newly Diagnosed HIV (+) Individuals
No full textIntroduction: Antiretroviral therapy (ART) increases life expectancy by positively affecting viral load and immune system cells in individuals infected with human immunodeficiency virus (HIV). In this study, it was aimed to examine the correlation between CD4 T cell count and viral load changes and Programmed death-1 (PD-1) level before and after ART in newly diagnosed HIV (+) individuals.
Materials and Methods: Thirty HIV-infected individuals who were admitted to Sakarya University Training and Research Hospital Infectious Diseases Outpatient Clinic, had no other chronic disease, were newly diagnosed, and were to be treated for the first time with this study were included. In the follow-up of all patients, before the treatment and in the later stages of the treatment (in the 1st and 3rd months); quantitative HIV RNA levels and CD4 T and CD8 T cells counts were determined. In our study, PD-1 levels expressed from CD4 and CD8 T cells were determined by flow cytometry method.
Results: A positive, moderate correlation and a statistically significant correlation (n=80, rs=0.49614, p<0.001) was found between the rate of PD-1 expressed in CD4 T cells and viral loads. A positive, moderate correlation and a statistically significant correlation (n=80, rs=0.50954, p<0.001) was found between the rate of PD-1 expressed in CD8 T lymphocytes and viral loads.
Conclusion: As a result, it was concluded that PD-1 might be a marker of viral load and might be useful for monitoring viremia and changes in treatment response
Use of Soluble Suppression of Tumorigenicity 2 for Predicting the Need for Intubation and Mortality Outcomes in Patients with COVID-19
No full textIntroduction: Suppression of tumorigenicity 2 (ST2) plays a key role in the serious complications that may occur during Coronavirus disease-2019 (COVID-19), including systemic inflammatory condition, sepsis, Acute respiratory distress syndrome, and fibrosis. In this study, we evaluated the relationship between the serum ST2 concentrations and the mortality and need for mechanical ventilation.
Materials and Methods: A prospective observational study was conducted in patients diagnosed with COVID-19 who presented to the emergency department (ED) between October 2021 and April 2022. Patients with Severe acute respiratory syndrome-Coronavirus-2 infection were consecutively enrolled according to the clinical spectrum defined in the guidelines. Admission to the intensive care unit (ICU), requirement of intubation, and 90-day mortality were the primary study outcomes. Clinical, imaging and laboratory data were assessed to determine the clinical spectrum and severity scores. ST2 was assessed using the micro ELISA method and Sandwich-ELISA principle.
Results: Of the 64 (48.5%) patients admitted to the ICU, 43 (32.6%) required mechanical ventilation. During the 90-day follow-up period, 44 (33.3%) patients died due to clinical deterioration. The median ST2 concentration at admission was 272.5 ng/mL in patients who died and 55.95 ng/mL in patients who survived (p<0.001). The median ST2 concentration at admission was 280 and 61.1 ng/mL in patients who did and did not require mechanical ventilation, respectively (p<0.001). Areas under the receiver operating characteristic curve of the ST2 level for predicting death and need for mechanical ventilation were 0.77 (p<0.001) and 0.79 (p<0.001), respectively.
Conclusion: Suppression of tumorigenicity 2 concentration at the time of admission from the ED is a valuable biomarker because it is more effective than lymphocyte count and D-dimer and ferritin levels in predicting the need for mechanical ventilation and mortality in patients with COVID-19
Comparison of syphilis seropositivity between non-immigrant and immigrant populations in the Anatolian side of Istanbul, Turkiye: Results of five-years retrospective study
No full textObjective: Our study aimed to evaluate the seropositivity for syphilis in non- immigrant and immigrant populations and compare the results regarding demographic data.
Methods: In accordance with the reverse algorithm, syphilis tests were performed between May 2014 and December 2018 in hospitals in our service zone for syphilis screening or symptomatic disease.
Results: A total of 135.328 non- immigrant and 6.641 immigrant were screened for syphilis. Seropositivity rates were 1.3% in the non- immigrant and 3.8% in immigrant groups (p=0.0001). There was a statistically significant difference in terms of seropositivity rates between the various age groups in the local group and immigrant groups (except 18 25 age group) (p<0.05). Syphilis seropositivity rates were found to be lower in indigenous population than immigrant groups according to the years tested (p=0.0001). The seropositivity rates were 2.4% and 3.2% among the males (p=0.025) and 0.6% and 4.0% among females (p=0.0001) in non-immigrantand immigrant groups, respectively. Whereas, 0.6% of pregnant women in the local group and 3.7% of pregnant women in immigrant groups were seropositive for syphilis (p=0.0001). Among the HIV positive group, syphilis seropositivity was only observed in the non-immigrant group with a rate of 23.0% (p=0.0001).
Conclusion: The antibodies against syphilis were found more frequently in immigrants than non-immigrant. Among the HIV positive individuals syphilis seropositivity was only observed in the non-immigrant group
