14 research outputs found
Molecular Epidemiology of Carbapenem-Resistant Acinetobacter Baumannii Isolates in Turkiye: Systematic Review
No full textCIFTCI, IHSAN HAKKI/0000-0002-9812-134X; Kahraman Kilbas, Elmas Pinar/0000-0003-1348-625X; KILBAS, IMDAT/0000-0002-8909-4140The World Health Organization has designated carbapenem-resistant Acinetobacter baumannii (CRAB) as a "critical" pathogen on the global priority list of antibiotic-resistant bacteria. This study aims to discuss the molecular epidemiology of CRAB isolates in Turkiye in the last 12 years and the prevalence of gene regions associated with resistance or pathogenesis using a systematic review method. Our study consists of a literature search, determination of eligibility and exclusion criteria, qualitative analysis of studies, data extraction, and statistical analysis. All studies were analyzed according to the Preferred Reporting Items for Systematic Reviews and Meta-Analysis Guidelines. The incidence rates of blaOXA-23, blaOXA-23-like, blaOXA-24/40, blaOXA-24/40-like, blaOXA-51, blaOXA-51-like, blaOXA-58, and blaOXA-58-like genes in CRAB strains were 76.4%, 68.6%, 1.2%, 3.4%, 97.0%, 98.6%, 8.4%, and 17.1%, respectively. It was determined that the prevalence of the blaOXA-23 and blaOXA-58 gene regions showed a statistically significant change over the years. Due to the high prevalence of A. baumannii strains carrying the blaOXA-23 variant, it is necessary to follow its geographical distribution and transposon and plasmid movements. Based on available data, molecular surveillance of CRAB strains should be standardized. In addition, sterilization and disinfection processes applied within the scope of an effective struggle against CRAB strains that can remain live on surfaces for a long time should be reviewed frequently.Emerging Sources Citation Inde
A Systematic Review and Meta-Analysis of Molecular Characteristics on Colistin Resistance of <i>acinetobacter Baumannii</I>
No full textKahraman Kilbas, Elmas Pinar/0000-0003-1348-625X; CIFTCI, IHSAN HAKKI/0000-0002-9812-134XBackground: This study aimed to determine the molecular epidemiology of colistin-resistant A. baumannii in the last ten years and the frequency of gene regions related to pathogenesis, to compare the methods used to detect genes, and to confirm colistin resistance. Methods: This meta-analysis study was conducted under Preferred Reporting Items for Systematic Reviews and Meta-Analysis Guidelines. In the meta-analysis, research articles published in English and Turkish in electronic databases between January 2012 and November 2023 were examined. International Business Machines (IBM) Statistical Package for the Social Sciences (SPSS) Statistics for Macbook (Version 25.0. Armonk, NY, USA) was used for statistical analysis. The Comprehensive Meta-Analysis (CMA) (Version 3.0. Biostat, NJ, USA) program was used for heterogeneity assessment in the articles included in the meta-analysis. Results: After evaluating the studies according to the elimination criteria, 18 original articles were included. Among colistin-resistant strains, blaOXA-51 positivity was 243 (19.61%), blaOXA-23 was 113 (9.12%), blaOXA-58 was 7 (0.56%), blaOXA-143 was 15 (1.21%), and blaOXA-72 was seen in two (0.16%) strains. The positivity rates of pmrA, pmrB, and pmrC were found to be 22 (1.77%), 26 (2.09%), and 6 (0.48%). The mcr-1 rate was found to be 91 (7.34%), the mcr-2 rate was 78 (6.29%), and the mcr-3 rate was 82 (6.61%). Conclusions: The colistin resistance rate in our study was found to be high. However, only some research articles report and/or investigate more than one resistance gene together. Additionally, it may be challenging to explain colistin resistance solely by expressing resistance genes without discussing accompanying components such as efflux pumps, virulence factors, etc.Science Citation Index Expande
Investigation of Colistin and Sulbactam Combination Effectivity in Multi Drug Resistant Acinetobacter baumannii Strains with Diagonal Gradient Strip Test Method
No full textConclusions: In this study, the colistin/sulbactam combination is determined to be 20% synergistic and 60% partial synergistic effective of MDR Acinetobacter baumannii isolates. Diagonal gradient strip test method was used for the first time in this study to research the in vitro synergistic effect of colistin/sulbactam combination on MDR Acinetobacter baumannii isolates. There is a need for larger scale studies about this topic. Although there are some limitations in guidelines related to colistin susceptibility for gradient strip test, it is a method that can be used for other antibiotic combinations. For more accurate and precise results, it would be useful to plan in vitro and in vivo studies concurrently
Antimicrobial resistance of Enterococcus isolates in Turkey: A meta-analysis of current studies
No full textPrevalence of Colistin-Resistant Klebsiella pneumoniae Isolates in Turkey over a 20-Year Period: A Systematic Review and Meta-Analysis
No full textKlebsiella pneumoniae is one of the leading causes of healthcare-associated infections and poses challenges in its treatment owing to its high antibiotic resistance. The development of resistance to colistin, which is used as a last resort, has become a major public health problem worldwide. This study was planned according to the PRISMA guidelines and included studies reporting the prevalence of colistin-resistant K. pneumoniae in Turkey between 2004 and 2024 through a systematic literature review. A total of 28 original research articles were included in the meta-analysis. Data were analyzed using the SPSS and CMA software. The pooled colistin resistance of a total of 8916 K. pneumoniae strains from 28 studies included in this meta-analysis was found to be 1.63% (95% CI: 1.51–3.12). Colistin resistance increased significantly over time. A higher resistance rate was detected in the strains tested using the EUCAST guidelines and broth microdilution method. The year of the study and validation methods contributed to the heterogeneity observed in the studies. This meta-analysis reveals that colistin-resistant K. pneumoniae strains have increased over time in Turkey. Current data show that colistin resistance is not only a laboratory finding but has become a crisis, requiring urgent action in terms of hospital infection management and patient safety. Regional and global measures should be taken to ensure the appropriate use of antibiotics to control the development of resistance
Seroprevalence of coxiella burnetii in human and animal populations in türkiye: meta-analysis
No full textThis study aims to reveal Coxiella burnetii by examining the studies reporting Q fever
seroprevalence in humans and animals in the last 25 years in Türkiye. In this study, based
on PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses),
various databases were searched between January 1997 and October. 2022. A literature
review was carried out using data analyses performed using the IBM SPSS Version
25.0 statistical package program and Comprehensive Meta-Analysis (CMA) program.
Overall prevalence of C. burnetii in humans was 22.78% (95% CI: 16.43%-29.12%),
overall prevalence in animals was 13.49% (95% CI: 10.04-16.93%) was detected. The
mean prevalence of C. burnetii in sheep was 19.1%±10.88, 10.46±6.39% in cattle,
15.21±10.01% in studies including cattle and sheep together, 11.17±10.74 in cattle,
sheep and goats, and 12.4%±1.15% in sheep and goats. As a result of this study, it was
determined that the prevalence of Q fever in humans in Türkiye is high in those dealing
with animals, women who had a miscarriage, and infertile individuals. Although it is
known that this disease is seen in Türkiye, there are not enough case reports in the
literature. Detailed studies on Q fever in humans and animals need to be conducted.
Further studies are needed to evaluate Q fever risk factors and prevalence data together
within the scope of One Health approach
A Systematic Review and Meta-Analysis of Molecular Characteristics on Colistin Resistance of Acinetobacter baumannii
No full textBackground: This study aimed to determine the molecular epidemiology of colistin-resistant A. baumannii in the last ten years and the frequency of gene regions related to pathogenesis, to compare the methods used to detect genes, and to confirm colistin resistance. Methods: This meta-analysis study was conducted under Preferred Reporting Items for Systematic Reviews and Meta-Analysis Guidelines. In the meta-analysis, research articles published in English and Turkish in electronic databases between January 2012 and November 2023 were examined. International Business Machines (IBM) Statistical Package for the Social Sciences (SPSS) Statistics for Macbook (Version 25.0. Armonk, NY, USA) was used for statistical analysis. The Comprehensive Meta-Analysis (CMA) (Version 3.0. Biostat, NJ, USA) program was used for heterogeneity assessment in the articles included in the meta-analysis. Results: After evaluating the studies according to the elimination criteria, 18 original articles were included. Among colistin-resistant strains, blaOXA-51 positivity was 243 (19.61%), blaOXA-23 was 113 (9.12%), blaOXA-58 was 7 (0.56%), blaOXA-143 was 15 (1.21%), and blaOXA-72 was seen in two (0.16%) strains. The positivity rates of pmrA, pmrB, and pmrC were found to be 22 (1.77%), 26 (2.09%), and 6 (0.48%). The mcr-1 rate was found to be 91 (7.34%), the mcr-2 rate was 78 (6.29%), and the mcr-3 rate was 82 (6.61%). Conclusions: The colistin resistance rate in our study was found to be high. However, only some research articles report and/or investigate more than one resistance gene together. Additionally, it may be challenging to explain colistin resistance solely by expressing resistance genes without discussing accompanying components such as efflux pumps, virulence factors, etc
Twenty-Year Course of Antifungal Resistance in <i>Candida albicans</i> in Türkiye: A Systematic Review and Meta-Analysis
No full textThis study aimed to systematically evaluate the resistance rates of Candida albicans to various antifungals based on studies conducted in Türkiye and published between 2005 and 2025 and to analyze the factors contributing to resistance. A systematic literature search was conducted using various keywords in electronic databases (PubMed, Embase, Web of Science, EBSCO, Scopus, Turk Medline and Google Scholar). A total of 42 studies were included in the meta-analysis according to the determined criteria. The quality of the studies was assessed using the Joanna Briggs Institute checklist, and the analyses were performed using appropriate statistical software. The highest resistance rates for fluconazole, itraconazole, and voriconazole were observed in the Aegean and Marmara regions. In the analyses performed with the random-effects model, heterogeneity was found to be high for itraconazole, fluconazole, posaconazole, voriconazole, and caspofungin, and the strongest explanatory variable of this heterogeneity was the geographical region variable. In our study, we determined that antifungal resistance in C. albicans strains in Türkiye is generally low; however, an increasing trend has been observed over the years, especially in amphotericin B resistance. Although the low resistance rates to major antifungal agents such as fluconazole, voriconazole and echinocandins are promising, regional differences and methodological heterogeneity necessitate the development of treatment strategies based on local data
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 War Against the Resistance of <i>acinetobacter Baumannii</I>: a Meta-Analysis of Findings in Turkiye
No full textObjective: Bacterial resistance to antibiotics continues to be a significant challenge to the global health system. This study was designed to examine changes in the antibiotic resistance of Acinetobacter baumannii (A. baumannii) strains isolated from various clinical samples taken between 2005 and 2020 and to support the development of new antibiotics policies for empirical treatment of multidrug-resistant isolates in Turkiye. Materials and Methods: This meta-analysis included a data search phase, determination of eligibility criteria, qualitative analysis of the studies selected, data extraction, and statistical analyses. All of the data were analyzed according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement. Results: According to Clinical and Laboratory Standards Institute and/or European Committee on Antimicrobial Susceptibility Testing standards and a random effects model, the breakpoint estimate of A. baumannii strain resistance in Turkiye for ampicillin-sulbactam, ceftazidime, imipenem, meropenem, gentamicin, amikacin, ciprofloxacin, piperacillin-tazobactam, trimethoprim-sulfamethoxazole, netilmicin, colistin, and tigecycline was 90.7%, 92.1%, 86.8%, 87.3%, 72.6%, 63.7%, 88%, 91.2%, 76.7%, 27.1%, 7.9%, and 18.5%, respectively. Conclusion: The reported rates of A. baumannii resistance from different regions demonstrated heterogeneity. Unfortunately, the use of standard antibiotics is unlikely to provide effective therapy throughout Turkiye. New therapy options and protocols are needed.Emerging Sources Citation Inde
