Carbapenem resistance in Klebsiella pneumoniae is primarily mediated by carbapenemase production. This study aimed to identify carbapenemase genes in carbapenem-resistant K. pneumoniae isolates using multiplex polymerase chain reaction (PCR) and to evaluate the performance of the combination disk assay (CDA) as a phenotypic detection method. A total of 123 carbapenem-resistant K. pneumoniae isolates were analyzed. Colistin and meropenem susceptibility were determined by broth microdilution, while ceftazidime-avibactam susceptibility was assessed using disk diffusion. Five common carbapenemase genes (blaOXA-48, blaNDM, blaKPC, blaIMP, blaVIM) were detected by multiplex PCR. CDA was performed using meropenem and temocillin disks in combination with specific inhibitors (EDTA, boronic acid, cloxacillin). Colistin (59.3

Introduction: Carbapenems are frequently used in the treatment of multidrug-resistant infections caused by Klebsiella pneumoniae. The aim of the study is to definition and incidence of transferable carbapenemase genes of carbapenem resistant K. pneumoniae (CRKP) and to determine clonal relatedness of these strains in tertiary care hospital in Turkey. Methods: Identification of all 100 K. pneumoniae isolates and low sensitivity to any of the carbapenem group antibiotics were determined by Vitek-2 (BioMerieux, France). The frequency of carbapenemase genes (bla(OXA-48), bla(NDM), bla(KPC), bla(VIM) /bla(IMP)) and extended spectrum beta-lactamase (ESBL) genes (b/acix_m, blasj,, b/aum) which frequently detected in Turkey, have been investigated by multiplex polymerase chain reaction (PCR). Clonal relatedness was determined using Pulsed-field gel electrophoresis(PFGE). Results: Ninety five isolates carried at least one of the carbapenemase genes (81.05% bla(OXA-48), 38.9% bla(NDM), 9.47% bla(KPC),1.05% bla(VIM)). One isolate was carried the bla(OXA-48+KPC) and the two isolates were carried the bla(KPC+NDM)(.) PFGE demonstrated the presence of 24 pulse types and 63.09% of the isolates were in four main pulse types. Conclusions: This study demonstrated the incidence of bla(NDM) is beginning to reach endemic levels, in addition to bla(OXA-48) found endemic in Turkey. To our knowledge, this is the first report of the co-production of these two genes (bla(KPC) + NDM and bla(OXA-48 + KPC)) in CRKP isolates.

Introduction: HCV infections are an important public health problem due to their high chronicity, cirrhosis and advanced complications like hepatocellular carcinoma. In HCV infections, it is important and necessary to determine genotypes before treatment because treatment times and protocols vary according to genotypes. The aim of this study was to determine the distribution of HCV genotypes in HCV-RNA positive individuals in Giresun province and to investigate whether there was a statistically significant difference between genotypes and patient ages. Materials and Methods: HCV-RNA level and HCV genotype of 147 patients were included in the study. HCV RNA levels of the samples were studied by QIAsymphony SP (Qiagen) automated device, genotype determination by Rotor Gene Q (Qiagen) automated device by “real-time polymerase chain reaction (PCR)” method. Each sample was tested for HCV genotypes 1a, 1b, 2, 3, 4, 5a and 6. Results: Of the 147 patients genotyped; 128 (87%) genotype 1b, 9 (6%) genotype 1a, 8 (6%) genotype 3, 2 (1%) genotype 2 were detected. Genotypes 4, 5a and 6 were not detected. According to the HCV genotype distribution, median age and range (min.-max.) of the patients weren50 (30-83) for 1a, 70 (22-87) for 1b, 48.5 (36-61) for 2 and 33 (25-52) for 3. HCV RNA levels were between 37 and 12.630.170 IU/mL. Conclusion: The predominant genotype in the world and Turkey is genotype 1b. In our study, the most common genotype was also genotype 1b (87%), consistent with other studies in our country. This study contributed to HCV genotype distribution data in our region and country.

Introduction: HCV infections are an important public health problem due to their high chronicity, cirrhosis and advanced complications like hepatocellular carcinoma. In HCV infections, it is important and necessary to determine genotypes before treatment because treatment times and protocols vary according to genotypes. The aim of this study was to determine the distribution of HCV genotypes in HCV-RNA positive individuals in Giresun province and to investigate whether there was a statistically significant difference between genotypes and patient ages. Materials and Methods: HCV-RNA level and HCV genotype of 147 patients were included in the study. HCV RNA levels of the samples were studied by QIAsymphony SP (Qiagen) automated device, genotype determination by Rotor Gene Q (Qiagen) automated device by "real-time polymerase chain reaction (PCR)" method. Each sample was tested for HCV genotypes 1a, 1b, 2, 3, 4, 5a and 6. Results: Of the 147 patients genotyped; 128 (87%) genotype 1 b, 9 (6%) genotype 1 a, 8 (6%) genotype 3, 2 (1%) genotype 2 were detected. Genotypes 4, 5a and 6 were not detected. According to the HCV genotype distribution, median age and range (min.-max.) of the patients weren50 (30-83) for 1 a, 70 (22-87) for 1 b, 48.5 (36-61) for 2 and 33 (25-52) for 3. HCV RNA levels were between 37 and 12.630.170 IU/mL. Conclusion: The predominant genotype in the world and Turkey is genotype 1b. In our study, the most common genotype was also genotype 1b (87%), consistent with other studies in our country. This study contributed to HCV genotype distribution data in our region and country.

Acinetobacter baumannii ve Pseudomonas aeruginosa suşlarında en etkili antibiyotiklerin

Introduction: Vancomycin-resistant enterococci (VRE) and methicillin-resistant Staphylococcus aureus (MRSA) infections are among the most common Gram-positive nosocomial infections. These isolates are resistant to most antibiotics, limiting the antibiotic options that can be used in treatment and causing treatment failure. Linezolid is an important option in the treatment of resistant Gram-positive infections, and came into use in Turkey in 2006. Linezolid-resistant Enterococci and Staphylococcus strains are rarely reported worldwide. The aim of this study was to investigate whether there was an increase in linezolid minimum inhibitory concentration (MIC) values in VRE and MRSA isolates over time. Materials and Methods: Thirteen VRE and 20 MRSA isolates from 2005-2009 (group 1), 18 VRE and 20 MRSA isolates from 2013-2014 (group 2), and seven VRE and 27 MRSA isolates from 2017-2018 (group 3) obtained from various clinical samples at Kocaeli University Medical Faculty Hospital were included in the study. The linezolid MIC values of the isolates were determined by broth microdilution method. The results were interpreted according to the European Committee on Antimicrobial Susceptibility Testing standards. Results: All of the VRE and MRSA isolates were susceptible to linezolid. Linezolid MIC50 and MIC90 values were 2 mg/l in VRE isolates in all three groups. In MRSA isolates, MIC50 was 2 mg/l in group 1, and 4 mg/l in groups 2 and 3, while MIC90 was 4 mg/l in all groups. Conclusion: Global rates of linezolid resistance has been reported to be <1% for S. aureus and VRE. There were no linezolid-resistant isolates in this study. However, we detected a significant increase in MIC50 and MIC90 values compared to most earlier studies performed in Turkey. This increase is expected due to the widespread use of linezolid over the years. The principles of rational antibiotic use should be applied to maintain the low resistance rates to linezolid, which is one of the few remaining options for the treatment of multidrug-resistant Gram-positive infections.

The aim of the study is to determine in-vitro effects of imipenem-tigecycline, imipenem-colistin and tigecycline-colistin against carbapenem-resistant Enterobacteriaceae (CRE) isolates. A total of 25 CRE isolates were included to the study. The minimum inhibition concentrations of imipenem, colistin-sulphate and tigecycline were determined with broth dilution method. Synergistic effects of imipenem-tigecycline, imipenem-colistin and tigecycline-colistin were investigated by microdilution checkerboard technique. All of the isolates were resistant to imipenem, whereas 25% of the isolates were resistant to colistin and tigecycline. Imipenem-colistin, imipenem-tigecycline and tigecycline-colistin combinations were synergistic against 40% (10/25), 24% (6/25), and 36% (9/25) of the isolates, respectively. Antagonism was observed in 8% (2/25) of the isolates in tigecycline-colistin combination. Tigecycline-colistin was the most effective (70% synergy) combination in Klebsiella spp. strains; whereas imipenem-colistin was the most effective (75% synergy) combination in Escherichia coli strains. Synergistic effect was variable and strain-depended against CRE isolates that have been tested.

Amaç: Bu çalışmanın amacı basit bir besiyeri olan Mueller-Hinton agar (MHA)’ın germ tüp testinde (GTT) kullanılabilirliğinin araştırılmasıdır.Yöntem: Çeşitli klinik örneklerden enfeksiyon etkeni olarak izole edilen toplam 86 Candida suşu çalışmaya alındı. Tüm izolatlar Sabouraud Dekstroz Agar (SDA) (Salubris, Türkiye)’a pasajlanarak, 37°C’de 24-48 saat inkübe edildi. İzolatlar VITEK-MS (Biomérieux, Fransa) cihazı ile tanımlandı. Serum GTT için tek bir Candida kolonisi 0.5 ml taze insan serumuna inoküle edildi. MHA GTT için tek koloniden MHA yüzeyine Dalmau tekniği ile çizgi ekimi yapıldı ve üzeri steril lamel ile kapatıldı. 37°C’de 1.5 ve 3 saat inkübasyon sonrasında tüm serumlar ve MHA plakları ışık mikroskobu ile değerlendirildi. Duyarlılık ve özgüllük değerlendirmesinde serum GTT altın standart yöntem olarak kabul edildi.Bulgular: Tanımlama sonuçları şöyleydi: 51 Candida albicans, bir C. dubliniensis, 12 C. parapsilosis, 12 C. glabrata, 4 C. kefyr, 3 C. tropicalis, 3 C. krusei. Serum GTT’nde 1.5 saat sonunda 30 (%58.8), 3 saat sonunda ise 36 (%70.6) C. albicans izolatı pozitif olarak bulundu. MHA GTT’nde ise 1.5 saat sonunda 21 (%41.2), 3 saat sonunda ise 40 (%78.4) C. albicans izolatı pozitif olarak saptandı. C. dubliniensis dışındaki tüm non-albicans türleri her iki testte de negatif olarak bulundu. C. dubliniensis her iki testte de 1.5 ve 3 saatte GTT pozitif olarak saptandı. MHA’ın 1.5 saatte duyarlılığı %58, özgüllüğü %92; 3 saatte ise duyarlılığı %86, özgüllüğü %81 olarak hesaplandı.Sonuç: MHA, GTT için güvenli ve kolay bulunabilen bir besiyeridir ve serum GTT’ne alternatif olarak kullanılabilir. MHA’da GTT araştırılması esnasında, daha yüksek duyarlılığa sahip olduğundan dolayı, 1.5 saat yerine 3 saatlik inkübasyon önerilmektedir.

tarihleri arasında Belek, Antalya'da düzenlenen XXXVI.Türk Mikrobiyoloji Kongresi'nde poster olarak sunulmuştur

Amac: Bu calismanin amaci basit bir besiyeri olan Mueller-Hinton agar (MHA)’in germ tup testinde (GTT) kullanilabilirliginin arastirilmasidir. Yontem: Cesitli klinik orneklerden enfeksiyon etkeni olarak izole edilen toplam 86 Candida susu calismaya alindi. Tum izolatlar Sabouraud Dekstroz Agar (SDA) (Salubris, Turkiye)’a pasajlanarak, 37°C’de 24-48 saat inkube edildi. Izolatlar VITEK-MS (Biomerieux, Fransa) cihazi ile tanimlandi. Serum GTT icin tek bir Candida kolonisi 0.5 ml taze insan serumuna inokule edildi. MHA GTT icin tek koloniden MHA yuzeyine Dalmau teknigi ile cizgi ekimi yapildi ve uzeri steril lamel ile kapatildi. 37°C’de 1.5 ve 3 saat inkubasyon sonrasinda tum serumlar ve MHA plaklari isik mikroskobu ile degerlendirildi. Duyarlilik ve ozgulluk degerlendirmesinde serum GTT altin standart yontem olarak kabul edildi. Bulgular: Tanimlama sonuclari soyleydi: 51 Candida albicans , bir C. dubliniensis , 12 C. parapsilosis , 12 C. glabrata , 4 C. kefyr , 3 C. tropicalis , 3 C. krusei . Serum GTT’nde 1.5 saat sonunda 30 (%58.8), 3 saat sonunda ise 36 (%70.6) C. albicans izolati pozitif olarak bulundu. MHA GTT’nde ise 1.5 saat sonunda 21 (%41.2), 3 saat sonunda ise 40 (%78.4) C. albicans izolati pozitif olarak saptandi. C. dubliniensis disindaki tum non-albicans turleri her iki testte de negatif olarak bulundu. C. dubliniensis her iki testte de 1.5 ve 3 saatte GTT pozitif olarak saptandi. MHA’in 1.5 saatte duyarliligi %58, ozgullugu %92; 3 saatte ise duyarliligi %86, ozgullugu %81 olarak hesaplandi. Sonuc: MHA, GTT icin guvenli ve kolay bulunabilen bir besiyeridir ve serum GTT’ne alternatif olarak kullanilabilir. MHA’da GTT arastirilmasi esnasinda, daha yuksek duyarliliga sahip oldugundan dolayi, 1.5 saat yerine 3 saatlik inkubasyon onerilmektedir.