Yazar "Şimşek H." seçeneğine göre listele
Listeleniyor 1 - 4 / 4
Sayfa Başına Sonuç
Sıralama seçenekleri
Öğe The epidemiology of carbapenemases in escherichia coli and klebsiella pneumoniae isolated in 2019 in Turkey [Türkiye'de 2019 Yili Içinde Izole Edilen Escherichia coli ve Klebsiella pneumoniae Izolatlarinda Karbapenemaz Epidemiyolojisi](Ankara Microbiology Society, 2021) Süzük Yildiz S.; Şimşek H.; Bakkalo?lu Z.; Numano?lu Çevik Y.; Hekimo?lu C.H.; Kiliç S.; Eryildiz C.Antibiotic resistance is one of the most important public health problem and one of the most critical steps in preventing resistance is the monitorization of the resistance. Local, regional and global monitoring enables the spread of antibiotic resistance to be understood more clearly. In this study, it was aimed to evaluate the results of the pilot study for the establishment of molecular-based carbapenem surveillance system in Escherichia coli and Klebsiella pneumoniae isolates and to investigate the carbapenemase epidemiology in Turkey. Hospitals (n= 28) from 26 different statistical level II regions from Turkey were included in the study. The hospitals participated in the study submitted ten carbapenem susceptible and ten carbapenem resistant E.coli and K.pneumoniae isolates to our laboratory that were isolated in two different periiods of six-month either between 1 March-31 August or 1 April-30 September 2019. A total of 509 isolates were collected from 26 of the 28 participating hospitals in the study. Isolates were identified by matrix assisted laser desorptionization-time of flight mass spectrophotometry (MALDI TOF MS) (Bruker Daltonics, Germany) method and antibiotic susceptibility tests for imipenem, meropenem and colistin were studied by broth microdilution. Moreover, susceptibilities to amikacin, amoxicillin-clavulanic acid, ampicillin, aztreonam, cefepime, cefotaxime, ceftazidime, ciprofloxacin, ertapenem, gentamicin, piperacillin-tazobactam, tobramycin and trimethoprim-sulfamethoxazole were determined by disc diffusion method. The resistance genes were investigated in isolates which were found to be phenotypically resistant to carbapenem and colistin, in house method was used to investigate carbapenemase genes and a commercial colistin resistant real-time PCR kit (Biospeedy, Turkey) was used for colistin resistance genes. In total, 493 of the 509 isolates collected from hospitals were identified as E.coli (25.7%, n= 127) and K.pneumoniae (74.3%, n= 366) and included in the study. It was determined that 31% of the isolates evaluated were from community-acquired infections and 69% were either from healthcare-associated infections or from colonization sites. Among the tested isolates, 248 (50.3%) were susceptible to carbapenems and 245 (49.7%) were resistant. The types of carbapenemases in carbapenemase-producing isolates were OXA-48 (52.2%), KPC (16.1%), NDM-1 (15%), OXA-48 + NDM-1 (12.6%), KPC + NDM-1 (2.8%) and VIM (0.5%) and OXA-48+VIM (0.5%). Resistance to colistin was detected in 23.3% of the isolates but mcr1-8 genes were not detected. It was found that all colistin resistant isolates are resistant to at least one of the carbapenems. The importance of a molecular-based antimicrobial resistance surveillance system in our country was demonstrated with this pilot study. It is thought that continuous monitoring of these epidemiological features will contribute to the management of infections due to carbapenemase-producing organisms. © 2021 Ankara Microbiology Society. All rights reserved.Öğe The first results of national antimicrobial resistance surveillance system in Turkey [Türkiye'de ulusal antimikrobiyal direnç surveyans sisteminin ilk sonuçlari](Refik Saydam National Public Health Agency (RSNPHA), 2018) Çöplü N.; Şimşek H.; Gür D.; Gözalan A.; Hasdemir U.; Gülay Z.; Bayramoğlu G.; Gürler N.; Aydemir S.; Eyigör M.; Perçin D.; Aktaş D.Objective: In order to combat with antimicrobial resistance, some measures should be taken and determination of the current status is one of them. National antimicrobial resistance surveillance system (NAMRSS) was established for this purpose in Turkey. It was targeted to be useful for guidence of ampirical therapy, create antimicrobial usage policies, provide data to the guidebooks, and supply initial information to evaluate the efficasy of the measures taken. Methods: Data of resistance was collected from 55 hospital, from blood and cerebrospinal fluid isolates, which were S. aureus, E. faecalis and E. faecium, S. pneumoniae, E. coli, K. pneumoniae and P. aeruginosa. The antimicrobials and test methods were chosen in accordance with international surveillance systems. The collected data was analysed by WHONET software. Results: S. aureus (1437); meticillin resistance was 31.5%, rifampin, linezolid and vancomycin resistance were 65.3%, 2.3%, and 0.0%, respectively. E. faecalis (n=760) resistance of ampicillin was 9.7%, linezolid, vancomycin, teicoplanin were lower than 1%, high level (HL) aminoglycoside was around 30%. E. faecium (n=756) resistance of ampicillin was 88,1%, linezolid, teicoplanin were lower than 1%, vancomycin 17%, HL aminoglycoside was around 50%. S. pneumoniae (n=128) with non-meningitis breakpoints; resistance were lower than 5.2% for all antimicrobials other than erythromycin (32%), with meningitis breakpoints: resistance increased to 14,3-44,8%. E. coli (2280) and K. pneumoniae (1307), extended spectrum beta-lactamase (ESBL) was 51.6% and 54.0%, respectively. P. aeruginosa (825) resistance were changed in between 8.4% (amikacin) and 36.4% (piperacillin). Conclusion: The resistance was higher among the countries in close geographical region and increased in time, indicating the need for developing policies to combat with it. Besides, the results will also be valuable to monitor the usefulness of the measures taken. © 2018 Refik Saydam National Public Health Agency (RSNPHA).Amaç: Antimikrobiyal direnç ile mücadele için bazi önlemler alinmalidir, mevcut durumun saptanmasi da bunlardan biridir. Türkiye'de ulusal antimikrobiyal direnç surveyans sistemi bu hedefle kurulmuştur. Ampirik tedaviyi desteklemek, antimikrobiyal kullanim politikalari oluşturmak, rehber kitaplara veri sağlamak, alinmiş olan önlemlerin etkinliğini değerlendirmek için başlangiç bilgilerini sağlamak amaçlanmiştir. Yöntem: Elli beş hastaneden, kan ve beyin omurilik sivisindan izole edilen Staphylococcus aureus, Enterococcus faecalis, Enterococcus faecium, Streptococcus pneumoniae, Escherichia coli, Klebsiella pneumoniae ve Pseudomonas aeruginosa izolatlarinin direnç verileri toplanmiştir. Antimikrobiyaller ve test yöntemleri uluslararasi surveyans sitemleri ile uyumlu olacak şekilde seçilmiştir. Toplanan veriler WHONET programi ile analiz edilmiştir. Bulgular: S. aureus (n = 1437); metisilin direnci %31,5, rifampin, linezolid ve vankomisin direnci sirasi ile %65,3; %2,3 ve %0,0, bulunmustur. E. faecalis (n = 760) ampisilin direnci %9,7, linezolid, vankomisin, teikoplanin direnci %1'in altinda, yüksek düzey (YD) aminoglikozid %30 civarinda bulunmuştur. E. faecium (n = 756) ampisilin direnci %88,1; linezolid ve teikoplanin %1'den az, vankomisin %17, YD aminoglikozid %50 civarinda bulunmuştur. S. pneumoniae (n = 128) nonmenenjit sinir değerler için eritromisin (%32) dişinda tüm antimikrobiyaller için direnç %5,2'den düşüktür, menejit sinir değerler için direnç %14,3-44,8'a yükselmiştir. E. coli (2280) ve K. pneumoniae (1307) için genişlemiş spektrumlu beta-laktamaz (GSBL) direnci sirasi ile %51,6 ve %54,0 bulunmuştur. P. aeruginosa (825) direnci %8,4 (amikacin) ve %36,4 (piperacillin) arasinda değişmektedir. Sonuç: Direnç Türkiye'ye yakin coğrafyadaki ülkelerden yüksek bulunmuş ve zaman içinde artiş göstermiş olup bununla mücadele için politikalar geliştirmek gerektiğine isaret etmektedir. Ayrica, alinan önlemlerin yararliliğini izlemek için de sonuçlar değerli olacaktir. © 2018 Refik Saydam National Public Health Agency (RSNPHA).Öğe High prevalence of cardiovascular risk factors in a western urban Turkish population: A community-based study [Bati{dotless} ve kentsel bir Türk toplumunda kardiyovasküler risk etmenlerinin yüksek prevalansi{dotless}: Toplum tabanli{dotless} bir çali{dotless}şma:](AVES Ibrahim Kara, 2013) Ünal B.; Sözmen K.; Uçku R.; Ergör G.; Soysal A.; Baydur H.; Meseri R.; Şimşek H.; Gerçeklioglu G.; Doganay S.; Budak R.; Kiliç B.; Günay T.; Ergör A.; Demiral Y.; Aslan O.; Çimrin D.; Akvardar Y.; Tuncel P.Objective: Cardiovascular diseases (CVD) are the largest cause of morbidity and mortality in Turkey and in the World. Heart of Balçova Project is a community- based health promotion project that aims to reduce CVD incidence and prevalence through risk factor modification in the individual and population level. This paper presents results of the baseline survey that aimed to define CVD risk factors and risk of developing coronary heart disease (CHD) in the Balçova population. Methods: The study population included 36,187 people over 30 years of age residing in Balçova in 2007. Individuals were interviewed at their homes. Anthropometrics and blood pressure were measured and in total 12914 fasting blood samples were collected for lipid and glucose analyses. CHD risk was estimated using Framingham risk equation. Student's t test, Chi-square for trend test and ANOVA were used to compare mean levels and percentages of risk factors between age groups and gender. Results: In total 5552 men and 10528 women participated in the study. Smoking prevalence was 38.6% in men and 26.8% in women. The prevalence of obesity was 29.4% among men and 44.2% among women and obesity prevalence increased until the age group 75 years old. While 14.6% of men and 12.6% of women had diabetes, 39.8% of men and 41.8% of women had hypertension. The prevalence of high total cholesterol was 56.0% in men and 50.6% in women. Men had a higher risk of developing CHD compared to women in the following 10 years (13.4% vs 2.5%). Conclusion: The prevalence of preventable risk factors for CHD is very high in Balçova population. Community-based interventions should be planned and implemented targeting both the high-risk individuals and whole population. © 2013 by AVES Yayi{dotless}nc{dotless}l{dotless}k Ltd.Öğe Obesity prevalence in the elderly and the association between obesity and cardiovascular risks [Yaşlilarda obezi·te sikligi ve obezi·teni·n kardi·yovasküler ri·sklerle i·li·şki·si·](Geriatrics Society, 2014) Şimşek H.; Yilmaz S.; Meseri R.; Uçku R.Introduction: Obesity prevalence is increasing among the elderly and obesity is association with diseases. The aim of this study was to determine obesity/ abdominal obesity prevalence according to four different anthropometric indices, and the effect of obesity on cardiovascular (CV) risk in the elderly. Materials and Method: This cross-sectional study involved 2,502 elderly participants, 65 years and older, who were parts of Balcova's Heart Project. The dependent variable was CV risk factors; the independent variable was obesity. Obesity measures were Body Mass Index (BMI), waist circumference (WC), waist-to-hip ratio (WHpR), and waist-to-height ratio (WHtR). Data were analyzed using t-test, Chi-square, Pearson's correlation and Logistic regression analyses. Results: The prevalence of obesity according to body mass index was 48.7%, WC: 52.4%, WHpR: 65.2%, and WHtR: 93.7%. High levels of all of anthropometric measurements were risk factors for diabetes, hypertension and metabolic syndrome. All measurements, except for BMI in women, were risk factors for dyslipidemia in both sexes. WHtR and WHpR in men and WC and WHpR in women were predictors of Framingham risk scores. In women, WHtR had more predictive value for CV risk, except for the Framingham risk score; in men WHtR had more predictive value than all other risks. Conclusion: In both genders, obesity (determined with anthropometric measurements) is associated with CV risks. However, abdominal obesity (WHtR and WC) is more effective than BMI in determining CV risk.
