Yazar "Cilli, Feriha" seçeneğine göre listele
Listeleniyor 1 - 13 / 13
Sayfa Başına Sonuç
Sıralama seçenekleri
Öğe Carbapenemase investigation with rapid phenotypic test (RESIST-4 O.K.N.V) and comparison with PCR in carbapenem-resistant Enterobacterales strains(Univ Medical Sciences-Danishgah-I Ulum-I Pizishki-I Tihran, 2022) Yasar-Duman, Melike; Cilli, Feriha; Tekintas, Yamac; Polat, Furkan; Hosgor-Limoncu, MineBackground and Objectives: RESIST-4 O.K.N.V. assay is a lateral immunochromatocraphic test for the identification of oxacillinase (OXA)-48-like, Klebsiella pneumoniae carbapenemase (KPC), New Delhi metallo-beta-lactamase (NDM), and Verona integron-encoded metallo-beta-lactamase (VIM) producing strains. It was aimed to evaluate the performance of the RESIST-4 O.K.N.V. test and to compare it with the reference method polymerase chain reaction (PCR). Also, the objective was to determine the distribution of carbapenemase types of CRE strains isolated in our hospital. Materials and Methods: Between January 2016-October 2019, 187 strains isolated from clinical samples were included in this study. Bacterial identification was done using MALDI-TOF MS. Antibiotic susceptibility tests were studied with the VITEK-2 automated system. Meropenem minimum inhibitory concentrations (MICs) were determined by the gradient test. All strains were studied with the RESIST-4 O.K.N.V. test and then the strains were selected for the PCR test. bla(OXA-48), bla(NDM), bla(KPC), and bla(VIM) were investigated with PCR. K. pneumoniae NCTC (R) 13438 (KWIKSTIKTM, Microbiologics (R),USA) was used as the positive control, E. coli ATTC (R) 25922 TM (Microbiologics (R),USA) and three carbapenem-sensitive clinical isolates were also used as the negative control. Results: Meropenem MIC50 and MIC90 values were determined to be >32 mg/ L. With PCR bla(OXA-48), bla(NDM), bla(KPC) and bla(VIM) were detected in 79, 63, 20, and 4 strains, respectively. bla(OXA-48) and bla(NDM) were found together in 51 of the isolates. bla(OXA-48), bla(NDM), bla(KPC), and bla(VIM) were not detected in two strains with carbapenem resistance in susceptibility tests. The sensitivity of the immunochromatographic test was 100% for OXA-48, KPC, and VIM but 84.1% for NDM. Specificity was determined as 100% for OXA-48, NDM, KPC, and VIM. Conclusion: RESIST-4 O.K.N.V. test showed high sensitivity and specificity in detecting OXA-48, KPC, NDM, and VIM type carbapenemases. However, it should be kept in mind that there may be false-negative results related to NDM.Öğe Ceftazidime-Avibactam Susceptibility Patterns of Carbapenem-Resistant Klebsiella pneumoniae and Pseudomonas aeruginosa Clinical Strains in a Tertiary-Care Educational Hospital in Turkiye(Bilimsel Tip Yayinevi, 2024) Noyan, Ayse; Sipahi, Oguz Resat; Cilli, Feriha; Aydemir, Sohret[Abstarct Not Available]Öğe Clinical outcomes and the impact of treatment modalities in children with carbapenem-resistant Enterobacteriaceae bloodstream infections: a retrospective cohort study from a tertiary university hospital(Oxford University Press, 2024) Avcu, Gulhadiye; Erci, Ece; Bilen, Nimet Melis; Ersayoglu, Irem; Ozek, Gulcihan; Celtik, Ulgen; Terek, Demet; Cilli, Feriha; Bal, Zumrut SahbudakBackground: The increasing prevalence of carbapenem-resistant Enterobacteriaceae (CRE) infections among children represents a significant global concern, leading to elevated mortality rates. The aim of this study was to evaluate the risk factors, outcomes, 30-day mortality rates and contributing factors in children with CRE bloodstream infections (CRE-BSIs). Methods: Data regarding demographic characteristics, treatment approaches and outcomes of hospitalized children aged 0-18 years diagnosed with CRE-BSIs between January 2018 and December 2022 were extracted from medical records. Mortality within 30 days of diagnosis and the predictive factors were analysed. Results: A total of 114 children, with a median age of 11 months (range: 6-69.5), were included. All cases of CRE-BSIs were either healthcare associated or hospital acquired and presented with at least one underlying comorbidity. A previous history of CRE colonization or infection rate was 48.2% (55/114). Klebsiella pneumoniae 87.7% (100/114) was the most frequently isolated microorganism, with a 30-day mortality rate of 14% (16/114). Multivariate analysis identified paediatric intensive care unit admission, invasive mechanical ventilation, inotropic support and thrombocytopenia due to CRE-BSIs as the most discriminative predictors for 30-day mortality (P < 0.001). Central venous catheter (CVC) removal was associated with a reduced mortality rate (P = 0.012). High-dose prolonged infusion of MEM-based or polymyxin-based antibiotic combinations did not impact survival. Lower MEM MIC values were associated with improved survival. Conclusions: The mortality rate of CRE-BSI is notably high in childhood. The use of antibiotic combination strategies did not demonstrate a significant impact on 30-day survival; however, the removal of CVCs was found to lower mortality rates.Öğe Comparison of Phenotypic Methods and Polymerase Chain Reaction for the Detection of Carbapenemase Production in Clinical Klebsiella pneumoniae Isolates(Ankara Microbiology Soc, 2017) Tekintas, Yamac; Cilli, Feriha; Erac, Bayri; Yasar, Melike; Aydemir, Sabire Sohret; Hosgor Limoncu, MineBeing a member of the Enterobacteriaceae family, Klebsiella pneumoniae is an opportunistic pathogen that inhabits normal human microbiota and causes predominantly hospital-acquired infections. The emergence of K.pneumoniae isolates which are resistant particularly to the carbapenem group of antibiotics has led to an increase in hospitalization period, mortality and morbidity. Although different rates of resistance are observed between countries, regions and even healthcare facilities, there has been a rapid increase in the prevalence of carbapenem-resistant strains in the last 10 years. Fast and correct identification of carbapenem-resistant strains is important for the successful treatment of infections caused by these resistant bacteria. The objective of this study was to investigate the presence and the types of carbapenemases in carbapenem-resistant K.pneumoniae strains using "MASTDISCS (TM) ID carbapenemase detection disc set", a commercial product that can be used for this purpose, and "Carbapenem Inactivation Method (CIM)", a relatively new method, and compare the results of these methods by polymerase chain reaction (PCR). For this purpose, we used 54 K.pneumoniae strains isolated in 2015-2016, that were resistant to any of the ertapenem, meropenem or imipenem antibiotics. The identification of the strains was performed using VITEK MS and their antibiotic susceptibility tests were carried out using the VITEK 2 Compact (R) automated system. For the strains that were found resistant to carbapenems in the automated system, the minimum inhibitor concentration (MIC) values were determined by the gradient testing method according to the recommendations of " The European Committee on Antimicrobial Susceptibility Testing (EUCAST)". The bla(OXA-48), bla(IMP), bla(NDM), bla(VIM), and bla(SIM) genes were investigated with PCR among these isolates. Phenotypic enzyme typing was performed in the carbapenem-resistant strains using the " MASTDISCS (TM) ID carbapenemase detection disc set" and " Carbapenem Inactivation Method (CIM)". REP-PCR was used to reveal clonal relationship of the isolates. The 54 K.pneumoniae isolates were found as resistant to carbapenem and the MIC50 and MIC90 values of imipenem, meropenem and ertapenem were 32 mu g/ml. Only 33 of the strains had bla(OXA-48) and two of them had only bla(NDM), the remaining 19 strains had both of these two genes. The bla(IMP), bla(VIM) and bla(SIM) genes were not encountered in any of the isolates. When the isolates were assessed by the REP-PCR method, six main clones were detected. The " MASTDISCS (TM) ID carbapenemase detection disc set" was able to detect all the carbapenemase producing strains and it remained incapable of distinguishing OXA-48 in the strains which had both OXA-48 and metallo beta lactamase (MBL) enzymes. The CIM method showed a low rate of positivity (46.15%) in the strains containing bla(OXA-48), but was found much more successful in the strains containing bla(NDM) with a detection rate of 85.71%. In this study, it was concluded that the Mastdiscs-ID method could be successfully used to detect the presence of bla(OXA-48) which has a high prevalence in our country.Öğe The Effect of Aminoglycosides on Colistin-Containing Regimens in the Treatment of Carbapenem-Resistant Gram-Negative Infections in Pediatric Intensive Care Units: A Two-Center Experience(Erciyes Univ Sch Medicine, 2019) Bal, Zumrut Sahbudak; Kamit, Fulya; Duyu, Muhterem; Yazici, Pinar; Anil, Ayse Berna; Yilmaz, Dilek Ciftdogan; Yilmaz, Nisel Ozkalay; Cilli, Feriha; Karapinar, BulentObjective: This study aimed to assess the outcomes including morbidity and mortality of carbapenem-resistant gram-negative (CRGN) infections in pediatric critical care setting. The second aim was to investigate the impact of aminoglycosides on colistin-containing regimen in CRGN-infected pediatric critical care patients. Materials and Methods: We retrospectively evaluated medical records of 82 patients who had received colistin in combination with an aminoglycoside (CA group) or another antibiotic (CO group) at two reference pediatric intensive care units (PICUs) between February 2011 and February 2016. Results: We enrolled 82 CRGN-infected patients who were admitted to PICUs of two hospitals. The median age of the patients was 24 (25th-75th percentile; 8-78.75) months, and the median duration of hospital stay was 30 days (25th-75th percentile; 16.7-57.7). No statistical difference was observed in the variables, including microbiological response, attributable mortality, crude mortality, and the duration of achieving first negative culture (p>0.05). Clinical response was significantly more observed in the CA group (85.5% vs. 63.2; p=0.048), and attributable mortality was higher in the CO group (12.7% vs. 31.6%; p=0.055). Nephrotoxicity did not show statistical difference between groups (p=0.357), and neurotoxicity was not observed. Conclusion: Colistin-containing regimen in combination with an aminoglycoside may be an effective and safe antimicrobial agent without a significant increase in side effects.Öğe The evaluation of safety and efficacy of colistin use in pediatric intensive care unit: Results from two reference hospitals and review of literature(Elsevier Science Bv, 2018) Bal, Zumrut Sahbudak; Can, Fulya Kamit; Yazici, Pinar; Anil, Ayse Berna; Duyu, Muhterem; Ciftdogan, Dilek Yilmaz; Yilmaz, Ozkalay Nisel; Cilli, Feriha; Karapinar, BulentColistin, an old cationic polypeptide antibiotic, have been reused due to rising incidence of infections caused by multi-drug resistant (MDR) Gram-negative microorganisms and the lack of new antibiotics. Therefore, we evaluated safety and efficacy of colistin in treatment of these infections. This study included 104 critically ill children with a median age of 55,9 months between January 2011 and January 2016. Nephrotoxicity occurred in 11 (10.5%) patients. Nephrotoxicity occurred between the third and seventh day of treatment in 63% of colistin induced nephrotoxicity episodes. The subgroup analysis between the patients who developed nephrotoxicity during colistin treatment and those that did not, showed no significant difference in terms of age, underlying disease, cause for PICU admission and type of infection required colistin treatment, P values were 0.615, 0.762, 0.621, 0.803, respectively. All patients were receiving a concomitant nephrotoxic agent (P = 0,355). The majority of the patients (52%) were having primary or secondary immune deficiency in treatment failure group and the most common cause of PICU admission was sepsis in treatment failure group, P values were 0.007 and 0.045, respectively. Mortality attributed to colistin failure and crude mortality were 14.4% and 29.8%, respectively. In conclusion, colistin may have a role in the treatment of infections caused by multidrug-resistant Gram-negative bacteria in critically ill children. However, the patients have to be followed for side effects throughout colistin treatment, not for only early stage. And the clinicians should be aware of increase in the rate of nephrotoxicity in patients those have been receiving a concomitant nephrotoxic agent. (C) 2017 Japanese Society of Chemotherapy and The Japanese Association for Infectious Diseases. Published by Elsevier Ltd. All rights reserved.Öğe In vitro activity of fosfomycin tromethamine and linezolid against vancomycin-resistant Enterococcus faecium isolates(Elsevier Science Bv, 2008) Cilli, Feriha; Pullukcu, Husnu; Aydemir, Sohret; Sipahi, Oguz Resat; Tasbakan, Meltem; Turhan, Ajda; Ulusoy, SercanÖğe IN VITRO ACTIVITY OF LINEZOLID/ERTAPENEM COMBINATION IN RESISTANT GRAM-POSITIVE BACTERIA(Ankara Microbiology Soc, 2009) Erac, Bayri; Tasli, Hueseyin; Ermertcan, Safak; Cilli, Feriha; Limoncu, Mine HosgoerThe increasing prevalence of vancomycin-resistant enterococcus and methicillin-resistant staphylococcus infections has become a major therapeutic challenge and alternative therapy options are under consideration. In the present study, we aimed to evaluate the in vitro antibacterial activity of linezolid combined with ertapenem against two vancomycin-resistant Enterococcus faecium (VREF), two methicillin-resistant Staphylococcus aureus (MRSA) and two methicillin-resistant Staphylococcus epidermidis (MRSE) strains isolated from clinical specimens. In vitro activity of linezolid/ertapenem combination at 112 x MIC (minimal Inhibitory Concentration), 1 x MIC and 4 x MIC concentrations for each of the isolates was determined by time-kill curve method. At 1 x MIC and 4 x MIC concentrations, additive effect was detected for MRSA (at 6 and 24 h) and VREF (at 6 h) strains. Synergism was observed between two antibiotics at 4 x MIC concentration against one of the MRSE strains at 6(th) hour. Additive effect was determined at 6(th) and 24(th) hours in this strain at 1 x MIC concentration. No synergism was present in the other MRSE strain but additive interaction was detected at 6 h (1/2 x MIC) and 24 h (1 x MIC). Although these results support the use of linezolid/ertapenem combination in infections caused by resistant gram-positive strains, further in vitro and in vivo studies are necessary.Öğe Kocuria rosea Meningitis(Mary Ann Liebert, Inc, 2014) Sipahi, Oguz Resat; Mermer, Sinan; Aydemir, Sohret; Ozgiray, Erkin; Cilli, Feriha; Oner, KazimÖğe A Rare Agent of Urinary Tract Infection: Chryseobacterium indologenes(Galenos Yayincilik, 2019) Yasar, Melike; Sipahi, Oguz Resat; Cilli, Feriha[No abstract available]Öğe Secondary bacterial infections and antimicrobial resistance in COVID-19: comparative evaluation of pre-pandemic and pandemic-era, a retrospective single center study(Bmc, 2021) Karatas, Mustafa; Yasar-Duman, Melike; Tunger, Alper; Cilli, Feriha; Aydemir, Sohret; Ozenci, VolkanPurpose In this study, we aimed to evaluate the epidemiology and antimicrobial resistance (AMR) patterns of bacterial pathogens in COVID-19 patients and to compare the results with control groups from the pre-pandemic and pandemic era. Methods Microbiological database records of all the COVID-19 diagnosed patients in the Ege University Hospital between March 15, 2020, and June 15, 2020, evaluated retrospectively. Patients who acquired secondary bacterial infections (SBIs) and bacterial co-infections were analyzed. Etiology and AMR data of the bacterial infections were collected. Results were also compared to control groups from pre-pandemic and pandemic era data. Results In total, 4859 positive culture results from 3532 patients were analyzed. Fifty-two (3.59%) patients had 78 SBIs and 38 (2.62%) patients had 45 bacterial co-infections among 1447 COVID-19 patients. 22/85 (25.88%) patients died who had bacterial infections. The respiratory culture-positive sample rate was 39.02% among all culture-positive samples in the COVID-19 group. There was a significant decrease in extended-spectrum beta-lactamase (ESBL)-producing Enterobacterales (8.94%) compared to samples from the pre-pandemic (20.76%) and pandemic era (20.74%) (p = 0.001 for both comparisons). Interestingly, Acinetobacter baumannii was the main pathogen in the respiratory infections of COVID-19 patients (9.76%) and the rate was significantly higher than pre-pandemic (3.49%, p < 0.002) and pandemic era control groups (3.11%, p < 0.001). Conclusion Due to the low frequency of SBIs reported during the ongoing pandemic, a more careful and targeted antimicrobial prescription should be taken. While patients with COVID-19 had lower levels of ESBL-producing Enterobacterales, the frequency of multidrug-resistant (MDR) A. baumannii is higher.Öğe Serratia marcescens sepsis outbreak caused by contaminated propofol(Mosby-Elsevier, 2019) Cilli, Feriha; Nazli-Zeka, Arzu; Arda, Bilgin; Sipahi, Oguz Resat; Aksit-Barik, Sukran; Kepeli, Nurhayat; Ozinel, Mehmet Ali; Gulay, Zeynep; Ulusoy, SercanWe presented a sepsis outbreak caused by Serratia marcescens from contaminated propofol to raise awareness. Three patients had sepsis syndrome after chest surgery. Isolation of S marcescens from patients' respiratory and blood samples alerted us to a possible outbreak. Four syringes filled with propofol and 1 saline solution yielded S marcescens. Nine of 10 isolates from samples of patients and environment genotyped by pulsed-field gel electrophoresis were the same. Disobeying aseptic injection rules of propofol is still causing outbreaks. (C) 2018 Association for Professionals in Infection Control and Epidemiology, Inc. Published by Elsevier Inc. All rights reserved.Öğe Synthesis, properties and photodynamic activities of some zinc(II) phthalocyanines against Escherichia coli and Staphylococcus aureus(World Sci Publ Co Inc, 2008) Seven, Ozlem; Dindar, Bircan; Aydemir, Sohret; Cilli, FerihaTwo new zinc phthalocyanine derivatives bearing four 3,5-di-tert-butyl-4-hydroxy-phenyl (ZnPc1) and 3,5-dimethylphenoxy (ZnPc2) have been synthesized and proved by elemental analyses and UV-vis, H-1 NMR, FTIR and MALDI-TOF mass spectra as spectroscopic determination. Thermal stabilities of these neutral Zn-phthalocyanines were performed by thermal gravimetric analysis and, significantly, were found stable up to 373 degrees C for ZnPc1 and 550 degrees C for ZnPc2. In addition, the photostability of the sensitizers was quite successful within 240 min. Furthermore, photodynamic therapy has been investigated using these neutral phthalocyanines. Singlet oxygen generation capacities of ZnPc1 and ZnPc2 were studied using 1,3-diphenyl-iso-benzofuran (50.0 mu M) as a selective singlet oxygen trap in DMSO and both of them demonstrated very high singlet oxygen generation capacity. Photodynamic therapy is of considerable interest for its potential its an antimicrobial therapy on the grounds that the photodynamic activity of these compounds was tested against a Gram-negative bacteria, Escherichia coli and a Gram-positive bacteria, Staphylococcus aureus. Suspensions of the microorganisms were irradiated for 240 min in the presence of ZnPc1 (with hydrophilic group) and ZnPc2 phthalocyanines. In order to simulate solar radiation, we used a 750 W xenon lamp. Minimum photosensitizer concentration was used as 0.1 mg.10 mL(-1) in 1% dimethylsulfoxide/phosphate buffer saline solution (DMSO/PBS). Moreover, the photostability of these compounds has been investigated and the effect of the amount of DMSO tested against selected bacteria. In the dark, with and without Pes, bacterial inactivation did not occur. Bacterial inactivation by light with ZnPc1 was observed in response to Gram-negative bacteria E. coli and Gram-positive bacteria S. aureus, whereas the photoinactivation studies with ZnPc2 have revealed that the lack of its activity is due to its poor affinity for either of the organisms. These results suggest that a neutral amphiphilic photosensitizer may be easily used in an application concerning photoinactivation of bacterial cells as well as ionic photosensitizers. Copyright (c) 2008 Society of Porphyrins & Phthalocyanines.
