RESUMO
OBJECTIVE: In our study, K. pneumoniae strains (non-susceptible to carbapenem) (n = 60) were obtained from various clinical samples from Rize State Hospital between 2015 and 2017 and it is aimed to identify antibiotic resistance genes and replicon typing. METHODS: Antibiotic susceptibility tests of the strains were performed with Kirby-Bauer disk diffusion test and the Vitek-2 automated system (BioMerieux, France). Antibiotic resistance genes and replicon typing was characterized by PCR method. RESULTS: It was determined that K. pneumaniae isolates were mostly isolated from the samples of the intensive care unit. All of the K. pneumoniae strains examined in this study were found to be ampicillin/sulbactam and ertapenem resistant but colistin susceptible. Amoxacillin/clavulonic acid resistance was detected at 98.14% of strains. The blaOXA-48 gene was mostly detected in isolates. The most common type of plasmid was I1 and 3 different plasmid types were found in five different strains together. CONCLUSION: This study also shows that the distribution of NDM-1 and OXA-48 carbapenemases has increased since the first co-display in Türkiye and that IncHI1 is the first record in our country. This study provides an overview of the major plasmid families occurring in multiple antibiotic-resistant strains of K. pneumoniae. To our knowledge, this study represents the first report of IncHI1 record in Türkiye.
Assuntos
Enterobacteriáceas Resistentes a Carbapenêmicos , Infecções por Klebsiella , Humanos , Klebsiella pneumoniae , Testes de Sensibilidade Microbiana , Proteínas de Bactérias/genética , Antibacterianos/farmacologia , beta-Lactamases/genética , Carbapenêmicos/farmacologia , Enterobacteriáceas Resistentes a Carbapenêmicos/genética , RepliconRESUMO
Molecular diagnosis of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) by real-time reverse transcription polymerase chain reaction (RT-PCR) in respiratory specimens is considered the gold standard method. This method is highly sensitive and specific but it has some limitations such as being expensive and requiring special laboratory equipment and skilled personnel. RapidFor™ Antigen Rapid Test Kit is a commercially available Ag-RDT which is produced in Turkey and designed to detect the nucleocapsid antigen of SARS-CoV-2 in nasopharyngeal swab samples. The aim of this study was to evaluate the performance of this novel SARS-CoV-2 antigen detection considering the RT-PCR method as the gold standard. Four hundred forty-four nasopharyngeal swab samples which were collected from the patients who met clinical criteria of COVID-19 from ten centers in Turkey between September 2020 and February 2021 were included in the study. All the nasopharyngeal swab samples were tested for SARS-CoV-2 RNA using commercial RT-PCR kits (Bioeksen and A1 Lifesciences, Istanbul, Turkey) according to the manufacturer's instructions. Viral loads were assessed according to the cycle threshold (Ct) values. RapidFor™ SARS-CoV-2 antigen test (Vitrosens Biotechnology, Istanbul, Turkey) was used to investigate the presence of SARS-CoV-2 antigen in all samples following the manufacturer's instructions. Out of 444 nasopharyngeal swab samples tested, 346 (77.9%) were positive and 98 (22.1%) were negative for SARS-CoV-2 RNA by RTPCR. Overall sensitivity of the RapidFor™. Antigen Rapid Test Kit was 80.3% whereas specificity was found to be 87.8%. Positivity rate of rapid antigen test in samples with Ct values over 25 and below 30 was 82.7%, while it increased to 95.7% in samples 20 ≤ Ct < 25 and reached 100% in samples with Ct values below 20. RapidFor™ SARS-CoV-2 Ag test might be a good choice in the screening of symptomatic and asymptomatic patients and their contacts for taking isolation measures early, with advantages over RT-PCR as being rapid, easy and being applicable in every laboratory and even at point of care.
Assuntos
COVID-19 , Humanos , COVID-19/diagnóstico , Reação em Cadeia da Polimerase Via Transcriptase Reversa , Transcrição Reversa , RNA Viral , SARS-CoV-2/genética , Técnicas de Laboratório Clínico , Sensibilidade e Especificidade , Teste para COVID-19RESUMO
BACKGROUND: A nosocomial outbreak of Acinetobacter baumannii (AB) infections occurred among intensive care units (ICU) (surgery, medical, cardiovascular surgery, coronary unit) of Recep Tayyip Erdogan University Medical School (Rize, Turkey) between January 2011 and May 2012. The identification of isolates and clonal relation among them were investigated by molecular techniques. METHODS: A total of 109 AB isolates were obtained from 64 clinical materials from 54 ICU patients and 3 from the hands of healthcare workers (HCWs) of 42 environmental samples. The isolates were identified by 16S rDNA sequencing and OXA- specific PCR. The clonal relation between isolates was investigated by PFGE methods using ApaI restriction enzyme. RESULTS: All isolates were determined as AB by 16S rDNA sequencing and OXA-spesific PCR. While the blaOXA-51-like gene was amplified in all isolates, the blaOXA-23-like gene was amplified from 103 isolates. The PFGE pattern generated 9 pulsotypes and showed that the isolates from patients, HCWs, and the environment were genetically related. In 7 of these pulsotypes, there were 107 strains (98%) showing similar PFGE profiles that cannot be distinguished from each other, ranging from 2 to 53. The remaining 2 pulsotypes were comprised of strains closely associated with the main cluster. Two major groups were discovered with similarity coefficient of 85% and above. The first group consisted of 97 strains that are similar to each other at 92.7% rate, and the second group consisted of 12 strains that are 100% identical. CONCLUSIONS: The common utilization of the blood gas device among ICU was the reason for the contamination. AB strains can remain stable for a long period of time, although due to the disinfection procedures applied in hospitals, there is a small chance that the same clone might reappear and cause another epidemic. For that reason, the resistance profiles of the strains must be continuously followed with amplification-based methods, and these methods should be used to support the PFGE method in the short term.
Assuntos
Infecções por Acinetobacter/epidemiologia , Infecções por Acinetobacter/prevenção & controle , Acinetobacter baumannii/efeitos dos fármacos , Infecção Hospitalar/epidemiologia , Infecção Hospitalar/prevenção & controle , Surtos de Doenças , Farmacorresistência Bacteriana Múltipla , Infecções por Acinetobacter/microbiologia , Acinetobacter baumannii/classificação , Acinetobacter baumannii/genética , Acinetobacter baumannii/isolamento & purificação , Portador Sadio/microbiologia , Análise por Conglomerados , Infecção Hospitalar/microbiologia , DNA Bacteriano/química , DNA Bacteriano/genética , DNA Ribossômico/química , DNA Ribossômico/genética , Eletroforese em Gel de Campo Pulsado , Microbiologia Ambiental , Genótipo , Humanos , Unidades de Terapia Intensiva , Epidemiologia Molecular , Tipagem Molecular , Reação em Cadeia da Polimerase , RNA Ribossômico 16S/genética , Análise de Sequência de DNA , Turquia/epidemiologia , beta-Lactamases/genéticaRESUMO
Proteus mirabilis (P. mirabilis) is one of Gram-negative pathogens encountered in clinical specimens. A clinical isolate (TRP41) of P. mirabilis was isolated from a Turkish patient in Turkey. The isolate was identified using the API 32GN system and 16S rRNA gene sequencing and it was found resistant to ampicillin/sulbactam, piperacillin, tetracycline, and trimethoprim/sulfamethoxazole. This isolate was harboring a Class 1 integron gene cassette and its DNA sequence analysis revealed a novel blaOXA variant exhibiting one amino acid substitution (Asn266Ile) from blaOXA-1 . This new variant of OXA was located on Class 1 integron together with aadA1 gene encoding aminoglycoside-modifying enzymes. According to sequence records, the new variant was named as blaOXA-320 . Cassette array and size of integron were found as blaOXA-320 -aadA1 and 2086 bp, respectively. The blaOXA-320 gene is not transferable according to conjugation experiment. In this study, we report the first identification of blaOXA-320 -aadA1 gene cassette, a novel variant of Class D ß-lactamase, in P. mirabilis from Turkey.
Assuntos
Integrons , Proteus mirabilis/genética , beta-Lactamases/genética , Farmacorresistência Bacteriana Múltipla/genética , Humanos , Dados de Sequência Molecular , Proteus mirabilis/efeitos dos fármacos , Proteus mirabilis/isolamento & purificação , RNA Ribossômico 16S/genética , Análise de Sequência de DNA , Turquia , Urina/microbiologia , beta-Lactamases/química , beta-Lactamases/isolamento & purificação , beta-Lactamases/metabolismoRESUMO
BACKGROUND: Hepatitis B infection is a health problem that affects more than 400 million people all over the world. We aimed to evaluate the usability of prolidase enzyme that plays an important role in collagen synthesis. Prolidase levels increase in hepatic damage, which can be used as diagnostic parameters in the progressions to chronic hepatitis B (CHB) infection by evaluating it in different clinical forms of hepatitis B infection. METHODS: A total of 69 patients who presented to our clinic with chronic hepatitis B (CHB) infection, 72 patients with inactive hepatitis B infection (IHB), and 45 healthy volunteers were included into this study. Alanine transaminase (ALT), Aspartate aminotransferase (AST) and prolidase levels of patients were measured. Hepatic biopsy was performed in patients with CHB infection. Prolidase levels were evaluated in three different groups, and its correlations with fibrosis were investigated. RESULTS: Prolidase was different between all groups (P < 0.001). Prolidase level was found to be higher in CHB and IHB compared to the control group. There was no correlation between this enzyme, fibrosis, and histological activity index. CONCLUSION: In this present study, it is shown that prolidase levels increase in hepatitis B infection. It may be used as a biochemical marker in the chronic hepatitis B.
Assuntos
Dipeptidases/sangue , Hepatite B Crônica/enzimologia , Fígado/enzimologia , Adulto , Alanina Transaminase/sangue , Aspartato Aminotransferases/sangue , Biomarcadores/sangue , Colágeno/metabolismo , Progressão da Doença , Feminino , Hepatite B Crônica/sangue , Hepatite B Crônica/diagnóstico , Humanos , Cirrose Hepática/diagnóstico , Masculino , Adulto JovemRESUMO
Taenia saginata is a zoonotic cestode causing taeniasis. Taeniasis refers to the intestinal infection with the adult stage of this tapeworm. An association between teaniasis and acute appendicitis is uncommon. We present the case of a 37 year old male who presented with abdominal pain for one day. He was diagnosed with having appendicitis and an appendectomy was performed. Pathology of the appendix showed Taenia saginata with eggs in the lumen. Histological analysis showed acute inflammation consistent with acute appendicitis caused by T. saginata.
Assuntos
Apendicite/parasitologia , Teníase/diagnóstico , Adulto , Apendicectomia , Apendicite/cirurgia , Humanos , MasculinoRESUMO
BACKGROUND: Epidemiological studies of tetracycline (TE) resistance genes and integron gene cassettes, particularly in urine samples, are limited in Turkey. OBJECTIVES: To investigate antibiotic susceptibility profiles, extended-spectrum beta-lactamase (ESBL) positivity, tet gene types, class-I/-II integron gene cassettes, and clonal relationships among tet-resistant isolates of Escherichia coli from urine cultures of outpatients. MATERIAL AND METHODS: Isolates were identified using conventional methods and the automated Vitek® 2 Compact system. Antimicrobial susceptibility was performed for 19 antibiotics. The ESBL production was performed using the Kirby-Bauer disk diffusion test. The double disk synergy test was used for confirmatory testing. Polymerase chain reaction (PCR) was used to determine the presence of class-I/-II integron gene cassettes and tetA, tetB and tetD resistance genes. The pulsed-field gel electrophoresis typing was performed to identify clonal relations. RESULTS: A total of 121 isolates were obtained and found to be resistant or sensitive to ampicillin and amikacin/imipenem. Resistance to ceftazidime, cefotaxime and ceftriaxone was determined to be 31.3%, 77.6% and 83.1%, respectively. Tetracycline resistance was detected in 82 isolates, mostly caused by the tetB gene. No tet gene was detected in the remaining 39 isolates. Although 64 out of 82 isolates carried a class-I integron, only 4 had a class-II integron (with sizes of 800-2900 base pairs). Furthermore, tet genes were identified with different size class-I integron gene cassettes. However, tet genes were not detected in any isolate identified with integron gene cassette II. Clonally, the isolates were found to be related in subgroups because they were community-acquired. CONCLUSIONS: This study showed that the tetB gene is most commonly found in E. coli isolates grown in urine samples from the Turkish population.
Assuntos
Infecções por Escherichia coli , Integrons , Antibacterianos/farmacologia , Escherichia coli/genética , Infecções por Escherichia coli/tratamento farmacológico , Infecções por Escherichia coli/epidemiologia , Humanos , Integrons/genética , Testes de Sensibilidade Microbiana , beta-Lactamases/genéticaRESUMO
INTRODUCTION: : Escherichia coli ranks among the most common sources of urinary tract infections (UTI). METHODS: Between November 2015 and August 2016, 90 isolates of E. coli were isolated from patients at Rize Education and Research Hospital in Turkey. Antibiotic susceptibility was determined for all isolates using the Kirby-Bauer disk diffusion method. These E. coli isolates were also screened for virulence genes, ß-lactamase coding genes, quinolone resistance genes, and class 1 integrons by PCR. RESULTS: With respect to the antibiotic resistance profile, imipenem and meropenem were effective against 98% and 90% of isolates, respectively. A high percentage of the isolates showed resistance against ß lactam/ß lactamase inhibitor combinations, quinolones, and cephalosporins. PCR results revealed that 63% (57/90) of the strains carried class 1 integrons. In addition, a high predominance of extended-spectrum ß-lactamases (ESBLs) was observed. The qnrA, qnrB, and qnrS genes were found in 24 (26.6%), 6 (6.6%), and 3 (3.3%), isolates, respectively. The most common virulence gene was fim (82.2%).The afa, hly, and cnf1 genes were detected in 16.6%, 16.6%, and 3.3% of isolates, respectively. Moreover, we observed eleven different virulence patterns in the 90 E. coli isolates. The most prevalent pattern was fim, while hly-fim, afa-aer-cnf-fim, aer-cnf, afa-aer, and afa-cnf-fim patterns were less common. CONCLUSIONS: Most of the E. coli virulence genes investigated in this study were observed in E. coli isolates from UTI patients. Virulence genes are very important for the establishment and maintenance of infection.
Assuntos
Antibacterianos/farmacologia , Farmacorresistência Bacteriana Múltipla , Infecções por Escherichia coli/tratamento farmacológico , Infecções por Escherichia coli/genética , Escherichia coli/genética , Escherichia coli/patogenicidade , Infecções Urinárias/tratamento farmacológico , Fatores de Virulência/genética , Escherichia coli/isolamento & purificação , Feminino , Humanos , Masculino , Testes de Sensibilidade Microbiana , Quinolonas , Turquia , Infecções Urinárias/microbiologia , beta-LactamasesRESUMO
Background: A toxin-antitoxin (TA) system is a set of two or more closely linked genes that are encoded as a poison and a corresponding antidote on a protein. In typical bacterial physiology, an antitoxin binds to a toxin and neutralizes it, which prevents the bacterium from killing itself. We aimed to determine whether P.aeruginosa and Staphylococcus isolates have TA genes and to investigate whether there is a relationship between the expression levels of TA genes and resistance to antibiotics. Methods: This study included 92 P. aeruginosa and 148 Staphylococcus isolates. RelBE, higBA genes were investigated in P.aeruginosa by multiplex polymerase chain reaction (PCR). The mazEF gene and the all TA genes expression were detected by real time PCR. Results: RelBE and higBA genes were detected in 100% of P. aeruginosa. It was found that the level of relBE TA gene expression is increased in isolates sensitive to aztreonam compared to resistant isolates (p<0.05). The mazEF gene was detected in 89.1% of Staphylococcus isolates. In terms of MazEF gene expression level there was no significant difference between methicillin-sensitive Staphylococcus aureus (MSSA) and methicillin-resistant S. aureus (MRSA) isolates (p>0.05) whereas there was a significant difference between MSSA and coagulase-negative Staphylococcus (CNS) isolates, MRSA and CNS isolates (p<0.05). The levels of mazEF gene expression were found to be higher in isolates sensitive to gentamicin, ciprofloxacin, levofloxacin, clindamycin, phosphomycine, nitrofurantoin, fusidic acid, cefoxitin compared to resistant isolates (p<0.05). Conclusion: Studies on the prevalence and functionality of TA systems emphasize that it may be possible to have new sensitive regions in bacteria by activating TA systems. The results of this study lead to the idea that resistance to antibiotics can be reduced by increasing TA gene expression levels. But there is need for further studies to support and develop this issue.
Assuntos
Antitoxinas/genética , Toxinas Bacterianas/genética , Resistência Microbiana a Medicamentos/genética , Staphylococcus aureus Resistente à Meticilina/genética , Infecções por Pseudomonas/microbiologia , Pseudomonas aeruginosa/genética , Infecções Estafilocócicas/microbiologia , Sistemas Toxina-Antitoxina/genética , Antibacterianos/farmacologia , Antitoxinas/metabolismo , Toxinas Bacterianas/metabolismo , Humanos , Staphylococcus aureus Resistente à Meticilina/classificação , Staphylococcus aureus Resistente à Meticilina/isolamento & purificação , Staphylococcus aureus Resistente à Meticilina/metabolismo , Testes de Sensibilidade Microbiana , Pseudomonas aeruginosa/classificação , Pseudomonas aeruginosa/isolamento & purificação , Pseudomonas aeruginosa/metabolismoRESUMO
Resistance to ß-lactams in Enterobacteriaceae has been increasing worldwide. This study aimed to determine the frequency of ß-lactamase genes and antibiotic resistance rates of 140 extended-spectrum ß-lactamase (ESBL)-producing Escherichia coli isolates obtained from urinary tract infection in Ordu Province, Turkey. Isolates were identified by classic methods and by automated system. ESBL production was confirmed by double disk synergy test and antimicrobial susceptibility was investigated by disk diffusion method. All isolates were screened for ß-lactamase coding genes from three groups (A, B, and D) by polymerase chain reaction. The highest rate of susceptible isolates was observed for imipenem (IPM, 99.3%) and ertapenem (ETP, 97.9%), and the highest rate of resistant isolates was observed for cefuroxime (97.9%), ceftriaxone (97.2%), and cefazolin (90.7%). In our study, blaCTX-M1-like group was the most prevalent ß-lactamase (n = 109), followed by blaTEM (n = 68), blaCTX-M2 (n = 22), and blaSHV (n = 2). By contrast to low resistance rate to IPM and ETP, we determined blaNDM in 31 isolates (22.1%). In co-prevalence of blaNDM-1 and ESBL-coding genes, a low carbapenem resistance was determined. We can confirm that blaCTX-M1-types are still the most frequent ß-lactamase coding gene in Turkey. Our study showed the highest prevalence of blaNDM-1 metallo-ß-lactamase coding gene in ESBL-producing E. coli.
Assuntos
Antibacterianos/farmacologia , Infecções por Escherichia coli/microbiologia , Proteínas de Escherichia coli/metabolismo , Escherichia coli/efeitos dos fármacos , Escherichia coli/enzimologia , Infecções Urinárias/microbiologia , beta-Lactamases/metabolismo , Adolescente , Adulto , Criança , Pré-Escolar , Farmacorresistência Bacteriana , Escherichia coli/genética , Infecções por Escherichia coli/epidemiologia , Proteínas de Escherichia coli/genética , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Turquia/epidemiologia , Infecções Urinárias/epidemiologia , Adulto Jovem , beta-Lactamases/genéticaRESUMO
The class A ß-lactamase GES-22 has been identified in Acinetobacter baumannii isolates in Turkey, and subsequently shown to differ from GES-11 by a single substitution (M169L). Because M169 is part of the omega loop, a structure that is known to have major effects on substrate selectivity in class A ß-lactamases, we expressed, purified and kinetically characterized this novel variant. Our results show that compared with GES-116 × His, GES-226 × His displays more efficient hydrolysis of penicillins, and aztreonam, but a loss of efficiency against ceftazidime. In addition, the M169L substitution confers on GES-22 more efficient hydrolysis of the mechanistic inhibitors clavulanic acid and sulbactam. These effects are highly similar to other mutations at the homologous position in other class A ß-lactamases, suggesting that this methionine has a key structural role in aligning active site residues and in substrate selectivity across the class.
Assuntos
Acinetobacter baumannii/genética , Farmacorresistência Bacteriana/genética , Mutação , beta-Lactamases/genética , beta-Lactamases/farmacologia , Acinetobacter baumannii/enzimologia , Sequência de Aminoácidos , Substituição de Aminoácidos , Antibacterianos/química , Antibacterianos/farmacologia , Aztreonam/farmacologia , Carbapenêmicos/farmacologia , Ceftazidima/farmacologia , Cefalosporinas/farmacologia , Ácido Clavulânico/farmacologia , Hidrólise , Penicilinas/farmacologia , Plasmídeos/genética , Conformação Proteica , Especificidade por Substrato , Turquia , Inibidores de beta-Lactamases/farmacologia , beta-Lactamases/químicaRESUMO
BACKGROUND: The prognostic value of blood culture testing in the diagnosis of bacteremia is limited by contamination. OBJECTIVES: In this multicenter study, the aim was to evaluate the contamination rates of blood cultures as well as the parameters that affect the culture results. MATERIALS AND METHODS: Sample collection practices and culture data obtained from 16 university/research hospitals were retrospectively evaluated. A total of 214,340 blood samples from 43,254 patients admitted to the centers in 2013 were included in this study. The blood culture results were evaluated based on the three phases of laboratory testing: the pre-analytic, the analytic, and the post-analytic phase. RESULTS: Blood samples were obtained from the patients through either the peripheral venous route (64%) or an intravascular catheter (36%). Povidone-iodine (60%) or alcohol (40%) was applied to disinfect the skin. Of the 16 centers, 62.5% have no dedicated phlebotomy team, 68.7% employed a blood culture system, 86.7% conducted additional studies with pediatric bottles, and 43.7% with anaerobic bottles. One center maintained a blood culture quality control study. The average growth rate in the bottles of blood cultures during the defined period (1259 - 26,400/year) was 32.3%. Of the growing microorganisms, 67% were causative agents, while 33% were contaminants. The contamination rates of the centers ranged from 1% to 17%. The average growth time for the causative bacteria was 21.4 hours, while it was 36.3 hours for the contaminant bacteria. The most commonly isolated pathogens were Escherichia coli (22.45%) and coagulase-negative staphylococci (CoNS) (20.11%). Further, the most frequently identified contaminant bacteria were CoNS (44.04%). CONCLUSIONS: The high contamination rates were remarkable in this study. We suggest that the hospitals' staff should be better trained in blood sample collection and processing. Sterile glove usage, alcohol usage for disinfection, the presence of a phlebotomy team, and quality control studies may all contribute to decreasing the contamination rates. Health policy makers should therefore provide the necessary financial support to obtain the required materials and equipment.
RESUMO
Cellulitis is an acute, subacute or chronic inflammation of the dermis and subdermal tissues, which is typically caused by bacteria, although other causes are possible. The present study aimed to evaluate the association between resistin levels and the recovery time of patients with cellulitis. In addition, the effect of resistin and insulin resistance on the prognosis of cellulitis was investigated. In total, 52 patients with cellulitis (male, 21; female, 31) and an age-matched group of 42 healthy individuals (male, 18; female, 24) were included in the study. The levels of serum resistin, fasting plasma glucose (FPG), homeostasis model assessment-insulin resistance (HOMA-IR), C-reactive protein (CRP) and other biochemical parameters were compared between the groups. The mean resistin levels in the cellulitis and control groups were 9.4±5.3 and 5.8±3.1 ng/ml, respectively. The levels of resistin, FPG, HOMA-IR and CRP were significantly higher in the cellulitis group compared with the control group (P<0.001). Furthermore, the mean recovery time of the patients with cellulitis was 21.2±5.6 days. Thus, increased levels of resistin (P=0.002) and HOMA-IR (P=0.005) could be used as predictive factors for the recovery time. The enhanced levels of resistin and HOMA-IR were shown to correlate with the high CRP levels in the cellulitis group. Therefore, the results indicated that increased levels of resistin may function as a prognostic marker for cellulitis.
RESUMO
Abstract INTRODUCTION : Escherichia coli ranks among the most common sources of urinary tract infections (UTI). METHODS: Between November 2015 and August 2016, 90 isolates of E. coli were isolated from patients at Rize Education and Research Hospital in Turkey. Antibiotic susceptibility was determined for all isolates using the Kirby-Bauer disk diffusion method. These E. coli isolates were also screened for virulence genes, β-lactamase coding genes, quinolone resistance genes, and class 1 integrons by PCR. RESULTS: With respect to the antibiotic resistance profile, imipenem and meropenem were effective against 98% and 90% of isolates, respectively. A high percentage of the isolates showed resistance against β lactam/β lactamase inhibitor combinations, quinolones, and cephalosporins. PCR results revealed that 63% (57/90) of the strains carried class 1 integrons. In addition, a high predominance of extended-spectrum β-lactamases (ESBLs) was observed. The qnrA, qnrB, and qnrS genes were found in 24 (26.6%), 6 (6.6%), and 3 (3.3%), isolates, respectively. The most common virulence gene was fim (82.2%).The afa, hly, and cnf1 genes were detected in 16.6%, 16.6%, and 3.3% of isolates, respectively. Moreover, we observed eleven different virulence patterns in the 90 E. coli isolates. The most prevalent pattern was fım, while hly-fım, afa-aer-cnf-fım, aer-cnf, afa-aer, and afa-cnf-fım patterns were less common. CONCLUSIONS: Most of the E. coli virulence genes investigated in this study were observed in E. coli isolates from UTI patients. Virulence genes are very important for the establishment and maintenance of infection.
Assuntos
Humanos , Masculino , Feminino , Infecções Urinárias/tratamento farmacológico , Farmacorresistência Bacteriana Múltipla , Fatores de Virulência/genética , Escherichia coli/genética , Escherichia coli/patogenicidade , Infecções por Escherichia coli/genética , Infecções por Escherichia coli/tratamento farmacológico , Antibacterianos/farmacologia , Turquia , Infecções Urinárias/microbiologia , beta-Lactamases , Testes de Sensibilidade Microbiana , Quinolonas , Escherichia coli/isolamento & purificaçãoRESUMO
Pseudomonas aeruginosa isolates were collected form a Turkish hospital. Antimicrobial susceptibility was performed using the Vitek 2 Compact system, and 24 isolates were categorized as multidrug resistant (n = 18), extensively-drug resistant (n = 5), or pan-drug resistant (n = 1). PCR and DNA sequence analysis revealed that 1 strain possessed the blaGES-5 and another carried a novel blaVIM variant, named VIM-38. This new gene exhibited 1 amino acid substitution (Ala265Val) in comparison to its closest variant, VIM-5. Both VIM encoding genes were clones and demonstrated similar susceptibility profile when expressed in identical background. The presence of VIM-38 increases the diversity of carbapenemases in Turkey.
Assuntos
Proteínas de Bactérias/genética , Farmacorresistência Bacteriana Múltipla/genética , Genes Bacterianos , Pseudomonas aeruginosa/enzimologia , beta-Lactamases/genética , Substituição de Aminoácidos , Antibacterianos/farmacologia , Carbapenêmicos/farmacologia , Clonagem Molecular , DNA Bacteriano/isolamento & purificação , Humanos , Testes de Sensibilidade Microbiana , Pseudomonas aeruginosa/genética , Pseudomonas aeruginosa/isolamento & purificação , Análise de Sequência de DNA , TurquiaRESUMO
Ascaris lumbricoides is a comman intestinal helminths in humans. It is a parasite which commonly affects society with a low socioeconomic status, especially in tropical and rural areas. Ascaris lumbricoides infestation can lead to serious complications because of the mobility of the worms. The parasite can cause a variety of complications like intestinal obstruction, perforation, biliary obstruction, pancreatitis, peritonitis, liver abscess, cholangiohepatitis, volvulus, and gangrene, etc. A 59-year-old female patient hospitalized with the diagnosis of mesenteric ischemia was operated on for jejunal resection. On the 6th postoperative day, a worm was noticed emerging through the nasogastric tube. Ascaris lumbricoides was determined as a result of the examination microbiology laboratory. The patient was treated successfully with one dose of albendazole 200 mg 1x2. Our case describes a clinical situation of ascariasis observed after jejunal resection and emphasizes the importance of remaining aware of this rare complication of ascariasis.
Assuntos
Ascaríase/diagnóstico , Ascaris lumbricoides/isolamento & purificação , Intubação Gastrointestinal/instrumentação , Isquemia/diagnóstico , Jejuno/cirurgia , Doenças Vasculares/diagnóstico , Albendazol/uso terapêutico , Animais , Antinematódeos/uso terapêutico , Ascaríase/complicações , Ascaríase/tratamento farmacológico , Feminino , Humanos , Isquemia/parasitologia , Isquemia Mesentérica , Pessoa de Meia-Idade , Doenças Vasculares/parasitologiaRESUMO
Acinetobacter baumannii is an important pathogen in hospitalized patients, particularly those in the intensive care unit (ICU). A total of 21 A. baumannii (6 from 5 patients and 15 from environmental samples) were isolated in the ICU and the isolation room of a state hospital in June 2011. The possible source of the outbreak was investigated. A. baumannii isolates were identified using conventional biochemical tests, BBL Crystal Identification Systems, OXA-51 specific PCR, and 16S rDNA sequencing. All the isolates were multidrug-resistant, showing resistance to cephalosporins, carbapenems, fluoroquinolones, and the aminoglycoside group of antibiotics. Pulsed-field gel electrophoresis suggested that all A. baumannii isolates were derived from a common source.
Assuntos
Infecções por Acinetobacter/epidemiologia , Acinetobacter baumannii/classificação , Acinetobacter baumannii/genética , Infecção Hospitalar/epidemiologia , Surtos de Doenças , Tipagem Molecular , Infecções por Acinetobacter/microbiologia , Acinetobacter baumannii/isolamento & purificação , Animais , Técnicas de Tipagem Bacteriana , Infecção Hospitalar/microbiologia , Farmacorresistência Bacteriana Múltipla , Eletroforese em Gel de Campo Pulsado , Genótipo , Hospitais Estaduais , Humanos , Testes de Sensibilidade Microbiana , Turquia/epidemiologiaRESUMO
OBJECTIVE: To investigate the antibiotic resistance genes inserted into class 1 and class 2 integrons in Acinetobacter baumannii (A. baumannii) isolates obtained from nine different cities in Turkey. METHODS: A collection of 281 A. baumannii clinical isolates were collected from nine diferent state hospitals in Turkey and were confirmed as A. baumannii by conventional biochemical, API testing and bla-OXA-51 specific PCR. The isolates were examined by PCR for existence of class 1 and 2 integron gene cassettes. RESULTS: They were characterized by antimicrobial susceptibility testing and the highest resistance rates were determined for piperacillin (90.03%), ciprofloxacin (87.54%), cefepime and trimethoprim/sulfamethoxazole (81.13%). The lowest resistance rates was for cefotaxime (3.55%). class I integrons were detected in 6.4% (18/281) of A. baumannii strains and no class 2 integron was detected. The gene cassettes of class 1 integrons AacC1-AAC(3)I-aadA1, AacC1-aadA1, AAC(3)-I, AAC(3)-I -AAC(3)-I -aadA1, TEM-1, AAC(3)-I-aadA1 - AAC(3)-I -AAC(3)-I, AAC(3)-I -AAC(3)-I -AAC(3)-I -aadA1, AAC(3)-I - aadA1, AAC(3)-I-AAC(3)-I, AAC(3)-I-aadA1- AAC(3)-I-aadA1, AAC(3)-I- AAC(3)-I- aadA1-AAC(3)-I-aadA1 were detected in eighteen strains. The aac genes family were most frequently found integrated into the class 1 integrons and it was followed by aadA genes and TEM-1 genes. CONCLUSIONS: This is an extensive study on the distribution of class 1 integron among A. baumannii in Turkey. In addition to these, two new alleles were observed. Their percentage rates of similarity to other cassettes are 95% aadA1 ( TKA18) and 89% aadA1 (ANKA3).