Browsing by Author "ÖZAKIN, CÜNEYT"
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Publication Conventional culture and molecular screening methods for detection of vancomycin-resistant enterococci activity(Carbone Editore, 2016-01-01) Karakecili, Faruk; Cilo, Burcu Dalyan; Akın, Hicran; Ağca, Harun; Sınırtaş, Melda; Özakın, Cüneyt; Yılmaz, Emel; Akalın, Halis; Cilo, Burcu Dalyan; Akın, Hicran; AĞCA, HARUN; Sınırtaş, Melda; ÖZAKIN, CÜNEYT; YILMAZ, EMEL; AKALIN, EMİN HALİS; Uludağ Üniversitesi/Tıp Fakültesi/Microbiooji Bölümü; 0000-0002-7368-7187; 0000-0002-2651-2034; 0000-0002-3894-1231; 0000-0001-7530-1279; IVV-5845-2023; AAH-4027-2021; AAU-8952-2020; AAG-8392-2021; ISU-9626-2023Introduction: Early identification of vancomycin-resistant enterococci (VRE) colonization by screening patients is necessary in tends of preventing spread and development of infection. The purpose of this study was to investigate the presence of VRE using and real time polymerase chain reaction (RT-PCR) and to compare the results and costs.Materials and methods: Patients in the risk group attending our hospital and planned for treatment with hospitalization were included. Two rectal swab specimens were taken. One swab specimen was inoculated into enterococci broth for CCSM. Resistant gene investigation was performed with the other specimen by using RT-PCR. The costs of the two methods were then compared.Results: VRE were detected in 75 (6.63%) of the 1130 patients screened using the two methods. Resistance gene was determined in 69 (6.1%) patients using RT-PCR and 32 (2.8%) with CCSM. RT-PCR results were negative in 6 patients with VRE growth determined using CCSM. VRE was detected with CCSM in all 26 patients in whom vanA genotype VRE were determined using RT-PCR, but no growth was determined with CCSM in any of the 43 patients in whom vanB genotype VRE were detected. Results obtained in 3 days using CCSM and within 4 hours using RT-PCR. Costs were 58 $ with CCSM and 46 $ with RT-PCR.Conclusion: VRE colonization being detected faster with RT-PCR than CCSM. When the costs in isolation of patients until VRE screening test results emerged were compared, VRE screening with RT-PCR was cost-effective. RT-PCR was markedly superior to CCSM in determining VanB type resistance. Due to the late results from CCSM and its failure to detect VanB type resistance, we think that RT-PCR can be an alternative to CCSM or that the two techniques can usefully be combined depending on the hospital conditions.Publication Evaluation of serum indirect haemagglutination test results of suspected cystic echinococcosis cases from 2009-2017(Pakistan Medical Assoc, 2022-06-01) Tuzemen, Nazmiye Ulku; Alver, Oktay; Ozakin, Cuneyt; Ener, Beyza; Tuzemen, Nazmiye Ulku; TÜZEMEN, NAZMİYE ÜLKÜ; Alver, Oktay; ALVER, OKTAY; Ozakin, Cuneyt; ÖZAKIN, CÜNEYT; Ener, Beyza; ENER, BEYZA; Bursa Uludağ Üniversitesi/Tıp Fakültesi/Mikrobiyoloji Anabilim Dalı.; A-4290-2018Objective: This study aims to evaluate the serological, radiological and epidemiological analysis of suspected cystic echinococcosis patients, and to assess the positivity rate in the region. Method: The retrospective study was conducted at Bursa Uludag University Hospital, Turkey and comprised data from January 2009 to December 2017 related to patients of either gender with suspected cystic echinococcosis who underwent indirect haemagglutination testing. Demographic and clinical data of patients who tested positive were analysed. Statistical analysis was done using SPSS 23. Results: Of the 3910 patients with a mean age of 41.6 +/- 19.35 years (range: 0-93 years) who underwent indirect haemagglutination testing, 692(17.7%) tested positive; 390(56.4%) females, and 302(43.6%) males. The highest seropositivity rate 107(15.5%) was observed in 2011, followed by 104(15%) in 2016. Seropositive cases were predominantly seen in those aged 40-49 years 131 (18.9%), followed by those aged 50-59 years 124 (17.9%). Conclusion: Cystic echinococcosis was found to be a public health problem in South Marmara region of Turkey.Publication First case of infective endocarditis associated with neisseria animaloris(Aves, 2018-08-01) Efe, Kadir; Tüzemen, Nazmiye Ulku; YİĞİT, MUHAMMED; TÜZEMEN, NAZMİYE ÜLKÜ; Hemis, Reside Borce; Yiğit, Muhammed; Kapsız, Mahmut; KAPSIZ, MAHMUT; Tuncel, Tekin; Heper, Yasemin; HEPER, YASEMİN; Güllülü, Sumeyye; GÜLLÜLÜ, NAZMİYE SÜMEYYE; Özakın, Cüneyt; ÖZAKIN, CÜNEYT; Bursa Uludağ Üniversitesi/Tıp Fakültesi/Kardiyoloji Anabilim Dalı.; Bursa Uludağ Üniversitesi/Tıp Fakültesi/Enfeksiyon Hastalıkları Anabilim Dalı.; Bursa Uludağ Üniversitesi/Tıp Fakültesi/Tıbbi Mikrobiyoloji Anabilim Dalı.; 0000-0003-3544-3509; AAH-6506-2021; AAG-8392-2021; A-4290-2018A 25-year-old female with no remarkable medical or family history presented with sudden chest pain and shortness of breath. Transesophageal echocardiography revealed a defect in intraventricular septum, and a loose mass image was observed on the septal cuspis of tricuspid valve. A total of 6 blood cultures were taken, one bottle of blood culture from each arm of the patient for three consecutive days. All bottles yielded growth of Neisseria animaloris. All isolates were identified by Phoenix (TM) 100 (Becton Dickinson, Diagnostic Instrument System, Sparks, MD, USA), and the identification was confirmed by matrix-assisted laser desorption/ionization time-of-flight mass spectrometry (MALDI-TOF MS) (Bruker Daltonik, Bremen, Germany). Antibiotic susceptibility results were studied by gradient diffusion method, and interpreted as resistant to penicillin G and susceptible to ceftriaxone by the European Committee on Antimicrobial Susceptibility Testing (EUCAST) 2013 standards for N. meningitidis. No risk factor such as animal contact or bite, and tooth or gum problems was detected in the patient evaluation because of the feature of the causative agent. Definitive infective endocarditis was diagnosed according to modified Duke criteria because of fever, infective endocarditis-prone cardiac condition and pulmonary embolism, vegetation in echocardiography and growth in consecutive blood cultures. Although there are some reports that N. animaloris causes wound infections in the cases bitten by a dog or a cat, there is no information about it as a causative agent for infective endocarditis. Our case is the only case of infective endocarditis that is caused by N. animaloris.Publication Healthcare-associated stenotrophomonas maltophilia bacteraemia: Retrospective evaluation of treatment and outcome(Springernature, 2021-10-20) Tuncel, Tekin; Akalın, Halis; Payaslıoğlu, Melda; Yılmaz, Emel; Kazak, Esra; Heper, Yasemin; Özakın, Cüneyt; Tuncel, Tekin; AKALIN, EMİN HALİS; PAYASLIOĞLU, AYŞE MELDA; YILMAZ, EMEL; KAZAK, ESRA; HEPER, YASEMİN; ÖZAKIN, CÜNEYT; Bursa Uludağ Üniversitesi/Tıp Fakültesi/Enfeksiyon Hastalıkları ve Klinik Mikrobiyoloji Anabilim Dalı.; 0000-0001-7530-1279; 0000-0003-1785-3539; AAU-8952-2020; EBR-5383-2022; FQO-1207-2022; GDP-0005-2022; AAG-8459-2021; CTY-9474-2022; JNH-9929-2023IntroductionStenotrophomonas maltophilia (SM) is one of the common gram-negative pathogens that cause nosocomial infections. The aim of the present study is to evaluate the treatment and outcome of SM bacteraemia.Materials and MethodsWe retrospectively evaluated antimicrobial treatment in adult patients with nosocomial SM bacteraemia, with the 14th and 30th-day mortality as the outcome.ResultsIn total, 140 adult patients with SM bacteraemia who were diagnosed between January 1, 2002, and December 31, 2016 were enrolled in the present study. Seventy-one (50.7%) patients were in the intensive care unit (ICU). The 14th and the 30th-day mortality rates were 32.9% (n=46) and 45.7% (n=64), respectively. Female sex (OR, 7.47; 95% CI 1.61-34.47, p<0.01), steroid use within the last month (OR, 10.2; 95% CI 1.27-82.27, p=0.029), Pittsburgh bacteraemia score (PBS) >= 4 (OR, 39.9; 95% CI 4.96-321.32, p<0.001) and solid organ malignancy (OR, 9.6; 95% CI 1.73-53.72, p<0.01) were independent risk factors for 14th day mortality. Removal of the catheter was an independent protective factor for both 14th (OR, 0.05; 95% CI 0.22-0.010, p<0.001) and 30th day (OR, 0.039;95% CI 0.164-0.009, p<0.001) mortality. We did not detect any difference between treatment regimens including trimethoprim-sulfamethoxazole (TMP/SMX) or levofloxacin in terms of mortality. We found that TMP/SMX and levofloxacin combination did not significantly improve patient prognosis.ConclusionDue to the high mortality rates associated with nosocomial SM bacteraemia, adequate antibiotic therapy should be initiated immediately in the suspicion of infection, and prompt removal of any indwelling central venous catheter is important.Publication In-vitro activity of fosfomycin against Escherichia coli and Klebsiella pneumoniae bloodstream isolates and frequency of OXA-48, NDM, KPC, VIM, IMP types of carbapenemases in the carbapenem-resistant groups(Taylor & Francis, 2021-07-28) Zarakolu, Pınar; Eser, Özgen Köseoğlu; Otlu, Barış; Gürpınar, Öznur; Özakın, Cüneyt; Akalın, Halis; Köksal, İftihar; Ünal, Serhat; ÖZAKIN, CÜNEYT; AKALIN, EMİN HALİS; Bursa Uludağ Üniversitesi/Tıp Fakültesi/Tıbbi Mikrobiyoloji Anabilim Dalı.; 0000-0001-5428-3630; 0000-0001-7530-1279; JGV-7010-2023 ; AAU-8952-2020The aim of this study was to determine the in-vitro activity of fosfomycin against Escherichia coli (E. coli) and Klebsiella pneumoniae (K. pneumoniae) isolates and the frequency of OXA-48, NDM, KPC, VIM, IMP types of carbapenemases in the carbapenem-resistant (CR) groups. A total of 346 isolates (126 E. coli and 220 K. pneumoniae) from nosocomial bloodstream infections were included. Carbapenem and fosfomycin susceptibility were tested by Etest (bioMerieux, France) and agar dilution methods, respectively and evaluated in accordance with EUCAST criteria. The presence of OXA-48, NDM, KPC, VIM, IMP types of carbapenemases were conducted by using PCR method. Of the total 346 isolates, 185 (41 E. coli, 144 K. pneumoniae) were CR. Fosfomycin susceptibility of E. coli was higher than 95% and was not statistically significant between the CR and carbapenem-susceptible (CS) groups. Fosfomycin susceptibility of CS and CR K. pneumoniae was 90.7% and 69.4%, respectively, and statistically significantly lower in CR group. Of the total 185 CR isolates, 163 (32 E. coli, 131 K. pneumoniae) were producing carbapenemases. OXA-48 was the prominent carbapenemase type produced by E. coli (96.8%) and K. pneumoniae (70.9%). The frequency of NDM and KPC types produced by K. pneumoniae was 20.6% and 15.2%, respectively. Fosfomycin has substantial in-vitro activity against nosocomial CS and CR E. coli and CS K. pneumoniae bloodstream isolates. However, due to the risk of emerging resistance with fosfomycin monotherapy, combination therapy should be considered to obtain the possible additive or synergistic activity. Emerging fosfomycin resistance of CR K. pneumoniae isolates is alarming and OXA-48 is still the prominent carbapenemase type in Turkey.Publication Investigation of infectious droplet dispersion in a hospital examination room cooled by split-type air conditioner(Springer, 2024-05-08) Yüce, Bahadir Erman; Kalay, Onur Can; Karpat, Fatih; Alemdar, Adem; Temel, Şehime Gülsün; Dilektaşlı, Aslı Görek; Başkan, Emel Bülbül; Özakın, Cüneyt; Coşkun, Burhan; YÜCE, BAHADIR ERMAN; Kalay, Onur Can; KARPAT, FATİH; ALEMDAR, ADEM; TEMEL, ŞEHİME GÜLSÜN; GÖREK DİLEKTAŞLI, ASLI; BÜLBÜL BAŞKAN, EMEL; ÖZAKIN, CÜNEYT; COŞKUN, BURHAN; Bursa Uludağ Üniversitesi/Yenişehir İbrahim Orhan Meslek Yüksekokulu/İklimlendirme ve Soğutma Teknolojisi Bölümü.; Bursa Uludağ Üniversitesi/Mühendislik Fakültesi/Makine Mühendisliği Bölümü.; Bursa Uludağ Üniversitesi/Sağlık Bilimleri Enstitüsü.; Bursa Uludağ Üniversitesi/Tıp Fakültesi/Tıbbi Genetik Anabilim Dalı.; Bursa Uludağ Üniversitesi/Tıp Fakültesi/Histoloji ve Embriyoloji Anabilim Dalı.; Bursa Uludağ Üniversitesi/Tıp Fakültesi/Göğüs Hastalıkları Anabilim Dalı.; Bursa Uludağ Üniversitesi/Tıp Fakültesi/Dermatoloji Anabilim Dalı.; Bursa Uludağ Üniversitesi/Tıp Fakültesi/Enfeksiyon Hastalıkları ve Mikrobiyoloji Anabilim Dalı.; Bursa Uludağ Üniversitesi/Tıp Fakültesi/Üroloji Anabilim Dalı.The novel coronavirus (SARS-CoV-2) outbreak has spread worldwide, and the World Health Organization (WHO) declared a global pandemic in March 2020. The transmission mechanism of SARS-CoV-2 in indoor environments has begun to be investigated in all aspects. In this regard, many numerical studies on social distancing and the protection of surgical masks against infection risk have neglected the evaporation of the particles. Meanwhile, a 1.83 m (6 feet) social distancing rule has been recommended to reduce the infection risk. However, it should be noted that most of the studies were conducted in static air conditions. Air movement in indoor environments is chaotic, and it is not easy to track all droplets in a ventilated room experimentally. Computational Fluid Dynamics (CFD) enables the tracking of all particles in a ventilated environment. This study numerically investigated the airborne transmission of infectious droplets in a hospital examination room cooled by a split-type air conditioner with the CFD method. Different inlet velocities (1, 2, 3 m/s) were considered and investigated separately. Besides, the hospital examination room is a model of one of the Bursa Uludag University Hospital examination rooms. The patient, doctor, and some furniture are modeled in the room. Particle diameters considered ranged from 2 to 2000 mu m. The evaporation of the droplets is not neglected, and the predictions of particle tracks are shown. As a result, locations with a high infection risk were identified, and the findings that could guide the design/redesign of the hospital examination rooms were evaluated.Publication Long term investigations on tick infestations of human(Kafkas Üniversitesi Veteriner Fakultesi Dergisi, 2015-11-01) Selçuk, Özgür; Aydın, Levent; Girişgin, Ahmet Onur; Şenlik, Bayram; Özakin, Cüneyt; Selçuk, Özgür; AYDIN, LEVENT; GİRİŞGİN, AHMET ONUR; ŞENLİK, BAYRAM; ÖZAKIN, CÜNEYT; Uludağ Üniversitesi/Veteriner Fakültesi/Mikrobioloji Bölümü; Uludağ Üniversitesi/Veteriner Fakültesi/Parasitoloji Bölümü; 0000-0002-0020-2708; 0000-0003-2964-2245; AAG-8392-2021; B-5286-2017; JLA-7878-2023; HLG-4450-2023; GBN-0139-2022In this study, a total of 19866 samples which were collected from humans who applied to the hospitals with tick bites in the western part of Turkey (Bursa) between the years 2007 and 2011 (from February to November) were examined. Approximately 10% (1985) of samples were found as non-ticks like bee stings, lice, fleas and other arthropods. The ticks were identified as Rhipicephalus spp. (72.98%), Ixodes spp. (18.96%), Hyalomma spp. (7.18%), Dermacentor marginatus (0.027%) and Haemaphysalis parva (0.005%). Based on localities, majority of the tick samples were reported from the urbanized areas (81%). Especially, Ixodes spp. species were commonly found in highland and forestry areas of Bursa.Publication Mycoplasma hominis and ureaplasma urealyticum: Their role in urogenital system infections and retrospective evaluation of antibiotic resistance rates(Aves, 2019-04-01) Tuüzemen, Nazmiye Ülkü; Efe, Kadir; Özakın, Cüneyt; TÜZEMEN, NAZMİYE ÜLKÜ; ÖZAKIN, CÜNEYT; Bursa Uludağ Üniversitesi/Tıp Fakültesi/Tıbbi Mikrobiyoloji Anabilim Dalı; 0000-0003-3544-3509; A-4290-2018; AAG-8392-2021Objective: Mycoplasma hominis and Ureaplasma urealyticum are opportunistic pathogens which can frequently be isolated from genitourinary tracts of humans. The aim of this study was to evaluate the presence, epidemiologic features and antibiotic susceptibility of M. hominis and U. urealyticum agents in urine specimens which were sent from various clinics of Uludag University, Hospital of Health Application and Research Center for diagnosis of genitourinary system infection.Methods: Urinary specimen results of M. hominis and U. urealyticum were retrospectively reviewed between January 2015 and December 2016 in our hospital. Urinary specimens were examined using Mycoplasma IES (Autobio Diagnostics, Zhengzhou, People's Republic of China) in 2015 and Biosynex (R) Mycoplasmatest (Biosynex, Illkirch-Graffenstaden, France) in 2016 for the identification of M. hominis and U. urealyticum. Simultaneous urine culture and complete urinalysis results were compared with results of M. hominis and U. urealyticum.Results: In our study, we evaluated 5852 samples of 2926 patients comprising 67.43% females and 32.57% males for detection of M. hominis and U. urealyticum in urine. While U. urealyticum, and M. hominis were detected in 22.25% (651/2926) and 1.23% (36/2926) of the samples, respectively; coinfection was detected in 3.79% (111/2926). M. hominis and/or U. urealyticum positivity (n=798/2926) were found to be 32.12% in women and 11.02% in men. Resistance rates of M. hominis according to sex were found to be higher in women for ciprofloxacin and a statistically significant difference was found (chi(2)=4.336, p=0.037).Conclusions: As there was no growth in routine urine cultures of about half of the M. hominis and/or U. urealyticum-positive patients, it is recommended to consider the presence of urogenital M. hominis and U. urealyticum infections for treatment and to use laboratory tests for the diagnosis of these agents especially in the presence of risky conditions such as pregnancy.Publication Nanoparticle liposomes: A new strategy in bacterial infections(Doc Design Informatics, 2021-08-01) Erkan Alkan, Perihan; Güneş, Mesu Ertan; Özakın, Cüneyt; Sabancı, A. Ümit; ERKAN ALKAN, PERİHAN; GÜNEŞ, MESUT ERTAN; ÖZAKIN, CÜNEYT; Bursa Uludağ Üniversitesi/Sağlık Hizmetleri Meslek Yüksekokulu; Bursa Uludağ Üniversitesi/Teknik Bilimler Meslek Yüksekokulu; Bursa Uludağ Üniversitesi/Tıp Fakültesi/Klinik Mikrobiyoloji Anabilim Dalı; 0000-0002-8837-3375; 0000-0002-9347-8307; AAK-4004-2021; AAK-4470-2021; JRO-4525-2023Objective: In our study, a nanoparticle liposome molecule with patent application number TR201804452A2 was used, and the Minimum Inhibitor Concentration (MIC) was found to be 1562 ppm. According to the ASTMF 1980 standard, it has been determined that the nanoparticle liposome solution kept at 37 days and 55 degrees C in return for one-year stability preserves its effectiveness. Our study aimed to show that the newly developed solution maintains its effectiveness for a long time.Methods: CLSI M07-A10 (Methods for Dilution Antimicrobial Susceptibility Tests for Bacteria That Grow Aerobically. Tenth ed. Approved Standard) standard test method of the nanoparticle liposome solution developed with a technique different from the standard ozonation mechanisms, and antibacterial tests were performed by modifying the contact time and the MIC value of the solution, and its effect on time has been determined. For the stability test of the nanoparticle liposome solution, it was kept at 55 degrees C for 37 days in return for one-year stability according to the ASTM F 1980 standard.Results: MIC of nanoparticular ozone solution CLSI M07-A10 standard test method for S. aureus (ATCC 25923) and E. coli (ATCC 25922) strains by modifying contact time It was determined as 1.562 ppm. For S. aureus (ATCC 25923), at the end of the first hour, it was determined that the activity started at 2000 and 1750 ppm nanoparticle liposome solution concentration. For E. coli (ATCC 25922) it was determined that the activity started at the 10th minute at 2000 ppm nanoparticular ozone solution concentration. The solution was still effective at the end of one year according to the ASTM F 1980 standard in terms of effectiveness.Conclusions: As a result, the nanoparticle liposome solution, a new product, does not lose its stability and effectiveness for a long time, contrary to what is known. Although the half-life of gaseous ozone is as short as 20 minutes, the stability in the nanoparticle liposome solution has been determined as at least one year. Since nanoparticle liposome solution is a natural and slow-release product, it is thought that it can create a barrier in mucosal membranes in regions such as the nose, throat, eye and ear with solutions to be prepared in appropriate doses thus preventing bacteria from settling.Publication New antibacterial agent: Nanobubble ozone stored in liposomes: The antibacterial activity of nanobubble ozone in liposomes and their thymol solutions(Taylor, 2021-03-30) Alkan, Perihan Erkan; Güneş, Mesut Ertan; Özakın, Cüneyt; Sabancı, Ahmet Ümit; ERKAN ALKAN, PERİHAN; GÜNEŞ, MESUT ERTAN; ÖZAKIN, CÜNEYT; Bursa Uludağ Üniversitesi/Sağlık Hizmetleri Meslek Yüksekokulu; Bursa Uludağ Üniversitesi/Teknik Bilimler Meslek Yüksekokulu/Gıda İşleme Bölümü; Bursa Uludağ Üniversitesi/Tıp Fakültesi/Enfeksiyon Hastalıkları ve Mikrobiyoloji Anabilim Dalı; 0000-0002-8837-3375; 0000-0002-9347-8307; 0000-0001-5428-3630; AAK-4470-2021; JHZ-5366-2023Ozone is a highly effective oxidant. In its gaseous form, ozone is not a stable compound; however, stability and effectiveness are sustained for a long period, when stored in vegetable oils. In this study, solutions are prepared containing a combination of ozone nanobubbles, vegetable oils and emulsifiers. Throughout the study, the antibacterial effectiveness and stability of ozone nanobubble carried in liposomes and their solutions with thymol are tested on strains of Staphylococcus aureus (ATCC 25923) and Escherichia coli (ATCC 25922). Findings of the study suggest that the stability range of the ozone nanobubbles carried in liposomes extend to a 1-year period. In addition, the antibacterial effectiveness of this structure, both with and without thymol, is tested to be substantially high on the sample bacteria. These ozone structures/solutions can be stored at +4 degrees for an extended period of time compared to ozone's possible stability range as a sole trioxygen molecule. Results of the study highlight the possibility of extending the storage/stability range even further.Publication Oxa-48 dominance meets ceftazidime-avibactam: A battle against life-threatening carbapenem-resistant klebsiella pneumoniae infections in the intensive care unit(Springernature, 2023-10-10) Önal, Uğur; Tüzemen, Ülkü; Kaya, Pınar K.; İşçimen, Remzi; Girgin, Nermin Küçükdemirci; Özakın, Cüneyt; Kahveci, Ferda; Akalın, Halis; ÖNAL, UĞUR; TÜZEMEN, NAZMİYE ÜLKÜ; KÜÇÜKDEMİRCİ KAYA, PINAR; ÖZAKIN, CÜNEYT; KAHVECİ, FERDA ŞÖHRET; İŞÇİMEN, REMZİ; Girgin, Nermin Küçükdemirci; AKALIN, EMİN HALİS; Bursa Uludağ Üniversitesi/Tıp Fakültesi/Enfeksiyon Hastalıkları; Bursa Uludağ Üniversitesi/Tıp Fakültesi/Mikrobiyoloji Bölümü; Bursa Uludağ Üniversitesi/Tıp Fakültesi/Anesteziyoloji ve Yoğun Bakım; Bursa Uludağ Üniversitesi/Tıp Fakültesi/Yoğun Bakım Ünitesi; Bursa Uludağ Üniversitesi/Tıp Fakültesi/Tıbbi Mikrobiyoloji; 0000-0001-6194-3254; 0000-0002-8428-8245; JCO-3678-2023; JCO-2264-2023; JNY-9122-2023; JMU-3479-2023; DTU-3148-2022; JNH-9929-2023; CYR-2043-2022; CYR-2043-2022; AAU-8952-2020ObjectiveIn this study, we aimed to describe the outcomes in ICU patients with bloodstream infection (BSI) or ventilatory-associated pneumonia (VAP) due to carbapenem-resistant Klebsiella pneumoniae (CRKP) who received ceftazidime-avibactam treatment at a tertiary care university hospital.MethodsPatients aged 18 years or older who were admitted to the Anesthesiology and Reanimation ICU at Bursa Uludag University Faculty of Medicine Hospital between June 13, 2021, and July 16, 2023, and diagnosed with BSI or VAP due to CRKP were included in this study.ResultsA total of 42 patients treated with ceftazidimeavibactam were included. Total crude mortality rates were 33.3% on day 14 and 54.8% on day 30. Mortality rates on the 14th and 30th days were 37.5% and 62.5% in patients with BSI and 27.8% and 44.4% in patients with VAP, respectively. There was no statistically significant difference between monotherapy and combination therapy in terms of mortality rates on days 14 and 30, respectively (3/11 vs. 11/31, p=0.620; 5/11 vs. 18/31, p=0.470). Immunosuppression (10/11 vs. 13/31, p=0.005), the Sequential Organ Failure Assessment (SOFA) score >= 8 (at the initiation of treatment; 19/25 vs. 4/17, p<0.001), INCREMENT-CPE score >= 10 (12/16 vs. 3/10, p=0.024) and longer duration (in days) from culture collection to treatment initiation (5.0 +/- 0.61 vs. 3.11 +/- 0.48, p=0.024) were found to have a statistically significant effect on 30-day mortality. In multivariate analysis, a SOFA score >= 8 at the initiation of treatment (p=0.037, OR: 17.442, 95% CI: 1.187-256.280) was found to be a significant risk factor affecting mortality (30-day).ConclusionThe mortality rates of patients with CRKP infection who were followed up in the ICU were found to be high, and it was observed that whether ceftazidime-avibactam treatment was given as a combination or monotherapy did not affect mortality. Further multicentre studies with a larger number of patients are needed to gain a comprehensive understanding of the topic, given that this treatment is typically reserved for documented infections.Publication Peritoneal fluid analysis of the newborn calves with intestinal atresia - A clinical approach(Univ Fed Rio Grande Do Sul, 2019-11-23) SALCI, HAKAN; Salcı, Hakan; Çatık, Serkan; Özakın, Cüneyt; ÖZAKIN, CÜNEYT; Salcı, Emsal Sinem Özdemir; ÖZDEMİR SALCI, EMSAL SİNEM; Bursa Uludağ Üniversitesi/Veteriner Fakültesi/İç Hastalıkları Anabilim Dalı.; Bursa Uludağ Üniversitesi/Veteriner Fakültesi/Jinekoloji ve Doğum Anabilim Dalı.; Bursa Uludağ Üniversitesi/Veteriner Fakültesi/Mikrobiyoloji Anabilim Dalı.; Bursa Uludağ Üniversitesi/Veteriner Fakültesi/Genel Cerrahi Anabilim Dalı.; AAE-6201-2021; AAH-5294-2021; AAG-8392-2021Background: Anomalies and fetal problems are encountered in all animals. Intestinal atresia is a congenital anomaly of both humans and animals. Intestinal atresia has four morphological types, and they can be observed in jejunum, ileum, cecum, colon, rectum and anus (type I: mucosal atresia, type II: atretic ends separated by fibrous cord, type III: atretic ends separated by a "V" shaped mesenteric gap or atretic end coil like an "apple peel", type IV: multiple atresia). In calves, it is also commonly encountered; it is still a question to be replied about the exact prognosis of the patients with intestinal atresia. Thus, the main objective of the present study was to evaluate peritoneal fluid analysis results of calves with intestinal atresia.Materials, Methods & Results: Twenty-two calves were presented with abdominal distension and lack of defecation. Clinical and radiological findings pointed out the intestinal atresia. Blood samples were collected for routine hematological and serum total protein (IP) analysis. Peritoneal fluids were aspirated with sterile technique from the caudal abdomen, and biochemical features, cell contents and microbiological cultures of the peritoneal fluids were analyzed. Following to preoperative, surgical and necropsy findings, intestinal atresia were diagnosed as type II, III and IV in calves. Neutrophilic leukocytosis was observed in calves with type IV intestinal atresia. Red blood cells and platelet counts were determined in the peritoneal fluids. 'IP and density values of the peritoneal fluid were high in all cases. These results pointed the presence of the acute infection and peritonitis. Statistical comparison of each parameter showed that there was no significant difference between the types of intestinal atresia. Microbiologically, fecal origin bacteria were cultured in 12 calves.Discussion: In general, four types of intestinal atresia are encountered in calves, and all types are fatal pathologies; thus, surgery should urgently be planned as soon as diagnostic work-ups are completed after birth. Peritoneal fluid analysis is a useful diagnostic choice because changes in the peritoneal fluid parameters help to diagnosis of the infra-abdominal pathology. Intestinal atresia as more common anomaly in Holstein, Jersey and Montafon breed calves. In animals with intestinal atresia, surgical treatment is not usually recommended due to economic reasons and small chance of postoperative success. Long-term survival rate of surgically treated animals depends on the type of intestinal atresia and applied surgical technique. Atresia recti and ani may occur simultaneously with atresia coli, and all atresias (atresia coli, ani, recti or ani et recti) can be successfully treated by surgery. Continuous distention of the large intestinal segments leads to ischemia, necrosis, peritonitis and bowel perforation. Peritoneal fluid analysis should include the classic parameters for diagnosis, but these analyses are often insufficient to identify the etiology or pathogenesis of the disease. An increase in total WBC count and percentage of the neutrophil cells in the peritoneal fluid indicate the acute infectious origin inflammation. Additional parameters in the peritoneal fluid analysis have been established to improve diagnostic precision and specific information. Presence or absence of the bacteria in the peritoneal fluid samples is important to characterize the transudate and exudate. Changings in the peritoneal fluid values does not related to type of the intestinal atresia in calves.Publication Retrospective evaluation of colistin-resistant isolates in automated system by gradient diffusion method and broth microdilution method(Doc Design Informatics, 2019-04-01) Efe, Kadir; Tüzemen, Nazmiye Ülkü; TÜZEMEN, NAZMİYE ÜLKÜ; Akalın, Halis; AKALIN, EMİN HALİS; Özakın, Cüneyt; ÖZAKIN, CÜNEYT; Bursa Uludağ Üniversitesi/Tıp Fakültesi/Tıbbi Mikrobiyoloji Anabilim Dalı.; Bursa Uludağ Üniversitesi/Tıp Fakültesi/Enfeksiyon Hastalıkları Anabilim Dalı.; 0000-0003-3544-3509; 0000-0001-7530-1279; A-4290-2018; AAU-8952-2020; AAG-8392-2021Objective: Optimizing colistin susceptibility testing has difficulties because of its high molecular weight and high binding capacity to polystyrene which is frequently used in antibiotic susceptibility testing. We aimed to compare the results of isolates, which were detected as colistin-resistant in the automated system, obtained by using broth microdilution (BMD) method which is the gold standard, with gradient diffusion method (GDM).Methods: We investigated 36 Klebsiella pneumoniae, 9 Acinetobacter baumannii and 5 Pseudomonas aeruginosa isolates, identified by the Phoenix (TM) 100 (Becton Dickinson, Sparks, MD, USA) automated system, isolated from various clinical specimens sent to the Central Microbiology Laboratory between August 2016 and April 2017. The susceptibility of the isolates was also tested by GDM and BMD method.Results: When the colistin resistance rates obtained from the gold standard BMD method were compared with the automated method, the categorical agreement (CA) rate of the automated system was 92% for all isolates, 100% for K. pneumoniae, 77.8% for A. baumannii, and 60% for P. aeruginosa. The very major error (VME) rate was 0%, and the major error (ME) rate was 8% for all isolates. When GDM was used for all isolates, CA was found to be 20% for all isolates, 16.7% for K. pneumoniae, 22.2% for P. aeruginosa and 40% for A. baumannii. VME was found to be 80%, and ME was %0 for all isolates.Conclusions: CA, VME and ME rates of Phoenix (TM) 100 for detecting colistin resistance is within acceptable limits according to ISO 20776 standard, but the rates of GDM is not suitable for this purpose.Publication Retrospective evaluation of colistin-resistant isolates in automated system by gradient diffusion method and broth microdilution method (vol 32, pg 57, 2019)(Aves, 2019-08-01) Tüzemen, Nazmiye Ülkü; Efe, Kadir; Akalın, Halis; Özakın, Cüneyt; TÜZEMEN, NAZMİYE ÜLKÜ; AKALIN, EMİN HALİS; ÖZAKIN, CÜNEYT; Bursa Uludağ Üniversitesi/Tıp Fakültesi/Tıbbi Mikrobiyoloji Anabilim Dalı.; Bursa Uludağ Üniversitesi/Tıp Fakültesi/Enfeksiyon Hastalıkları ve Klinik Mikrobiyoloji Anabilim Dalı.; 0000-0003-3544-3509; 0000-0001-7530-1279; AAG-8392-2021; AAU-8952-2020; A-4290-2018Publication Testing the antibacterial efficacy of various commercially available alcohol-based hand antiseptics and the world health organization formulation II with the EN 1500 standard(Doc Design Informatics, 2022-06-01) Topaç, Tuncay; Özakın, Cüneyt; ÖZAKIN, CÜNEYT; 0000-0001-5428-3630; AAG-8392-2021Objective: The European Norm (EN) 1500 standard, which was developed to evaluate the antibacterial efficacy of widely used hand rub agents, is the most common in vivo test method used in Europe and has been accepted by the Turkish Standards Institute. This study aimed to test five antiseptic products supplied from the market and the hand antiseptic formulation II recommended by the World Health Organization (WHO-II) for two application types using the EN 1500.Methods: In the first application, the hands were rubbed with 3 mL of antiseptic for 30 seconds (1x3 ml; 30 sec); in the second application, which lasted 60 seconds, the hands were rubbed with 3 ml of antiseptic for 30 seconds, and the same process was repeated once more (2x3 ml; 2x30 sec). After the participants' hands were artificially contaminated with Escherichia coli K12 standard strain, the bactericidal efficacy of the tested antiseptics was compared with the ap-plication of a 60% by volume isopropyl alcohol solution (2x3 ml; 2x30 sec) as the reference procedure.Results: When the antiseptics were tested, and WHO-II was applied in the form of "1x3 ml; 30 sec", they were found to be significantly less effective than the reference procedure and did not meet the EN 1500. On the other hand, when they were applied in the "2x3 ml; 2x30 sec" procedure, all of them met the EN 1500.Conclusion: Tested antiseptic products and WHO-II should be applied in the form of "2x3 ml; 2x30 sec" to meet the EN 1500. Considering the length of the 60-seconds period in practice, raising the alcohol ratio should be considered in order to provide adequate hand antisepsis in 30 seconds.Publication The diagnostic value of endoscopic narrow band imaging in helicobacter pylori gastritis in children(Aves, 2015-03-01) Özgür, Taner; Özkan, Tanju Başarır; Erdemir, Gülin; Özakın, Cüneyt; Yerci, Ömer; ÖZGÜR, TANER; Özkan, Tanju Başarır; Erdemir, Gülin; ÖZAKIN, CÜNEYT; YERCİ, ÖMER; Uludağ Üniversitesi/Tıp Fakültesi/Çocuk Gastroenteroloji Anabilim Dalı.; Uludağ Üniversitesi/Tıp Fakültesi/Mikrobiyoloji Anabilim Dalı.; Uludağ Üniversitesi/Tıp Fakültesi/Patoloji Anabilim Dalı.; 0000-0002-9726-8219; 0000-0001-5740-9729; 0000-0001-5428-3630; AAG-8381-2021; AAG-8392-2021; DKU-2575-2022; GBW-0079-2022; EIS-5114-2022Background/Aims: In this study we aimed to investigate the sensitivity and specificity of Narrow Band Imaging (NBI) in H. pylori gastritis and compare them with those of rapid urease test and urea breath test.Materials and Methods: A hundred sixty-five children who admitted to Uludag University Pediatric Gastroenterology Unit between October 2009-March 2011 with upper gastrointestinal symptoms were consecutively enrolled. During the endoscopy procedure gastric corporeal, antral and fundal images were obtained, afterwards the same areas were visualized with narrow band imaging and images were recorded again.Results: The study included 68 (41.2%) boys and 97(58.8%) girls. The mean age of the patients were 11.88 +/- 4.55. Tissue culture positivity and/or histopathological staining for H. pylori was determined in 56 (33.9%) patients (Group 1) and the other patients (n:109, 43.6%) didn't have an evidence of H. pylori infection (Group 2). Narrow band images have supported H. pylori infection in 56.4%. The sensitivity of narrow band images for determining H. pylori infection was 92.86% (95% CI 82.7-98), specificity was 62.39% (95% CI 52.6-71.5).Conclusion: Our study is the first to show the role of NBI in diagnosing H. pylori infection in children, as well as determining the sensitivity and specificity of the technique. The specificity is low; however, we suggest that the specific mucosal view of H. pylori gastritis provided by NBI is useful for identifying the areas from which the biopsies should be taken. Moreover, by using this technique, treatment of H. pylori infection may be initiated immediately without performing rapid urease test and without waiting for histopathology report and tissue culture.Publication The investigation by PCR and culture methods of foulbrood diseases in honey bees in south marmara region(Kafkas Üniversitesi, 2015-01-01) Borum, A. Ebru; Özakin, Cüneyt; Güneş, Ertan; Aydın, Levent; Ülgen, Mihriban; Çakmak, İbrahim; ÖZAKIN, CÜNEYT; Güneş, Ertan; AYDIN, LEVENT; ÜLGEN, MİHRİBAN; ÇAKMAK, İBRAHİM; Uludağ Üniversitesi/Tıp Fakültesi/Mikrobiyoloji ve Enfeksiyon Hastalıkları Anabilim Dalı.; Uludağ Üniversitesi/Teknik Bilimler Meslek Yüksekokulu.; Uludağ Üniversitesi/Veteriner Fakültesi/Parazitoloji Anabilim Dalı.; Uludağ Üniversitesi/Veteriner Fakültesi/Mikrobiyoloji Anabilim Dalı.; Uludağ Üniversitesi/Mustafakemalpaja Meslek Yüksekokulu.; 0000-0002-9347-8307; 0000-0001-5428-3630; 0000-0002-6307-5179; AAG-8392-2021; AAG-8117-2021; AAH-2558-2021; AAK-4470-2021; HLG-4450-2023American Foulbrood and European Foulbrood diseases of honeybees were examined in 725 beehives from 23 apiaries located in the South Marmara Region of Turkey. We determined that 19 apiaries were infected and the suspected clinical signs of foulbrood diseases were investigated in 102 beehives by PCR and cultural method. Broods and combs from colonies with suspected clinical symptoms of foulbrood diseases were collected and cultured for bacteriological examination. All of the specimens contaminated with bacteriae and 37 species of bacteriae were isolated such as Stapylococcus epidermidis, Bacillus subtilis, Corynebacterium jeikum, Corynebacterium pseudotuberculosis, Bacillus spp. All of these bacteria are related to human, animal and environmental origins. In this study, Paenibacillus larvae by PCR amplifying the 973-bp region PL1 and PL2 with 1f, Melissococcus plutonius amplifying the 973-bp region EFB-F and EFB-R gene were amplified. American Foulbrood causative agent Paenibacillus larvae and European Foulbrood causative agent Melissococcus plutonius were not detected in any sample examined by PCR and cultural methods. On the other hand, Paenibacillus alvei that is a seconder agent to European Foulbrood was found in two samples by cultural methods. In conclusion, the results showed that P. larvae and M. plutonius are not present in South Marmara Region. In this study, human, animal and environment originated agents were isolated.Publication Trends of bloodstream infections in a university hospital during 12 years(Polskie Towarzystwo Mikrobiologow-polish Society Of Microbiologists, 2022-09-24) Tuzemen, Nazmiye Ulku; Payaslioglu, Melda; Özakin, Cuneyt; Ener, Beyza; Akalin, Halis; Tuzemen, Nazmiye Ulku; TÜZEMEN, NAZMİYE ÜLKÜ; Payaslioglu, Melda; PAYASLIOĞLU, AYŞE MELDA; Ozakin, Cuneyt; ÖZAKIN, CÜNEYT; Ener, Beyza; ENER, BEYZA; Akalin, Halis; AKALIN, EMİN HALİS; Bursa Uludağ Üniversitesi/Tıp Fakültesi/Tıbbi Mikrobiyoloji Anabilim Dalı.; Bursa Uludağ Üniversitesi/Tıp Fakültesi/Enfeksiyon Hastalıkları ve Klinik Mikrobiyoloji Anabilim Dalı.; 0000-0001-7530-1279; A-4290-2018; AAU-8952-2020This study aims to investigate trends in bloodstream infections and their antimicrobial susceptibility profiles over 12 years in our hospital. This retrospective study was carried out in the Bursa Uludag University Hospital, Turkey, during 2008-2019. Blood cultures from patients were performed using BACTEC System. Isolates were identified with Phoenix System until 2018 and "matrix-assisted laser desorption ionization time-of-flight mass spectrometry" (MALDI-TOF MS) in 2019. Antibiotic susceptibility testing was performed with Phoenix System. Patient data came from the BD EpiCenter (TM) data management system. Escherichia coli was found to be the most common Gram-negative (11.6%), and coagulase-negative staphylococci were the most common Gram-positive (10.1%) monomicrobial growth. Overall, there was a significant increase in rates of extended-spectrum beta-lactamase positive E. coli (p = 0.014) and Klebsiella pneumonia (p < 0.001), carbapenem-resistant E. coli (p < 0.001), and K. pneumoniae (p < 0.001) and colistin-resistant K. pneumoniae (p < 0.001) and Acinetobacter baumannii (p < 0.001) over 12 years. Carbapenem and colistin resistance has increased dramatically in recent years. We believe that regular monitoring of the distribution of pathogens and antibiotic susceptibility profiles, especially in intensive care units, can contribute to evidence for the increase in resistant microorganisms and help prevent their spread with antimicrobial stewardship and infection control policies.