Person: TÜZEMEN, NAZMİYE ÜLKÜ
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TÜZEMEN
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NAZMİYE ÜLKÜ
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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 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 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.Publication Acanthamoeba keratitis and acanthamoeba conjunctivitis: A case report(Iranian Scientific Society Medical Entomology, 2020-04-01) Alver, Oktay; Baykara, Mehmet; Yuruk, Merve; Ülkü Tüzemen, Nazmiye; ALVER, OKTAY; BAYKARA, MEHMET; TÜZEMEN, NAZMİYE ÜLKÜ; Bursa Uludağ Üniversitesi/Tıp Fakültesi/Tıbbi Mikrobiyoloji Anabilim Dalı; Bursa Uludağ Üniversitesi/Tıp Fakültesi/Göz Hastalıkları Anabilim Dalı; 0000-0002-5555-1649; AAA-5241-2021; ABI-7051-2020; CGE-2103-2022Acanthamoeba species are vision-threatening agents by causing cornea infections known as Acanthamoeba keratitis. A 5 year-old kid with the complaints of erythema, eyelid edema, inflammation, limitation of eye movements in the right eye, and having no history of wearing contact lenses or trauma, was diagnosed of Acanthamoeba conjunctivitis through laboratory examinations in the Ophthalmology clinic. The visual sharpness of the patient improved after the treatment. A 44 year-old female patient suffering from pain, stinging, irritation, and inability to see in the left eye with the history of wearing contact lenses or trauma was diagnosed of Acanthamoeba keratitis through laboratory examinations. The agent was isolated and identified as "A. castellam" in the Genotype "T2". Examination of the left eye on the 15th day of treatment indicated that all complaints disappeared except for the cataract originated visual loss. However, the first diagnosis of Acanthamoeba keratitis appeared in the literature on a case with no history of wearing contact lenses and trauma it is found to be attention grabbing. We think that Acanthamoeba should not be ignored among microbial agents that cause eye infection with or without trauma and contact lens usage history.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 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 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 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 Aspergillus infections in intensive care units: Before and after the COVID-19 pandemic(Bilimsel Tıp Yayınevi, 2022-01-01) Tüzemen, Nazmiye Ülkü; Önal, Uğur; Akalın, Emin Halis; Kazak, Esra; Heper, Yasemin; İşçimen, Remzi; Kelebek Girgin, Nermin; Yılmaz, Emel; Özakın, Cüneyt; Şöhret Kahveci, Ferda; Ener, Beyza; TÜZEMEN, NAZMİYE ÜLKÜ; ÖNAL, UĞUR; AKALIN, EMİN HALİS; KAZAK, ESRA; HEPER, YASEMİN; İŞÇİMEN, REMZİ; KELEBEK GİRGİN, NERMİN; YILMAZ, EMEL; ÖZAKIN, CÜNEYT; KAHVECİ, FERDA ŞÖHRET; ENER, BEYZA; Bursa Uludağ Üniversitesi/Tıp Fakültesi/Tıbbi Mikrobiyoloji Anabilim Dalı.; Bursa Uludağ Üniversitesi/Tıp Fakültesi/İnfeksiyon Hastalıkları ve Klinik Mikrobiyoloji Anabilim Dalı.; Bursa Uludağ Üniversitesi/Tıp Fakültesi/Anestezi ve Reanimasyon Anabilim Dalı.; 0000-0003-3544-3509; 0000-0001-6194-3254; 0000-0001-7530-1279; 0000-0002-5882-1632; 0000-0002-3894-1231; ACQ-7832-2022; AAU-8952-2020; JCO-3678-2023; A-4290-2018; CTY-9474-2022; DWL-9897-2022; GBC-7197-2022; HJZ-6992-2023; JKC-3728-2023; IMY-6211-2023; CNK-0895-2022Introduction: Aspergillus species have begun to cause invasive pulmonary aspergillosis (IPA) with increasing frequency in patients with known risk factors in intensive care units (ICU). An international multicenter cohort study (AspICU) established criteria for diagnosis of invasive pulmonary aspergillosis (IPA) in intensive care units. In our study, patients with Aspergillus spp. growth in deep tracheal aspirate (DTA) samples in ICU were evaluated according to AspICU criteria.Materials and Methods: This study is a retrospective study. DTA samples were collected from the Pandemic and Reanimation ICU and performed in the Medical Microbiology Laboratory by separated two periods; pre-pandemic (1 March 2019-31 December 2019) and post-pandemic (1 March 2020-31 December 2020). Cases with Aspergillus spp. growth in the DTA samples in the Pandemic ICU were evaluated as COVID 19 associated pulmonary aspergillosis (CAPA) according to AspICU criteria.Results: While Aspergillus spp. was grown in the DTA of three patients in 2019 and five patients in 2020 in the Reanimation ICU, and 11 patients in the Pandemic ICU. Growths belonging to one patient from both Reanimation (2019) and Pandemic ICUs were considered as colonization. Other growths were interpreted as IPA according to AspICU criteria. When the incidence rates according to 10000 patient days were compared, the incidence rate increased significantly in 2020 (19.1) (p< 0.001) compared to 2019 (3.4); In 2020, it was determined that it increased significantly in the Pandemic ICU (40.4) (p< 0.001) compared to Reanimation ICU (9.2).Conclusion: It should not be forgotten that intensive care patients are also at risk for IPA, especially after viral infections (such as COVID-19, Influenza). Although the incidence of IPA was not very high, it was observed that it tended to increase according to our study. The diagnosis of IPA is problematic, therefore it is necessary to increase awareness and sample diversity and to use biomarkers more widely other than hematology patients.Publication Evaluation of the combination treatments with intravenous fosfomycin for carbapenem-resistant Klebsiella pneumoniae(Assoc Medica Brasileira, 2023-01-01) ÖNAL, UĞUR; Tüzemen, Nazmiye Ülkü; TÜZEMEN, NAZMİYE ÜLKÜ; Kaya, Pınar Küçükdemirci; KELEBEK GİRGİN, NERMİN; KÜÇÜKDEMİRCİ KAYA, PINAR; İŞÇİMEN, REMZİ; ÖZAKIN, CÜNEYT; Özakın, Cüneyt; Kahveci, Ferda Şöhret; KAHVECİ, FERDA ŞÖHRET; Akalın, Halis; AKALIN, EMİN HALİS; Bursa Uludağ Üniversitesi/Tıp Fakültesi/Tıbbi Mikrobiyoloji Anabilim Dalı.; Bursa Uludağ Üniversitesi/Tıp Fakültesi/Mikrobiyoloji Anabilim Dalı.; Bursa Uludağ Üniversitesi/Tıp Fakültesi/Anestezi ve Reanimasyon Anabilim Dalı.; 0000-0003-3544-3509; 0000-0002-8428-8245; 0000-0002-5882-1632; 0000-0001-7530-1279; JCO-3678-2023; AAU-8952-2020; A-4290-2018OBJECTIVE: The aim of this study was to evaluate the combination treatments with intravenous fosfomycin for carbapenem-resistant Klebsiella pneumoniae infections in a tertiary-care center.METHODS: Between December 24, 2018 and November 21, 2022, adult patients diagnosed with bloodstream infection or ventilator-associated pneumonia due to culture-confirmed carbapenem-resistant Klebsiella pneumoniae in the anesthesiology and reanimation intensive care units were investigated retrospectively.RESULTS: There were a total of 62 patients fulfilling the study inclusion criteria. No significant difference was recorded in 14-and 30-day mortality among different types of combination regimens such as fosfomycin plus one or two antibiotic combinations. Hypokalemia (OR:5.651, 95%CI 1.019- 31.330, p=0.048) was found to be a significant risk factor for 14-day mortality, whereas SOFA score at the time of diagnosis (OR:1.497, 95%CI 1.103- 2.032, p=0.010) and CVVHF treatment (OR:6.409, 95%CI 1.395-29.433, p=0.017) were associated with 30-day mortality in multivariate analysis.CONCLUSION: In our study, high mortality rates were found in patients with bloodstream infection or ventilator-associated pneumonia due to carbapenem-resistant Klebsiella pneumoniae, and no significant difference was recorded in 14-and 30-day mortality among different types of combination regimens such as fosfomycin plus one or two antibiotic combinations.