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    Carriage of class 1 and 2 integrons in acinetobacter baumannii and Pseudomonas aeruginosa isolated from clinical specimens and a novel gene cassette array: BlaOXA-11-cmlA7
    (2014) Mengeloglu, Firat Zafer; Çopur Çiçek, Ayşegül; Koço?lu, Esra; Sandalli, Cemal; Budak, Emine Esra; Özgümüş, Osman Birol
    The dissemination of antibiotic resistance genes between bacteria leads to serious problems in the treatment of infectious diseases. It has been shown that resistance genes can also be carried by the integrons. There are limited studies regarding the carriage of class 1 and 2 integrons in Adnetobacter baumannii and Pseudomonas aeruginosa clinical strains in Turkey. The aims of this study were to investigate the carriage rates of class 1 and class 2 integrans in A.baumannii and P.aeruginosa strains isolated from clinical samples in Abant Izzet Baysal University Hospital, and to characterize the antibiotic resistance gene cassettes in these integrans by sequence analyses. A total of 137 strains (77 Abaumannii and 60 P.aeruginosa) isolated from various clinical specimens (56% were sputum, 19% wound, 11 % urine, 11 % blood, 3% catheter), between March 2010-December 2012, were included in the study. The identification and antibiotic susceptibility tests of the isolates were performed by Vitek 2 Compact (bioMérieux, France) and BD Phoenix 100 (Becton Dickinson, USA) systems. The presence of intégrons were screened by PCR method using specific primer pairs targeting class 1 (intll) and 2 (intl2) integrase regions. All the samples that revealed integran amplification were subjected to DNA sequence analysis, both in the forms of cloned products and PCR amplicons. In the study, the highest susceptibility rates were found against colistin 96% and tigecycline 78% in A.baumannii, and against piperacillin/tazobactam 97% and piperacillin 93% in P.aeruginosa isolates. The highest resistance rate was determined for piperacillin/tazobactam 95% in A.baumannii strains. The presence of intll gene was detected in 33% (26/77) of A.baumannii and 10% (6/60) of P.aeruginosa isolates. When variable regions in intl1 positive strains were amplified by PCR, eight (8/77, 10%) A.baumannii and three (3/60, 5%) P.aeruginosa strains were found to harbor antibiotic resistance gene cassettes. Intl2 gene was not detected in any of the isolates. Resistance to piperacillin/tazobactam, ceftazidime, cefepime, ceftriaxone and ampicillin/sulbactam was detected as the common resistance pattern in all integron-positive A.baumannii strains, whereas resistance to ceftazidime, gentamicin and ciprofloxacin was the common pattern in all integron-positive P.aeruginosa strains. DNA sequence analysis of variable regions of integrons indicated that two separate gene cassette arrays (aacCl-aadA1 and aac(3)-1) were carried by A.baumannii strains, and two types of gene cassette arrays (bla QXA-30-aadA1 and bla0XA-11- cmlA7) were carried by P.aeruginosa strains. To our best knowledge, this is the first report of the gene sequence of blaQXA-11-cmlA7 defined in an integron gene cassette of P.aeruginosa.
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    Carriage of Class 1 and 2 Integrons in Acinetobacter baumannii and Pseudomonas aeruginosa Isolated from Clinical Specimens and a Novel Gene Cassette Array: blaOXA-11-cmlA7
    (Ankara Microbiology Soc, 2014) Mengeloglu, Firat Zafer; Cicek, Aysegul Copur; Kocoglu, Esra; Sandalli, Cemal; Budak, Emine Esra; Ozgumus, Osman Birol
    The dissemination of antibiotic resistance genes between bacteria leads to serious problems in the treatment of infectious diseases. It has been shown that resistance genes can also be carried by the integrons. There are limited studies regarding the carriage of class 1 and 2 integrons in Acinetobacter baumannii and Pseudomonas aeruginosa clinical strains in Turkey. The aims of this study were to investigate the carriage rates of class 1 and class 2 integrons in A.baumannii and P.aeruginosa strains isolated from clinical samples in Abant Izzet Baysal University Hospital, and to characterize the antibiotic resistance gene cassettes in these integrons by sequence analyses. A total of 137 strains (77 A.baumannii and 60 P.aeruginosa) isolated from various clinical specimens (56% were sputum, 19% wound, 11% urine, 11% blood, 3% catheter), between March 2010-December 2012, were included in the study. The identification and antibiotic susceptibility tests of the isolates were performed by Vitek 2 Compact (bioMerieux, France) and BD Phoenix 100 (Becton Dickinson, USA) systems. The presence of integrons were screened by PCR method using specific primer pairs targeting class 1 (intil1) and 2 (intl2) integrase regions. All the samples that revealed integron amplification were subjected to DNA sequence analysis, both in the forms of cloned products and PCR amplicons. In the study, the highest susceptibility rates were found against colistin (96%) and tigecycline (78%) in A.baumannii, and against piperacillin/tazobactam (97%) and piperacillin (93%) in P.aeruginosa isolates. The highest resistance rate was determined for piperacillin/tazobactam (95%) in A.baumannii strains. The presence of intl1 gene was detected in 33% (26/77) of A.baumannii and 10% (6/60) of P.aeruginosa isolates. When variable regions in intl1 positive strains were amplified by PCR, eight (8/77, 10%) A.baumannii and three (3/60, 5%) P.aeruginosa strains were found to harbor antibiotic resistance gene cassettes. Intl2 gene was not detected in any of the isolates. Resistance to piperacillin/tazobactam, ceftazidime, cefepime, ceftriaxone and ampicillin/sulbactam was detected as the common resistance pattern in all integron-positive A.baumannii strains, whereas resistance to ceftazidime, gentamicin and ciprofloxacin was the common pattern in all integron-positive P.aeruginosa strains. DNA sequence analysis of variable regions of integrons indicated that two separate gene cassette arrays (aacC1-aadAl and aac(3)-1) were carried by A.baumannii strains, and two types of gene cassette arrays (bla(OXA-30)-aadA1 and bla(OXA-11)-cmlA7) were carried by P.aeruginosa strains. To our best knowledge, this is the first report of the gene sequence of bia(OXA-11)-cmlA7 defined in an integron gene cassette of P.aeruginosa.
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    A Case of Giant Hepatic Hydatid Cyst Infected with Morganella morganii and the Literature Review
    (Hindawi Ltd, 2012) Hakyemez, Ismail Necati; Sit, Mustafa; Aktas, Gulali; Tas, Tekin; Mengeloglu, Firat Zafer; Kucukbayrak, Abdulkadir
    Hydatid cyst disease is a common worldwide zoonosis. Most of the cysts are located in the liver. Abscess formation due to infection of the cyst is an important complication. M. morganii, a Gram-negative Bacillus, is a quite rare cause of liver abscess. A 77-year-old woman was admitted to hospital with complaints of fever, chills, nausea, vomiting, loss of appetite, and abdominal pain located in the right-upper quadrant. Her history was positive for hepatic hydatid cyst disease ten years ago. Physical examination revealed a painful mass filling the right-upper quadrant and extending down to umbilicus. Indirect hemagglutinin test for hydatid cyst was positive at a titer of 1/320. Giant liver abscess due to infected hydatid cyst was found in computed tomography scan. Surgeons performed cystectomy and cholecystectomy. Cefazoline, cefuroxime, and metronidazole were administered empirically, but all the three agents were replaced with intravenous ceftriaxone after M. morganii was isolated from the cultures of the abscess material. Clinical signs of the patient resolved at the second week of treatment, and she was discharged.
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    Investigating the Relationship Between HBV DNA Levels and HBV Serological Markers
    (Galenos Yayincilik, 2013) Kocoglu, Esra; Tas, Tekin; Mengeloglu, Firat Zafer; Karabork, Seyda; Ceylan, Kubra
    Objective: In this study, it is aimed to investigate the relationship between the HBV DNA positivity and serological markers such as HBsAg, HBeAg and anti-HBe in patients with acute or chronic hepatitis. Materials and Methods: Data of 574 patients whose serum specimens were processed in microbiology laboratory between march 2010 and july 2012 were retrospectively analysed. Results: In the study, HBV DNA was detected in 44.8% of HBsAg-positive, in 67.1% of HBeAg-positive and in 35.9% of anti-HBE-positive patients. HBV DNA was detected in 61.2% of the patients both of whose HBsAg and HBeAg were positive. However, HBV DNA was positive in one of 29 patients (3.4%) who had negativity of both HBsAg and HBeAg. DNA positivity was 6.3% in HBsAg-negative patients and 37.7% in HBeAg-negative ones. In the study, HBeAg was negative in 79.4% of HBV DNA-positive patients; anti-HBeAg was negative in 17.7% of DNA-positive patients. DNA levels were found significantly high in HBeAg-positive patients (p<0.001) as well as DNA levels were significantly high in anti-HBenegative ones (p<0.001). Conclusion: In conclusion, serological markers may be insufficient either in diagnosis of HBV infection or in determining the viral replication. In this study, it is observed that evaluating those tests together is useful in laboratory diagnosis.