Browsing by Author "Gencer, Serap"

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A prospective multicenter study on the evaluation of antimicrobial resistance and molecular epidemiology of multidrug-resistant Acinetobacter baumannii infections in intensive care units with clinical and environmental features
(BMC, 2019-01-01) Boral, Baris; Unaldi, Ozlem; Ergin, Alper; Durmaz, Riza; Eser, Ozgen Koseoglu; Zarakolu, Pinar; Ersoz, Gulden; Kaya, Ali; Haciseyitoglu, Demet; Ak, Oznur; Gencer, Serap; Sariguzel, Fatma Mutlu; Celik, Ilhami; Uyanik, Muhammet Hamdullah; Ozden, Kemalettin; Acikgoz, Ziya Cibali; Guner, Rahmet; Akcali, Alper; Sener, Alper; Adiloglu, Ali; Bulut, Cemal; Yalinay, Meltem; Dizbay, Murat; Aydemir, Sohret; Sipahi, Oguz Resat; Grp, Acinetobacter Study
BackgroundMultidrug-resistant (MDR) Acinetobacter baumannii infections are considered as emerging nosocomial infections particularly in patients hospitalized in intensive care units (ICUs). Therefore, reliable detection of MDR strains is crucial for management of treatment but also for epidemiological data collections. The purpose of this study was to compare antimicrobial resistance and the clonal distribution of MDR clinical and environmental A. baumannii isolates obtained from the ICUs of 10 different hospitals from five geographical regions of Turkey in the context of the demographic and clinical characteristics of the patients.MethodsA multicenter-prospective study was conducted in 10 medical centers of Turkey over a 6month period. A total of 164 clinical and 12 environmental MDR A. baumannii isolates were included in the study. Antimicrobial susceptibility testing was performed for amikacin (AN), ampicillin-sulbactam (SAM), ceftazidime (CAZ), ciprofloxacin (CIP), imipenem (IMP) and colistin (COL) by microdilution method and by antibiotic gradient test for tigecycline (TIG). Pulsed-field gel electrophoresis (PFGE) was performed to determine the clonal relationship between the isolates. The detection of the resistance genes, bla(OXA-23),bla(OXA-24),bla(OXA-51,)bla(OXA-58,)bla(IMP,)bla(NDM), bla(KPC), bla(OXA-48) and bla(PER-1) was carried out using the PCR method.ResultsThe mortality rate of the 164 patients was 58.5\%. The risk factors for mortality included diabetes mellitus, liv1er failure, the use of chemotherapy and previous use of quinolones. Antimicrobial resistance rates for AN, SAM, CAZ, CIP, IMP, COL and TIG were 91.8\%, 99.4\%, 99.4\%, 100\%, 99.4\%, 1.2\% and 1.7\% respectively. Colistin showed the highest susceptibility rate. Four isolates did not grow on the culture and were excluded from the analyses. Of 172 isolates, 166 (96.5\%) carried bla(OXA-23), 5 (2.9\%) bla(OXA-58) and one isolate (0.6\%) was positive for both genes. The frequency of bla(PER-1) was found to be 2.9\%. None of the isolates had bla(IMP), bla(KPC), bla(NDM) and bla(OXA-48) genes. PFGE analysis showed 88 pulsotypes. Fifteen isolates were clonally unrelated. One hundred fifty-seven (91.2\%) of the isolates were involved in 14 different clusters.ConclusionsColistin is still the most effective antibiotic for A. baumannii infections. The gene bla(OXA-23) has become the most prevalent carbapenemase in Turkey. The distribution of invasive A. baumannii isolates from different regions of Turkey is not diverse so, infection control measures at medical centers should be revised to decrease the MDR A. baumannii infections across the country. The results of this study are expected to provide an important baseline to assess the future prophylactic and therapeutic options.
Prediction of Mortality in Patients with Sepsis Due to Gram-negative Bacteremia: Pitt Bacteremia Score, qSOFA, SIRS
(BILIMSEL TIP YAYINEVI, 2021-01-01) Kiran, Pinar; Batirel, Ayse; Gencer, Serap
Introduction: Sepsis is a syndrome of physiologic, biochemical and pathologic abnormalities induced by infection and has been associated with high mortality and morbidity. This study aimed to compare Systemic Inflammatory Response Syndrome (SIRS) criteria, Pitt bacteremia score and quick Sequential Organ Failure Assessment (qSOFA) for the prediction of mortality in patients with sepsis due to Gram-negative bacteremia. Materials and Methods: Patients with sepsis due to Gram-negative bacteremia admitted to emergency medicine clinic were observed retrospectively from March 2016 to March 2018. Clinical data, laboratory results, co-morbidities, antimicrobial treatment, Pitt bacteremia score, qSOFA score, SIRS criteria of patients were evaluated. Results: A total of 106 patients with sepsis due to gram-negative bacteremia according to Sepsis-2 definition were included. Thirty-day mortality was 20.8\%. Multivariate analysis determined Pitt bacteraemia score (OR:1.63, 95\% CI 1.29-2.05, p< 0.001) as predictors of mortality among septic patients. The area under the ROC curve was 0.885 (95\% CI 0.737-0.933) for Pitt bacteremia score 0.808 (95\% CI 0.713-0.904) for qSOFA and 0.623 (95\% CI 0.492-0.753) for SIRS. Pitt bacteremia score showed the highest specificity (\%71.4) and positive predictive value (\%40.0) as compared to other scores. Conclusion: As the result of the analyses, the mortality rate in patients with sepsis due to gram-negative bacteremia was better predicted with the Pitt bacteremia score than qSOFA score and SIRS criteria.
Severe acute respiratory syndrome coronavirus (SARS-CoV-2) is not detected in the vagina: A prospective study
(PUBLIC LIBRARY SCIENCE, 2021-01-01) Takmaz, Ozguc; Kaya, Eren; Erdi, Burak; Unsal, Gozde; Sharifli, Pari; Agaoglu, Nihat Bugra; Ozbasli, Esra; Gencer, Serap; Gungor, Mete
Objective To determine whether severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is present in the vagina of women diagnosed with coronavirus disease-19 (COVID-19) pneumonia. Study design The study was conducted prospectively in a university affiliated hospital. Forty-one women of reproductive age whose nasopharyngeal PCR test were positive for SARS-CoV-2 and clinically diagnosed with pneumonia were included in the study. Vaginal swabs were obtained for SARS-CoV-2 PCR tests when the patients were admitted to the inpatient service before pneumonia treatment was initiated. Results Vaginal swab samples of 38 patients were analysed with SARS-CoV-2 PCR tests. None of the vaginal swabs were positive for SARS-CoV-2. Conclusions SARS-CoV-2 does not infect the vagina of women diagnosed with SARS-CoV-2 pneumonia.