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Permanent URI for this collectionhttps://hdl.handle.net/11443/932

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Author: search.filters.author.Guner, Rahmet

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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.
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    A micro-elimination approach to addressing hepatitis C in Turkey
    (BMC, 2020-01-01) Idilman, Ramazan; Razavi, Homie; Robbins-Scott, Sarah; Akarca, Ulus Salih; Ormeci, Necati; Kaymakoglu, Sabahattin; Aygen, Bilgehan; Tozun, Nurdan; Guner, Rahmet; Bodur, Hurrem; Lazarus, Jeffrey V.
    Background In 2016, WHO passed the Global Health Sector Strategy on Viral Hepatitis (GHSS), calling for its elimination by 2030. Two years later, Turkey approved a strategy to reach the WHO targets. This study reports new national prevalence data, breaks it down by subpopulation, and models scenarios to reach HCV elimination. Methods Literature was reviewed for estimates of HCV disease burden in Turkey. They were discussed with stakeholders and used as inputs to develop a disease burden model. The infected population was estimated by sequelae for the years 2015-2030. Three scenarios were developed to evaluate the disease burden in Turkey: a Base 2017 scenario, representing the current standard of care in Turkey
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    Eliminating Viral Hepatitis in Turkey: Achievements and Challenges
    (GALENOS PUBL HOUSE, 2022-01-01) Akarca, Ulus Salih; Baykam, Nurcan; Guner, Rahmet; Gunsar, Fulya; Idilman, Ramazan; Kaymakoglu, Sabahattin; Koksal, Iftihar; Tabak, Fehmi; Yamazhan, Tansu
    After the declaration Global Health Sector Strategy on Viral Hepatitis by the World Health Organization in 2016, the Turkish Government defined a national strategy covering 2018-2023 to reach goals by 2030. Following a participatory decision process and a series of workshops, the strategy was built on eight separate subheadings. Apart from the official Prevention and Control Program, two separate road maps for hepatitis B and C were developed to obtain targets accessible with the cooperation of the Viral Hepatitis Society and the Turkish Association for the Study of the Liver in 2018 and 2020, respectively. Up to 2023, achievements and the current situation of the National Viral Hepatitis Prevention and Control Program and the hepatitis B virus and hepatitis C virus road maps were assessed in detail on June 28th, 2022, by the subject matter experts in Turkey. Besides the officially reported achievement rate (42\%) of the Program in 2021, participants mentioned undesirable effects of the coronavirus disease-2019 pandemic, unregulated migration, low levels of professional and public awareness, and barriers to access to anti-viral treatment. Recommendations focused on increasing the efficiency of screening and surveillance by integrating the viral carrier identity of individuals into the national health information system, simplifying the drug supplement and treatment initiation process and insisting on education to raise awareness.