Araştırma Çıktıları
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Item Six-year distribution pattern of hepatitis C virus in Turkey: a multicentre study(TAYLOR \& FRANCIS LTD, 2016-01-01) Altindis, Mustafa; Dal, Tuba; Akyar, Isin; Karatuna, Onur; Gokahmetoglu, Selma; Ulger, Seda Tezcan; Kulah, Canan; Uzun, Berrin; Sener, Asli Gamze; Ozdemir, Mehmet; Aydogan, Sibel; Kuskucu, Mert Ahmet; Midilli, Kenan; Otlu, Baris; Celen, Mustafa Kemal; Buruk, Kurtulus; Guducuoglu, HuseyinHepatitis C infection is a public health problem. The aim of this retrospective study was to determine the distribution of hepatitis C virus (HCV) genotypes in seven regions of Turkey, by evaluating 7002 patients with chronic HCV in a six-year period. During the 2009-2014 period, serum/plasma samples from 7002 new consecutive HCV RNA positive patients were collected. The female patients were 3867 (55.2\%). The genotype distribution of HCV patiens was evaluated by ages and years. Statistical analysis was performed by using the Mann-Whitney test and the chi(2) analysis. During the six-year period, genotype 1b was the most common genotype (67.7\%) followed by untypeable genotype 1 (7.7\%), genotype 4 (7.3\%) and genotype 3 (6.7\%). In 2014, genotype 3 was the second most common one (11.3\%) and genotype 4 was the third most common one (9.8\%). In the group with <25 years old patients, genotype 1b was most common (78.48\%, 62/79) between the years of 2009 and 2011, whereas genotype 3 (34.8\%, 86/247), between the years of 2012 and 2014. Genotype 1b was the most common in the groups between 26 and 35 years, 36 and 45 years, 46 and 55 years, 56 and 65 years. The rate of genotype 3 was increased from 4.78\% to 10.06\% and the rate of genotype 4 was increased from 1.3\% to 3.84\%, from 2009-2011 to 2012-2014. In recent years, genotypes 3 and 4 have gained importance. New therapeutic strategies and survey studies may be required for the modified HCV genotype pattern.Item The carbapenem-resistant Enterobacteriaceae threat is growing: NDM-1 epidemic at a training hospital in Turkey(BMC, 2016-01-01) Karabay, Oguz; Altindis, Mustafa; Koroglu, Mehmet; Karatuna, Onur; Aydemir, Ozlem Akkaya; Erdem, Ali FuatBackground: Recently, new carbapenemases in Enterobacteriaceae strains and non-fermentative gram-negative bacilli have been reported. The New Delhi metallo-beta-lactamase-1 (NDM-1) is a major problem around the world. The purpose of this article is to address the NDM-1 Klebsiella pneumoniae epidemic detected in eight cases in our hospital. Methods: Bacteria identified in this epidemic were from patients already admitted to the intensive care unit of the Sakarya University Training and Research Hospital during efforts toward establishment of infection surveillance and control program. Antimicrobial susceptibility testing of strains was performed using the VITEK 2 system (bioMerieux, France), E-test gradient strips (bioMerieux, France), and the disc diffusion test. For the metallo-beta-lactamase activity, the combined disc diffusion test and modified Hodge test as phenotypic tests were performed. To identify the resistance gene, the Xpert Carba-R kit (Cepheid Inc., USA) and an in-house multiplex polymerase chain reaction (PCR) method designed for five common carbapenemase genes (IMP, VIM, KPC, NDM-1, and OXA-48) were employed. The clonal relationship of these strains was explored by the repetitive PCR (rep-PCR, DiversiLab System, bioMerieux, France) method. Results: During the December 2014 to March 2015 period, NDM-1 positive K. pneumoniae strains were detected in eight patients. All of these strains were found to produce NDM-1, while two of them also revealed the presence of OXA-48. The rep-PCR results reveal a clonal proximity of 95 \% for six of the eight strains. Conclusions: Our findings suggest the tendency of NDM-1-producing strains to spread in our country as well. A carbapenem-resistant K. pneumoniae threat may pose a great risk to our country. It is clear that more comprehensive infection control precautions should be implemented in our hospitals.