Investigation of the Chitosan Immobilized Eggshell for the Biosorption of Brillant Blue R Dye

T lant Blue R BBR dyestuff, which is a textile dyestuff, by biosorption is investigated. For this purpose, eggshell immobilized with chitosan ESIC is designed as a biosorbent. The biosorption mechanism was studied in batch and continuous mode. As far as the batch system is concerned, the following results have been obtained: The optimum pH 2, dye concentration 25 ppm, interaction time 60 minutes, biosorbent amount 2.0 g/L, removal real wastewater 53.28%. Regarding continuous systems, the following flow speed of 0.5 mL/min, biosorbent amount 2.0 g/L, removal real wastewater 91.01%. Also, recycle ex- periments showed that there was 24.11% loss in the biosorption capacity of ESIC for BBR dye after 7 times reuse. Obtained results were consistent with Langmuir and Freundlich isotherm models. All the results demonstrate that ESIC is a natural, recyclable and cost- effective biosorbent for BBR dye removal in wastewate

Investigation of Molecular Mechanisms of Carbapenemase Producing Acinetobacter baumannii complex Isolates Isolated from Blood Cultures

INTRODUCTION: It was aimed to determine the presence of metallo-beta-lactamases (MBL) and oxacillinases (OXA) enzymes in Acinetobacter baumannii complex (ABC) isolates, which show decreased sensitivity to carbapenems isolated from blood cultures and to investigate the relationships of isolates among each other and with European clones (EU) I, II, III. METHODS: The study included ABC isolate which has reduced sensitivity to at least one of either imipenem or meropenem which was isolated from blood samples obtained from 74 patients who were admitted to the hospital between 2008 and 2009. Identification of isolates and their antimicrobial susceptibilities were performed using BD Phoenix Automated System (Becton-Dickinson, USA). OXA and MBL genes were investigated by polymerase chain reaction (PCR). The clonal relationship of the isolates was determined by pulsed-field gel electrophoresis (PFGE) method. RESULTS: MBL genes and blaOXA-24-like gene were not determined in any of the isolates. blaOXA-51-like was detected in all isolates, blaOXA-58-like gene in 32 isolates and blaOXA-23-like gene in 26 isolates. Using PFGE method, it was detected that fifty-five blood isolates carrying the blaOXA23-like and/or blaOXA-58-like gene were clustered under six clusters. The similarity of EU clones with clinical ABC isolates in the clusters was found to be over 90%. DISCUSSION AND CONCLUSION: ABC isolates producing oxacillinase in our hospital; The presence of association with EU clone III, which is reported very rarely in our country, and the detection of possible related isolates with EU clones I and II show the potential for the spread of these clones in our hospital and in our country

Do patients with diabetes use the insulin pen properly?

Aim: This study was conducted to evaluate the insulin pen application knowledge and skills of patients with diabetes. Methods: In our descriptive study, 200 patients with diabetes were asked to present the insulin pen injection technique on a mannequin and the steps of the pen injection implementation were noted on the data collection form as correct/incorrect by researchers. Results: More than 3 out of 4 (79.5%) of the participants were using the insulin pen or the cartridge after the expiry date, 70.5% were not rotating the injection site, and 63.0% were massaging the skin after injection. Injection sites complications were significantly more in those who were using the insulin pen or the cartridge after the expiry date, those who don\u2019t know the proper length of the needle and the possible body injection sites, those who don\u2019t rotate the injection sites, those who massage after injection, and those who don\u2019t use a new needle at each injection (p<0.05). Conclusion: This study put into light some failures in the knowledge and skills of patients with diabetes regarding insulin pen use. Nurses should provide patients with diabetes an effective and repetitive training concerning insulin pen use. DOI: https://dx.doi.org/10.4314/ahs.v19i1.38 Cite as: Tosun B, Cinar FI, Topcu Z, Masatoglu B, Ozen N, Bagcivan G, et al. Do patients with diabetes use the insulin pen properly? Afri Health Sci. 2019;19(1). 1628-1637. https://dx.doi.org/10.4314/ahs.v19i1.3

Naiv hepatit C enfeksiyonlu hastaların on-altı yıllık prognozu

Objectives: In this study, we aimed to evaluate the clinical course of treatment-naive patients infected with hepatitis C virus (HCV) who were followed up in various centers in Turkey. Materials and Methods: This was a retrospective study performed with the participation of 15 centers. Patients aged 18 years and older with HCV infection were included. Results: A total of 391 treatment-naive patients infected with HCV were included in this study. During the follow-up period, the final values of alanine aminotransferase, aspartate transaminase, and total protein were significantly decreased when compared to the initial values (p<0.001, p<0.001, and p=0.005, respectively). In the study group, 19.2% of the patients underwent liver biopsy and 4.1% underwent transient elastography (FibroScan). An increased histological activity index (HAI) score and fibrosis in the second biopsy were observed in one patient, only increased HAI in two patients and increased fibrosis in one patient, as shown on the FibroScan. In the 16 years of the study period, cirrhosis was radiologically detected in only one patient. Conclusion: Even if rapid progression is not observed, close monitoring of the clinical findings related to liver failure and fibrosis with invasive or non-invasive methods may be useful.Amaç: Bu çalışmada ülkemizin çeşitli merkezlerinde takip edilen naiv hepatit C virüs (HCV) ile enfekte hastaların klinik seyrini değerlendirmeyi amaçladık. Gereç ve Yöntemler: Bu çalışma retrospektif olarak 15 merkezin katılımıyla gerçekleştirilmiştir. Çalışmaya 18 yaş üstü, HCV enfeksiyonu olan hastalar dahil edilmiştir. Bulgular: Çalışmada 391 tedavi-naiv HCV enfeksiyonlu hasta yer almıştır. Hastaların takip süresinde son alanine aminotransferase, aspartate transaminase ve total protein değerleri ilk düzeyine göre önemli düzeyde azalmıştır (sırasıyla p<0,001, p<0,001, p=0,005). Çalışma grubunda hastaların %19,2’sine karaciğer biyopsisi, %4,1’ine elastografi (FibroScan) uygulanmıştır. Takip esnasında bir hastada ikinci biyopside histolojik aktivite indeksi (HAI) ve fibroziste artma, iki hastada sadece HAI’da artma, birinde FibroScan ile fibrozis değerinde artma olduğu gözlenmiştir. Bir hastada 16 yıl içinde radyolojik olarak siroz saptanmıştır. Sonuç: Hızlı progresyon gözlenmemekle birlikte hastaların izleminde karaciğer yetmezliği ile ilgili klinik bulguların ve invaziv veya noninvaziv yöntemlerle fibrozisin yakın takibi yararlı olabilir

In a real-life setting, direct-acting antivirals to people who inject drugs with chronic hepatitis c in Turkey

Background: People who inject drugs (PWID) should be treated in order to eliminate hepatitis C virus in the world. The aim of this study was to compare direct-acting antivirals treatment of hepatitis C virus for PWID and non-PWID in a real-life setting. Methods: We performed a prospective, non-randomized, observational multicenter cohort study in 37 centers. All patients treated with direct-acting antivirals between April 1, 2017, and February 28, 2019, were included. In total, 2713 patients were included in the study among which 250 were PWID and 2463 were non-PWID. Besides patient characteristics, treatment response, follow-up, and side effects of treatment were also analyzed. Results: Genotype 1a and 3 were more prevalent in PWID-infected patients (20.4% vs 9.9% and 46.8% vs 5.3%). The number of naïve patients was higher in PWID (90.7% vs 60.0%), while the number of patients with cirrhosis was higher in non-PWID (14.1% vs 3.7%). The loss of follow-up was higher in PWID (29.6% vs 13.6%). There was no difference in the sustained virologic response at 12 weeks after treatment (98.3% vs 98.4%), but the end of treatment response was lower in PWID (96.2% vs 99.0%). In addition, the rate of treatment completion was lower in PWID (74% vs 94.4%). Conclusion: Direct-acting antivirals were safe and effective in PWID. Primary measures should be taken to prevent the loss of follow-up and poor adherence in PWID patients in order to achieve World Health Organization’s objective of eliminating viral hepatitis

Comparison of secretory acid proteinase, phospholipase activity, and slime production in candida parapsilosis complex strains isolated from blood cultures and other clinical samples

Amaç: Yüksek mortalite ve morbidite nedeni olan hastane kaynaklı kan akımı enfeksiyonlarında Candida türleri en sık dört etkenden biridir. Candida parapsilosis, Candida albicans'tan daha az virülan olarak kabul edilmesine rağmen, son yirmi yılda insidansında en fazla artış görülen Candida türü olmuştur. Çalışmamızda kan ve diğer klinik örneklerden izole edilen C. parapsilosis suşlarının salgısal asit proteinaz (Sap), fosfolipaz enzim aktivitelerinin ve slime üretiminin karşılaştırılması amaçlanmıştır.Gereç ve Yöntem: On sekiz aylık süreçte kan kültürleri ve diğer klinik örneklerden izole edilen 28 C. parapsilosis suşunun asit proteinaz aktivitesi süt tozu agaroz yöntemiyle, fosfolipaz aktivitesi yumurta sarılı agar yöntemiyle, slime üretimi ise glukozlu sıvı sabouraud besiyeri ve glukozlu triptik soy broth kullanılarak tüp adezyon yöntemi ile belirlendi.Bulgular: Çalışma izolatlarının tümünde Sap aktivitesi belirlenemedi. Ancak kan ve kan dışı klinik izolatların Sap aktiviteleri arasında istatistiksel olarak anlamlı fark bulunmadı. İzolatların hiçbirinde fosfolipaz aktivitesi belirlenemedi. İzolatların 23'ünde her iki besiyeriyle de slime üretimi görüldü. Yalnızca bir izolat her iki besiyeri ile de slime negatifti. Dört izolatta ise iki farklı besiyeri ile slime üretimi açısından farklı sonuçlar elde edildi. Kan izolatları ile diğer klinik izolatların slime üretimleri arasında istatistiksel olarak anlamlı bir fark görülmedi.Sonuç: C. parapsilosis izolatlarında Sap aktivitesi ve slime üretimi virülans faktörü olarak öne çıkmaktadır. Fosfolipaz aktivitesinin belirlenmesinde başka yöntemlerin kullanılmasının yararlı olabileceği düşünülmektedirObjective: Candida species comprise one of the four most common agents in hospital-acquired bloodstream infections with high mortality and morbidity. Although C. parapsilosis is accepted as less virulent than C. albicans, it has been the Candida species with the highest increase in incidence within the last two decades. In our study, a comparison is made between the secretory acid proteinase (Sap), phospholipase enzyme activity and the slime production of C. parapsilosis strains isolated from blood with those isolated from other clinical samples. Material and Methods: Sap activity was determined by the milk powder agarose method, phospholipase activity by the egg-yolk agar method and slime production by the tube adhesion method using a liquid Sabouraud medium with glucose and tryptic soy broth with glucose of 28 C. parapsilosis strains isolated from blood cultures and other clinical samples during a period of eighteen months. Results: Sap activity was detected in all the study isolates; however, there was no statistically significant difference in Sap activity between the blood and non-blood clinical isolates. Phospholipase activity was not detected in any of the isolates. In 23 of the isolates, slime production was observed in both media, while only one isolate was slime negative in both culture media. In the remaining four isolates slime production results were different for the two different media. There was no statistically significant difference in slime production between the blood and other clinical isolates

The identification of Meyerozyma guilliermondii from blood cultures and surveillance samples in a university hospital in Northeast Turkey: A ten-year survey

WOS: 000424857000010PubMed: 28843335Meyerozyma (Pichia) guilliermondii exists in human skin and mucosal surface microflora. It can cause severe fungal infections like candidemia, which is an opportunistic pathogen. One hundred and forty-one M. Guilliermondii isolates, consisting of 122 blood culture isolates, belonging to 126 patients; 13 total parenteral nutrition solution isolates; and two rectal swab isolates were identified according to carbohydrate assimilation reactions in a university hospital in Turkey between January 2006 and December 2015. Following Candida albicans (34.0%) and C. Parapsilosis (21.2%), the third yeast species most commonly isolated from blood cultures in the Farabi Hospital was M. guilliermondii (20.6%). The patients were hospitalised in 27 different departments. A total of 50% of the patients were in pediatric departments, 49.2% were in intensive care units, and 17.2% were in haematology-oncology departments. Molecular identification of the isolates was performed using DNA sequence analysis of ribosomal ITS gene regions and IGS amplification-Alul fingerprinting (IGSAF). With molecular identification, 140 isolates were identified as M. guilliermondii and one isolate was identified as Candida membranifaciens. It was observed that the ITS1 region specifically helps in identifying these species. It was demonstrated that biochemical and molecular methods were 99.3% consistent in identifying M. guilliermondii. The Wild-Type (WT) Minimum Inhibitory Concentrations (MICs) distribution of fluconazole, voriconazole, itraconazole, and flucytosine were determined using the Sensititre YeastOne YO2V system after 24 h of incubation. One M. guilliermondii strain was determined to be non-WT for fluconazole, voriconazole, itraconazole and flucytosine. In total, three M. guilliermondii strains, for fluconazole, were determined to be non-WT in this study. (C) 2017 Elsevier Masson SAS. All rights reserved.Giresun University Scientific Research Projects Coordination UnitGiresun University [SAG-BAP-A-140316-96]This study was partially supported by Giresun University Scientific Research Projects Coordination Unit, with the project no. SAG-BAP-A-140316-96

Horizontol dissemination of TEM- and SHV-typr beta-lactamase genes-carrying resistance plasmids amongst clonical isolates of Enterobacteriaceae Disseminação horizontal de plasmídios de resistência contendo genes de beta-lactamase dos tipos TEM e SHV entre isolados clínicos de Enterobacteriaceae

The extended-spectrum &#946;-lactamase (ESBL)-producing bacteria have been isolated at increasing frequency worldwide. Expression of ESBL is often associated with multidrug resistance and dissemination by resistance plasmids. During a two-month period in 2000, 133 clinical isolates of enterobacterial strains were randomly collected from outpatients and inpatients at a university hospital in Turkey. The ESBL producing strains were determined by double-disk synergy (DDS) testing. Twenty ESBL producing strains (15%) including Escherichia coli (n = 9), Klebsiella pneumoniae (n = 7), Klebsiella oxytoca (n = 2) and Enterobacter aerogenes (n = 2) were detected and further analyzed for their resistance transfer features, plasmid profile and nature of the resistance genes. Plasmid transfer assays were performed using broth mating techniques. TEM- and SHV- genes were analyzed by polymerase chain reaction (PCR) and hybridization using specific probes. EcoRI restriction enzyme analyses of R plasmids were used in the detection of epidemic plasmids. Fourteen plasmid profiles (A, B1, B2, C1, and C2 to L) were obtained with EcoRI restriction enzyme analysis. Most of these plasmids were detected to carry both TEM- and SHV-derived genes by PCR, and confirmed by localizing each gene by hybridization assay. Epidemiological evidence indicated that there was an apparent horizontal dissemination of conjugative R plasmids among multidrug-resistant enterobacterial genera and species in this hospital<br>O isolamento de bactérias produtoras de beta-lactamases de espectro expandido (ESBL) está aumentando no mundo todo. Freqüentemente, a expressão de ESBL está associada com resistência a múltiplas drogas e disseminação por plasmídios de resistência. Durante um período de dois meses em 2000, 133 isolados clínicos de cepas de enterobactérias foram obtidos aleatoriamente de pacientes internos e externos de um hospital universitário na Turquia. As cepas produtoras de ESBL foram identificadas pelo teste de sinergia em disco-duplo (DDS). Foram detectadas vinte cepas produtoras de ESBL, entre as quais Escherichia coli (n=9), Klebsiella pneumoniae (n=7), Klebsiella oxytoca (n=2) e Enterobacter aerogenes (n=2), que foram posteriormente analisadas quanto a suas características de transferência de resistência, perfil plasmidial e natureza dos genes de resistência. Os testes de transferência de plasmídios foram realizados empregando técnicas de conjugação em caldo. Os genes TEM e SHV foram analisados pela reação da polimerase em cadeia (PCR) e hibridização com sondas especificas. A detecção de plasmídios epidêmicos foi feita por análise dos plasmídios R com a enzima de restrição EcoRI. Através desta análise, foram obtidos catorze perfis plasmidiais (A, B1, B2, C1 e C2 até L).Observou-se pela PCR que a maioria dos plasmidios carregavam genes derivados de TEM e SHV, confirmados através da detecção dos genes pelos testes de hibridização. As evidencias epidemiológicas indicaram que havia uma aparente transferência horizontal dos plasmídios R conjugativos entre as enterobactérias multiresistentes neste hospital

Enterrobacteriaceae'nin klinik izolatları arasındaki temel ve SHV tipi Beta-Laktamaz genler taşıyan direnç plasmidlerinin horizontol yaygınlaştırılması

Genişletilmiş spektrumlu beta-laktamaz (ESBL) üreten bakteriler, dünya çapında artan sıklıkta izole edilmiştir. ESBL'nin ifadesi genellikle çoklu ilaç direnci ve direnç plazmidleri tarafından yayılma ile ilişkilidir. 2000 yılında iki aylık bir süre boyunca, enterobakteriyel suşların 133 klinik izolatı, Türkiye'deki bir üniversite hastanesinde ayaktan ve yatan hastalardan rastgele toplandı. ESBL üreten suşlar, çift disk sinerji (DDS) testi ile belirlendi. Escherichia coli (n = 9), Klebsiella pneumoniae (n = 7), Klebsiella oxytoca (n = 2) ve Enterobacter aerogenes (n = 2) dahil olmak üzere 20 ESBL üreten suş (% 15) tespit edildi ve direnç aktarım özellikleri açısından daha fazla analiz edildi direnç genlerinin plazmid profili ve doğası. Plazmid transfer deneyleri, broth çiftleşme teknikleri kullanılarak yapıldı. TEM- ve SHV-genleri, polimeraz zincir reaksiyonu (PCR) ve spesifik problar kullanılarak hibridizasyon ile analiz edildi. Salgın plazmidlerin saptanmasında R plazmidlerinin EcoRI restriksiyon enzim analizleri kullanıldı. EcoRI restriksiyon enzim analizi ile on dört plazmid profili (A, B1, B2, C1 ve C2 ila L) elde edildi. Bu plazmitlerin çoğunun, PCR ile hem TEM hem de SHV'den türetilmiş genleri taşıdığı tespit edildi ve her bir genin hibridizasyon deneyi ile lokalize edilmesiyle doğrulandı. Epidemiyolojik kanıtlar, bu hastanede çoklu ilaca dirençli enterobakteriyel cinsler ve türler arasında konjugatif R plazmidlerinin görünür bir yatay yayılımı olduğunu gösterdi. EcoRI restriksiyon enzim analizi ile on dört plazmid profili (A, B1, B2, C1 ve C2 ila L) elde edildi. Bu plazmitlerin çoğunun, PCR ile hem TEM hem de SHV'den türetilmiş genleri taşıdığı tespit edildi ve her bir genin hibridizasyon deneyi ile lokalize edilmesiyle doğrulandı. Epidemiyolojik kanıtlar, bu hastanede çoklu ilaca dirençli enterobakteriyel cinsler ve türler arasında konjugatif R plazmidlerinin belirgin bir yatay yayılımı olduğunu göstermiştir. EcoRI restriksiyon enzim analizi ile on dört plazmid profili (A, B1, B2, C1 ve C2 ila L) elde edildi. Bu plazmitlerin çoğunun, PCR ile hem TEM hem de SHV'den türetilmiş genleri taşıdığı tespit edildi ve her bir genin hibridizasyon deneyi ile lokalize edilmesiyle doğrulandı. Epidemiyolojik kanıtlar, bu hastanede çoklu ilaca dirençli enterobakteriyel cinsler ve türler arasında konjugatif R plazmidlerinin görünür bir yatay yayılımı olduğunu gösterdi.The extended-spectrum ß-lactamase (ESBL)-producing bacteria have been isolated at increasing frequency worldwide. Expression of ESBL is often associated with multidrug resistance and dissemination by resistance plasmids. During a two-month period in 2000, 133 clinical isolates of enterobacterial strains were randomly collected from outpatients and inpatients at a university hospital in Turkey. The ESBL producing strains were determined by double-disk synergy (DDS) testing. Twenty ESBL producing strains (15%) including Escherichia coli (n = 9), Klebsiella pneumoniae (n = 7), Klebsiella oxytoca (n = 2) and Enterobacter aerogenes (n = 2) were detected and further analyzed for their resistance transfer features, plasmid profile and nature of the resistance genes. Plasmid transfer assays were performed using broth mating techniques. TEM- and SHV- genes were analyzed by polymerase chain reaction (PCR) and hybridization using specific probes. EcoRI restriction enzyme analyses of R plasmids were used in the detection of epidemic plasmids. Fourteen plasmid profiles (A, B1, B2, C1, and C2 to L) were obtained with EcoRI restriction enzyme analysis. Most of these plasmids were detected to carry both TEM- and SHV-derived genes by PCR, and confirmed by localizing each gene by hybridization assay. Epidemiological evidence indicated that there was an apparent horizontal dissemination of conjugative R plasmids among multidrug-resistant enterobacterial genera and species in this hospital