Nasal carriage of S.aureus in children with allergic rhinitis

INTRODUCTION: INTRODUCTION: Allergic rhinitis is an Ig E mediated mucosal inflammation of the nasal mucosa. S.aureus may be identified as a coloniser of the nasal flora of heathy individuals. In this study, we aimed to evaluate the effect of topical mometazon furoat (MF) usage on nasal S.aureus carriage among patients with allergic rhinitis. METHODS: METHODS: Our study included 44 newly diagnosed allegic rhinitis patients never used drugs previously, 45 patients whom have been using MF minimum of six months and 27 healthy children as control group. All volunteers' gave nasal samples via Stuart transport swab and samples cultured and incubated to agar for 24 to 48 hours. Identification of the colonies performed via conventional methods and VITEK®2 Compact. RESULTS: RESULTS: The percentages of positive S.aureus nazal culture detected 40.9, 48.9 and 11.1 for newly diagnosed allegic rhinitis cases, patients using MF minimum of six months and healthy control group, respectively. DISCUSSION AND CONCLUSION: DISCUSSION AND CONCLUSION: The allergic rhinitis seems to increase nasal S.aureus colonisation significantly, but nasal MF don't increase the possibility of this colonisation

Investigation of Antibiotic Resistance Patterns and Reduced Vancomycin Susceptibilities of Methicillin-Resistant Staphylococcus aureus Isolates: A Multi-Center Study

WOS: 000355774200010PubMed ID: 26167824The aims of this study were to determine the minimum inhibitory concentration (MIC) values of vancomycin, teicoplanin, daptomycin, quinupristin/dalfopristin, linezolid, tigecycline, chloramphenicol, rifampicin, ofloxacin and tetracycline and to investigate the reduced vancomycin susceptibility among methicillin-resistant Staphylococcus aureus (MRSA) strains isolated in hospitals located in different geographical regions of Turkey. A total of 100 MRSA strains isolated from patients (of which 50% were from intensive care units) hospitalized in seven centers in Turkey [Istanbul (n= 15), Ankara (n= 15), Izmir (n= 15), Adana (n= 15), Diyarbakir (n=15), Erzincan (n= 15), Van (n= 10)], between August 201 3 August 2014, were included in the study. Fourty-three strains were isolated from blood, whereas 21 were from lower respiratory tract, 17 from wounds, eight from catheters, six from urine, four from nasal swab and one from cerebrospinal fluid samples. Methicillin resistance of the isolates was determined by using cefoxitin (30 mu g) disk with standard disk diffusion method, while the MIC values of other antibiotics were determined with E-test in accordance with the recommendations of Clinical and Laboratory Standards Institute (CLSI). MIC results obtained for quinupristin-dalfopristin (Q/D) were evaluated according to the CLSI criteria used for methicillin-susceptible S.aureus and for tigecycline according to the criteria recommended by the Food and Drug Administration for MRSA. Primarily, agar screening method (ASM) was used for determination of vancomycin-intermediate S.aureus (VISA) and heterogeneous VISA (hVISA) strains. Brain heart infusion agar containing 6 mu g/ml vanconnycin was used in ASM, and the strains with suspicion of VISA/hVISA were screened by standard E-test and macro E-test methods. All MRSA strains were susceptible to vancomycin, teicoplanin, daptomycin, Q/D and linezolid by E-test method; and their rates of susceptibility for tigecycline, chloramphenicol, rifampicin, ofloxacin and tetracycline were detected as 89%, 97%, 40%, 39% and 32%, respectively. MIC50/MIC90 values were 1.5/2 mu g/ml for vancomycin, 2/4 mu g/ml for teicoplanin, 0.19/0.38 mu g/ml for daptomycin, 0.19/0.38 mu g/ml for Q/D, 0.75/1 mu g/ml for linezolid, 0.19/0.75 mu g/ml for tigecycline, 3/6 mu g/ml for chloramphenicol, 32/32 mu g/ml for rifampicin, 32/32 mu g/ml for ofloxacin and 32/64 mu g/ml for tetracycline, respectively. For the evaluation of reduced vancomycin susceptibility, 2% (2/100) of MRSA strains were defined as VISA and 5% (5/100) as hVISA with ASM. One of those seven isolates identified as VISA/hVISA with ASM was evaluated as suspected hVISA by using both standard E-test and macro E-test methods. In conclusion, no MRSA resistant strain to vancomycin, teicoplanin, daptomycin, Q/D and linezolid was determined in our study. However tigecycline resistance (11%) was found higher than expected. As the glycopeptide resistance is increasing in the world and because of the intense use of these drugs in Turkey, the rates of vancomycin resistance among MRSA strains should be investigated periodically

Investigation of Extended Spectrum Beta-Lactamase (ESBL) Genes in ESBL-Producing Escherichia coli and Klebsiella pneumoniae Strains

Introduction: Extended spectrum beta-lactamase (ESBL)-producing Enterobacteriaceae is an important health problem all over the world. In this study, it was aimed to determine the ESBL genes in Escherichia coli and Klebsiella pneumoniae strains isolated for approximately four-year period. Materials and Methods: A total 100 ESBL-producing E. coli and 100 ESBL-producing K. pneumoniae strains which were isolated between January 2008 and October 2012 were included into this study. The strains were identified using classical bacteriologic methods and BD Phoenix (Becton Dickinson, US) automatized bacterial identification device. CTX-M, TEM, SHV, VEB, GES, PER and OXA beta-lactamase genes were analyzed with the PCR method. Results: The beta-lactamase genes detected in ESBL-positive K. pneumoniae strains were as follows: 99% for CTX-M, 91% for SHV, 71% for TEM, 10% for OXA-10 group, and 5% for OXA-2 group. In E. coli strains, the prevalence of CTX-M was 92%; TEM was 70%, SHV was 21%, and OXA-2 group was 3%. CTX-M alone was found to be positive in 25 of the 98 (25.5%) in E. coli strains; TEM alone was found to be positive in 2 of 98 (2%) and SHV alone was found in 2 of 98 (2%). CTX-M alone was found positive in 3 of 100 (3%) K. pneumoniae strains. No other resistance genes alone were found in the strains. No GES, VEB and PER-producing strains were determined in this study. Conclusion: In the study, high prevalence of CTX-M beta-lactamase was found in ESBL-producing strains. It was thought that the high potential of mobility with CTX-M genes was the most possible reason for this result. Determination of ESBL genes will be useful to understand resistance epidemiology, develop effective therapeutic strategies, and plan the appropriate preventive measurements

The relationship between bronchoscopy, radiology and microbiology in non cystic fibrosis patients

28th International Congress of the European-Respiratory-Society (ERS) -- SEP 15-19, 2018 -- Paris, FRANCEWOS: 000455567107327...European Respiratory Societ

Distribution of blaOXA genes in Acinetobacter baumannii strains: A multicenter study

Acinetobacter cinsi içerisinde hastane enfeksiyonlarının en önemli etkeni Acinetobacter baumannii’dir. Bu gram-negatif kokobasil, antimikrobiyal tedavide kullanılan çoğu antibiyotiğe dirençli olup aynı zamanda karbapenemlere de direnç geliştirme kapasitesindedir. Bu çalışmanın amacı, A.baumannii’nin OXA alt grupları için multipleks gerçek zamanlı polimeraz zincir reaksiyonu (qPCR) kiti tasarlamak ve Türkiye'nin farklı bölgelerinden toplanan A.baumannii izolatlarında OXA alt gruplarının dağılımını araştırmaktır. Çalışmaya, çeşitli illerdeki (Afyonkarahisar, Ankara, Bolu, Elazığ, Erzurum, Isparta, İstanbul, Kahramanmaraş, Konya, Sakarya, Van) 13 üniversite ve devlet hastanesinin mikrobiyoloji laboratuvarlarında, 2008-2011 tarihleri arasında izole edilen toplam 834 A.baumannii klinik izolatı dahil edilmiştir. İzolatlar, konvansiyonel yöntemler ve otomatize sistemler [Vitek2 (bioMerieux, ABD) ve Phoenix (BD Diagnostic, MD)] kullanıla- rak tanımlanmış; duyarlılık testleri otomatize sistemler ve disk difüzyon yöntemiyle yapılmıştır. Tüm örnek- lere blaOXA-51-like, blaOXA-23-like ve blaOXA-58-like genleri için qPCR uygulanmış; ayrıca, blaOXA-24-like geni araştırılmasında konvansiyonel PCR yöntemi kullanılmıştır. Çalışmamızda saptanan antibiyotik direnç oranları; amoksisilin-klavulanat için %96.8, siprofloksasin için %86.8, gentamisin için %74.7, amikasin için %71.7, sefaperazon-sulbaktam için %73.5, imipenem için %72.1 ve meropenem için %73 olarak izlenmiştir. Altı yüz iki (%72.2) izolat hem imipenem hem de meropeneme dirençli bulunmuştur. A.baumannii izolatları için en etkili antibiyotiğin, %100 duyarlılık oranı ile kolistin olduğu görülmüştür. İzolatların tümünde bla-geni pozitif bulunmuş; ancak blaOXA-24-like geni hiçbir izolatta gösterilememiştir. Toplam blaOXA-23- OXA-51-like ve blaOXA-58-like gen pozitiflikleri sırasıyla %53.7 ve %12.5 olarak saptanmıştır. Karbapeneme dirençli izolike latların blaOXA-23-like ve blaOXA-58-like gen pozitiflikleri ise sırasıyla %74.4 ve %17.3 olarak tespit edilmiştir. Yir- mi beş izolat hem blaOXA-23-like hem de blaOXA-58-like gen pozitifliği göstermiştir. blaOXA-24-like hariç, karbapeneme dirençli izolatların tamamında OXA tipi genler saptanmıştır. Çalışmaya katılan merkezlerin blaOXA-23- ve blaOXA-58-like gen pozitiflik oranları farklı bulunmuştur. Ek olarak, çalışma sürecinde blaOXA-58-like gen like pozitifliği azalırken, blaOXA-23-like gen pozitifliği ile birlikte karbapenem direncinin arttığı belirlenmiştir. So- nuç olarak, karbapenemler dahil antimikrobiyal tedavide kullanılan çoğu antibiyotiğe yüksek direnç gös- teren A.baumannii izolatlarının kolistine duyarlılığı devam etmektedir. Hem blaOXA-23-like hem de blaOXA-58- genleri karbapeneme dirençli A.baumannii klinik izolatlarında oldukça yaygın olmakla birlikte, yıllar için- like deki blaOXA-23-like pozitif izolatların artışı dikkat çekicidir. Günümüzde, hastane kaynaklı enfeksiyonların ön- lenmesi için dirençli bakterilerin hızlı tanısında, multipleks qPCR en uygun yöntemdir. Bu çalışmada geliştirilen multipleks qPCR kiti karbapeneme dirençli A.baumannii klinik izolatlarında blaOXA-23-like, blaOXA-58-like ve blaOXA-51-like genlerinin hızlı tanısı ve sıklığının ortaya konmasında yararlı olabilir.Acinetobacter baumannii is the most important agent of nosocomial infections within the Acinetobac- ter genus. This gram-negative coccobacillus is intrinsically resistant to many antibiotics used in antimic- robial therapy, and capable of developing resistance including carbapenems. The objective of this study was to develop a multiplex real time polymerase chain reaction (qPCR) kit for OXA subgroups in A.ba- umannii, and to investigate the distribution of OXA subgroups in A.baumannii strains isolated from ge- ographically different regions of Turkey. A total of 834 A.baumannii clinical isolates collected from diffe- rent state and university medical centers in 13 provinces (Afyonkarahisar, Ankara, Bolu, Elazig, Erzurum, Isparta, Istanbul, Kahramanmaras, Konya, Sakarya, Van) between 2008-2011, were included in the study. The isolates were identified by conventional methods and automated systems [Vitek2 (bioMeri- eux, ABD) and Phoenix (BD Diagnostic, MD)]. The susceptibility profiles of the isolates were studied with automated systems and standard disc diffusion method. All samples were subjected to qPCR to detect blaOXA-51-like, blaOXA-23-like and blaOXA-58-like genes. A conventional PCR method was also used to detect bla- gene. The resistance rates observed during the study period were as follows: 96.8% for amo- OXA-24-like xicillin-clavulanate, 86.8% for ciprofloxacin, 74.7% for gentamicin, 71.7% for amikacin, 73.5% for ce- faperozone-sulbactam, 72.1% for imipenem and 73% for meropenem. Six hundred and two (72.2 %) isolates were resistant to both imipenem and meropenem. Colistin was found to be the most effective antibiotic against A.baumannii isolates with 100% susceptibility rate. All isolates were positive for blaOXA- gene, however blaOXA-24-like gene could not be demonstrated in any isolate. Total positivity rates of 51-like blaOXA-23-like and blaOXA-58-like genes were found as 53.7% and 12.5%, respectively, while these rates we- re 74.4% and 17.3% in carbapenem-resistant isolates, respectively. Twenty-five isolates were positive for both blaOXA-23-like and blaOXA-58-like genes. All of the carbapenem-resistant isolates have OXA type genes with the exception of blaOXA-24-like gene. The positivity rates for blaOXA-23-like and blaOXA-58-like genes vari- ed for each center. In addition, there was a decrease in the frequency of blaOXA-58-like gene, however both blaOXA-23-like gene and carbapenem resistance rates increased during the study period. In conclusion, high rates of resistance to carbapenems were also remarkable but A.baumannii strains keep on sensiti- vity to colistin. Both blaOXA-23-like and blaOXA-58-like genes were shown to be widespread in carbapenem- resistant A.baumannii clinical isolates. However, blaOXA-23-like gene positive strains were increased throug- hout the study. Currently, multiplex qPCR is the best way for rapid diagnosis of resistant bacteria for pre- vention of hospital-acquired infections. The multiplex qPCR kit developed in this study could be useful for rapid diagnosis and identify the frequencies of blaOXA-23-like, blaOXA-51-like and blaOXA-58-like genes in car- bapenem-resistant A.baumannii clinical isolates

Distribution of blaOXA genes in Acinetobacter baumannii strains: A multicenter study

Acinetobacter cinsi içerisinde hastane enfeksiyonlarının en önemli etkeni Acinetobacter baumannii’dir. Bu gram-negatif kokobasil, antimikrobiyal tedavide kullanılan çoğu antibiyotiğe dirençli olup aynı zamanda karbapenemlere de direnç geliştirme kapasitesindedir. Bu çalışmanın amacı, A.baumannii’nin OXA alt grupları için multipleks gerçek zamanlı polimeraz zincir reaksiyonu (qPCR) kiti tasarlamak ve Türkiye'nin farklı bölgelerinden toplanan A.baumannii izolatlarında OXA alt gruplarının dağılımını araştırmaktır. Çalışmaya, çeşitli illerdeki (Afyonkarahisar, Ankara, Bolu, Elazığ, Erzurum, Isparta, İstanbul, Kahramanmaraş, Konya, Sakarya, Van) 13 üniversite ve devlet hastanesinin mikrobiyoloji laboratuvarlarında, 2008-2011 tarihleri arasında izole edilen toplam 834 A.baumannii klinik izolatı dahil edilmiştir. İzolatlar, konvansiyonel yöntemler ve otomatize sistemler [Vitek2 (bioMerieux, ABD) ve Phoenix (BD Diagnostic, MD)] kullanıla- rak tanımlanmış; duyarlılık testleri otomatize sistemler ve disk difüzyon yöntemiyle yapılmıştır. Tüm örnek- lere blaOXA-51-like, blaOXA-23-like ve blaOXA-58-like genleri için qPCR uygulanmış; ayrıca, blaOXA-24-like geni araştırılmasında konvansiyonel PCR yöntemi kullanılmıştır. Çalışmamızda saptanan antibiyotik direnç oranları; amoksisilin-klavulanat için %96.8, siprofloksasin için %86.8, gentamisin için %74.7, amikasin için %71.7, sefaperazon-sulbaktam için %73.5, imipenem için %72.1 ve meropenem için %73 olarak izlenmiştir. Altı yüz iki (%72.2) izolat hem imipenem hem de meropeneme dirençli bulunmuştur. A.baumannii izolatları için en etkili antibiyotiğin, %100 duyarlılık oranı ile kolistin olduğu görülmüştür. İzolatların tümünde bla-geni pozitif bulunmuş; ancak blaOXA-24-like geni hiçbir izolatta gösterilememiştir. Toplam blaOXA-23- OXA-51-like ve blaOXA-58-like gen pozitiflikleri sırasıyla %53.7 ve %12.5 olarak saptanmıştır. Karbapeneme dirençli izolike latların blaOXA-23-like ve blaOXA-58-like gen pozitiflikleri ise sırasıyla %74.4 ve %17.3 olarak tespit edilmiştir. Yir- mi beş izolat hem blaOXA-23-like hem de blaOXA-58-like gen pozitifliği göstermiştir. blaOXA-24-like hariç, karbapeneme dirençli izolatların tamamında OXA tipi genler saptanmıştır. Çalışmaya katılan merkezlerin blaOXA-23- ve blaOXA-58-like gen pozitiflik oranları farklı bulunmuştur. Ek olarak, çalışma sürecinde blaOXA-58-like gen like pozitifliği azalırken, blaOXA-23-like gen pozitifliği ile birlikte karbapenem direncinin arttığı belirlenmiştir. So- nuç olarak, karbapenemler dahil antimikrobiyal tedavide kullanılan çoğu antibiyotiğe yüksek direnç gös- teren A.baumannii izolatlarının kolistine duyarlılığı devam etmektedir. Hem blaOXA-23-like hem de blaOXA-58- genleri karbapeneme dirençli A.baumannii klinik izolatlarında oldukça yaygın olmakla birlikte, yıllar için- like deki blaOXA-23-like pozitif izolatların artışı dikkat çekicidir. Günümüzde, hastane kaynaklı enfeksiyonların ön- lenmesi için dirençli bakterilerin hızlı tanısında, multipleks qPCR en uygun yöntemdir. Bu çalışmada geliştirilen multipleks qPCR kiti karbapeneme dirençli A.baumannii klinik izolatlarında blaOXA-23-like, blaOXA-58-like ve blaOXA-51-like genlerinin hızlı tanısı ve sıklığının ortaya konmasında yararlı olabilir.Acinetobacter baumannii is the most important agent of nosocomial infections within the Acinetobac- ter genus. This gram-negative coccobacillus is intrinsically resistant to many antibiotics used in antimic- robial therapy, and capable of developing resistance including carbapenems. The objective of this study was to develop a multiplex real time polymerase chain reaction (qPCR) kit for OXA subgroups in A.ba- umannii, and to investigate the distribution of OXA subgroups in A.baumannii strains isolated from ge- ographically different regions of Turkey. A total of 834 A.baumannii clinical isolates collected from diffe- rent state and university medical centers in 13 provinces (Afyonkarahisar, Ankara, Bolu, Elazig, Erzurum, Isparta, Istanbul, Kahramanmaras, Konya, Sakarya, Van) between 2008-2011, were included in the study. The isolates were identified by conventional methods and automated systems [Vitek2 (bioMeri- eux, ABD) and Phoenix (BD Diagnostic, MD)]. The susceptibility profiles of the isolates were studied with automated systems and standard disc diffusion method. All samples were subjected to qPCR to detect blaOXA-51-like, blaOXA-23-like and blaOXA-58-like genes. A conventional PCR method was also used to detect bla- gene. The resistance rates observed during the study period were as follows: 96.8% for amo- OXA-24-like xicillin-clavulanate, 86.8% for ciprofloxacin, 74.7% for gentamicin, 71.7% for amikacin, 73.5% for ce- faperozone-sulbactam, 72.1% for imipenem and 73% for meropenem. Six hundred and two (72.2 %) isolates were resistant to both imipenem and meropenem. Colistin was found to be the most effective antibiotic against A.baumannii isolates with 100% susceptibility rate. All isolates were positive for blaOXA- gene, however blaOXA-24-like gene could not be demonstrated in any isolate. Total positivity rates of 51-like blaOXA-23-like and blaOXA-58-like genes were found as 53.7% and 12.5%, respectively, while these rates we- re 74.4% and 17.3% in carbapenem-resistant isolates, respectively. Twenty-five isolates were positive for both blaOXA-23-like and blaOXA-58-like genes. All of the carbapenem-resistant isolates have OXA type genes with the exception of blaOXA-24-like gene. The positivity rates for blaOXA-23-like and blaOXA-58-like genes vari- ed for each center. In addition, there was a decrease in the frequency of blaOXA-58-like gene, however both blaOXA-23-like gene and carbapenem resistance rates increased during the study period. In conclusion, high rates of resistance to carbapenems were also remarkable but A.baumannii strains keep on sensiti- vity to colistin. Both blaOXA-23-like and blaOXA-58-like genes were shown to be widespread in carbapenem- resistant A.baumannii clinical isolates. However, blaOXA-23-like gene positive strains were increased throug- hout the study. Currently, multiplex qPCR is the best way for rapid diagnosis of resistant bacteria for pre- vention of hospital-acquired infections. The multiplex qPCR kit developed in this study could be useful for rapid diagnosis and identify the frequencies of blaOXA-23-like, blaOXA-51-like and blaOXA-58-like genes in car- bapenem-resistant A.baumannii clinical isolates