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

Reliability And Validity Of The Schedule For Affective Disorders And Schizophrenia For School-Age Children-Present And Lifetime Version, Dsm-5 November 2016-Turkish Adaptation (K-Sads-Pl-Dsm-5-T)

Objective: The aim of this study was evaluate the reliability and validity of the Schedule for Affective Disorders and Schizophrenia for School-Age Children-Present and Lifetime Version, DSM-5 November 2016 -Turkish Adaptation (K-SADS-PL-DSM-5-T). Method: A total of 150 children and adolescents between 6 and 17 years of age were assessed with K-SADS-PL-DSM-5-T. The degree of agreement between the DSM-5 criteria diagnoses and the K-SADS-PL-DSM-5-T diagnoses were considered as the measure of consensus validity. In addition, concurrent validity was examined by analyzing the correlation between the diagnoses on K-SADS-PL-DSM-5-T and relevant scales. Interrater reliabilities were assessed on randomly selected 20 participants. Likewise, randomly selected 20 other participants were interviewed with K-SADS-PL-DSM-5-T three weeks after the first interview to evaluate test-retest reliability. Results: The consistency of diagnoses was almost perfect for eating disorders, selective mutism and autism spectrum disorder (K=0.92-1.0), substantial for elimination disorders, obsessive-compulsive disorder, oppositional defiant disorder, generalized anxiety disorder, social anxiety disorder, depressive disorders, disruptive mood dysregulation disorder and attention deficit hyperactivity disorder (K=0.67-0.80). Interrater reliability was perfect for selective mucism (K=1.0), substantial for oppositional defiant disorder, disruptive mood dysregulation disorder, attention deficit hyperactivity disorder, depressive disorders and social anxiety disorder (K=0.63-0.73). Test-retest reliability was almost perfect for autism spectrum disorder (K=0.82), substantial for attention deficit hyperactivity disorder, oppositional defiant disorder, disruptive mood dysregulation disorder, depressive disorders and generalized anxiety disorder (K=0.62-0.78). Conclusion: The results of this study show that the K-SADS-PL-DSM-5-T is an effective instrument for diagnosing major childhood psychiatric disorders including selective mutism, disruptive mood dysregulation disorder and autism spectrum disorder which have recently been added to the schedule.WoSScopu

The prevalence of childhood psychopathology in Turkey: a cross-sectional multicenter nationwide study (EPICPAT-T).

Aim: The aim of this study was to determine the prevalence of childhood psychopathologies in Turkey

The prevalence of childhood psychopathology in Turkey: a cross-sectional multicenter nationwide study (EPICPAT-T)

Conclusion: This is the largest and most comprehensive epidemiological study to determine the prevalence of psychopathologies in children and adolescents in Turkey. Our results partly higher than, and partly comparable to previous national and international studies. It also contributes to the literature by determining the independent predictors of psychopathologies in this age group

Prevalence of Childhood Affective disorders in Turkey: An epidemiological study

Aim: To determine the prevalence of affective disorders in Turkey among a representative sample of Turkish population. Methods: This study was conducted as a part of the "The Epidemiology of Childhood Psychopathology in Turkey" (EPICPAT-T) Study, which was designed by the Turkish Association of Child and Adolescent Mental Health. The inclusion criterion was being a student between the second and fourth grades in the schools assigned as study centers. The assessment tools used were the K-SADS-PL, and a sociodemographic form that was designed by the authors. Impairment was assessed via a 3 point-Likert type scale independently rated by a parent and a teacher. Results: A total of 5842 participants were included in the analyses. The prevalence of affective disorders was 2.5 % without considering impairment and 1.6 % when impairment was taken into account. In our sample, the diagnosis of bipolar disorder was lacking, thus depressive disorders constituted all the cases. Among depressive disorders with impairment, major depressive disorder (MDD) (prevalence of 1.06%) was the most common, followed by dysthymia (prevalence of 0.2%), adjustment disorder with depressive features (prevalence of 0.17%), and depressive disorder-NOS (prevalence of 0.14%). There were no statistically significant gender differences for depression. Maternal psychopathology and paternal physical illness were predictors of affective disorders with pervasive impairment. Conclusion: MDD was the most common depressive disorder among Turkish children in this nationwide epidemiological study. This highlights the severe nature of depression and the importance of early interventions. Populations with maternal psychopathology and paternal physical illness may be the most appropriate targets for interventions to prevent and treat depression in children and adolescents