OXA- and GES-type beta-lactamases predominate in extensively drug-resistant Acinetobacter baumannii isolates from a Turkish University Hospital

This study was supported by grants from Recep Tayyip Erdogan University (BAP-2012.106.01.11 and BAP-2011.102.03.3). AYP was supported by the Australian National Health and Medical Research Council (APP1047916 and APP1010114).We determined the antibiotic susceptibility and genetic mechanisms of resistance in clinical strains of Acinetobacter baumannii from Istanbul, Turkey. A total of 101 clinical strains were collected between November 2011 and July 2012. Antimicrobial susceptibility was performed using the Vitek 2 Compact system and E-test. Multiplex PCR was used for detecting bla(OXA-51-like), bla(OXA-23-like), bla(OXA-40-like) and bla(OXA-58-like) genes. ISAba1, bla(IMP-like), bla(VIM-like), bla(GES), bla(VEB), bla(PER-2), aac-3-Ia and aac-6'-Ib and NDM-1 genes were detected by PCR and sequencing. By multiplex PCR, all strains were positive for bla(OXA-51), 79 strains carried bla(OXA-23) and one strain carried bla(OXA-40). bla(OXA-51) and bla(OXA-23) were found together in 79 strains. ISAba1 element was detected in 81 strains, and in all cases it was found upstream of bla(OXA-51). GES-type carbapenemases were found in 24 strains (GES-11 in 16 strains and GES-22 in 8 strains) while bla(PER-2), bla(VEB-1), bla(NDM-1), bla(IMP)- and bla(VIM)-type carbapenemases were not observed. Aminoglycoside modifying enzyme (aac-3-Ia and aac-6'Ib) genes were detected in 13 and 15 strains, respectively. Ninety-seven (96%) A. baumannii strains were defined as MDR and of these, 98% were extensively drug resistant (sensitive only to colistin). Colistin remains the only active compound against all clinical strains. As seen in other regions, OXA-type carbapenemases, with or without an upstream ISAba1, predominate but GES-type carbapenemases also appear to have a significant presence. REP-PCR analysis was performed for molecular typing and all strains were collected into 12 different groups. To our knowledge, this is the first report of GES-11 and OXA-40 in A. baumannii from Turkey

Apendektomi Olgular�Nda Parazitoz

Aim: Obstruction of lumen of appendix vermiformis causes inflammation and requires surgery. The study aimed to detect any parasitosis in appendiceal specimens brought to pathology laboratory. Method: A total 916 appendectomy specimens from Faculty of Medicine at Inonu University between 2002 and 2005 were examined for inflammation and luminal parasitosis. Result: Adult worms and eggs of Enterobius vermicularis were detected in 23 (2.5%) of all cases, while Taenia spp. were found in only 2 (0.2%) cases. Also parasites were found in 8 of (2.0%) of 391 construction appendicitis, and in 5 (1.3%) of 384 acute appendicitis cases. Moreover, plasma cells and polymorphonuclear leukocytes were observed, respectively, in 18, and 2 of Appendix vermiformis cases with parasite. Eosinophils in lamina propria were detected in all cases. Conclusion: Therefore, the intestinal parasitosis should be considered in the differential diagnoses of appendicitis. Education on how to prevent parasitosis should be included in training programs to avoid any unnecessary surgery.Amaç: Appendiks vermiformisin lümeninin tıkanması inflamasyona neden olur ve operasyon gerektirir. Bu çalışmada patoloji laboratuarına götürülen appendiks örneğinde parazitoz varlığının tespiti amaçlandı. Metod: İnönü Üniversitesi Tıp Fakültesinde 2002-2005 yılları arasında toplam 916 apendektomi örneği inflamasyon ve luminal parazitoz yönünden incelendi. Bulgular: Enterobius vermikularisin erişkin kurt ve yumurtaları toplam vakaların 23 (%2,5)’inde tespit edilirken, tenya türleri sadece vakaların 2 (%0,2)’sinde bulundu. Ayrıca 391 konstrüksiyon apandisitin 8 (%2,0)’inde ve 384 akut apandisitin 5 (%1,3)’inde parazit bulundu. Aynı zamanda sırasıyla 18 ve 2 parazitli appendiks vermiformis vakasında plazma hücreleri ve polimorfonükleer lökositler izlendi. Lamina propriada eozinofiller tüm vakalarda tespit edildi. Sonuç: Bu nedenle intestinal parazitler apandisitin ay considered in the differential diagnoses of appendicitis. Education on how to prevent parasitosis should be included in training programs to avoid any unnecessary surge

Ratlarda Kurkuminin Kadmiyum ile İndüklenen Karaciğer Apopitozu Üzerine Koruyucu Etkisi

Objective: Cadmium (CD), which is used for many industrial purposes, is a toxic agent. CD accumulates in the liver; therefore, exposure to toxic doses of Cd results in hepatic damage. Studies in rats have shown that CD induces apoptosis in hepatocytes. Curcumin is a natural compound isolated from Curcuma longa. It has a powerful anti-inflammatory affect and scavenges reactive oxygen radicals. Additionally, it has been shown to have an anti-apoptotic effect in a dose-dependent manner. The aim of the present study was to evaluate the effects of therapeutic doses of curcumin on Cd-induced hepatic apoptosis as well as hepatic biochemical and inflammatory changes in Sprague-Dawley rats

Protective Effect of Curcumin on Cadmium-Induced Liver Apoptosis in Rats

Objective: Cadmium (CD), which is used for many industrial purposes, is a toxic agent. CD accumulates in the liver; therefore, exposure to toxic doses of Cd results in hepatic damage. Studies in rats have shown that CD induces apoptosis in hepatocytes. Curcumin is a natural compound isolated from Curcuma longa. It has a powerful anti-inflammatory affect and scavenges reactive oxygen radicals. Additionally, it has been shown to have an anti-apoptotic effect in a dose-dependent manner. The aim of the present study was to evaluate the effects of therapeutic doses of curcumin on Cd-induced hepatic apoptosis as well as hepatic biochemical and inflammatory changes in Sprague-Dawley rats

Protective Effects of Curcumin on Cadmium-Induced Renal Injury in Young and Aged Rats

Objective: We aimed to investigate the protective effects of curcumin (Cr) against cadmium (Cd) toxicity on the kidneys of both young and aged rats

Protective Effects of Curcumin on Cadmium-Induced Renal Injury in Young and Aged Rats

Objective: We aimed to investigate the protective effects of curcumin (Cr) against cadmium (Cd) toxicity on the kidneys of both young and aged rats

Nasal care in intensive care unit patients

WOS: 000418528600006PubMed ID: 28916414Purpose: The aim of this study was to investigate nasal hygiene in intensive care patients and improve patient care using isotonic saline nasal spray. Material and methods: In the study group, over a period of ten days saline nasal spray was administered four times daily. Nasal treatment was not given to the control group. Each patient was examined with a flexible nasopharyngoscope before and after the treatment and a nasal culture was taken. Results: In the study group, the secretion score (1- absent; 2- serosal; 3- seropurulent and 4- purulent) mean value improved from 1.9 to 1.4. In the control group, the secretion score mean value had risen from 1.7 to 3.1. At the beginning of the study, there was no difference in secretion scores between the groups, but on the tenth day a statistically significant difference was found. Conclusion: The use of saline nasal spray in this group of intensive care patients was found to be effective in achieving nasal hygiene

Characterization of novel VIM carbapenemase, VIM-38, and first detection of GES-5 carbapenem-hydrolyzing beta-lactamases in Pseudomonas aeruginosa in Turkey

Pseudomonas aeruginosa isolates were collected form a Turkish hospital. Antimicrobial susceptibility was performed using the Vitek 2 Compact system, and 24 isolates were categorized as multidrug resistant (n = 18), extensively-drug resistant (n = 5), or pan-drug resistant (n = I). PCR and DNA sequence analysis revealed that 1 strain possessed the bla(GES-5) and another carried a novel bla(VIM) variant, named VIM-38. This new gene exhibited 1 amino acid substitution (Ala265Val) in comparison to its closest variant, VIM-5. Both VIM encoding genes were clones and demonstrated similar susceptibility profile when expressed in identical background. The presence of VIM-38 increases the diversity of carbapenemases in Turkey. (C) 2014 Elsevier Inc. All rights reserved.This work was supported by Recep Tayyip Erdogan University Research Fund Grants BAP-2012.106.01.11 and BAP-2011.102.03.3

Distribution of beta-lactamase genes among carbapenem-resistant Klebsiella pneumoniae strains isolated from patients in Turkey

BACKGROUND: The emergence of carbapenem-resistant Klebsiella pneumoniae poses a serious problem to antibiotic management. We investigated the β-lactamases in a group of carbapenem-resistant K. pneumoniae clinical isolates from Turkey. METHODS: Thirty-seven strains of K. pneumoniae isolated from various clinical specimens were analyzed by antimicrobial susceptibility testing, PCR for the detection of β-lactamase genes, DNA sequencing, and repetitive extragenic palindronic (REP)-PCR analysis. RESULTS: All 37 isolates were resistant to ampicillin, ampicillin/sulbactam, piperacillin, piperacillin/tazobactam, ceftazidime, cefoperazone/sulbactam, cefepime, imipenem, and meropenem. The lowest resistance rates were observed for colistin (2.7%), tigecycline (11%), and amikacin (19%). According to PCR and sequencing results, 98% (36/37) of strains carried at least one carbapenemase gene, with 32 (86%) carrying OXA-48 and 7 (19%) carrying NDM-1. No other carbapenemase genes were identified. All strains carried a CTX-M-2-like β-lactamase, and some carried SHV- (97%), TEM- (9%), and CTX-M-1-like (62%) β-lactamases. Sequence analysis of bla(TEM) genes identified a bla(TEM-166) with an amino acid change at position 53 (Arg53Gly) from bla(TEM-1b), the first report of a mutation in this region. REP-PCR analysis revealed that there were seven different clonal groups, and temporo-spatial links were identified within these groups. CONCLUSIONS: Combinations of β-lactamases were found in all strains, with the most common being OXA-48, SHV, TEM, and CTX-M-type (76% of strains). We have reported, for the first time, a high prevalence of the NDM-1 (19%) carbapenemase in carbapenem-resistant K. pneumoniae from Turkey. These enzymes often co-exist with other β-lactamases, such as TEM, SHV, and CTX-M β-lactamases