Person: HASDEMİR GÖKBOĞA, MÜNEVVER UFUK
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HASDEMİR GÖKBOĞA
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MÜNEVVER UFUK
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Publication Metadata only Performance of RESIST-3 OKN K-SeT immunochromatographic assay for the detection of OXA-48 like, KPC, and NDM carbapenemases in Klebsiella pneumoniae in Turkey(SPRINGER, 2018) ALTINKANAT GELMEZ, GÜLŞEN; Sagiroglu, Pinar; Hasdemir, Ufuk; Gelmez, Gulsen Altinkanat; Aksu, Burak; Karatuna, Onur; Soyletir, GunerIn this study, the performance of the RESIST-3 O.K.N. K-SeT (Cofis BioConcept, Gembloux, Belgium) immunochromatographic assay was evaluated in 132 Klebsiella pneumoniae comprising 102 carbapenem resistant and 30 carbapenem susceptible isolates. Genotypically known isolates of Gram negative bacteria (n = 22) including various species were also tested by the assay as controls. The isolates tested by the immunochromatographic assay and also were run PCR for bla(KPC), bla(VIM) bla(NDM), and bla(OXA-48). The rates of bla(NDM), bla(OXA-48), and bla(KPC) in carbapenem resistant isolates were found at 52.9%, 39.2%, and 2.0%, respectively. Both bla(NDM) and bla(OXA-48) were found in six (5.9%) isolates. The results of the assay showed 100% concordance with those obtained by PCR in 132 K. pneumoniae. The agreement between the two methods was found to be identical at the isolate level. The assay also correctly detected all genotypically known isolates of Escherichia coli, Serratia marcescens, Citrobacter freundii, Enterobacter cloacae, K. pneumoniae carrying bla(KPC), bla(NDM), and/or bla(OXA-48). On the other hand, the assay did not exhibit any cross-reaction in control isolates harboring bla(IMP) and bla(VIM). We conclude that the RESIST-3 O.K.N. K-SeT is a reliable, rapid, and user friendly test and we recommend it for routine diagnostic laboratories. (C) 2018 Sociedade Brasileira de Microbiologia. Published by Elsevier Editora Ltda.Publication Metadata only Genişletilmiş spektrumlu beta-laktamaz enzimini üreten enterobacterales izolatlarına yönelik hızlı tanı kitinin geliştirilmesi(2023-05-25) ALTINKANAT GELMEZ, GÜLŞEN; AKSU, MEHMET BURAK; HASDEMİR GÖKBOĞA, MÜNEVVER UFUK; Budak B., Can E., Oral D., Öz Ö. B., Sağlam Y., Altınkanat Gelmez G., Aksu M. B., Hasdemir Gökboğa M. U.Giriş ve Amaç: Antibiyotik direnci günümüzün önemli bir sağlık problemi olup, gram negatif bakterilerde genişletilmiş spektrumlu beta-laktamaz (GSBL) enzimi üretimi, etkin tedaviyi engelleyen önemli bir direnç mekanizmasıdır. Klinikte yaygın olarak görülen GSBL enzimleri; CTX-M, SHV ve TEM gruplarıdır. Enfeksiyon etkeni bakteride GSBL üretiminin erken saptanması, tedavinin doğru yönlendirilmesi açısından çok önemlidir. Rutin laboratuvarda bu süre en az 24 saati bulmaktadır. Bu çalışmada, gram negatif bakterilerde bu enzimlerin üretimini hızlı saptayacak fenotipik bir test geliştirilmesi amaçlanmıştır. Gereç ve Yöntem: Marmara Üniversitesi Pendik Eğitim ve Araştırma Hastanesi Mikrobiyoloji Laboratuvarı’nda enfeksiyon etkeni olarak izole edilen 16 Escherichia coli ve 22 Klebsiella pneumoniae çalışmaya dahil edilmiştir. Bakteriler Triton-X (%0,1) ile muamele edilip varsa GSBL enzimlerini açığa çıkartmak üzere hücre çeperleri parçalanmıştır. Bu bakteri süspansiyonları, sefotaksim antibiyotiği (12 mg/mL) ve pH indikatörü olarak fenol kırmızısı (%0,05) içeren tüplere eklenmiştir. GSBL enzimleri varlığında sefotaksim antibiyotiğinin parçalanması ve sonucunda pH’nin asidik yönde değişmesiyle indikatörün renginin kırmızıdan sarı/turuncu’ya dönmesi beklenmiştir. Çalışmanın diğer aşamasında fenotipik testin performansını belirlemek üzere bakterilerde GSBL enzimlerini kodlayan genlerin (blaCTX-M-1, blaCTX-M-2, bla CTX-M-8, bla CTX-M-9, blaSHV-3, blaSHV-18) varlığı altın standart PCR ile araştırılmıştır. Çalışmaya bu enzimleri taşıdığı önceden bilinen kontrol izolatları da dahil edilmiştir. Bulgular: PCR ile 26 izolatta GSBL kodlayan gen saptanırken, 12 izolatta herhangi bir gen saptanmamıştır. Geliştirmeyi hedeflediğimiz fenotipik test, GSBL geni saptanan 26 izolatın hepsinde GSBL enzimini 2 saatte saptamıştır. GSBL geni saptanmayan 12 izolatın hiçbirinde fenotipik testte bu sürede renk değişimi olmamıştır. Sonuç: Testimizin duyarlılığı, özgüllüğü, pozitif prediktif değeri, negatif prediktif değeri %100 olarak bulunmuş olup, bu testin, GSBL üreten mikroorganizmaları 2 saat gibi kısa bir sürede saptamasının, hızla doğru tedavi uygulanmasına ve hasta sağ kalımına çok önemli katkı sağlayacağını düşünüyoruz.Publication Metadata only Yenidoğan yoğun bakımdaki bebeklerin karbapenem dirençli gram(-) bakterilerle kolonizasyonundaki risklerin incelenmesi(2021-10-06) MEMİŞOĞLU, ASLI; ALTINKANAT GELMEZ, GÜLŞEN; KEPENEKLİ KADAYİFCİ, EDA; AY, NADİYE PINAR; BİLGEN, HÜLYA SELVA; HASDEMİR GÖKBOĞA, MÜNEVVER UFUK; ÖZEK, EREN; YALÇINOĞLU İ., MEMİŞOĞLU A., ALTINKANAT GELMEZ G., TAVİLOĞLU Z. Ş. , ÖZDEMİR H., KEPENEKLİ KADAYİFCİ E., AY N. P. , BİLGEN H. S. , HASDEMİR M. U. , ÖZEK E.Publication Metadata only Kandan izole edilen çok ilaca dirençli escherichia coli, klebsiella pneumoniae ve pseudomonas aeruginosa kökenlerinde meropenem-vaborbaktamın etkinliğinin diğer Antibiyotiklerle karşılaştırmalı olarak araştırılması: çok merkezli çalışma(2022-11-16) GÜNEŞER, DENİZ; HASDEMİR GÖKBOĞA, MÜNEVVER UFUK; KORTEN, VOLKAN; ALTINKANAT GELMEZ, GÜLŞEN; Altınkanat Gelmez G., Güneşer D., Hasdemir Gökboğa M. U. , Korten V., Sağıroğlu P., Hazırolan G., Gür D., Öktem İ. M. A. , Aygün G.Publication Metadata only The impact of a pneumococcal conjugate vaccination program on the nasopharyngeal carriage, serotype distribution and antimicrobial resistance of Streptococcus pneumoniae among healthy children in Turkey(ELSEVIER SCI LTD, 2016) KEPENEKLİ KADAYİFCİ, EDA; Soysal, Ahmet; Karabag-Yilmaz, Esra; Kepenekli, Eda; Karaaslan, Ayse; Cagan, Eren; Atici, Serkan; Atinkanat-Gelmez, Gulsen; Boran, Peran; Merdan, Selim; Hasdemir, Ufuk; Soyletir, Guner; Bakir, MustafaBackground: The 7-valent conjugate pneumococcal vaccine (PCV7) was introduced by the Turkey National Immunization Program in 2008 and replaced by the PCV13 in 2011. We assessed the impact of PCV vaccination on the nasopharyngeal (NP) carriage, serotype distribution and antimicrobial resistance of Streptococcus pneumoniae (SP) among healthy Turkish children. Methods: A prospective surveillance study was performed between September 2011 and September 2013 in Istanbul, Turkey. NP swabs, demographic data, and vaccination statuses were obtained from 2165 healthy children aged 0-18 years. Pneumococcal carriage was defined by a positive culture; serotyping was performed via multiplex conventional PCR, and the antibiotic susceptibilities of the isolates were determined based on the minimum inhibitory concentration (MIC) values of the Clinical Laboratory Standards Institute (CLSI). Results: The prevalence of pneumococcal carriage was 6.4%. The carriage rates were 8%, 7%, and 5% in the following age groups: 0-24 months, 25-60 months, and >60 months, respectively. The carriage rate was significantly higher in the 0-24 month age group than in the >60 months age group (p = 0.03). Sixty percent of the children were not vaccinated with any PCV; 4%, 2%, and 4% received at least 1, 2 or 3 doses and 30% children received the full schedule (4 doses) of either PCV7 or PCV13. Among the isolated S. pneumoniae strains, 45% were of the non-vaccine type (NVT) and 55% were of the vaccine type (VT). The children who received at least a single PCV dose had significantly lower odds of colonization via VT serotypes than the non-vaccinated children [odds ratio: 0.61 (95% confidence interval = 0.41-0.91), p = 0.01]. The percentages of the serotypes covered by PCV7 and PCV13 were 51% and 56%, respectively. The most frequently isolated serotypes were 6A/B/C (n = 22, 16.5%), 19F (n = 18, 13.5%), 23F (n = 15, 11.2%), serotype 9V/A (n = 10, 7.5%), 12F (n = 5, 4.5%), 15A/F (n = 7, 4.5%) and 22 A/F (n = 6, 4.5%). Using the meningitis criteria and the MIC, 62% of the isolates were resistant to penicillin and 13% were non sensitive to ceftriaxone. Erythromycin and clindamycin resistance were 43% and 31%, respectively. Conclusion: We shown that following nation-wide PCV vaccination, S. pneumoniae NP carriage was decreased. (C) 2016 Elsevier Ltd. All rights reserved.Publication Metadata only Evaluation of two commercial methods for rapid detection of the carbapenemase-producing Klebsiella pneumoniae(ELSEVIER, 2020) ALTINKANAT GELMEZ, GÜLŞEN; Gelmez, Gulsen Altinkanat; Can, Baris; Hasdemir, Ufuk; Soyletir, GunerIn this study, we evaluated the performance of the two commercial methods (Rapidec Carba NP and NG-Test Carba-5) for the rapid detection of carbapenemase-producing Klebsiella pneumoniae. A total of 224 Klebsiella pneumoniae strains previously characterized for carbapenemase genes by polymerase chain reaction were included in the study. The strain collection included 30 non-carbapenemase producers, 85 OXA-48-like, 59 NDM, 14 IMP, 7 KPC, 7 VIM, 19 OXA-48-like plus NDM, and 3 KPC plus NDM producers. Rapidec Carba NP and NG-Test Carba 5 was performed according to the manufacturer's instructions. NG-Test Carba 5 correctly detected all carbapenemase-producing K. pneumoniae, however, Rapidec Carba NP failed to detect 41% of OXA-48-like producers even with extended incubation time. The overall sensitivity and specificity were 81,9% and 100% for Rapidec Carba NP, 100% and 100% for NG-Test Carba 5, respectively. Both tests seem to be fast and reliable for the detection of carbapenemase-producing K. pneumoniae especially for microbiology laboratories where molecular tests cannot be performed. However, Rapidec Carba NP with weak hydrolysis activity for OXA-48 like might be used in regions where OXA-48 is not prevalent. The additional advantage of NG-Test Carba 5 is that it specifically detects carbapenemases giving way to threat-related infections with an effective drug such as ceftazidime-avibactam or meropenem- vaborbactam.Publication Metadata only Evaluation of phenotypic tests for detection of carbapenemases: New modifications with new interpretation(ELSEVIER, 2021) ALTINKANAT GELMEZ, GÜLŞEN; Gelmez, Gulsen Altinkanat; Can, Baris; Hasdemir, Ufuk; Soyletir, GunerIntroduction: The emergence and spread of carbapenemase-producing Enterobacterales (CPE) is a worldwide public health threat. Rapid and accurate detection of CPE is essential to prevent their dissemination within health care settings. The aim of this study was to evaluate the performance of CIM, mCIM and mCIM with ammonium bicarbonate (mCIM-A) methods by using different interpretation criteria for detection of carbapenemases. Methods: One hundred and fifty-three Klebsiella pneumoniae isolates previously characterized by molecular tests, including 133 carbapenemase producers and 20 non-carbapenemase producers, were collected in this study. CIM and mCIM tests were performed as described previously. mCIM-A by adding 50 mM ammonium bicarbonate to the bacterial suspension prepared in tryptic soy broth. The inhibition zone diameter of around meropenem disc was measured and interpreted as positive according to i) Pierce and colleagues (<19 mm), ii) EUCAST meropenem susceptibility breakpoint (<22). Results: CIM, although seems to be good for carbapenemases other than OXA-48-like and NDM, is not satisfactory (42.3% and 83.4%, respectively) for those enzymes with any of the interpretation criteria. OXA-48-like and NDM were detected with a better performance (88.7% and 92.8, respectively) with mCIM when results were interpreted according to <22 mm zone diameter for OXA-48-like and NDM. The best results were obtained with mCIM-A using <22 mm criteria without any difference in the results of other enzymes and negative strains. Conclusions: mCIM- A method interpreted with <22 mm meropenem zone diameter seems to be preferable compared to CIM and mCIM. mCIM-A is simple and useful tool for identification of CPEs in clinical microbiology laboratories. (C) 2020 Japanese Society of Chemotherapy and The Japanese Association for Infectious Diseases. Published by Elsevier Ltd. All rights reserved.Publication Metadata only Serotype distrubution and antibiotic susceptibilities of streptococcus pneumoniae causing acute exacerbations and pneumonia in children with chronic respiratory diseases [Kronik akciǧer hastaliǧi olan, akut alevlenme ve pnömoni tanisi ile başvuran çocuklarda streptococcus pneumoniae serotip daǧilimi ve antimikrobiyal duyarliliklari](Ankara Microbiology Society, 2013) KARADAĞ, BÜLENT TANER; Altinkanat Gelmez G., Soysal A., Kuzdan C., Karadaǧ B., Hasdemlr U., Bakir M., Söyletir G.This study aimed to investigate serotype distribution and antimicrobial resistance of Streptococcus pneumoniae isolates obtained from children with chronic respiratory diseases admitted to hospital with a diagnosis of acute exacerbations between 2008-2010 at Marmara University Hospital, Istanbul, Turkey. Sixty one S.pneumoniae strains isolated from the respiratory samples of patients were studied for erythromycin, clindamycin, tetracyline, trimethoprim-sulphametoxazole (TMP-SMX), vancomycin, levofloxa-cin susceptibilities by disk diffusion method; MIC values of penicillin and ceftriaxone were determined by E-test (AB Biodisk, Sweden). Results were evaluated according to the CLSI standards. The erythromycin-clindamycin double disc method was applied for the detection of macrolide resistance phenotypes. The presence of macrolide resistance genes, ermB, mef(A)/(E), ermTR were determined by PCR using specific primers for each gene. The serotypes were determined by multiplex PCR using specific primers for 40 different serotypes. According to CLSI criteria, penicillin resistance in S.pneumoniae isolates were found to be 8.2% (5/61) and intermediate resistance rate was 54% (33/61) for oral penicillin. Penicillin resistance were found to be only 1.6% (1/61) for parenteral penicillin. Resistance rates of erythromycin, clindamycin, tetracyline, TMP-SMX were detected as 55.8%, 46%, 47.5% and 67.2%; respectively. No resistance was detected to vancomycin and levofloxacin. Constitutive macrolide-lincosamide-streptog-ramin B (cMLSB) phenotype and M phenotype were observed in 82.4% (n= 28) and 17.6% (n= 6) of the macrolide resistant isolates, respectively. Inducible macrolide-lincosamide-streptogramin B (iMLSg) phenotype was not detected. The macrolid resistance genotypes, ermB, mef(A)/(E), were positive 50% and 14.7%; respectively. Both ermB and mef(A)/(E) genes were detected 35.3% of the macrolid resistant isolates. None of the isolates were positive for ermTR gene. The most common S.pneumoniae serotypes were determined as serotype 19F, 23F and 6, furthermore penicillin (34%, 15.7% and 18.4%, respectively) and macrolide (38.2%, 20.6% and 14.7%, respectively) resistance rates of those serotypes were found relatively high. Serotype covarage of 7-, 10-, 13-valent conjugated pneumococcal vaccines and 23-valent pneumococcal vaccine were 65%, 67%, 69%, and 78.6%, respectively. In our country, use of the vaccines with these coverage rates has been observed to be effective in children exposed to intensive use of antibiotics with chronic lung disease.Publication Metadata only Karbapenem dirençli klebsiella pneumoniae kökenlerinde kolistin duyarlılığının belirlenmesinde kolistin sıvı disk elüsyon yönteminin performansının değerlendirilmesi(2022-05-27) KÜÇÜKSU, UĞUR; ALTINKANAT GELMEZ, GÜLŞEN; HASDEMİR GÖKBOĞA, MÜNEVVER UFUK; Aghabalapoor Keshtiban E., Güner O. E. , Özgen B., Seyyedsayyah M., Küçüksu U., Altınkanat Gelmez G., Hasdemir Gökboğa M. U.Publication Metadata only Hastanemizde klinik örneklerden İzole edilen karbapenem dirençli klebsiella pneumoniae suşlarındaki fosfomisin direnç durumlarının araştırılması(2022-12-01) ALTINKANAT GELMEZ, GÜLŞEN; HASDEMİR GÖKBOĞA, MÜNEVVER UFUK; KÜÇÜKSU U., ALTINKANAT GELMEZ G., HASDEMİR GÖKBOĞA M. U.