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 Open Access Catalase-negative Staphylococcus aureus: a rare isolate of human infection(BLACKWELL SCIENCE LTD, 2000-12) HASDEMİR GÖKBOĞA, MÜNEVVER UFUK; Over, U; Tuc, Y; Soyletir, GPublication Open Access Performance of “RESIST-3 O.K.N. K-SeT” immunochromatographic assay for the detection of OXA-48 like, KPC, and NDM carbapenemases in Klebsiella pneumoniae in Turkey(2018-10) ALTINKANAT GELMEZ, GÜLŞEN; Sağıroğlu, Pınar; Hasdemir, Ufuk; Altınkanat Gelmez, Gülşen; Aksu, Burak; Karatuna, Onur; Söyletir, GünerPublication Metadata only Simple and reliable detection of slime production of Candida spp. directly from blood culture bottles: Comparison of visual tube method and transmission electron microscopy(SPRINGER, 2004) HASDEMİR GÖKBOĞA, MÜNEVVER UFUK; Cerikcioglu, N; Hasdemir, UO; San, T; Salik, E; Soyletir, GEarly detection of slime production may be useful for clinical decision because of its suggestive property for potential pathogenic capacity of a Candida strain especially in patients with a prosthetic device. In this study we aimed to compare the visual tube method (VTM) with transmission electron microscopy (TEM) in order to confirm the reliability of the former method. In order to demonstrate the reproducibility of the tube method and to determine the correct timing for the test, Candida isolates directly obtained from blood culture (DBC) bottles and their two subsequent subcultures were used. The results of this study showed that VTM is a simple and reliable method which can be used in every clinical mycology laboratory, provided that the test is applied on DBC isolates; as the ability of slime production is decreased or lost even after the first subculturing. We suggest that this simple method can be used and may have some contributions to the ongoing studies on the controversial issue concerning removal of biomaterials in candidemic patients.Publication Open Access VITEK-MS Sistemi ile Karbapenemaz ID Üretiminin Hızlı Tespiti(2019) SÖYLEDİR, GÜNER; GÜLŞEN ALTINKANAT GELMEZ;Barış CAN;MÜNEVVER UFUK HASDEMİR;Güner SÖYLETİRSon yıllarda karbapenemaz üreten Enterobacteriaceae kaynaklı enfeksiyonların dünya çapındaartması önemli halk sağlığı sorunudur. Araştırıcılar, mikroorganizmanın kısa sürede tanımlanmasınaolanak sağlayan MALDI-TOF sisteminin antibiyotik duyarlılık testlerinde de kullanılabileceğinigösteren çalışmalar bildirilmektedir. Çalışmamızda karbapenemaz üretiminin hızlısaptanmasına yönelik olarak ertapenemin karbapenemazlar tarafından hidrolizinin VITEK-MS(bioMérieux, Fransa) sistemi tarafından tespit edilebilirliği değerlendirilmiştir. Çalışmamızaçeşitli klinik örneklerden izole edilen karbapenem dirençli (n=86) ve duyarlı (n=20) toplam 106Klebsiella pneumoniae kökeni dahil edilmiştir. KPC, NDM, IMP, VIM ve OXA-48 genlerinin varlığınıPCR ile tespit edilmiştir. Bakteri süspansiyonları 4 McFarland bulanıklığında hazırlanmış,0.5 μg/ml’lik ertapenem ile muamele edildikten sonra iki ve dört saat inkübe edilip analiz edilmeküzere VITEK-MS RUO (bioMérieux, Fransa) sistemine aktarılmıştır. Karbapenem dirençli 86K.pneumoniae kökeninin blaOXA-48 (n=39), blaNDM (n= 37), blaIMP (n=8) ve blaKPC (n=2) karbapenemazgenlerini taşıdığı tespit edilmiştir. Tüm antibiyotiklere duyarlı olan kökenlerde hiçbir karbapenemazgenine rastlanmamıştır. Ertapenemin tek başına sahip olduğu spektrumlar çalışmakökenlerinin ertapenem ile muamele edilip inkübe edilmesi sonucu elde edilen spektrumlar ilekarşılaştırıldığında; iki saatlik inkübasyon sonrasında NDM, IMP ve KPC geni pozitif kökenlerintamamında ertapenem hidrolizi gözlenirken, OXA-48 geni pozitif olan 14 kökende ertapenemhidrolizinin zayıf olduğu tespit edilmiştir. Dört saatlik inkübasyon sonrası OXA-48 geni pozitifolan kökenlerin sadece % 64.1’inde ertapenem hidrolizi gözlemlenmiştir. İki ve dört saat inkübasyonsonrası karbapenemaz geni içermeyen kökenlerin hiçbirinde ertapenem hidrolizi gözlemlenmemiştir.Rutin laboratuvarda mikroorganizmaların hızlı tespitinde önemli başarı sağlayanMALDI-TOF sistemlerinin antibiyotik duyarlılık testlerinde de benzer başarı göstermesioldukça ümit vericidir. Ancak OXA-48 pozitif kökenlerin saptanmasını kolaylaştıracak farklıprotokollerin geliştirilmesi gereklidir. MALDI-TOF sistemleri ile kısa sürede, düşük maliyetlekarbapenemaz üretiminin tespit edilmesi özellikle salgınların çok daha kısa sürede kontrol altınaalınmasında önemli katkı sağlayacaktır.Publication Metadata only Investigation of Carbapenemases in Carbapenem-Resistant Escherichia coli and Klebsiella pneumoniae Strains Isolated in 2014 in Turkey(ANKARA MICROBIOLOGY SOC, 2016) HASDEMİR GÖKBOĞA, MÜNEVVER UFUK; Cakar, Asli; Akyon, Yakut; Gur, Deniz; Karatuna, Onur; Ogunc, Dilara; Baysan, Betil Ozhak; Coplu, Nilay; Cagatay, Mustafa; Kilic, Abdullah; Baysallar, Mehmet; Bakici, Zahir; Celik, Cem; Gulay, Zeynep; Aydemir, Sohret; Tunger, Alper; Kilic, Huseyin; Ercal, Baris Derya; Toraman, Zulal Asci; Zer, Yasemin; Buyuktas, Ayse; Ay, Selma; Aktas, Zerrin; Kayacan, Cigdem; Bayramoglu, Gulcin; Aydin, Faruk; Dundar, Devrim; Hasdemir, Ufuk; Ayas, Ramazan; Yanik, Keramettin; Gunaydin, Murat; Guducuoglu, Huseyin; Parlak, MehmetCarbapenems are the choice of treatment in infections caused by multidrug resistant Enterobacteriaceae. In recent years carbapenem-resistant Enterobacteriaceae isolates due to carbapenemases have been increasingly reported worldwide. Multicenter studies on carbapenemases are scarce in Turkey. The aim of this study was to determine the distribution of carbapenemases from different parts of Turkey as a part of the European Survey of Carbapenemase Producing Enterobacteriaceae (EuSCAPE) project. Beginning in November 2013, carbapenem-resistant isolates resistant to at least one of the agents, namely imipenem, meropenem, and ertapenem were sent to the coordinating center. Minimum inhibitory concentrations for these carbapenems were determined by microdilution tests following EUCAST guidelines. Production of carbapenemase was confirmed by combination disk synergy tests. Types of carbapenemases were investigated using specific primers for VIM, IMP; NDM, KPC and OXA-48 genes by multiplex polymerase chain reaction. In a six month period, 155 suspected carbapenemase-positive isolates were sent to the coordinating center of which 21 (13.5%) were E.coli and 134 (86.5%) were K.pneumoniae. Nineteen (90.5%) strains among E.coli and 124 (92.5%) strains among K.pneumoniae were shown to harbour at least one carbapenemase gene by molecular tests, with a total of 92.3% (143/155). Carbapenemases were determined as a single enzyme in 136 strains (OXA-48: 84.6%; NDM: 6.3%; VIM: 2.8%; IMP: 1.4%) and as a combination in seven isolates (OXA-48 + NDM: 2.1%; OXA-48 + VIM: 2.1%; VIM + NDM: 0.7%). KPC was not detected in any of the isolates. According to the microdilution test results, resistance to imipenem, meropenem and ertapenem in OXA-48 isolates were 59.5%, 52.9% and 100%, respectively. The combination disk synergy test was 100% compatible with the molecular test results. As most of the OXA-48 producing isolates were susceptible to meropenem but all were resistant to ertapenem, ertapenem seems to be the most sensitive agent in screening carbapenemases in areas where OXA-48 is prevalent and phenotypic combination tests can be useful in centers where molecular tests are not available.Publication Open Access Disseminated Flavimonas oryzihabitans Infection in a Diabetic Patient Who Presented with Suspected Multiple Splenic Abscesses(1997-08) HASDEMİR GÖKBOĞA, MÜNEVVER UFUK; Kirtş, Serhan; Över, Ufuk; Babacan, Funda; Lawrence, Roger; Korten, VolkanPublication 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 Open Access The changing nature of aminoglycoside resistance mechanisms and prevalence of newly recognized resistance mechanisms in Turkey(BLACKWELL SCIENCE LTD, 2001-09) HASDEMİR GÖKBOĞA, MÜNEVVER UFUK; Over, U; Gur, D; Unal, S; Miller, GHObjective, To determine the most frequently. occurring individual and combined resistance mechanisms, in Gram-negative bacteria resistant to any of the clinically available aminoglycosides in Turkey, and to compare these mechanisms with those found in smaller, earlier studies. Methods Aminoglycoside resistance mechanisms in Gram-negative isolates, resistant to either gentamicin, tobramycin, netilmicin or amikacin collected in different regions of Turkey were evaluated both phenotypically and genotypically using 12 aminoglycosides, and up to 22 aminoglycoside resistance gene probes. Results Among 696 aminoglycoside-resistant Gram-negative bacteria, resistance rates were very high for gentamicin (94.5%), tobramycin (82.4%). netilmicin (53.6%), and amikacin (49.7%). Although isepamicin was the most active aminoglycoside, against Gram-negative bacteria, increased resistance (29.7%) was found and resistance rates were higher than those in most of the other countries surveyed in earlier studies. The most common aminoglycoside resistance mechanisms (AAC(3)-II (GTN), AAC(6)-I (TNA), and ANT(2)-I (GT)) in the earlier studies were also found in the present isolates of Klebsiella spp., Enterobacter spp. and Escherichia coli, with increased complexity. In addition to these old mechanisms, two new aminoglycoside resistance mechanisms, namely AAC(6)-III (TNAI) and AAC(6)-IV (GTNA), were also found at significant frequencies (11.9% and 26.9%, respectively) in these isolates of Enterobacteriaceae (n = 435). Among the isolates of Pseudomonas spp. (n = 150), in addition to the increased complexity of enzymatic resistance mechanisms (AAC(3)-I (16.6%), AAC(6')-II (29.3%), AAC(6)-III (19.3%), ANT(2)-I (40%)), permeability resistance seemed to be responsible for the high rates of resistance to, aminoglycosides. Conclusion The results of this. study indicated increased resistance to clinically available aminoglycosides, including isepamicin, even though it was, the most active, as a result of both the presence of new aminoglycoside resistance mechanisms and the increased, complexity of all mechanisms, including permeability resistance, particularly in Pseudomonas in Turkey.Publication Metadata only The relationship between macrolide resistance mechanisms and serotypes of streptococcus pneumoniae(2012-01-01) AKSU, MEHMET BURAK; HASDEMİR GÖKBOĞA, MÜNEVVER UFUK; Tiryakioglu N., AKSU M. B., HASDEMİR GÖKBOĞA M. U.Objective: Increased resistance rate to macrolides used as empirical treatment of pneumococcal infections is a major problem in our country and all over the world. In our study, we aimed to determine macrolide resistance mechanisms of the erythromycin-resistant Streptococcus pneumonia isolated from clinical samples and to investigate serotype and resistance relationship within our region with the high macrolide resistance rates among pneumococci.