Browsing by Author "Kilbas, Imdat"

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Citation - WoS: 0
Investigation of the Synergic Effect of the Colistin/Sulbactam Combination in Carbapenem-Resistant acinetobacter Baumannii Complex Strains With Time-Kill and Checkerboard Methods
(Bilimsel Tip Yayinevi, 2021) Kahraman Kılbaş, Elmas Pınar; Hatipoglu, Huseyin; Kilic, Umit; Kahraman Kilbas, Elmas Pinar; Koroglu, Mehmet; Altindis, Mustafa; Tıbbi Hizmetler ve Teknikler Bölümü
Introduction: Infections caused by carbapenem-resistant Acinetobacter strains have become very common in recent years, and the most frequently used medicinal treatment is colistin. Combination treatments should also be applied to prevent development of resistance to colistin. This study examines the in vitro synergic effect of the colistin/sulbactam combination in carbapenem-resistant Acinetobacter strains with the time-kill and checkerboard methods. Materials and Methods: Twenty carbapenem-resistant Acinetobacter baumannii-calcoaceticus complex strains, which were isolated from various clinical samples, were included in this study. Strains were identified with mass spectrometry, and antibiotic sensitivity results were determined with the VITEK 2 (R) system. The in vitro effect and synergic activity of the colistin, sulbactam, and colistin/sulbactam combination on the carbapenem-resistant strains were determined using the time-kill and checkerboard methods. Seventeen strains were examined with the time-kill method, and twenty strains were examined using the checkerboard method. The fractional inhibitory concentration index of strains was calculated for detection of synergic effect. Results: Using the time-kill method applied on the colistin/sulbactam combination showed that the combination had a synergic effect on all 17 strains, while sulbactam alone did not have a bactericidal effect in the studied concentrations. When applying the checkerboard method, it was determined that the colistin/sulbactam combination had a synergic effect on 17 of the strains (85%) and an additive effect on 3 strains (15%), sulbactam had a low effect alone (15%), and colistin was effective on all strains. Conclusion: Study results indicated that the colistin/sulbactam combination had a high level of synergic effect on all studied strains using both methods.
Citation - WoS: 0
Molecular Characterization of Resistance and Virulence Genes in Enterococcus Faecium Strains Isolated Between 2000-2021; Systematic Review
(Bilimsel Tip Yayinevi, 2022) Kahraman Kılbaş, Elmas Pınar; Kilbas, Imdat; Ciftci, Ihsan Hakki; Tıbbi Hizmetler ve Teknikler Bölümü
Introduction: The spread of Vancomycin-Resistant Enterococci (VRE) is a major threat in healthcare institutions, especially for patients in the risk group. The aim of this study is to reveal the antibiotic resistance genes, virulence genes and other accompanying factors detected in vancomycin resistant Enterococcus faecium strains isolated from various clinical specimens in different parts of Turkiye. Material and Methods: For this purpose, a systematic search was carried out using different electronic databases between January 2000 and September 2021. A total of 17 studies were evaluated within the scope of systematic review. Results: The vanA gene was detected the most between the years 2000-2007, and no statistically significant difference was found according to the years. The prevalence of the vanB gene was highest between 2008 and 2013, and no statistical difference was found according to the years (p> 0.05). The vanA gene was mostly detected in Eastern Anatolia, Black Sea, Mediterranean and Aegean, vanB Central Anatolia and Southeastern Anatolia regions. No reports related to the vanC gene were found. Since all strains were E. faecium in our study, it is an expected finding that the vanC gene region was never reported. The esp and hyl gene between 2014-2021. Conclusion: The prevalence of resistance and virulence genes among bacteria is a matter of great concern, limiting treatment options. In particular, effective measures should be taken to prevent healthcare-associated VRE infections, and each institution should report its own resistance data.
Citation - WoS: 4
Citation - Scopus: 4
Molecular Epidemiology of Carbapenem-Resistant Acinetobacter Baumannii Isolates in Turkiye: Systematic Review
(Kare Publ, 2023) Kahraman Kılbaş, Elmas Pınar; Kilbas, Imdat; Ciftci, Ihsan Hakki; Tıbbi Hizmetler ve Teknikler Bölümü
The World Health Organization has designated carbapenem-resistant Acinetobacter baumannii (CRAB) as a "critical" pathogen on the global priority list of antibiotic-resistant bacteria. This study aims to discuss the molecular epidemiology of CRAB isolates in Turkiye in the last 12 years and the prevalence of gene regions associated with resistance or pathogenesis using a systematic review method. Our study consists of a literature search, determination of eligibility and exclusion criteria, qualitative analysis of studies, data extraction, and statistical analysis. All studies were analyzed according to the Preferred Reporting Items for Systematic Reviews and Meta-Analysis Guidelines. The incidence rates of blaOXA-23, blaOXA-23-like, blaOXA-24/40, blaOXA-24/40-like, blaOXA-51, blaOXA-51-like, blaOXA-58, and blaOXA-58-like genes in CRAB strains were 76.4%, 68.6%, 1.2%, 3.4%, 97.0%, 98.6%, 8.4%, and 17.1%, respectively. It was determined that the prevalence of the blaOXA-23 and blaOXA-58 gene regions showed a statistically significant change over the years. Due to the high prevalence of A. baumannii strains carrying the blaOXA-23 variant, it is necessary to follow its geographical distribution and transposon and plasmid movements. Based on available data, molecular surveillance of CRAB strains should be standardized. In addition, sterilization and disinfection processes applied within the scope of an effective struggle against CRAB strains that can remain live on surfaces for a long time should be reviewed frequently.
Citation - WoS: 0
Prevalence of Colistin-Resistant Klebsiella Pneumoniae Isolates in Turkey Over a 20-Year Period: a Systematic Review and Meta-Analysis
(Mdpi, 2025) Kilbas, Elmas Pinar Kahraman; Kilbas, Imdat; Ciftci, Ihsan Hakki
Klebsiella pneumoniae is one of the leading causes of healthcare-associated infections and poses challenges in its treatment owing to its high antibiotic resistance. The development of resistance to colistin, which is used as a last resort, has become a major public health problem worldwide. This study was planned according to the PRISMA guidelines and included studies reporting the prevalence of colistin-resistant K. pneumoniae in Turkey between 2004 and 2024 through a systematic literature review. A total of 28 original research articles were included in the meta-analysis. Data were analyzed using the SPSS and CMA software. The pooled colistin resistance of a total of 8916 K. pneumoniae strains from 28 studies included in this meta-analysis was found to be 1.63% (95% CI: 1.51-3.12). Colistin resistance increased significantly over time. A higher resistance rate was detected in the strains tested using the EUCAST guidelines and broth microdilution method. The year of the study and validation methods contributed to the heterogeneity observed in the studies. This meta-analysis reveals that colistin-resistant K. pneumoniae strains have increased over time in Turkey. Current data show that colistin resistance is not only a laboratory finding but has become a crisis, requiring urgent action in terms of hospital infection management and patient safety. Regional and global measures should be taken to ensure the appropriate use of antibiotics to control the development of resistance.
Citation - WoS: 0
Citation - Scopus: 0
Seroprevalence of coxiella Burnetii in Human and Animal Populations in Tiirkiye: Meta-Analysis
(Kafkas Univ, veteriner Fakultesi dergisi, 2023) Kahraman Kılbaş, Elmas Pınar; Kahraman Kilbas, Elmas Pinar; Ciftci, Ihsan Hakki; Tıbbi Hizmetler ve Teknikler Bölümü
This study aims to reveal Coxiella burnetii by examining the studies reporting Q fever seroprevalence in humans and animals in the last 25 years in Turkiye. In this study, based on PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses), various databases were searched between January 1997 and October. 2022. A literature review was carried out using data analyses performed using the IBM SPSS Version 25.0 statistical package program and Comprehensive Meta-Analysis (CMA) program. Overall prevalence of C. burnetii in humans was 22.78% (95% CI: 16.43%-29.12%), overall prevalence in animals was 13.49% (95% CI: 10.04-16.93%) was detected. The mean prevalence of C. burnetii in sheep was 19.1%+/- 10.88, 10.46 +/- 6.39% in cattle, 15.21 +/- 10.01% in studies including cattle and sheep together, 11.17 +/- 10.74 in cattle, sheep and goats, and 12.4%+/- 1.15% in sheep and goats. As a result of this study, it was determined that the prevalence of Q fever in humans in Turkiye is high in those dealing with animals, women who had a miscarriage, and infertile individuals. Although it is known that this disease is seen in Turkiye, there are not enough case reports in the literature. Detailed studies on Q fever in humans and animals need to be conducted. Further studies are needed to evaluate Q fever risk factors and prevalence data together within the scope of One Health approach.
Citation - WoS: 0
Citation - Scopus: 0
Seroprevalence of Torch Viral Agents in Pregnant Women in Turkey: Systematic Review and Meta-Analysis
(Mdpi, 2025) Kilbas, Elmas Pinar Kahraman; Ciftci, Ihsan Hakki; Kilbas, Imdat; Toptan, Hande
Rubella Virus, Cytomegalovirus (CMV), Herpes Simplex Virus-2 (HSV-2), Hepatitis B (HBV) and Hepatitis C virus (HCV) can cause serious fetal disease. The seropositivity rates of these agents vary among countries and geographic regions. This study aimed to analyze the prevalence rates and diagnostic methods used in studies investigating the seroprevalence of viral pathogens in the TORCH group among pregnant women in Turkey between 2005 and 2024. A systematic search was conducted using electronic databases between January 2005 and January 2024. A total of 60 studies meeting the inclusion criteria were included. Data quality control was assessed using the Joanna Briggs Institute guideline prevalence studies checklist. Heterogeneity was measured using the I-squared (I-2) statistic in the Comprehensive Meta Analysis (CMA) program. The average seropositivity rates for Rubella, CMV, HSV-2, HBV and HCV in Turkey were determined as 91.18%, 94.81%, 35.52%, 1.66% and 0.25%, respectively. When the diagnostic methods were examined, it was determined that ELISA and ECLIA methods were used most frequently. The seropositivity of the agents did not show statistically significant differences according to the year periods, geographical regions and age of the patients (p > 0.05). The highest prevalence rates of Rubella and HSV-2 in pregnant women were reported in the Mediterranean region, the highest prevalence rates of CMV and HCV in the Southeastern Anatolia region and the highest seroprevalence of Anti HBs in the Marmara region. The results of this study support the necessity of increasing public awareness in the control of fetal infection caused by TORCH viral agents, prenatal screening, vaccination for Rubella and HBV and compliance with hygiene conditions for agents such as CMV, HSV-2 and HCV. The results of this study highlight the need to increase public awareness on prenatal screening for the control of fetal infection caused by all TORCH viral agents, vaccination for Rubella and HBV and compliance with hygiene conditions for agents such as CMV, HSV-2 and HCV.
Citation - WoS: 1
Citation - Scopus: 1
A Systematic Review and Meta-Analysis of Molecular Characteristics on Colistin Resistance of acinetobacter Baumannii
(Mdpi, 2024) Kahraman Kılbaş, Elmas Pınar; Kilbas, Elmas Pinar Kahraman; Kilbas, Imdat; Tıbbi Hizmetler ve Teknikler Bölümü
Background: This study aimed to determine the molecular epidemiology of colistin-resistant A. baumannii in the last ten years and the frequency of gene regions related to pathogenesis, to compare the methods used to detect genes, and to confirm colistin resistance. Methods: This meta-analysis study was conducted under Preferred Reporting Items for Systematic Reviews and Meta-Analysis Guidelines. In the meta-analysis, research articles published in English and Turkish in electronic databases between January 2012 and November 2023 were examined. International Business Machines (IBM) Statistical Package for the Social Sciences (SPSS) Statistics for Macbook (Version 25.0. Armonk, NY, USA) was used for statistical analysis. The Comprehensive Meta-Analysis (CMA) (Version 3.0. Biostat, NJ, USA) program was used for heterogeneity assessment in the articles included in the meta-analysis. Results: After evaluating the studies according to the elimination criteria, 18 original articles were included. Among colistin-resistant strains, blaOXA-51 positivity was 243 (19.61%), blaOXA-23 was 113 (9.12%), blaOXA-58 was 7 (0.56%), blaOXA-143 was 15 (1.21%), and blaOXA-72 was seen in two (0.16%) strains. The positivity rates of pmrA, pmrB, and pmrC were found to be 22 (1.77%), 26 (2.09%), and 6 (0.48%). The mcr-1 rate was found to be 91 (7.34%), the mcr-2 rate was 78 (6.29%), and the mcr-3 rate was 82 (6.61%). Conclusions: The colistin resistance rate in our study was found to be high. However, only some research articles report and/or investigate more than one resistance gene together. Additionally, it may be challenging to explain colistin resistance solely by expressing resistance genes without discussing accompanying components such as efflux pumps, virulence factors, etc.
Citation - WoS: 1
The War Against the Resistance of acinetobacter Baumannii: a Meta-Analysis of Findings in Turkiye
(Erciyes Univ Sch Medicine, 2022) Kahraman Kılbaş, Elmas Pınar; Kilbas, Imdat; Kilbas, Elmas Pinar Kahraman; Tıbbi Hizmetler ve Teknikler Bölümü
Objective: Bacterial resistance to antibiotics continues to be a significant challenge to the global health system. This study was designed to examine changes in the antibiotic resistance of Acinetobacter baumannii (A. baumannii) strains isolated from various clinical samples taken between 2005 and 2020 and to support the development of new antibiotics policies for empirical treatment of multidrug-resistant isolates in Turkiye. Materials and Methods: This meta-analysis included a data search phase, determination of eligibility criteria, qualitative analysis of the studies selected, data extraction, and statistical analyses. All of the data were analyzed according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement. Results: According to Clinical and Laboratory Standards Institute and/or European Committee on Antimicrobial Susceptibility Testing standards and a random effects model, the breakpoint estimate of A. baumannii strain resistance in Turkiye for ampicillin-sulbactam, ceftazidime, imipenem, meropenem, gentamicin, amikacin, ciprofloxacin, piperacillin-tazobactam, trimethoprim-sulfamethoxazole, netilmicin, colistin, and tigecycline was 90.7%, 92.1%, 86.8%, 87.3%, 72.6%, 63.7%, 88%, 91.2%, 76.7%, 27.1%, 7.9%, and 18.5%, respectively. Conclusion: The reported rates of A. baumannii resistance from different regions demonstrated heterogeneity. Unfortunately, the use of standard antibiotics is unlikely to provide effective therapy throughout Turkiye. New therapy options and protocols are needed.