WoS İndeksli Yayınlar Koleksiyonu
Permanent URI for this collectionhttps://hdl.handle.net/20.500.14627/6
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Review Citation - WoS: 6Citation - Scopus: 7Molecular Epidemiology of Carbapenem-Resistant Acinetobacter Baumannii Isolates in Turkiye: Systematic Review(Kare Publ, 2023) Kilbas, Elmas Pinar Kahraman; Kilbas, Imdat; Ciftci, Ihsan Hakki; Kahraman Kilbas, Elmas PinarThe 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.Review Citation - WoS: 2Citation - Scopus: 2A Systematic Review and Meta-Analysis of Molecular Characteristics on Colistin Resistance of <i>acinetobacter Baumannii</I>(Mdpi, 2024) Ciftci, Ihsan Hakki; Kilbas, Elmas Pinar Kahraman; Kilbas, Imdat; Kahraman Kilbas, Elmas PinarBackground: 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.Article Investigation of the Synergic Effect of the Colistin/Sulbactam Combination in Carbapenem-Resistant <i>acinetobacter Baumannii</I> Complex Strains With Time-Kill and Checkerboard Methods(Bilimsel Tip Yayinevi, 2021) Kilbas, Imdat; Hatipoglu, Huseyin; Kilic, Umit; Kahraman Kilbas, Elmas Pinar; Koroglu, Mehmet; Altindis, Mustafa; Kılbaş, Elmas Pınar KahramanIntroduction: 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.