WoS İndeksli Yayınlar Koleksiyonu
Permanent URI for this collectionhttps://hdl.handle.net/20.500.14627/6
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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.Review Citation - WoS: 3The War Against the Resistance of <i>acinetobacter Baumannii</I>: a Meta-Analysis of Findings in Turkiye(Erciyes Univ Sch Medicine, 2022) Ciftci, Ihsan Hakki; Kilbas, Imdat; Kilbas, Elmas Pinar KahramanObjective: 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.Review Molecular Characterization of Resistance and Virulence Genes in Enterococcus Faecium Strains Isolated Between 2000-2021; Systematic Review(Bilimsel Tip Yayinevi, 2022) Kahraman Kilbas, Elmas Pinar; Kilbas, Imdat; Ciftci, Ihsan Hakki; Kılbaş, Elmas Pınar KahramanIntroduction: 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.