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  • Küçük Resim Yok
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    Evaluation of antibiotic susceptibilities of enterococcus strains isolated from clinical samples of hospitalized patients
    (Refik Saydam National Public Health Agency (RSNPHA), 2018) Ödemiş, Ilker; Köse, Şükran; Ersan, Gürsel; çelik, Didem; Akbulut, Ilkay
    Objective: Enterococci can cause urinary tract infection, wound infection and bacteremia. It is one of the most commonly detected agents in hospitalacquired infections. Increasing resistance to antibiotics has been observed in enterococci in recent years. The distribution of enterococci isolated from cultures and antibiotic resistance may vary between health care centers, so it would be beneficial for each center to evaluate its own results at certain intervals. The aim of this study is to determine the antibiotic resistance rates of Enterococcus faecalis and Enterococcus faecium strains isolated from urine, blood, wound, sputum and cerebrospinal fluid (CSF) specimens of patients hospitalized in our hospital, such as ampicillin, gentamicin, streptomycin, ciprofloxacin, vancomycin, teicoplanin and linezolid. Methods: Between January 2010 and January 2015, 390 Enterococcus strains isolated from various clinical specimens of patients in Izmir Tepecik Training and Research Hospital were evaluated retrospectively. Identification and antibiotic susceptibility testing of the enterococci strains were performed by fully automated bacterial identification system VITEK-2 (bioMerieux, France). Vancomycin, teicoplanin and linezolid resistance was also tested by the E-test method (bioMerieux, Fransa). Susceptibility results were evaluated according to the guidelines of Clinical and Laboratory Standards Institute (CLSI). Results: A total of 390 strains were identified as follows; 154 (%40) were E. faecalis, 236 (%60) were E. faecium. Clinical specimens from which E. faecium strains were isolated were; 126 (53%) urine, 65 (27%) blood, 39 (17%) wound, 4 (2%) sputum and 2 (1%) CSF. Clinical specimens from which E. faecalis strains were isolated were; 77 (50%) urine, 50 (33%) blood, 22 (14%) wound, 3 (2%) sputum and 2 (1%) CSF. Linezolid was the most sensitive antibiotic against both E. faecalis and E. faecium strains, Ampicillin was the most resistant antibiotic for both E. faecalis and E. faecium strains. Conclusion: In our study; the detection of high ampicillin, vancomycin and teicoplanin resistance in both E. faecalis and E. faecium strains is considered to be a data that should be taken into consideration in the selection of empirical antibiotics for these strains. © 2018 Refik Saydam National Public Health Agency (RSNPHA).; Amaç: Enterokoklar idrar yolu yara yeri enfeksiyonlari ile bakteriyemiye neden olabilmektedir. Hastane kökenli enfeksiyonlarda en sik saptanan etkenlerden birisidir. Enterokoklarda son yillarda antibiyotiklere karşi artan oranda direnç gözlenmektedir. Kültürlerden izole edilen enterokoklarin dağilimi ve antibiyotik direncinin sağlik bakim merkezleri arasinda değişebildiği, bu nedenle de merkezin kendi sonuçlarini belli araliklarla değerlendirmesinin faydali olacaği düşünülmüştür. Bu çalişmanin amaci hastanemizde yatan hastalarin idrar, kan, yara, balgam ve beyin omurilik sivisi (BOS) örneklerinden izole edilen Enterococcus faecalis ve Enterococcus faecium suşlarinin ampisilin, gentamisin, streptomisin, siprofloksasin, vankomisin, teikoplanin ve linezolid gibi antibiyotiklere direnç oranlarini belirlemektir. Yöntem: Ocak 2010 - Ocak 2015 arasinda Izmir Tepecik Eğitim ve Araştirma Hastanesinde yatan hastalarin çeşitli klinik örneklerinden izole edilen 390 enterokok suşu retrospektif olarak değerlendirilmiştir. Suşlarin identifikasyonu ve antibiyotik duyarliliklari; tam otomatize bakteri tanimlama sistemi VITEK-2 (bioMerieux, Fransa) ile çalişilmistir. Vankomisin, teikoplanin ve linezolid duyarliliklari E-test (bioMerieux, Fransa) ile de test edilmiştir. Duyarlilik sonuçlari ise Clinical and Laboratory Standarts Institute (CLSI) kriterleri esas alinarak belirlenmiştir. Bulgular: Identifiye edilen toplam 390 susun 154 (%40)'ü E. faecalis, 236 (%60)'si E. faecium olarak tanimlandi. E. faecium suşlarinin izole edildikleri klinik örnekler sirasiyla; 126 (%53)'si idrar, 65 (%27)'i kan, 39 (%17)'u yara yeri, 4 (%2)'ü balgam ve 2 (%1)'si BOS'dur. E. faecalis suşlarinin izole edildikleri klinik örnekler ise 77 (%50)'si idrar, 50 (%33)'si kan, 22 (%14)'si yara yeri, 3 (%2)'ü balgam ve 2 (%1)'si ise BOS'dur. E. faecalis ve E. faecium suşlarinin her ikisi için en duyarli bulunan antibiyotik linezolid'dir. Hem E. faecalis hem de E. faecium için en dirençli antibiyotiğin ampisilin olduğu saptandi. Sonuç: çalişmamizda hem E. faecalis hem de E. faecium suşlarinda ampisilin, vankomisin ve teikoplanin direncinin yüksek saptanmasi, bu suşlara yönelik ampirik antibiyotik seçiminde dikkate alinmasi gereken bir veri olduğu düşünülmektedir. © 2018 Refik Saydam National Public Health Agency (RSNPHA).
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    Seroprevalence of measles, mumps, rubella, and varicella zoster virus antibodies among healthcare students: analysis of vaccine efficacy and cost-effectiveness
    (Sociedad Espanola Quimioterapia, 2019) Odemis, Ilker; Kose, Sukran; Akbulut, Ilkay; Albayrak, Hazal
    Introduction. The aims of this study are to determine the seroprevalence for measles, mumps, rubella, and varicella zoster virus (VZV) in a cohort of nursing students, to evaluate vaccination response rates of nonimmune students, and to calculate the cost of vaccinating students based on seroprevalence screening. Material and methods. A cross-sectional study was conducted August 2015-November 2016 among 326 healthy nursing students aged 14.1-18.1 years. Serum IgG antibodies were measured by ELISA. Results were analyzed by the Chi-square test; a p-value of < 0.05 was considered statistically significant. Results. The number of seropositive participants (%) was 308 (94.5%) for rubella, 295 (90.5%) for VZV, 244 (74.9%) for measles, and 219 (67.2%) for mumps. A significant correlation was found between measles IgG and age. A relationship was also observed between VZV IgG and kindergarten attendance. Response rates to measles, rubella, VZV, and mumps vaccination were 96%, 92.3%, 87.5%, 78.8%, respectively. The total cost of vaccination after IgG screening was less than vaccination without screening. Conclusions. In this study, participants' immunity to measles and VZV was low. Prevaccination serological screening was cost-effectiveness method for preventing measles, mumps, rubella, and varicella infections. We believe that administering booster measles, mumps, and rubella (MMR) vaccine doses or developing a special MMR vaccination strategy for at-risk groups may prevent MMR outbreaks.