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Öğe ANTIMICROBIAL RESISTANCE PROFILE OF ESCHERICHIA COLI CAUSING BACTEREMIA IN PATIENTS IN INTENSIVE CARE UNITS(Carbone Editore, 2015) Durmaz, Suleyman; Kiraz, Asli; Percin, Duygu; Doganay, MehmetAims: A crucial mechanism of antibiotic resistance of Escherichia coli (E.coli), a member of gram-negative bacteria that cause infections in intensive care units (ICUs), is beta-lactamase production. This study aims to determine extended-spectrum beta-lactamase (ESBL) production frequency and antibiotic resistance profile of E.coli strains isolated from blood cultures of adult patients in different intensive ICUs at Erciyes University-Kayseri, Turkey. Materials and methods: This study includes only one E.coli strain per patient. Antibiotic susceptibility test of 81 E.coli strains were performed using Kirby-Bauer disk diffusion method. ESBL-production was determined using double-disk synergy test. Results: A total of 58 (72%) strains were isolated from patients in internal ICUs while 23 (28%) strains were isolated from patients in surgical ICUs. A total of 44 (54.3%) strains were found to produce ESBL with ESBL-production rate of 55.2% in internal ICUs and 52.2% in surgical ICUs. Difference between the presence of ESBL-producing E.coli in male and female patients in ICUs is not statistically significant. 8 (9.8%), 46(56.8%), 69 (85.2%), 22 (27.2%), and 44 (543%) and zero strains were resistant to amikacine, ciprofloxacine, ampicillin, piperacillin-tazobactam, cefotaxime, and imipenem, respectively, and no strains were resistant to imipenenm. Resistance to amikacin, ciprofloxacin, ampicillin and cefotaxime in ESBL producing strains were significantly higher than ESBL non-producing strains (p<0.05). Piperacillin-tazobactam resistance ratio for E.coli strains isolated from surgical ICUs was found to be significantly greater than those isolated from internal ICUs (p<0.05). Despite higher ratios of ESBL-production of E.coli strains, carbapenem resistance was not gratifyingly determined in the ICUs. Conclusion: Early diagnosis and immediate treatment of nosocomial bacteremia are important for patients' survival. Therefore, monitoring antibiotic susceptibility profiles of isolated microorganisms will guide clinicians for controlling infections.Öğe Antimicrobial resistance profile of Escherichia coli causing bacteremia in patients in intensive care units(Acta Medica Mediterranea, 2015) Durmaz, Suleyman; Kiraz, Asli; Percin, Duygu; Doganay, MehmetAims: A crucial mechanism of antibiotic resistance of Escherichia coli (E.coli), a member of gram-negative bacteria that cause infections in intensive care units (ICUs), is beta-lactamase production. This study aims to determine extended-spectrum betalactamase (ESBL) production frequency and antibiotic resistance profile of E.coli strains isolated from blood cultures of adult patients in different intensive ICUs at Erciyes University-Kayseri, Turkey. Materials and methods: This study includes only one E.coli strain per patient. Antibiotic susceptibility test of 81 E.coli strains were performed using Kirby-Bauer disk diffusion method. ESBL-production was determined using double-disk synergy test. Results: A total of 58 (72%) strains were isolated from patients in internal ICUs while 23 (28%) strains were isolated from patients in surgical ICUs. A total of 44 (54.3%) strains were found to produce ESBL with ESBL-production rate of 55.2% in internal ICUs and 52.2% in surgical ICUs. Difference between the presence of ESBL-producing E.coli in male and female patients in ICUs is not statistically significant. 8 (9.8%), 46 (56.8%), 69 (85.2%), 22 (27.2%), and 44 (54.3%) and zero strains were resistant to amikacine, ciprofloxacine, ampicillin, piperacillin-tazobactam, cefotaxime, and imipenem, respectively, and no strains were resistant to imipenenm. Resistance to amikacin, ciprofloxacin, ampicillin and cefotaxime in ESBL producing strains were significantly higher than ESBL non-producing strains (p<0.05). Piperacillin-tazobactam resistance ratio for E.coli strains isolated from surgical ICUs was found to be significantly greater than those isolated from internal ICUs (p<0.05). Despite higher ratios of ESBL-production of E.coli strains, carbapenem resistance was not gratifyingly determined in the ICUs. Conclusion: Early diagnosis and immediate treatment of nosocomial bacteremia are important for patients' survival. Therefore, monitoring antibiotic susceptibility profiles of isolated microorganisms will guide clinicians for controlling infections.Öğe In Vitro Evaluation of Antimicrobial Activity of Esmolol(Colegio Farmaceuticos Provincia De Buenos Aires, 2016) Kiraz, Asli; Kiraz, Hasan AliContamination of drugs is an important issue and may occur during the production, preparation and treatment process. Esmolol is a specific cardioselective beta-1-blocker without preservative used in clinical practice. In this study, it was decided to evaluate whether esmolol itself has antimicrobial activity in vitro. Antimicrobial activity of esmolol was determined by using the broth macrodilution method against bacterial strains Escherichia coli (ATCC 25922), Staphylococcus aureus (ATCC 25923), Staphylococcus epidermidis (ATCC 1490) and Pseudomonas aeruginosa (ATCC 27853) in both 25 degrees C and 37 degrees C. Esmolol had no antimicrobial effect on S. aureus, S. epidermidis, E. coli and P. aeruginosa at any concentration and temperature. The lack of antimicrobial activity of esmolol is a risk for microbial growth. Therefore, infusion bags of esmolol should not be allowed to stand at room temperature for a long time and storage conditions should be monitored rigorously. It will be protective to administer drugs to patients preferably by infusion pumps instead of syringe pumps against possible contamination.Öğe L-carnitine has a protective effect on the colonic mucosa during abdominopelvic radiotherapy in rats(Acta Cirurgica Brasileira, 2016) Tas, Sukru; Ozkan, Omer Faruk; Cikman, Oztekin; Kiraz, Asli; Akgun, Yilmaz; Karaayvaz, MuammerPURPOSE: To evaluate histopathologically the radioprotective effect of L-carnitine on the colonic mucosa in rats undergoing abdominopelvic irradiation. METHODS: Thirty-two rats were randomly assigned to four experimental groups: intraperitoneal administration of normal saline (group 1) or L-carnitine (300 mL/kg; group 2), followed in groups 3 and 4, respectively, by one dose of abdominopelvic radiation (20 Gy) 30 min later. Rats were sacrificed 5 days after radiation, and their descending colons were resected for histopathological evaluation of the presence and severity of damage. RESULTS: Average damage scores did not differ significantly between groups 1 and 2 (0.13 +/- 0.35 and 0.25 +/- 0.46, respectively); the group 3 score was highest (10.25 +/- 0.71), and the group 4 score (3.63 +/- 1.41) was significantly lower than that of group 3 (both p = 0.0001). Pre-radiation L-carnitine administration significantly reduced mucosal thinning, crypt distortion, reactive atypia, inflammation, cryptitis, and reactive lymph-node hyperplasia (all p < 0.01). CONCLUSIONS: L-carnitine had a radioprotective effect on rat colonic mucosa. L-carnitine use should be explored for patients with gastrointestinal cancer, who have reduced serum L-carnitine levels.Öğe Macrolide-Lincosamide-Streptogramin B Resistance Phenotypes in Staphylococcus Aureus(Modestum Ltd, 2014) Durmaz, Suleyman; Kiraz, Asli; Ozer, Turkan Toka; Percin, DuyguStaphylococcus aureus is one of the most frequently isolated pathogens in community and hospital-acquired infections. Macrolidelincosamide- streptogramin B (MLSB) group antibiotics have frequently been preferred. In this study, it was aimed to determine MLSB group antibiotics resistance phenotypes observed in S. aureus strains. A total of 182 S. aureus strains were included in the study. Methicillin resistance was assessed using the cefoxitin (30 mu g) disc, MLSB resistance phenotypes were assessed using D zone test with erythromycin (15 mu g mu) and clindamycin (2 mu g) discs according to the Clinical and Laboratory Standards Institute (CLSI) recommendations. Of the strains included in the study, 38 (20.9%) methicillin-resistant S. aureus (MRSA) and 144 (79.1%) methicillin-susceptible S. aureus (MSSA) were identified. MLSB resistance phenotype was found in 65 (35.7%) strains. MLSB resistance was found 84% in MRSA strains and 23% in MSSA strains: There was statistically significant between MRSA and MSSA strains. Constitutional MLSB resistance was found higher in MRSA strains (71%) and however, in MSSA strains was higher inducibleMLSB resistance (16.5%). It is suggested that, using the D test method in routine antibiotic susceptibility testing and determining resistance phenotypes in microbiology laboratories is the right approach and may play an important role in the prevention of treatment failure according to the substantial proportion of inducible resistance MLSB resistance observed.Öğe MANAGEMENT OF FLAP DEHISCENCE AFTER LIMBERG PROCEDURE FOR RECURRENT PILONIDAL DISEASE BY NEGATIVE PRESSURE WOUND THERAPY (NPWT)(Colegio Brasileiro Cirurgia Digestiva-Cbcd, 2017) Tas, Sukru; Ozkan, Omer Faruk; Ocakli, Muzaffer Muazzez; Arslan, Emrah; Kiraz, Asli; Karaayvaz, Muammer[Anstract Not Available]Öğe Same-day Detection of Methicillin Resistance in Staphylococcus aureus Isolates by StaResMet® Kit(Ahvaz Jundishapur Univ Med Sci, 2017) Sezgin, Fikriye Milletli; Vural, Ahmet; Kiraz, Asli; Cayci, Yeliz Tanriverdi; Coban, Cagri; Bozdogan, Bulent; Coban, Ahmet YilmazBackground: Staphylococcus aureus is an important cause of hospital-acquired infections. The most important issue with S. aureus is that the isolates are getting increasingly methicillin-resistant. Rapid differentiation between methicillin-resistant and methicillin-susceptible S. aureus species is necessary to optimize treatment and minimize costs. Objectives: The current study aimed at evaluating the StaResMet (R) kit for rapid detection of methicillin resistance in S. aureus isolates. Methods: A total of 217 methicillin-resistant S. aureus (MRSA) and 252 methicillin-susceptible S. aureus (MSSA) isolates were tested using the StaResMet (R) kit. The test was performed according to the manufacturer's instructions. Results: The kit identified the MRSA isolates with 100% accuracy, and found that the minimum inhibitory concentrations (MICs) was > 32 mu g/mL cefoxitin for 133 of the isolates, 32 mu g/mL cefoxitin for 49, 16 mu g/mL cefoxitin for 8, and 8 mu g/mL cefoxitin for 11 of the isolates. Likewise, all 177 MSSA isolates were correctly identified using the kit, and the MICs against them were determined within the range of 1 to 4 mu g/mL cefoxitin. The MIC of cefoxitin can be determined in 6 hours using the StaResMet (R) kit. Conclusions: The obtained results indicated that the StaResMet (R) kit allowed the detection of MRSA isolates rapidly and reliably, and could be a valuable tool for microbiology laboratories with limited facilities. Authors believed that the routine use of this timesaving and easy-to-use test contributes to rapid clinical diagnoses and treatments.Öğe The effect of amifostine on bacterial translocation after radiation induced acute enteritis(Acta Cirurgica Brasileira, 2016) Tas, Sukru; Ozkul, Faruk; Arik, Muhammet Kasim; Kiraz, Asli; Vural, AhmetPURPOSE: To investigate the effects of amifostine on bacterial translocation and overgrowth in colonic flora after acute radiation enteritis in a rat model. METHODS: Thirty-two female Wistar albino rats were divided into four groups: Group-1 (n = 8): only normal saline was administered intraperitoneally. Group-2 (n = 8): first serum saline was administered intraperitoneally and 30 minutes later 20 Gy radiation was applied to abdominopelvic region. Group-3 (n = 8): only amifostine 200 ml/kg was administered intraperitoneally and radiation was not applied. Group-4 (n = 8): first amifostine 200 ml/kg was administered intraperitoneally and 30 minutes later 20 Gy radiation was applied to abdominopelvic region. On the 5th day after radiation, samples of mesenteric lymph tissues and cecal contents were taken by laparotomy for microbiological culture. RESULTS: Intraperitoneal amifostine administration significantly decreased the bacterial overgrowth related to radiation in colon but did not significantly decrease the bacterial translocation. CONCLUSION: Although not providing a full protection on the damaged mucosal barrier, amifostine significantly decreased the bacterial overgrowth in the cecal content after high dose radiation. There is a need to find out appropriate amifostine dose under different radiation applications avoiding bacterial translocation in gastrointestinal system.Öğe The effect of pycnogenol on lymphatic nodes and adhesion during in a peritoneal adhesion model in rats(Acta Cirurgica Brasileira, 2018) Goret, Ceren Canbey; Goret, Nuri Emrah; Kiraz, Asli; Ozkan, Omer Faruk; Karaayvaz, MuammerPurpose: To investigate the effects of pycnogenol on peritoneal adhesions and additionally to investigate the immunohistochemical effects of free oxygen radicals and reactive lymph nodes detected in the adhesive tissue that was sampled surrounding the cecum on intra-abdominal adhesions. Methods: Twenty-seven Wistar Albino rats were divided into three groups. In group 1 (sham), laparotomy was performed and stitched up. In group 2 (control), after laparotomy was performed, punctate hemorrhage was induced by cecal abrasion in the cecum and each rat was intraperitoneally administered 2 cc of saline. In group 3 (experimental), after laparotomy was performed, punctate hemorrhage was induced by cecal abrasion in the cecum and each rat was intraperitoneally administered a sterile Pycnogenol derivative. The rats in all groups were re-laparotomized on postoperative day 7; samples were obtained from the peritoneal tissue surrounding the cecum, and the rats were sacrificed. Results: In group 3, there was a statistically significant difference in terms of inflammation, lymph node size, and free oxygen radicals; these parameters tended to increase. In terms of fibrosis evaluated using H&E and MT, there was no significant difference between groups 2 and 3. Conclusions: No positive outcomes indicating that pycnogenol reduces intra-abdominal adhesions were obtained. However, it caused severe inflammation in the tissue. Moreover, a significant increase in lymph node size was detected secondary to inflammation. Additionally, in immunohistochemical analyses conducted to detect oxidative stress, pycnogenol increased the production of free oxygen radicals in the tissue.Öğe The Effect of Systemic Carnitine Administration on Colon Anastomosis Healing in an Experimental Sepsis Model(Taylor & Francis Inc, 2015) Ercan, Umut; Kiraz, Asli; Cikman, Oztekin; Turkon, Hakan; Kilinc, Nihal; Otkun, Muserref Tatman; Ozkan, Omer FarukAim: This study aimed to investigate the effects of L-carnitine, with its known antioxidant properties and positive effects on wound healing, on the healing of colon anastomosis in a cecal ligation and puncture sepsis model in rats.Materials and Methods: A total of 40 Sprague-Dawley rats were used. The rats were randomly divided into four groups of 10 (n = 10). Groups 1 and 2 had laparotomy and colon anastomosis performed. Groups 3 and 4 had cecal ligation and puncture (CLP) and colon anastomosis performed. Rats in Groups 1 and 3 were given 15mL/kg intraperitoneal 0.9% isotonic NaCl, while the rats in Groups 2 and 4 were given 100mg/kg intraperitoneal L-carnitine. On the postoperative fifth day, the rats were sacrificed and the burst pressure of anastomosis, histopathological effects, and tissue hydroxyproline levels were investigated.Results: In Groups 2 and 4, the anastomosis burst pressure and histopathological results in both noninfected abdomen and presence of peritonitis were statistically high compared to the control group (p < 0.05). Though the hydroxyproline levels were also high, there was no statistically significant difference for this parameter (p > 0.05).Conclusions: The findings obtained from the experimental sepsis model showed that healing of anastomosis in both the presence of peritonitis and noninfected abdomen was positively affected by the systemic administration of L-carnitine and this may contribute to the safety of anastomosis.Öğe The effects of apomorphine on paracetamol-induced hepatotoxicity in rats(C M B Assoc, 2017) Sehitoglu, Muserref Hilal; Yayla, Muhammet; Kiraz, Asli; Oztopuz, Rahime Ozlem; Bayir, Yasin; Karaca, Turan; Khalid, SumbulIt is becoming progressively more understandable that overdose of paracetamol in both humans and animals causes severe hepatotoxicity. Apomorphine is known as a neuroprotective agent. Due to the protective effect, apomorphine had been tested in experimental studies on different models. Findings obtained through series of expriments suggested that apomorphine may also be useful in liver toxicity. The aim of this study is to investigate the relationship among the hepatoprotective mechanism of apomorphine and to determine the possible role of apomorphine on paracetamol-induced hepatotoxicity in rats. 30 Sprague Dawley rats (adult male) were distributed into 5 groups. Group 1 was the control group and did not receive any medication. Group 2 received only paracetamol 2 g/kg by intragastric gavage to induce hepatotoxicity. Groups 3 and 4 were given apomorphine 1 mg/kg and 2 mg/kg by intraperitoneal injection, respectively. Groups 3 and 4 were given 2g/kg of Paracetamol. In Group 5, rats were treated with 2 mg/kg of apomorphine. Drug-treated rats were given food for the next 24 h until they were sacrified. Moreover, we also performed AST, ALT measurements in serum, MDA and SOD levels in liver tissues and histopathological analysis of the liver in all groups. Apomorphine had positive effects on both liver enzymes, oxidative stress markers and histopathological results in paracetamol-induced hepatotoxicity. Additionally, apomorphine at 2 mg/kg dose was significantly more protective as compared to 1 mg/kg as evidenced by the histopathological examination results. It was thought that apomorphine was found hepatoprotective on paracetamol-induced hepatotoxicity, especially at higher doses such as 2 mg/kg.Öğe The hepatoprotective effect of Aloe vera on ischemia-reperfusion injury in rats(Kare Publ, 2019) Sehitoglu, Muserref Hilal; Karaboga, Ihsan; Kiraz, Asli; Kiraz, Hasan AliOBJECTIVE: Aloe vera is known for its antioxidant properties. In this experimental study, we aimed to investigate the efficacy of Aloe vera in ischemia-reperfusion (I/R) liver injury in rats. METHODS: Male Wistar Albino rats were divided into three groups, where the sham group (n=7) underwent no medication or surgical procedures, the I/R group (n=7) was the control group that received 45 minutes of applied abdominal aorta ischemia and rats were sacrificed 24 hours after reperfusion, and the I/R+AV group (n=7) was the treatment group that was given Aloe vera (30 mg/kg) every day followed by gastric lavage for a month before applying ischemia and performing sacrifice as in the previous group. Before sacrifice, all the liver tissues were removed. Tissues were examined for histopathological investigation, iNOS immunoreactivity and tissue biochemistry, malondialdehyde (MDA), catalase (CAT), superoxide dismutase (SOD), and glutathione peroxidase (GSH-Px) activities. RESULTS: The SOD, CAT, and GSH-Px levels of the I/R+AV group were not significantly different from the sham group (p>0.05) but were significantly higher when compared to the I/R group. MDA levels of liver tissues were significantly lower (p<0.05) in the I/R+AV group as compared to the I/R group. Disrupted hepatic cords, sinusoidal dilatation, hemorrhage, cytoplasmic vacuolization of hepatocytes, and intensive iNOS immunoreactivity were detected in the I/R group. Decreased histopathological change score and iNOS immunoreactivity score were noticed in the I/R+AV group as compared to the I/R group. CONCLUSION: It was found that Aloe vera showed a hepatoprotective effect against I/R injury. Further research is required to determine the effective dose, administration method, and effects of Aloe vera for liver transplantation.
