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    Clinical importance of extended-spectrum ?-lactamase (PER-1-type)-producing Acinetobacter spp. and Pseudomonas aeruginosa strains
    (Lippincott Williams & Wilkins, 2001) Vahaboglu, H; Coskunkan, F; Tansel, O; Ozturk, R; Sahin, N; Koksal, I; Kocazeybek, B
    Recently, an extended-spectrum beta -lactamase (PER-I) was found to be disseminated among Acinetobacter spp, and Pseudomonas aeruginosa isolates in Turkey. A population-based cohort study was conducted to elucidate predictive mortality factors in patients with nosocomial infections caused by Acinetobacter spp. and P. aeruginosa, with particular reference to PER-1-type extended-spectrum beta -lactamase (ESBL) production. The study group comprised 16 and 21 non-survivors and 82 and 126 survivors in cohorts infected with Acinetobacter and E. aeruginosa, respectively. In the Acinetobacter-infected cohort, nosocomial pneumonia, hypotension and infection with a PER-positive isolate were independent predictors of mortality. In the P. aeruginosa-infected cohort, impaired consciousness, a PER-positive isolate, male sex and (with a negative relative risk) urinary tract infection were independent predictors of death. This study demonstrated the relationship of PER-1-type ESBL-producing Acinetobacter spp. and P. aeruginosa with poor clinical outcome.
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    A methicillin-resistant Staphylococcus aureus outbreak in a new university hospital due to a strain transferred with an infected patient from another city six months previously
    (Luigi Ponzio E Figlio, 2003) Tansel, O; Kuloglu, F; Mutlu, B; Anthony, RM; Uyar, A; Vahaboglu, H; French, GL
    Kocaeli University Medical School was established in 1995. The first methicillin resistant Staphylococcus aureus isolate was detected two years later in a patient transferred from a different city. Six months after this, we detected a small MRSA outbreak in the intensive care unit involving four patients, two of whom had bacteremia, and a staff nasal carrier. All isolates, including the first, appeared to be a single outbreak strain, demonstrated by pulsed field gel electrophoresis profiles which different by at most two bands, identical randomly amplified polymorphic DNA profiles, and identical coagulase gene types by PCR. Antibiogram were identical except that one isolate was additionally resistant to cotrimoxazole. These results show that MRSA isolates can spread between hospitals with infected or colonized patients and can apparently persist in the hospital for six months without causing infection. Screening of asymptomatic patients on wards affected by MRSA or transferred from other hospitals may be helpful in controlling these infections.
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    The molecular epidemiology of trimethoprim-sulphamethoxazole-resistance of Shigella flexneri in the Trakya region of Turkey
    (Luigi Ponzio E Figlio, 1997) Otkun, M; Akata, F; Vahaboglu, H; TatmanOtkun, M; Tugrul, M; Dundar, V
    Trimethoprim-sulphamethoxazole (SXT) resistance increased among Shigella flexneri isolates in 1995 relative to previous years, in the Trakya region, the European part of Turkey. Since this region is the entrance to Turkey from northern countries, a heavy traffic of travellers passing through should have been importing or exporting the resistant isolates. We studied the genetic basis and epidemiology of this resistance and monitored the clonal changes which have taken place in the meanwhile. During the study period, a total of 70 Shigella spp. were isolated. Of these 58 were S. flexneri, 10 were S. sonnei and two were S. boydii. S. dysenteriae was not isolated. Of S. flexneri isolates 32 were SXT, ampicillin, chloramphenicol and tetracycline resistant (pattern I), while two isolates were found to be resistant only to SXT (Pattern II). Transconjugation experiments revealed that an approximately 80 Kbp self-transmissible plasmid carried the SXT resistance genes in both groups. However, EcoRI and HindIII restriction patterns of the plasmids from resistance pattern I and resistance pattern II were different. Ribotypes of three randomly selected isolates from pattern I were identical and were distinguishable from the ribotype of the isolate from pattern II. We concluded that at least two different clones with different plasmids and resistance patterns were spreading in our territory.
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    Outbreak of tularaemia in Golcuk, Turkey in 2005: Report of 5 cases and an overview of the literature from Turkey
    (Informa Healthcare, 2005) Karadenizli, A; Gurcan, S; Kolayli, F; Vahaboglu, H
    Tularaemia was diagnosed by TaqMan RT-PCR and microagglutination tests in 5 patients, all from a new settlement constructed after the earthquake of 1999. During the follow-up, 129 more cases were found in this settlement (data from the local Health Care Authority). In this study, clinical features of 5 cases are presented briefly, and the Turkish literature on past outbreaks of tularaemia is reviewed.
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    Widespread detection of PER-1-type extended-spectrum ?-lactamases among nosocomial Acinetobacter and Pseudomonas aeruginosa isolates in Turkey
    (Amer Soc Microbiology, 1998) Vahaboglu, H; Öztürk, R; Aygün, G; Coskunkan, F; Yaman, A; Kaygusuz, A; Leblebicioglu, H
    [Abstract Not Available]
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    Widespread detection of PER-1-type extended-spectrum beta-lactamases among nosocomial Acinetobacter and Pseudomonas aeruginosa isolates in Turkey: a nationwide multicenter study
    (Amer Soc Microbiology, 1997) Vahaboglu, H; Ozturk, R; Aygun, G; Coskunkan, F; Yaman, A; Kaygusuz, A; Leblebicioglu, H
    We studied the prevalence and molecular epidemiology of PER-1-type beta-lactamases among Acinetobacter, Klebsiella, and Pseudomonas aeruginosa strains isolated over a 3-month period id eight university hospitals from distinct regions of Turkey, A total of 72, 92, and 367 Acinetobacter, Klebsiella, and P. aeruginosa isolates were studied, respectively, The presence of bla(PER) aas determined by the colony hybridization method and later confirmed by isoelectric focusing, We detected PER-1-type beta-lactamases in 46% (33/72) of Acinetobacter strains and in 11% (40/367) of P. aeruginosa strains but not in klebsiella strains. PER-1-type enzyme producers were highly resistant to ceftazidime and gentamicin, intermediately resistant to amikaein, and susceptible or moderately susceptible to imipenem and meropenem, Among PER-1-type-beta-lactamase-positive isolates, five Acinetobacter isolates and six P, aeruginosa isolates from different hospitals were selected for ribosomal DNA fingerprinting with EcoRI and SalI, The EcoRI-digested DNAs were later hybridized with a digoxigenin-labelled PER-1 probe, The ribotypes and the lengths of bla(PER)-carrying fragments were identical in four Acinetobacter strains. A single isolate (Ac3) harbored a PER gene on a different fragment (approximately 4.2 kbp) than the others (approximately 3.4 kbp) and showed a clearly distinguishable ribotype, Ribotypes of P. aeruginosa strains obtained with EcoRI showed three patterns. Similarly, in Pseudomonas strains two different EcoRI fragments harbored bla(PER) (approximately 4.2 kbp in five isolates and 3.4 kbp in one isolate), PER-1-type beta-lactamases appear to be restricted to Turkey, However, their clonal diversity and high prevalence indicate a high spreading potential.