No abstract

No abstract

Being a member of the Enterobacteriaceae family, Klebsiella pneumoniae is an opportunistic pathogen that inhabits normal human microbiota and causes predominantly hospital-acquired infections. The emergence of K.pneumoniae isolates which are resistant particularly to the carbapenem group of antibiotics has led to an increase in hospitalization period, mortality and morbidity. Although different rates of resistance are observed between countries, regions and even healthcare facilities, there has been a rapid increase in the prevalence of carbapenem-resistant strains in the last 10 years. Fast and correct identification of carbapenem-resistant strains is important for the successful treatment of infections caused by these resistant bacteria. The objective of this study was to investigate the presence and the types of carbapenemases in carbapenem-resistant K.pneumoniae strains using "MASTDISCS™ ID carbapenemase detection disc set", a commercial product that can be used for this purpose, and "Carbapenem Inactivation Method (CIM)", a relatively new method, and compare the results of these methods by polymerase chain reaction (PCR). For this purpose, we used 54 K.pneumoniae strains isolated in 2015-2016, that were resistant to any of the ertapenem, meropenem or imipenem antibiotics. The identification of the strains was performed using VITEK MS and their antibiotic susceptibility tests were carried out using the VITEK 2 Compact® automated system. For the strains that were found resistant to carbapenems in the automated system, the minimum inhibitor concentration (MIC) values were determined by the gradient testing method according to the recommendations of "The European Committee on Antimicrobial Susceptibility Testing (EUCAST)". The blaOXA-48, blaIMP, blaNDM, blaVIM, and blaSIM genes were investigated with PCR among these isolates. Phenotypic enzyme typing was performed in the carbapenem-resistant strains using the "MASTDISCS™ ID carbapenemase detection disc set" and "Carbapenem Inactivation Method (CIM)". REP-PCR was used to reveal clonal relationship of the isolates. The 54 K.pneumoniae isolates were found as resistant to carbapenem and the MIC50 and MIC90 values of imipenem, meropenem and ertapenem were 32 µg/ml. Only 33 of the strains had blaOXA-48 and two of them had only blaNDM, the remaining 19 strains had both of these two genes. The blaIMP, blaVIM and blaSIM genes were not encountered in any of the isolates. When the isolates were assessed by the REP-PCR method, six main clones were detected. The "MASTDISCS™ ID carbapenemase detection disc set" was able to detect all the carbapenemase producing strains and it remained incapable of distinguishing OXA-48 in the strains which had both OXA-48 and metallo beta lactamase (MBL) enzymes. The CIM method showed a low rate of positivity (46.15%) in the strains containing blaOXA-48, but was found much more successful in the strains containing blaNDM with a detection rate of 85.71%. In this study, it was concluded that the Mastdiscs-ID method could be successfully used to...

Objective:Pseudomonas aeruginosa is an opportunistic pathogen that can cause serious infections, especially in health care settings where host defense is impaired. In addition to resistance problem, the different virulence characteristics of these bacteria can change the course of infection and cure. In this study, it was aimed to determine antibiotic susceptibilities, epidemiological relations and virulence factors of clinical P. aeruginosa isolates. Methods:This study was performed, a total of 83 P. aeruginosa isolated from different clinical samples of

INTRODUCTION: Candida spp. are clinically important pathogens that cause the difficulties for treatment by biofilm formation. Considering antifungal resistance rates and the limitations in discovery of new antifungals, it's getting more important the antifungal and antibiofilm effects of various drugs which are using for different therapeautic purposes. The main goal of our study was to determine antifungal and antibiofilm effects of selective serotonin reuptake inhibitors (SSRIs) sertraline (SRT), paroxetine (PRX), fluoxetine (FLX), alone and in combination with fluconazole (FLC), against Candida spp. METHODS: Twenty Candida spp. strains isolated from clinical samples at Ege University Hospital, were identified by Dalmau method and matriks assisted laser desorption ionization time of flight mass spectrometry. Minimum inhibitory concentrations of SSRIs and fluconazole were detected by broth microdilution method. Synergistic interactions between SSRIs and fluconazole were investigated by checkerboard assay. The antibiofilm effects of SSRIs were determined by spectrophotometric microplate method. RESULTS: Five different Candida spp. (Candida albicans, Candida glabrata, Candida krusei, Candida tropicalis, Candida parapsilosis) were identified among the isolates. The MIC ranges of SSRIs were found as 16-512 µg/mL. It was detected that sertraline was the agent have highest antifungal effect. The antibiofilm efficacy of fluoxetine was found to be higher than other SSRIs. Additionally, fluoxetine and paroxetine showed synergistic effect with fluconazole in thirteen and ten isolates, respectively. Nine isolates were detected as moderate biofilm producer, four isolates were identified as strong biofilm producer. C. parapsilosis strains showed higher biofilm production than other species. Fluoxetine and sertraline alone, at MIC/2, inhibited mature biofilms in six and five isolates, respectively while paroxetine was found to increase biofilm formation in seven isolates. DISCUSSION AND CONCLUSION: This study revealed that sub-MICs of SSRIs could have antifungal and antibiofilm effects. The antidepressants sertraline and fluoxetine, alone and in combination with antifungals are considered to may have therapeutic potential for combating fungal infections.