TR-Dizin Açık Erişimli Yayınlar

Permanent URI for this collectionhttps://hdl.handle.net/11727/10759

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Author: search.filters.author.Mirza, Hasan Cenk

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    Co-existence of Multiple Resistance Mechanisms in Clinical Isolates of Carbapenem-Resistant Pseudomonas Aeruginosa
    (2022) Uskudar-Guclu, Aylin; Mirza, Hasan Cenk; Unlu, Sezin; https://orcid.org/0000-0002-1872-028X; https://orcid.org/0000-0002-8853-3893; AAU-6196-2020; F-1232-2015
    Introduction: Multidrug resistance phenotype of Pseudomonas aeruginosa utilizes several resistant mechanisms to overcome the action of antibiotics. This phenotype is caused by several resistance mechanisms or a combination of thereof. This study aimed to evaluate various resistance mechanisms by phenotypic methods. Materials and Methods: Carbapenem-resistant P. aeruginosa were included in this study. Antimicrobial resistance mechanisms such as efflux pump activity, reduced outer membrane permeability (OMP), various beta-lactamase activities, and biofilm formation ability of clinical P aeruginosa isolates were determined by phenotypic methods. Results: Of the P aeruginosa isolates, 33.7% (n= 33/98) had a positive efflux pump activity. The co-existence of positive efflux pump activity and Metallo beta-lactamase (MBL) production was detected in 30.3% (10/33) of the isolates. In 34.7% of the clinical P. aeruginosa isolates, reduced OMP was detected and 70.6% of them were also biofilm producers. Totally 21.4% (21/98) of P aeruginosa isolates were evaluated as extended-spectrum beta-lactamase (ESBL) positive. AmpC beta-lactamase was detected in 15.3% (n= 15/98) of the clinical P. aeruginosa isolates. MBL activity was detected in 33.7% (n= 33/98) of the clinical P. aeruginosa isolates. Of the MBL-positive isolates, 69.7% were biofilm producers. The co-existence of MBL and reduced OMP was detected in 36.4% (n= 12/33). Conclusion: High resistance of P. aeruginosa was attributed to several resistance mechanisms or a combination of thereof. This infections caused by multidrug-resistant (MDR) P. aeruginosa are difficult to treat due to the co-existence of different resistance mechanisms.
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    In vitro Activity of Delafloxacin against Methicillin-Resistant Staphylococcus aureus Isolated from Various Clinical Specimens
    (2021) Mirza, Hasan Cenk; Basustaoglu, Ahmet; Yanik Yalcin, Tugba; 0000-0002-8853-3893; F-1232-2015
    Introduction: Delafloxacin is a novel fluoroquinolone which has anionic and weak acid character at neutral pH. Activity of delafloxacin is reported to be increased in acidic environments. Many infections are characterized by acidic pH. Staphylococcus aureus is a microorganism which can survive and multiply in mildly acidic environments. The aim of this study was to compare the activity of delafloxacin and other fluoroquinolones (ciprofloxacin, levofloxacin, moxifloxacin) against MRSA isolates at neutral (7.4) and acidic (5.5) pH. Materials and Methods: A total of 51 MRSA isolated from various clinical specimens were included in the study. Disk diffusion method was used for antimicrobial susceptibility testing. The pH of Mueller Hinton Agar was adjusted to 7.4 or 5.5, and used as the medium for antimicrobial susceptibility testing. EUCAST breakpoints were used for ciprofloxacin, levofloxacin and moxifloxacin. FDA breakpoints were used for delafloxacin. Results: The most active fluoroquinolones against MRSA isolates at neutral pH were delafloxacin and moxifloxacin. Delafloxacin and moxifloxacin susceptibility rates of isolates were same (82.4%) at neutral pH. Of the isolates, 9.8% and 17.6% were resistant to delafloxacin and moxifloxacin, respectively. Four moxifloxacin-resistant isolates were categorized as intermediate to delafloxacin. Of the isolates, 76.5% and 78.4% were 'I - susceptible, increased exposure' to ciprofloxacin and levofloxacin, respectively. Of the isolates, 23.5% and 21.6% were resistant to ciprofloxacin and levofloxacin, respectively. At acidic pH; ciprofloxacin, levofloxacin and moxifloxacin susceptibility rates of isolates were not changed. However, all delafloxacin resistant/intermediate isolates at neutral pH became susceptible to delafloxacin at acidic pH. Conclusion: Delafloxacin was the most active fluoroquinolone against MRSA isolates at acidic pH. Based on our findings, delafloxacin may represent a treatment option for MRSA infections characterized by low pH.