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Item Retrospective evaluation of viral respiratory tract infections in a university hospital in Ankara, Turkey (2016-2019)(2022) Altay-Kocak, Aylin; Sarzhanova, Shakhnoza; Tapisiz, Anil; Dizbay, Murat; Basustaoglu, Ahmet; Bozdayi, Gulendam; 0000-0002-0451-0142; 35656958; AAI-8012-2021Introduction: Viruses are responsible for two-thirds of all acute respiratory tract infections. This study aims to retrospectively detect respiratory tract viruses in patients from all age groups who visited the hospital. Methodology: A total of 1592 samples from 1416 patients with respiratory tract symptoms were sent from several clinics to the Molecular Microbiology Laboratory at Gazi University Hospital from February 2016 to January 2019. Nucleic acid extraction from nasopharyngeal swabs, throat swabs or bronchoalveolar lavage (BAL) samples sent to our laboratory was done using a commercial automated system. Extracted nucleic acids were amplified by a commercial multiplex-real time Polymerase Chain Reaction (PCR) method, which can detect 18 viral respiratory pathogens. Results: Among 1592 samples, 914 (57.4%) were positive for respiratory viruses. The most prevalent were rhinovirus (25.2%) and influenza A virus (12.1%), the least prevalent was the bocavirus (2.6%). Rhinovirus was the most detected as a single agent (21.2%, 194/914) among all positive cases, followed by coronavirus (9.3%, 85/914). The detection rates of coronavirus, human adenovirus, respiratory syncytial virus A/B, human parainfluenza viruses, human metapneumovirus-A/B, human parechovirus, enterovirus and influenza B virus were 9.9%, 8%, 7.7%, 5%, 3.4%, 3.1%, 3%, and 2.8%, respectively. Conclusions: The most detected viral agents in our study were influenza A virus and rhinovirus. Laboratory diagnosis of respiratory viruses is helpful to prevent unnecessary antibiotic use and is essential in routine diagnostics for antiviral treatment. Multiplex Real-time PCR method is fast and useful for the diagnosis of viral respiratory infections.Item Antibacterial Resistance in Lower Respiratory Tract Bacterial Pathogens: A Multicenter Analysis from Turkey(2021) Guclu, Aylin Uskudar; Kocak, Aylin Altay; Ok, Mehtap Akcil; Tutluoglu, Bulent; Basustaoglu, Ahmet; 0000-0002-1872-028X; 0000-0002-0451-0142; 33690209; AAU-6196-2020; AAI-8012-2021Introduction: This study aimed to evaluate the etiology of lower respiratory tract infections (LRTIs) and their antibiotic resistance. Methodology: Bacterial culture results of LRT samples from 17 hospitals between 2016-2019 were included in the study. All isolates were identified and AST were performed by automated microbiology systems. AST was performed according to EUCAST. Results: Non-duplicate 30,051 (26,890 HA and 3156 CA) isolates detected as causative pathogen. LRTIs are caused by 85.1% Gram-negative bacterial pathogens and 14.9% Gram-positive. The most common isolates among HA pathogens were Acinetobacter spp. (27.4%), P. aeruginosa (22.2%), K. pneumoniae (17.9%); among CA pathogen S. pneumoniae (19.9%), P. aeruginosa (18.9%), H. influenzae (14.6%). ESBL rate was 62.5% in K. penumoniae; 53.1% in E.coli; 19.1% in Klebsiella spp; 13.9% in Enterobacter spp.; 8.6% in Proteus spp.; 6.3% in Citrobacter spp.; and 4.3% in Serratia spp. Resistance rates to carbapenems and colistin were 92.8% and 12.8% in A baumannii, 39.8% and 7.5% in P. aeruginosa, 47.3% and 18.5% in K. penumoniae. Among staphylococci, 27.3% of S. aureus and 82.4% of CoNS were methicillin resistant. 7.6% of E.faecium and 0.9% of E. faecalis were vancomycin resistant. Linezolid resistant S. aureus, CoNS, E. faecalis and E. faecium rates were 0.3%, 2.9%, 0.0% and 4.6%. Inducible clindamycin resistant rate was 17.2% in S. aureus 38.2% in CoNS. Non-susceptible S. pneumoniae isolate rate to penicillin was 37.0%. 6.5% of S. maltophilia and 4.4% of B. cepacia isolates were resistant to trimethoprim/sulfamethoxazole. Conclusions: Antibiotic resistance was mainly observed among A. baumannii and K. pneumoniae and continuous surveillance of antimicrobial resistance patterns in the management of LRTIs is important.Item Predominant Mutations of SARS-CoV-2: Their Geographical Distribution and Potential Consequences(2021) Unlu, Sezin; Uskudar Guclu, Aylin; Basustaoglu, Ahmet; 0000-0001-7490-7981; 0000-0002-1872-028X; AAQ-4702-2021; AAU-6196-2020Severe Acute Respiratory Syndrome Coronavirus-2 (SARS-CoV-2) emerged in late December 2019 in Wuhan, China. More than 83 million people have been infected, and more than 1.8 million people have died, as reported to the World Health Organization on the 3rd of January, 2021. Analysis of genetic variations is critical for understanding the spreading pattern of SARS-CoV-2 across several countries. This review aimed to gather information about the prominent mutations of SARS-CoV-2 by analyzing the origin, viral pathogenesis, and mutation rate. Moreover, we concluded their potential impacts on SARS-CoV-2 therapeutics. Mutations in the spike protein (D614G, N501Y, E484K, A222V, S477N, and G485R), ORF1ab (P323L, N628N, Y455Y, A97V, and F106F), nucleocapsid protein (R203K and G204R), ORF8 (L84S), and ORF3a (Q57H and G251V) were examined in this review by analyzing relevant articles from the beginning of the current pandemic to the most recent date. A detailed analysis of articles demonstrates that D614G is the major variation distributed globally, and its frequency increased rapidly from early in March, followed by several other variations in either spike or different proteins. In addition, it was seen that the currently circulating N501Y and E484K variants revealed a public concern regarding vaccines' efficacy. Investigation of variations of SARS-CoV-2 would lead to understanding their potential mechanism of action against SARS-CoV-2, thereby suggesting suitable therapeutics. Several mechanisms were suggested to have a role in SARS-CoV-2 mutation rate and evolution. Possible therapeutics and vaccines against SARS-CoV-2 were proposed.Item Comparison of in vitro activities of plazomicin and other aminoglycosides against clinical isolates of Klebsiella pneumoniae and Escherichia coli(2021) Ince, Gizem; Mirza, Hasan Cenk; Guclu, Aylin Uskudar; Gumus, Hale; Erol, Cigdem; Basustaoglu, Ahmet; 0000-0001-9071-9606; 0000-0002-1872-028X; 0000-0002-2535-2534; 0000-0002-8853-3893; 34499728; AAJ-2108-2021; AAU-6196-2020; AAJ-1219-2021; F-1232-2015Objectives: To compare the in vitro activity of plazomicin and two older aminoglycosides (gentamicin and amikacin) against 180 isolates of Escherichia coli and Klebsiella pneumoniae, including subsets of 60 non-ESBL-producing, 60 ESBL-producing and 60 carbapenem-resistant (46 carrying bla(OXA-48), 11 carrying bla(NDM) and 3 carrying bla(OXA-48) and bla(NDM)) strains. Methods: MICs of plazomicin, gentamicin and amikacin were determined by a gradient diffusion method. Gentamicin and amikacin MICs were interpreted according to CLSI criteria and EUCAST breakpoint tables. Plazomicin MICs were interpreted using FDA-defined breakpoints. Results: All non-ESBL-producing and ESBL-producing isolates were susceptible to plazomicin. The plazomicin susceptibility rate (71.7%) in carbapenem-resistant isolates was significantly higher than those observed for gentamicin (45%) and amikacin (56.7% and 51.7% according to CLSI and EUCAST breakpoints, respectively). Gentamicin, amikacin and plazomicin susceptibility rates (35.6% for gentamicin; 44.4% and 37.8% for amikacin according to CLSI and EUCAST breakpoints, respectively; 64.4% for plazomicin) in carbapenem-resistant K. pneumoniae were significantly lower than those observed for carbapenem-resistant E. coli isolates (73.3% for gentamicin; 93.3% for amikacin and plazomicin). Gentamicin, amikacin and plazomicin susceptibility rates for bla(NDM)-positive isolates were lower than those observed for bla(OXA-48)-positive isolates, but differences were not statistically significant. Among the isolates that were non-susceptible to both gentamicin and amikacin, the plazomicin susceptibility rate was less than 30%. Conclusions: Although plazomicin showed excellent in vitro activity against carbapenem-susceptible isolates, the plazomicin resistance rate increased to 35.6% among carbapenem-resistant K. pneumoniae and further increased to 45.5% among bla(NDM)-positive isolates.Item Antibacterial, Antifungal and Antibiofilm Activity of Methylglyoxal: A Phytochemical from Manuka Honey Metilglioksalin Antibakteriyel, Antifungal ve Antibiyofilm Aktivitesi: Manuka Balindan Bir Fitokimyasal(2021) Uskudar-Guclu, Aylin; Simsek, Derya; Ata-Vural, Ilgin; Unlu, Sezin; Basustaoglu, Ahmet; 0000-0002-1872-028X; AAU-6196-2020Introduction: Honey has been known for its ability to promote wound healing for a long time. It is utilized for several skin and soft tissue infections caused by a wide range of microorganisms due to its antimicrobial property. Methylglyoxal (MGO), the unique antibacterial compound contained by Manuka honey, is believed as the reason for the antimicrobial activity of Manuka honey. This study aims to identify the antibacterial, antifungal and anti-adherent activity of MGO in changing concentrations and determine the viable number of bacteria and fungi in biofilm after the treatment of MGO. Materials and Methods: Antibacterial and antifungal activity of MGO was determined by broth microdilution method for identifying minimum inhibitory and bactericidal and fungicidal concentrations (MIC, MBC and MFC, respectively). Percentage of biofilm formation inhibition and the number of viable microorganisms in biofilm after the MGO treatment was determined by the colony-forming unit method. Results: Minimum inhibitory concentration values for the bacterial strains ranged from 0.0078 to 0.125010 (v/v), while MBC ranged from 0.0312 to 2010 (v/v). Among fungi, MIC and MFC values were higher than those for tested bacterial strains; MIC values ranged from 0.0156 to 1010 (v/v), while MFC values ranged from 0.0625 to 2010 (v/v). Methylglyoxal was able to prevent biofilm formation in the all tested biofilm forming isolates. Number of viable bacteria, even in the sub-inhibitory doses of MGO, reduced remarkably. Conclusion: Unique compound of Manuka honey, MGO, exerts significant antimicrobial and antibiofilm activity against clinically important strains of both bacteria and fungi which may be utilized for the search of promising alternatives for antibiotics and may lead to combat antibiotic resistance.Item Prevention of Candida biofilm formation over polystyrene by plasma polymerization technique(2020) Kaleli-Can, Gizem; Hortac-Istar, Elvan; Ozguzar, Hatice Ferda; Mutlu, Mehmet; Mirza, Hasan Cenk; Basustaoglu, Ahmet; Gocmen, Julide Sedef; 0000-0002-8853-3893; 0000-0002-2571-0637; F-1232-2015; AAI-8926-2021This work investigates the antifungal effect of plasma polymer films produced by low-pressure RF-generated plasma system using acrylic acid, 2-hydroxyethyl methacrylate, and diethyl phosphite (DEP). Unmodified and plasma-modified polystyrene (PS) microplate wells were tested by 30 biofilm-positive Candida spp. isolated from blood samples and two control strains using a quantitative plaque assay method. Regardless of the precursors and plasma parameters, biofilm formation was inhibited for all plasma-modified microplate wells. The most significant anti-biofilm effect was observed on PS modified by DEP at 90 W plasma power with the inhibition of all Candida species' biofilm formation.