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Öğe Antibiotic resistance patterns and plasmid profiles of Salmonella typhimurium isolates in Turkey(Springer-Verlag, 2001) Otkun, M; Erdem, B; Akata, F; Tatman-Otkun, M; Gerceker, D; Yagci, S; Ozkan, ETo understand the resistance mechanisms present in 75 isolates of Salmonella typhimurium derived from clinical infections in Turkey, antimicrobial resistance patterns and associated plasmids were investigated. Among the 22 strains that produced extended-spectrum beta -lactamase (ESBL), 20 were resistant to aminoglycosides and 12 to trimethoprim-sulfamethoxazole, Strains that did not produce ESBL did not express aminoglycoside or trimethoprim-sulfamethoxazole resistance, although 27 of them were ampicillin resistant. None of the strains were resistant to imipenem or fluoroquinolones. Nineteen strains producing ESBL carried a plasmid of >100 MDa, Seven ESBL-producing strains conjugally transferred their ESBLs and trimethoprim-sulfamethoxazole resistance. No correlation was found between the resistance patterns and plasmids in non-ESBL-producing strains.Öğe Bilateral multiple retinal hyperfluorescent dots in a presumed Rickettsia conorii infection(Lippincott Williams & Wilkins, 2001) Esgin, H; Akata, F[Abstract Not Available]Öğe The epidemiology of hepatitis a virus infection in children, in Edirne, Turkey(Springer, 2004) Erdogan, MS; Otkun, M; Tatman-Otkun, M; Akata, F; Türe, MTurkey is a middle endemic area with respect to Hepatitis A virus (HAV) infection. However, the frequency of this infection varies due to socioeconomic differences in various regions. The aim of this study was to detect the most likely age of exposure to HAV and factors affecting infection rates among children living in Edirne. A sample of 645 children between the ages of 0-19 living in Edirne were tested for total anti-HAV levels using ELISA method. A questionnaire on socio-economic status (SES), possible risk factors, and place of residence was completed for each child. Anti-HAV seropositivity was found to be 4.4, 25, 37.3 and 43.2%, in 2-5, 6-10, 11-14 and 15-19 age groups, respectively. Seropositivity was found to be increasing with age (p < 0.05). According to logistic regression analysis results; mother's education, SES of family, history of hepatitis in primary family members and the number of brothers or sisters were determined as factors increasing the seropositivity of HAV. Furthermore, HAV infection risk was found to be a decreasing function of income that is higher the income less likely the infection. These results showed that HAV infection rate in Edirne is in middle endemicity and the most likely way of exposure is transmission from family members. Although it requires further cost-effectiveness studies, our results indicate that applying the HAV vaccination in early childhood would be beneficial to decrease the prevalence of the infection and prevent HAV epidemics.Öğe Exposure time to hepatitis B virus and associated risk factors among children in Edirne, Turkey(Cambridge Univ Press, 2005) Otkun, M; Erdogan, MS; Tatman-Otkun, M; Akata, FHepatitis B virus (HBV) infection is endemic in Turkey, but the main routes of transmission were not well established. This study aims to detect the exposure time to HBV and associated risk factors among children. In a sampling group of children aged 0-19 years living in Edirne, antiHBc, antiHBs and HBsAg were screened by the microELISA method. A questionnaire was also completed for each child. In 717 children that were included in the study, the total antiHBc seropositivity was 5.4% and was 1.8, 0.8, 1.7, 6.8, 11.8% in 0-1, 2-5, 6-10, 11-14, 15-19 years age groups respectively. The overall HBsAg seropositivity was 1.7%. The risk of HBV infection increased after the age of 10 years (OR 7.79, 95% CI 3.01-20.16). Collective circumcision was the only independent factor according to regression analysis. Children living in Edirne should be vaccinated against HBV before reaching 11 years of age.Öğe First isolation of Rickettsia conorii from humans in the Trakya (European) region of Turkey(Springer, 2004) Kuloglu, F; Rolain, JM; Fournier, PE; Akata, F; Tugrul, M; Raoult, DIn the Trakya region of Turkey, located in the European part of the country, presumptive cases of Mediterranean spotted fever have been diagnosed and treated every summer since the beginning of the 1990s. The aim of this prospective study was to isolate and identify the rickettsial strains from blood samples of 11 patients and from skin biopsies of 10 of these 11 patients with the diagnosis of spotted fever in the Trakya region of Turkey in 2003. Immunofluorescence assay was performed with acute-phase and convalescent-phase serum samples of 11 patients. All patients had significant antibody titers against spotted fever group rickettsiae. Rickettsia conorii was isolated from the skin biopsies of three of ten patients and was also demonstrated by polymerase chain reaction in skin biopsies of nine of ten patients. In southeastern Europe, the Balkan Peninsula (including the Trakya region of Turkey) is an area where arthropods are endemic and where new arthropod-borne infections can be detected.Öğe A food-borne outbreak caused by salmonella enteritidis(Yonsei Univ Coll Medicine, 2003) Tansel, Ö; Ekuklu, G; Otkun, M; Tatman-Otkun, M; Akata, F; Tugrul, MThis study was designed to define the epidemiology of a food-borne outbreak caused by Salmonella enteritidis that affected only one squadron of a military battalion located in the vicinity of the city of Edirne in Turkey. The outbreak was analyzed by a standard surveillance form of the Centers for Disease Control and Prevention. The relationship between the eaten foods and cases was analyzed by Fisher's exact chi-square test, and odds ratios were calculated by a case-control study. The outbreak affected 60 of 168 soldiers in the squadron, 16 of whom were hospitalized. S.enteritidis was cultured in stools from 13 of the hospitalized soldiers and from 3 soldiers who had prepared the food. All strains were completely susceptible to antibiotics; their plasmid profiles were also identical. The highest attack rate detected was 55.7% in an omelet eaten 24 hours before (p<0.001). Furthermore, it was the riskiest food according to the case-control study (OR=7.88; 95% CI=3.68-16.89). The food samples were unobtainable because they had been discarded. All of the hospitalized cases recovered, and none of the control cultures of stools yielded the pathogen after three weeks. In conclusion, although our results didn't indicate the exact source of the outbreak microbiologically, the omelet was considered to be the source based on the epidemiological proofs.Öğe Meningitis due to Bacillus anthracis(Yonsei Univ College Medicine, 2005) Gürcan, S; Akata, F; Kuloglu, F; Erdogan, S; Tugrul, MThe first case of haemorrhagic meningitis due to Bacillus anthracis in the European part of Turkey is reported here. B. anthracis, sensitive to penicillin, was isolated from the cerebrospinal fluid and blood cultures. Although appropriate therapy was administered, the patient died two days after hospitalization.Öğe 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, VTrimethoprim-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.Öğe Prevalence of extended-spectrum beta-lactamases produced by nosocomial isolates of Enterobacteriaceae in Trakya University Hospital, Turkey(Luigi Ponzio E Figlio, 2003) Akata, F; Tatman-Otkun, M; Özkan, E; Tansel, Ö; Otkun, M; Tugrul, MThe prevalence of extended-spectrum beta-lactamase (ESBL) production by 194 nosocomial isolates of Enterobacteriacea recovered from 1995 to 1999 was investigated. The ESBL production was determined by the double-disk synergy test and was confirmed by the E-test ESBL strip. Twenty-three isolates (21 Klebsiella pneumoniae, one Escherichia coli, one Providencia rettgeri) were found as ES-BL-producers (11.8%). These isolates were also usually resistant to non-betalactam antibiotics. Most of them contained a beta-lactamase with a pI of 7.6. All the strains conjugally transferred their ESBLs to recipient E.coli. Contrary to others, ESBL-producing K.pneumoniae strains isolated in 1999 were resistant to ciprofloxacin, and had the identical plasmid profiles suggestive of an outbreak. Ciprofloxacin resistance in these strains could not be transferred. In conclusion, K. pneumoniae was the main ESBL-producing species among nosocomial isolates of Enterobacteriacae in our hospital.Öğe Resistance to macrolides in Group A streptococci from the European section of Turkey(Elsevier Science Bv, 2002) Akata, F; Öztürk, D; Tansel, Ö; Tatman-Otkun, M; Otkun, M; Fitoussi, F; Bingen, EThe aim of this study was to determine the susceptibilities to macrolides of Group A streptococcal isolates from the European section of Turkey. In the case of resistant isolates, the patterns and genetic mechanisms of erythromycin resistance were studied. Seven (2.7%) of the 260 isolates were resistant to erythromycin. Four of them showed the M phenotype and harboured mefA genes whereas three isolates showed the inducible macrolide, lincosamide and streptogramin B resistance phenotype and harboured ermTR genes. In the European section of Turkey, the current resistance rate of Group A streptococci to macrolides remains low. (C) 2002 Elsevier Science B.V. and International Society of Chemotherapy. All rights reserved.
