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Copyright of Van Tip Dergisi is the property of Yuzuncu Yil University, Faculty of Medicine and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Introduction: The healthcare burden of carbapenem-resistant Klebsiella pneumoniae (K. pneumoniae) infections is growing. The newly developed beta-lactam/beta-lactamase inhibitor combination, ceftazidime-avibactam, shows promise in the treatment of such infections. We aimed to explore the in vitro efficacy of ceftazidime-avibactam against carbapenem-resistant K. pneumoniae isolates carrying the blaOXA-48 gene. Materials and Methods: The isolates were identified using MALDI-TOF MS (Brucker, USA). The isolates that were non-susceptible to imipenem, meropenem, or ertapenem by the disk diffusion method using the European Committee of Antimicrobial Susceptibility Testing (EUCAST) breakpoints were screenes. Minimum inhibitory concentration (MIC) values were determined via broth microdilution according to the EUCAST criteria. A time-kill study was performed according to Clinical and Laboratory Standards Institute guidelines. Beta-lactamase genes were screened for using polymerase chain reaction with previously published primers. Results: A total of 129 K. pneumoniae isolated between April 2011 and February 2021 were studied. Of these, 98, 23, and eight isolates carried the blaOXA-48, blaNDM, and blaOXA-48 with blaNDM genes, respectively. All isolates carrying the blaNDM gene were resistant to ceftazidime-avibactam. Approximately 79.6% of the blaOXA-48-positive isolates were susceptible to ceftazidime-avibactam. The time-kill study for ceftazidime-avibactam was performed with one blaOXA-48-positive isolate (MIC, 4 mg/l). Ceftazidime-avibactam time-kill kinetics were evaluated in multiples of MIC. There was a decrease of ≥3-log10 in CFU/ml count at a concentration of 8, 16, and 32 MIC at 6 hours. The minimum bactericidal concentration was 8 mg/l. Conclusion: Ceftazidime-avibactam is an important treatment alternative alternative for blaOXA-48 positive carbapenem-resistant K. pneumoniae infections. The most rational approach to the treatment of carbapenem-resistant K. pneumoniae infections appears to be the initiatiion of targeted therapy according to culture antibiogram results or revision of the empirically initiated combination or monotherapy as early as possible according to culture antibiogram results.

Copyright of ANKEM Antibiyotik & Kemoterapi Dergisi is the property of ANKEM Antibiyotik & Kemoterapi Dergisi and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Aim: Klebsiella pneumoniae causes hospital-acquired pneumonia, urinary tract infection and bacteremia in immunocompromised patients. Klebsiella pneumoniae, which has become more common recently, causes antibiotic resistance as well as pyogenic liver abscesses and hematogenous metastatic spread in humans. Developing antibiotic resistance complicates the treatment of liver infections. In our study, we aimed to evaluate the effect of boron compounds in an infection model created by Klebsiella pneumoniae 700603. Materials and Methods: Minimum inhibitory concentration and fractional inhibitory concentration studies, resistance gene levels, and HepG2 cell analyses were performed and evaluated. Results: We determined the low and high minimum inhibitory concentration values of boron components, sodium perborate monohydrate and etidote, respectively. In addition, sodium perborate monohydrate is also effective on biofilm formation. Our findings have shown that boron compounds are more effective when used in a combination. In the toxicity model created in the cellular study, the boron compounds cytotoxic effect decreased due to their antibacterial effects. Conclusion: İt seems that boron compounds are effective, and the positive effect increases when used together.

The presence of beta-lactam resistant Enterobacterales strains was investigated in 96 green vegetable samples sold in Çanakkale neighborhood markets. Samples taken from stem and leaf parts were inoculated in Violet Red Bile Glucose (VRBG) Agar. Enterobacterales loads were determined between <1 log CFU/g and 6.11 log CFU/g. One hundred twenty-nine isolates grown on EMB Agar containing 2 mg/ml meropenem and chromogenic ESBL Agar were identified as, Serratia liquefaciens (n=35), Serratia plymuthica (n=31), Klebsiella oxytoca (n=25), Klebsiella pneumonia (n=6), Raoultella ornithinolytica (n=14), Raoultella terrigena (n=3), Enterobacter cloacae (n=11), Enterobacter ludwigii (n=4), Enterobacter asburiae (n=1), Lelliottia amnigena (n=16), Escherichia coli (n=2), Escherichia hermannii (n=1), Leclercia adecarboxylata (n=3), Pantoea agglomerans (n=3), Kluyvera intermedia (n=2), Kosakonia cowanii (n=1) and Hafnia alvei (n=1) with MALDI-TOF MS method. According to the disk diffusion method, 11.62% (n=15) of the isolates were found to be Extended Spectrum Beta-Lactamase (ESBL) and 4.65% (n=6) carbapenemase positive. ESBL and carbapenem-resistant isolates in green vegetables reveal the public health risk in these foods consumed without heat treatment. [ABSTRACT FROM AUTHOR]

Copyright of Journal of Faculty of Pharmacy of Ankara University / Ankara Üniversitesi Eczacilik Fakültesi Dergisi is the property of Ankara University and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Objectives: The study evaluated the 10-year healthcare-associated infections (HCAI) data in the pediatric cardiovascular surgery intensive care unit (PCVS-ICU). Methods: The electronic data of 106 patients with HCAI between 2012 and 2021 were retrospectively analyzed for the infection sites, isolated microorganisms, and antibiotic resistance. Results: 3617 patients with 29155 patient days in our 12-bedded PCVS-ICU were evaluated. There were 64 HCAIs during 2012–2016, comprised of 17 (26.5%) bloodstream infections (BSI), 16 (25%) pneumonia, 13 (20.3%) urinary tract infections (UTI), 8 (12.5%) ventilator-associated pneumonia (VAP), 7 (11.1%) surgical site infection (SSI), and 3 (4.6%) soft-tissue infection (STI). In contrast, 42 HCAIs were observed in 2017–2021, which included 17 (40.4%) BSI, 10 (23.8%) pneumonia, 7 (16.6%) VIP, 4 (9.6%) UTI, 3 (7.2%) SSI, and 1 (2.4%) STI. The most common pathogen was the Candida species. The ventilator usage rate was 2.8 per 8635 ventilator days and 0.42 per 6439 ventilator days in the first and second five years, respectively. The rate of central venous catheter (CVC) use was 2.04 and 0.96 in the first and second five years, respectively. Conclusion: The most common HCAI was BSI, and the most common isolated pathogen was Candida species within ten years in our PCVS-ICU. The infection rate, CVC, and UC usage rates were decreased, with an increased compliance rate on hand hygiene in the second five years, indicating strict adherence to infection control measures. [ABSTRACT FROM AUTHOR]

Objective: Urinary tract infection in newborn may be the first sign of an underlying urinary system problems. If not treated on time, the risk of renal scarring and renal failure increases with advancing age. In this study, it was aimed to review the clinical and laboratory findings, causative microorganisms, urinary system anomalies and the efficacy of antibiotic treatments in newborn diagnosed with UTI. Material and Method: This study was conducted between 01.09.2017 and 01.09.2018 in the Neonatal Intensive Care Unit of Gaziantep Cengiz Gökçek Children's Hospital. Term and late preterm newborn those bacteria were detected in the urine culture taken by bladder catheterization were included in the study. Clinical, laboratory and radiological imaging results of the cases were evaluated retrospectively. Results: Of these cases, 45.9% (n:28) were term and 52.5% (n:32) were late preterm babies. It was determined that the presence of maternal UTI during pregnancy was a risk factor for late preterm infants (p <0.001). The most common presenting symptom was jaundice (n:45, 75%) in both groups. The most frequently isolated microorganisms were Escherichia coli (40%) and Klebsiella pneumonia (35%). It was observed that the causative microorganisms were resistant to ampicillin as the most (n:32, 53.3%) and to meropenem as the least (n:7, 11.7%). Conclusion: History of UTI in the mother during pregnancy, late preterm baby and having urinary system anomaly are important risk factors for UTI in the newborn. Therefore, the patients in the risk group should be followed up at regular intervals for the development of renal scarring. [ABSTRACT FROM AUTHOR]

Copyright of Journal of Faculty of Pharmacy of Ankara University / Ankara Üniversitesi Eczacilik Fakültesi Dergisi is the property of Ankara University and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Amaç:Karbapenemaz üreten organizmalar , içerdikleri karbapenemaz enzimleri ile antibiyotiklerin bir çoğuna, bazen tamamına dirençli Gram negatif bakterilerdir. Karbapenemazların hızlı ve doğru saptanması dirençli hastane enfeksiyonlarının erken tespiti ve yayılımının önlenmesi için gereklidir. Çalışmada Moleküler yöntemle karbapenemaz gen tayini yapılmış Escherichia coli ve Klebsiella pneumoniae İzolatları BD Phoenix CPO Detect (Becton Dickinson, ABD) kiti ile çalışılarak testin karbapenemaz varlığı ve sınıflarını doğru saptayabilme durumu değerlendirilmiştir. Çalışmaya ….. Üniversitesi Hastanesi Merkez Laboratuvarı bakteriyoloji birimine Ocak 2020 – Aralık 2020 tarihleri arasında gönderilen çeşitli klinik örneklerden izole edilen K. pneumoniae ve E. coli suşları dahil edilmiştir. Moleküler test ile İzolatların 64’ü Oxa-48, 6’sı NDM, 2’si NDM+Oxa-48 içerdiği tespit edilen 72 izolat ile karbapenemazlardan KPC, NDM, VIM, OXA-48 ve IMP-1’i içermeyen 16 izolat dahil edilmiştir. K. pneumoniae ve E. coli izolatları matriks aracılı lazer desorpsiyon iyonizasyon uçuş süresi kütle spektrometrisi [“matrix assisted laser desorptionization-time of flight mass spectrophotometry” (MALDI-TOF MS)] (Bruker Daltonics, Almanya) yöntemi ile tanımlanmış ,üretici firma önerileri doğrultusunda BD Phoenix CPO Detect (Becton Dickinson, ABD) kiti ile karbapenemaz durumu araştırılmıştır. Bulgular: BD Phoenix CPO Detect testinin PCR ile uyumu Oxa-48 geni bulunan izolatlar için %95,3, NDM geni bulunanlar için %100 olarak bulunmuştur. Testin negatif prediktif oranı tüm izolatlarda %88,8, K. pneumoniae izolatlarında %83,3, E. coli izolatlarında %100,0 olarak saptanmıştır. Sonuç: Enterobacterales, P.auroginosa, A.baumanii karbapenemaz enzimlerini saptayabilen BD Phoenix CPO Detect testinin rutin tanı laboratuvarlarında kullanılması dirençli bakterilerin erken tanı ve doğru tedavisine katkı sağlayacaktır.

Aim: In this prospective study we aimed to compare the effectiveness of VITEK-2 (bioMérieux, France) automated system, double-disc synergy (DDST) versus combined disc test (CDT) in detecting the Extended-Spectrum Beta-Lactamase (ESBL) positivity in Escherichia coli and Klebsiella pneumoniae strains isolated from various clinical samples. Material and Method: E.coli and K. pneumoniae strains inoculated on Mueller Hinton Agar plate. Susceptibility tests were performed with the VITEK 2 (BioMérieux, France) system before. Afterward, EBSL positivity was investigated manually DDST and CDT. Minimal inhibitor concentration (MIC) results of three tests were compared with each other according to the European Committee on Antimicrobial Susceptibility Testing (EUCAST) criteria. Results: 184 E. coli and K.pneumoniae strains, elevated. 92.9% of 98 patients with VITEK 2 positive results were positive with combined disc and DDS method, 100% of the 86 patients with negative results of VITEK 2 were negative with combined disc and MDC. Conclusion: VITEK 2 was found to have a sensitivity of 100%, a specificity of 92.4%, a positive predictive value of 92.8% and a negative predictive value of 100%. VITEK 2 was found to be compatible with validation tests for ESBL positivity.

Introduction: To investigate the efficacy of double carbapenem therapy (ertapenem + meropenem combination) in an experimental sepsis model in rats with Klebsiella pneumoniae (K. pneumoniae), which is carbapenem-resistant and colistin susceptible, and compare it with colistin and meropenem monotherapy. Materials and Methods: K. pneumoniae isolate that is known to carry the blaOXA-48 and blaNDM carbapenemase genes was used, and 1-2×108 colony forming unit/ml was inoculated intraperitoneally to 40 rats (20 males/20 females), and a sepsis model was created. The rats were divided into four equal groups: control, colistin, meropenem, and meropenem + ertapenem combination. The rats were followed for 24 h for signs of sepsis and mortality. Euthanasia was then performed, and blood cultures were taken. Results: After 24 h, none of the rats in the control or treatment groups died. K. pneumoniae growth was observed in all rats in the control, five in the colistin, seven in the meropenem, and five in the meropenem + ertapenem combination groups. A statistically significant difference was found between the control group and the colistin and meropenem + ertapenem combination groups (p=0.033 and p=0.033, respectively). No statistically significant difference was found between the control group and the meropenem monotherapy group (p=0.215). The numbers of non-growth blood cultures were comparable between the colistin group and the meropenem + ertapenem combination group, and no statistically significant difference was found between the two groups (p=1). The mean time of growth signals (minutes) were compared between the treatment groups: colistin, 642.6 ± 116.4; meropenem, 582.6 ± 107.7; and meropenem + ertapenem combination, 701.2 ± 70.4 min. Conclusion: Meropenem + ertapenem combination treatment was comparable to colistin monotherapy, and the mean time of growth signals of blood cultures were longer than those in the colistin and meropenem monotherapy groups.

Copyright of Journal of Health Sciences of Kocaeli University / Kocaeli Üniversitesi Sağlık Bilimleri Dergisi is the property of Institute of Health Sciences of Kocaeli University and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Objective: Bacteremia is a serious condition that causes hospitalization and increases mortality. Gram negative bacteria are frequently isolated as causative agents. The aim of this study was to evaluate the distribution and antimicrobial resistance of the gram negative bacteria isolated from blood cultures in our hospital. Methods: Gram negative bacteria isolated from blood culture samples sent to the microbiology laboratory between 2016-2019 were retrospectively analyzed. The blood cultures were performed by BacT/ALERT 3D (bioMérieux, France) and Render-BC128 (China). Bacterial identification and antibiotic susceptibility tests were performed using conventional methods and BD Phoenix 100 (BD Phoenix System, Beckton Dickinson, ABD) automated systems. Results: A total of 10,315 blood cultures obtained from hospitalized patients between 2016 and 2019 were evaluated. Microbial growth was detected in 3,177 (30.8%) of the blood cultures. Gram negative bacteria were isolated in 873 (27.5%) blood cultures and were included in the study. Among gram negative bacteria, Escherichia coli (38.7%) and Klebsiella pneumoniae (12.3%) species are the most common pathogens. In our study, E. coli strains showed the highest resistance to ampicillin (76.6%), K. pneumoniae and other Enterobacterales species to amoxicillin-clavulonate (65.9% and 43.9%), Acinetobacter baumannii to carbapenems (95.4%), Pseudomonas aeruginosa to ciprofloxacin (26.1%). The most susceptible antibiotics were carbapenems and amikasin for Enterobacterales, amikasin and gentamycin for P. aeruginosa, amikasin and trimethoprim-sulfamethaxazole for A.baumannii. Conclusion: In our study, the frequency of gramnegative bacteria growth in blood culture was found to be 27.5%, similar to literature data. It was observed that the determined bacterial distribution was compatible with different studies. Blood culture is the most important test in the diagnosis of bacteremia and in directing the right treatment. The distribution of microorganisms isolated in bacteremia and their antibiotic resistance rates changes by center. For this reason, it was think that each hospital should determine its own data at regular intervals and guide antibiotic selection according to these results. [ABSTRACT FROM AUTHOR]

R. acetosella is a perennial herbaceous plant in the Polygonaceae family and is consumed as a vegetable among the people in Turkey. In this study, antimicrobial (Escherichia coli, Bacillus megaterium, Bacillus subtilis, Proteus vulgaris, Pseudomonas aeruginosa, Listeria monocytogenes, Klebsiella pneumoniae, Staphylococcus aureus bacteria and Candida albicans yeast-fungi), antiradical (against to DPPH, ABTS and OH radicals), anticancer (against to human prostate cancer (PC-3), human colon cancer (HCT-116), human ovarian cancer (A2780) and human breast cancer (MCF-7) cell lines) and phytochemical properties (lipid-soluble vitamins, fatty acids, flavonoids, phenolic acids, phytosterols, total phenolic compounds, total flavonoid, and total proanthocyanidins) of ethanol, water and methanol extracts of R. acetosella aerial parts were investigated. According to our results, it was determined that R. acetosella extracts have higher activity than the BHT in scavenging tests of ABTS, DPPH and OH radicals. It has also been understood that this plant has high antimicrobial activity and phytochemical content and effective anticancer activities against to PC-3 human prostate cancer cell lines. Also the presented study is the first study on the in vitro anticancer activity of R. acetosella extracts. [ABSTRACT FROM AUTHOR]

Purpose: Renal transplantation is the most important and successful treatment method for renal failure. In this study, it was aimed to investigate the frequency of Cytomegalovirus (CMV), BK virus (BKV) and bacterial agents in kidney transplant recipient (KTR)s before and in the first six months after transplantation. Materials and Methods: CMV and BKV were investigated by Real-time PCR in blood samples taken from patients who underwent kidney transplantation at the Organ Transplantation Center of our faculty, one week before the transplantation and in the first, third and sixth months after transplantation. Blood, urine, respiratory tract /wound (if necessary) cultures were performed. Decoy cells were evaluated in urine cytology. Results: The mean age of KTRs was 32.60±11.71 years, 28 (62.2%) were male. Donor origins were living related donors 39 (86.7%) and cadaveric 6 (13.3%). After transplantation, BKV was detected in 11/38 (28.9%) patients, CMV was found in 25/41 (60.9%) patients, and Decoy cell positivity was detected in 11/31 (35.4%) patients. While the highest rate of Real-time PCR positivities were in the third months and sixth months for BKV and first, month for CMV and gradually decreased towards the sixth month. Escherichia coli, Klebsiella pneumoniae, Candida nonalbicans, Enterococcus faecalis were most commonly grown in urine culture. Staphylococcus hominis, Streptecoccus epidermidis, were grown in blood culture. Acinetobacter baumannii, Klebsiella pneumoniae, Aspergillus fumigatus and Candida albicans grew in the culture of respiratory tract samples. Conclusion: Bacterial infections developed early in our KTRs. While the highest Real-time PCR positivity rate was in the third and sixth months for BKV, it was the first month for CMV and gradually decreased towards the sixth month. Decoy cell positivity may be also important for diagnosis of BKV infection in KTRs. [ABSTRACT FROM AUTHOR]

Giriş: Amfizematöz sistit (AS), öncelikle diyabetik ve immünosüpresif orta yaşlı kadın hastalarda görülen nispeten nadir bir komplike idrar yolu enfeksiyonudur (İYE). Ateş, dizüri ve hematüri gibi şikayet ve semptomlarla karakterizedir. Görüntüleme çalışmalarında mesane duvarında ve/veya mesane lümeninde hava bulunmasıyla tanımlanır. AS'nin en önemli risk faktörleri diabetes mellitus (DM), nörojenik mesane, kalıcı üretral kateter ve immünosüpresyondur. Hastalık, başarılı yönetim ve uygun antibiyotik tedavisi ile genellikle iyi prognozla sonuçlanır. Burada immünosüpresif tedavi alan hastada K. pneumoniae etken olduğu bir AS olgusu sunulmaktadır. Olgu: Altmış beş yaşında sistemik skleroz tanılı kadın hasta 1 haftadır olan ateş ve üşüme-titreme, dispne ve dizüri şikayeti ile başvurdu. Yapılan fizik muayenede ateş 38,5 °C idi ve suprapubik hassasiyeti mevcuttu. Tetkiklerinde hemogramda lökosit: 18,600, PNL: %84 ve tam idrar tahlili: lökosit sayısı 340, lökosit esteraz 3 pozitif ve C-reaktif protein: 109 mg/l olarak saptandı. Dizüri şikayeti olan, yüksek ateş, akut faz yüksekiği, piyüri saptanan ve immünosüpresif tedavi (mikofenolat mofetil ve desktametazon) alan hastaya komplike İYE ön tanısıyla abdomen bilgisayarlı tomografi (BT) görüntülemesi yapıldı ve mesane duvarında hava ekojeniteleri saptandı. AS olarak değerlendirildi. Kan ve idrar kültürü gönderildi. Hastaya idrar sondası takılıp IV antibiyotik ve destek tedavisi başlandı. İdrar kültüründe genişlemiş spektrumlu betalaktamaz üreten K. pneumoniae üremesi oldu ve antibiyogram sonucuna göre ertapenem tedavisi planlandı. Sonuç: AS'nin klinik belirtileri asemptomatikten sepsise kadar oldukça değişkendir ve insidansı bilinmemektedir. Obstrüktif üropati, immünosüpresif, nörojenik mesane ve tekrarlayan İYE'si olan hastalar yüksek risk altındadır. Bu ölümcül enfeksiyon, DM'li hastalarda daha sık görüldüğünden belirtilerine karşı dikkatli olunmalıdır. Radyografik görüntülemenin gerekli olduğu olağandışı prezentasyonlu İYE olgularında kesin tanı için BT çekilmeli, bu ayırıcı tanı olanağı da sağlamaktadır. Vajinal/kolovezikal fistül, Crohn hastalığı, mesane karsinomu ve travma gaz üretiminin diğer nedenleridir ve AS ile ayırıcı tanı yapılmalıdır. AS enfeksiyonlarının yaklaşık üçte ikisine E. coli neden olur; geri kalan üçte birine K. pneumoniae, S. aureus ve Pr. mirabilis neden olur. Kandida türleri de sorumlu olabilir. Etiyolojinin tanımlanması için aerobik ve anaerobik kültürler gereklidir. Üçüncü kuşak sefalosporinler, β-laktam/β-laktamaz inhibitörleri ve karbapenem ajanları kullanılabilir. Antibiyotiğe yanıt vermeyen veya nekrotizan dokuya sahip olgularda debridman düşünülmelidir. AS'de yüksek mortalite ihtimalinden dolayı hızlı ve erken tanı önemlidir. BT tanı açısından son derece yardımcıdır. Tanıyı uygun antibiyotik ve gerekirse cerrahi müdahale takip etmelidir. Bu hastalık nadir görülmesine rağmen özellikle diyabetik ve immünosüpresif hastalarda düşünülmelidir. [ABSTRACT FROM AUTHOR]

Objective: In recent years, infections caused by Escherichia coli (E.coli) and Klebsiella pneumoniae (K.pneumoniae) have increased in intensive care units (ICUs), and their high resistance to many antibiotics has made their treatment difficult. The aim of this study was to determine the frequency and antibiotic resistance rates of E.coli and K.pneumoniae strains isolated from patients hospitalized in our hospital's ICU. Material and Method: In this study, E.coli and K.pneumoniae strains isolated from clinical samples sent from ICUs to microbiology laboratory between 2016-2020, were included. Bacterial identification and antibiotic susceptibility tests were performed using conventional methods and automated systems. Results: A total of 1154 E.coli and 924 K.pneumoniae isolates were included in the study. Among the gram-negative bacteria, E.coli and K. pneumoniae strains were detected as the first and the second most common respectively. Both microorganisms were isolated most frequently from urine samples and secondly from endotracheal aspirate samples. The highest resistance rates were to amoxicillin-clavulanate, ceftriaxone, trimethoprimsulfamethoxazole and ciprofloxacin. It was observed that ESBL positivity was higher in E.coli strains, carbapenem and piperacillin-tazobactam resistance was much higher in K.pneumonia. Also, the resistance rates have changed over the years. Conclusion: High rates of antibiotic resistance seen in gram-negative bacteria reduce the success of the treatment. For this reason, regular follow-up of their resistance surveillance and determining treatment protocols will contribute to the decrease in resistance. [ABSTRACT FROM AUTHOR]

Copyright of ANKEM Antibiyotik & Kemoterapi Dergisi is the property of ANKEM Antibiyotik & Kemoterapi Dergisi and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Objective: COVID-19 pneumonia, which has affected the whole world for more than two years, has forced the health system. In this period, when the delivery of health services is in danger, the use of appropriate antibiotics has remained in the background. With this study, we wanted to investigate the effect of changing antibiotic use during the pandemic period on the distribution of microorganisms that cause nosocomial infections and changing antibiotic resistances. Methods: The study was carried out in the Dışkapı Yıldırım Beyazıt Training and Research Hospital. Hospital-acquired infections caused by E. coli, Klebsiella penumonia, Enterobacter spp., P. aeruginosa and Acinetobacter spp. between 2016 and 2020 were evaluated for our study. We classified the patients in 2016 as 1st group, 2017 as a 2nd group, 2018 as a 3rd group, 2019 as a 4th group, 2020 as a 5th group. The groups were compared with each other in terms of the rate of hospital-acquired infection, their resistance status and the amount of antibiotics used in the relevant years. The factors that showed significant difference only in the 5th year were attributed to the changing health services during the pandemic period and were examined. Results: The most commonly used antibiotic in our study was ceftriaxone with a DDD of 150.72. Piperacillin + tazobactam and levofloxacin were the second and third most commonly used antibiotics, respectively. The amount of piperacillin + tazobactam use attributed to the pandemic period is significantly higher in the 5th group than in the 1st, 2nd, 3rd and 4th groups. Meropenem, levofloxacin, and colistin, which had increased usage during the pandemic period, were not attributed to the pandemic period since they did not differ with all other groups in pairwise comparisons. There was no change in the rates of microorganisms causing hospital infections for the pandemic period. Piperacillin resistance rate at 5th group for K. pneumonia and E. coli was significantly higher than at 1, 2, 3 and 4 groups. There was a positive correlation between the use of piperacillin/tazobactam and piperacillin resistance for K. pneumoniae and E. coli. Conclusion: In our study, we found that the use of piperacillin/tazobactam and levofloxacin in our hospital increased significantly during the pandemic period. There was no significant increase in the correlation between increasing antibiotic use and antibiotic resistance. Resistant strains, which will be triggered by the increasing amount of antibiotic consumption during the pandemic period, will be a problem that should be followed up in the coming years. [ABSTRACT FROM AUTHOR]

Objective: The aim of this study was detect to infection source before the bloodstream infection (BSI) of patients with secondary BSI to examine the epidemiological features, sources of infection, prognosis and antibiotic resistance. Materials and Methods: Culture/antibiotic susceptibility results of all hospitalized patients were evaluated retrospectively. Age, gender, localization of infection, causative microorganism, antibiogram test results, time frame between primary and secondary BSI and prognosis of each patients with secondary BSI was investigated. Results: In a total of 1,584 patients, secondary BSI was detected in 200 patients, 158 (79%) of them in the intensive care unit and 42 (21%) of inpatient services. Median of time between primary and secondary bloodstream infections among specimen species were statistically insignificant (p=0.091). Urinary tract infection (37%) is the most common, followed by respiratory tract infections (31%), skin and soft tissue infections (18%), central nervous system infections (10%) and other infections (4%). Acinetobacter baumannii complex species had a resistance against more than 95% of antibiotics except aminoglycosides. Resistance to carbapenem group antibiotics was observed at a rate of 2% in Escherichia coli strains and the rate was found to be 35% in Klebsiella pneumoniae isolates. Methicillin resistance was found in 29% of Staphylococcus aureus and 90% of coagulase negative staphylococci and 25% of Enterococcus spp. were resistant to vancomycin. Conclusion: Knowing a source of infection in secondary bloodstream infections will lead to an identification of risk factors for infections and a description of infection control practices. It will reduce health expenditure as well as mortality rate.. [ABSTRACT FROM AUTHOR]

Objective: This study aims to determine the distribution of microorganisms isolated from urine cultures collected from patients treated in the intensive care unit (ICU) of our hospital in the last 4 years and to conduct a study on antibiotic resistance in Gram-negative bacterial isolates. Materials and Methods: In this study, the distribution of microorganisms in urine cultures sent to the microbiology laboratory of our hospital, collected from patients who stayed in the ICU between July 2014 and July 2018, and the resistance profiles of Gram-negative bacteria to antibiotics were evaluated retrospectively. Results: No microorganism growth was observed in 692 (74.4%) of 930 urine samples sent from the ICU. Sixty-three (25.6%) of the cultures positive for microorganisms were Gram-positive bacteria, 64 (26.8%) were Candida strains, and 113 (47.4%) were Gram-negative bacteria. Strains of Escherichia coli and Klebsiella pneumoniae had the highest sensitivity to the antibiotic imipenem, whereas Pseudomonas aeruginosa strains (100%) were the most sensitive to tobramycin. Proteus spp. strains were generally susceptible to antibiotics; however, a high rate of resistance was seen in Acinetobacter spp. strains. Regarding extended-spectrum beta-lactamase production, 28 E. coli (53.8%) and 13 K. pneumoniae (46.4%) strains were found to be positive. Conclusion: Our results show an increase in microbial resistance, especially among Acinetobacter strains. Variations in the results of microorganism distribution and susceptibility clearly show the importance of every center reviewing their own data to make the correct choice of an empirical treatment. [ABSTRACT FROM AUTHOR]

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Objective: Inula viscosa is a perennial medicinal plant belonging to the Asteraceae family. This study aimed at investigating the antibacterial and anticarcinogenic activities of methanol and hexane extracts derived from I. viscosa. Methods: The antibacterial activity of different concentrations of I. viscosa methanol (1.56-800 mg/ml) and hexane (0.19-100 mg/ml) extracts was tested using the disc diffusion method. Listeria monocytogenes, Micrococcus luteus, Escherichia coli and Klebsiella pneumoniae were used as standard reference strains. Minimum inhibitory concentration (MIC) values of the extracts were made for each bacteria using the microdilution method. MIC value was determined as the lowest extract concentration at which growth was not observed. Minimum bactericide concentrations (MBC) were determined for all wells after MIC. The anticarcinogenic activity of I. viscosa was examined using the MTT test. MDA-MB-231 and HT-29 cells were stained with acridine orange and propidium iodide at the IC50 values of the extracts to determine the viable, apoptotic and necrotic cells. Results: Zone diameters of the methanol extract for L. monocytogenes, M. luteus, E. coli and K. pneumoniae were 8, 16, 7 and 9 mm, respectively. Zone diameters of the hexane extract for M. luteus, E. coli and K. pneumoniae were 14, 7 and 9 mm, respectively. MIC values of the methanol extract were 25 mg/ml for M. luteus, 200 mg/ml for L. monocytogenes and K. pneumoniae, and 400 mg/ml for E. coli. MIC values of the hexane extract were 400 mg/ml for L. monocytogenes, E. coli ve K. pneumoniae, and 100 mg/ml for M. luteus. MBC values were similar to MIC values. IC50 values for MDA-MB-231 and HT-29 cells were 25 mg/ml and 200 mg/ ml for the methanol extract, and 6.25 mg/ml and 12.5 mg/ml for the hexane extract, respectively. Depending on increased concentration levels, the presence of necrotic and early apoptotic cells was observed among MDA-MB-231 and HT-29 cells. Conclusion: Methanol and hexane extracts of I. viscosa were found to have antibacterial effects on the studied bacteria and anticarcinogenic activity on MDAMB- 231 and HT-29 cells. Conducting further studies to demonstrate the effects of these extracts on different cancer cell lines and bacterial strains will contribute to the field of complementary medicine. [ABSTRACT FROM AUTHOR]

Objective: In this study, it was aimed to investigate the antimicrobial effect of 16 different essential oils by commercially sold, against different standard bacterial strains and one clinical bacterial strain and one standard yeast strain. Methods: Essential oils used in the study were determined in parallel with the relevant literature review. Microbial strains were obtained from American Type Culture Collection (ATCC) and Sivas Cumhuriyet University Application and Research Hospital Clinical Microbiology Laboratory. Study inoculums were determined according to the McFarland 0.5 standard, and antimicrobial activity was investigated according to the standard disk diffusion method of the European Committee on Antimicrobial Susceptibility Testing (EUCAST). Results: Essential oils and inhibition zone values that have the highest effect against the standard strains and the clinical isolate used in the research are as follows: to Thymus vulgaris; Staphylococcus aureus =50 mm, Acinetobacter baumannii 43 mm, Escherichia coli 35 mm, Enterococcus feacalis 35 mm; Klebsiella pneumoniae 9 mm, Candida albicans =50 mm; to Melaleuca alternifolia; Staphylococcus aureus 14 mm, Acinetobacter baumannii 19 mm, Escherichia coli 20 mm, Enterococcus feacalis =10 mm, Klebsiella pneumoniae 13 mm, Candida albicans =50 mm; to Mentha piperita; Staphylococcus aureus =50 mm, Acinetobacter baumannii 20 mm, Escherichia coli 18 mm, Enterococcus feacalis 14 mm, Candida albicans = -50 mm, Klebsiella pneumoniae no inhibition zone was observed. To Lavandula officinalis; Staphylococcus aureus 16 mm, Acinetobacter baumannii 10 mm, Escherichia coli 11 mm, Enterococcus feacalis 14 mm, Candida albicans 18 mm and Klebsiella pneumoniae no inhibition zone was observed. Conclusion: The essential oils, whose effects were investigated against standard bacterial strains, a clinical bacterial isolate, and yeast strain, it was observed that high antimicrobial activities at different levels. It was observed that thyme, tea tree, mint and lavender essential oils among the essential oils studied had stronger antimicrobial effect than other essential oils. As a result, we think that these essential oils, which we have investigated, may contribute to the study of new antimicrobial substances, and antimicrobial drug due to their high antimicrobial effect. [ABSTRACT FROM AUTHOR]

Introduction: Pathogens have persisted as major agents in the progress of infections that constitute a threat to human health the world over. Extracting remedies from plants is a longstanding human tradition. This study assesses the antimicrobial action of extracts of turmeric (Curcuma longa) and garlic (Allium sativum) against several bacterial clinical isolates. Materials and Methods: The phytochemical constituents of ethanolic and aqueous extracts of turmeric and garlic and their susceptibility in single and combined absorptions were determined using a Clinical and Laboratory Standards Institute standard. Results: Steroids, flavonoids, terpenoids, and alkaloids were detected in both extracts, whereas anthraquinone was only present in turmeric. On the other hand, tannins and saponins were present in extracts of garlic. Ethanolic extract of garlic showed a zone of inhibition measuring 12 mm at the absorption of 100 mg/ml against Staphylococcus aureus, a zone of inhibition 10 mm at a concentration of 100 mg/ml against Escherichia coli and a zone of inhibition of 7 mm at a concentration of 100 mg/ml against Klebsiella pneumoniae. The aqueous extract of the same garlic was effective against the tested bacteria. Ethanolic extract of turmeric showed the largest zone of inhibition of 13 mm at a concentration of 100 mg/ml against Staphylococcus aureus and 7 mm at a concentration of 100 mg/ml against Klebsiella pneumoniae. Equally, the aqueous extract of turmeric showed the highest zone of inhibition of 11 mm at a concentration of 100 mg/ml on Staphylococcus aureus and 7 mm against Klebsiella pneumoniae. The aqueous extract of garlic was active against the isolate, and the combination of the two extracts was active against the tested organism. Conclusion: Spices can be used as effective antimicrobial agents against both Gram-positive and Gram-negative bacteria in both individual and combined forms.

Introduction: A new approach to carbapenem resistance-K. pneumoniae infections is to use combination drug therapies. However, little data are available about the effectiveness of the in vitro carbapenem plus colistin combination against oxacillinase-48 (OXA-48) producing K. pneumoniae. Therefore, the aim of this study is to assess the potential synergistic activity of imipenem plus colistin in OXA-48-producing K. pneumoniae strains and investigate the changes in the imipenem minimal inhibitory concentrations (MICs) to varying MICs of colistin. Materials and Methods: Carbapenem and colistin resistance (ColR) genes were investigated by polymerase chain reaction. In the first stage, synergistic properties were determined by the checkerboard combination method. In the second step, at varying colistin concentrations, changes in the imipenem MICs were investigated. Results: Colistin MIC50 2 µg/ml, MIC90 16 µg/ml, and imipenem MIC50 32 µg/ml, MIC90 128 µg/ml were found, respectively. According to the fractional inhibitor concentration (FIC) formula, 62.2% of the isolates were synergistic, and 37.8% were indifference. When the colistin was fixed at 0.125 µg/ml, 0.25 µg/ml, 0.5 µg/ml, 1 µg/ml, and 2 µg/ml, respectively. Significant decreases were observed in the imipenem MICs, especially of colistin-sensitive isolates. However, imipenem MICs of ColR isolates did not decrease to susceptible levels. Conclusion: This information will facilitate the design of antibiotic regimens that are more suitable for treating infections due to such pathogens producing OXA-48 and prolong these antibiotics’ efficacy. Further in vitro research is required to determine which treatment combination is best and its optimal use as combination therapy to treat these infections.

Most of the plants in the world are known to have effective substances both in accelerating the healing process of wounds and in the treatment of infections due to injury. Previous studies by scientists have shown that mosses and liverworts also have antimicrobial activity against various bacteria and fungi. In this study, the antimicrobial activities of ethyl alcohol extracts of Philonotis seriata Mitt, Porella arboris-vitae (With) Grolle, Porella platyphylla (L.) Pfeiff, Syntrichia calcicola J.J.Amann species were analyzed on a total of 18 strains, 8 gram positive, 9 gram negative bacteria and 1 yeast. As a result of the analysis, it was determined that all moss and liverwort samples have antimicrobial activity against a few strains and they have significant antimicrobial effects especially on gram-positive Staphylococcus aureus and gramnegative Klebsiella pneumoniae. [ABSTRACT FROM AUTHOR]

Objective: Carbapenem-resistant Klebsiella pneumoniae (CRKp) is among the leading causes of hospital-acquired infections worldwide and causes serious and life-threatening infections. Treatment options are very limited for blood stream infections (BSIs) and prognosis is poor due to increasing multi-drug resistance. The aim of this study was to assess risk factors for the mortality due to CRKp-BSI. Methods: A retrospective study was conducted in a university hospital from September 2013 to October 2017. Patients (aged >16 years) with CRKp-BSI were included in this study. Data, including demographics, Charlson comorbidity index (CCI), acute physiology and chronic health evaluation II (APACHE II) score on hospitalisation date, minimum inhibitory concentration (MIC) of CRKp, antibiotic treatment and outcome (30-day mortality) data were collected from the electronic medical records and microbiology databases. Results: A total of 82 patients with CRKP-BSIs were analysed. The median age was 54.5 years, and 48 (58.5%) of them were male. The median APACHE II score on hospitalisation was 14 (IQR 6-28) and CCI was 4.0 (IQR 0-12). Forty-six (56.1%) patients had ICU-acquired bacteremia and 36 (43.9%) had central-line associated bacteremia and 25 (30.5%) had primary bacteremia. Fifty (61.0%) patients had combination therapy, colistin/tigecycline (28%) was the most used antibiotic combination. The mortality of all patients was 56.1% (46/82) and 65.2% (30/46) in ICU patients. In univariate analysis, risk factors for the mortality of CRKp-BSI were high CCI, not having clinical response on the fifth day of treatment, high APACHE II score on hospitalisation and infection date and multiple organ dysfunction syndrome. In multivariate analysis, the most significant risk factor for mortality was APACHE II score on infection day (OR: 1.190; 95% CI: 1.088-1.301). Treatment regimens and combination therapy vs. monotherapy were not found to be significantly associated with survival. In addition, MIC values of CRKp were not associated with mortality. Conclusions: Patients with CRKp-BSI had high mortality (56.1%). APACHE II score on infection day was significantly associated with mortality. The outcome was similar between patients receiving combination (54.3%) or monotherapy (45.7%). [ABSTRACT FROM AUTHOR]

Objective: Klebsiella pneumoniae infections have been a problem in intensive care units (ICU) in recent years due to multi-drug resistance. In this study, it was aimed to analyze K. pneumoniae infections in ICU, determine distribution of carbapenem resistance rates and risk factors. Methods: Nosocomial infections (NI) with K. pneumoniae between January 2017-January 2020 were evaluated retrospectively. In cases with recurrent K. pneumoniae infection, only the first episode was included. Results: K. pneumoniae infections were developed in a total of 78 patients. Bloodstream infections (BSI) were the most common (51.3%), followed by pneumonia (41%) and urinary tract infections (7.7%). Among BSI cases, 52.5% were associated with central venous catheter (CVC) and 81.2% of pneumonia cases were ventilator-associated pneumonia (VIP). It was observed that while the proportion of BSI was gradually decreasing in years, pneumonia rates have increased. Among BSI, it was observed that the rate of CVC-related BSI was increased from 33.3% in 2017 to 62.5% in 2019. Carbapenem resistance was 52.6% and colistin resistance was 17.9% in K. pneumoniae isolates and both increased over 3 years. When carbapenem-resistant K. pneumoniae infections were compared with carbapenem-sensitive K. pneumoniae infections, the independent risk factors associated with carbapenem resistance were found to be carbapenem use (p=0.008, OR: 8.45, 95% CI: 1.76-40.64), prior NI developing with different microorganism (p=0.005, OR: 8.70, 95% CI: 1.91-39.65) and total parenteral nutrition (TPN) use (p=0.04, OR: 4.2, 95% CI: 1.06-16.67). Conclusions: Carbapenem-resistant K. pneumoniae infections are gradually increasing in ICUs, and colistin resistance has started to be observed recently. Our study showed that carbapenems are independent risk factors in carbapenem resistance and suggested that carbapenem use should be restricted in our unit. It is important for each center to reveal its own data of frequency and resistance, in order to decrease infection rates with the infection control measures and determine the antibiotic using policies. [ABSTRACT FROM AUTHOR]

Giriş: Dirençli Klebsiella pneumoniae enfeksiyon sıklığındaki artışın önemli etkileri vardır; tedavi başarısızlığı ve mortalitede artış ile ilişkilendirilmektedir. Tedavi seçeneklerimizin oldukça az olduğu bu hasta grubunda direnç oranlarının ve verilen antibiyotiklerin etkinliğinin irdelenmesi amaçlandı. Gereç ve Yöntem: Hastanemizde 2023 yılı içerisinde klinik izolatlarında etken olarak Klebsiella pneumoniae saptanan hastaların verileri retrospektif olarak değerlendirildi. Karbapenem, kolistin, seftazidim avibaktam direnç varlığı, verilen tedaviler ve bunların mortaliteye etkisi incelendi. Mortaliteyi etkileyen faktörleri belirlemek için lojistik regresyon analizi yapıldı. Bulgular: Klinik izolatlarında etken olarak Klebsiella pneumoniae saptanan 145 hasta verisi retrospektif olarak değerlendirildi. Altısı tedavi başlamadan eksitus olduğu için çalışma kapsamı dışında tutuldu. Erkek olan 73 (%52,5) hasta vardı, 128'inde (%92,1) sistemik enfeksiyon saptandı ve 31'inde (%22,3) sekonder bakteriyemi gelişti. İzolatların 103'ünde (%74,1) karbapenem direnci saptanırken, kolistin duyarlılığının ancak 59'unda (%42,4) çalışıldığı, bunların 22'sinde (%37,2) direnç saptandığı görüldü. On dokuz (%13,7) hastada kolistin ve karbapenem direnci birlikte görüldü. Seftazidim avibaktam duyarlılığı ise 56 (%39,6) izolatta çalışıldı ve bunların 8'inde (%14,2) direnç saptandı. Tedavide kullanılan ajanlar sıklık sırasıyla karbapenemler (%65,5), diğer beta-laktamlar (%39,3), kolistin (%37,2), aminoglikozidler (%20,7), kinolonlar (%6,9), kotrimaksozol (%2,1) ve ortalama tedavi süresi ise 12,63±10,43 idi. Kırk altı (%33,1) hastaya tek, 45'ine (%32,4) ikili, 48'ine (%34,5) üç ve üzerinde antibiyotik verildiği görüldü. Hastaların 68'inde (%48,9) eksitus, 36'sında (%25,9) şifa, 35'inde (%25,2) aynı bakteri ile re-enfeksiyon görüldü. Kombinasyon tedavilerinde sürenin daha uzun olduğu fakat mortaliteyi etkilemediği görüldü (p=0,068). Kurulan regresyon modelinin modele dahil olan değişkenlerle mortaliteyi açıklama yüzdesi Nagelkerke R2 göre %44,7'dir. Kurulan regresyon modeli istatistiksel olarak anlamlı bulundu (χ2=40.664, p=0,002). Kadınlarda mortalite istatistiksel anlamlı olarak 0,251 kat azdı (sig=0,021). Seftazidim avibaktam direnci istatistiksel anlamlı olarak mortaliteyi 14.875 kat artırmaktadır (sig=0,025). Kolistin tedavisi alması istatistiksel anlamlı olarak mortaliteyi 0,220 kat azaltmaktadır (sig=0,050 sınırda). Aminoglikozid verilen hastalarda da mortalitenin anlamlı olarak azaldığı görülmektedir (p=0,030). Sonuç: Hastane kaynaklı Klebsiella pneumoniae enfeksiyonlarının yönetimi her geçen gün zorlaşmaktadır. Seftazidim avibaktam duyarlılığının tüm suşlarda bakılması klinik olarak fayda sağlayabilir. Fazla sayıda antibiyotik vermenin tedavi başarısını artırmadığı, kolistin ve aminoglikozid tedavilerinin sağkalım üzerine olumlu etkisi olduğu göz önünde tutulmalıdır. [ABSTRACT FROM AUTHOR]

Introduction: This study aims to assess the in vitro activity of ceftazidime-avibactam (CZA) and ceftolozane-tazobactam (C/T) against the multi-drug resistant (MDR) Klebsiella pneumoniae. Furthermore, we aimed to determine the types of carbapenemase enzyme responsible for carbapenem resistance and compare the activity of ceftolozane-tazobactam and CZA according to the types of carbapenemase enzymes produced. Materials and Methods: Twenty-two MDR isolates were investigated in the study. The identification and antimicrobial susceptibilities of the isolates were performed by VITEK 2 (BioMérieux, France) automated system. The activity of C/T and CZA was determined by the gradient strip test (Liofilchem MIC strip test, Italy). In all K. pneumoniae isolates, blaIMP-1, blaKPC, blaNDM-1, blaOXA-48 and blaVIM gene regions encoding the carbapenemase enzyme were investigated by using Xpert CARBA-R test kits (Cepheid, Sunnyvale, CA, USA) of the Gene-Xpert® system. Results: Ceftolozane-tazobactam resistance was detected in 21 (95%) isolates, whereas CZA resistance was detected in six (27%) isolates. Among the 22 K. pneumoniae isolates, NDM-1 gene region was detected in three, NDM-1+OXA-48 gene region was detected in two, OXA-48 was detected in eight, and KPC gene region was detected in nine isolates. VIM and IMP-1 gene regions were not detected. Ceftolozane-tazobactam resistance was detected in seven isolates, whereas CZA resistance was not detected among the eight K. pneumoniae isolates producing only OXA-48. NDM-1 and OXA-48 co-producing isolates were detected resistant to C/T and CZA with high minimum inhibitory concentration (MIC) levels (MIC ≥256 µg/ml). All NDM-1 producing isolates had high MIC levels (MIC ≥256 µg/ml) to both C/T and CZA. Ceftazidime-avibactam resistance was detected in only one isolate, whereas C/T resistance was detected in all K. pneumoniae isolates producing KPC. Ceftolozane-tazobactam was detected inefficient whereas CZA was found very efficient in MDR K. pneumoniae isolates producing KPC. Conclusion: According to the obtained data, we detected the in vitro antibacterial activity of CZA against the MDR K. pneumoniae isolates was superior to that of C/T. Ceftolozane-tazobactam was found to be weakly efficient, whereas CZA was found to be highly efficient against the MDR K. pneumoniae isolates producing OXA-48 and KPC. Because avibactam can inhibit the activity of KPC-type carbapenemase, the combination drug CZA should be considered to be effective in the treatment of KPC-type carbapenemase-producing strains but noneffective against NDM-type carbapenemase-producing strains.

Introduction: Infections with extended-spectrum beta-lactamase (ESBL)-producing strains are seen at increasing rates, resulting in increased morbidity, mortality, length of hospitalization, and cost. Effective and safe treatment of these infections is important. The aim of this study was to compare the effectiveness of piperacillin-tazobactam (PTZ) and carbapenems in nosocomial infections with ESBL-producing Escherichia coli and Klebsiella pneumoniae in hospitalized patients. Materials and Methods: This study was performed retrospectively on patients who were infected with ESBL-producing E. coli and K. pneumoniae while hospitalized in Ankara Atatürk Tranining and Research Hospital between 2014 and 2017. Both PTZ- and carbapenem-susceptible isolates were included in the study. Patients with signs of infection who were older than 18 years, hospitalized for at least 48 hours, and received PTZ or carbapenem therapy were included in the study. Patients who received PTZ and carbapenem antibiotics consecutively in same infectious episode, received another antibiotic active against ESBL-producing microorganisms, received the selected antibiotic for less than 48 hours, or had polymicrobial infection were excluded from the study. Demographic characteristics, comorbid diseases, antibiotics used and their dose/duration, mechanical ventilation, presence of central catheter, clinical and microbiological responses to treatment, and end-of-treatment and 30-day mortality were recorded and compared. Results: Of the total 113 patients, 60 (53.1%) were male and the mean age was 66.14±18.2 years. Of the patients, 73.5% had E. coli and 26.5% had K. pneumoniae. Seventy patients (61.9%) received carbapenem and 43 patients (38.1%) received PTZ treatment. Microbiological eradication rate was 71.7% (43/60) in patients with control cultures. Clinical response was observed in 72.6% of the cases. The overall mortality rate was 31.0% (n=35). There were no significant differences between the groups in clinical and microbiological response (p=0.055; p=0.303) or end-of-treatment and 30-day mortality (p=0.180, p=0.288). Age and bacteremia was found to be independent risk factors for mortality (p=0.006 for both). Conclusion: PTZ is an important alternative for infections caused by ESBL-producing microorganisms. In recent years, the need for rational antibiotic use has increased and carbapenem-sparing treatments have became more important. Piperacillin-tazobactam is one of the best alternatives and has comparable effectiveness in infections caused by ESBL-producing E. coli and Klebsiella spp.

Purpose: The aim of this study was to determine the rate of catheter-related bloodstream infection (CRBSI), exit site infection, and responsible microorganisms in pediatric hemodialysis patients. Materials and Methods: In this study, the data of catheter exit site and blood cultures from 12 chronic hemodialysis patients who were followed during 2015-2017 were retrospectively analyzed. Results: Twelve pediatric hemodialysis patients in 2015, 2016 and 2017 were hospitalized 127 times for various reasons. Seventeen (13.3%) of these hospitalizations were due to CRBSI or exit site infections. Seven of these patients (58.3%) had both CRBSI and exit site infection, two (16.6%) had exit site infection only, and one (8.3%) had CRBSI. Nine (75%) patients with suspected exit site infection had 22 culture positivity. Microorganisms growing in cultures were Staphylococcus aureus, Staphylococcus epidermidis, Acinetobacter baumannii complex, Enterobacter cloacae, Pseudomonas aeruginosa, and Klebsiella pneumonia, respectively. Nine (75%) patients with suspected CRBSI had 31 culture positivity. Microorganisms growing in cultures were S.aureus, S.epidermidis, E.cloacaa, A.baumannii complex, S.hominis, and P. aeruginosa, respectively. Conclusion: In children with chronic hemodialysis, CRBSI and/or exit cite infections are seen as common. While CRBSI rate is low alone, the education of the family and the child for the care of catheter should be considered first due to the development of the CRBSI and exit site infection at the same time, or the development of CRBSI following exit site infection. [ABSTRACT FROM AUTHOR]

Honey is highly nutritious, and a functional food rich in bioactive components. The biological activity of honey differs according to its botanical origin, geographic properties, and climate characteristics. Therefore, it is necessary to handle the monofloral and multifloral honey produced in our country in a comprehensive manner. Adopting the understanding of displacement of natural preservatives with synthetic ones enables the exploration of alternative uses of honey. For this purpose, in our study, the antimicrobial activity of lavender, lemon, thyme and multifloral honey were determined and compared with each other. According to the results obtained, it was found that multifloral honey has higher antimicrobial activity than monofloral honey, but lemon honey which is one of the monofloral honey types, shows strong inhibition against microorganisms tested, and thyme honey had the weakest antibacterial effect. Antimicrobial activity (except for Bacillus cereus DSM 4312) was found to be strongest against bacterial then yeast and then mold in all honey varieties. In addition, we found that that the most resistant bacteria statistically was B. cereus DSM 4312, while the most sensitive bacteria was Klebsiella pneumoniae ATCC 700603 and Pseudomonas aeruginosa ATCC 35032. [ABSTRACT FROM AUTHOR]

Objective: Antimicrobial resistance is one of the most important health problems of recent years. Multidrug-resistant Klebsiella pneumoniae strains have been causing serious problems in many countries including Turkey in recent years. Aim of this study was to detect molecular mechanisms behind the car-bapenem resistance in carbapenem-resistant K. pneumoniae strains isolated from rectal swab samples and investigate the susceptibility of two potentially alternative drugs, fosfomycin, and chloramphenicol. Methods: 46 K. pneumoniae strains isolated from rectal screening cultures of intensive care unit patients by using MacConkey agar containing 2 mg/L meropenem were included in this study. Carbapenem resistance of strains were confirmed by minimum inhibitor concentrations of meropenem obtained with gradient strip test. Presence of the blaKPC, blaNDM, blaOXA, blaIMP and blaVIM genes were investigated by the real-time polymerase chain reaction. Broth microdilution method was used to investigate chloramphenicol susceptibility, and gradient strip test was used to investigate fosfomycin susceptibility of the strains. Results: At least one carbapenemase gene was detected in all K. pneumoniae strains. While all strains were found positive for the presence of OXA-48 type carbapenemase gene, 12 (26%) out of 46 were positive for both OXA-48 and NDM-1 carbapenemase genes, and only one (2%) strain was positive for OXA-48, NDM-1, and IMP-1 carbapenemase genes. Only 3 (6%) out of 46 strains were found susceptible to fosfomycin while 23 (50%) of them were susceptible to chloramphenicol. Additionally, we observed that the resistance rates to fosfomycin and chloamphenicol tended to be higher among carbapenemase producers. Conclusions: It is estimated that fosfomycin is not going to be a good option for the treatment of infections caused by carbapenem-resistant K. pneumoniae strains in Turkey since only 6% of them were susceptible. Although the chloramphenicol susceptibility rate (50%) was higher than fosfomycin, further clinical studies are required to provide a better knowledge about the usage of this antibiotic in systemic infections. Moreover, multiple carbapenemase producers tended to be more resistant to fosfomycin and also chlor-amphenicol. [ABSTRACT FROM AUTHOR]

In this study, new alternative compounds were synthesized as a result of changing the groups in these compounds with the aim of minimizing the harmful effects of paraben compounds. Due to the investigation of the antimicrobial properties of these synthetic com pounds which can be used as protective excipients in pharmaceuticals, gram positive and gram negative bacteria Klebsiella pneumoniae ATCC 13883, Escherichia coli ATCC 36218, Bacillus megaterium DSM-32, Staphylococcus aureus ATCC 25923 and eukaryotic yeast Candida albicans ATCC 10231 and Yarrowia lipolytica were used. [ABSTRACT FROM AUTHOR]

Today, the active ingredients of the preparations used in the treatment of some diseases can be completely herbal source. Some plants or spice mixtures are known to have antiviral, antibacterial and antifungal effects, and are known to be used as supplements to treat simple infections or to strengthen the immune system as a preservative. The zahter used in the study is a spice mixture that is consumed as breakfast in Southeastern Anatolia. In this study; The antimicrobial effects of zahterin Escherichia coli ATCC 25322, Pseudomonas aeruginosa DMS50071 SCOTTA, Klebsiella pneumoniae ATCC 700603 were investigated by using the hollow agar method. Zahterin ethanol and chloroform extracts were applied at 25mg / ml - 50mg / ml - 75mg / ml - 100mg / ml. 100% DMSO for negative control and amoxicillin, clindamycin and penicillin for positive control were used. According to the results; Zahter extract was found to be effective against E. coli in its extract prepared with chloroform at concentrations of 25mg / ml-50mg / ml-75mg / ml and 100mg / ml (zone not seen, 18mm, 24mm, 27mm). It was determined that Zahter extract inhibited the development of P. aeruginosa in its extract prepared with chloroform at concentrations of 25mg / ml-50mg / ml-75mg / ml and 100mg / ml (9mm, 11mm, 14mm, 27mm). Zahter extract was observed to be effective against K. pneumoniae in its extract with chloroform at concentrations of 25mg / ml-50mg / ml-75mg / ml and 100mg / ml (13mm, 17mm, no zone, no zone). Zahter extract was found to be effective against K. pneumoniae in its extract with ethanol at concentrations of 25mg / ml-50mg / ml-75mg / ml and 100mg / ml (13mm, 17mm, no zone, no zone seen). But it did not affect E. coli and P. aeruginosa. In addition, zahter extract with chloroform was found to have a stronger antimicrobial effect than zahter extract made with ethanol. [ABSTRACT FROM AUTHOR]

Objective: IgY antibody is found in chickens' serum and egg yolk. IgY antibody in chickens is specific antibodies that develop highly against microorganisms during infection and is known to be transferred to egg yolk. IgY technology is a method based on producing and isolating antibodies in chicken eggs. The isolation of the IgY antibody from egg yolk is more easier to isolate, noninvasive, long life and higher in amount than it's isolation from sheep, goat and rabbit. Chicken antibodies used in diagnostic methods, will be lower cost than the mammalian antibody. In this study, the aim was to produce IgY antibodies against bacteria of Staphylococcus aureus (S. aureus), Klebsiella pneumoniae (K. pneumoniae) and Pseudomonas aeruginosa (P. aeruginosa) which are commonly identified as the cause of nosocomial pneumonia and to investigate the efficiency of these antibodies by of ELISA method. Methods: Immunization of chicken was performed using S. aureus ATTC 6538, P. aeruginosa ATCC 27853 and K. pneumoniae ATCC13883 bacteria grown in blood agar and inactivated subsequently. Twenty-twoweek- old Lohmann Brown laying hens were immunized through intramuscular injection with Freund's complete adjuvant and re-stimulate immunizations with Freund's incomplete adjuvant were performed four times at an interval of two weeks. PEG 6000 procedure was used for the isolation and purification of IgY antibodies synthesized by immunized hens against bacteria. Efficacy of antibodies was evaluated with ELISA method and OD values of IgY the antibodies isolated from the eggs of immunized and non-immunized hens were subjected to comparison. Results: IgY antibodies isolated from hens immunized with S. aureus, K. pneumoniae and P. aeruginosa bacterial antigens and from non-immunized hens were compared in order to determine OD values with ELISA method. In both dilutions (1/100 and 1/1000) IgY OD values of immunized hens were observed to be higher than the calculated cut off value (ODC) (p<0.05). Conclusion: The data obtained from a study shows high efficacy of IgY antibodies isolated from chickens against bacteria which are commonly identified as the cause of nosocomial pneumonia. The fact that IgY antibodies can be obtained quickly through non-invasive cost-effective methods allowed these antibodies to be used in diagnostic procedures over the past decade as well as making them a viable choice among prevention and treatment options against certain diseases. Therefore, based on the results of this study, it was concluded that IgY antibodies might be largely and actively used for the purposes of diagnosis and treatments in the future. [ABSTRACT FROM AUTHOR]

In this study it was aimed to determine the microbial diversity and level of antibiotic resistance patterns of Gram-negative bacterial isolates from the hospital sewages. The 219 Gram-negative bacterial isolates to 16 different antibiotics (belonging 10 classes), was investigated by agar diffusion method. A total of 18 species of bacteria were isolated: the most common strains isolated from all samples were Klebsiella oxytoca (27.4%), Klebsiella pneumoniae (20.5%) and Escherichia coli (20.1%). There was a high incidence of resistance to ampicillin (98.6%), streptomycin (95.9%) and erythromycin (90.0%), and a low incidence of resistance to cefepim (13.2%), imipenem (5.0%) and meropenem (3.2%). 35.6% of all bacteria isolated from hospital sewage were resistant to 9 different antibiotics. The multiple antibiotic resistances (MAR) index ranged from 0.25 to 0.94. Results show that hospital sewages have a significant proportion of antibiotic resistant Gram-negative bacteria, and these bacteria constitute a potential risk for public health.

Antimicrobial resistance (AMR) is one of the most important problems threatening human health worldwide. The impact of the Coronavirus disease-2019 (COVID-19) pandemic on AMR continues to be discussed. Some researchers argue that the pandemic will increase AMR rates, while others suggest the opposite. The aim of this study was to investigate the change in AMR of Escherichia coli, Klebsiella pneumoniae and Staphylococcus aureus strains in three cross-sectional periods in Türkiye, the first one before the COVID-19 pandemic, the second and the third one during the pandemic. The change in antibiotic susceptibility in Escherichia coli, Klebsiella pneumoniae and Staphylococcus aureus strains isolated from urine, blood, and lower respiratory tract samples of patients hospitalized in intensive care units and wards of hospitals before (November 2019) and during the COVID-19 pandemic (November 2020 and July 2021) was investigated in this study. A total of 17 voluntary hospitals, members of the Antibiotic Susceptibility Surveillance Study Group (ADSI) of the Society for Clinical Microbiology Specialists (KLIMUD), participated in the study. Identification of bacteria was performed with automated bacterial identification systems (VITEK2, bioMérieux, France or Phoenix, BD, USA). Antibiotic susceptibility tests were performed in one center with the Kirby-Bauer disc diffusion method and in other centers with automated antibiotic susceptibility test systems (VITEK2, bioMérieux, France or Phoenix, BD, USA), and the results were evaluated according to European Committee on Antimicrobial Susceptibility Testing (EUCAST) criteria. Antibiotic susceptibility ratios were statistically analyzed using either the chi-square or Fisher's exact test. A p-value of < 0.05 was considered statistically significant. Antibiotic susceptibility test results of a total of 4030 strains; 1152, 1139, and 1739 belonging to November 2019, November 2020, and July 2021, respectively; were examined. While cefotaxime and ceftazidime susceptibility rates in E.coli strains increased during the pandemic period compared to previous period (p= 0.04, p= 0.001, respectively); nitrofurantoin sensitivity (p= 0.02) and extended-spectrum beta-lactamase (ESBL) ratios (p< 0.001) were found to be decreased. It was determined that the susceptibility rates of all other examined antimicrobials did not change statistically. It was observed that the susceptibility rates of all antibiotics in K.pneumoniae isolates decreased during the pandemic period, but the ESBL rates increased between 2019-2020 (p= 0.01) and decreased between 2020-2021 (p= 0.02). It was found that ESBL rates increased before and after the pandemic. It was observed that the susceptibility to ciprofloxacin (p= 0.0001), levofloxacin (p= 0.003), and gentamicin (p= 0.005) in S.aureus strains increased during the pandemic period. No significant changes were observed in other antibiotic susceptibility rates. Methicillin resistance of S.aureus (MRSA) strains decreased between 2019-2020 (p= 0.03) and increased again in 2021 (p= 0.04) and returned to the pre-pandemic rate. Our study results suggest that the measures taken to reduce the spread of COVID-19 with the pandemic (such as quarantine practices, increased hand hygiene, mask use, and national/international travel restriction) may reduce the spread of bacteria such as ESBL-producing E.coli and the rate of MRSA, which is considered as a hand hygiene indicator. The increase in the later stages of the pandemic recalls the relaxation in compliance with hand hygiene rules. The decrease in the susceptibility rate of K.pneumoniae isolates to antibiotics and the increase in the ESBL rate may be due to inappropriate and excessive use of antibiotics during the pandemic period. However, we believe that these data should be supported by studies to be conducted nowadays when all the rules and measures are back as if the pandemic has ended.

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Objective: In this study, it was aimed to determine the antibiotic susceptibility of Pseudomonas aeruginosa, Klebsiella pneumoniae and Acinetobacter baumanii bacteria isolated from blood and endotracheal aspirate samples, and to start the appropriate empirical antibiotic treatment. Materials and Methods: The antibiogram results of the patients’ whose blood and endotracheal aspirate samples sent from Erciyes University Faculty of Medicine Pediatric Intensive Care Unit to our hospital between January 1, 2013-August 30, 2017, and Pseudomonas aeruginosa, Klebsiella pneumoniae and Acinetobacter baumannii bacteria reproduction detecting were evaluated retrospectively. Results: One hundred thirty-five samples sent from a total of 111 patients [65 male (63.6%), 56 female (36.4%)] with a median age of 17 months (7-112) were analyzed retrospectively. Of these samples reproduction of Pseudomonas aeruginosa were detected in 68 [blood: 31, endotrakealaspirat (ETA): 37], Acinetobacter baumannii in 42 (blood: 22, ETA: 20), Klebsiella pneumoniae in 25 samples (blood: 18, ETA: 7). Amikacin resistance rate was the lovest antibiotic (23.7%), while cefepime, ceftazidime, meropenem, ciprofloxacin and gentamicin resistance rates were 49.6%, 53.7%, 62.2%, 46.7% and 60%, respectively. Amikacin resistance was determined as 5.9%, 64.3% and 4% for Pseudomonas aeruginosa, Acinetobacter baumannii and Klebsiella pneumoniae, respectively. Conclusion: Our study also suggests that, clinicians should be more careful when deciding to use this drug because of the severe carbapenem resistance for Acinetobacter, Pseudomonas and Klebsiella in Intensive Care Units. It also reveals that amikacin is a good option in empirical treatment. [ABSTRACT FROM AUTHOR]

Numerous virulence factors are present in the hypervirulent/hypermucoviscous Klebsiella pneumoniae, which primarily causes community-acquired infections. In recent years, hypervirulent/hypermucoviscous K.pneumoniae has acquired resistance genes and has been linked to healthcare-associated infections. The aims of this study were to determine whole genome sequencing of hypermucoviscous K.pneumoniae that induces healthcare-associated bloodstream infection utilizing the Oxford Nanopore (MinION) platform, to identify resistance genes using various databases, and to compare the database results. K.pneumoniae isolates that were sent to the Dokuz Eylül University Research and Training Hospital Center Laboratory and were isolated from blood cultures were included in this study between January 2018 and December 2020. K.pneumoniae isolates were identified using the automated VITEK-2 system. The disc diffusion method was used to characterize the antimicrobial resistance profile, and the string test was used to assess the hypermucoviscous phenotype. By using specific primers blaOXA-48, blaNDM, blaKPC, blaIMP, and blaVIM, carbapenem resistance genes were investigated using the PCR method. To ascertain clonal relatedness among hypermucoviscous K.pneumoniae isolates, PFGE was used. The whole genome sequencing of five K.pneumoniae strains with different origins was determined by Oxford Nanopore (MinION) technology. Using the ResFinder, CARD and BacWGSTdb databases, resistance genes were examined. Capsule regulation genes were analyzed with the BacWGSTdb database. Resistance genes on the plasmid were discovered using the ResFinder database after plasmid analyses were carried out using the PLSDB and PlasmidFinder databases. A total of 244 K.pneumoniae isolates were included in the study. Ten isolates were found to be hypermucoviscous. A carbapenem-resistant hypermucoviscous K.pneumoniae isolate was discovered to carry the blaOXA-48. Five hypermucoviscous isolates of which whole genome sequences were determined had blaSHV types, oqxB, oqxA, and fosA genes on the chromosome. Capsule regulation genes rcsA, rcsB were detected in all five isolates, and rmpA/rmpA2 genes caused hypermucoviscous phenotype was detected in two of the five isolates. In the plasmid analysis, IncFIB (K) pCAV1099- 14, Col (pHAD28), IncFIA (HI1)-IncR, Col (pHAD28), Col440, IncFIB (pNDM&#95;Mar)-IncHI1 (pNDM&#95;MAR), IncL, IncFIB (K)-IncHI1 (K), IncFIB (K), IncR, IncFIB (pNDM&#95;Mar)-IncHI1 (pNDM&#95;MAR)-IncR, repB plasmids were identified. Resistance genes; aac(3)-IId, aph(6)-Id, aph(3")-Ib qnrB1, sul2, dfrA14, blaTEM-1A, blaCTX-M-15, armA, msr(E), mph(E), catB3, blaOXA-1, aac(6')-Ib-cr, catA1 and blaOXA-48 were detected on the plasmid. In the bioinformatic analyzes, it was determined that two study isolates with hypermucoviscous phenotype had various plasmids and carried many resistance genes on these plasmids. Various resistance and virulence genes are spread through plasmids and the number of resistant hypermucoviscous K.pneumoniae is increasing day by day. Appropriate infection control strategies should be implemented to prevent healthcare-associated infections and outbreaks caused by antimicrobial-resistant hypermucoviscous K.pneumoniae. For this purpose, resistance monitoring of antimicrobials used in the treatment of K.pneumoniae infections should be performed. There were some differences in the results of the three databases used to detect resistance genes in this study. For this reason, it is important to analyze different databases and compare the database results in studies while performing whole genome sequencing. Further studies and updates using different databases will increase the compatibility between the databases.

Aim: Klebsiella species can be found in the nasopharynx and intestine, rare pathogen but causes serious infections. Those kinds isolated from people most frequently from Klebsiella pneumoniae (K. pneumoniae) and Klebsiella oxytoca; like urinary tract, gallbladder, surgical site infection, bacteremia, pneumonia and abscesses in various organs infections bacteria identified as a factor. Urinary tract infections are the most common infections among community acquired and health care related infections. Thus treatment is usually given empirically, it is necessary and important to know the pathogens and the antibiotic susceptibility patterns of these pathogens in urinary tract infections for the success of treatment. Therefore in this study, antimicrobial susceptibility of 871 K. pneumoniae strains isolated from various clinical samples was investigated in our hospital. Material and Method: Between the April 2014-October 2015, sent to Sakarya University Training and Research Hospital medical microbiology laboratory isolated from various clinical specimens 871 K. pneumoniae isolates were included to study. Isolates, eosin methylene blue (EMB) agar and blood agar cultivation was carried out and samples were incubated at 37 °C for 18-24 hours. Vitek 2 (bioMérieux, France) automatised system was used for identification and antibiotic susceptibility tests, and susceptibility results were determined according to the guidelines of CLSI and/or EUCAST. Using the SPSS version 20.0 (SPSS, Inc., USA) program was performed descriptive statistical analysis of the isolates in our study. Results: K. pneumoniae strains were frequently isolated from urine (415, 48%), blood (91, 10%), wound (76, 9%), tracheal aspirate (52, 6%), sputum (19, %2) and (218, %25) other samples. The rates of ESBL production that was detected in all isolated-strain were 55%. The resistance rate was 37% in all isolates-strains for the only beta-lactam antibiotic, carbapenem group that can be used in the treatment of infections caused by ESBL producing strains. Resistance values of ESBL producing strains; for AN, AMC, CRO, CIP, CAZ, FEP, GM, IPM, MEM, SXT, TZP antibiotics respectively were found to be 8%, 34%, 24%, 51%, 28%, 1%, 8%, 5%, 7%, 6%, 3%. Conclusion: There is a high rate of ESBL-producing K. pneumoniae isolates and also to the high rate of resistance to antimicrobial agents of these strains., making ESBL detection tests in the clinical microbiology laboratory and we believe that each hospital should periodically evaluate its own data and concordantly assess its antibiotic use policies. [ABSTRACT FROM AUTHOR]

Klebsiella pneumoniae is a global pathogen that can cause hospital-acquired and community-acquired infections and is known for its resistance to antibiotics. The pathotype, which is defined as hypervirulent K.pneumoniae (hvKp) is more lethal than classical K.pneumoniae (cKp) isolates and causes many community-acquired infections such as liver abscess, endophthalmitis, pneumonia in healthy young adults. There are no clear clinical or microbiological criteria to define hvKp. String test showing hypermucoviscosity and the iucA gene encoding aerobactin, a siderophore, were used to demonstrate hypervirulence. In this study, it was aimed to investigate the presence of various virulence genes and carbapenem resistance genes in the isolates of K.pneumoniae isolated from various clinical samples in our laboratory and classified as classical and hypervirulent by string test and also to detect the presence of various virulence and carbapenem resistance genes in hvKp isolates. Presence of four virulence genes (fimH-1, rmpA, magA, iucA), K1-K2 serotypes in all isolates and five carbapenem resistance genes (blaOXA-48, blaKPC, blaIMP, blaVIM, blaNDM-1) in carbapenem resistant isolates were investigated with polymerase chain reaction (PCR) method. Forty-five percent of the isolates were defined as hvKp and 55% as cKp. The fimH-1 gene was found to be positive in 94% of the isolates, the iucA gene in 37%, the magA gene (K1) in 34%, the rmpA gene in 5%, and the K2 serotype in 3% of the isolates. iucA gene was positive in 68.9% of hvKp isolates and 10.9% of cKp isolates, and the presence of iucA gene in hvKp isolates was statistically significant compared to cKp isolates (p<0.05). magA gene and K1 serotype were detected in 28.9% of hvKp isolates and 38.2% of cKp isolates. Although the magA gene ratio was high in cKp isolates, this difference was not statistically significant (p> 0.05). fimH-1 gene was found positive in 93.3% of hvKp isolates and 94.5% of cKp isolates. The rmpA gene was positive in 8.9% of hvKp isolates and 1.8% of cKp isolates. The K2 serotype was positive in 4.4% of hvKp isolates and 1.8% of cKp isolates. Although there was no statistical difference in antibiotic susceptibility between hvKp and cKp isolates; ceftriaxone, cefuroxime, ceftazidime, amikacin, cefoxitin, ertapenem, cefuroxime axetil were found to be more sensitive in hvKp isolates. Ciprofloxacin and trimethoprim sulfamethoxazole were found to be more sensitive in hvKp isolates than cKp isolates, and the difference was statistically significant (p<0.05). Although gentamicin, amoxicillin, piperacillintazobactam were not statistically significant in the cKp group, they were more sensitive than the hvKp group (p> 0.05). Carbapenem resistance were found to be 65.7% in cKp and 34.3% in hvKp isolates. Although not statistically significant, hvKp isolates were found to be more sensitive to carbapenems. The most common gene among 35 carbapenem resistant isolates was blaOXA-48 detected in 29 isolates. While the blaKPC gene was detected in five isolates, blaIMP, blaVIM and blaNDM-1 were not detected in any isolates. Sixty nine percent of blaOXA-48 positive samples were found to be in cKp isolates and 31% in hvKp isolates. It was determined that all of the blaKPC positive isolates were hvKp isolates. It was concluded that the string test and virulence factors alone would not be sufficient to show hypervirulence, and that more than one virulence factor combination should be shown in the presence of clinical features of hypervirulent infections to show hypervirulence.