Mehmet Sait Tekerekoglu

Laboratory-acquired skin infections in a clinical microbiologist: Is wearing only gloves really safe?

Laboratory-acquired infection is one of the leading occupational health hazards. On a laboratory workers hands, carbuncles occurred. Staphylococcus aureus was isolated from pus samples of the carbuncles, with the same pulsed field gel electrophoresis band pattern with one of the recently studied strains in the laboratory. Incorrect or inadequate application of infection control measures may result in pathogen acquisition from the clinical samples, and wearing only gloves is not sufficient for the biosafety of laboratory workers in clinical diagnostic laboratories.

Changing trends of carbapenem resistance of escherichia coli and klebsiella pneumoniae strains isolated from intensive care units, inpatient services and outpatient's clinics: a five years retrospective analysis

Background: Carbapenem resistance (CR) was rarely reported in Klebsiella pneumoniae and Escherichia coli strains until ten years ago. In recent years, increasing carbapenem resistance in gram negative bacteria is a substantial concern. Objectives: In this study; we aimed to evaluate the changing frequency of CR in K.pneumoniae and E.coli strains that were isolated from the patients from intensive care units, inpatient services and outpatientsÂ’ clinics in the last five years. Methods: Data of antimicrobial susceptibility belonging to clinical isolates of K.pneumoniae and E.coli strains determined between 2013 and 2017 were retrospectively collected from Laboratory Information System. Results were statistically analyzed. Results: A total 4002 K.pneumoniae and 13462 E.coli strains were included. The CR of K.pneumoniae strains were found as 11.6%; while of E.coliÂ’s were found as 0.6%. The highest CR frequency was detected among intensive care unitsÂ’ isolates of K. pneumoniae as 20.1%. We determined that CR significantly increased in intensive care unit isolates of E.coli and K.pneumoniae about 5-10 folds throughout the study period; however, there was no remarkable change in the CR of E.coli strains from the outpatientsÂ’ clinics. Conclusion: We determined that the resistances of K.pneumoniae and E.coli strains to carbapenems were progressively increasing by years, especially in intensive care units and inpatient services. Therefore, appropriate antimicrobial use policies sought to be considered against to this growing problem.

Investigation of HBV DNA in HBsAg positive patients

Hepatitis B virus is an important health problem which about 400 million people are infected chronically and 500,000 to 1,200,000 people die every year due to HBV-related diseases. In the study we aimed to investigate the HBV DNA results in HBsAg positive patients. HBsAg positivity was detected by ELISA method in patients who were admitted to our hospital with suspicion of hepatitis. HBV DNA was performed by real time PCR. In this context, the presence of HBV DNA in serum sample results of 2437 HBsAg-positive patients which were sent to our Microbiology laboratory between August 2014 and August 2015 was retrospectively examined. HBV DNA was positive in 1037 (42.5%) and 1400 (57.5%) of the HBsAg positive cases. 42.2% of male patients’ and 43% of female patients’ HBV DNA was positive. HBV DNA positivity was detected in 42% of adult patients and 55% of children in child age group. As a result; we suggest that viral replication should be demonstrated in HBsAg-positive cases and HBV DNA level should be determined for follow-up the antiviral therapy.

Evaluation of Metallo Beta Lactamase E test Results from Different Brands of Mueller Hinton Agar Plates

Aim: MBL E test for MBL screening in carbapenem resistant Pseudomonas aeruginosa isolates is recommended as a fast and reliable phenotypic screening test. However, as it has been put forward by some reserachers, because of variations in antibiotic susceptibility tests or MBL E test with different brands of Mueller- Hinton Agar (MHA) media, the possibility that carbapenem MIK values and MBL E test results can, therefore, be influenced by these media. To this end, we aim to determine the most suitable MHA media to be used in search for MBL E test in routine microbiology laboratories by employing five different brands of MHA media. Materials and Methods: 29 carbapenem resistant Pseudomonas aeruginosa strains isolated from hospitalised patients have been used in this study. P.aeruginosa isolates were identified by conventional methods. Imipenem and meropenem E test were used for verification of carbapenem resistance. MBL E test was used for detecting MBL production by five different brands of Mueller Hinton agar plates and the results of these tests were compared with polymerase chain reaction (PCR) results. Results: IMP, VIM, GIM, SIM and SPM type genes were found to be negative with polymerase chain reaction for 29 isolates that were resistant to carbapenem. One isolate with BBL brand MHA, two isolates with Oxoid brand MHA, 19 isolates with Himedia brand MHA, 21 isolates with Merck brand MHA, and 27 isolates with Plasmatec brand MHA gave positive results. Conclusion: The present results indicate that use of BBL or Oxoid brand MHA media, especially in laboratories without any fascilities for molecular diagnosis, can be more reliable compared to other brands.