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    Bacterial adhesion to braided surgical sutures: an in vitro study
    (Springer, 2016) Boybeyi, Ozlem; Kacmaz, Birgul; Gunal, Yasemin Dere; Gul, Serdar; Yorubulut, Serap; Aslan, Mustafa Kemal
    Background Surgical suture materials are accepted to be associated with a substantial proportion of surgical site infections. These infections are related with biofilm formation similar to that of other synthetic and implantable medical devices. Methods We conducted an in vitro study to investigate the bacterial adherence to different types of braided surgical sutures. The included sutures were polyglactin (Vicryl (R)) group (VG), rapidly absorbable polyglactin (Rapide-Vicryl (R)) group (RVG), nitrofurazone-coated polyglactin (Vicryl (R)) group (FVG), polyethylene terephthalate (Etibond (R)) group (EG), and natural silk (Silk (R)) group (SG). All sutures were cut in 1 cm length, embedded into tryptic soy broth, and then 10(6)-CFU/ml Escherichia coli and Staphylococcus aureus were added. After the 24th and 96th hour of incubation, bacterial colonies were counted, and results were expressed as CFU/cm. Results E. coli adhesion was significantly lower in VG and significantly higher in SG compared to FVG, RVG, and EG at the 24th and 96th hour of cultivation (p< 0.05). The S. aureus adhesion results at 24th hour showed that VG had the least bacterial adhesion, and FVG had the most bacterial adhesion compared to other sutures (p< 0.05). The S. aureus adhesion results at the 96th hour of cultivation showed that bacterial adhesion on sutures was not significantly different between groups (p> 0.05). Conclusion Of all braided surgical sutures, bacterial adhesion is significantly lower in polyglactin and significantly higher in silk sutures. Nitrofurazone coverage of suture worsens S. aureus contamination of the suture.
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    A comparison of the recoverable proportion of methicillin-resistant Staphylococcus aureus from two different types of papers
    (German Medical Science-Gms, 2016) Kacmaz, Birgul; Gul, Serdar
    Aim: Paper is used for various purposes in hospitals. Generally, there are two different types of paper, which are commonly used in our facility: wood-free paper, and paper containing wood. We compared the recoverable proportion of methicillin-resistant Staphylococcus aureus (MRSA; ATCC 43300) from the surface of such papers. Method: The papers were divided into two groups: Group 1: wood-free paper; Group 2: paper containing wood. The papers were contaminated in a standardized procedure with 0.1 mL of a 5x10(7) CFU MRSA/mL stock solution. Results: The recoverable proportion of MRSA was higher in the wood-containing papers than in the papers without wood (P=0.043). Conclusion: This study indicates that if paper is purchased for healthcare facilities it should not contain wood, but rather wood-free paper types should be considered.
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    Does influenza subtype H1N1 have a place in the etiology of pityriasis rosea?
    (Termedia Publishing House Ltd, 2019) Demirkan, Serkan; Kacmaz, Birgul
    Introduction: Pityriasis rosea (PR) is an acute, inflammatory skin disease of unknown cause. Various infectious agents including viruses have been proposed as causative agents and presence of influenza subtype H1N1 was shown in case reports with PR, but the relation was not conclusive. We hypothesited that there may be a relation between PR and H1N1, since both of them are prevalent in the same period as winter or season transitions. Aim: To investigate the effect of the H1N1 virus in PR in this study. Material and methods: Twenty-one female and 12 male PR patients who applied to Kirikkale University Faculty of Medicine Hospital Dermatology Outpatient Clinic were included in the study. Influenza subtype H1N1 IgM and IgG antibodies were detected by enzyme immunoassay (EIA) in sera of patients; tissue biopsy specimens were examined for influenza subtype H1N1 RNA by PCR. Results: Seven (23%) of the 33 patients had positive IgM and IgG antibodies. Influenza subtype H1N1 RNA was not detected in the tissue samples of 33 PR patients. Conclusions: According to the results of this study, we can say that influenza subtype H1N1 does not play a role in PR etiology.
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    Does penile tourniquet application alter bacterial adhesion to rat urethral cells: an in vitro study
    (W B Saunders Co-Elsevier Inc, 2018) Boybeyi-Turer, Ozlem; Kacmaz, Birgul; Arat, Esra; Atasoy, Pinar; Kisa, Ucler; Gunal, Yasemin Dere; Soyer, Tutku
    Purpose: To investigate the effects of penile tourniquet (PT) application on bacterial adhesion to urothelium. Methods: Fifty-six ratswere allocated into control group (CG), shamgroup (SG), PT group (PTG). No intervention was applied in CG. A 5mm-length urethral repair was performed in SG and PTG. In PTG, a 10-min duration of PT was applied during the procedure and the tissue oxygenation monitor was used to adjust the same degree of ischemia in all subjects. Sampleswere examined for wound healing parameters and tissue levels of inflammatory markers, eNOS, e-selectin, and ICAM-1antibodies. The adhesion of Escherichia coli to urotheliumwas investigated with in vitro adhesion assay. Results: Inflammation was higher and wound healing was worse in SG than CG and in PTG in comparison to CG and SG (p < 0.05). The endothelial damage, as shown by eNOS expression, was significantly higher in PTG compared to CG and SG (p < 0.05). The staining with ICAM-1 and e-selectin antibodies, showing increased inflammatory response to bacterial adhesion, was significantly higher in PTG compared to CG and SG (p < 0.05). In vitro urethral cell proliferation was achieved only in CG and SG revealing significantly increased adhesion in SG compared to CG (p < 0.05). The PT application caused endothelial corruption and prevented cell proliferation in cell culture. Conclusion: The PT application does not improve wound healing and increases bacterial adhesion molecules in penile tissue. The in vitro assays showed that PT causes severe endothelial damage and inhibits endothelial cell proliferation. (c) 2017 Elsevier Inc. All rights reserved.
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    Drug resistance profiles and clonality of sporadic Shigella sonnei isolates in Ankara, Turkey
    (Soc Brasileira Microbiologia, 2014) Kacmaz, Birgul; Unaldi, Ozlem; Sultan, Nedim; Durmaz, Riza
    The aims of this study were to investigate drug resistance rates, types of extended spectrum beta lactamases (ESBLs), and molecular epidemiological characteristics of 43 Shigella sonnei isolates. Ampicillin-sulbactam, amoxicillin-clavulanate, chloramphenicol, and ciprofloxacin were the most active antibiotics. Five isolates harbored bla(SHV-12), bla(TEM-1) and bla(CTX-M-15). More than 90% of the isolates had an indistinguishable pulsotype.
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    Helicobacter pylori resistance to clarithromycin and fluoroquinolones in a pediatric population in Turkey: A cross-sectional study
    (Wiley, 2019) Guven, Burcu; Gulerman, Fulya; Kacmaz, Birgul
    BackgroundHelicobacter pylori antimicrobial resistance is gradually increasing around the world. However, there are a limited number of studies reporting on this issue in the pediatric population. In this study, we aimed to determine Hpylori resistance to clarithromycin and fluoroquinolones in the pediatric patients living in Krkkale province that were detected with Hpylori in gastric biopsies. Moreover, we also aimed to investigate the concordance between the histopathologic and molecular methods used in the diagnosis of Hpylori infection. Materials and MethodsPatients aged 2-18years who had a history of epigastric pain and/or nausea persisting for longer than 1month underwent upper gastrointestinal endoscopy. Biopsies were taken from the gastric antral mucosa. In the samples detected with Hpylori in the histopathologic examination, the presence of Hpylori and Hpylori resistance to clarithromycin and fluoroquinolones was investigated using the GenoType HelicoDR test which allows the detection of wild-type and mutant genes. The strains detected with more than one mutant gene are defined as hetero-resistant strains. ResultsThe 93 patients that underwent DNA extraction and amplification included 68 (73.1%) girls and 25 (26.9%) boys with a median age of 152.62 (range 6-17) years. The overall concordance for the diagnosis of Hpylori infection between histopathology and PCR was 94%, and Hpylori resistance to clarithromycin and fluoroquinolones was 27% and 15%, respectively. ConclusionsThe high Hpylori resistance to clarithromycin and fluoroquinolones among the pediatric patients in our region implicates that the antibiotic sensitivity of strains should be studied prior to administration in accordance with the recommendations provided in the guidelines. Moreover, the presence of hetero-resistant strains in our patients may be a reason for treatment failure.
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    Importance of Delta Over Baseline Values in Predicting the Severity of Helicobacter pylori Infection in Children
    (Bursa Uludag Univ, 2021) Guven, Burcu; Gulerman, Hacer Fulya; Kacmaz, Birgul
    Introduction:Although severe forms of the disease are seen in adults, the Helicobacter pylori (H. pylori) infection is usually acquired during childhood. Therefore, prompt diagnosis of H. pylori infection in childhood is of prime importance. In the present study, we aimed to identify the sensitivity and specificity of 13C urea breath test (UBT) in the diagnosis of H. pylori infection and to assess the severity of the disease with delta over baseline (DOB) values. Materials and Methods: UBT was administered to 200 children who presented with epigastric pain and/or nausea. Esophagogastroduodenoscopy (EGD) was performed in patients. UBT results were compared with histopathological findings. In the Area Under the ROC Curve analysis, a cutoff DOB value was found for the severity of H. pylori infection. Results: 193 children with a mean age of 13.50 +/- 2.98 years were included in the analysis. Of these, 71 (36.8%) patients had a positive UBT and 122 (63.2%) had a negative UBT. EGD was performed in 60 out of 71 patients with positive UBT and in 30 out of 122 patients with negative UBT. The sensitivity and specificity of UBT were 85.1% and 100%. DOB was found to be a significant predictor of moderate/marked H. pylori density at a cutoff value of 6%. Conclusions: The positive correlation detected between the level of DOB values and the density of H. pylori and inflammatory activity can be an advantage for detecting the severity of disease
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    Intralesional Avirulent Bacillus Calmette-Guerin Injection as a Promising Method for the Treatment of Tuberculosis Verrucosa Cutis
    (Karger, 2022) Gunduz, Ozgur; Kocak, Gulsah; Kacmaz, Birgul; Devrim, Tuba; Simsek, Hulya
    Cutaneous involvement is a relatively uncommon manifestation of tuberculosis (TB), particularly outside the endemic regions. Cutaneous TB manifests itself in various clinical forms, depending on the host's immune status and mode of transmission. Nonetheless, the same treatment regimen is recommended for every subtype. Tuberculosis verrucosa cutis (TBVC) is a specific subgroup in which the affected persons are usually healthy adults who are vaccinated or exposed to mycobacteria during their occupational activities. These patients have the ability to launch a strong cellular immune reaction against mycobacteria. In this article, we present an elderly patient with a 4-year history of TBVC who was treated with intralesional injection of avirulent Bacillus Calmette-Guerin (BCG) and report our clinical observation on the inflammatory and healing process of the patient's lesion following the intralesional BCG injection.
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    Reliability of VITEK (R) 2 System for Identification of Yeasts: An Isolate of Candida parapsilosis Incorrectly Identified as Cryptococcus neoformans
    (Aves, 2017) Kacmaz, Birgul; Gul, Serdar; Karabicak, Nilgun; Ayaslioglu, Ergin; Bulut, Cemal; Caliskan, Okan
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