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    Comparison of broth microdilution method with BD phoenix, micro scan and e-test for carbapenem-resistant enterobacterales colistin susceptibility testing
    (2022) Yiş, Reyhan
    Objective: In the past years, due to the increasing carbapenem resistant Enterobacterales (CRE) infection rates, colistin use has been on the rise. Multi-drug resistant Gram-negative bacteria and colistin resistance are increasing simultaneously; therefore, an accurate method for antimicrobial susceptibility testing of colistin is crucial. Clinical and Laboratory Standards Institute and European Committee on Antimicrobial Susceptibility Testing recommend the standard broth microdilution (BMD) method for colistin minimum inhibitory concentration testing. In this study, we aimed to examine the performance of BD Phoenix, MicroScan, and E-tests on CRE isolates on the determination of colistin susceptibility. The existing commercial tests were compared to the reference BMD method. Methods: One hundred and twenty non-duplicate clinical Enterobacterales isolates such as Klebsiella pneumoniae (K. pneumoniae), Escherichia coli (E. coli), Enterobacter cloace (E. cloacae) were collected between August 2017 to June 2018. The BD Phoenix, MicroScan systems, and E-tests were used to test colistin susceptibility. Commercial methods were compared with the reference method BMD. Results: Colistin susceptibility was evaluated in 120 Gram-negative clinical isolates, including 108 K. pneumoniae, 10 E. coli, 2 E. cloacae, during the study period. Among the isolates, 66 (55%) were susceptible, and 54 (45%) were resistant to colistin, according to BMD. BD Phoenix, MicroScan, and E-test had 90.90%, 95.45%, and 96.96% sensitivity, respectively, when colistin was tested. Conclusion: In routine clinical practice, the worldwide reference method can hardly be implemented, and commercially available systems are used for the interpretation of colistin susceptibility. Colistin use is increasing for the treatment of multiresistant Gram-negative infections, further and more extensive studies are needed for precise susceptibility testing methods for this compound. We recommend that laboratories use the BMD method at least in selected patient groups in the face of increasing antimicrobial resistance.
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    Is adenotonsillectomy safe in Covid-19 era? Investigation of SARS-CoV2 in adenoid and tonsil tissues
    (W B Saunders Co-Elsevier Inc, 2022) Müderris, Togay; Aysel, Abduelhalim; Yiş, Reyhan; Muderris, Tuba; Oketem, Ibrahim Mehmet Ali; corakci, Onur
    Objectives: COVID-19 has seriously altered physicians' approach to patients and diseases, with a tendency to postpone elective procedures. Tonsillectomy, alone or with adenoidectomy, is one of the most common surgeries performed by otolaryngologists. Although they are generally accepted as elective surgeries, they significantly improve the quality of life, and postponing these surgeries for a long time can have deteriorative effects on the patients. We aimed to investigate the presence of SARS CoV-2 in the adenotonsillectomy materials to find out if performing adenotonsillectomy is safe during the COVID-19 pandemic. Methods: Forty-eight tissue samples from 32 patients that underwent tonsillectomy with or without adenoidectomy were investigated whose SARS-CoV-2 RT-PCR test in the samples obtained from nasopharyngeal (NP) and oropharyngeal (OP) swabs were negative within 24 h before the operation. While 16 patients underwent only tonsillectomy and one of their tonsils was investigated, 16 of the patients underwent adenotonsillectomy and their adenoid tissues were sent along with one of their tonsils. SARS-CoV-2 viral RNA was investigated with Real-Time PCR in tissue samples. Results: Two (4.2%) tissue samples had positive PCR tests for SARS-CoV-2, while 46 of them were negative. One of the positive patients had undergone tonsillectomy with the indication of chronic recurrent tonsillitis, and the other patient had undergone adenotonsillectomy for obstructive adenotonsillar hypertrophy. PCR test was positive in the adenoidectomy specimen and negative in the tonsillectomy specimen in this patient. Conclusions: Adenotonsillectomy can be done safely in asymptomatic patients without a history of Covid-19, with a negative PCR test result obtained within the last 24 h.