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Akyol D, Çankayalı İ, Ersel M, Demirağ K, Uyar M, Can Ö, Özçete E, Karbek-Akarca F, Yağdı T, Engin Ç, Özgiray E, Yurtseven T, Yağmur B, Nalbantgil S, Ekren P, Bozkurt D, Şirin H, Çilli F, Sezer ED, Taşbakan M, Yamazhan T, Pullukçu H, Sipahi H, Arda B, Ulusoy S, Sipahi OR. Impact of the empirical therapy timing on the clinical progress of septic shock patients. Diagn Microbiol Infect Dis 2024; 108:116149. [PMID: 38142580 DOI: 10.1016/j.diagmicrobio.2023.116149] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2023] [Revised: 11/11/2023] [Accepted: 11/24/2023] [Indexed: 12/26/2023]
Abstract
AIM To evaluate the effect of timing of antimicrobial therapy on clinical progress of patients with septic shock. MATERIALS AND METHOD We included 204 adult patients diagnosed with septic shock according to Sepsis-3 criteria between March 2016 and April 2021. One-month survival was evaluated using univariate and logistic regression analysis. RESULTS Antibiotic treatment was initiated within 1 h of the vasopressors in 26.4 % of patients. One-month mortality did not differ significantly between patients with and without empirical therapy coverage on etiological agents. Univariate factors that significantly affected one-month survival were starting antibiotics at the first hour, the unit where the case was diagnosed with septic shock, SOFA scores, qSOFA scores, and lactate level. In multivariate analysis, diagnosis of septic shock in the Emergency Service, SOFA score ≥11, qSOFA score of three and lactate level ≥4 were significantly associated with one-month mortality. CONCLUSION Training programs should be designed to increase the awareness of septic shock diagnosis and treatment in the Emergency Service and other hospital units. Additionally, electronic patient files should have warning systems for earlier diagnosis and consultation.
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Affiliation(s)
- Deniz Akyol
- Ege University Faculty of Medicine, Department of Infectious Diseases and Clinical Microbiology, Izmir, Turkey.
| | - İlkin Çankayalı
- Ege University Faculty of Medicine, Department of Anesthesiology and Reanimation, Izmir, Turkey
| | - Murat Ersel
- Ege University Faculty of Medicine, Department of Emergency Department, Izmir, Turkey
| | - Kubilay Demirağ
- Ege University Faculty of Medicine, Department of Anesthesiology and Reanimation, Izmir, Turkey
| | - Mehmet Uyar
- Ege University Faculty of Medicine, Department of Anesthesiology and Reanimation, Izmir, Turkey
| | - Özge Can
- Ege University Faculty of Medicine, Department of Emergency Department, Izmir, Turkey
| | - Enver Özçete
- Ege University Faculty of Medicine, Department of Emergency Department, Izmir, Turkey
| | - Funda Karbek-Akarca
- Ege University Faculty of Medicine, Department of Emergency Department, Izmir, Turkey
| | - Tahir Yağdı
- Ege University Faculty of Medicine, Department of Cardiovascular Surgery, Izmir, Turkey
| | - Çağatay Engin
- Ege University Faculty of Medicine, Department of Cardiovascular Surgery, Izmir, Turkey
| | - Erkin Özgiray
- Ege University Faculty of Medicine, Department of Neurosurgery, Izmir, Turkey
| | - Taşkın Yurtseven
- Ege University Faculty of Medicine, Department of Neurosurgery, Izmir, Turkey
| | - Burcu Yağmur
- Ege University Faculty of Medicine, Department of Cardiology, Izmir, Turkey
| | - Sanem Nalbantgil
- Ege University Faculty of Medicine, Department of Cardiology, Izmir, Turkey
| | - Pervin Ekren
- Ege University Faculty of Medicine, Department of Pulmonology, Izmir, Turkey
| | - Devrim Bozkurt
- Ege University Faculty of Medicine, Department of Internal Medicine, Izmir, Turkey
| | - Hadiye Şirin
- Ege University Faculty of Medicine, Department of Neurology, Izmir, Turkey
| | - Feriha Çilli
- Ege University Faculty of Medicine, Department of Medical Microbiology İzmir, Turkey
| | - Ebru Demirel Sezer
- Ege University Faculty of Medicine, Department of Medical Biochemistry, Izmir, Turkey
| | - Meltem Taşbakan
- Ege University Faculty of Medicine, Department of Infectious Diseases and Clinical Microbiology, Izmir, Turkey
| | - Tansu Yamazhan
- Ege University Faculty of Medicine, Department of Infectious Diseases and Clinical Microbiology, Izmir, Turkey
| | - Hüsnü Pullukçu
- Ege University Faculty of Medicine, Department of Infectious Diseases and Clinical Microbiology, Izmir, Turkey
| | - Hilal Sipahi
- Bornova Public Health Directorate, Izmir, Turkey
| | - Bilgin Arda
- Ege University Faculty of Medicine, Department of Infectious Diseases and Clinical Microbiology, Izmir, Turkey
| | - Sercan Ulusoy
- Ege University Faculty of Medicine, Department of Infectious Diseases and Clinical Microbiology, Izmir, Turkey
| | - Oğuz Reşat Sipahi
- Ege University Faculty of Medicine, Department of Infectious Diseases and Clinical Microbiology, Izmir, Turkey; King Hamad University Hospital, Bahrain Oncology Center, Infectious Diseases and Clinical Microbiology, Bahrain
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Soylu M, Sağıroğlu P, Özarslan MA, Acet O, Yüce ZT, İzci Çetinkaya F, Durmaz S, Parkan ÖM, Akyol D, Zeytinoğlu A, Kalın Ünüvar G, Taşbakan M, Gökahmetoğlu S, Atalay MA, Durusoy İR, Çiçek C, Pullukçu H, Yıldız O, Sertöz ŞR, Erensoy MS. COVID-19 Antibody Levels among Various Vaccination Groups, One-Year Antibody Follow-Up in Two University Hospitals from Western and Central Turkey. Vaccines (Basel) 2024; 12:59. [PMID: 38250872 PMCID: PMC10819475 DOI: 10.3390/vaccines12010059] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2023] [Revised: 12/28/2023] [Accepted: 01/02/2024] [Indexed: 01/23/2024] Open
Abstract
Various clinical outcomes, reinfections, vaccination programs, and antibody responses resulted from the COVID-19 pandemic. This study investigated the time-dependent changes in SARS-CoV-2 antibody responses in infected and/or vaccinated and unvaccinated individuals and to provide insights into spike and nucleocapsid antibodies, which fluctuate during infectious and non-infectious states. This cohort study was carried out at the Ege University Faculty of Medicine hospital in İzmir (western Turkey) and the Erciyes University Faculty of Medicine hospital in Kayseri (central Turkey) between December 2021 and January 2023, which coincided with the second half of COVID-19 pandemic. The study included 100 COVID-19 PCR-positive patients and 190 healthcare workers (HCWs). Antibody levels were followed up via quantitative anti-SARS-CoV-2 spike and qualitative anti-nucleocapsid immunoassays (Elecsys™). Antibody levels declined after infection but persisted for at least 6-8 months. Individuals who had received only CoronaVac had higher anti-nucleocapsid antibody levels in the early months than those who received mixed vaccination. However, anti-spike antibodies persisted longer and at higher levels in individuals who had received mixed vaccinations. This suggests that combining two different vaccine platforms may provide a synergistic effect, resulting in more durable and broad-spectrum immunity against SARS-CoV-2. The study provides information about the vaccination and antibody status of healthcare workers in the second half of the pandemic and provides valuable insights into the dynamics of antibody responses to COVID-19 infection and vaccination.
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Affiliation(s)
- Mehmet Soylu
- Department of Medical Microbiology, Faculty of Medicine, Ege University, Izmir 35100, Turkey; (M.A.Ö.); (C.Ç.); (Ş.R.S.); (M.S.E.)
| | - Pınar Sağıroğlu
- Department of Medical Microbiology, Faculty of Medicine, Erciyes University, Kayseri 38039, Turkey; (P.S.); (Ö.M.P.); (S.G.); (M.A.A.)
| | - Muhammed Alper Özarslan
- Department of Medical Microbiology, Faculty of Medicine, Ege University, Izmir 35100, Turkey; (M.A.Ö.); (C.Ç.); (Ş.R.S.); (M.S.E.)
| | - Oğuzhan Acet
- Department of Infectious Diseases, Faculty of Medicine, Ege University, Izmir 35100, Turkey; (O.A.); (D.A.); (G.K.Ü.); (M.T.); (H.P.)
| | - Zeynep Türe Yüce
- Department of Infectious Diseases, Faculty of Medicine, Erciyes University, Kayseri 38039, Turkey; (Z.T.Y.); (F.İ.Ç.); (O.Y.)
| | - Feyza İzci Çetinkaya
- Department of Infectious Diseases, Faculty of Medicine, Erciyes University, Kayseri 38039, Turkey; (Z.T.Y.); (F.İ.Ç.); (O.Y.)
| | - Seyfi Durmaz
- Department of Public Health, Faculty of Medicine, Ege University, Izmir 35100, Turkey; (S.D.); (İ.R.D.)
| | - Ömür Mustafa Parkan
- Department of Medical Microbiology, Faculty of Medicine, Erciyes University, Kayseri 38039, Turkey; (P.S.); (Ö.M.P.); (S.G.); (M.A.A.)
| | - Deniz Akyol
- Department of Infectious Diseases, Faculty of Medicine, Ege University, Izmir 35100, Turkey; (O.A.); (D.A.); (G.K.Ü.); (M.T.); (H.P.)
| | - Ayşin Zeytinoğlu
- Department of Medical Microbiology, Faculty of Medicine, İzmir Economy University, Izmir 35330, Turkey;
| | - Gamze Kalın Ünüvar
- Department of Infectious Diseases, Faculty of Medicine, Ege University, Izmir 35100, Turkey; (O.A.); (D.A.); (G.K.Ü.); (M.T.); (H.P.)
| | - Meltem Taşbakan
- Department of Infectious Diseases, Faculty of Medicine, Ege University, Izmir 35100, Turkey; (O.A.); (D.A.); (G.K.Ü.); (M.T.); (H.P.)
| | - Selma Gökahmetoğlu
- Department of Medical Microbiology, Faculty of Medicine, Erciyes University, Kayseri 38039, Turkey; (P.S.); (Ö.M.P.); (S.G.); (M.A.A.)
| | - Mustafa Altay Atalay
- Department of Medical Microbiology, Faculty of Medicine, Erciyes University, Kayseri 38039, Turkey; (P.S.); (Ö.M.P.); (S.G.); (M.A.A.)
| | - İsabel Raika Durusoy
- Department of Public Health, Faculty of Medicine, Ege University, Izmir 35100, Turkey; (S.D.); (İ.R.D.)
| | - Candan Çiçek
- Department of Medical Microbiology, Faculty of Medicine, Ege University, Izmir 35100, Turkey; (M.A.Ö.); (C.Ç.); (Ş.R.S.); (M.S.E.)
| | - Hüsnü Pullukçu
- Department of Infectious Diseases, Faculty of Medicine, Ege University, Izmir 35100, Turkey; (O.A.); (D.A.); (G.K.Ü.); (M.T.); (H.P.)
| | - Orhan Yıldız
- Department of Infectious Diseases, Faculty of Medicine, Erciyes University, Kayseri 38039, Turkey; (Z.T.Y.); (F.İ.Ç.); (O.Y.)
| | - Şaziye Rüçhan Sertöz
- Department of Medical Microbiology, Faculty of Medicine, Ege University, Izmir 35100, Turkey; (M.A.Ö.); (C.Ç.); (Ş.R.S.); (M.S.E.)
| | - Memnune Selda Erensoy
- Department of Medical Microbiology, Faculty of Medicine, Ege University, Izmir 35100, Turkey; (M.A.Ö.); (C.Ç.); (Ş.R.S.); (M.S.E.)
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Önal U, Akyol D, Kaya A, Başkol D, Kenanoglu B, Şanlıdağ G, Önal AU, Avşar CB, Mert M, Memetali S, Erdem HA, Bozkurt D, Şimşir A, Bozbıyık O, Kahraman Ü, Özgiray E, Korkmaz P, Çilli F, Pullukçu H, Yamazhan T, Taşbakan MI, Arda B, Ulusoy S, Sipahi OR. Ertapenem plus meropenem combination treatment in carbapenem-resistant Klebsiella pneumoniae bacteremia: an analysis of 53 cases. Eur J Clin Microbiol Infect Dis 2023; 42:1269-1273. [PMID: 37676420 DOI: 10.1007/s10096-023-04660-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2023] [Accepted: 09/03/2023] [Indexed: 09/08/2023]
Abstract
Herein, we aimed to describe the outcomes of patients with blood stream infections due to carbapenem-resistant Klebsiella pneumoniae (CR-Kp) who received ertapenem plus meropenem combination treatment (EMCT). A total of 53 patients with culture proven CR-Kp bacteremia treated with ertapenem + meropenem were included. The patients with secondary bacteremia due to urinary tract infection exhibited a significantly lower 1-month mortality (OMM), particularly in those with microbiological eradication and those with end-of-treatment success. Salvage EMCT resulted in 49% 1-month survival.
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Affiliation(s)
- Uğur Önal
- Department of Infectious Diseases and Clinical Microbiology, Faculty of Medicine, Ege University, Izmir, Turkey.
- Department of Infectious Diseases and Clinical Microbiology, Faculty of Medicine, Uludag University, Bursa, Turkey.
| | - Deniz Akyol
- Department of Infectious Diseases and Clinical Microbiology, Faculty of Medicine, Ege University, Izmir, Turkey
- Infectious Diseases Clinic, Kagizman State Hospital, Kars, Turkey
| | - Arda Kaya
- Department of Infectious Diseases and Clinical Microbiology, Faculty of Medicine, Ege University, Izmir, Turkey
| | - Dilşah Başkol
- Department of Infectious Diseases and Clinical Microbiology, Faculty of Medicine, Ege University, Izmir, Turkey
| | - Buse Kenanoglu
- Department of Infectious Diseases and Clinical Microbiology, Faculty of Medicine, Ege University, Izmir, Turkey
| | - Gamze Şanlıdağ
- Department of Infectious Diseases and Clinical Microbiology, Faculty of Medicine, Ege University, Izmir, Turkey
| | - Ayşe Uyan Önal
- Department of Infectious Diseases and Clinical Microbiology, Faculty of Medicine, Ege University, Izmir, Turkey
- Yüksek Ihtisas Teaching and Research Hospital, Bursa, Turkey
| | - Cansu Bulut Avşar
- Department of Infectious Diseases and Clinical Microbiology, Faculty of Medicine, Ege University, Izmir, Turkey
- Çiğli Teaching and Research Hospital, Bakırçay University, Izmir, Turkey
| | - Merve Mert
- Department of Infectious Diseases and Clinical Microbiology, Faculty of Medicine, Ege University, Izmir, Turkey
| | - Seichan Memetali
- Department of Infectious Diseases and Clinical Microbiology, Faculty of Medicine, Ege University, Izmir, Turkey
| | - Hüseyin Aytaç Erdem
- Department of Infectious Diseases and Clinical Microbiology, Faculty of Medicine, Ege University, Izmir, Turkey
| | - Devrim Bozkurt
- Department of Internal Medicine, Ege University Faculty of Medicine, Izmir, Turkey
| | - Adnan Şimşir
- Department of Urology, Ege University Faculty of Medicine, Izmir, Turkey
| | - Osman Bozbıyık
- Department of General Surgery, Ege University Faculty of Medicine, Izmir, Turkey
| | - Ümit Kahraman
- Department of Cardiovascular Surgery, Ege University Faculty of Medicine, Izmir, Turkey
| | - Erkin Özgiray
- Department of Neurosurgery, Ege University Faculty of Medicine, Izmir, Turkey
| | - Pervin Korkmaz
- Department of Chest Diseases, Ege University Faculty of Medicine, Izmir, Turkey
| | - Feriha Çilli
- Department of Medical Microbiology, Ege University Faculty of Medicine, Izmir, Turkey
| | - Hüsnü Pullukçu
- Department of Infectious Diseases and Clinical Microbiology, Faculty of Medicine, Ege University, Izmir, Turkey
| | - Tansu Yamazhan
- Department of Infectious Diseases and Clinical Microbiology, Faculty of Medicine, Ege University, Izmir, Turkey
| | - Meltem Işıkgöz Taşbakan
- Department of Infectious Diseases and Clinical Microbiology, Faculty of Medicine, Ege University, Izmir, Turkey
| | - Bilgin Arda
- Department of Infectious Diseases and Clinical Microbiology, Faculty of Medicine, Ege University, Izmir, Turkey
| | - Sercan Ulusoy
- Department of Infectious Diseases and Clinical Microbiology, Faculty of Medicine, Ege University, Izmir, Turkey
| | - Oğuz Reşat Sipahi
- Department of Infectious Diseases and Clinical Microbiology, Faculty of Medicine, Ege University, Izmir, Turkey
- Infectious Diseases Department, Bahrain Oncology Center, King Hamad University Hospital, Muharraq, Bahrain
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4
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Sipahi OR, Akyol D, Ormen B, Cicek-Senturk G, Mermer S, Onal U, Amer F, Saed MA, Ozdemir K, Tukenmez-Tigen E, Oztoprak N, Altin U, Kurtaran B, Popescu CP, Sakci M, Suntur BM, Gautam V, Sharma M, Kaya S, Akcil EF, Kaya S, Turunc T, Ergen P, Kandemir O, Cesur S, Bardak-Ozcem S, Ozgiray E, Yurtseven T, Erdem HA, Sipahi H, Arda B, Pullukcu H, Tasbakan M, Yamazhan T, Aydemir S, Ulusoy S. Empirical cefepime+vancomycin versus ceftazidime+vancomycin versus meropenem+vancomycin in the treatment of healthcare-associated meningitis: results of the multicenter ephesus study. BMC Infect Dis 2023; 23:639. [PMID: 37770836 PMCID: PMC10540455 DOI: 10.1186/s12879-023-08596-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2023] [Accepted: 09/11/2023] [Indexed: 09/30/2023] Open
Abstract
BACKGROUND Herein, we analyzed the efficacy of main antibiotic therapy regimens in the treatment of healthcare-associated meningitis (HCAM). MATERIALS/METHODS This retrospective cohort study was conducted in 18 tertiary-care academic hospitals Turkey, India, Egypt and Romania. We extracted data and outcomes of all patients with post-neurosurgical meningitis cases fulfilling the study inclusion criteria and treated with empirical therapy between December 2006-September 2018. RESULTS Twenty patients in the cefepime + vancomycin-(CV) group, 31 patients in the ceftazidime + vancomycin-(CFV) group, and 119 patients in the meropenem + vancomycin-(MV) group met the inclusion criteria. The MV subgroup had a significantly higher mean Glasgow Coma Score, a higher rate of admission to the intensive care unit within the previous month, and a higher rate of antibiot herapy within the previous month before the meningitis episode (p < 0.05). Microbiological success on Day 3-5, end of treatment (EOT) clinical success (80% vs. 54.8%% vs 57.9%), and overall success (EOT success followed by one-month survival without relapse or reinfection 65% vs. 51.6% vs. 45.3%), EOT all cause mortality (ACM) and day 30 ACM (15% vs. 22.6% vs. 26%) did not differ significantly (p > 0.05) among the three cohorts. No regimen was effective against carbapenem-resistant bacteria, and vancomycin resulted in an EOT clinical success rate of 60.6% in the methicillin-resistant staphylococci or ampicillin-resistant enterococci subgroup (n = 34). CONCLUSIONS Our study showed no significant difference in terms of clinical success and mortality among the three treatment options. All regimens were ineffective against carbapenem-resistant bacteria. Vancomycin was unsuccessful in approximately 40% of cases involving methicillin-resistant staphylococci or ampicillin-resistant enterococci.
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Affiliation(s)
- Oguz Resat Sipahi
- Department of Infectious Diseases and Clinical Microbiology, Faculty of Medicine, Ege University, Izmir, Turkey
- Department of Infectious Diseases, Bahrain Oncology Center, King Hamad University Hospital, Muharraq, Bahrain
| | - Deniz Akyol
- Department of Infectious Diseases and Clinical Microbiology, Faculty of Medicine, Ege University, Izmir, Turkey.
- Infectious Diseases Clinic, Kagizman State Hospital, Kagizman, Kars, Turkey.
| | - Bahar Ormen
- Infectious Diseases and Clinical Microbiology Clinic, Izmir Katip Celebi University Ataturk Training and Research Hospital, Izmir, Turkey
| | - Gonul Cicek-Senturk
- Infectious Diseases and Clinical Microbiology Clinic, SB Diskapi Yildirim Beyazit Training and Research Hospital, Ankara, Turkey
| | - Sinan Mermer
- Department of Infectious Diseases and Clinical Microbiology, Faculty of Medicine, Ege University, Izmir, Turkey
- Department of Infectious Diseases and Clinical Microbiology, Faculty of Medicine, Ekonomi University, Izmir, Turkey
| | - Ugur Onal
- Department of Infectious Diseases and Clinical Microbiology, Faculty of Medicine, Ege University, Izmir, Turkey
- Department of Infectious Diseases and Clinical Microbiology, Faculty of Medicine, Uludag University, Bursa, Turkey
| | | | | | - Kevser Ozdemir
- Department of Infectious Diseases and Clinical Microbiology, Pamukkale University, Denizli, Turkey
| | - Elif Tukenmez-Tigen
- Department of Infectious Diseases and Clinical Microbiology, Marmara University, Istanbul, Turkey
| | - Nefise Oztoprak
- Department of Infectious Diseases and Clinical Microbiology, Faculty of Medicine, Uludag University, Bursa, Turkey
- Infectious Diseases and Clinical Microbiology Clinic, Antalya Education and Research Hospital, Antalya, Turkey
| | - Ummugulsum Altin
- Infectious Diseases and Clinical Microbiology Clinic, Bozyaka Training and Research Hospital, Izmir, Turkey
| | - Behice Kurtaran
- Department of Infectious Diseases and Clinical Microbiology, Cukurova University, Adana, Turkey
| | - Corneliu Petru Popescu
- Dr Victor Babes Clinical Hospital of Infectious and Tropical Diseases, Bucharest, Romania
| | - Mustafa Sakci
- Medical Student, Faculty of Medicine, Ege University, Izmir, Turkey
| | - Bedia Mutay Suntur
- Infectious Diseases and Clinical Microbiology Clinic, Adana Numune Training and Research Hospital, Adana, Turkey
| | - Vikas Gautam
- Post-Graduate Institute of Medical Education & Research, Chandigarh, India
| | - Megha Sharma
- Department of Microbiology, All India Institute of Medical Sciences (AIIMS), Bilaspur, Himachal Pradesh, India
| | - Safak Kaya
- Infectious Diseases and Clinical Microbiology Clinic, Gazi Yasargil Education and Research Hospital, Diyarbakir, Turkey
| | - Eren Fatma Akcil
- Department of Anaesthesiology and Reanimation, Istanbul University, Istanbul, Turkey
| | - Selcuk Kaya
- Department of Infectious Diseases and Clinical Microbiology, Medical Faculty, Karadeniz Technical University, Trabzon, Turkey
| | - Tuba Turunc
- Department of Infectious Diseases and Clinical Microbiology, Baskent University, Adana, Turkey
| | - Pınar Ergen
- Department of Infectious Diseases and Clinical Microbiology, Istanbul Medeniyet University, Goztepe Educational and Research Hospital, Istanbul, Turkey
| | - Ozlem Kandemir
- Department of Infectious Diseases and Clinical Microbiology, Mersin University School of Medicine, Mersin, Turkey
| | - Salih Cesur
- Infectious Diseases and Clinical Microbiology Clinic, Ankara Training Hospital, Ankara, Turkey
| | - Selin Bardak-Ozcem
- Department of Infectious Diseases and Clinical Microbiology, Dr. Burhan Nalbantoğlu State Hospital, Nicosia, Northern Cyprus
| | - Erkin Ozgiray
- Department of Neurosurgery, Faculty of Medicine, Ege University, Izmir, Turkey
| | - Taskın Yurtseven
- Department of Neurosurgery, Faculty of Medicine, Ege University, Izmir, Turkey
| | - Huseyin Aytac Erdem
- Department of Infectious Diseases and Clinical Microbiology, Faculty of Medicine, Ege University, Izmir, Turkey
| | | | - Bilgin Arda
- Department of Infectious Diseases and Clinical Microbiology, Faculty of Medicine, Ege University, Izmir, Turkey
| | - Hüsnü Pullukcu
- Department of Infectious Diseases and Clinical Microbiology, Faculty of Medicine, Ege University, Izmir, Turkey
| | - Meltem Tasbakan
- Department of Infectious Diseases and Clinical Microbiology, Faculty of Medicine, Ege University, Izmir, Turkey
| | - Tansu Yamazhan
- Department of Infectious Diseases and Clinical Microbiology, Faculty of Medicine, Ege University, Izmir, Turkey
| | - Sohret Aydemir
- Department of Clinical Microbiology, Faculty of Medicine, Ege University, Izmir, Turkey
| | - Sercan Ulusoy
- Department of Infectious Diseases and Clinical Microbiology, Faculty of Medicine, Ege University, Izmir, Turkey
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Kahraman Ü, Akyol D, Çiçek C, Balcıoğlu Ö, Engin Ç, Yağdı T, Taşbakan M, Özbaran M. Retrospective Evaluation of COVID-19 Infection and COVID-19 Vaccines in Heart Transplant Patients. Transplant Proc 2023:S0041-1345(23)00312-3. [PMID: 37271605 DOI: 10.1016/j.transproceed.2023.04.033] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2022] [Revised: 04/13/2023] [Accepted: 04/25/2023] [Indexed: 06/06/2023]
Abstract
BACKGROUND Patients who have performed solid organ transplantation in terms of COVID-19 infection are included in the high-risk group. In this study, it was aimed to evaluate the relationship between vaccination and retrospective evaluation of 32 patients who underwent a heart transplant in the clinic and tested positive for SARS-CoV-2 polymerase chain reaction. METHODS In this study, demographic characteristics of the cases, comorbidities, timing of heart transplantation, immunosuppressive treatments, symptoms of COVID-19 infection, lung imaging findings, follow-up (outpatient/inpatient), treatments, 1-month mortality, and vaccination histories against COVID-19 infection were evaluated. The data obtained from the study were analyzed with SPSS version 25.0. RESULTS The 3 most common symptoms are cough (37.5%), myalgia (28.1%), and fever (21.8%). COVID-19 infection was severe in 6.2% of the patients, moderate in 37.5%, and mild in 56.2%. Hospitalization was required in 5 patients (15.6%, 1 in the intensive care unit), and the other patients were followed up as an outpatient. Severe COVID-19 infection was seen more in 33% of unvaccinated patients; 93.5% were vaccinated. Nineteen patients (68%) were vaccinated before COVID-19 infection. Our patients received the CoronoVac (Sinovac, China) vaccine. CONCLUSION COVID-19 infection is more likely to be severe and mortal in patients with heart transplant recipients. It is also crucial to comply with preventive measures other than immunization in this group of patients. This study is the largest series investigating COVID-19 infection in heart transplant recipient patients in our country.
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Affiliation(s)
- Ümit Kahraman
- Department of Cardiovascular Surgery, Ege University Faculty of Medicine, İzmir, Turkey.
| | - Deniz Akyol
- Infectious Diseases and Clinical Microbiology, Kağızman State Hospital, Kars, Turkey
| | - Candan Çiçek
- Department of Medical Microbiology, Ege University Faculty of Medicine, İzmir, Turkey
| | - Özlem Balcıoğlu
- Department of Cardiovascular Surgery, Near East University Faculty of Medicine, Nicosia, Turkish Republic of Northern Cyprus
| | - Çağatay Engin
- Department of Cardiovascular Surgery, Ege University Faculty of Medicine, İzmir, Turkey
| | - Tahir Yağdı
- Department of Cardiovascular Surgery, Ege University Faculty of Medicine, İzmir, Turkey
| | - Meltem Taşbakan
- Department of Infectious Diseases and Clinical Microbiology, Ege University Faculty of Medicine, İzmir, Turkey
| | - Mustafa Özbaran
- Department of Cardiovascular Surgery, Ege University Faculty of Medicine, İzmir, Turkey
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Marasco G, Cremon C, Barbaro MR, Cacciari G, Falangone F, Kagramanova A, Bordin D, Drug V, Miftode E, Fusaroli P, Mohamed SY, Ricci C, Bellini M, Rahman MM, Melcarne L, Santos J, Lobo B, Bor S, Yapali S, Akyol D, Sapmaz FP, Urun YY, Eskazan T, Celebi A, Kacmaz H, Ebik B, Binicier HC, Bugdayci MS, Yağcı MB, Pullukcu H, Kaya BY, Tureyen A, Hatemi İ, Koc ES, Sirin G, Calıskan AR, Bengi G, Alıs EE, Lukic S, Trajkovska M, Hod K, Dumitrascu D, Pietrangelo A, Corradini E, Simren M, Sjölund J, Tornkvist N, Ghoshal UC, Kolokolnikova O, Colecchia A, Serra J, Maconi G, De Giorgio R, Danese S, Portincasa P, Di Sabatino A, Maggio M, Philippou E, Lee YY, Salvi D, Venturi A, Borghi C, Zoli M, Gionchetti P, Viale P, Stanghellini V, Barbara G. Post COVID-19 irritable bowel syndrome. Gut 2022; 72:gutjnl-2022-328483. [PMID: 36591612 DOI: 10.1136/gutjnl-2022-328483] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/15/2022] [Accepted: 11/23/2022] [Indexed: 01/03/2023]
Abstract
OBJECTIVES The long-term consequences of COVID-19 infection on the gastrointestinal tract remain unclear. Here, we aimed to evaluate the prevalence of gastrointestinal symptoms and post-COVID-19 disorders of gut-brain interaction after hospitalisation for SARS-CoV-2 infection. DESIGN GI-COVID-19 is a prospective, multicentre, controlled study. Patients with and without COVID-19 diagnosis were evaluated on hospital admission and after 1, 6 and 12 months post hospitalisation. Gastrointestinal symptoms, anxiety and depression were assessed using validated questionnaires. RESULTS The study included 2183 hospitalised patients. The primary analysis included a total of 883 patients (614 patients with COVID-19 and 269 controls) due to the exclusion of patients with pre-existing gastrointestinal symptoms and/or surgery. At enrolment, gastrointestinal symptoms were more frequent among patients with COVID-19 than in the control group (59.3% vs 39.7%, p<0.001). At the 12-month follow-up, constipation and hard stools were significantly more prevalent in controls than in patients with COVID-19 (16% vs 9.6%, p=0.019 and 17.7% vs 10.9%, p=0.011, respectively). Compared with controls, patients with COVID-19 reported higher rates of irritable bowel syndrome (IBS) according to Rome IV criteria: 0.5% versus 3.2%, p=0.045. Factors significantly associated with IBS diagnosis included history of allergies, chronic intake of proton pump inhibitors and presence of dyspnoea. At the 6-month follow-up, the rate of patients with COVID-19 fulfilling the criteria for depression was higher than among controls. CONCLUSION Compared with controls, hospitalised patients with COVID-19 had fewer problems of constipation and hard stools at 12 months after acute infection. Patients with COVID-19 had significantly higher rates of IBS than controls. TRIAL REGISTRATION NUMBER NCT04691895.
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Affiliation(s)
- Giovanni Marasco
- Azienda Ospedaliero-Universitaria di Bologna IRCCS, Bologna, Emilia-Romagna, Italy
- Department of Medical and Surgical Sciences, University of Bologna, Bologna, Italy
| | - Cesare Cremon
- Azienda Ospedaliero-Universitaria di Bologna IRCCS, Bologna, Emilia-Romagna, Italy
- Department of Medical and Surgical Sciences, University of Bologna, Bologna, Italy
| | | | - Giulia Cacciari
- Azienda Ospedaliero-Universitaria di Bologna IRCCS, Bologna, Emilia-Romagna, Italy
- Department of Medical and Surgical Sciences, University of Bologna, Bologna, Italy
| | - Francesca Falangone
- Medical-Surgical Department of Clinical Sciences and Translational Medicine, University Sapienza Rome, Rome, Italy
| | - Anna Kagramanova
- Loginov Moscow Clinical Scientific Center, Moscow, Russian Federation
| | - Dmitry Bordin
- Loginov Moscow Clinical Scientific Center, Moscow, Russian Federation
- Tver State Medical University, Tver, Russian Federation
- Medicine and Dentistry, A.I. Yevdokimov Moscow State University of Medicine and Dentistry, Moscow, Russia
| | - Vasile Drug
- Gastroenterology, Grigore T Popa University of Medicine and Pharmacy Faculty of Medicine, Iasi, Romania
| | - Egidia Miftode
- Department of Infectious Diseases, 'Grigore T Popa' University of Medicine and Pharmacy, Iasi, Romania
| | | | | | - Chiara Ricci
- Gastroenterology Unit, University of Brescia, Brescia, Italy
| | - Massimo Bellini
- Department of New Technologies and Translational Research in Medicine and Surgery, University of Pisa, Pisa, Italy
| | - Mohammed Masudur Rahman
- Department of Gastroenterology, Sheikh Russel National Gastroliver Institute and Hospital, Dhaka, Bangladesh
| | - Luigi Melcarne
- Gastroenterology Department, Hospital Universitario Parc Tauli, Sabadell, Cataluña, Spain
| | - Javier Santos
- Digestive System Research Unit, Hospital General Vall D'Hebron, Barcelona, Spain
| | - Beatriz Lobo
- Digestive System Research Unit, Hospital General Vall D'Hebron, Barcelona, Spain
| | - Serhat Bor
- Ege University School of Medicine, Izmir, Turkey
| | - Suna Yapali
- Division of Gastroenterology, Acibadem University, Altunizade Acibadem Hospital, Istanbul, Turkey
| | - Deniz Akyol
- Department of Infectious Diseases, Ege University, Izmir, Turkey
| | - Ferdane Pirincci Sapmaz
- Division of Gastroenterology, University of Health Sciences, Keciören Education and Research Hospital, Keciören, Turkey
| | - Yonca Yilmaz Urun
- Division of Gastroenterology, Eskisehir City Hospital, Eskisehir, Turkey
| | - Tugce Eskazan
- Cerrahpasa Faculty of Medicine, Istanbul University-Cerrahpasa, Division of Gastroenterology, Turkey
| | - Altay Celebi
- Division of Gastroenterology, Kocaeli University, Kocaeli, Turkey
| | - Huseyin Kacmaz
- Division of Gastroenterology, Adiyaman Education and Research Hospital, Adiyaman, Turkey
| | - Berat Ebik
- Division of Gastroenterology, University of Health Sciences, Diyabakır Gazi Yasargil Education and Research Hospital, Diyarbakır, Turkey
| | | | - Mehmet Sait Bugdayci
- Division of Gastroenterology, İstanbul Aydın University Florya Liv Hospital, Istanbul, Turkey
| | | | - Husnu Pullukcu
- Department of Infectious Diseases, Ege University, Izmir, Turkey
| | | | - Ali Tureyen
- Division of Gastroenterology, Eskisehir City Hospital, Eskisehir, Turkey
| | - İbrahim Hatemi
- Cerrahpasa Faculty of Medicine, Istanbul University-Cerrahpasa, Division of Gastroenterology, Turkey
| | - Elif Sitre Koc
- Division of Gastroenterology, Acibadem University, Altunizade Acibadem Hospital, Istanbul, Turkey
| | - Goktug Sirin
- Division of Gastroenterology, Kocaeli University, Kocaeli, Turkey
| | - Ali Riza Calıskan
- Division of Gastroenterology, Adiyaman Education and Research Hospital, Adiyaman, Turkey
| | - Goksel Bengi
- Division of Gastroenterology, Dokuz Eylül University, Izmir, Turkey
| | - Esra Ergun Alıs
- Department of Infectious Diseases, İstanbul Aydın University Florya Liv Hospital, Istanbul, Turkey
| | - Snezana Lukic
- Clinic for Gastroenterology and Hepatology, Clinical Center of Serbia, Beograd, Beograd, Serbia
| | - Meri Trajkovska
- Clinic of Gastroenterohepatology, Skopje, Macedonia (the former Yugoslav Republic of)
| | - Keren Hod
- Research Division, Assuta Medical Center, Tel Aviv, Tel Aviv, Israel
| | - Dan Dumitrascu
- 2nd Medical Department of Internal Medicine, University of Medicine and Pharmacy, Cluj-Napoca, Romania
| | - Antonello Pietrangelo
- Division of Internal Medicine, University of Modena and Reggio Emilia, Modena, Italy
| | - Elena Corradini
- Division of Internal Medicine, University of Modena and Reggio Emilia, Modena, Italy
| | - Magnus Simren
- Department of Internal Medicine, Sahlgrenska University Hospital, Gothenburg, Sweden
| | - Jessica Sjölund
- Department of Internal Medicine, Sahlgrenska University Hospital, Gothenburg, Sweden
| | - Navkiran Tornkvist
- Department of Internal Medicine, Sahlgrenska University Hospital, Gothenburg, Sweden
| | - Uday C Ghoshal
- Department of Gastroenterology, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, Uttar Pradesh, India
| | | | - Antonio Colecchia
- Division of Gastroenterology, University of Modena and Reggio Emilia, Modena, Italy
| | - Jordi Serra
- CIBERehd, University Hospital Germans Trias i Pujol, Barcelona, Spain
| | | | - Roberto De Giorgio
- Department of Translational Medicine, University of Ferrara, Ferrara, Italy
| | - Silvio Danese
- Gastroenterology and Endoscopy, IRCCS Ospedale San Raffaele and University Vita-Salute San Raffaele, Milano, Italy
| | - Piero Portincasa
- Division of Internal Medicine "A. Murri", Department of Biomedical Sciences and Human Oncology, University of Bari "Aldo Moro", Bari, Italy
| | - Antonio Di Sabatino
- First Department of Internal Medicine, Università degli Studi di Pavia Facoltà di Medicina e Chirurgia, PV, Lombardia, Italy
| | - Marcello Maggio
- Geriatric Clinic Unit, Department of Clinical and Experimental Medicine, University of Parma, Parma, Italy
| | - Elena Philippou
- Department of Life and Health Sciences, Cyprus University of Nicosia, Nicosia, Cyprus
| | - Yeong Yeh Lee
- School of Medical Sciences, Universiti Sains Malaysia, Kota Bharu, Kelantan, Malaysia
| | - Daniele Salvi
- Department of Medical and Surgical Sciences, University of Bologna, Bologna, Italy
| | - Alessandro Venturi
- Azienda Ospedaliero-Universitaria di Bologna IRCCS, Bologna, Emilia-Romagna, Italy
| | - Claudio Borghi
- Azienda Ospedaliero-Universitaria di Bologna IRCCS, Bologna, Emilia-Romagna, Italy
- Department of Medical and Surgical Sciences, University of Bologna, Bologna, Italy
| | - Marco Zoli
- Department of Medical and Surgical Sciences, University of Bologna, Bologna, Italy
| | - Paolo Gionchetti
- Azienda Ospedaliero-Universitaria di Bologna IRCCS, Bologna, Emilia-Romagna, Italy
- Department of Medical and Surgical Sciences, University of Bologna, Bologna, Italy
| | - Pierluigi Viale
- Azienda Ospedaliero-Universitaria di Bologna IRCCS, Bologna, Emilia-Romagna, Italy
- Department of Medical and Surgical Sciences, University of Bologna, Bologna, Italy
| | - Vincenzo Stanghellini
- Azienda Ospedaliero-Universitaria di Bologna IRCCS, Bologna, Emilia-Romagna, Italy
- Department of Medical and Surgical Sciences, University of Bologna, Bologna, Italy
| | - Giovanni Barbara
- Azienda Ospedaliero-Universitaria di Bologna IRCCS, Bologna, Emilia-Romagna, Italy
- Department of Medical and Surgical Sciences, University of Bologna, Bologna, Italy
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Önal U, Akyol D, Mert M, Başkol D, Memetali SC, Şanlıdağ G, Kenanoğlu B, Uyan-Önal A, Quliyeva G, Avşar CB, Akdağ D, Demir M, Erdem HA, Kahraman Ü, Bozbıyık O, Özgiray E, Bozkurt D, Akarca FK, Demirağ K, Çankayalı İ, Uyar M, Çilli F, Arda B, Yamazhan T, Pullukçu H, Taşbakan MI, Sipahi H, Ulusoy S, Sipahi OR. Carbapenem-resistant Gram-negative pathogens associated with septic shock: a review of 120 cases. J Chemother 2022; 34:436-445. [PMID: 35446235 DOI: 10.1080/1120009x.2022.2064703] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
This study aimed to evaluate the influencing variables for outcomes in patients with septic shock having culture-proven carbapenem-resistant Gram-negative pathogens. It included 120 patients (mean age 64.29 ± 1.35 years and 58.3% female). The mean Sequential Organ Failure Assessment score during septic shock diagnosis was found to be 11.22 ± 0.43 and 9 ± 0.79 among the patients with mortality and among the survivors, respectively (P = 0.017). The logistic regression analysis showed that empirical treatment as mono Gram-negative bacteria-oriented antibiotic therapy (P = 0.016, odds ratio (OR) = 17.730, 95% confidence interval (CI): 1.728-182.691), Charlson Comorbidity Index >2 (P = 0.032, OR = 7.312, 95% CI: 5.7-18.3), and systemic inflammatory response syndrome score 3 or 4 during septic shock diagnosis (P = 0.014, OR = 5.675, 95% CI: 1.424-22.619) were found as independent risk factors for day 30 mortality. Despite early diagnosis and effective management of patients with septic shock, the mortality rates are quite high in CRGNP-infected patients.
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Affiliation(s)
- Uğur Önal
- Faculty of Medicine, Department of Infectious Diseases and Clinical Microbiology, Ege University, Bornova, Izmir, Turkey.,Faculty of Medicine, Department of Infectious Diseases and Clinical Microbiology, Uludag University, Bursa, Turkey
| | - Deniz Akyol
- Faculty of Medicine, Department of Infectious Diseases and Clinical Microbiology, Ege University, Bornova, Izmir, Turkey
| | - Merve Mert
- Faculty of Medicine, Department of Infectious Diseases and Clinical Microbiology, Ege University, Bornova, Izmir, Turkey
| | - Dilşah Başkol
- Faculty of Medicine, Department of Infectious Diseases and Clinical Microbiology, Ege University, Bornova, Izmir, Turkey
| | - Seichan Chousein Memetali
- Faculty of Medicine, Department of Infectious Diseases and Clinical Microbiology, Ege University, Bornova, Izmir, Turkey
| | - Gamze Şanlıdağ
- Faculty of Medicine, Department of Infectious Diseases and Clinical Microbiology, Ege University, Bornova, Izmir, Turkey
| | - Buse Kenanoğlu
- Faculty of Medicine, Department of Infectious Diseases and Clinical Microbiology, Ege University, Bornova, Izmir, Turkey
| | - Ayşe Uyan-Önal
- Faculty of Medicine, Department of Infectious Diseases and Clinical Microbiology, Ege University, Bornova, Izmir, Turkey.,Yüksek İhtisas Research and Teaching Hospital, Department of Infectious Diseases and Clinical Microbiology, Bursa, Turkey
| | - Günel Quliyeva
- Bona Dea International Hospital, Infectious Diseases Clinic, Baku, Azerbaijan
| | - Cansu Bulut Avşar
- Faculty of Medicine, Department of Infectious Diseases and Clinical Microbiology, Ege University, Bornova, Izmir, Turkey
| | - Damla Akdağ
- Faculty of Medicine, Department of Infectious Diseases and Clinical Microbiology, Ege University, Bornova, Izmir, Turkey
| | - Melike Demir
- Faculty of Medicine, Department of Infectious Diseases and Clinical Microbiology, Ege University, Bornova, Izmir, Turkey
| | - Hüseyin Aytaç Erdem
- Faculty of Medicine, Department of Infectious Diseases and Clinical Microbiology, Ege University, Bornova, Izmir, Turkey
| | - Ümit Kahraman
- Faculty of Medicine, Department of Cardiovascular Surgery, Ege University, Bornova, Izmir, Turkey
| | - Osman Bozbıyık
- Faculty of Medicine, Department of General Surgery, Ege University, Bornova, Izmir, Turkey
| | - Erkin Özgiray
- Faculty of Medicine, Department of Neurosurgery, Ege University, Bornova, Izmir, Turkey
| | - Devrim Bozkurt
- Faculty of Medicine, Department of Internal Medicine, Ege University, Bornova, Izmir, Turkey
| | - Funda Karbek Akarca
- Faculty of Medicine, Department of Emergency Medicine, Ege University, Bornova, Izmir, Turkey
| | - Kubilay Demirağ
- Faculty of Medicine, Department of Anaesthesiology and Reanimation, Ege University, Bornova, Izmir, Turkey
| | - İlkin Çankayalı
- Faculty of Medicine, Department of Anaesthesiology and Reanimation, Ege University, Bornova, Izmir, Turkey
| | - Mehmet Uyar
- Faculty of Medicine, Department of Anaesthesiology and Reanimation, Ege University, Bornova, Izmir, Turkey
| | - Feriha Çilli
- Faculty of Medicine, Department of Medical Microbiology, Ege University, Bornova, Izmir, Turkey
| | - Bilgin Arda
- Faculty of Medicine, Department of Infectious Diseases and Clinical Microbiology, Ege University, Bornova, Izmir, Turkey
| | - Tansu Yamazhan
- Faculty of Medicine, Department of Infectious Diseases and Clinical Microbiology, Ege University, Bornova, Izmir, Turkey
| | - Hüsnü Pullukçu
- Faculty of Medicine, Department of Infectious Diseases and Clinical Microbiology, Ege University, Bornova, Izmir, Turkey
| | - Meltem Işıkgöz Taşbakan
- Faculty of Medicine, Department of Infectious Diseases and Clinical Microbiology, Ege University, Bornova, Izmir, Turkey
| | - Hilal Sipahi
- Department of Medical Microbiology, Bornova Directorate of Health, Bornova, Izmir, Turkey
| | - Sercan Ulusoy
- Faculty of Medicine, Department of Infectious Diseases and Clinical Microbiology, Ege University, Bornova, Izmir, Turkey
| | - Oguz Resat Sipahi
- Faculty of Medicine, Department of Infectious Diseases and Clinical Microbiology, Ege University, Bornova, Izmir, Turkey
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8
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Akyol D, özcem SB, Mermer S, Aydemir Ş, Yamazhan T, Arda B, Özgiray E, Yurtseven T, Ulusoy S, Sipahi OR. 268. Methicillin Sensitive Versus Methicillin Resistant Staphylococcus aureus Nosocomial Meningitis. Open Forum Infect Dis 2021. [PMCID: PMC8644750 DOI: 10.1093/ofid/ofab466.470] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background
Herein, we aimed to analyze the outcomes of the methicillin sensitive (MS) versus methicillin resistant (MR) culture-proven Staphylococcus spp. nosocomial meningitis (S-NM) in our setting.
Methods
We extracted data and outcomes for all adult patients (age >18 years) consulted by the Infectious Diseases Consultants and diagnosed NM (developed at a compatible time according to CDC nosocomial meningitis definitions) between January 2006 and 2021 and fulfilled the following study inclusion criteria: (a) Age ≥18-year-old; (b) CSF culture is positive for Staphylococcus spp. (c) Presence of at least two of three clinical/laboratory criteria as meningitis findings: (i) Body temperature >38oC; (ii) CSF finding; >250 leucocytes/mm3; (iii) at least one of the following clinical findings, ie. impairment of consciousness, neck stiffness, nausea/vomiting. Identification of the infecting bacteria and determination of antimicrobial susceptibility were performed using the VITEK 2 automated system (BioMerieux Inc, Mercy L’etoil, France) and conventional methods. Resistance to methicillin was tested by E-test (bioMérieux). Antibacterial susceptibility tests were evaluated according to Clinical Laboratory Standards Institute (CLSI) criteria until 2014 and EUCAST between 2015 and 2021. Chi-square and Student T tests were used for statistical comparison.
Results
A total of 9 patients in MSS-NM, 41 patients in MRS-NM group fulfilled the study inclusion criteria. Age, gender, and CSF findings (except CSF glucose was significantly lower in MSS-NM) were similar in both groups (Table 1). Besides, EOT clinical success and overall success (EOT success followed by one-month survival without relapse or reinfection) rates were similar (Table 1). Relapse and reinfection rates during post-treatment one month period were 0%-0% and 0%-6.6% in MSS/MRS-NM, respectively. In MRS-NM group reinfection pathogens were Acinetobacter baumannii and Pseudomonas aeruginosa after 12 and 30 days end of treatment.
Characteristics of NM
Conclusion
Overall success in MSS-NM was acceptable while it was non-significantly lower in MRS-NM. The medical community should seek better infection control measures from NM.
Disclosures
All Authors: No reported disclosures
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Affiliation(s)
| | | | - Sinan Mermer
- Ege University Faculty of Medicine, İzmir, Izmir, Turkey
| | - Şöhret Aydemir
- Ege University Faculty of Medicine, İzmir, Izmir, Turkey
| | | | - Bilgin Arda
- Ege University Faculty of Medicine, İzmir, Izmir, Turkey
| | - Erkin Özgiray
- Ege University Faculty of Medicine, İzmir, Izmir, Turkey
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Akyol D, Quliyeva G, özcem SB, kayıkçıoğlu M, Yamazhan T, Ulusoy S, Sipahi H, Taşbakan M, Sipahi OR. 691. Infective Endocarditis with an Indication for Cardiac Surgery in a Tertiary Care Educational Hospital: Does Cardiac Surgery Improve Outcomes? Open Forum Infect Dis 2021. [PMCID: PMC8644365 DOI: 10.1093/ofid/ofab466.888] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
Abstract
Background In this retrospective cohort study, it was aimed to compare the clinical characteristics and outcomes of IE cases without and with an indication for cardiac surgery in terms of whether they have been operated or not, in a tertiary-care educational hospital. Methods Patients that were followed up for definite IE (diagnosed according to modified Duke criteria between March 2007 and November 2020) with an indication for cardiac surgery according to European Society of Cardiology Guidelines, comprised the study group. Subjects were evaluated in terms of whether these cases have been operated or not, demographic features, underlying diseases, risk factors, clinical and laboratory findings, therapy responses, complications, and mortality. The timing of surgery is defined as emergency; surgery performed within 24 hours, urgent; within a few days, elective; after at least one-two weeks of antibiotic therapy. Statistical analysis was performed via Chi square and Student T tests and a p value < 0.05 was considered significant. Results A total of 90 patients with an indication for surgery, 33.3% patients in underwent surgery, 66.6% patients in not underwent surgery group fulfilled the study criteria. The most frequently seen complaints in patients were fever (91.1%), cold-shiver (56.6%), weight-loss (27.7%), dyspnea (25.5%), and tachycardia (20%). Heart murmur was detected during cardiac auscultation of 44 patients. Mean blood leukocyte count, C-reactive protein and erythrocyte sedimentation rate were 12324 ± 6558/mm3 (1408-30330), 11.46 ± 8.38 mg/dl (0.18-34.6) and 61.43 ± 33.4 mm/h (2-130), respectively. There was no significant difference between two groups in terms of cardiac/non-cardiac risk factors, age, gender, etiologic agents, laboratory findings, septic embolisms and complaints (Table 1). In total IE with an indication for surgery mortality was 27.7%. Mortality rate was significantly less and heart murmur was significantly higher in cases who underwent surgery than those did not undergo surgery (p: 0.0447). Table 1. Comparison of basic characteristics of patients in the two operated / unoperated cohorts. ![]()
Conclusion These data support the importance of the guidelines’ criteria for cardiac surgery in the management of IE. Assuming that only 1/3 of the surgery needing cases received surgery, more interventions are needed to decrease the barriers against surgery. Disclosures All Authors: No reported disclosures
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10
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Parlak E, Kerget F, Demirdal T, Şen P, Ulaş AB, Öztürk Durmaz Ş, Pekok U, Ertürk A, Akyol D, Kepenek Kurt E, Köksal Alay H, Pullukçu H, Taşbakan M, Erol S, Laloğlu E, Öztürk Engin D, Ağalar C, Parlak M. The Epidemiology, Clinical Manifestations, Radiology, Microbiology, Treatment, and Prognosis of Echinococcosis: Results of NENEHATUN Study. Vector Borne Zoonotic Dis 2021; 21:948-954. [PMID: 34647813 DOI: 10.1089/vbz.2021.0029] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Aim: Echinococcosis, caused by Echinococcus species, is an important zoonotic disease causing major health problems in humans and animals. Herein, we aimed to evaluate the epidemiology, clinical and laboratory parameters, radiological, serological, pathological, and treatment protocols of followed-up cases of hydatidosis. Methods: A total of 550 patients diagnosed with hydatid cyst disease were included in this study. Patients who were positive for one or more of the enzyme-linked immunosorbent assay or indirect hemagglutination test, pathological results, or radiological findings were examined. The data analyzed were collected from nine centers between 2008 and 2020. Records were examined retrospectively. Results: Among the patients, 292 (53.1%) were women and 258 (46.9%) were men. The patients' mean age was 44.4 ± 17.4 years. A history of living in rural areas was recorded in 57.4% of the patients. A total of 435 (79.1%) patients were symptomatic. The most common symptoms were abdominal pain in 277 (50.4%), listlessness in 244 (44.4%), and cough in 140 (25.5%) patients. Hepatomegaly was found in 147 (26.7%), and decreased breath sounds were observed in 124 (22.5%) patients. Radiological examination was performed in all cases and serological methods were also applied to 428 (77.8%) patients. The most frequently applied serological test was IHA (37.8%). A single cyst has been found in 66% patients. Hepatic involvement occurred in 327 (59.4%), pulmonary involvement was found in 128 (23.3%), whereas both of them were recorded in 43 (7.8%) patients. Splenic involvement was only detected in nine (1.6%) patients. Echinococcus granulosus (72.5%) was most frequently detected. Cyst diameters of 56.9% of the patients were in the range of 5-10 cm. A total of 414 (75.2%) patients received albendazole as an antiparasitic. Mortality was noted in nine (1.6%) patients. Conclusion: Echinococcosis is an important public health problem in Turkey. It can affect the social, economic, and political structures of the community. Public education and awareness are extremely important.
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Affiliation(s)
- Emine Parlak
- Department of Infectious Diseases and Clinical Microbiology, Atatürk University Faculty of Medicine, Erzurum, Turkey
| | - Ferhan Kerget
- Department of Infectious Diseases and Clinical Microbiology, Erzurum Regional Training and Research Hospital, Erzurum, Turkey
| | - Tuna Demirdal
- Department of Infectious Diseases and Clinical Microbiology, Kâtip Çelebi University Atatürk Training and Research Hospital, İzmir, Turkey
| | - Pınar Şen
- Department of Infectious Diseases and Clinical Microbiology, Saruhanlı State Hospital, Manisa, Turkey
| | - Ali Bilal Ulaş
- Department of Thoracic Surgery, Atatürk University Faculty of Medicine, Erzurum, Turkey
| | - Şenay Öztürk Durmaz
- Department of Infectious Diseases and Clinical Microbiology, Antalya, Turkey
| | - Umut Pekok
- Department of Infectious Diseases and Clinical Microbiology, VM Medical Park Pendik Hospital, İstanbul, Turkey
| | - Ayşe Ertürk
- Department of Infectious Diseases and Clinical Microbiology, Recep Tayyip Erdoğan University Faculty of Medicine, Rize, Turkey
| | - Deniz Akyol
- Department of Infectious Diseases and Clinical Microbiology, Ege University Faculty of Medicine, İzmir, Turkey
| | - Esma Kepenek Kurt
- Department of Infectious Diseases and Clinical Microbiology, Necmettin Erbakan University Faculty of Medicine, Konya, Turkey
| | - Handan Köksal Alay
- Department of Infectious Diseases and Clinical Microbiology, Atatürk University Faculty of Medicine, Erzurum, Turkey
| | - Hüsnü Pullukçu
- Department of Infectious Diseases and Clinical Microbiology, Ege University Faculty of Medicine, İzmir, Turkey
| | - Meltem Taşbakan
- Department of Infectious Diseases and Clinical Microbiology, Ege University Faculty of Medicine, İzmir, Turkey
| | - Serpil Erol
- Infectious Diseases and Clinical Microbiology Clinic, Istanbul Haydarpaşa Numune Training and Research Hospital, İstanbul, Turkey
| | - Esra Laloğlu
- Department of Biochemistry, Atatürk University Faculty of Medicine, Erzurum, Turkey
| | - Derya Öztürk Engin
- Infectious Diseases and Clinical Microbiology Clinic, Fatih Sultan Mehmet Training and Research Hospital, Istanbul, Turkey
| | - Canan Ağalar
- Department of Infectious Diseases and Clinical Microbiology, Medıcana Ataşehir Hospital, İstanbul, Turkey
| | - Mehmet Parlak
- Department of Infectious Diseases and Clinical Microbiology, Atatürk University Faculty of Medicine, Erzurum, Turkey
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Sürgeç E, Can H, Döşkaya M, Karakavuk M, Atalay Şahar E, Değirmenci Döşkaya A, Pullukçu H, Taşbakan M, Sezai Taşbakan M, Akyol D, Yargucu Zihni F, Ün C, Yüksel Gürüz A, Demir S. Genotyping of Pneumocystis jirovecii isolates obtained from clinical samples by multilocus sequencing: a molecular epidemiology study conducted in Turkey. Arch Microbiol 2020; 202:1647-1652. [PMID: 32274557 DOI: 10.1007/s00203-020-01874-3] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2020] [Revised: 03/20/2020] [Accepted: 04/01/2020] [Indexed: 12/12/2022]
Abstract
Pneumocystis jirovecii is an opportunistic respiratory pathogen causing Pneumocystis pneumonia (PcP) in immunocompromised patients. The aim of this study was to investigate the genetic diversity of P. jirovecii isolates (n: 84) obtained from PcP patients using multilocus sequencing method based on mt26S, SOD, and CYB loci. Among the 84 clinical samples that were positive for P. jirovecii DNA, 31 (36.90%) of them were genotyped using at least one locus. Of the 31 clinical samples, 26 of them were successfully genotyped using all loci whereas three samples were genotyped using either mt26S/CYB loci or mt26S/SOD loci. Additionally, there were two more clinical samples that were genotyped using CYB or SOD locus. Using mt26S locus, genotypes 2, 3, 7, and 8 were detected. Frequencies of genotype 7 and 8 were higher and both of them were found in 11 (n: 29; 37.93%) clinical samples. Using SOD locus, SOD 1, 2, and 4 genotypes were detected. SOD 1 was the predominant genotype (20/28; 71.42%). During the analyses of CYB locus, CYB 1, 2, 5, 6, and 7 as well as a new CYB genotype were detected. CYB 1 (16/29; 55.17%) and 2 (10/29; 34.48%) were the predominant genotypes. Overall, according to the multilocus sequencing results E, F, M, N, P, and V multilocus genotypes were detected among the PcP patients. In addition, SOD 1 was the predominant genotype and CYB had a more polymorphic locus.
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Affiliation(s)
- Ecem Sürgeç
- Faculty of Science, Department of Biology, Zoology Section, Ege University, Izmir, Turkey
| | - Hüseyin Can
- Faculty of Science, Department of Biology, Molecular Biology Section, Ege University, Izmir, Turkey
| | - Mert Döşkaya
- Faculty of Medicine, Department of Parasitology, Ege University, Izmir, Turkey
| | | | - Esra Atalay Şahar
- Faculty of Engineering, Department of Biotechnology, Ege University, Izmir, Turkey
| | - Aysu Değirmenci Döşkaya
- Faculty of Medicine, Department of Parasitology, Ege University, Izmir, Turkey.,Faculty of Medicine, Blood Bank, Ege University, Izmir, Turkey
| | - Hüsnü Pullukçu
- Faculty of Medicine, Department of Infectious Diseases, Ege University, Izmir, Turkey
| | - Meltem Taşbakan
- Faculty of Medicine, Department of Infectious Diseases, Ege University, Izmir, Turkey
| | | | - Deniz Akyol
- Faculty of Medicine, Department of Infectious Diseases, Ege University, Izmir, Turkey
| | - Figen Yargucu Zihni
- Faculty of Medicine, Department of Rheumatology, Ege University, Izmir, Turkey
| | - Cemal Ün
- Faculty of Science, Department of Biology, Molecular Biology Section, Ege University, Izmir, Turkey
| | - Adnan Yüksel Gürüz
- Faculty of Medicine, Department of Parasitology, Ege University, Izmir, Turkey
| | - Samiye Demir
- Faculty of Science, Department of Biology, Zoology Section, Ege University, Izmir, Turkey.
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Akyol D, Pullukcu H, Celtik A, Mermut G, Tasbakan Isikgoz M. A Case of Chickenpox Developing 11 Years after Renal Transplantation. Turk J Nephrol 2020. [DOI: 10.5152/turkjnephrol.2020.3603] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
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Akyol D, Uyan Önal A, Önal U, Akdağ D, Bulut Avşar C, Uysal S, Guliyeva G, Başkol D, Demir M, Mermer S, Chousein Memetali S, Şanlıdağ G, Mert M, Sipahi H, Ulusoy S, Reşat Sipahi O. 219. Is the modified quick SOFA scale superior to quick SOFA in patients with diagnosed septic shock? Open Forum Infect Dis 2019. [PMCID: PMC6810696 DOI: 10.1093/ofid/ofz360.294] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Background In this study it was aimed to compare the effects of qSOFA (Quick Sequential Organ Failure Assessment) score with modified qSOFA score (PLoS One. 2018 Sep 26;13(9):e0204608) for predicting one month survival in patients with diagnosed septic shock (SS) in a tertiary-care educational university hospital in a developing country. Methods Modified qSOFA was created by adding age factor (>50 years=1 point) to patients with qSOFA scale 1 or 2 or 3 who had SS (sepsis+hypotension+adrenergic agent) and consulted by Infectious Diseases consultants between December 2013-December 2018. Arterial lactate level of >2 mmol/L criterion was added as an including criteria for SS according to 3rd International Sepsis and Septic Shock Consensus Statement after 23rd February 2016. Statistical analysis was performed via Chi-square test and a p-value <0.05 was considered significant. Results The number of patients with qSOFA score of 1 or 2 or 3 from 527 patients are in Table1 [some of the cases were diagnosed as septic shock according to elder definition (without lactate criterion) and there was a subgroup with qSOFA score 1]. Among the >50-year aged group, the 30-day survival rate was lower in patients with qSOFA3 vs. qSOFA 2 vs. qSOFA 1 (Table1, 3x2 Chi Square test, P = 0.0057). Among the <50 years group, the qSOFA one month survival rate was lower in patients with qSOFA 3 vs. qSOFA 2 vs. qSOFA 1 (Table, 3x2 Chi Square Test, P = 0.0052). According to modified qSOFA, there was a significant difference for one month survival among SS cases with scores of 1, 2, 3 and 4 (12/21 57% vs. Fifty/126 40% vs. 78/269 29% vs. 22/111 20%, 4x2 Chi-square test, P = 0.0003). On the other hand, there was no significant difference in terms of one month survival when we performed subgroup analysis in qSOFA score 1, 2, or 3 subgroups, as ≤50 years vs. >50 years (table, Chi-square test, 12/21 vs. 39/97 P = 0.224, 11/29 vs. 75/244 P = 0.526, 3/25 vs. 22/111 P = 0.572). Conclusion In terms of survival at one month, there was a significant difference between qSOFA score 1, 2, 3 and 4 subgroups. In patients with qSOFA score of 1 or 2 or 3, being under 50 years did not have a significant effect on one-month survival. Modified qSOFA may be beneficial to foresee the probable mortality but these findings need to be validated in larger cohorts ![]()
Disclosures All authors: No reported disclosures.
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Kuman Tunçel Ö, Akyol D, Pullukçu H, Yamazhan T, Işıkgöz Taşbakan M, Önen Sertöz Ö. Impact of Direct Acting Antiviral Agents on Psychiatric and Sexual Health of Patients with Hepatitis C Virus. Egypt J Immunol 2019. [DOI: 10.4274/vhd.galenos.2019.0006] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
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15
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Taşbakan MS, Akdağ D, Kahraman H, Akyol D, Taşbakan M, Çavuşoğlu C. [Culture proven extra pulmonary tuberculosis: drug susceptibility and genetic profile analysis]. Tuberk Toraks 2019; 66:234-238. [PMID: 30479231 DOI: 10.5578/tt.67376] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Introduction Tuberculosis is seen generally in the lungs. Besides, all organs in the body can be affected by tuberculosis. Diagnosis of extra pulmonary tuberculosis (EPTB) is more difficult than pulmonary tuberculosis (PTB). Although, the isolation of Mycobacterium tuberculosis is gold standard of diagnosis of EPTB, the rate of bacteriologic isolation is low especially in EPTB. If M. tuberculosis is detected, it gives some information about the epidemiological features of the disease and drug susceptibility. Materials and Methods In this study, extra pulmonary samples isolated M. tuberculosis in mycobacteriology laboratory were evaluated between 2009-2016. The identification of the genotype of isolated bacteria and drug sensitivity tests were conducted. Spoligotyping was accomplished using a standard technique as described previously. Result During the study period, M. tuberculosis were cultured in 171 extra pulmonary samples of 165 patients (75 male, 90 female, mean age: 53.35 ± 19.92). Initial direct microscopically examination was revealed M. tuberculosis in 44 patients. There were more than one extra pulmonary organ involvement in six patients. The most common EPTB forms were lymph node TB in 60 patients, pleural tuberculosis in 32 patients and bone tuberculosis in 25 patients. Immunosuppression was detected in 44 (%26.6) patients. Among these, seven patients were infected with HIV. In 21 of 175 samples, drug resistance was detected. Rifampicin resistance in 7 samples, high level isoniazid resistance in 11 samples and rifampicin plus isoniazid resistance (multiply drug resistance) in 6 samples were demonstrated. One hundred thirty-five clinical isolates were cultured from tuberculosis patient's different samples, of which the genetic profile was determined by using Spoligotyping. The major Spoligotypes were T (n= 62; 45.9%), LAM7-TUR (ST41) (n= 11; 8.1%) and H1 (n= 9; 6%) genotypes. Conclusions The most common EPTB form was lymph node tuberculosis in culture proven patients. In these patients group, multiply drug resistance rate was low (3.6%). Spoligotypes T (45.9%) was detected as most common genetic profile.
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Affiliation(s)
| | - Damla Akdağ
- Department of Infectious Diseases and Clinical Microbiology, Faculty of Medicine, Ege University, Izmir, Turkey
| | - Hasip Kahraman
- Clinic of Infectious Diseases and Clinical Microbiology, Datca State Hospital, Mugla, Turkey
| | - Deniz Akyol
- Department of Infectious Diseases and Clinical Microbiology, Faculty of Medicine, Ege University, Izmir, Turkey
| | - Meltem Taşbakan
- Department of Infectious Diseases and Clinical Microbiology, Faculty of Medicine, Ege University, Izmir, Turkey
| | - Cengiz Çavuşoğlu
- Department of Medical Microbiology, Faculty of Medicine, Ege University, Izmir, Turkey
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Taşbakan MI, Durusoy R, Tosun S, Akyol D, Pullukçu H, Yamazhan T. Relationship Between Tetanus Antitoxin Titration Level and Vaccination History. J Clin Exp Invest 2017. [DOI: 10.5799/jcei.382398] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
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Grossmann E, Akyol D, Eder L, Hofmann B, Haneya A, Graf BM, Bucher M, Raspé C. Thromboelastometric detection of clotting Factor XIII deficiency in cardiac surgery patients. Transfus Med 2013; 23:407-15. [DOI: 10.1111/tme.12069] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2012] [Revised: 02/15/2013] [Accepted: 03/10/2013] [Indexed: 11/30/2022]
Affiliation(s)
- E. Grossmann
- Abteilung für Anästhesie; Herzzentrum Leipzig GmbH; Struempelstrasse 39 04289 Leipzig Germany
| | - D. Akyol
- Department of Anesthesiology; Regensburg University; Regensburg Germany
| | - L. Eder
- Abteilung für Anästhesie; Herzzentrum Leipzig GmbH; Struempelstrasse 39 04289 Leipzig Germany
| | - B. Hofmann
- Department of Cardiothoracic Surgery; Halle-Wittenberg University; Halle Germany
| | - A. Haneya
- Department of Cardiothoracic Surgery; Regensburg University; Regensburg Germany
| | - B. M. Graf
- Department of Anesthesiology; Regensburg University; Regensburg Germany
| | - M. Bucher
- Abteilung für Anästhesie; Herzzentrum Leipzig GmbH; Struempelstrasse 39 04289 Leipzig Germany
| | - C. Raspé
- Abteilung für Anästhesie; Herzzentrum Leipzig GmbH; Struempelstrasse 39 04289 Leipzig Germany
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Abstract
The aim of this study was to determine the feasibility, results and complications of vaginal hysterectomy. A total of 886 consecutive patients who had undergone vaginal hysterectomy for benign gynecological diseases were retrospectively analysed. Vaginal hysterectomy was successfully performed in 96.1% of the nulliparous and 99.9% of the parous patients. The mean duration (min) of the operation was 89.1+/-29.1. The operation time (min) of the nulliparous women was significantly higher than that of the primiparous and multiparous women (109.3+/-40.2 vs 81.1+/-33.2 and 85.1+/-28.3, respectively). The overall complication rate was 14.6%. The intraoperative and postoperative complication rates were 4.1% and 10.5%, respectively. The most common intraoperative complication was bladder injury (2.5%). Vaginal hysterectomy for benign gynaecological diseases has high feasibility with acceptable complication rates.
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Affiliation(s)
- D Akyol
- Department of Obstetrics and Gynaecology, Hacettepe University Faculty of Medicine, Ankara, Turkey
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Goepfert MS, Reuter D, Akyol D, Lamm P, Kilger E, Goetz AE. Goal directed fluid management reduces the use of vasoactive drugs and shortens need of postoperative ICU-therapy in cardiac surgery patients. Thorac Cardiovasc Surg 2007. [DOI: 10.1055/s-2007-967341] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Affiliation(s)
- I Esinler
- Department of Obstetrics and Gynecology, Hacettepe University School of Medicine, Ankara, Turkey
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21
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Ferber A, Akyol D, Kane LA, Grassi A, Divon MY. Nucleated red blood cells in human fetal scalp capillary blood samples: a feasibility study. J Matern Fetal Neonatal Med 2002; 11:26-9. [PMID: 12380604 DOI: 10.1080/jmf.11.1.26.29] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
OBJECTIVE Elevated umbilical cord nucleated red blood cell (NRBC) counts have been suggested as a predictor of adverse perinatal outcome. We sought to evaluate the feasibility of obtaining fetal scalp capillary blood NRBC counts during labor and to assess their correlation with umbilical cord NRBC counts. METHODS Fetal scalp capillary blood specimens were prospectively collected in laboring patients who underwent scalp sampling because of the presence of an abnormal fetal heart rate pattern. Matched umbilical cord blood samples were collected immediately after birth. Outcome measures were the feasibility of obtaining fetal scalp NRBC counts and their correlation with umbilical cord NRBC counts. RESULTS Thirteen term singleton pregnancies formed the study population. In four patients, fetal scalp capillary blood sampling was performed twice. Of the attempts to evaluate fetal scalp capillary samples for NRBC counts, 16 out of 17 (94.1%) were successful. The mean fetal scalp capillary blood NRBC count per 100 white blood cells was 12.6 +/- 7.6 (+/- SD). Umbilical cord mixed, venous and arterial NRBC counts were 15.5 +/- 8.8, 13.4 +/- 10.7 and 12.6 +/- 10.7, with p = 0.09, p = 0.59 and p = 0.68, respectively, when compared to the corresponding scalp sample. The Spearman rank correlation between fetal scalp capillary samples and umbilical cord mixed, venous and arterial NRBC counts were r = 0.86, r = 0.92 and r = 0.95, respectively, with all p values < 0.001. CONCLUSION Previous studies have established the clinical utility of umbilical cord NRBC counts. Our study demonstrated that it was possible to obtain NRBC counts from a fetal scalp capillary sample and that these counts correlated highly with umbilical cord NRBC counts. Future studies are needed to evaluate fetal scalp NRBC counts as a predictor of perinatal outcome.
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Affiliation(s)
- A Ferber
- Department of Obstetrics and Gynecology and Pediatrics, Lenox-Hill Hospital, New York, New York 10021, USA
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22
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Abstract
Hexachlorobenzene (C(6)Cl(6), HCB) is a chemical that has been associated with significant immediate and long term adverse health effects in humans. It has been associated with both porphyria cutanea tarda and spontaneous abortions among survivors of widespread exposure in the 1950s in southeastern Turkey. HCB binds to the Ah receptor, albeit with lower affinity than dioxin. Dioxin exposure has been reported to lower human secondary sex ratio, putatively through a male mediated effect. We therefore wished to evaluate the impact of the HCB environmental event on the sex ratio of the progeny of the survivors. We undertook an assessment of 1) the effects of HCB exposure on the proportion of male births of individual subjects who had survived, 2) variables that significantly predicted the proportion of males among these individuals, and 3) the trend of the population sex ratio born in Turkey from 1935 to 1990. Women known to have been exposed to HCB in the 1950s did not have offspring with a significantly different sex ratio when compared to control populations. However, subjects reporting exposure at the peak of the episode (1955-57) had a significantly lower lifetime proportion of males than those exposed at a later date. The lifetime reported spontaneous abortion rate of these women also significantly predicted the percent males per subject. The available national data demonstrated a significant reduction in the calculated proportion of males from 1935 to 1970 that stabilized from 1970 to 1990. These data indicate that HCB exposure that was sufficient to induce clinical porphyria cutanea tarda may also have reduced the proportion of males in subjects over their reproductive life-span. The HCB episode does not explain the pattern of the national trend from a population perspective.
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Affiliation(s)
- J F Jarrell
- Department of Obstetrics and Gynecology, University of Calgary, Alberta, Calgary, Canada.
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23
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Akyol D, Mungan T, Baltaci V. A comparative study of genotoxic effects in the treatment of trichomonas vaginalis infection: metronidazole or nalidixic acid. Arch Gynecol Obstet 2000; 264:20-3. [PMID: 10985613 DOI: 10.1007/pl00007476] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
We performed a prospective randomized study to compare the potential genotoxic effects of metronidazole and nalidixic acid which they are used in the treatment of Trichomonas vaginalis infection. 20 patients with Trichomonas vaginalis infections participated in this study. 14 patients with vaginal trichomoniasis were treated with therapeutic doses of metronidazole 250 mg 3 times/d and six patients were treated with nalidixic acid 400 mg twice a day for 10 d. The genotoxic potential of a variety of mutagenic and carcinogenic agents can be evaluated by sister-chromatid exchange (SCE) test as a rapid cytogenetic test. An increased number of exchanges in lymphocytes reflects the influence of mutagens. No significant difference was observed in the SCE frequency of metronidazole treated patient however, a statistically significant increase (P<0.05) after nalidixic acid treatment could be described. We conclude that in spite of wide use of nalidixic acid for Trichomonas vaginalis infection, because of its potential genotoxic effect its usage must be individualized especially for pregnant women and small babies.
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Affiliation(s)
- D Akyol
- Dr Zekai Tahir Burak Women's Hospital, Ankara, Turkey.
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Abstract
Vitamin E, a potent antioxidant, may play a role in preventing preeclampsia. Maternal blood samples were collected between 28 and 40 weeks' gestation from women with mild preeclampsia (n=17), women with severe preeclampsia (n=16) and the control group (n=15). This control group was consisted of 15 pregnant women without hypertension episode during their pregnancy. Vitamin E levels were significantly higher in normotensive pregnant women (1.00+/-0.20 mg/dL) than in those with mild (0.56+/-0.15 mg/dL) or severe (0.37+/-0.75 mg/dL) preeclampsia (P<0.001). In preeclamptic women, when systolic blood pressure increases, maternal levels of vitamin E significantly decrease (P<0.05), also when diastolic blood pressure increases, maternal levels of vitamin E significantly decrease (P<0.05). Measurement of vitamin E concentration in plasma may be useful as a prognostic marker of the likely development of preeclampsia.
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Affiliation(s)
- D Akyol
- Dr Zekai Tahir Burak Women's Hospital, Ankara, Turkey.
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Abstract
We performed a prospective randomized study to compare maternal and fetal outcomes in pregnancies with prelabour rupture of the membranes (PROM) at term with early induction of labour or expectant management, 126 women with singleton pregnancy, cephalic presentation and gestational duration > or = 37 weeks, were randomized either to immediate induction of labour with oxytocin (Group 1) (n=52), or conservative management (Group 2) (n=74). Women who constituted Group 2 were divided into 2 groups. The first group (Group 2A) (n=25) included women in whom spontaneous labour did not begin after a waiting period of 24 hours, in which case labour was induced with oxytocin i.e. expectant management. The second group consisted of women (Group 2B) (n=49) in whom labour began spontaneously within 24 hours. The base Caesarean section rate was significantly higher in Group 2 (28.4%) (p<0.05). The rates of Caesarean section in the Groups 1-2A-2B were 19.2%, 60%, and 12.2%, respectively for nulliparous and parous women together. The rate of fetal distress was significantly higher in Group 2 (p<0.05). For determining maternal outcomes, the other parameters such as clinical chorioamnionitis, fever before or during labour, receiving antibiotics before or during labour, postpartum fever, analgesia, anaesthesia did not differ in Groups 1 and 2. Women in Group 1 went into active labour sooner, had fewer digital vaginal examinations, had a shorter interval between membrane rupture and delivery, and spent less time in the hospital before delivery than those in Group 2 (p<0.05). Babies in Group 2 were more likely to receive antibiotics, and more likely to stay in an intensive care nursery for more than 24 hours, and more likely to receive ventilation after initial resuscitation than those babies in Group 1. For developing apnoea and hypotonia, there was no significant difference between Groups 1 and 2. However, for babies in Group 2A there was a significant difference. We conclude that immediate induction of labour with oxytocin does not increase the risk of Caesarean section, compared with a practice of expectant management. Women at term with prelabour rupture of the membranes should therefore be reassured that immediate induction with oxytocin currently appears to be the best policy with respect to maternal and neonatal morbidity.
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Affiliation(s)
- D Akyol
- Dr Zekai Tahir Burak Women's Hospital, Faculty of Economic and Administrated Science, Gazi University, Ankara, Turkey
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Akyol D, Mungan T, Baltaci V, Kozinoglu H, Oguz S, Oztekin O, Gökmen O. Clinical assessment of EMA/CO induced DNA damage in peripheral blood lymphocytes of high-risk gestational trophoblastic tumor patients. EUR J GYNAECOL ONCOL 1999; 20:150-5. [PMID: 10376437] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/12/2023]
Abstract
From 1989 to 1994, Etoposide, Methotrexate, Actinomycin-D, Cyclophosphamide, Vincristine, Folic acid (EMA/CO) regimen was administered to seven patients with high-risk gestational tumours according to the Bagshawe 1976 criteria. Peripheral blood lymphocytes were obtained from two of these seven high-risk gestational trophoblastic patients receiving the EMA/CO regimen, and damage levels of DNA during chemotherapy were assessed using SCGE (single cell gel electrophoresis) assay. Additionally, the efficacy, toxicity and clinical results of EMA/CO regimen were evaluated in patients with high-risk gestational trophoblastic tumours. Fever (71.4%), leukopenia (57%), increase in transaminase concentrations (57%), trombocytopenia (57%), and anemia (57%) were among the most frequent side-effects of the EMA/CO regimen. All these toxic effects were reversible and there was no need to stop the therapy. EMA/CO is highly effective in patients with high-risk gestational trophoblastic disease and its toxicity is predictable and reversible. Because of chemotherapy, DNA damage that is shown in peripheral blood lymphocytes, increases at the 8th day of the EMA/CO regimen. When DNA damage is higher in patients, the course of chemotherapy per each patient is shortened. When DNA damage is higher in the patients, the multisystem effects due to toxicity are more significant. The SCGE assay has many possibilities in such research and has proved to be a relatively simple, quick and sensitive technique.
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Affiliation(s)
- D Akyol
- Dr. Zekai Tahir Burak Women's Hospital, Ankara, Turkey
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Abstract
Within the pathology of human reproduction, genetic abnormalities play an important role in spontaneous abortions. This paper describes the morphologic, karyotypic features of a consecutive series of singleton spontaneous abortions collected as part of this study and also reports the application of the alkaline comet assay to assess levels of DNA damage in 31 couples comprised of 13 control couples and a patient group of 18 couples with a history of more than one fetal loss. For the cytogenetic analyses, the conventional lymphocyte culture method was applied to all subjects. In this analysis, two women with habitual abortion were determined to carry balanced chromosomal translocation. The alkaline comet assay (single cell gel electrophoresis technique) was applied also to lymphocytes. The comparison of the results of alkaline comet assay in patient and control individuals showed a significant difference in the number of damaged cells. The cells were evaluated according to their grades of damage as: normal (undamaged-no migration), limited migration, (at low damage level) and extensive migration (comet imaged cells-with increasing numbers of breaks, DNA pieces migrate freely into the tail forming a comet image). The frequency of limited migrated and extensive migrated cells in the women in the patient group were higher than in the women in the control group (p<0.001). However, all above parameters were equal for husbands in both the control and patient group (p>0.05).
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Affiliation(s)
- V Baltaci
- Başkent University School of Medicine, Department of Genetics, Kubilay sokak, No. 36, 06570 Maltepe, Ankara, Turkey
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Oguz S, Sener B, Ozcan S, Akyol D, Gökmen O. Nonfreeing of the lower leaf of the rectus sheath at caesarean section: a randomized controlled trial. Aust N Z J Obstet Gynaecol 1998; 38:317-8. [PMID: 9761162 DOI: 10.1111/j.1479-828x.1998.tb03075.x] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Affiliation(s)
- S Oguz
- Dr Zekai Tahir Burak Women's Hospital, Ankara, Turkey
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Abstract
Bacterial vaginosis (BV) is the most common cause of vaginal discharge in women of child-bearing age. A common symptom of this condition is a fishy-smelling vaginal discharge. Trimethylamine (TMA) is the substance which is primarily responsible for this distinctive odour. The ability to metabolize TMA is polymorphically distributed such that the majority of individuals metabolize a large part of the body burden of TMA to the odourless trimethylamine N-oxide (TMAO) which is excreted in urine with a small amount of TMA. However, in certain individuals, N-oxidation of TMA is impaired which results in the excretion of large amounts of TMA in the urine, breath, sweat and vaginal secretions. In the present study the metabolism of TMA to TMAO was determined in women with clinically diagnosed BV, women with fishy-smelling vaginal discharge but with no other evidence of BV and control women with no evidence of fishy-smelling vaginal discharge. An index of TMA N-oxidation was established for all subjects after analysis of a 24 h urine sample for free TMA and total TMA after reduction of TMAO. We show that, irrespective of diagnosis of BV or not, women with fishy-smelling vaginal discharge excrete significantly more free TMA and have a similarly significantly reduced capacity to N-oxidize TMA when compared to healthy control women. Thus, the results of this study suggest that a woman's ability to metabolize TMA to TMAO is an important factor which predisposes to a fishy-smelling vaginal discharge.
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Affiliation(s)
- S Sardas
- Department of Toxicology, Faculty of Pharmacy, Gazi University, Ankara, Turkey
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Affiliation(s)
- B Yildirim
- Department of Gastroenterology, Türkiye Yüksek Ihtisas Hospital, Ankara, Turkey
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Sardaş S, Walker D, Akyol D, Karakaya AE. Assessment of smoking-induced DNA damage in lymphocytes of smoking mothers of newborn infants using the alkaline single-cell gel electrophoresis technique. Mutat Res 1995; 335:213-7. [PMID: 8524335 DOI: 10.1016/0165-1161(95)00023-2] [Citation(s) in RCA: 22] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
The single-cell gel electrophoretic (SCGE) technique for detecting the presence of DNA strand breaks and alkali-labile damage in individual cells was used to examine the effect on newborn infants of maternal exposure to cigarette smoke. The levels of DNA damage in the lymphocytes of 21 newborns of mothers with different smoking habits were compared to those in 10 newborn infants whose mothers had never smoked and 8 newborns whose mothers were passively exposed for at least 40 h per week in the workplace and home. DNA damage was undetected in lymphocytes of newborns of passively exposed mothers or newborns with mothers of low smoking habit by conditions allowing 40 min DNA unwinding and 40 min electrophoresis. Presumably longer times were needed for lower levels of damage to be detected by SCGE. The mean length of DNA migration in lymphocytes between the newborns of smoking mothers did not show any significance but the percentage of damaged cells increased with the frequency of smoking when assessed by non-parametric Mann-Whitney U test. The results of SCGE were compared with our results published in the same individuals of sister-chromatid exchange (SCE) frequency. The results show similar trends with mean measures of DNA damage increasing with frequency and long history of maternal smoking. These observations encourage the application of SCGE as a sensitive and useful technique for quantitating DNA damage in individual cells.
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Affiliation(s)
- S Sardaş
- Gazi University, Faculty of Pharmacy, Department of Toxicology, Ankara, Turkey
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Sardaş S, Karahalil B, Akyol D, Kükner S, Karakaya AE. The effect of smoking on sister chromatid exchange rate of newborn infants born to smoking mothers. Mutat Res 1995; 341:249-53. [PMID: 7531284 DOI: 10.1016/0165-1218(95)90096-9] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Abstract
Sister chromatid exchange (SCE) frequencies in lymphocytes of 21 smoking mothers and their 21 newborns were compared to those that of 10-infants whose mothers had never smoked and to those of 8 infants whose mothers were passive smokers and reported high exposure to tobacco smoke by living or working with smokers. Mothers in the first group also smoked throughout their pregnancy. Results confirm our earlier study on smoking effects reported for adults. Additionally, we saw that neonates have consistently lower SCE frequencies than adults.
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Affiliation(s)
- S Sardaş
- Faculty of Pharmacy, Toxicology Department, Gazi University Ankara, Turkey
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