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Eser F, Hasanoğlu İ, Kayaaslan B, Kaya Kalem A, Bilen Ş, Orhan G, Güner R. Iatrogenic botulism cases after gastric and axillary application of botulinum toxin and review of literature. J Infect Dev Ctries 2024; 18:480-487. [PMID: 38635607 DOI: 10.3855/jidc.18868] [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: 07/10/2023] [Accepted: 09/02/2023] [Indexed: 04/20/2024] Open
Abstract
INTRODUCTION Iatrogenic botulism is a rare, serious disease that progresses with descending paralysis and develops after cosmetic or therapeutic botulinum toxin-A (BoNT-A) application. CASE PRESENTATIONS In this case series; six cases of iatrogenic botulism followed up in our center are presented. Four of these developed after gastric BoNT-A and two after axillary BoNT-A application. RESULTS The most important cause for the disease was the use of unlicensed products and high-dose toxin applications. The first symptoms were blurred vision, double vision, difficulty in swallowing, and hoarseness. Symptoms appeared within 4-10 days after the application of BoNT-A. Symptoms progressed in the course of descending paralysis in the following days with fatigue, weakness in extremities and respiratory distress. Diagnosis was based on patient history and clinical findings. The main principles of foodborne botulism therapy were applied in the treatment of iatrogenic botulism. If clinical worsening continued, regardless of the time elapsed after BoNT-A application, the use of botulinum antitoxin made a significant contribution to clinical improvement and was recommended. CONCLUSIONS Routine and new indications for BoNT-A usage are increasing and, as a result, cases of iatrogenic botulism will be encountered more frequently. Physicians should be alert for iatrogenic botulism in the follow-up after BoNT-A applications and in the differential diagnosis of neurological diseases that are presented with similar findings.
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Affiliation(s)
- Fatma Eser
- Ankara Yildirim Beyazit University, Ankara City Hospital, Department of Infectious Disease and Clinical Microbiology, Ankara, Turkey
| | - İmran Hasanoğlu
- Ankara Yildirim Beyazit University, Ankara City Hospital, Department of Infectious Disease and Clinical Microbiology, Ankara, Turkey
| | - Bircan Kayaaslan
- Ankara Yildirim Beyazit University, Ankara City Hospital, Department of Infectious Disease and Clinical Microbiology, Ankara, Turkey
| | - Ayşe Kaya Kalem
- Ankara Yildirim Beyazit University, Ankara City Hospital, Department of Infectious Disease and Clinical Microbiology, Ankara, Turkey
| | - Şule Bilen
- University of Health Sciences, Ankara City Hospital, Department of Neurology, Ankara, Turkey
| | - Gürdal Orhan
- University of Health Sciences, Ankara City Hospital, Department of Neurology, Ankara, Turkey
| | - Rahmet Güner
- Ankara Yildirim Beyazit University, Ankara City Hospital, Department of Infectious Disease and Clinical Microbiology, Ankara, Turkey
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Asiltürk D, Güner R, Kalem AK, Tufan IÖ, Hasanoğlu İ, Eser F, Malhan S, Kayaaslan B. ANTIBIOTIC MANAGEMENT PROGRAM IN A TERTIARY INTENSIVE CARE UNIT: INVESTIGATION OF THE EFFECTS OF A CARBAPENEM-RESTRICTED PERIOD ON CLINICAL AND LABORATORY PARAMETERS AND COSTS OF INFECTIONS. J Hosp Infect 2024:S0195-6701(24)00100-2. [PMID: 38521418 DOI: 10.1016/j.jhin.2024.03.006] [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: 12/20/2023] [Revised: 03/11/2024] [Accepted: 03/12/2024] [Indexed: 03/25/2024]
Abstract
OBJECTIVES The aim of this study was to investigate the effects of the carbapenem-restricted antimicrobial stewardship program (ASP) on changes in the resistance profiles of infectious agents, the amount of antibiotics used, length of stay in the intensive care unit (ICU), mortality and costs. MATERIALS AND METHODS The patients hospitalized in ICU between July 1, 2020 - May 1, 2021 were included the study. The study was divided in to two different periods, carbapenem not-restricted period (CNRP) and carbapenem restricted period (CRP). During CNRP, carbapenem were used by any restriction, and in CRP, the alternative antibiotics to carbapenems were preferred during infection. The Defined Daily Dose (DDD)-100 Patient Day (PD) methodology was used to calculate the antibiotic consumption. RESULTS Of the 572 patients included in the study, 62.2% of the patients were male, mean age was 70.5 years. In the blood culture the most frequently gram negative agent was A.baumannii (25%). A. baumannii bloodstream infections with MDR, XDR was significantly different between the two periods (CNRP: 95.6% (22), CRP: 66.6%(8) p=0.04). A gradual decrease in the incidence density and rate of nosocomial infection was noted (p=0.06). During the study, a significant decrease in meropenem consumption was detected between the two periods (CNRP-CRP: 21.19-6.37 DDD/100 PD p=0.007). ASP provided a 8600 USD of antibiotic cost savings and a total of 14% patient cost savings (p<0.05) per patient. CONCLUSION We believe that combining an effective ASP with a comprehensive infection control program will mitigate the emergence of antimicrobial-resistant bacteria.
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Affiliation(s)
- Dilek Asiltürk
- Infection Disease and Clinical Microbiology, Bilkent City Hospital, ANKARA, TÜRKİYE.
| | - Rahmet Güner
- Infection Disease and Clinical Microbiology, Bilkent City Hospital, ANKARA, TÜRKİYE
| | - Ayşe Kaya Kalem
- Infection Disease and Clinical Microbiology, Bilkent City Hospital, ANKARA, TÜRKİYE
| | | | - İmran Hasanoğlu
- Infection Disease and Clinical Microbiology, Bilkent City Hospital, ANKARA, TÜRKİYE
| | - Fatma Eser
- Infection Disease and Clinical Microbiology, Bilkent City Hospital, ANKARA, TÜRKİYE
| | - Simten Malhan
- Department of Health Care Management,Başkent University, ANKARA, TÜRKİYE
| | - Bircan Kayaaslan
- Infection Disease and Clinical Microbiology, Bilkent City Hospital, ANKARA, TÜRKİYE
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Somayaji R, Luke DR, Lau A, Guner R, Tabak ŎF, Hepokoski M, Gardetto N, Conrad SA, Kumar SD, Ghosh K, Robbins SM, Senger DL, Sun D, Lim RKS, Liu J, Eser F, Karaali R, Tremblay A, Muruve D. Multicentre, randomised, double-blind, placebo-controlled, proof of concept study of LSALT peptide as prevention of acute respiratory distress syndrome and acute kidney injury in patients infected with SARS-CoV-2 (COVID-19). BMJ Open 2024; 14:e076142. [PMID: 38490660 PMCID: PMC10946381 DOI: 10.1136/bmjopen-2023-076142] [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] [Grants] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/30/2023] [Accepted: 02/26/2024] [Indexed: 03/17/2024] Open
Abstract
OBJECTIVE Dipeptidase-1 (DPEP-1) is a recently discovered leucocyte adhesion receptor for neutrophils and monocytes in the lungs and kidneys and serves as a potential therapeutic target to attenuate inflammation in moderate-to-severe COVID-19. We aimed to evaluate the safety and efficacy of the DPEP-1 inhibitor, LSALT peptide, to prevent specific organ dysfunction in patients hospitalised with COVID-19. DESIGN Phase 2a randomised, placebo-controlled, double-blinded, trial. SETTING Hospitals in Canada, Turkey and the USA. PARTICIPANTS A total of 61 subjects with moderate-to-severe COVID-19. INTERVENTIONS Randomisation to LSALT peptide 5 mg intravenously daily or placebo for up to 14 days. PRIMARY AND SECONDARY OUTCOME MEASURES The primary endpoint was the proportion of subjects alive and free of respiratory failure and/or the need for renal replacement therapy (RRT). Numerous secondary and exploratory endpoints were assessed including ventilation-free days, and changes in kidney function or serum biomarkers. RESULTS At 28 days, 27 (90.3%) and 28 (93.3%) of subjects in the placebo and LSALT groups were free of respiratory failure and the need for RRT (p=0.86). On days 14 and 28, the number of patients still requiring more intensive respiratory support (O2 ≥6 L/minute, non-invasive or invasive mechanical ventilation or extracorporeal membrane oxygenation) was 6 (19.4%) and 3 (9.7%) in the placebo group versus 2 (6.7%) and 2 (6.7%) in the LSALT group, respectively (p=0.14; p=0.67). Unadjusted analysis of ventilation-free days demonstrated 22.8 days for the LSALT group compared with 20.9 in the placebo group (p=0.4). LSALT-treated subjects had a significant reduction in the fold expression from baseline to end of treatment of serum CXCL10 compared with placebo (p=0.02). Treatment-emergent adverse events were similar between groups. CONCLUSION In a Phase 2 study, LSALT peptide was demonstrated to be safe and tolerated in patients hospitalised with moderate-to-severe COVID-19. TRIAL REGISTRATION NUMBER NCT04402957.
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Affiliation(s)
- Ranjani Somayaji
- Department of Medicine, University of Calgary, Calgary, Alberta, Canada
- Department of Microbiology, Immunology and Infectious Disease, University of Calgary, Calgary, Alberta, Canada
- Department of Community Health Sciences, University of Calgary, Calgary, Alberta, Canada
- Snyder Insititute for Chronic Diseases, University of Calgary, Calgary, Alberta, Canada
| | | | - Arthur Lau
- Department of Medicine, University of Calgary, Calgary, Alberta, Canada
- Arch Biopartners Inc, Toronto, Ontario, Canada
| | - Rahmet Guner
- Istanbul University-Cerrahpasa School of Medicine, Ankara, Turkey
| | - Ŏ Fehmi Tabak
- Istanbul University-Cerrahpasa School of Medicine, Ankara, Turkey
| | - Mark Hepokoski
- University of California San Diego Medical Center, San Diego, California, USA
- Veterans Administration San Diego Healthcare System, San Diego, California, USA
| | - Nancy Gardetto
- University of California San Diego Medical Center, San Diego, California, USA
- Veterans Administration San Diego Healthcare System, San Diego, California, USA
| | - Steven A Conrad
- Departments of Medicine, Pediatrics, and Emergency Medicine, Louisiana State University Health Sciences Center, Shreveport, Louisiana, USA
| | - Sunil D Kumar
- Broward Health Medical Center, Ft. Lauderdale, Florida, USA
| | | | - Stephen M Robbins
- Department of Oncology, University of Calgary, Calgary, Alberta, Canada
- Lady Davis Institute for Medical Research - Jewish General Hospital, Montreal, Quebec, Canada
- Gerald Bronfman Department of Oncology, McGIll University, Montreal, Quebec, Canada
| | - Donna L Senger
- Department of Oncology, University of Calgary, Calgary, Alberta, Canada
- Lady Davis Institute for Medical Research - Jewish General Hospital, Montreal, Quebec, Canada
- Gerald Bronfman Department of Oncology, McGIll University, Montreal, Quebec, Canada
| | - Daisy Sun
- Arch Biopartners Inc, Toronto, Ontario, Canada
| | - Rachel K S Lim
- Department of Medicine, University of Calgary, Calgary, Alberta, Canada
| | - Jonathan Liu
- Department of Medicine, University of Calgary, Calgary, Alberta, Canada
| | - Fatma Eser
- Departments of Medicine, Infectious Diseases and Clinical Microbiology - Ankara City Hospital, Ankara Yildirim Beyazit University, Ankara, Turkey
| | - Ridvan Karaali
- Istanbul University-Cerrahpasa School of Medicine, Ankara, Turkey
| | - Alain Tremblay
- Department of Medicine, University of Calgary, Calgary, Alberta, Canada
- Snyder Insititute for Chronic Diseases, University of Calgary, Calgary, Alberta, Canada
| | - Daniel Muruve
- Department of Medicine, University of Calgary, Calgary, Alberta, Canada
- Department of Microbiology, Immunology and Infectious Disease, University of Calgary, Calgary, Alberta, Canada
- Snyder Insititute for Chronic Diseases, University of Calgary, Calgary, Alberta, Canada
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Başkol Elik D, Kaya Ş, Alkan S, Demirdal T, Sener A, Kaya S, Güzel Tunçcan Ö, Kayaaslan B, Güner R, Eser F, Kahraman H, Birengel S, Sarıcaoğlu EM, Eroğlu E, Çölkesen F, Öztürk E, Berk Cam H, Mermutluoğlu Ç, Özer Balin Ş, Sincan G, Altın N, Sili U, Suntur BM, Arslan Gülen T, Deveci B, Saba R, İncecik Ş, Eser Karlıdağ G, Hakko E, Akdağ D, Erdem HA, Sipahi H, Çicek C, Taşbakan MS, Taşbakan M, Pullukçu H, Yamazhan T, Arda B, Ulusoy S, Sipahi OR. The clinical features, treatment and prognosis of neutropenic fever and Coronavirus disease 2019 results of the multicentre teos study. Sci Rep 2024; 14:5218. [PMID: 38433274 PMCID: PMC10909849 DOI: 10.1038/s41598-024-55886-w] [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] [Accepted: 02/28/2024] [Indexed: 03/05/2024] Open
Abstract
This multicentre (22 centres in Turkey) retrospective cohort study aimed to assess the clinical outcomes of patients with neutropenic fever and SARS-CoV-2 positivity. Study period was 15 March 2020-15 August 2021. A total of 170 cases (58 female, aged 59 ± 15.5 years) that fulfilled the inclusion criteria were included in the study. One-month mortality rate (OMM) was 44.8%. The logistic regression analysis showed the following significant variables for the mentioned dependent variables: (i) achieving PCR negativity: receiving a maximum of 5 days of favipiravir (p = 0.005, OR 5.166, 95% CI 1.639-16.280); (ii) need for ICU: receiving glycopeptide therapy at any time during the COVID-19/FEN episode (p = 0.001, OR 6.566, 95% CI 2.137-20.172), the need for mechanical ventilation (p < 0.001, OR 62.042, 95% CI 9.528-404.011); (iii) need for mechanical ventilation: failure to recover from neutropenia (p < 0.001, OR 17.869, 95% CI 3.592-88.907), receiving tocilizumab therapy (p = 0.028, OR 32.227, 95% CI 1.469-707.053), septic shock (p = 0.001, OR 15.4 96% CI 3.164-75.897), and the need for ICU (p < 0.001, OR 91.818, 95% CI 15.360-548.873), (iv) OMM: [mechanical ventilation (p = 0.001, OR 19.041, 95% CI 3.229-112.286) and septic shock (p = 0.010, OR 5.589,95% CI 1.509-20.700)]. Although it includes a relatively limited number of patients, our findings suggest that COVID-19 and FEN are associated with significant mortality and morbidity.
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Affiliation(s)
- Dilşah Başkol Elik
- Department of Infectious Disease and Clinical Microbiology, Faculty of Medicine, Ege University, Bornova, Izmir, Turkey.
- Infectious Disease and Clinical Microbiology, Turgutlu State Hospital, Manisa, Turkey.
| | - Şafak Kaya
- Department of Infectious Diseases, Gazi Yaşargil Training and Research Hospital, University of Health Sciences, Diyarbakir, Turkey
| | - Sevil Alkan
- Department of Infectious Disease, Faculty of Medicine, Canakkale Onsekiz Mart University, Canakkale, Turkey
| | - Tuna Demirdal
- Department of Infectious Disease and Clinical Microbiology, Faculty of Medicine, Izmir Katip Celebi University, Izmir, Turkey
| | - Alper Sener
- Department of Infectious Disease, Faculty of Medicine, Canakkale Onsekiz Mart University, Canakkale, Turkey
- Department of Infectious Disease and Clinical Microbiology, Faculty of Medicine, Izmir Katip Celebi University, Izmir, Turkey
| | - Selçuk Kaya
- Department of Infectious Disease and Clinical Microbiology, Faculty of Medicine, Karadeniz Technical University, Trabzon, Turkey
| | - Özlem Güzel Tunçcan
- Department of Infectious Disease and Clinical Microbiology, Faculty of Medicine, Gazi University, Ankara, Turkey
| | - Bircan Kayaaslan
- Department of Infectious Disease and Clinical Microbiology, Ankara City Hospital, Ankara Yıldırım Beyazit University, Ankara, Turkey
| | - Rahmet Güner
- Department of Infectious Disease and Clinical Microbiology, Ankara City Hospital, Ankara Yıldırım Beyazit University, Ankara, Turkey
| | - Fatma Eser
- Department of Infectious Disease and Clinical Microbiology, Ankara City Hospital, Ankara Yıldırım Beyazit University, Ankara, Turkey
| | - Hasip Kahraman
- Department of Infectious Disease and Clinical Microbiology, Faculty of Medicine, Eskisehir Osmangazi University, Eskisehir, Turkey
| | - Serhat Birengel
- Department of Infectious Disease and Clinical Microbiology, Faculty of Medicine, Ankara University, Ankara, Turkey
| | - Elif Mukime Sarıcaoğlu
- Department of Infectious Disease and Clinical Microbiology, Faculty of Medicine, Ankara University, Ankara, Turkey
| | - Esma Eroğlu
- Department of Infectious Disease and Clinical Microbiology, Konya Meram State Hospital, Konya, Turkey
| | - Fatma Çölkesen
- Department of Infectious Disease and Clinical Microbiology, Konya Meram State Hospital, Konya, Turkey
| | - Erman Öztürk
- Department of Hematology, Faculty of Medicine, Istanbul Medeniyet University, Istanbul, Turkey
| | - Hande Berk Cam
- Department of Infectious Disease and Clinical Microbiology, Antalya Training and Research Hospital, University of Health Sciences, Antalya, Turkey
| | - Çiğdem Mermutluoğlu
- Department of Infectious Disease and Clinical Microbiology, Faculty of Medicine, Dicle University, Diyarbakir, Turkey
| | - Şafak Özer Balin
- Department of Infectious Disease and Clinical Microbiology, Faculty of Medicine, Firat University, Elazig, Turkey
| | - Gülden Sincan
- Department of Hematology, Faculty of Medicine, Atatürk University, Erzurum, Turkey
| | - Nilgün Altın
- Department of Infectious Disease and Clinical Microbiology, Dışkapı Yıldırım Beyazıt Training and Research Hospital, University of Health Sciences, Ankara, Turkey
| | - Uluhan Sili
- Department of Infectious Disease and Clinical Microbiology, Faculty of Medicine, Marmara University, Istanbul, Turkey
| | - Bedia Mutay Suntur
- Infectious Diseases, Adana City Training and Research Hospital, Adana, Turkey
| | - Tuğba Arslan Gülen
- Infectious Diseases, Adana City Training and Research Hospital, Adana, Turkey
| | - Burak Deveci
- Department of Hematology and Stem Cell Transplant Unit, Medstar Antalya Hospital, Antalya, Turkey
| | - Rabin Saba
- Department of Hematology and Stem Cell Transplant Unit, Medstar Antalya Hospital, Antalya, Turkey
| | - Şaban İncecik
- Department of Infectious Disease and Clinical Microbiology, Faculty of Medicine, Van Yüzüncü Yıl University, Van, Turkey
| | - Gülden Eser Karlıdağ
- Department of Infectious Disease and Clinical Microbiology, Elazığ Fethi Sekin City Hospital, University of Health Sciences, Elazig, Turkey
| | - Elif Hakko
- Department of Infectious Disease and Clinical Microbiology, Anadolu Medical Center, Istanbul, Turkey
| | - Damla Akdağ
- Department of Infectious Diseases and Clinical Microbiology, Basaksehir Cam Sakura City Hospital, Istanbul, Turkey
| | - Hüseyin Aytaç Erdem
- Department of Infectious Disease and Clinical Microbiology, Faculty of Medicine, Ege University, Bornova, Izmir, Turkey
| | - Hilal Sipahi
- Bornova Directorate of Health, Bornova, Izmir, Turkey
| | - Candan Çicek
- Department of Medical Microbiology, Faculty of Medicine, Ege University, Bornova, Izmir, Turkey
| | - Mehmet Sezai Taşbakan
- Department of Chest Diseases, Faculty of Medicine, Ege University, Bornova, Izmir, Turkey
| | - Meltem Taşbakan
- Department of Infectious Disease and Clinical Microbiology, Faculty of Medicine, Ege University, Bornova, Izmir, Turkey
| | - Hüsnü Pullukçu
- Department of Infectious Disease and Clinical Microbiology, Faculty of Medicine, Ege University, Bornova, Izmir, Turkey
| | - Tansu Yamazhan
- Department of Infectious Disease and Clinical Microbiology, Faculty of Medicine, Ege University, Bornova, Izmir, Turkey
| | - Bilgin Arda
- Department of Infectious Disease and Clinical Microbiology, Faculty of Medicine, Ege University, Bornova, Izmir, Turkey
| | - Sercan Ulusoy
- Department of Infectious Disease and Clinical Microbiology, Faculty of Medicine, Ege University, Bornova, Izmir, Turkey
| | - Oguz Resat Sipahi
- Department of Infectious Disease and Clinical Microbiology, Faculty of Medicine, Ege University, Bornova, Izmir, Turkey
- Department of Infectious Diseases, Bahrain Oncology Center, King Hamad University Hospital, Muharraq, Bahrain
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Ayhan M, Coşkun B, Kayaaslan B, Hasanoğlu İ, Kalem AK, Eser F, Bilir YA, Ünlü S, Güner R. Point prevalence of antibiotic usage in major referral hospital in Turkey. PLoS One 2024; 19:e0296900. [PMID: 38295065 PMCID: PMC10830045 DOI: 10.1371/journal.pone.0296900] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2022] [Accepted: 12/21/2023] [Indexed: 02/02/2024] Open
Abstract
INTRODUCTION The most important and undesirable consequence of inappropriate antibiotic use is the spread of antibiotic resistance, increased adverse effects, increased mortality and healthcare costs. We aimed to assess antibiotic usage characteristics in inpatient setting in our center. MATERIALS AND METHODS A one-day, single center point-prevalence study was carried out on June 9th 2021, in Ankara City Hospital in Turkey. Data of antibiotic consumption, appropriateness of usage and predictors of inappropriate use in adult patients were evaluated. RESULTS Out of 2640 adult patients, 893 (33.8%) were receiving at least one antibiotic. A total of 1212 antibiotic prescriptions with an average of 1.44±0.64 were found. Antibiotics were most commonly used for therapeutic purpose (84.7%), followed by surgical prophylaxis (11.6%). Majority of therapeutically used antibiotics were empirical (67.9%). Infectious diseases consultation was present in 68.3% with a compliance rate of 95.7%. Rate of inappropriate use was 20%. The most frequent cause of inappropriateness was unnecessary use (52.5%). Most commonly and most inappropriately used antibiotics were carbapenems (17.5%) and first generation cephalosporins (38.7%), respectively. Most of the inappropriateness observed in first-generation cephalosporins was due to inappropriate longer surgical prophylaxis. While age is an independent risk factor for inappropriate antibiotic use (p = 0.042), COVID-19 unit admission, use for therapeutic purpose and infectious diseases consultation were protective factors (p<0.001, p<0.001, p<0.001). CONCLUSION Rate of inappropriate use was low, but inappropriate surgical prophylaxis remains an important problem in surgical units. There is a considerable need to implement an antimicrobial stewardship program that focuses on surgical prophylaxis practices.
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Affiliation(s)
- Müge Ayhan
- Department of Infectious Diseases and Clinical Microbiology, Ankara City Hospital, Ankara, Turkey
| | - Belgin Coşkun
- Department of Infectious Diseases and Clinical Microbiology, Ankara City Hospital, Ankara, Turkey
| | - Bircan Kayaaslan
- Department of Infectious Diseases and Clinical Microbiology, Ankara Yıldırım Beyazıt University, Ankara City Hospital, Ankara, Turkey
| | - İmran Hasanoğlu
- Department of Infectious Diseases and Clinical Microbiology, Ankara Yıldırım Beyazıt University, Ankara City Hospital, Ankara, Turkey
| | - Ayşe Kaya Kalem
- Department of Infectious Diseases and Clinical Microbiology, Ankara Yıldırım Beyazıt University, Ankara City Hospital, Ankara, Turkey
| | - Fatma Eser
- Department of Infectious Diseases and Clinical Microbiology, Ankara Yıldırım Beyazıt University, Ankara City Hospital, Ankara, Turkey
| | - Yeşim Aybar Bilir
- Department of Infectious Diseases and Clinical Microbiology, Ankara City Hospital, Ankara, Turkey
| | - Serpil Ünlü
- Department of Infectious Diseases and Clinical Microbiology, Ankara City Hospital, Ankara, Turkey
| | - Rahmet Güner
- Department of Infectious Diseases and Clinical Microbiology, Ankara Yıldırım Beyazıt University, Ankara City Hospital, Ankara, Turkey
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Ceylan AC, Çavdarlı B, Ceylan GG, Topçu V, Satılmış SBA, Bektaş ŞG, Kalem AK, Kayaaslan B, Eser F, Kalkan EA, İnan O, Hasanoğlu İ, Yüksel S, Ateş İ, İzdeş S, Güner R, Gündüz CNS. Impact of Inflammation-Related Genes on COVID-19: Prospective Study at Turkish Cohort. TOHOKU J EXP MED 2023; 261:179-185. [PMID: 37635061 DOI: 10.1620/tjem.2023.j071] [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] [Indexed: 08/29/2023]
Abstract
The pandemic coronavirus disease 2019 (COVID-19) has caused a high mortality rate and poses a significant threat to the population. The disease may progress with mild symptoms or may cause the need for intensive care, depending on many factors. In this study, it was aimed to determine if there is a tendency due to genetic factors in COVID-19 patients. Ninety-four of 188 patients with mild clinical and 94 with severe clinical symptoms were included in the study. The targeted panel including coagulopathy (F2, F5), viral invasion (ACE2), and inflammation (CXCL8, IFNAR2, IFNL4, IL10, IL2, IL6, IRF7, TLR3, TLR7, TNF) related genes was performed sequenced by the next generation sequencing (NGS). The variants found were classified and univariate analyses were performed to select candidate variables for logistic model. Risk factors and variants were compared. It was revealed that the presence of 2 or more risk factors caused the disease to progress severely (p < 0.001). Heterozygous IRF7:c.1357-23dup variant had a 2.5 times higher risk for mild disease compared to severe disease. Other variants were found to be more significant in mild disease. Since polymorphic variants were not evaluated in the literature, the findings of our study could not be compared with the literature. However, as variants that may be effective in the severity of infections may differ according to ethnicity. This study has the feature of being a guide for subsequent studies to be carried out especially in Turkish population. Clinical course of the COVID-19 is likely to depend on a variety of risk factors, including age, sex, clinical status, immunology and genetic factors.
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Affiliation(s)
- Ahmet Cevdet Ceylan
- Department of Medical Genetics, Faculty of Medicine, Ankara Yıldırım Beyazıt University
- Department of Medical Genetics, Ankara City Hospital
| | | | - Gülay Güleç Ceylan
- Department of Medical Genetics, Faculty of Medicine, Ankara Yıldırım Beyazıt University
- Department of Medical Genetics, Ankara City Hospital
| | - Vehap Topçu
- Department of Medical Genetics, Ankara City Hospital
| | | | | | - Ayşe K Kalem
- Department of Infectious Diseases and Clinical Microbiology, Faculty of Medicine, Ankara Yıldırım Beyazıt University
- Department of Infectious Diseases and Clinical Microbiology, Ankara City Hospital
| | - Bircan Kayaaslan
- Department of Infectious Diseases and Clinical Microbiology, Faculty of Medicine, Ankara Yıldırım Beyazıt University
- Department of Infectious Diseases and Clinical Microbiology, Ankara City Hospital
| | - Fatma Eser
- Department of Infectious Diseases and Clinical Microbiology, Faculty of Medicine, Ankara Yıldırım Beyazıt University
- Department of Infectious Diseases and Clinical Microbiology, Ankara City Hospital
| | | | - Osman İnan
- Department of Internal Medicine, Ankara City Hospital
| | - İmran Hasanoğlu
- Department of Infectious Diseases and Clinical Microbiology, Faculty of Medicine, Ankara Yıldırım Beyazıt University
- Department of Infectious Diseases and Clinical Microbiology, Ankara City Hospital
| | - Selcen Yüksel
- Department of Biostatistics, Ankara Yıldırım Beyazıt University
| | - İhsan Ateş
- Department of Internal Medicine, Ankara City Hospital, Health Science University
| | - Seval İzdeş
- Department of Anesthesiology and Reanimation-Critical Care, Ankara City Hospital
- Department of Anesthesiology and Reanimation-Critical Care, Faculty of Medicine, Ankara Yıldırım Beyazıt University
| | - Rahmet Güner
- Department of Infectious Diseases and Clinical Microbiology, Faculty of Medicine, Ankara Yıldırım Beyazıt University
- Department of Infectious Diseases and Clinical Microbiology, Ankara City Hospital
| | - C Nur Semerci Gündüz
- Department of Medical Genetics, Faculty of Medicine, Ankara Yıldırım Beyazıt University
- Department of Medical Genetics, Ankara City Hospital
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Ozdemir B, Akinci E, Koksal M, Rodoplu E, Altunsoy A, Guner R, Kayaaslan B, Kalem AK, Hasanoglu I, Eser F, Ayhan M, Saricaoglu EM, Bilir YA, Coskun B. The role of chest X-ray in coronavirus disease 2019 (COVID-19) infection: findings and correlation with clinical outcome. Eur Rev Med Pharmacol Sci 2023; 27:6563-6572. [PMID: 37522668 DOI: 10.26355/eurrev_202307_33127] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Subscribe] [Scholar Register] [Indexed: 08/01/2023]
Abstract
OBJECTIVE It is possible to diagnose coronavirus disease 2019 (COVID-19) faster and more accurately with chest X-ray (CXR) and chest computed tomography (CT) than with reverse transcriptase PCR (RT-PCR) tests. The aim of this study was to verify the possibility of reducing the use of CT in diagnosis and follow-up of COVID-19 infection by using CXR. PATIENTS AND METHODS A total of 326 COVID-19 patients who were hospitalized in Ankara City Hospital were included in this retrospective study. RESULTS A total of 326 patients were RT-PCR positive for COVID-19 infection; 178 were male (54.6%) and 148 were female (45.4%), with a median age of 45. Considering the results, the baseline CXR sensitivity in our experience was approximately 72%. The CXRs of 113 patients with abnormal CT were divided into 2 groups, the CXR normal and abnormal groups, and were then compared. In the 1st group with abnormal CXR, the mean age, the number of patients over 65 years old, and the comorbidity rate were higher. Additionally, it was determined that the number of patients requiring respiratory support and intensive care unit (ICU) admission in this 1st group was higher than in the 2nd group (with normal CXR). Most of the patients who died (91%, 10/11) were in Group 1. In the group with normal CXR, no patients in the critically ill category needed invasive or non-invasive mechanical ventilators. CONCLUSIONS CXR can help in detecting clinically moderate and severe cases of COVID-19. CXR can assist clinicians in patient management and treatment planning regarding the clinical course, respiratory support, ICU need, and mortality and can help them prepare for potential negative outcomes.
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Affiliation(s)
- B Ozdemir
- Department of Infectious Diseases and Clinical Microbiology, Ankara City Hospital, Ankara, Turkey.
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Eser F, Güner R, Gürbüz Y, Akdoğan M, Bilgiç Z, Korkmaz N, Arı D, Şanlıdağ G, Kesim Uçar Ş, Düzenli T, Yamazhan T. Impact of COVID-19 pandemic on diagnosis and treatment access of patients with viral hepatitis in Turkey. J Infect Dev Ctries 2023; 17:461-467. [PMID: 37159894 DOI: 10.3855/jidc.17585] [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: 10/25/2022] [Accepted: 02/10/2023] [Indexed: 05/11/2023] Open
Abstract
INTRODUCTION We aimed to evaluate access to diagnosis, treatment and follow-up in patients with viral hepatitis during the COVID-19 pandemic. METHODOLOGY Patients who started treatment for hepatitis B and hepatitis C were included in the study and analyzed in two periods: before-pandemic and during-pandemic. Indication for treatment and frequency of laboratory follow-up was obtained from hospital records. A telephone survey was administered to evaluate treatment access and compliance. RESULTS Four centers with 258 patients were included in the study. Of these 161 (62.4%) were male, median age was 50 years. The number of patients, admitted to outpatient clinics was 134647 in the before-pandemic period and 106548 in the during-pandemic period. Number of patients who started treatment for hepatitis B were significantly high during-pandemic period compared with before-pandemic (78 (0.07%); 73 (0.05%) respectively; p = 0.04). The number who received treatment for hepatitis C was similar in both periods: 43 (0.04%); 64 (0.05%), respectively (p = 0.25). Prophylactic treatment for hepatitis B, due to immunosuppressive agents was significantly higher in during-pandemic period (p = 0.001). In the laboratory follow-ups at 4th, 12th and 24th weeks of treatment, worse adherence was detected in during-pandemic (for all p < 0.05). Access to treatment and compliance of all patients was over 90% and did not differ in the two periods. CONCLUSIONS During-pandemic, hepatitis patients' access to diagnosis, treatment initiation and follow-up had worsened in Turkey. The health policy implemented during the pandemic had a positive impact on patients' access to and compliance to treatment.
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Affiliation(s)
- Fatma Eser
- Ankara Yıldırım Beyazıt University, Ankara City Hospital, Infectious Disease and Clinical Microbiology, Ankara, Turkey
| | - Rahmet Güner
- Ankara Yıldırım Beyazıt University, Ankara City Hospital, Infectious Disease and Clinical Microbiology, Ankara, Turkey
| | - Yunus Gürbüz
- University of Health Sciences, Ankara Dışkapı Yıldırım Beyazıt Training and Research Hospital, Infectious Disease and Clinical Microbiology, Ankara, Turkey
| | - Meral Akdoğan
- University of Health Sciences, Ankara City Hospital, Department of Gastroenterology, Ankara, Turkey
| | - Zeynep Bilgiç
- Tunceli Public Hospital, Infectious Disease and Clinical Microbiology, Tunceli, Turkey
| | - Nesibe Korkmaz
- Ankara Dışkapı Yıldırım Beyazıt Training and Research Hospital, Infectious Disease and Clinical Microbiology, Ankara, Turkey
| | - Derya Arı
- Ankara City Hospital, Department of Gastroenterology, Ankara, Turkey
| | - Gamze Şanlıdağ
- Ege University, Infectious Disease and Clinical Microbiology, İzmir, Turkey
| | - Şengül Kesim Uçar
- Hitit University, Infectious Disease and Clinical Microbiology, Çorum, Turkey
| | - Tolga Düzenli
- Hitit University, Department of Gastroenterology, Çorum, Turkey
| | - Tansu Yamazhan
- Ege University, Infectious Disease and Clinical Microbiology, İzmir, Turkey
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9
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Erdem H, Baymakova M, Alkan S, Letaief A, Yahia WB, Dayyab F, Kolovani E, Grgic S, Cosentino F, Hasanoglu I, Khedr R, Marino A, Pekok AU, Eser F, Arapovic J, Guner HR, Miftode IL, Poposki K, Sanlidag G, Tahmaz A, Sipahi OR, Miftode EG, Oncu S, Cagla-Sonmezer M, Addepalli SK, Darazam IA, Kumari HP, Koc MM, Kumar MR, Sayana SB, Wegdan AA, Amer F, Ceylan MR, El-Kholy A, Onder T, Tehrani HA, Hakamifard A, Kayaaslan B, Shehata G, Caskurlu H, El-Sayed NM, Mortazavi SE, Pourali M, Elbahr U, Kulzhanova S, Yetisyigit T, Saad SA, Cag Y, Eser-Karlidag G, Pshenichnaya N, Belitova M, Akhtar N, Al-Majid F, Ayhan M, Khan MA, Lanzafame M, Makek MJ, Nsutebu E, Cascio A, Dindar-Demiray EK, Evren EU, Kalas R, Kalem AK, Baljić R, Ikram A, Kaya S, Liskova A, Szabo BG, Rahimi BA, Mutlu-Yilmaz E, Sener A, Rello J. Classical fever of unknown origin in 21 countries with different economic development: an international ID-IRI study. Eur J Clin Microbiol Infect Dis 2023; 42:387-398. [PMID: 36790531 PMCID: PMC9930069 DOI: 10.1007/s10096-023-04561-5] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2022] [Accepted: 02/03/2023] [Indexed: 02/16/2023]
Abstract
Fever of unknown origin (FUO) is a serious challenge for physicians. The aim of the present study was to consider epidemiology and dynamics of FUO in countries with different economic development. The data of FUO patients hospitalized/followed between 1st July 2016 and 1st July 2021 were collected retrospectively and submitted from referral centers in 21 countries through ID-IRI clinical research platform. The countries were categorized into developing (low-income (LI) and lower middle-income (LMI) economies) and developed countries (upper middle-income (UMI) and high-income (HI) economies). This research included 788 patients. FUO diagnoses were as follows: infections (51.6%; n = 407), neoplasms (11.4%, n = 90), collagen vascular disorders (9.3%, n = 73), undiagnosed (20.1%, n = 158), miscellaneous diseases (7.7%, n = 60). The most common infections were tuberculosis (n = 45, 5.7%), brucellosis (n = 39, 4.9%), rickettsiosis (n = 23, 2.9%), HIV infection (n = 20, 2.5%), and typhoid fever (n = 13, 1.6%). Cardiovascular infections (n = 56, 7.1%) were the most common infectious syndromes. Only collagen vascular disorders were reported significantly more from developed countries (RR = 2.00, 95% CI: 1.19-3.38). FUO had similar characteristics in LI/LMI and UMI/HI countries including the portion of undiagnosed cases (OR, 95% CI; 0.87 (0.65-1.15)), death attributed to FUO (RR = 0.87, 95% CI: 0.65-1.15, p-value = 0.3355), and the mean duration until diagnosis (p = 0.9663). Various aspects of FUO cannot be determined by the economic development solely. Other development indices can be considered in future analyses. Physicians in different countries should be equally prepared for FUO patients.
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Affiliation(s)
- Hakan Erdem
- Department of Infectious Diseases & Clinical Microbiology, Gulhane School of Medicine, Turkish Health Sciences University, Ankara, Turkey
| | - Magdalena Baymakova
- Department of Infectious Diseases, Military Medical Academy, Sofia, Bulgaria
| | - Sevil Alkan
- Department of Infectious Diseases and Clinical Microbiology, Onsekiz Mart University School of Medicine, Canakkale, Turkey
| | - Amel Letaief
- Department of Infectious Diseases, Farhat Hached University Hospital, Ibn El Jazzar Medical School, University of Sousse, Sousse, Tunisia
| | - Wissal Ben Yahia
- Department of Infectious Diseases, Farhat Hached University Hospital, Ibn El Jazzar Medical School, University of Sousse, Sousse, Tunisia
| | - Farouq Dayyab
- Department of Internal Medicine, King Hamad University Hospital, Al Sayh, Manama, Bahrain
| | - Entela Kolovani
- Infectious Disease Clinic, University Hospital Center 'Mother Theresa', Tirana, Albania
| | - Svjetlana Grgic
- Department of Infectious Diseases, University Clinical Hospital Mostar, Mostar, Bosnia and Herzegovina
| | - Federica Cosentino
- Department of Clinical and Experimental Medicine, Unit of Infectious Diseases, ARNAS Garibaldi Hospital, University of Catania, Catania, Italy
| | - Imran Hasanoglu
- Department of Infectious Diseases & Clinical Microbiology, Ankara City Hospital, Ankara, Turkey
| | - Reham Khedr
- Department of Pediatric Oncology, National Cancer Institute - Cairo University, Children Cancer Hospital Egypt, Cairo, Egypt
| | - Andrea Marino
- Department of Clinical and Experimental Medicine, Unit of Infectious Diseases, ARNAS Garibaldi Hospital, University of Catania, Catania, Italy
| | | | - Fatma Eser
- Department of Infectious Diseases & Clinical Microbiology, Ankara City Hospital, Ankara, Turkey
| | - Jurica Arapovic
- Department of Infectious Diseases, University Clinical Hospital Mostar, Mostar, Bosnia and Herzegovina
| | - Hatice Rahmet Guner
- Department of Infectious Diseases & Clinical Microbiology, Ankara City Hospital, Ankara, Turkey
| | | | - Kostadin Poposki
- Faculty of Medicine, University Clinic for Infectious Diseases and Febrile Conditions, Skopje, Republic of North Macedonia
| | - Gamze Sanlidag
- Department of Infectious Diseases & Clinical Microbiology, Ege School of Medicine, Izmir, Turkey
| | - Alper Tahmaz
- Department of Infectious Diseases & Clinical Microbiology, Antalya Training and Research Hospital, Antalya, Turkey
| | - Oguz Resat Sipahi
- Department of Infectious Diseases & Clinical Microbiology, Ege School of Medicine, Izmir, Turkey
| | | | - Serkan Oncu
- Department of Infectious Diseases & Clinical Microbiology, School of Medicine, Adnan Menderes University, Aydin, Turkey
| | - Meliha Cagla-Sonmezer
- Department of Infectious Diseases & Clinical Microbiology, Hacettepe School of Medicine, Hacettepe University, Ankara, Turkey
| | - Syam Kumar Addepalli
- Department of Pharmacology, GITAM Institute of Medical Sciences and Research, Visakhapatnam, Andhra Pradesh, India
| | - Ilad Alavi Darazam
- Infectious Diseases and Tropical Medicine Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Hema Prakash Kumari
- Department of Microbiology, GITAM Institute of Medical Sciences and Research, Visakhapatnam, Andhra Pradesh, India
| | - Meliha Meriç Koc
- Department of Infectious Diseases & Clinical Microbiology, School of Medicine, Bezmialem Vakif University, Istanbul, Turkey
| | - Meela Ranjith Kumar
- Department of Pharmacology, Government Medical College &, Government General Hospital, Suryapet, Telangana, India
| | - Suresh Babu Sayana
- Department of Pharmacology, Government Medical College, Suryapet, Telangana, India
| | - Ahmed Ashraf Wegdan
- Department of Medical Microbiology and Immunology, Faculty of Medicine, Fayoum University, Fayoum, Egypt
| | - Fatma Amer
- Department of Medical Microbiology and Immunology, Faculty of Medicine, Zagazig University, Zagazig, Egypt
| | - Mehmet Resat Ceylan
- Department of Infectious Diseases & Clinical Microbiology, School of Medicine, Harran University, Sanliurfa, Turkey
| | - Amani El-Kholy
- Department of Clinical Pathology, Faculty of Medicine, Cairo University, Giza, Egypt
| | - Taylan Onder
- Department of Infectious Diseases and Clinical Microbiology, Onsekiz Mart University School of Medicine, Canakkale, Turkey
| | - Hamed Azhdari Tehrani
- Department of Hematology and Medical Oncology, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Atousa Hakamifard
- Infectious Diseases and Tropical Medicine Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Bircan Kayaaslan
- Department of Infectious Diseases & Clinical Microbiology, Ankara City Hospital, Ankara, Turkey
| | | | - Hulya Caskurlu
- Department of Infectious Diseases and Clinical Microbiology, Faculty of Medicine, Istanbul Medeniyet University, Istanbul, Turkey
| | | | - Seyed Erfan Mortazavi
- Infectious Diseases and Tropical Medicine Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Mohammad Pourali
- Infectious Diseases and Tropical Medicine Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Umran Elbahr
- Department of Infectious Diseases, Bahrain Oncology Center, King Hamad University Hospital, Busaiteen, Bahrain
| | - Sholpan Kulzhanova
- Department of Infectious Diseases, Astana Medical University, Nur-Sultan, Kazakhstan
| | - Tarkan Yetisyigit
- Department of Oncology, Bahrain Oncology Center, King Hamad University Hospital, Busaiteen, Bahrain
| | - Sahar Ahmed Saad
- Department of Rheumatology, King Hamad Univesity Hospital, Al Sayh, Bahrain
| | - Yasemin Cag
- Department of Infectious Diseases and Clinical Microbiology, Faculty of Medicine, Istanbul Medeniyet University, Istanbul, Turkey.
| | - Gulden Eser-Karlidag
- Department of Infectious Diseases and Clinical Microbiology, University of Health Sciences, Elazig Fethi Sekin City Hospital, Elazig, Turkey
| | | | | | - Nasim Akhtar
- Pakistan Institute of Medical Sciences, Islamabad, G-8/3, Pakistan
| | - Fahad Al-Majid
- Department of Medicine, Infectious Diseases Division, King Saud University, Riyadh, Saudi Arabia
| | - Muge Ayhan
- Department of Infectious Diseases & Clinical Microbiology, Ankara City Hospital, Ankara, Turkey
| | | | | | | | - Emmanuel Nsutebu
- Tropical and Infectious Diseases Division, Sheikh Shakhbout Medical City, Abu Dhabi, United Arab Emirates
| | - Antonio Cascio
- Department of Health Promotion Sciences, Maternal and Infant Care, Internal Medicine and Medical Specialties (PROMISE) - Infectious Disease Unit, Policlinico 'P. Giaccone', University of Palermo, Palermo, Italy
| | | | - Emine Unal Evren
- Department of Infectious Diseases and Clinical Microbiology, School of Medicine, University of Kyrenia, Kyrenia, Cyprus
| | - Rama Kalas
- Internal Medicine Division, Sheikh Shakhbout Medical City, Abu Dhabi, United Arab Emirates
| | - Ayşe Kaya Kalem
- Department of Infectious Diseases & Clinical Microbiology, Ankara City Hospital, Ankara, Turkey
| | | | - Aamer Ikram
- National Institutes of Health, Islamabad, Pakistan
| | - Selcuk Kaya
- Department of Infectious Diseases and Clinical Microbiology, Karadeniz Technical University School of Medicine, Trabzon, Turkey
| | - Anna Liskova
- Hospital Nitra, St. Elisabeth University of Health Care and Social Work, Bratislava, Slovak Republic
| | - Balint Gergely Szabo
- South Pest Central Hospital, National Institute of Hematology and Infectious Diseases, Budapest, Hungary
| | - Bilal Ahmad Rahimi
- Department of Infectious Diseases, Kandahar University Medical Faculty, Teaching Hospital, Kandahar, Afghanistan
| | - Esmeray Mutlu-Yilmaz
- Department of Infectious Diseases & Clinical Microbiology, Samsun Training and Research Hospital, Samsun, Turkey
| | - Alper Sener
- Department of Infectious Diseases and Clinical Microbiology, Onsekiz Mart University School of Medicine, Canakkale, Turkey
| | - Jordi Rello
- Clinical Research and Epidemiology in Pneumonia and Sepsis, Vall d'Hebron Institute of Research (VHIR), Barcelona, Spain
- Clinical Research, CHRU Nîmes, Nîmes, France
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Baydar Toprak O, Akpolat T, Uzun O, Pınar Deniz P, Kokturk N, Varol A, Guzel E, Ercelik M, Gultekin O, Guner R, Turan S, Gökbulut Bektaş Ş, Coskun N, Bakan N, Nuri Yakar M, Eren Kutsoylu O, Ergan B, Argun Barış S, Başyiğit I, Boyacı H, Çetinkaya F, Çolak H, Aykac N, Baran Ketencioğlu B, Türe Yüce Z, Akkaya Isık S, Serap Yılmaz E, Karaoğlanoğlu S, Berik Safci S, Ozkan G, Kose N, Kizilirmak D, Havlucu Y, Nural S, Kerget F, Sunal Ö, Yuksel A, Bestepe Dursun Z, Deveci F, Kuluozturk M, Ataoglu O, Dursun M, Keskin S, Emin Sezgin M, Aktepe Sezgin EN, Eser F, Akyildiz L, Selim Almaz M, Kayaaslan B, Hasanoğlu I, Bayrak M, Gümüş A, Sağcan G, Cuhadaroglu C, Kucuk H, Onyilmaz T, Mete B, Kilinc O, Oya Itil B. COVID-19: booster(s) vs. hospitalization and Intensive Care Unit admission. Eur Rev Med Pharmacol Sci 2023; 27:2132-2142. [PMID: 36930513 DOI: 10.26355/eurrev_202303_31586] [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] [Subscribe] [Scholar Register] [Indexed: 03/18/2023]
Abstract
OBJECTIVE As the pandemic continues, different vaccine protocols have been implemented to maintain the protection of vaccines and to provide protection against new variants. The aim of this study was to assess hospitalized patients' vaccination status and document the efficacy of boosters. PATIENTS AND METHODS The patients that were hospitalized due to COVID-19 were enrolled from 28 hospitals in Turkey for five months from September 2021. 5,331 confirmed COVID-19 patients from collaborating centers were randomly enrolled to understand/estimate the distribution of vaccination status in hospitalized patients and to compare the efficacy of vaccination/booster protocols. RESULTS 2,779 men and 2,552 women of which 2,408 (45.2%) were admitted to Intensive Care Units participated in this study. It was found that the highest risk reduction for all age groups was found in groups that received 4 doses. Four doses of vaccination for every 3.7 people under 50 years of age, for every 5.7 people in the 50-64 age group, and for every 4.3 people over 65 years of age will prevent 1 patient from being admitted to intensive care. Regardless of the type of vaccine, it was found that the risk of ICU hospitalization decreased in those who were vaccinated compared to those who were not vaccinated. Regardless of the type of vaccine, the ICU risk was found to decrease 1.25-fold in those who received 1 or 2 doses of vaccine, 1.18-fold in those who received 3 doses, and 3.26-fold in those who received 4 doses. CONCLUSIONS The results suggested that the addition of a fourth dose is more effective in preventing intensive unit care even in disadvantaged groups.
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Affiliation(s)
- O Baydar Toprak
- Department of Chest Diseases, Faculty of Medicine, Cukurova University, Adana, Turkey.
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Eser F, Kayaaslan B, Kaya Kalem A, Hasanoğlu İ, Bilgiç Z, Asiltürk D, Kaplan B, Güner R. Effect of 2 Different High-Dose Methylprednisolone Treatments on Clinical Outcomes in Severe COVID-19 Patients. Thorac Res Pract 2023; 24:66-75. [PMID: 37503642 PMCID: PMC10652074 DOI: 10.5152/thoracrespract.2023.22050] [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] [Subscribe] [Scholar Register] [Received: 03/03/2022] [Accepted: 10/06/2022] [Indexed: 07/29/2023]
Abstract
OBJECTIVE The present study aimed to evaluate and compare the use of 2 different high-dose methylprednisolone posology in treating severe coronavirus disease 2019 pneumonia regarding mortality and recovery time between themselves and against steroidal/ non-steroidal treatment. MATERIAL AND METHODS Severe coronavirus disease 2019 patients followed up between March 2020 and January 2021 were included. The steroid-free treatment protocol was applied before August 2020 (non-pulse group) and a treatment algorithm containing normal and high doses of methylprednisolone was applied after August 2020 (pulse group). Patients with clinical deterioration under the normal dose of methylprednisolone were administered 250 mg or 1000 mg of methylprednisolone for 3 days. We compared the pulse and non-pulse groups, in addition to pulse subgroups with each other, for clinical outcomes. RESULTS A total of 138 patients were included, including 36 patients in the non-pulse group and 102 in the pulse group. In the pulse group, 70 patients received 1000 mg/day and 32 received 250 mg/day of high-dose methylprednisolone therapy. In the comparison of pulse and non-pulse patient groups, mortality rate was lower in the pulse group (P < .001), and the time to discharge without oxygen support was shorter. Although the patients in the 250 mg subgroup were older, there was no difference between the 250 mg and 1000 mg subgroups in terms of end of oxygen requirement, discharge with oxygen support, and mortality. In addition, the required time to reach the oxygen-free period in patients discharged without oxygen support was similar in the 2 subgroups, and the majority of patients in both subgroups reached the oxygen-free period on the 20th day after initiating methylprednisolone. CONCLUSION Since there was no difference in clinical improvement between the use of 250 mg or 1000 mg methylprednisolone in patients with severe coronavirus disease 2019 infection, 1000 mg methylprednisolone was not required.
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Affiliation(s)
- Fatma Eser
- Department of Infectious Diseases and Clinical Microbiology, Yıldırım BeyazıtUniversity, Faculty of Medicine, Ankara City Hospital, Ankara, Turkey
| | - Bircan Kayaaslan
- Department of Infectious Diseases and Clinical Microbiology, Yıldırım BeyazıtUniversity, Faculty of Medicine, Ankara City Hospital, Ankara, Turkey
| | - Ayşe Kaya Kalem
- Department of Infectious Diseases and Clinical Microbiology, Yıldırım BeyazıtUniversity, Faculty of Medicine, Ankara City Hospital, Ankara, Turkey
| | - İmran Hasanoğlu
- Department of Infectious Diseases and Clinical Microbiology, Yıldırım BeyazıtUniversity, Faculty of Medicine, Ankara City Hospital, Ankara, Turkey
| | - Zeynep Bilgiç
- Department of Infectious Diseases and Clinical Microbiology, nkara City Hospital, , Ankara, Turkey
| | - Dilek Asiltürk
- Department of Infectious Diseases and Clinical Microbiology, nkara City Hospital, , Ankara, Turkey
| | - Betül Kaplan
- Department of Infectious Diseases and Clinical Microbiology, nkara City Hospital, , Ankara, Turkey
| | - Rahmet Güner
- Department of Infectious Diseases and Clinical Microbiology, Yıldırım BeyazıtUniversity, Faculty of Medicine, Ankara City Hospital, Ankara, Turkey
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12
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Azak E, Sertcelik A, Ersoz G, Celebi G, Eser F, Batirel A, Cag Y, Ture Z, Ozturk Engin D, Yetkin MA, Kaygusuz S, Candevir A, Tartari E, Rello J, Alp E. Evaluation of the implementation of WHO infection prevention and control core components in Turkish health care facilities: results from a WHO infection prevention and control assessment framework (IPCAF)-based survey. Antimicrob Resist Infect Control 2023; 12:11. [PMID: 36782267 PMCID: PMC9923650 DOI: 10.1186/s13756-023-01208-0] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2022] [Accepted: 01/21/2023] [Indexed: 02/15/2023] Open
Abstract
BACKGROUND The core components (CCs) of infection prevention and control (IPC) from World Health Organization (WHO) are crucial for the safety and quality of health care. Our objective was to examine the level of implementation of WHO infection prevention and control core components (IPC CC) in a developing country. We also aimed to evaluate health care-associated infections (HAIs) and antimicrobial resistance (AMR) in intensive care units (ICUs) in association with implemented IPC CCs. METHODS Members of the Turkish Infectious Diseases and Clinical Microbiology Specialization Association (EKMUD) were invited to the study via e-mail. Volunteer members of any healt care facilities (HCFs) participated in the study. The investigating doctor of each HCF filled out a questionnaire to collect data on IPC implementations, including the Infection Prevention and Control Assessment Framework (IPCAF) and HAIs/AMR in ICUs in 2021. RESULTS A total of 68 HCFs from seven regions in Türkiye and the Turkish Republic of Northern Cyprus participated while 85% of these were tertiary care hospitals. Fifty (73.5%) HCFs had advanced IPC level, whereas 16 (23.5%) of the 68 hospitals had intermediate IPC levels. The hospitals' median (IQR) IPCAF score was 668.8 (125.0) points. Workload, staffing and occupancy (CC7; median 70 points) and multimodal strategies (CC5; median 75 points) had the lowest scores. The limited number of nurses were the most important problems. Hospitals with a bed capacity of > 1000 beds had higher rates of HAIs. Certified IPC specialists, frequent feedback, and enough nurses reduced HAIs. The most common HAIs were central line-associated blood stream infections. Most HAIs were caused by gram negative bacteria, which have a high AMR. CONCLUSIONS Most HCFs had an advanced level of IPC implementation, for which staffing was an important driver. To further improve care quality and ensure everyone has access to safe care, it is a key element to have enough staff, the availability of certified IPC specialists, and frequent feedback. Although there is a significant decrease in HAI rates compared to previous years, HAI rates are still high and AMR is an important problem. Increasing nurses and reducing workload can prevent HAIs and AMR. Nationwide "Antibiotic Stewardship Programme" should be initiated.
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Affiliation(s)
- Emel Azak
- grid.411105.00000 0001 0691 9040Department of Infectious Diseases and Clinical Microbiology, Faculty of Medicine, Kocaeli University, Kocaeli, Türkiye
| | - Ahmet Sertcelik
- grid.14442.370000 0001 2342 7339Division of Epidemiology, Department of Public Health, Faculty of Medicine, Hacettepe University, Ankara, Türkiye
| | - Gulden Ersoz
- grid.411691.a0000 0001 0694 8546Department of Infectious Diseases and Clinical Microbiology, Faculty of Medicine, Mersin University, Mersin, Türkiye
| | - Guven Celebi
- grid.411822.c0000 0001 2033 6079Department of Infectious Diseases and Clinical Microbiology, Zonguldak Bulent Ecevit University Faculty of Medicine, Zonguldak, Türkiye
| | - Fatma Eser
- grid.449874.20000 0004 0454 9762Department of Infectious Diseases and Clinical Microbiology, Ankara Yildirim Beyazit University, Ankara, Türkiye
| | - Ayse Batirel
- grid.488643.50000 0004 5894 3909Department of Infectious Diseases and Clinical Microbiology, University of Health Sciences, Kartal Dr. Lutfi Kirdar City Hospital, Istanbul, Türkiye
| | - Yasemin Cag
- grid.411776.20000 0004 0454 921XDepartment of Infectious Diseases and Clinical Microbiology, Istanbul Medeniyet University Faculty of Medicine, Istanbul, Türkiye
| | - Zeynep Ture
- grid.411739.90000 0001 2331 2603Department of Infectious Diseases and Clinical Microbiology, Erciyes University Faculty of Medicine, Kayseri, Türkiye
| | - Derya Ozturk Engin
- grid.414850.c0000 0004 0642 8921Department of Infectious Diseases and Clinical Microbiology, Sancaktepe Sehit Prof. Dr. Ilhan Varank Training and Research Hospital, Istanbul, Türkiye
| | - Meltem Arzu Yetkin
- grid.411709.a0000 0004 0399 3319Department of Infectious Diseases and Clinical Microbiology, Giresun University Faculty of Medicine, Giresun, Türkiye
| | - Sedat Kaygusuz
- grid.411047.70000 0004 0595 9528Department of Infectious Diseases and Clinical Microbiology, Kirikkale University Faculty of Medicine, Kirikkale, Türkiye
| | - Aslıhan Candevir
- grid.98622.370000 0001 2271 3229Department of Infectious Diseases and Clinical Microbiology, Cukurova University Faculty of Medicine, Adana, Türkiye
| | - Ermira Tartari
- grid.4462.40000 0001 2176 9482Faculty of Health Sciences, University of Malta, Msida, Malta
| | - Jordi Rello
- grid.410675.10000 0001 2325 3084Catedràtic de Medicina, Universitat Internacional de Catalunya, Barcelona, Spain
| | - Emine Alp
- Department of Infectious Diseases and Clinical Microbiology, Ankara Yildirim Beyazit University, Ankara, Türkiye.
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13
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Sezer S, Bal C, Kalem AK, Kayaaslan B, Eser F, Hasanoglu İ, Akıncı E, Güner R, Erel Ö, Yılmaz G. COVID-19 patients with altered steroid hormone levels are more likely to have higher disease severity. Endocrine 2022; 78:373-379. [PMID: 35907083 PMCID: PMC9362412 DOI: 10.1007/s12020-022-03140-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/07/2022] [Accepted: 07/09/2022] [Indexed: 11/25/2022]
Abstract
PURPOSE This study aims to evaluate the correlations between the severity of the disease and serum steroid levels by analyzing the serum steroid levels in COVID-19 patients with different levels of disease progression and the control group. METHODS Morning serum Aldosterone, 11-deoxycortisol, Androstenedione, 17-hydroxyprogesterone, Dihydrotestosterone (DHT), Dehydroepiandrosterone (DHEA), Corticosterone, Dehydroepiandrosterone sulfate (DHEAS), Estrone, Estradiol, Progesterone, 11-deoxycorticosterone, Cortisol, Corticosterone, Androsterone, Pregnenolone, 17-hydroxypregnenolone and 21-deoxycortisol levels were measured in 153 consecutive patients were grouped as mild, moderate, and severe based on the WHO COVID-19 disease severity classification and the control group. Steroid hormone levels were analyzed at once with a liquid chromatography-tandem mass spectrometric method (LC-MS/MS). RESULTS In our study, nearly all steroids were statistically significantly higher in the patients' group than in the control group (p < 0.001). Also, DHEA was an independent indicator of the disease severity with COVID-19 CONCLUSIONS: Our study reveals that the alteration in steroid hormone levels was correlated with disease severity. Also, steroid hormone levels should be followed up during COVID-19 disease management.
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Affiliation(s)
- Sevilay Sezer
- Department of Medical Biochemistry, Ankara City Hospital, Ankara, Turkey.
| | - Ceylan Bal
- Department of Medical Biochemistry, Ankara City Hospital, Ankara, Turkey
- Department of Medical Biochemistry, Ankara Yıldırım Beyazıt University, Faculty of Medicine, Ankara, Turkey
| | - Ayşe Kaya Kalem
- Department of Infectious Diseases and Clinical Microbiology, Ankara City Hospital, Ankara Yıldırım Beyazıt University, Faculty of Medicine, Ankara, Turkey
| | - Bircan Kayaaslan
- Department of Infectious Diseases and Clinical Microbiology, Ankara City Hospital, Ankara Yıldırım Beyazıt University, Faculty of Medicine, Ankara, Turkey
| | - Fatma Eser
- Department of Infectious Diseases and Clinical Microbiology, Ankara City Hospital, Ankara Yıldırım Beyazıt University, Faculty of Medicine, Ankara, Turkey
| | - İmran Hasanoglu
- Department of Infectious Diseases and Clinical Microbiology, Ankara City Hospital, Ankara Yıldırım Beyazıt University, Faculty of Medicine, Ankara, Turkey
| | - Esragül Akıncı
- Department of Infectious Diseases and Clinical Microbiology, Health Sciences University, Ankara City Hospital, Ankara, Turkey
| | - Rahmet Güner
- Department of Infectious Diseases and Clinical Microbiology, Ankara City Hospital, Ankara Yıldırım Beyazıt University, Faculty of Medicine, Ankara, Turkey
| | - Özcan Erel
- Department of Medical Biochemistry, Ankara City Hospital, Ankara, Turkey
- Department of Medical Biochemistry, Ankara Yıldırım Beyazıt University, Faculty of Medicine, Ankara, Turkey
| | - Gülsen Yılmaz
- Department of Medical Biochemistry, Ankara City Hospital, Ankara, Turkey
- Department of Medical Biochemistry, Ankara Yıldırım Beyazıt University, Faculty of Medicine, Ankara, Turkey
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14
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Kilic H, Arguder E, Karalezli A, Unsal E, Guner R, Kayaslan B, Hasanoglu İ, Ates İ, Civak M, Akpınar E, Parlak E, Sadi F, Kocaman Y, Günay S, Metan E, Er M, Dalkıran A, Hezer H, Ergüden H, Hancıoğlu Z, Kalem A, Eser F, Aypak A, Akıncı E, Karahmetoğlu S, Gemcioglu E, Kalkan E, İnan O, Yilmaz A, Güler B, Çopuroğlu E, Turan İ, Gökmen D, Hayme S, Surel AA. Effect of chronic lung diseases on mortality of prevariant COVID-19 pneumonia patients. Front Med (Lausanne) 2022; 9:957598. [PMID: 36314036 PMCID: PMC9606396 DOI: 10.3389/fmed.2022.957598] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2022] [Accepted: 09/20/2022] [Indexed: 11/26/2022] Open
Abstract
Background The aim of the study is to assess the effect of chronic lung disease on mortality in patients hospitalized with the diagnosis of prevariant COVID-19 Pneumonia compared to patients without chronic lung disease. Research design and methods A cohort of 1,549 patients admitted to the pandemic clinic with a COVID-19 Pneumonia diagnosis was analyzed. Group 1 and Group 2 were compared in terms of the treatment they received, admission to intensive care, mortality and follow-up parameters. Results The patient group with COVID-19 and lung disease consisted of 231 participants (14.91%) (Group 1). The patient group with COVID-19 but without lung disease had 1,318 participants (85.19%). Group 1 cases were found to receive more oxygen therapy and mechanical ventilation than Group 2 cases (p ≤ 0.001), Following univariate and multiple logistic regression analyses, it was determined that patients with chronic lung disease had a 25.76% higher mortality risk [OR: 25.763, 95% CI (Lower-Upper) (2.445–271.465), p = 0.007]. Conclusion It was found that chronic lung disease contributed significantly to mortality in this study. Among chronic lung diseases, Chronic Obstructive Pulmonary Disease (COPD), lung cancer and interstitial lung diseases (ILDs) were shown to be more effective than other chronic lung diseases in patients with prevariant COVİD-19 population.
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Affiliation(s)
- Hatice Kilic
- Department of Pulmonary Medicine, Faculty of Medicine, Ankara Yildirim Beyazit University, Ankara, Turkey,*Correspondence: Hatice Kilic,
| | - Emine Arguder
- Department of Pulmonary Medicine, Faculty of Medicine, Ankara Yildirim Beyazit University, Ankara, Turkey
| | - Aysegul Karalezli
- Department of Pulmonary Medicine, Faculty of Medicine, Ankara Yildirim Beyazit University, Ankara, Turkey
| | - Ebru Unsal
- Department of Pulmonary Medicine, Faculty of Medicine, Ankara Yildirim Beyazit University, Ankara, Turkey
| | - Rahmet Guner
- Department of Infectious Disease, Faculty of Medicine, Ankara Yildirim Beyazit University, Ankara, Turkey
| | - Bircan Kayaslan
- Department of Infectious Disease, Faculty of Medicine, Ankara Yildirim Beyazit University, Ankara, Turkey
| | - İmran Hasanoglu
- Department of Infectious Disease, Faculty of Medicine, Ankara Yildirim Beyazit University, Ankara, Turkey
| | - İhsan Ates
- Department of Internal Medicine Disease, Faculty of Medicine, Ankara University of Health Science, Ankara City Hospital, Ankara, Turkey
| | - Musa Civak
- Department of Internal Medicine Diseases, Ankara City Hospital, Ankara, Turkey
| | - Esmehan Akpınar
- Department of Chest Diseases, Ankara City Hospital, Ankara, Turkey
| | - Ebru Parlak
- Department of Chest Diseases, Ankara City Hospital, Ankara, Turkey
| | - Filiz Sadi
- Department of Chest Diseases, Ankara City Hospital, Ankara, Turkey
| | - Yasin Kocaman
- Department of Chest Diseases, Ankara City Hospital, Ankara, Turkey
| | - Sibel Günay
- Department of Chest Diseases, Ankara City Hospital, Ankara, Turkey
| | - Esra Metan
- Department of Chest Diseases, Ankara City Hospital, Ankara, Turkey
| | - Mukremin Er
- Department of Chest Diseases, Ankara City Hospital, Ankara, Turkey
| | - Aynil Dalkıran
- Department of Chest Diseases, Ankara City Hospital, Ankara, Turkey
| | - Habibe Hezer
- Department of Chest Diseases, Ankara City Hospital, Ankara, Turkey
| | - Hülya Ergüden
- Department of Chest Diseases, Ankara City Hospital, Ankara, Turkey
| | - Zeynep Hancıoğlu
- Department of Chest Diseases, Ankara City Hospital, Ankara, Turkey
| | - Ayşe Kalem
- Department of Infectious Disease, Faculty of Medicine, Ankara Yildirim Beyazit University, Ankara, Turkey
| | - Fatma Eser
- Department of Infectious Disease, Faculty of Medicine, Ankara Yildirim Beyazit University, Ankara, Turkey
| | - Adalet Aypak
- Department of Infectious Disease, Faculty of Medicine, University of Health Science, Ankara, Turkey
| | - Esragül Akıncı
- Department of Infectious Disease, Faculty of Medicine, University of Health Science, Ankara, Turkey
| | - Selma Karahmetoğlu
- Department of Internal Medicine Diseases, Ankara City Hospital, Ankara, Turkey
| | - Emin Gemcioglu
- Department of Internal Medicine Diseases, Ankara City Hospital, Ankara, Turkey
| | - Emra Kalkan
- Department of Internal Medicine Diseases, Ankara City Hospital, Ankara, Turkey
| | - Osman İnan
- Department of Internal Medicine Diseases, Ankara City Hospital, Ankara, Turkey
| | - Abdulrezzak Yilmaz
- Department of Internal Medicine Diseases, Ankara City Hospital, Ankara, Turkey
| | - Bagdagul Güler
- Department of Internal Medicine Diseases, Ankara City Hospital, Ankara, Turkey
| | - Esra Çopuroğlu
- Department of Internal Medicine Diseases, Ankara City Hospital, Ankara, Turkey
| | - İşil Turan
- Department of Anesthesia, Ankara City Hospital, Ankara, Turkey
| | - Derya Gökmen
- Department of Biostatistics, School of Medicine, Ankara University, Ankara, Turkey
| | - Serhat Hayme
- Department of Biostatistics, School of Medicine, Ankara University, Ankara, Turkey
| | - Aziz Ahmet Surel
- Department of General Surgery, Ankara City Hospital, Ankara, Turkey
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15
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Kayaaslan B, Eser F, Asilturk D, Oktay Z, Hasanoglu I, Kalem AK, Dönertaş G, Kaplan B, Ozkocak Turan I, Erdem D, Bektas H, Guner R. Development and validation of COVID-19 associated candidemia score (CAC-Score) in ICU patients. Mycoses 2022; 66:128-137. [PMID: 36135336 PMCID: PMC9537877 DOI: 10.1111/myc.13531] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2022] [Revised: 09/02/2022] [Accepted: 09/15/2022] [Indexed: 01/12/2023]
Abstract
BACKGROUND The development of candidemia is a highly fatal condition in severe COVID-19 infection. OBJECTIVES This study aimed to develop a candidemia prediction score in COVID-19 patient based on the patient's clinical characteristics, and healthcare-related factors during intensive care units (ICU) follow-up. PATIENTS/METHODS Severe COVID-19 patients hospitalised in ICU in Ankara City Hospital during the one-year period (August 15, 2020, and August 15, 2021) were included. After univariate analysis, multivariate analysis was applied using variable selection approach to investigate the effects of variables together and to create a score model for candidemia. Statistically significant factors were included in the development process of candida prediction score. RESULTS Of 1305 COVID-19 ICU patients, 139 had a candidemia episode. According to the final model, four variables, presence of central venous catheter (CVC) (OR 19.07, CI 8.12-44.8, p < .0001), multifocal colonisation (OR 2.28, CI 1.39-3.72, p 0.001), length of ICU stays ≥14 days (OR 3.62, CI 2.42-5.44, p < .0001) and corticosteroids (OR 0.51, CI 0.34-0.76, p 0.0011) were the only statistically significant independent risk factors for candidemia. Score model was demonstrated by a nomogram, and the risk for candidemia was calculated to be high in patients who scored ≥56 points by using the criteria [CVC = 51, multifocal colonisation = 14, prolonged hospitalisation = 23, no steroid use = 12 points]. The AUC of the score is 0.84 (CI 0.81-0.87). CONCLUSION We developed and validated an easy-to-use clinical prediction score for candidemia in severe COVID-19 infection. In COVID-19 ICU patients, the risk of candidemia is high if one of the other risk factors is present together with CVC.
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Affiliation(s)
- Bircan Kayaaslan
- Department of Infectious Disease and Clinical Microbiology, Ankara City HospitalAnkara Yildirim Beyazit UniversityAnkaraTurkey
| | - Fatma Eser
- Department of Infectious Disease and Clinical Microbiology, Ankara City HospitalAnkara Yildirim Beyazit UniversityAnkaraTurkey
| | - Dilek Asilturk
- Department of Infectious Disease and Clinical MicrobiologyAnkara City HospitalAnkaraTurkey
| | - Zeynep Oktay
- Department of Infectious Disease and Clinical MicrobiologyAnkara City HospitalAnkaraTurkey
| | - Imran Hasanoglu
- Department of Infectious Disease and Clinical Microbiology, Ankara City HospitalAnkara Yildirim Beyazit UniversityAnkaraTurkey
| | - Ayşe Kaya Kalem
- Department of Infectious Disease and Clinical Microbiology, Ankara City HospitalAnkara Yildirim Beyazit UniversityAnkaraTurkey
| | - Gülen Dönertaş
- Department of Infectious Disease and Clinical MicrobiologyAnkara City HospitalAnkaraTurkey
| | - Betul Kaplan
- Department of Infectious Disease and Clinical MicrobiologyAnkara City HospitalAnkaraTurkey
| | - Isıl Ozkocak Turan
- Department of Intensive Care UnitUniversity of Health Sciences Ankara City HospitalAnkaraTurkey
| | - Deniz Erdem
- Department of Intensive Care UnitUniversity of Health Sciences Ankara City HospitalAnkaraTurkey
| | - Hesna Bektas
- Department of Neurology, Ankara City HospitalAnkara Yildirim Beyazit UniversityAnkaraTurkey
| | - Rahmet Guner
- Department of Infectious Disease and Clinical Microbiology, Ankara City HospitalAnkara Yildirim Beyazit UniversityAnkaraTurkey
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16
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Kayaaslan B, Kaya Kalem A, Asilturk D, Kaplan B, Dönertas G, Hasanoglu I, Eser F, Korkmazer R, Oktay Z, Ozkocak Turan I, Erdem D, Bektas H, Guner R. Incidence and risk factors for COVID-19 associated candidemia (CAC) in ICU patients. Mycoses 2022; 65:508-516. [PMID: 35156742 PMCID: PMC9115269 DOI: 10.1111/myc.13431] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2022] [Revised: 02/07/2022] [Accepted: 02/09/2022] [Indexed: 12/15/2022]
Abstract
BACKGROUND Critically ill COVID-19 patients have a high risk for the development of candidemia due to being exposed to both well-defined classical risk factors and COVID-19-specific risk factors in ICU. OBJECTIVES In this study, we investigated the incidence of candidemia in critically COVID-19 patients, and the independent risk factors for candidemia. PATIENTS/METHODS COVID-19 patients hospitalised in ICU during 1-year period (August 2020 to August 2021) were included. Clinical and laboratory characteristics of all COVID-19 patients, applied treatments, and invasive procedures that may predispose to candidemia were recorded. RESULTS Of 1229 COVID-19 patients, 63 developed candidemia. Candidemia incidence rate was 4.4 episodes per 1000 ICU days. The most common species was Candida albicans (52.3%). Only 37 patients (58.7%) received antifungal therapy. The presence of central venous catheter (OR 4.7, 95% CI 1.8-12.2, p < .005), multifocal candida colonisation (OR 2.7, 95% CI 1.4-5.2, p < .005), a prolonged ICU stay (≥14 days) (OR 1.9, 95% CI 1.08-3-37, p < .05), the absence of chronic lung disease (OR 0.4, 95% CI 0.1-0.9, p < .05) and the absence of corticosteroid use (OR 0.3, 95% CI 0.14-0.52, p < .0001) were significantly associated with candidemia. CONCLUSIONS Our study filled the knowledge gap in the literature about the impact of COVID-19-associated risk factors for the development of candidemia. The classical risk factors for candidemia had a significant effect on candidemia, and contrary to expectations, corticosteroids had a protective effect against the development of candidemia. The results of these studies showing interesting effects of corticosteroids in critically ill COVID-19 patients should be confirmed by further studies.
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Affiliation(s)
- Bircan Kayaaslan
- Department of Infectious Disease and Clinical MicrobiologyAnkara Yildirim Beyazit UniversityAnkara City HospitalAnkaraTurkey
| | - Ayşe Kaya Kalem
- Department of Infectious Disease and Clinical MicrobiologyAnkara Yildirim Beyazit UniversityAnkara City HospitalAnkaraTurkey
| | - Dilek Asilturk
- Department of Infectious Disease and Clinical MicrobiologyAnkara City HospitalAnkaraTurkey
| | - Betul Kaplan
- Department of Infectious Disease and Clinical MicrobiologyAnkara City HospitalAnkaraTurkey
| | - Gülen Dönertas
- Department of Infectious Disease and Clinical MicrobiologyAnkara City HospitalAnkaraTurkey
| | - Imran Hasanoglu
- Department of Infectious Disease and Clinical MicrobiologyAnkara Yildirim Beyazit UniversityAnkara City HospitalAnkaraTurkey
| | - Fatma Eser
- Department of Infectious Disease and Clinical MicrobiologyAnkara Yildirim Beyazit UniversityAnkara City HospitalAnkaraTurkey
| | - Ruveyda Korkmazer
- Department of Infectious Disease and Clinical MicrobiologyAnkara City HospitalAnkaraTurkey
| | - Zeynep Oktay
- Department of Infectious Disease and Clinical MicrobiologyAnkara City HospitalAnkaraTurkey
| | - Isıl Ozkocak Turan
- Department of Intensive Care UnitUniversity of Health Sciences Ankara City HospitalAnkaraTurkey
| | - Deniz Erdem
- Department of Intensive Care UnitUniversity of Health Sciences Ankara City HospitalAnkaraTurkey
| | - Hesna Bektas
- Department of NeurologyAnkara City HospitalAnkara Yildirim Beyazit UniversityAnkaraTurkey
| | - Rahmet Guner
- Department of Infectious Disease and Clinical MicrobiologyAnkara Yildirim Beyazit UniversityAnkara City HospitalAnkaraTurkey
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17
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Kaya Kalem A, Kayaaslan B, Eser F, Hasanoglu İ, Ayhan M, Coskun B, Guner R. Investigation of the relation between risk assessment of exposure and nosocomial SARS-CoV-2 transmission in healthcare workers: a prospective single-centre study. BMJ Open 2022; 12:e056858. [PMID: 35039302 PMCID: PMC8764715 DOI: 10.1136/bmjopen-2021-056858] [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] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
OBJECTIVES Healthcare workers (HCWs) are among the risk groups for COVID-19. Determining transmission routes and risk levels during healthcare is of great importance in preventing nosocomial outbreaks. This study aimed to investigate the frequency of nosocomial transmission and factors affecting the transmission in HCW. METHODS HCWs admitted to the infectious diseases outpatient clinic due to contact with a COVID-19 patient and diagnosed with SARS-COV-2 by reverse-transcriptase PCR (RT-PCR) between 20 March 2020 and 30 June 2020 were included in the study. RESULTS A total of 822 HCWs with 295 low, 284 intermediate and 243 high-risk exposures were included in the study. 27.1% of the HCWs were male, and the median age was 31.9 years (20-62). 89.5% of these patients were directly in charge of patient care. Of the index cases contacted, 72.6% were HCW, and 27.4% were non-HCW patients. Most of the risky exposure (51.7%) occurred in nurses. The occurrence frequency of high-risk exposure was lower in those assigned to direct patient care when compared with the occurrence frequency of moderate-risk or low-risk exposures (76.5%, 94.7, 95.3, respectively p<0.001). In most high-risk exposures (220/253), the index cases were HCWs (p<0.001). Symptoms were detected in 311 of the HCWs (37.8%) during the follow-up. The median time to perform SARS-CoV-2 RT-PCR was 5.3 days (IQR) after the last risky exposure. In multivariate analysis, SARS-CoV-2 RT-PCR positivity was 5.65 times higher in HCWs not directly involved in patient care than HCWs who are not involved in patient care (95% CI 2.437 to 13.111; p<0.001). CONCLUSIONS This study provides particularly useful information on post-exposure COVID-19 follow-up and management of working schedules and procedures of HCWs.
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Affiliation(s)
- Ayse Kaya Kalem
- Infectious Diseases and Clinical Microbiology Clinic, Ankara Yıldırım Beyazıt University, Ankara City Hospital, Ankara, Turkey
| | - Bircan Kayaaslan
- Infectious Diseases and Clinical Microbiology Clinic, Ankara Yıldırım Beyazıt University, Ankara City Hospital, Ankara, Turkey
| | - Fatma Eser
- Infectious Diseases and Clinical Microbiology Clinic, Ankara Yıldırım Beyazıt University, Ankara City Hospital, Ankara, Turkey
| | - İmran Hasanoglu
- Infectious Diseases and Clinical Microbiology Clinic, Ankara Yıldırım Beyazıt University, Ankara City Hospital, Ankara, Turkey
| | - Muge Ayhan
- Infectious Diseases and Clinical Microbiology Clinic, Ankara City Hospital, Ankara, Turkey
| | - Belgin Coskun
- Infectious Diseases and Clinical Microbiology Clinic, Ankara City Hospital, Ankara, Turkey
| | - Rahmet Guner
- Infectious Diseases and Clinical Microbiology Clinic, Ankara Yıldırım Beyazıt University, Ankara City Hospital, Ankara, Turkey
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18
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Bozdemir K, Çallıoğlu EE, İslamoğlu Y, Ercan MK, Eser F, Özdem B, Kıraç A, Bayazıt D, Güner R, Babademez MA. Evaluation of the effects of Covid-19 on cochleovestibular system with audiovestibular tests. Ear Nose Throat J 2022:1455613211069916. [PMID: 34991362 DOI: 10.1177/01455613211069916] [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: 11/16/2022] Open
Abstract
PURPOSE The purpose of the present study was to investigate the effects of COVID-19 on audiovestibular system with Transiently Evoked Distortion Otoacoustic Emissions (TOAE), Distortion Product Otoacoustic Emissions (DPOAE), video head impulse test (vHIT) and caloric test. METHODS Audiovestibular findings of 24 patients with moderate/severe COVID-19 and 24 healthy controls were compared using pure tone audiometry, tympanometry, TOAE, DPOAE, caloric test, and vHIT. RESULTS On audiometry, the pure tone averages of the COVID-19 patients were higher than the controls (P = .038). The TEOAE amplitudes at 4000 and 5000 Hz (P = .006 and P < .01), and DPOAE amplitudes at 3000, 6000, and 8000 Hz (P < .001, P = .003 and P < .001) were significantly lower in COVID-19 patients compared to the controls. On vestibular tests, there was no significant difference between the caloric test results of the patients and the controls (P > .05). On vHIT testing, amplitudes of right semicircular canal was found to be significantly lower in COVID-19 group compared to the control group (P = .008). CONCLUSION COVID-19 may affect inner ear functions causing a subtle damage in the outer hair cells and lateral semicircular canals. It must be kept in mind that COVID-19 may cause cochleovestibular problems.
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Affiliation(s)
- Kazım Bozdemir
- Department of Otolaryngology-Head and Neck Surgery, 442146Yıldırım Beyazıt University, Ankara, Turkey
| | - Elif Ersoy Çallıoğlu
- Department of Otolaryngology-Head and Neck Surgery, Ankara Bilkent City Hospital, Ankara, Turkey
| | - Yüce İslamoğlu
- Department of Otolaryngology-Head and Neck Surgery, Ankara Bilkent City Hospital, Ankara, Turkey
| | | | - Fatma Eser
- Department of İnfectious Diseases and Microbiology, Ankara Bilkent City Hospital, Ankara, Turkey
| | - Birsen Özdem
- Department of İnfectious Diseases and Microbiology, Ankara Bilkent City Hospital, Ankara, Turkey
| | - Arda Kıraç
- Department of Otolaryngology-Head and Neck Surgery, Ankara Bilkent City Hospital, Ankara, Turkey
| | - Dilara Bayazıt
- Deparment of Audiology, İstanbul Medipol University, İstanbul, Turkey
| | - Rahmet Güner
- Department of İnfectious Diseases and Microbiology, 442146Yıldırım Beyazıt University, Ankara, Turkey
| | - Mehmet Ali Babademez
- Department of Otolaryngology-Head and Neck Surgery, 442146Yıldırım Beyazıt University, Ankara, Turkey
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19
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Kayaaslan B, Oktay Z, Hasanoglu I, Kalem AK, Eser F, Ayhan M, Guner R. Increasing rates of extended-spectrum B-lactamase-producing Escherichia coli and Klebsiella pneumoniae in uncomplicated and complicated acute pyelonephritis and evaluation of empirical treatments based on culture results. Eur J Clin Microbiol Infect Dis 2022; 41:421-430. [PMID: 34977996 DOI: 10.1007/s10096-021-04392-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [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: 08/19/2021] [Accepted: 11/30/2021] [Indexed: 11/30/2022]
Abstract
Increasing rates of extended-spectrum beta-lactamase (ESBL) producing E. coli and K. pneumoniae over time made empirical treatment complicated. Knowing local antimicrobial resistance patterns of common pathogens can make it easier to decide on empirical antibiotics. We aimed to investigate the prevalence and risk factors of ESBL positivity of E. coli and K. pneumoniae strains in uncomplicated and complicated pyelonephritis acquired in community and healthcare associations and to evaluate the appropriateness of empirical treatment. Adult patients hospitalized with diagnosis of community-acquired or healthcare-associated uncomplicated/complicated pyelonephritis initiated empirical antimicrobial therapy were included in the study. Appropriateness of empirical treatment at 48-72 h based on culture results and treatment modifications were evaluated. A total of 369 uncomplicated (94) and complicated (275) episodes of pyelonephritis were evaluated. The most common agents were E. coli (71.0%) and K. pneumoniae (17.7%), and the ESBL-production rate was 64.4%, and higher in healthcare-associated pyelonephritis (P 0.013). Being of healthcare-associated infection, previous antibiotic use, and presence of urinary catheters were independent risk factors for ESBL-producing E. coli and K. pneumoniae (P 0.009, < 0.001, and 0.024, respectively). The treatment inappropriateness was mostly associated with use of ceftriaxone (56.3%) (P < 0.001). Treatment has escalated in 41.5% of ceftriaxone-initiated patients, in only 8.8% and 9.5% ertapenem and piperacillin-tazobactam-initiated patients, respectively. ESBL-production rates are quite high even in community-acquired infections. The use of broad-spectrum antibiotics covering ESBL-producing pathogens to increase the appropriateness of empirical treatment and then narrowing treatment based on culture results appears a better and life-saving choice.
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Affiliation(s)
- Bircan Kayaaslan
- Department of Infectious Disease and Clinical Microbiology, Ankara Yildirim Beyazit University, Ankara City Hospital, Bilkent Street no:1, Ankara, 06800, Turkey.
| | - Zeynep Oktay
- Department of Infectious Disease and Clinical Microbiology, Ankara City Hospital, Ankara, Turkey
| | - Imran Hasanoglu
- Department of Infectious Disease and Clinical Microbiology, Ankara Yildirim Beyazit University, Ankara City Hospital, Bilkent Street no:1, Ankara, 06800, Turkey
| | - Ayse Kaya Kalem
- Department of Infectious Disease and Clinical Microbiology, Ankara Yildirim Beyazit University, Ankara City Hospital, Bilkent Street no:1, Ankara, 06800, Turkey
| | - Fatma Eser
- Department of Infectious Disease and Clinical Microbiology, Ankara Yildirim Beyazit University, Ankara City Hospital, Bilkent Street no:1, Ankara, 06800, Turkey
| | - Muge Ayhan
- Department of Infectious Disease and Clinical Microbiology, Ankara City Hospital, Ankara, Turkey
| | - Rahmet Guner
- Department of Infectious Disease and Clinical Microbiology, Ankara Yildirim Beyazit University, Ankara City Hospital, Bilkent Street no:1, Ankara, 06800, Turkey
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Guner R, Hasanoglu I, Kayaaslan B, Aypak A, Akinci E, Bodur H, Eser F, Kaya Kalem A, Kucuksahin O, Ates I, Bastug A, Tezer Tekce Y, Bilgic Z, Gursoy FM, Akca HN, Izdes S, Erdem D, Asfuroglu E, Hezer H, Kilic H, Civak M, Aydogan S, Buzgan T. Response to the letter to the editor. J Infect Public Health 2022; 15:65-67. [PMID: 34915424 PMCID: PMC8664607 DOI: 10.1016/j.jiph.2021.12.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2021] [Indexed: 11/19/2022] Open
Affiliation(s)
- Rahmet Guner
- Department of Infectious Disease and Clinical Microbiology, Ankara Yildirim Beyazit University, Ankara City Hospital, Ankara, Turkey.
| | - Imran Hasanoglu
- Department of Infectious Disease and Clinical Microbiology, Ankara Yildirim Beyazit University, Ankara City Hospital, Ankara, Turkey.
| | - Bircan Kayaaslan
- Department of Infectious Disease and Clinical Microbiology, Ankara Yildirim Beyazit University, Ankara City Hospital, Ankara, Turkey.
| | - Adalet Aypak
- Department of Infectious Disease and Clinical Microbiology, Ankara City Hospital, Ankara, Turkey.
| | - Esragul Akinci
- Department of Infectious Disease and Clinical Microbiology, University of Health Sciences, Ankara City Hospital, Ankara, Turkey.
| | - Hurrem Bodur
- Department of Infectious Disease and Clinical Microbiology, University of Health Sciences, Ankara City Hospital, Ankara, Turkey.
| | - Fatma Eser
- Department of Infectious Disease and Clinical Microbiology, Ankara Yildirim Beyazit University, Ankara City Hospital, Ankara, Turkey.
| | - Ayse Kaya Kalem
- Department of Infectious Disease and Clinical Microbiology, Ankara Yildirim Beyazit University, Ankara City Hospital, Ankara, Turkey.
| | - Orhan Kucuksahin
- Department of Rheumatology, Ankara Yildirim Beyazit University, Ankara City Hospital, Ankara, Turkey.
| | - Ihsan Ates
- Department of Internal Medicine, Ankara City Hospital, Ankara, Turkey.
| | - Aliye Bastug
- Department of Infectious Disease and Clinical Microbiology, University of Health Sciences, Ankara City Hospital, Ankara, Turkey.
| | - Yasemin Tezer Tekce
- Department of Infectious Disease and Clinical Microbiology, University of Health Sciences, Ankara City Hospital, Ankara, Turkey.
| | - Zeynep Bilgic
- Department of Infectious Disease and Clinical Microbiology, University of Health Sciences, Ankara City Hospital, Ankara, Turkey.
| | - Fahriye Melis Gursoy
- Department of Infectious Disease and Clinical Microbiology, University of Health Sciences, Ankara City Hospital, Ankara, Turkey.
| | - Hatice Nisa Akca
- Department of Infectious Disease and Clinical Microbiology, University of Health Sciences, Ankara City Hospital, Ankara, Turkey.
| | - Seval Izdes
- Department of Anaesthesiology and Reanimation Ankara, Yildirim Beyazit University, Ankara City Hospital, Ankara, Turkey.
| | - Deniz Erdem
- Department of Anaesthesiology and Reanimation Ankara, Ankara City Hospital, Ankara, Turkey.
| | - Emra Asfuroglu
- Department of Internal Medicine, Ankara City Hospital, Ankara, Turkey.
| | - Habibe Hezer
- Department of Pulmonary Diseases, Ankara City Hospital, Ankara, Turkey.
| | - Hatice Kilic
- Department of Pulmonary Diseases, Ankara Yildirim Beyazit University, Ankara City Hospital, Ankara, Turkey.
| | - Musa Civak
- Department of Internal Medicine Ankara City Hospital, Ankara, Turkey.
| | - Sibel Aydogan
- Department of Virology, Ankara City Hospital, Ankara, Turkey.
| | - Turan Buzgan
- Department of Infectious Disease and Clinical Microbiology, Ankara Yildirim Beyazit University, Ankara City Hospital, Ankara, Turkey.
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21
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Kayaaslan BU, Asilturk D, Eser F, Korkmaz M, Kucuksahin O, Pamukcuoglu M, Guner R. A case of Hemophagocytic lymphohistiocytosis induced by COVID-19, and review of all cases reported in the literature. J Infect Dev Ctries 2021; 15:1607-1614. [PMID: 34898486 DOI: 10.3855/jidc.14829] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [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: 02/02/2021] [Accepted: 04/03/2021] [Indexed: 10/31/2022] Open
Abstract
Novel coronavirus infections 2019 (COVID-19) associated hyperinflammatory syndromes are well-defined clinical conditions and have a potential risk for severe infection. Hemophagocytic lymphohistiocytosis (HLH), a rare type of acute progressive hyperinflammatory syndrome, has been reported in a limited number of COVID-19 cases. In this article, we aimed to present a patient with HLH secondary to COVID-19 diagnosed by bone marrow biopsy, and to summarize and review HLH cases associated with COVID-19 in the literature. A 47-year-old male patient presented with complaints of fever, cough, abdominal discomfort, and nausea-vomiting. He had recovered from COVID-19 a month ago and was readmitted to the hospital due to the re-appearance of clinical symptoms after a two-week interval. The patient was diagnosed with HLH secondary to COVID-19 on sixth day of admission and fully recovered with systemic pulse steroid, intravenous immunoglobulin, and plasma exchange therapy. Analysis of literature searches revealed that 22 cases were definitely diagnosed with COVID-19-associated HLH, 16 of them were male. They had been treated with different anti-cytokine drugs, of which nine had died. The increasing number of HLH cases, which have high mortality rates, shows the importance of hyperinflammatory syndromes in COVID-19 patients. Some patients may experience hemophagocytosis in the late period of COVID-19, even while in recovery. Increased awareness and early treatment for HLH triggered by COVID-19 can be a life-saving effort for reducing mortality in severe COVID-19 cases.
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Affiliation(s)
- Bırcan Unal Kayaaslan
- Department of Infectious Disease and Clinical Microbiology, Ankara Yildirim Beyazit University, Ankara, Turkey.
| | - Dilek Asilturk
- Department of Infectious Disease and Clinical Microbiology Ankara City Hospital, Ankara, Turkey
| | - Fatma Eser
- Department of Infectious Disease and Clinical Microbiology, Ankara Yildirim Beyazit University, Ankara, Turkey
| | - Meryem Korkmaz
- Department of Infectious Disease and Clinical Microbiology Ankara City Hospital, Ankara, Turkey
| | - Orhan Kucuksahin
- Department of Internal Medicine, Division of Rheumatology, Ankara City Hospital, Ankara, Turkey
| | - Merve Pamukcuoglu
- Hematology and Bone Marrow Transplantation Department, Ankara City Hospital, Ankara, Turkey
| | - Rahmet Guner
- Department of Infectious Disease and Clinical Microbiology, Ankara Yildirim Beyazit University, Ankara, Turkey
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22
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Dagcioglu BF, Keskin A, Guner R, Kaya Kalem A, Eser F, Erel O, Neselioglu S, Bayrakdar F, Ozkara A. Thiol levels in mild or moderate COVID-19 patients: A comparison of variant and classic COVID-19 cases. Int J Clin Pract 2021; 75:e14753. [PMID: 34431185 PMCID: PMC8646474 DOI: 10.1111/ijcp.14753] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/24/2021] [Revised: 08/17/2021] [Accepted: 08/22/2021] [Indexed: 01/06/2023] Open
Abstract
BACKGROUND Various variants of the COVID-19 have started to attract attention recently. The clinical course of these variants and possible predictive parameters are being investigated. This study aimed to examine the relationship between thiol levels, which are indicators of oxidative stress, and variant COVID-19 types. METHODS In this cross-sectional study, patients with a diagnosis of classic COVID-19 and patients with a diagnosis of variant COVID-19 with mild and moderate symptoms followed in the clinical observatory of Ankara city hospital were included in the study group. The patients were divided into two groups according to the COVID-19 type as a variant and classic COVID-19, and a healthy control group was added for comparison. A complete blood count and thiol analysis were performed from the venous blood samples. Obtained results were compared between groups, and the ROC analysis was performed. RESULTS Thiol levels were significantly lower in patients with a diagnosis of COVID-19 compared with the control group. In terms of WBC, lymphocyte, neutrophil, NLR, ferritin and thiol parameters, patients with variant COVID-19 differed significantly from patients with a classic COVID-19 diagnosis. Thiol levels' cut-off values to distinguish between variant COVID-19 patients and control group from classical COVID-19 patients were almost identical (423 and 422 µmol/L, respectively). CONCLUSIONS It seems possible to use thiol as a sensitive, specific and cost-effective marker to suspect variant COVID-19 cases. Since this study is probably the first example in this subject, it would form a basis for further studies.
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Affiliation(s)
- Basri Furkan Dagcioglu
- Department of Family MedicineFaculty of MedicineAnkara Yildirim Beyazit UniversityAnkaraTurkey
| | - Ahmet Keskin
- Department of Family MedicineFaculty of MedicineAnkara Yildirim Beyazit UniversityAnkaraTurkey
| | - Rahmet Guner
- Department of Infectious Diseases and Clinical MicrobiologyFaculty of MedicineAnkara Yildirim Beyazit UniversityAnkaraTurkey
| | - Ayse Kaya Kalem
- Department of Infectious Diseases and Clinical MicrobiologyFaculty of MedicineAnkara Yildirim Beyazit UniversityAnkaraTurkey
| | - Fatma Eser
- Department of Infectious Diseases and Clinical MicrobiologyFaculty of MedicineAnkara Yildirim Beyazit UniversityAnkaraTurkey
| | - Ozcan Erel
- Department of BiochemistryFaculty of MedicineAnkara Yildirim Beyazit UniversityAnkaraTurkey
- Biochemistry LaboratoryAnkara City HospitalAnkaraTurkey
| | - Salim Neselioglu
- Department of BiochemistryFaculty of MedicineAnkara Yildirim Beyazit UniversityAnkaraTurkey
- Biochemistry LaboratoryAnkara City HospitalAnkaraTurkey
| | - Fatma Bayrakdar
- Virology Reference and Research LaboratoryGeneral Directorate of Public Health of TurkeyRefik Saydam CampusAnkaraTurkey
| | - Adem Ozkara
- Department of Family MedicineAnkara City HospitalAnkaraTurkey
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23
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Guner R, Kayaaslan B, Hasanoglu I, Aypak A, Bodur H, Ates I, Akinci E, Erdem D, Eser F, Izdes S, Kalem AK, Bastug A, Karalezli A, Surel AA, Ayhan M, Karaahmetoglu S, Turan IO, Arguder E, Ozdemir B, Mutlu MN, Bilir YA, Sarıcaoglu EM, Gokcinar D, Gunay S, Dinc B, Gemcioglu E, Bilmez R, Aydos O, Asilturk D, Inan O, Buzgan T. Development and validation of nomogram to predict severe illness requiring intensive care follow up in hospitalized COVID-19 cases. BMC Infect Dis 2021; 21:1004. [PMID: 34563117 PMCID: PMC8467006 DOI: 10.1186/s12879-021-06656-w] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2020] [Accepted: 09/03/2021] [Indexed: 02/07/2023] Open
Abstract
BACKGROUND Early identification of severe COVID-19 patients who will need intensive care unit (ICU) follow-up and providing rapid, aggressive supportive care may reduce mortality and provide optimal use of medical resources. We aimed to develop and validate a nomogram to predict severe COVID-19 cases that would need ICU follow-up based on available and accessible patient values. METHODS Patients hospitalized with laboratory-confirmed COVID-19 between March 15, 2020, and June 15, 2020, were enrolled in this retrospective study with 35 variables obtained upon admission considered. Univariate and multivariable logistic regression models were constructed to select potential predictive parameters using 1000 bootstrap samples. Afterward, a nomogram was developed with 5 variables selected from multivariable analysis. The nomogram model was evaluated by Area Under the Curve (AUC) and bias-corrected Harrell's C-index with 95% confidence interval, Hosmer-Lemeshow Goodness-of-fit test, and calibration curve analysis. RESULTS Out of a total of 1022 patients, 686 cases without missing data were used to construct the nomogram. Of the 686, 104 needed ICU follow-up. The final model includes oxygen saturation, CRP, PCT, LDH, troponin as independent factors for the prediction of need for ICU admission. The model has good predictive power with an AUC of 0.93 (0.902-0.950) and a bias-corrected Harrell's C-index of 0.91 (0.899-0.947). Hosmer-Lemeshow test p-value was 0.826 and the model is well-calibrated (p = 0.1703). CONCLUSION We developed a simple, accessible, easy-to-use nomogram with good distinctive power for severe illness requiring ICU follow-up. Clinicians can easily predict the course of COVID-19 and decide the procedure and facility of further follow-up by using clinical and laboratory values of patients available upon admission.
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Affiliation(s)
- Rahmet Guner
- Department of Infectious Disease and Clinical Microbiology, Ankara Yildirim Beyazit University, Ankara City Hospital, Bilkent Street no:1, Ankara, 06800, Turkey
| | - Bircan Kayaaslan
- Department of Infectious Disease and Clinical Microbiology, Ankara Yildirim Beyazit University, Ankara City Hospital, Bilkent Street no:1, Ankara, 06800, Turkey.
| | - Imran Hasanoglu
- Department of Infectious Disease and Clinical Microbiology, Ankara Yildirim Beyazit University, Ankara City Hospital, Bilkent Street no:1, Ankara, 06800, Turkey
| | - Adalet Aypak
- Department of Infectious Disease and Clinical Microbiology, Ankara City Hospital, Ankara, Turkey
| | - Hurrem Bodur
- Department of Infectious Disease and Clinical Microbiology, University of Health Sciences, Ankara City Hospital, Ankara, Turkey
| | - Ihsan Ates
- Department of Internal Medicine, Ankara City Hospital, Ankara, Turkey
| | - Esragul Akinci
- Department of Infectious Disease and Clinical Microbiology, University of Health Sciences, Ankara City Hospital, Ankara, Turkey
| | - Deniz Erdem
- Department of Anesthesiology and Reanimation, Ankara City Hospital, Ankara, Turkey
| | - Fatma Eser
- Department of Infectious Disease and Clinical Microbiology, Ankara Yildirim Beyazit University, Ankara City Hospital, Bilkent Street no:1, Ankara, 06800, Turkey
| | - Seval Izdes
- Department of Anesthesiology and Reanimation and Intensive Care Unıt, Ankara Yildirim Beyazit University, Ankara City Hospital, Ankara, Turkey
| | - Ayse Kaya Kalem
- Department of Infectious Disease and Clinical Microbiology, Ankara Yildirim Beyazit University, Ankara City Hospital, Bilkent Street no:1, Ankara, 06800, Turkey
| | - Aliye Bastug
- Department of Infectious Disease and Clinical Microbiology, University of Health Sciences, Ankara City Hospital, Ankara, Turkey
| | - Aysegul Karalezli
- Department of Pulmonary Diseases, Ankara Yildirim Beyazit University, Ankara City Hospital, Ankara, Turkey
| | - Aziz Ahmet Surel
- Department of General Surgery, Ankara City Hospital, Ankara, Turkey
| | - Muge Ayhan
- Department of Infectious Disease and Clinical Microbiology, Ankara City Hospital, Ankara, Turkey
| | | | - Isıl Ozkocak Turan
- Department of Anesthesiology and Reanimation, University of Health Sciences, Ankara City Hospital, Ankara, Turkey
| | - Emine Arguder
- Department of Anesthesiology and Reanimation and Intensive Care Unıt, Ankara Yildirim Beyazit University, Ankara City Hospital, Ankara, Turkey
| | - Burcu Ozdemir
- Department of Infectious Disease and Clinical Microbiology, Ankara City Hospital, Ankara, Turkey
| | - Mehmet Nevzat Mutlu
- Department of Anesthesiology and Reanimation, Ankara City Hospital, Ankara, Turkey
| | - Yesim Aybar Bilir
- Department of Infectious Disease and Clinical Microbiology, Ankara City Hospital, Ankara, Turkey
| | - Elif Mukime Sarıcaoglu
- Department of Infectious Disease and Clinical Microbiology, Ankara City Hospital, Ankara, Turkey
| | - Derya Gokcinar
- Department of Anesthesiology and Reanimation, University of Health Sciences, Ankara City Hospital, Ankara, Turkey
| | - Sibel Gunay
- Department of Pulmonary Diseases, Ankara City Hospital, Ankara, Turkey
| | - Bedia Dinc
- Department of Microbiology, Ankara City Hospital, Ankara, Turkey
| | - Emin Gemcioglu
- Department of Internal Medicine, Ankara City Hospital, Ankara, Turkey
| | - Ruveyda Bilmez
- Department of Infectious Disease and Clinical Microbiology, Ankara City Hospital, Ankara, Turkey
| | - Omer Aydos
- Department of Infectious Disease and Clinical Microbiology, Ankara City Hospital, Ankara, Turkey
| | - Dilek Asilturk
- Department of Infectious Disease and Clinical Microbiology, Ankara City Hospital, Ankara, Turkey
| | - Osman Inan
- Department of Internal Medicine, Ankara City Hospital, Ankara, Turkey
| | - Turan Buzgan
- Department of Infectious Disease and Clinical Microbiology, Ankara Yildirim Beyazit University, Ankara City Hospital, Bilkent Street no:1, Ankara, 06800, Turkey
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24
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Kaya Kalem A, Güner R, Eser F, Hasanoğlu İ, Yılmaz GR, Taşyaran MA. The Knowledge Level and Behavior of Patients with HBV Regarding HBV Infection and Prevention. Egypt J Immunol 2021. [DOI: 10.4274/vhd.galenos.2021.2020-12-3] [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: 12/01/2022]
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25
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Kaya Kalem A, Güner R, Eser F, Hasanoğlu İ, Yılmaz GR, Akın Taşyaran M. Evaluation of Knowledge Levels, Attitudes and Behaviors Among the Relatives of Patients Infected with Hepatitis B. Egypt J Immunol 2021. [DOI: 10.4274/vhd.galenos.2021.2020-12-4] [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: 12/01/2022]
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Kayaaslan B, Eser F, Kalem AK, Kaya G, Kaplan B, Kacar D, Hasanoglu I, Coskun B, Guner R. Post-COVID syndrome: A single-center questionnaire study on 1007 participants recovered from COVID-19. J Med Virol 2021; 93:6566-6574. [PMID: 34255355 PMCID: PMC8426910 DOI: 10.1002/jmv.27198] [Citation(s) in RCA: 59] [Impact Index Per Article: 19.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2021] [Accepted: 07/09/2021] [Indexed: 12/18/2022]
Abstract
Post recovery manifestations have become another concern in patients who have recovered from coronavirus disease 2019 (COVID-19). Numerous reports have shown that COVID-19 has a variety of long-term effects on almost all systems including respiratory, cardiovascular, gastrointestinal, neurological, psychiatric, and dermatological systems. We aimed to investigate the prevalence and characteristics of the post-COVID syndrome among COVID-19 survivors and to determine the factors associated with persistent symptoms. This prospective study enrolled in patients with COVID-19 followed in hospital or outpatient clinics in Ankara City Hospital. We performed a special questionnaire to inquire about the presence of persistent symptoms beyond 12 weeks from the first diagnosis. Demographic data, comorbid diseases, characteristics of acute COVID-19, presence of persistent symptoms by systems, and knowledge about outpatient clinic visits after recovery were assessed. Of a total of 1007 participants, 39.0% had at least one comorbidity, and 47.5% had persistent symptoms. Fatigue/easy fatigability, myalgia, and loss of weight were the most frequent persistent symptoms (overall 29.3%) followed by respiratory symptoms (25.4%). A total of 235 participants had visited outpatient clinics due to several reasons during the post-COVID-19 period, and 17 of them were hospitalized. Severe acute COVID-19, hospitalization, and presence of comorbidity were independent factors for the development of persistent symptoms. Fully understanding the spectrum of the post-COVID syndrome is essential for appropriate management of all its long-term effects. Our study once again underlined the fact that the prevalence of post-COVID syndrome is higher than expected and concerns many systems, and a multidisciplinary follow-up should be provided to COVID-19 survivors in the post recovery period.
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Affiliation(s)
- Bircan Kayaaslan
- Department of Infectious Disease and Clinical Microbiology, Ankara City Hospital, Ankara Yildirim Beyazit University, Ankara, Turkey
| | - Fatma Eser
- Department of Infectious Disease and Clinical Microbiology, Ankara City Hospital, Ankara Yildirim Beyazit University, Ankara, Turkey
| | - Ayse K Kalem
- Department of Infectious Disease and Clinical Microbiology, Ankara City Hospital, Ankara Yildirim Beyazit University, Ankara, Turkey
| | - Gamze Kaya
- Department of Infectious Disease and Clinical Microbiology, Ankara City Hospital, Ankara, Turkey
| | - Betul Kaplan
- Department of Infectious Disease and Clinical Microbiology, Ankara City Hospital, Ankara, Turkey
| | - Duygu Kacar
- Department of Infectious Disease and Clinical Microbiology, Ankara City Hospital, Ankara, Turkey
| | - Imran Hasanoglu
- Department of Infectious Disease and Clinical Microbiology, Ankara City Hospital, Ankara Yildirim Beyazit University, Ankara, Turkey
| | - Belgin Coskun
- Department of Infectious Disease and Clinical Microbiology, Ankara City Hospital, Ankara, Turkey
| | - Rahmet Guner
- Department of Infectious Disease and Clinical Microbiology, Ankara City Hospital, Ankara Yildirim Beyazit University, Ankara, Turkey
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Kayaaslan B, Eser F, Kaya Kalem A, Bilgic Z, Asilturk D, Hasanoglu I, Ayhan M, Tezer Tekce Y, Erdem D, Turan S, Mumcuoglu I, Guner R. Characteristics of candidemia in COVID-19 patients; increased incidence, earlier occurrence and higher mortality rates compared to non-COVID-19 patients. Mycoses 2021; 64:1083-1091. [PMID: 34085319 PMCID: PMC8242769 DOI: 10.1111/myc.13332] [Citation(s) in RCA: 60] [Impact Index Per Article: 20.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2021] [Revised: 05/28/2021] [Accepted: 05/31/2021] [Indexed: 12/16/2022]
Abstract
Severe COVID‐19 patients in ICU are at high risk for candidemia due to exposure to multiple risk factors for candidemia. We aimed to compare the incidence of candidemia in ICU patients with and without COVID‐19, and to investigate epidemiologic and clinical characteristics of candidemia patients and risk factors for mortality in candidemia patients. This retrospective study was conducted in patients followed in the ICUs of Ankara City Hospital for 2 years, divided into pre‐pandemic and pandemic periods. The incidence (event per 1000 patient‐days) and epidemiology of candidemia, clinical and laboratory characteristics of patients were compared in COVID‐19 and non‐COVID‐19 groups. Candidemia incidence was higher in the COVID‐19 group (2.16, 95% CI 1.77–2.60) than the non‐COVID‐19 group (1.06, 95% CI 0.89–0.125) (p < .001). A total of 236 candidemia episodes (105 in COVID‐19 patients and 131 in non‐COVID‐19 patients) were detected during the study periods. COVID‐19 cases had a higher rate of corticosteroid use (63.8% vs. 9.9%, p < .001). Epidemiology of candidemia and antifungal susceptibility were similar. Candidemia developed 2 weeks earlier in COVID‐19 groups and resulted in higher mortality (92.5% vs. 79.4%, p .005). One‐third of candidemia patients died before receiving any antifungal treatment, and this rate was higher in the COVID‐19 group. In multivariate logistic regression analysis, corticosteroid use, presence of sepsis and age older than 65 years were independent risk factors for mortality in candidemia patients. Candidemia with high mortality is a more serious problem for COVID‐19 patients due to its increased incidence, earlier occurrence and a higher rate of mortality.
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Affiliation(s)
- Bircan Kayaaslan
- Department of Infectious Disease and Clinical Microbiology, Ankara Yildirim Beyazit University, Ankara City Hospital, Ankara, Turkey
| | - Fatma Eser
- Department of Infectious Disease and Clinical Microbiology, Ankara Yildirim Beyazit University, Ankara City Hospital, Ankara, Turkey
| | - Ayşe Kaya Kalem
- Department of Infectious Disease and Clinical Microbiology, Ankara Yildirim Beyazit University, Ankara City Hospital, Ankara, Turkey
| | - Zeynep Bilgic
- Department of Infectious Disease and Clinical Microbiology, Ankara City Hospital, Ankara, Turkey
| | - Dilek Asilturk
- Department of Infectious Disease and Clinical Microbiology, Ankara City Hospital, Ankara, Turkey
| | - Imran Hasanoglu
- Department of Infectious Disease and Clinical Microbiology, Ankara Yildirim Beyazit University, Ankara City Hospital, Ankara, Turkey
| | - Muge Ayhan
- Department of Infectious Disease and Clinical Microbiology, Ankara City Hospital, Ankara, Turkey
| | - Yasemin Tezer Tekce
- Department of Infectious Disease and Clinical Microbiology, Ankara City Hospital, Ankara, Turkey
| | - Deniz Erdem
- Department of Intensive Care Unit, Ankara City Hospital, Ankara, Turkey
| | - Sema Turan
- Department of Intensive Care Unit, Ankara City Hospital, Ankara, Turkey
| | - Ipek Mumcuoglu
- Department of Medical Microbiology, Ankara City Hospital, Ankara, Turkey
| | - Rahmet Guner
- Department of Infectious Disease and Clinical Microbiology, Ankara Yildirim Beyazit University, Ankara City Hospital, Ankara, Turkey
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Okumuş N, Demirtürk N, Çetinkaya RA, Güner R, Avcı İY, Orhan S, Konya P, Şaylan B, Karalezli A, Yamanel L, Kayaaslan B, Yılmaz G, Savaşçı Ü, Eser F, Taşkın G. Evaluation of the effectiveness and safety of adding ivermectin to treatment in severe COVID-19 patients. BMC Infect Dis 2021; 21:411. [PMID: 33947344 DOI: 10.21203/rs.3.rs-224203/v1] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [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: 02/08/2021] [Accepted: 04/15/2021] [Indexed: 05/24/2023] Open
Abstract
BACKGROUND AND OBJECTIVES An effective treatment option is not yet available for SARS-CoV2, which causes the COVID-19 pandemic and whose effects are felt more and more every day. Ivermectin is among the drugs whose effectiveness in treatment has been investigated. In this study; it was aimed to investigate the presence of gene mutations that alter ivermectin metabolism and cause toxic effects in patients with severe COVID-19 pneumonia, and to evaluate the effectiveness and safety of ivermectin use in the treatment of patients without mutation. MATERIALS AND METHODS Patients with severe COVID19 pneumonia were included in the study, which was planned as a prospective, randomized, controlled, single-blind phase 3 study. Two groups, the study group and the control group, took part in the study. Ivermectin 200 mcg/kg/day for 5 days in the form of a solution prepared for enteral use added to the reference treatment protocol -hydroxychloroquine + favipiravir + azithromycin- of patients included in the study group. Patients in the control group were given only reference treatment with 3 other drugs without ivermectin. The presence of mutations was investigated by performing sequence analysis in the mdr1/abcab1 gene with the Sanger method in patients included in the study group according to randomization. Patients with mutations were excluded from the study and ivermectin treatment was not continued. Patients were followed for 5 days after treatment. At the end of the treatment and follow-up period, clinical response and changes in laboratory parameters were evaluated. RESULTS A total of 66 patients, 36 in the study group and 30 in the control group were included in the study. Mutations affecting ivermectin metabolism was detected in genetic tests of six (16.7%) patients in the study group and they were excluded from the study. At the end of the 5-day follow-up period, the rate of clinical improvement was 73.3% (22/30) in the study group and was 53.3% (16/30) in the control group (p = 0.10). At the end of the study, mortality developed in 6 patients (20%) in the study group and in 9 (30%) patients in the control group (p = 0.37). At the end of the follow-up period, the average peripheral capillary oxygen saturation (SpO2) values of the study and control groups were found to be 93.5 and 93.0%, respectively. Partial pressure of oxygen (PaO2)/FiO2 ratios were determined as 236.3 ± 85.7 and 220.8 ± 127.3 in the study and control groups, respectively. While the blood lymphocyte count was higher in the study group compared to the control group (1698 ± 1438 and 1256 ± 710, respectively) at the end of the follow-up period (p = 0.24); reduction in serum C-reactive protein (CRP), ferritin and D-dimer levels was more pronounced in the study group (p = 0.02, p = 0.005 and p = 0.03, respectively). CONCLUSIONS According to the findings obtained, ivermectin can provide an increase in clinical recovery, improvement in prognostic laboratory parameters and a decrease in mortality rates even when used in patients with severe COVID-19. Consequently, ivermectin should be considered as an alternative drug that can be used in the treatment of COVID-19 disease or as an additional option to existing protocols.
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Affiliation(s)
- Nurullah Okumuş
- Afyonkarahisar Health Sciences University, Afyonkarahisar, Turkey.
| | - Neşe Demirtürk
- Afyonkarahisar Health Sciences University, Afyonkarahisar, Turkey
| | - Rıza Aytaç Çetinkaya
- Haydarpasa Sultan Abdulhamid Han Training and Research Hospital, Istanbul, Turkey
| | - Rahmet Güner
- Ankara Yıldırım Beyazıt University, Ankara City Hospital, Ankara, Turkey
| | - İsmail Yaşar Avcı
- Gulhane Faculty of Medicine, University of Health Sciences, Ankara, Turkey
| | - Semiha Orhan
- Afyonkarahisar Health Sciences University, Afyonkarahisar, Turkey
| | - Petek Konya
- Afyonkarahisar Health Sciences University, Afyonkarahisar, Turkey
| | - Bengü Şaylan
- Haydarpasa Sultan Abdulhamid Han Training and Research Hospital, Istanbul, Turkey
| | - Ayşegül Karalezli
- Ankara Yıldırım Beyazıt University, Ankara City Hospital, Ankara, Turkey
| | - Levent Yamanel
- Gulhane Faculty of Medicine, University of Health Sciences, Ankara, Turkey
| | - Bircan Kayaaslan
- Ankara Yıldırım Beyazıt University, Ankara City Hospital, Ankara, Turkey
| | - Gülden Yılmaz
- Gulhane Faculty of Medicine, University of Health Sciences, Ankara, Turkey
| | - Ümit Savaşçı
- Gulhane Faculty of Medicine, University of Health Sciences, Ankara, Turkey
| | - Fatma Eser
- Ankara Yıldırım Beyazıt University, Ankara City Hospital, Ankara, Turkey
| | - Gürhan Taşkın
- Gulhane Faculty of Medicine, University of Health Sciences, Ankara, Turkey
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Eser F, Kayaaslan B, Güner R, Hasanoğlu I, Kaya Kalem A, Aypak A, Akinci E. The Effect of prolonged PCR Positivity on patient Outcomes and Determination of Isolation period in COVID-19 patients. Int J Clin Pract 2021; 75:e14025. [PMID: 33449410 PMCID: PMC7995230 DOI: 10.1111/ijcp.14025] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/13/2020] [Revised: 10/22/2020] [Accepted: 12/14/2020] [Indexed: 01/12/2023] Open
Abstract
AIMS The impact of ongoing PCR positivity on COVID-19 patients and the strategy and period of isolation were not fully understood. We aimed to investigate the factors that cause prolonged PCR positivity and its clinical impact on COVID-19 infection. In addition, we searched for an answer on what length of time would be best for isolation. METHODS Patients with confirmed COVID-19 infection were included in this retrospective study. Patients with PCR positivity (after symptom onset) longer than 14 days and PCR positivity less than 14 days were compared. The relationship between duration of symptoms and PCR negation time was examined. RESULTS A total of 339 patients were included in this study. Fifty (14%) patients had prolonged PCR positivity after 14 days. Demographic and clinical features, and clinical outcomes (disease severity and mortality) were similar among the two groups. Age (p 0.035) and symptom duration at admission (P < .001) were found as independent factors for prolonged PCR positivity. Median of total symptom duration was 7 days (IQR: 5-11). The duration of negative conversion of PCR test was median 9 days (IQR: 7-12) after symptom onset and PCR tests became negative 3 days (IQR: 2-5) after symptom improvement. CONCLUSIONS We found that ongoing PCR positivity has no detrimental effect on the course of the disease and clinical outcomes in COVID-19 patients. In addition, our results showed that isolation may be discontinued 10-14 days after symptom onset and/or after 2-5 days after resolution of symptoms. This results also support WHO and ECDC recommendations on this matter.
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Affiliation(s)
- Fatma Eser
- Ankara City Hospital, Faculty of Medicine, Infectious Disease and Clinical MicrobiologyAnkara Yildirim Beyazit UniversityAnkaraTurkey
| | - Bircan Kayaaslan
- Ankara City Hospital, Faculty of Medicine, Infectious Disease and Clinical MicrobiologyAnkara Yildirim Beyazit UniversityAnkaraTurkey
| | - Rahmet Güner
- Ankara City Hospital, Faculty of Medicine, Infectious Disease and Clinical MicrobiologyAnkara Yildirim Beyazit UniversityAnkaraTurkey
| | - Imran Hasanoğlu
- Ankara City Hospital, Faculty of Medicine, Infectious Disease and Clinical MicrobiologyAnkara Yildirim Beyazit UniversityAnkaraTurkey
| | - Ayse Kaya Kalem
- Ankara City Hospital, Faculty of Medicine, Infectious Disease and Clinical MicrobiologyAnkara Yildirim Beyazit UniversityAnkaraTurkey
| | - Adalet Aypak
- Ankara City Hospital, Infectious Disease and Clinical MicrobiologyUniversity of Health SciencesAnkaraTurkey
| | - Esragul Akinci
- Ankara City Hospital, Infectious Disease and Clinical MicrobiologyUniversity of Health SciencesAnkaraTurkey
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Cosgun Y, Altas AB, Kuzucu EA, Guner R, Erdinc S, Eser F, Kilic EK, Korukluoglu G. Role of rapid antibody and ELISA tests in the evaluation of serological response in patients with SARS-CoV-2 PCR positivity. Folia Microbiol (Praha) 2021; 66:579-586. [PMID: 33825112 PMCID: PMC8024037 DOI: 10.1007/s12223-021-00861-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [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] [Received: 09/08/2020] [Accepted: 03/08/2021] [Indexed: 01/13/2023]
Abstract
From 7 to 8 days after the onset of symptoms in COVID-19 infection, the sensitivity of serological tests was found to be higher than that of nucleic acid tests. The aims of this study were to investigate antibody levels in patients with SARS-CoV-2 infection, to examine the relationship between antibody levels and virus load, and to evaluate the performance of 2 different commercial kits. A total of 103 patients with confirmed SARS-CoV-2 infection were included in the study. Antibodies against SARS-CoV-2 in serum samples taken from patients were investigated simultaneously with anti-SARS-CoV-2 IgG and IgA ELISAs (Euroimmun) and COVID-19 (SARS-CoV-2) IgG/IgM (Deep Blue) kits. No positivity was detected with any of the test kits in 18 (17.4%) of the 103 samples. In symptomatic patients, 100% of IgM and IgA tests were found to be positive in the group sampled after 10 days, while 100% of IgG tests were found positive after 20 days. The sensitivity of the Deep Blue COVID-19 IgG antibody kit was calculated as 81.48% and the specificity was 97.96%. While there was no statistically significant difference between the PCR CT and ELISA OD values, a positive correlation was found between the ELISA OD values and the days since the date of symptom initiation. The sensitivity and specificity of the rapid antibody test used in this study were found to be quite high. In conditions where ELISA tests cannot be applied, it is thought that it can give an idea in terms of the presence of antibodies as a simple and fast test. Although ELISA tests are valuable in the diagnosis of COVID-19 during the acute period, they are tests that can be used safely in the diagnosis of previous infections and seroepidemiological studies.
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Affiliation(s)
- Yasemin Cosgun
- General Directorate of Public Health, Department of Microbiology Reference and Biological Products Laboratories, Ministry of Health, Ankara, Turkey.
| | - Ayse Basak Altas
- General Directorate of Public Health, Department of Microbiology Reference and Biological Products Laboratories, Ministry of Health, Ankara, Turkey
| | - Esra Akkan Kuzucu
- General Directorate of Public Health, Department of Microbiology Reference and Biological Products Laboratories, Ministry of Health, Ankara, Turkey
| | - Rahmet Guner
- Department of Infectious Disease and Clinical Microbiology, Yildirim Beyazit University, Ankara City Hospital, Ankara, Turkey
| | - Sebnem Erdinc
- Department of Infectious Diseases and Clinical Microbiology, Ankara Training and Research Hospital, Ankara, Turkey
| | - Fatma Eser
- Department of Infectious Disease and Clinical Microbiology, Yildirim Beyazit University, Ankara City Hospital, Ankara, Turkey
| | - Esra Kaya Kilic
- Department of Infectious Diseases and Clinical Microbiology, Ankara Training and Research Hospital, Ankara, Turkey
| | - Gulay Korukluoglu
- General Directorate of Public Health, Department of Microbiology Reference and Biological Products Laboratories, Ministry of Health, Ankara, Turkey
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Kalem AK, Kayaaslan B, Neselioglu S, Eser F, Hasanoglu İ, Aypak A, Akinci E, Akca HN, Erel O, Guner R. A useful and sensitive marker in the prediction of COVID-19 and disease severity: Thiol. Free Radic Biol Med 2021; 166:11-17. [PMID: 33588050 PMCID: PMC7880846 DOI: 10.1016/j.freeradbiomed.2021.02.009] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/17/2020] [Revised: 02/01/2021] [Accepted: 02/04/2021] [Indexed: 12/11/2022]
Abstract
Thiol-disulphide homeostasis (TDH) is a new parameter indicating oxidative stress that plays a role in the pathogenesis of various clinical disorders. Our study planned to investigate TDH in COVID-19 patients. Age and gender-matched healthy subjects (n = 70) and COVID-19 patients (n = 144) were included in the study. In addition to the routine laboratory parameters of the groups, their native thiol (NT), total thiol (TT) and disulphide levels were measured. Primarily, we compared COVID-19 patients to the healthy control group for inflammatory parameters, NT, TT and disulphide levels. Then, COVID-19 patients were divided into two groups according to the severity of the disease as mild to moderate and severe COVID-19, and the three groups were compared with each other. Predictive value of thiol parameters in the diagnosis of COVID-19 and in the determining its severity, and its correlation with presence and duration of symptoms were investigated. Severe COVID-19 patients had lower NT and TT levels compared with healthy controls and mild to moderate patients (P < 0.001 for both). The results of ROC analysis show that the greatest AUC was IL-6 and NT (AUC = 0.97, AUC = 0.96, respectively) between control and COVID-19 patients, while it was CRP and NT (AUC = 0.85, AUC = 0.83) between mild to moderate and severe patients. A negative correlation was found between duration of symptoms of dyspnoea, cough, fever, and sore throat and NT (r = -0.45, P = 0.017, r = -0.418, P < 0.001, r = -0.131, P = 0.084, r = -0.452, P = 0.040, respectively). NT and TT levels have a strong predictive value in the diagnosis of COVID-19 and in determining disease severity. Our results support that changing TDH parameters appears to have an important role in disease pathogenesis and it can be used in clinical management of patients.
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Affiliation(s)
- Ayse Kaya Kalem
- Department of Infectious Diseases and Clinical Microbiology, Faculty of Medicine, Ankara Yildirim Beyazit University, Ankara City Hospital, Ankara, Turkey.
| | - Bircan Kayaaslan
- Department of Infectious Diseases and Clinical Microbiology, Faculty of Medicine, Ankara Yildirim Beyazit University, Ankara City Hospital, Ankara, Turkey
| | - Salim Neselioglu
- Department of Biochemistry, Faculty of Medicine, Ankara Yildirim Beyazit University, Ankara City Hospital, Ankara, Turkey
| | - Fatma Eser
- Department of Infectious Diseases and Clinical Microbiology, Faculty of Medicine, Ankara Yildirim Beyazit University, Ankara City Hospital, Ankara, Turkey
| | - İmran Hasanoglu
- Department of Infectious Diseases and Clinical Microbiology, Faculty of Medicine, Ankara Yildirim Beyazit University, Ankara City Hospital, Ankara, Turkey
| | - Adalet Aypak
- Department of Infectious Diseases and Clinical Microbiology, Ankara City Hospital, Ankara, Turkey
| | - Esragul Akinci
- Department of Infectious Diseases and Clinical Microbiology, Faculty of Medicine, University of Health Sciences, Ankara City Hospital, Ankara, Turkey
| | - H Nisa Akca
- Department of Infectious Diseases and Clinical Microbiology, Faculty of Medicine, Ankara Yildirim Beyazit University, Ankara City Hospital, Ankara, Turkey
| | - Ozcan Erel
- Department of Biochemistry, Faculty of Medicine, Ankara Yildirim Beyazit University, Ankara City Hospital, Ankara, Turkey
| | - Rahmet Guner
- Department of Infectious Diseases and Clinical Microbiology, Faculty of Medicine, Ankara Yildirim Beyazit University, Ankara City Hospital, Ankara, Turkey
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Guner R, Hasanoglu I, Kayaaslan B, Aypak A, Akinci E, Bodur H, Eser F, Kaya Kalem A, Kucuksahin O, Ates I, Bastug A, Tezer Tekce Y, Bilgic Z, Gursoy FM, Akca HN, Izdes S, Erdem D, Asfuroglu E, Hezer H, Kilic H, Cıvak M, Aydogan S, Buzgan T. Comparing ICU admission rates of mild/moderate COVID-19 patients treated with hydroxychloroquine, favipiravir, and hydroxychloroquine plus favipiravir. J Infect Public Health 2021; 14:365-370. [PMID: 33647553 PMCID: PMC7771901 DOI: 10.1016/j.jiph.2020.12.017] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2020] [Revised: 12/10/2020] [Accepted: 12/15/2020] [Indexed: 12/20/2022] Open
Abstract
BACKGROUND In this study, we aimed to compare the intensive care unit (ICU) admission rate of hospitalized mild/moderate COVID-19 patients treated with hydroxychloroquine (HCQ), favipiravir, and HCQ plus favipiravir. METHODS Single center retrospective designed observational study conducted in Ankara City Hospital. Patients who were hospitalized between March 15, 2020 and June 1, 2020 in COVID-19 inpatient clinics with laboratory confirmed diagnosis of COVID-19 were included in the study. An inverse probability of treatment weighting (IPTW) for multiple treatment groups approach was used to balance the differences in several variables on admission. RESULTS Among 2441 patients hospitalized with diagnosis of COVID-19 during the study period, 824 were eligible for the analysis. Median age of patients was 42 (18-93 years). Among all, 347 (43.2%) of the patients had mild disease, 470 (56.8%) had pneumonia. Propensity scores ranged from 0.1841 to 0.9381 in the HCQ group, from 0.03643 to 0.29885 in the favipiravir group, and from 0.03542 to 0.56184 in the HCQ plus favipiravir group. After IPTW for multiple treatment groups was applied, all the covariates in the planned propensity score had weighted standardized effect sizes below 10% which were ranged from 0.005 to 0.092. Multivariate analysis of treatment effect (adjusted effect of treatment) was indicated that there is no statistically significant difference between HCQ, favipiravir, and HCQ plus favipiravir treatment. After using combination of SMOTE and Bootstrap resampling approach, we found no statistically significant difference between HCQ and HCQ plus favipiravir groups in terms of ICU admission. However, compared with the HCQ group, ICU admission rate was statistically significantly higher in the favipiravir group. We obtained the similar results after the sensitivity analysis. CONCLUSIONS HCQ with or without favipiravir treatment is associated with reduced risk of ICU admission compared to favipiravir alone in mild to moderate COVID-19 adult patients.
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Affiliation(s)
- Rahmet Guner
- Department of Infectious Disease and Clinical Microbiology, Ankara Yildirim Beyazit University, Ankara City Hospital, Ankara, Turkey.
| | - Imran Hasanoglu
- Department of Infectious Disease and Clinical Microbiology, Ankara Yildirim Beyazit University, Ankara City Hospital, Ankara, Turkey.
| | - Bircan Kayaaslan
- Department of Infectious Disease and Clinical Microbiology, Ankara Yildirim Beyazit University, Ankara City Hospital, Ankara, Turkey.
| | - Adalet Aypak
- Department of Infectious Disease and Clinical Microbiology, Ankara City Hospital, Ankara, Turkey.
| | - Esragul Akinci
- Department of Infectious Disease and Clinical Microbiology, University of Health Sciences, Ankara City Hospital, Ankara, Turkey.
| | - Hurrem Bodur
- Department of Infectious Disease and Clinical Microbiology, University of Health Sciences, Ankara City Hospital, Ankara, Turkey.
| | - Fatma Eser
- Department of Infectious Disease and Clinical Microbiology, Ankara Yildirim Beyazit University, Ankara City Hospital, Ankara, Turkey.
| | - Ayse Kaya Kalem
- Department of Infectious Disease and Clinical Microbiology, Ankara Yildirim Beyazit University, Ankara City Hospital, Ankara, Turkey.
| | - Orhan Kucuksahin
- Department of Rheumatology, Ankara Yildirim Beyazit University, Ankara City Hospital, Ankara, Turkey.
| | - Ihsan Ates
- Department of Internal Medicine, Ankara City Hospital, Ankara, Turkey.
| | - Aliye Bastug
- Department of Infectious Disease and Clinical Microbiology, University of Health Sciences, Ankara City Hospital, Ankara, Turkey.
| | - Yasemin Tezer Tekce
- Department of Infectious Disease and Clinical Microbiology, Ankara City Hospital, Ankara, Turkey.
| | - Zeynep Bilgic
- Department of Infectious Disease and Clinical Microbiology, Ankara City Hospital, Ankara, Turkey.
| | - Fahriye Melis Gursoy
- Department of Infectious Disease and Clinical Microbiology, Ankara City Hospital, Ankara, Turkey.
| | - Hatice Nisa Akca
- Department of Infectious Disease and Clinical Microbiology, Ankara City Hospital, Ankara, Turkey.
| | - Seval Izdes
- Department of Anaesthesiology and Reanimation, Ankara Yildirim Beyazit University, Ankara City Hospital, Ankara, Turkey.
| | - Deniz Erdem
- Department of Anaesthesiology and Reanimation, Ankara City Hospital, Ankara, Turkey.
| | - Emra Asfuroglu
- Department of Internal Medicine, Ankara City Hospital, Ankara, Turkey.
| | - Habibe Hezer
- Department of Pulmonary Diseases, Ankara City Hospital, Ankara, Turkey.
| | - Hatice Kilic
- Department of Pulmonary Diseases, Ankara Yildirim Beyazit University, Ankara City Hospital, Ankara, Turkey.
| | - Musa Cıvak
- Department of Internal Medicine, Ankara City Hospital, Ankara, Turkey.
| | - Sibel Aydogan
- Department of Virology, Ankara City Hospital, Ankara, Turkey.
| | - Turan Buzgan
- Department of Infectious Disease and Clinical Microbiology, Ankara Yildirim Beyazit University, Ankara City Hospital, Ankara, Turkey.
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Hasanoglu I, Korukluoglu G, Asilturk D, Cosgun Y, Kalem AK, Altas AB, Kayaaslan B, Eser F, Kuzucu EA, Guner R. Higher viral loads in asymptomatic COVID-19 patients might be the invisible part of the iceberg. Infection 2020; 49:117-126. [PMID: 33231841 PMCID: PMC7685188 DOI: 10.1007/s15010-020-01548-8] [Citation(s) in RCA: 67] [Impact Index Per Article: 16.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2020] [Accepted: 10/28/2020] [Indexed: 01/01/2023]
Abstract
Purpose SARS-CoV-2 virus dynamics in different hosts and different samples and their relationship with disease severity have not been clearly revealed. The aim of this study is to evaluate the viral loads of 6 different sample types (nasopharyngeal/oropharyngeal combined, oral cavity, saliva, rectal, urine, and blood) of patients with different ages and clinics, to reveal the relationship between disease course and SARS-CoV-2 viral load, and differences in viral loads of asymptomatic and symptomatic patients. Methods Nasopharyngeal/oropharyngeal, oral cavity, saliva, rectal, urine, and blood samples are collected from patients who were hospitalized with diagnosis of COVID-19 on admission. Laboratory analysis were carried out at Public Health Institute of Turkey Virology Reference and Research Laboratory. Results A total of 360 samples from 60 patients were obtained on admission. Fifteen (25%) of the patients were asymptomatic while 45 (75%) were symptomatic. A significant difference was found between mean ages of asymptomatic vs symptomatic patients (26.4 and 36.4, respectively, p = 0.0248). No PCR positivity were found in blood. Only one asymptomatic patient had positive PCR result for urine sample. Viral loads of asymptomatic patients were found to be significantly higher (p = 0.0141) when compared with symptomatic patients. Viral load had a significant negative trend with increasing age. A significant decrease in viral load was observed with increasing disease severity. Conclusion In conclusion, this study demonstrates that asymptomatic patients have higher SARSCoV-2 viral loads than symptomatic patients and unlike in the few study in the literature, a significant decrease in viral load of nasopharyngeal/oropharyngeal samples was observed with increasing disease severity. Factors associated with poor prognosis are found to be significantly correlated with low viral load.
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Affiliation(s)
- Imran Hasanoglu
- Department of Infectious Diseases and Clinical Microbiology, Ankara City Hospital, Yildirim Beyazit University School of Medicine, Bilkent, Ankara, Turkey.
| | - Gulay Korukluoglu
- Virology Reference Laboratory, Public Health Institutions of Turkey, Ankara, Turkey
| | - Dilek Asilturk
- Department of Infectious Diseases and Clinical Microbiology, Ankara City Hospital, Yildirim Beyazit University School of Medicine, Bilkent, Ankara, Turkey
| | - Yasemin Cosgun
- Virology Reference Laboratory, Public Health Institutions of Turkey, Ankara, Turkey
| | - Ayse Kaya Kalem
- Department of Infectious Diseases and Clinical Microbiology, Ankara City Hospital, Yildirim Beyazit University School of Medicine, Bilkent, Ankara, Turkey
| | - Ayşe Basak Altas
- Virology Reference Laboratory, Public Health Institutions of Turkey, Ankara, Turkey
| | - Bircan Kayaaslan
- Department of Infectious Diseases and Clinical Microbiology, Ankara City Hospital, Yildirim Beyazit University School of Medicine, Bilkent, Ankara, Turkey
| | - Fatma Eser
- Department of Infectious Diseases and Clinical Microbiology, Ankara City Hospital, Yildirim Beyazit University School of Medicine, Bilkent, Ankara, Turkey
| | - Esra Akkan Kuzucu
- Virology Reference Laboratory, Public Health Institutions of Turkey, Ankara, Turkey
| | - Rahmet Guner
- Department of Infectious Diseases and Clinical Microbiology, Ankara City Hospital, Yildirim Beyazit University School of Medicine, Bilkent, Ankara, Turkey
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Kayaaslan B, Korukluoglu G, Hasanoglu I, Kalem AK, Eser F, Akinci E, Guner R. Semen Does Not Cause Additional Risk for SARS-CoV-2 Transmission during Sexual Contact. Urol Int 2020; 104:1003-1004. [PMID: 33070138 PMCID: PMC7649694 DOI: 10.1159/000511618] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2020] [Accepted: 09/11/2020] [Indexed: 12/29/2022]
Affiliation(s)
- Bircan Kayaaslan
- Infectious Disease and Clinical Microbiology, Ankara Yildirim Beyazit University, Ankara City Hospital, Ankara, Turkey,
| | - Gulay Korukluoglu
- Clinical Microbiology, Virology, National Virology Laboratory, Turkish Public Health Institution, Ankara, Turkey
| | - Imran Hasanoglu
- Infectious Disease and Clinical Microbiology, Ankara Yildirim Beyazit University, Ankara City Hospital, Ankara, Turkey
| | - Ayse Kaya Kalem
- Infectious Disease and Clinical Microbiology, Ankara Yildirim Beyazit University, Ankara City Hospital, Ankara, Turkey
| | - Fatma Eser
- Infectious Disease and Clinical Microbiology, Ankara Yildirim Beyazit University, Ankara City Hospital, Ankara, Turkey
| | - Esragul Akinci
- Infectious Disease and Clinical Microbiology, University of Health Sciences, Ankara City Hospital, Ankara, Turkey
| | - Rahmet Guner
- Infectious Disease and Clinical Microbiology, Ankara Yildirim Beyazit University, Ankara City Hospital, Ankara, Turkey
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Kayaaslan B, Kalem AK, Eser F, Hasanoglu I, Guner R. The Additional Contribution of Second Nasopharyngeal PCR to COVID-19 Diagnosis in Patients with Negative Initial Test. Infect Dis Now 2020; 51:194-196. [PMID: 33038445 PMCID: PMC7540190 DOI: 10.1016/j.medmal.2020.10.003] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2020] [Revised: 09/03/2020] [Accepted: 10/01/2020] [Indexed: 11/02/2022]
Abstract
OBJECTIVE The World Health Organization (WHO) recommends performing a second test in patients with a high suspicion of novel coronavirus disease (COVID-19) whose first PCR test is negative. However, the additional contribution of the second PCR test to the diagnosis is unknown. PATIENTS AND METHODS In this study, we aimed to investigate the contribution of second SARS-CoV-2 PCR to diagnosis in patients with a suspicion of COVID-19 whose initial test was negative. RESULTS A total of 1449 patients were hospitalized in infectious disease clinics with the suspicion of COVID-19 infection during the study period. We performed the second PCR test (697 nasopharyngeal sample, 5 tracheal aspirate) in 702/766 (91.6%) patients whose first tests were negative and detected as positive in only 6.6% (46) of samples. CONCLUSIONS The strategy of using the second nasopharyngeal PCR test to confirm or exclude the diagnosis seems to cause the loss of labor and time, and is costly, because its additional contribution to the first test is very low.
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Affiliation(s)
- Bircan Kayaaslan
- Infectious Diseases and Clinical Microbiology, Ankara Yildirim Beyazit University, Ankara City Hospital, Ankara, 06800, Turkey.
| | - Ayse Kaya Kalem
- Infectious Diseases and Clinical Microbiology, Ankara Yildirim Beyazit University, Ankara City Hospital, Ankara, 06800, Turkey.
| | - Fatma Eser
- Infectious Diseases and Clinical Microbiology, Ankara Yildirim Beyazit University, Ankara City Hospital, Ankara, 06800, Turkey.
| | - Imran Hasanoglu
- Infectious Diseases and Clinical Microbiology, Ankara Yildirim Beyazit University, Ankara City Hospital, Ankara, 06800, Turkey.
| | - Rahmet Guner
- Infectious Diseases and Clinical Microbiology, Ankara Yildirim Beyazit University, Ankara City Hospital, Ankara, 06800, Turkey.
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Kayaaslan B, Korukluoglu G, Hasanoglu I, Kalem AK, Eser F, Akinci E, Guner R. Investigation of SARS-CoV-2 in Semen of Patients in the Acute Stage of COVID-19 Infection. Urol Int 2020; 104:678-683. [PMID: 32781456 PMCID: PMC7490499 DOI: 10.1159/000510531] [Citation(s) in RCA: 70] [Impact Index Per Article: 17.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2020] [Accepted: 07/27/2020] [Indexed: 12/26/2022]
Abstract
Introduction The presence of new coronavirus (SARS-CoV-2) in semen and the possibility of sexual transmission have become new subjects of curiosity. There is a discrepancy regarding this issue in the literature. The presence of SARS-CoV-2 in semen has been investigated in a limited number of studies, and mostly in recovering patients. We aimed to investigate the presence of SARS-CoV-2 RNA in semen of patients with a positive nasopharyngeal swab test for SARS-CoV-2 in the acute stage. Methods We enrolled adult male patients who were hospitalized with confirmed SARS-COV-2 infection in the study. In addition to routine laboratory and radiological tests, semen sample was obtained from volunteers and transferred to the Turkish Public Health Institution, National Virology Laboratory. The samples were processed for the detection of SARS-CoV-2 RNA on the day of collection. Results Sixteen patients were included in the study. The median age was 33.5 years (18–54). All but one had respiratory symptoms. None of the patients had a history or symptoms of urogenital disease. All semen samples were obtained during hospitalization and in the acute stage of the infection. The median time to obtain a semen sample after positive nasopharyngeal test was 1 day (0–7). All semen samples were detected as negative for SARS-CoV-2 PCR. Discussion/Conclusion Although all semen samples were obtained in acute stage of the infection when the nasopharyngeal swab test was positive, we did not detect SARS-CoV-2 in semen. The results of our study support the thought that sexual transmission via semen does not have an important role in the person-to-person transmission of SARS-CoV-2. We think that our study will provide new information to fill the gap in the literature.
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Affiliation(s)
- Bircan Kayaaslan
- Infectious Disease and Clinical Microbiology, Ankara Yildirim Beyazit University, Ankara City Hospital, Ankara, Turkey,
| | - Gulay Korukluoglu
- Clinical Microbiology, Virology, National Virology Laboratory, Turkish Public Health Institution, Ankara, Turkey
| | - Imran Hasanoglu
- Infectious Disease and Clinical Microbiology, Ankara Yildirim Beyazit University, Ankara City Hospital, Ankara, Turkey
| | - Ayse Kaya Kalem
- Infectious Disease and Clinical Microbiology, Ankara Yildirim Beyazit University, Ankara City Hospital, Ankara, Turkey
| | - Fatma Eser
- Infectious Disease and Clinical Microbiology, Ankara Yildirim Beyazit University, Ankara City Hospital, Ankara, Turkey
| | - Esragul Akinci
- Infectious Disease and Clinical Microbiology, University of Health Sciences, Ankara City Hospital, Ankara, Turkey
| | - Rahmet Guner
- Infectious Disease and Clinical Microbiology, Ankara Yildirim Beyazit University, Ankara City Hospital, Ankara, Turkey
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Hasanoglu I, Bilgic Z, Olcucuoglu E, Karakan MS, Demirci BG, Kalem AK, Kayaaslan B, Eser F, Guner R. Do Lifestyle Changes of Renal Transplant Recipients During the Pandemic Reduce the Risk of Coronavirus Disease 2019? Transplant Proc 2020; 52:2667-2670. [PMID: 32782108 PMCID: PMC7837155 DOI: 10.1016/j.transproceed.2020.07.003] [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] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2020] [Accepted: 07/07/2020] [Indexed: 12/20/2022]
Abstract
Introduction There is no published study regarding the effects of preventive measures on coronavirus disease 2019 (COVID-19) frequency in renal transplantation recipients. The aim of this study is to reveal the preventive measures taken by renal transplant recipients during the COVID-19 pandemic and whether these measures influence the prevalence of the disease. Materials and Methods After detecting the first COVID-19 case in Turkey, we briefed all of our renal transplant recipients on preventive measures regarding COVID-19. Two months afterward, a questionnaire was prepared regarding the preventive measures practiced by renal transplant recipients, and patients were asked whether they had any COVID-19 symptoms or had received a COVID-19 diagnosis. Results Among 132 patients, 68 were surveyed through telephone calls. During this time, 95.5% of patients were in isolation at home except for when seeing to their essential needs. Two (2.9%) patients were hospitalized due to increases in creatinine level and urinary tract infection. All patients have worn masks when going out and stated that they washed their hands more frequently. There was a decrease in the frequency of hospital controls in 79.4% of patients. Although 2 (2.9%) patients had complaints of dysuria and fever, they did not apply to the hospital because they thought hospitals carried risk during the pandemic. One patient had a cough with fever and was admitted to the hospital with suspicion of COVID-19 but tested negative. Discussion It was determined that renal transplant recipients in our study population meticulously complied with preventive measures and increased the use of masks and hand hygiene practices. As a result, none were infected with severe acute respiratory syndrome coronavirus 2. Transplant recipients are thought to have higher mortality and morbidity for COVID-19. We found that 95.5% of renal transplant recipients complied with the isolation rules. They complied with preventive measures, increasing the use of masks and hand hygiene practices. None of the renal transplant recipients were infected with SARS-CoV-2.
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Affiliation(s)
- Imran Hasanoglu
- Yildirim Beyazit University School of Medicine, Ankara City Hospital, Department of Infectious Diseases and Clinical Microbiology, Bilkent, Ankara, Turkey.
| | - Zeynep Bilgic
- Yildirim Beyazit University School of Medicine, Ankara City Hospital, Department of Infectious Diseases and Clinical Microbiology, Bilkent, Ankara, Turkey
| | - Erkan Olcucuoglu
- Ankara City Hospital, Department of Urology, Bilkent, Ankara, Turkey
| | - Mine Sebnem Karakan
- Yildirim Beyazit University School of Medicine, Ankara City Hospital, Department of Nephrology, Ankara, Turkey
| | - Bahar Gurlek Demirci
- Yildirim Beyazit University School of Medicine, Ankara City Hospital, Department of Nephrology, Ankara, Turkey
| | - Ayse Kaya Kalem
- Yildirim Beyazit University School of Medicine, Ankara City Hospital, Department of Infectious Diseases and Clinical Microbiology, Bilkent, Ankara, Turkey
| | - Bircan Kayaaslan
- Yildirim Beyazit University School of Medicine, Ankara City Hospital, Department of Infectious Diseases and Clinical Microbiology, Bilkent, Ankara, Turkey
| | - Fatma Eser
- Yildirim Beyazit University School of Medicine, Ankara City Hospital, Department of Infectious Diseases and Clinical Microbiology, Bilkent, Ankara, Turkey
| | - Rahmet Guner
- Yildirim Beyazit University School of Medicine, Ankara City Hospital, Department of Infectious Diseases and Clinical Microbiology, Bilkent, Ankara, Turkey
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Hasanoğlu İ, Bilgiç Z, Kaya Kalem A, Kayaaslan B, Eser F, Güner R. An Important Disease for Our Country in Lymphadenopathy Etiology: Tularemia. Ankara Med J 2020. [DOI: 10.5505/amj.2020.32967] [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: 11/04/2022] Open
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Abstract
In patients undergoing immunotherapy, the quality of the immune response is reduced, which may negatively affect the efficacy of vaccination. This study was conducted in order to evaluate the efficacy of the hepatitis B virus (HBV) vaccine in patients using immunomodulators. Seronegative patients for HBV who were using biological agents, were included in the study. The vaccination was administered on the standard schedule in 3 doses of 20 or 40 µg/ml. Eighty-two patients (52%) were males and the mean age of all patients was 44,8 ± 10,3 years. Among these 109 patients, 83 had psoriasis, 12 had Crohn's disease, six had rheumatoid arthritis, three had ulcerative colitis, three had hydradenitis supurativa, one had Behcet's disease and one had ankylosing spondylitis. The biological agents that were being used by these patients were adalimumab (62), ustekinumab (25), infliximab (12), etanercept (9) and golimumab (1). Seventy-three of the patients were vaccinated with a dose of 20 µg/ml and 36 with 40 µg/ml. The anti-HBs titers of fifty-eight (53.2%) patients were above 10 mIU/ml. The antibody response rate was lowest in infliximab-users (16.7%) (p = 0.007), which was followed by adalimumab (48.4%), and higher protection rates were achieved in patients using ustekinumab and etanercept (72% and 88.9%, respectively; p < 0.05). The HBV vaccine response rate in patients using immunomodulators was significantly lower than that in immunocompetent patients. Furthermore, high dose vaccination did not increase the response rate. Clinicians should take into account administering HBV vaccination before treatment with biological agent in patients who have negative HBV serology.
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Affiliation(s)
- Asli Haykir Solay
- a Infection Disease and Clinical Microbiology Department , University of Health Sciences, Dışkapı Yıldırım Beyazıt Training and Research Hospital , Ankara , Turkey
| | - Fatma Eser
- a Infection Disease and Clinical Microbiology Department , University of Health Sciences, Dışkapı Yıldırım Beyazıt Training and Research Hospital , Ankara , Turkey
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Solay AH, Acar A, Eser F, Kuşcu F, Tütüncü EE, Kul G, Şentürk GÇ, Gürbüz Y. Reactivation rates in patients using biological agents, with resolved HBV infection or isolated anti-HBc IgG positivity. Turk J Gastroenterol 2019; 29:561-565. [PMID: 30260778 DOI: 10.5152/tjg.2018.18032] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
BACKGROUND/AIMS Tumor necrosis factor-α (TNF-α) inhibitors and ustekunimab are widely used in autoimmune diseases. It is known that these biological agents cause the reactivation of hepatitis B virus (HBV). There is no standardized strategy to prevent the reactivation in patients with evidence of a previous HBV infection. In our study, anti-HBc IgG-positive patients who received a biological agent were evaluated in terms of HBV reactivation. MATERIALS AND METHODS Patients who were followed up for the use of biological agents in our clinic were evaluated retrospectively. Patients with isolated anti-HBc IgG positivity were included in the study. The HBV reactivation data were recorded from the patients' files retrospectively. RESULTS Two hundred and seventy-eight patients who received biological treatment were evaluated. Twenty-nine patients with isolated anti-HBc IgG positivity or resolved HBV infection were included in the study. The HBV reactivation was seen in 5 patients (17.2%). Of these patients, 3 were using adalimumab, 1 infliximab, and 1 ustekunimab. It was controlled by antiviral therapy that was started in the early period. CONCLUSION Drugs that block TNF-α and ustekunimab cause an increase in viral replication. In literature, the HBV reactivation rate was approximately 1% in HBsAg-negative, anti-HBC IgG-positive cases, whereas it was found to be as high as 17.2% in our study. Patients receiving the immunomodulator therapy should be evaluated for HBV serology before treatment and carefully monitored for HBV reactivation during and after treatment.
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Affiliation(s)
- Aslı Haykır Solay
- Department of Infection Disease and Clinical Microbiology, Health Sciences University, Dışkapı Yıldırım Beyazıt Training and Research Hospital, Ankara, Turkey
| | - Ali Acar
- Department of Infection Disease and Clinical Microbiology, Health Sciences University, Dışkapı Yıldırım Beyazıt Training and Research Hospital, Ankara, Turkey
| | - Fatma Eser
- Department of Infection Disease and Clinical Microbiology, Health Sciences University, Dışkapı Yıldırım Beyazıt Training and Research Hospital, Ankara, Turkey
| | - Ferit Kuşcu
- Department of Infection Disease and Clinical Microbiology, Çukurova University School of Medicine, Adana, Turkey
| | - Emin Ediz Tütüncü
- Department of Infection Disease and Clinical Microbiology, Health Sciences University, Dışkapı Yıldırım Beyazıt Training and Research Hospital, Ankara, Turkey
| | - Gülnur Kul
- Department of Infection Disease and Clinical Microbiology, Health Sciences University, Dışkapı Yıldırım Beyazıt Training and Research Hospital, Ankara, Turkey
| | - Gönül Çiçek Şentürk
- Department of Infection Disease and Clinical Microbiology, Health Sciences University, Dışkapı Yıldırım Beyazıt Training and Research Hospital, Ankara, Turkey
| | - Yunus Gürbüz
- Department of Infection Disease and Clinical Microbiology, Health Sciences University, Dışkapı Yıldırım Beyazıt Training and Research Hospital, Ankara, Turkey
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Kurgan Ş, Önder C, Balcı N, Fentoğlu Ö, Eser F, Balseven M, Serdar MA, Tatakis DN, Günhan M. Gingival crevicular fluid tissue/blood vessel-type plasminogen activator and plasminogen activator inhibitor-2 levels in patients with rheumatoid arthritis: effects of nonsurgical periodontal therapy. J Periodontal Res 2016; 52:574-581. [DOI: 10.1111/jre.12425] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/04/2016] [Indexed: 01/11/2023]
Affiliation(s)
- Ş. Kurgan
- Department of Periodontology; Faculty of Dentistry; Ankara University; Ankara Turkey
| | - C. Önder
- Department of Periodontology; Faculty of Dentistry; Ankara University; Ankara Turkey
| | - N. Balcı
- Department of Periodontology; Faculty of Dentistry; Istanbul Medipol University; İstanbul Turkey
| | - Ö. Fentoğlu
- Department of Periodontology; Faculty of Dentistry; Süleyman Demirel University; Isparta Turkey
| | - F. Eser
- Department of Physical Medicine and Rehabilitation; Ankara Numune Training and Research Hospital; Ankara Turkey
| | - M. Balseven
- Department of Periodontology; Faculty of Dentistry; Pamukkale University; Denizli Turkey
| | - M. A. Serdar
- Department of Medical Biochemistry; School of Medicine; Acıbadem University; Ankara Turkey
| | - D. N. Tatakis
- Division of Periodontology; College of Dentistry; The Ohio State University; Columbus OH USA
| | - M. Günhan
- Department of Periodontology; Faculty of Dentistry; Ankara University; Ankara Turkey
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Kurgan Ş, Fentoğlu Ö, Önder C, Serdar M, Eser F, Tatakis DN, Günhan M. The effects of periodontal therapy on gingival crevicular fluid matrix metalloproteinase-8, interleukin-6 and prostaglandin E2 levels in patients with rheumatoid arthritis. J Periodontal Res 2015; 51:586-95. [PMID: 26575440 DOI: 10.1111/jre.12337] [Citation(s) in RCA: 36] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/25/2015] [Indexed: 11/27/2022]
Abstract
OBJECTIVE The aim of this study was to evaluate the effects of non-surgical periodontal therapy on gingival crevicular fluid levels of matrix metalloproteinase-8 (MMP-8), interleukin-6 (IL-6) and prostaglandin E2 (PGE2 ) in patients with rheumatoid arthritis (RA) with periodontal disease. MATERIAL AND METHODS Twenty-seven patients with gingivitis and periodontitis with RA, 26 patients with gingivitis and periodontitis that were systemically healthy and 13 periodontally and systemically healthy volunteers (control group) were included in this study. RA activity was assessed by disease activity score test. The clinical periodontal parameters, fasting venous blood and gingival crevicular fluid samples were obtained and gingival crevicular fluid MMP-8, IL-6 and PGE2 levels were evaluated at baseline and at 3 mo follow-up after non-surgical periodontal treatment. RESULTS Gingival crevicular fluid MMP-8, PGE2 and IL-6 levels were higher in all groups than the control group. Following periodontal therapy, there were significant decreases in gingival crevicular fluid MMP-8, PGE2 and IL-6 levels from patients with RA with periodontitis (p < 0.05). Plaque index, gingival index and bleeding on probing were significantly correlated with IL-6 and PGE2 at baseline and at 3 mo follow-up after non-surgical periodontal treatment. CONCLUSION Non-surgical periodontal therapy of patients with RA with periodontitis may provide beneficial effects on local inflammatory control via decreases in gingival crevicular fluid MMP-8, PGE2 and IL-6 levels.
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Affiliation(s)
- Ş Kurgan
- Department of Periodontology, Faculty of Dentistry, Ankara University, Ankara, Turkey
| | - Ö Fentoğlu
- Department of Periodontology, Faculty of Dentistry, Süleyman Demirel University, Isparta, Turkey
| | - C Önder
- Department of Periodontology, Faculty of Dentistry, Ankara University, Ankara, Turkey
| | - M Serdar
- Department of Medical Biochemistry, School of Medicine, Acıbadem University, Ankara, Turkey
| | - F Eser
- Department of Physical Medicine and Rehabilitation, Ankara Numune Training and Research Hospital, Ankara, Turkey
| | - D N Tatakis
- Division of Periodontology, College of Dentistry, The Ohio State University, Columbus, OH, USA
| | - M Günhan
- Department of Periodontology, Faculty of Dentistry, Ankara University, Ankara, Turkey
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Güven T, Yilmaz G, Güner HR, Kaya Kalem A, Eser F, Taşyaran MA. Increasing resistance of nosocomial Acinetobacter baumannii: are we going to be defeated? Turk J Med Sci 2015; 44:73-8. [PMID: 25558562 DOI: 10.3906/sag-1211-21] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Abstract
AIM To investigate the change of the antibiotic resistance profiles of the nosocomial Acinetobacter baumannii isolates in intensive care units (ICUs) between the years 2008 and 2011. MATERIALS AND METHODS A. baumannii isolates that were responsible for ICU-acquired nosocomial infections between 2008 and 2011 were included in the study. The susceptibility rates of the antibiotics that are mainly used in the treatment of Acinetobacter infections were compared by years. Clinical and Laboratory Standards Institute criteria were used to determine antimicrobial susceptibility. RESULTS There were 252 infection episodes detected in 229 hospitalized patients in the ICU that were caused by A. baumannii. Imipenem resistance was found as 98.9% in 2011 whereas it was 54% in 2008. A significant increase was observed for meropenem resistance from 2008 (73.5%) to 2011 (98.9%). Colistin resistance, confirmed by E-test, was found in 4 strains. The resistance rates of other antimicrobial agents were as follows: ampicillin/sulbactam 95.7% and 93.5%, cefoperazone/sulbactam 45.7% and 90.3%, netilmicin 41.7% and 53%, gentamicin 96% and 87.2%, and trimethoprimsulfamethoxazole 91.7% and 72%, in 2008 and 2011, respectively. The resistance rate to tigecycline increased to 81.3% in 2011 from 12.5% in 2008.
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Affiliation(s)
- Tümer Güven
- Department of Infectious Diseases and Clinical Microbiology, Ankara Atatürk Training and Research Hospital, Ankara, Turkey.
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Garip Y, Eser F, Erten S, Yilmaz O, Yildirim P. Brucellosis in spondyloarthritis mimicking an exacerbation. Acta Reumatol Port 2014; 39:351-352. [PMID: 25584623] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
Spondyloarthritis are a group of chronic inflammatory diseases that affect the axial skeleton, entheses and peripheral joints and may have extraarticular manifestations such as uveitis, psoriasis and inflammatory bowel disease. Brucellosis is a systemic infectious disease, endemic in Middle East, Latin America, and Mediterranean countries, which may present manifestations that resemble other diseases posing serious problems of differential diagnosis. Some hallmarks of Brucellosis may mimic a spondyloarthritis flare. In this paper, authors present a clinical case of brucellosis occurring in a patient with spondyloarthritis. Clinical symptoms initially mimicked exacerbation of spondyloarthritis.
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Ferraz-Amaro I, Hernandez-Hernandez V, Quevedo JC, Muniz J, Franco A, Arce-Franco M, Lopez-Fernandez J, Diaz-Gonzalez F, Eser F, Garip Y, Bodur H. Thematic stream: co-morbidity: BPP7. Effect of Anti Tnf-Alpha Therapies on Insulin Resistance, Body Composition and Adipokines in Rheumatoid Arthritis Patients. Rheumatology (Oxford) 2011. [DOI: 10.1093/rheumatology/ker096] [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: 11/13/2022] Open
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Eser F, Yavuzer G, Karakus D, Karaoglan B. The effect of balance training on motor recovery and ambulation after stroke: a randomized controlled trial. Eur J Phys Rehabil Med 2008; 44:19-25. [PMID: 18385624] [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: 05/26/2023]
Abstract
AIM To investigate the effects of balance training, using force platform biofeedback, on motor recovery, mobility and activity level of hemiparetic patients with stroke. METHODS In this randomized, controlled, assessor-blinded trial 41 inpatients [mean (+/-SD) age of 60.9 (+/-11.7) years] with hemiparesis after stroke (median time since stroke 6 months) were randomly assigned to an experimental or a control group. The control group (n=19) participated in a conventional stroke inpatient rehabilitation program, whereas the experimental group (n=22) received 15 sessions of balance training (using force platform biofeedback) in addition to the conventional program. Main outcome measures were motor recovery of the lower extremity (Brunnstrom staging), mobility (Rivermead Mobility Index, RMI) and activity level (Functional Independence Measure, FIM) that performed one week before and after the experimental treatment program. RESULTS Both groups were similar in terms of baseline clinical characteristics. Motor recovery, mobility and activity level improved significantly in both groups (P<0.05). Between-group difference of mean change score was not significant for the Brunnstrom stages (0.23 vs 0.26), RMI (2.9 vs 2.2) and FIM score (10.7 vs 11.5). CONCLUSION In our group of stroke patients, balance training combined with a conventional rehabilitation program does not provide additional benefit in terms of lower extremity motor recovery, mobility and activity level.
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Affiliation(s)
- F Eser
- Clinic of Physical Medicine and Rehabilitation, Ankara Numune Education and Research Hospital Ankara,Turkey
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Kavukçu S, Başdemir G, Eroğlu Y, Türkmen M, Eser F, Büyükgebiz B. Interferon treatment in hepatitis B virus-associated membranous glomerulopathy. Pediatr Nephrol 1995; 9:539-40. [PMID: 7577424 DOI: 10.1007/bf00866747] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
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