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Mete AÖ, Bayar Muluk N, Şahan MH, Karaoğlan I. Evaluation of peripheral and central olfactory pathways in HIV-infected patients by MRI. Clin Radiol 2024; 79:e295-e304. [PMID: 38030506 DOI: 10.1016/j.crad.2023.10.035] [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: 04/28/2023] [Revised: 10/24/2023] [Accepted: 10/26/2023] [Indexed: 12/01/2023]
Abstract
AIM To investigate peripheral and central olfactory pathways using cranial magnetic resonance imaging (MRI) in human immunodeficiency virus (HIV)-infected patients. MATERIALS AND METHODS The cranial MRI images of 37 HIV-infected adult patients and 37 adults without HIV infection having normal cranial MRI results were included in the study. In both groups, olfactory bulb (OB) volume and olfactory sulcus (OS) depth; and insular gyrus and corpus amygdala areas were measured using cranial MRI. In the HIV group, disease duration, HIV RNA, and CD4 lymphocyte count and levels as a percentage were also recorded. RESULTS The HIV group had significantly lower bilateral OB volumes, insular gyrus and corpus amygdala areas compared to the control group. The HIV group showed positive correlations between OB volumes, OS depths, insular gyrus, and corpus amygdala areas bilaterally. Increases in OB volumes and OS depths were associated with an increase in the insular gyrus area. The corpus amygdala and insular gyrus areas increased similarly. There was no significant correlation between age, gender, disease duration, CD4 lymphocyte count and per cent, HIV RNA values, and the measurement values of the central and peripheral olfactory regions. CONCLUSION A decrease in olfactory regions of OB, insular gyrus, and corpus amygdala in HIV-infected patients shows that HIV infection may cause olfactory impairment. There is no correlation between disease duration and olfactory impairment. It may be related to neuroinflammation, HIV-related brain atrophy, acquired immunodeficiency syndrome (AIDS) dementia complex, or neurocognitive impairment, which are the other explanations for the olfactory impairment in HIV. The possible toxicity from antiretroviral therapy (ART) may be another cause that should be investigated further.
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Affiliation(s)
- A Ö Mete
- Infectious Diseases and Clinical Microbiology Department, Faculty of Medicine, Gaziantep University, Gaziantep, Turkey
| | - N Bayar Muluk
- ENT Department, Faculty of Medicine, Kırıkkale University, Kırıkkale, Turkey.
| | - M H Şahan
- Radiology Department, Faculty of Medicine, Gaziantep University, Gaziantep, Turkey
| | - I Karaoğlan
- Infectious Diseases and Clinical Microbiology Department, Faculty of Medicine, Gaziantep University, Gaziantep, Turkey
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2
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Aydın M, Ergönül Ö, Azap A, Bilgin H, Aydın G, Çavuş SA, Demiroğlu YZ, Alışkan HE, Memikoğlu O, Menekşe Ş, Kaya Ş, Demir NA, Karaoğlan I, Başaran S, Hatipoğlu Ç, Erdinç Ş, Yılmaz E, Tümtürk A, Tezer Y, Demirkaya H, Çakar ŞE, Keske Ş, Tekin S, Yardımcı C, Karakoç Ç, Ergen P, Azap Ö, Mülazımoğlu L, Ural O, Can F, Akalın H. Rapid emergence of colistin resistance and its impact on fatality among healthcare-associated infections. J Hosp Infect 2017; 98:260-263. [PMID: 29248504 DOI: 10.1016/j.jhin.2017.11.014] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [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: 10/15/2017] [Accepted: 11/26/2017] [Indexed: 10/18/2022]
Abstract
This article describes the emergence of resistance and predictors of fatality for 1556 cases of healthcare-associated Gram-negative bloodstream infection in 2014 and 2015. The colistin resistance rate in Klebsiella pneumoniae was 16.1%, compared with 6% in 2013. In total, 660 (42.4%) cases were fatal. The highest fatality rate was among patients with Acinetobacter baumannii bacteraemia (58%), followed by Pseudomonas aeruginosa (45%), Klebsiella pneumoniae (41%), Enterobacter cloacae (32%) and Escherichia coli (28%). On multi-variate analysis, the minimum inhibitory concentrations for carbapenems [odds ratio (OR) 1.02, 95% confidence interval (CI) 1.01-1.04; P = 0.002] and colistin (OR 1.1, 95% CI 1.03-1.17; P = 0.001) were found to be significantly associated with fatality.
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Affiliation(s)
- M Aydın
- Infectious Diseases and Clinical Microbiology Department, School of Medicine, Başkent University, Istanbul, Turkey.
| | - Ö Ergönül
- Infectious Diseases and Clinical Microbiology Department, School of Medicine, Koç University, Istanbul, Turkey
| | - A Azap
- Infectious Diseases and Clinical Microbiology Department, School of Medicine, Ankara University, Ankara, Turkey
| | - H Bilgin
- Infectious Diseases and Clinical Microbiology Department, School of Medicine, Marmara University, Istanbul, Turkey
| | - G Aydın
- Infectious Diseases and Clinical Microbiology Department, School of Medicine, Ankara University, Ankara, Turkey; Infectious Diseases and Clinical Microbiology Department, Afyonkarahisar Training and Research Hospital, Afyonkarahisar, Turkey
| | - S A Çavuş
- Infectious Diseases and Clinical Microbiology Department, School of Medicine, Dokuz Eylül University, İzmir, Turkey
| | - Y Z Demiroğlu
- Infectious Diseases and Clinical Microbiology Department, School of Medicine, Başkent University, Adana, Turkey
| | - H E Alışkan
- Clinical Microbiology Department, School of Medicine, Başkent University, Adana, Turkey
| | - O Memikoğlu
- Infectious Diseases and Clinical Microbiology Department, School of Medicine, Ankara University, Ankara, Turkey
| | - Ş Menekşe
- Infectious Diseases and Clinical Microbiology Department, SBÜ Kartal Koşuyolu Yüksek İhtisas Hospital, Training and Research Hospital, Istanbul, Turkey
| | - Ş Kaya
- Infectious Diseases and Clinical Microbiology Department, Diyarbakır Training and Research Hospital, Diyarbakır, Turkey
| | - N A Demir
- Infectious Diseases and Clinical Microbiology Department, School of Medicine, Selçuk University, Konya, Turkey
| | - I Karaoğlan
- Infectious Diseases and Clinical Microbiology Department, School of Medicine, Gaziantep University, Gaziantep, Turkey
| | - S Başaran
- Infectious Diseases and Clinical Microbiology Department, School of Medicine, İstanbul University, Istanbul, Turkey
| | - Ç Hatipoğlu
- Infectious Diseases and Clinical Microbiology Department, Ankara Training and Research Hospital, Ankara, Turkey
| | - Ş Erdinç
- Infectious Diseases and Clinical Microbiology Department, Ankara Training and Research Hospital, Ankara, Turkey
| | - E Yılmaz
- Infectious Diseases and Clinical Microbiology Department, School of Medicine, Uludağ University, Bursa, Turkey
| | - A Tümtürk
- Infectious Diseases and Clinical Microbiology Department, Ankara Yüksek İhtisas Training and Research Hospital, Ankara, Turkey
| | - Y Tezer
- Infectious Diseases and Clinical Microbiology Department, Ankara Yüksek İhtisas Training and Research Hospital, Ankara, Turkey
| | - H Demirkaya
- Infectious Diseases and Clinical Microbiology Department, School of Medicine, Başkent University, Ankara, Turkey
| | - Ş E Çakar
- Infectious Diseases and Clinical Microbiology Department, Ümraniye Training and Research Hospital, Istanbul, Turkey
| | - Ş Keske
- Infectious Diseases and Clinical Microbiology Department, School of Medicine, Koç University, Istanbul, Turkey
| | - S Tekin
- Infectious Diseases and Clinical Microbiology Department, School of Medicine, Koç University, Istanbul, Turkey
| | - C Yardımcı
- Infectious Diseases and Clinical Microbiology Department, Şanlıurfa Training and Research Hospital, Şanlıurfa, Turkey
| | - Ç Karakoç
- Infectious Diseases and Clinical Microbiology Department, School of Medicine, İstinye University, Istanbul, Turkey
| | - P Ergen
- Infectious Diseases and Clinical Microbiology Department, School of Medicine, Medeniyet University, Istanbul, Turkey
| | - Ö Azap
- Infectious Diseases and Clinical Microbiology Department, School of Medicine, Başkent University, Ankara, Turkey
| | - L Mülazımoğlu
- Infectious Diseases and Clinical Microbiology Department, School of Medicine, Marmara University, Istanbul, Turkey
| | - O Ural
- Infectious Diseases and Clinical Microbiology Department, School of Medicine, Selçuk University, Konya, Turkey
| | - F Can
- Clinical Microbiology Department, School of Medicine, Koç University, Istanbul, Turkey
| | - H Akalın
- Infectious Diseases and Clinical Microbiology Department, School of Medicine, Uludağ University, Bursa, Turkey
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3
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Ergönül Ö, Aydin M, Azap A, Başaran S, Tekin S, Kaya Ş, Gülsün S, Yörük G, Kurşun E, Yeşilkaya A, Şimşek F, Yılmaz E, Bilgin H, Hatipoğlu Ç, Cabadak H, Tezer Y, Togan T, Karaoğlan I, İnan A, Engin A, Alışkan HE, Yavuz SŞ, Erdinç Ş, Mulazimoglu L, Azap Ö, Can F, Akalın H, Timurkaynak F. Healthcare-associated Gram-negative bloodstream infections: antibiotic resistance and predictors of mortality. J Hosp Infect 2016; 94:381-385. [PMID: 27717604 DOI: 10.1016/j.jhin.2016.08.012] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.9] [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: 01/31/2016] [Accepted: 08/02/2016] [Indexed: 12/28/2022]
Abstract
This article describes the prevalence of antibiotic resistance and predictors of mortality for healthcare-associated (HA) Gram-negative bloodstream infections (GN-BSI). In total, 831 cases of HA GN-BSI from 17 intensive care units in different centres in Turkey were included; the all-cause mortality rate was 44%. Carbapenem resistance in Klebsiella pneumoniae was 38%, and the colistin resistance rate was 6%. Multi-variate analysis showed that age >70 years [odds ratio (OR) 2, 95% confidence interval (CI) 1.22-3.51], central venous catheter use (OR 2.1, 95% CI 1.09-4.07), ventilator-associated pneumonia (OR 1.9, 95% CI 1.1-3.16), carbapenem resistance (OR 1.8, 95% CI 1.11-2.95) and APACHE II score (OR 1.1, 95% CI 1.07-1.13) were significantly associated with mortality.
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Affiliation(s)
- Ö Ergönül
- Koç University School of Medicine, Infectious Diseases and Clinical Microbiology Department, Istanbul, Turkey.
| | - M Aydin
- Başkent University School of Medicine, Istanbul Hospital, Infectious Diseases and Clinical Microbiology Department, Turkey
| | - A Azap
- Ankara University Medical Faculty, Infectious Diseases and Clinical Microbiology Department, Turkey
| | - S Başaran
- Istanbul University Istanbul Medical School, Infectious Diseases and Clinical Microbiology Department, Istanbul, Turkey
| | - S Tekin
- Koç University School of Medicine, Infectious Diseases and Clinical Microbiology Department, Istanbul, Turkey
| | - Ş Kaya
- Diyarbakır Training and Research Hospital, Infectious Diseases and Clinical Microbiology Department, Diyarbakır, Turkey
| | - S Gülsün
- Diyarbakır Training and Research Hospital, Infectious Diseases and Clinical Microbiology Department, Diyarbakır, Turkey
| | - G Yörük
- Istanbul Training and Research Hospital, Infectious Diseases and Clinical Microbiology Department, Istanbul, Turkey
| | - E Kurşun
- Başkent University School of Medicine, Adana Hospital, Infectious Diseases and Clinical Microbiology Department, Adana, Turkey
| | - A Yeşilkaya
- Başkent University School of Medicine, Ankara Hospital, Infectious Diseases and Clinical Microbiology Department, Ankara, Turkey
| | - F Şimşek
- Okmeydanı Training and Research Hospital, Infectious Diseases and Clinical Microbiology Department, Istanbul, Turkey
| | - E Yılmaz
- Uludağ University School of Medicine, Infectious Diseases and Clinical Microbiology Department, Bursa, Turkey
| | - H Bilgin
- Marmara University School of Medicine, Infectious Diseases and Clinical Microbiology Department, Istanbul, Turkey
| | - Ç Hatipoğlu
- Ankara Training and Research Hospital, Infectious Diseases and Clinical Microbiology Department, Ankara, Turkey
| | - H Cabadak
- Ankara Specialty Hospital, Infectious Diseases and Clinical Microbiology Department, Ankara, Turkey
| | - Y Tezer
- Ankara Specialty Hospital, Infectious Diseases and Clinical Microbiology Department, Ankara, Turkey
| | - T Togan
- Başkent University School of Medicine, Konya Hospital, Infectious Diseases and Clinical Microbiology Department, Konya, Turkey
| | - I Karaoğlan
- Gaziantep University School of Medicine, Infectious Diseases and Clinical Microbiology Department, Gaziantep, Turkey
| | - A İnan
- Haydarpaşa Numune Training and Research Hospital, Infectious Diseases and Clinical Microbiology Department, Istanbul, Turkey
| | - A Engin
- Cumhuriyet University School of Medicine, Infectious Diseases and Clinical Microbiology Department, Sivas, Turkey
| | - H E Alışkan
- Başkent University School of Medicine, Adana Hospital, Infectious Diseases and Clinical Microbiology Department, Adana, Turkey
| | - S Ş Yavuz
- Istanbul University Istanbul Medical School, Infectious Diseases and Clinical Microbiology Department, Istanbul, Turkey
| | - Ş Erdinç
- Ankara Training and Research Hospital, Infectious Diseases and Clinical Microbiology Department, Ankara, Turkey
| | - L Mulazimoglu
- Marmara University School of Medicine, Infectious Diseases and Clinical Microbiology Department, Istanbul, Turkey
| | - Ö Azap
- Başkent University School of Medicine, Ankara Hospital, Infectious Diseases and Clinical Microbiology Department, Ankara, Turkey
| | - F Can
- Koç University School of Medicine, Infectious Diseases and Clinical Microbiology Department, Istanbul, Turkey
| | - H Akalın
- Uludağ University School of Medicine, Infectious Diseases and Clinical Microbiology Department, Bursa, Turkey
| | - F Timurkaynak
- Başkent University School of Medicine, Istanbul Hospital, Infectious Diseases and Clinical Microbiology Department, Turkey
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Sayan M, Gündüz A, Ersöz G, İnan A, Deveci A, Özgür G, Sargın F, Karagöz G, İnci A, İnan D, Ülçay A, Karaoğlan I, Kaya S, Kutlu SS, Süer K, Çağatay A, Akalın H. Integrase Strand Transfer Inhibitors (INSTIs) Resistance Mutations in HIV-1 Infected Turkish Patients. HIV Clin Trials 2016; 17:109-13. [PMID: 27125365 DOI: 10.1080/15284336.2016.1153303] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
OBJECTIVES Integrase strand transfer inhibitor (INSTI) is a new class of antiretroviral (ARV) drugs designed to block the action of the integrase viral enzyme, which is responsible for insertation of the HIV-1 genome into the host DNA. The aim of this study was to evaluate for the first time INSTI resistance mutations in Turkish patients. METHODS This study was conducted in Turkey, between April 2013 and April 2015 using 169 HIV-1-infected patients (78 ARV naive patients and 91 ARV-experienced patients). Laboratory and clinical characteristics of ARV naive and ARV-experienced patients were as follows: gender (M/F): 71/7 and 80/11, median age: 38 and 38.4; median CD4(+) T-cell: 236 and 216 cells/mm(3), median HIV-1 RNA: 4.95+E5 and 1.08E+6 copies/ml. Population-based seqeunces of the reverse transcriptase, protease, and integrase domains of the HIV-1 pol gene were used to detect HIV-1 drug resistance mutations. RESULT INSTI resistance mutations were not found in recently diagnosed HIV-1-infected patients. However, ARV-experienced patients had major resistance mutations associated with raltegravir and elvitegravir; the following results were generated:F121Y, Y143R, Q148R and E157Q (6/91 - 6.6%). CONCLUSIONS The prevalence of INSTI resistant mutations in ART-experienced patients suggested that resistance testing must be incorporated as an integral part of HIV management with INSTI therapies.
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Affiliation(s)
- M Sayan
- a Faculty of Medicine, Clinical Laboratory, PCR Unit , University of Kocaeli , Kocaeli , Turkey.,b Research Center of Experimental Health Sciences, University of Near East , Nicosia , Northern Cyprus
| | - A Gündüz
- c Clinic of Infectious Diseases , Sisli Etfal, Educational and Research Hospital , Istanbul , Turkey
| | - G Ersöz
- d Faculty of Medicine, Department of Infectious Diseases , University of Mersin , Mersin , Turkey
| | - A İnan
- e Clinic of Infectious Diseases , Haydarpasa Numune, Educational and Research Hospital , Istanbul , Turkey
| | - A Deveci
- f Faculty of Medicine, Department of Infectious Diseases , University of 19 Mayis , Samsun , Turkey
| | - G Özgür
- g Clinic of Infectious Diseases , Samsun Educational and Research Hospital , Samsun , Turkey
| | - F Sargın
- h Clinic of Infectious Diseases , Medeniyet University, Goztepe Educational and Research Hospital , Istanbul , Turkey
| | - G Karagöz
- i Clinic of Infectious Diseases , Umraniye Educational and Research Hospital , İstanbul , Turkey
| | - A İnci
- j Clinic of Infectious Diseases , Istanbul Kanuni Sultan Süleyman, Educational and Research Hospital , Istanbul , Turkey
| | - D İnan
- k Faculty of Medicine, Department of Infectious Diseases , University of Akdeniz , Antalya , Turkey
| | - A Ülçay
- l Clinic of Infectious Diseases , Gulhane Military Medical Academy , Istanbul , Turkey
| | - I Karaoğlan
- m Faculty of Medicine, Department of Infectious Diseases , University of Gaziantep , Gaziantep , Turkey
| | - S Kaya
- n Faculty of Medicine, Department of Infectious Disease , University of Karadeniz Technical , Trabzon , Turkey
| | - S S Kutlu
- o Faculty of Medicine, Department of Infectious Diseases , University of Pamukkale , Denizli , Turkey
| | - K Süer
- p Faculty of Medicine, Department of Infectious Diseases , University of Near East , Nicosia , Northern Cyprus
| | - A Çağatay
- q Faculty of Medicine, Department of Infectious Diseases , University of Istanbul , İstanbul , Turkey
| | - H Akalın
- r Faculty of Medicine, Department of Infectious Diseases , University of Uludag , Bursa , Turkey
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5
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Namıduru ES, Tarakçıoğlu M, Namıduru M, Kocabaş R, Erbağcı B, Meram I, Karaoğlan I, Yılmaz N, Cekmen M. Increased serum nitric oxide and malondialdehyde levels in patients with acute intestinal amebiasis. Asian Pac J Trop Biomed 2015; 1:478-81. [PMID: 23569817 DOI: 10.1016/s2221-1691(11)60104-4] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [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: 03/15/2011] [Revised: 04/10/2011] [Accepted: 04/28/2011] [Indexed: 10/28/2022] Open
Abstract
OBJECTIVE To determine the level of oxygen-nitrogen stress parameters in the pathogenesis of amebiasis. METHODS Twenty-four acute intestinal amebiasis patients and 20 healthy controls were enrolled in the present study. Serum malondialdehyde and nitric oxide levels were determined spectrophotometrically. RESULTS Serum malondialdehyde and nitric oxide levels were significantly higher in acute intestinal amebiasis patients than healthy controls (P<0.001). CONCLUSIONS These results suggest that oxidative and nitrosative stress may play a major role in tissue damage in acute intestinal amebiasis patients. Also these parameters can be used to supplement the conventional microscopic method for reliable diagnosis of intestinal amebiasis.
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Affiliation(s)
- E S Namıduru
- University of Gaziantep, Faculty of Medicine, Department of Biochemistry, Gaziantep, Turkey
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Namiduru M, Güngör G, Karaoğlan I, Dikensoy O. Antibiotic Resistance of Bacterial Ventilator-Associated Pneumonia in Surgical Intensive Care Units. J Int Med Res 2004; 32:78-83. [PMID: 14997711 DOI: 10.1177/147323000403200113] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Ventilator-associated pneumonia (VAP) is the most common infection in intensive care units. It is caused by prolonged hospitalization and results in high mortality rates. This retrospective clinical study, of 140 patients in a surgical intensive care unit, aimed to identify the bacterial agents responsible for VAP infection, and determine antibiotic resistance rates in VAP. Antibiotic sensitivity was evaluated by culturing and testing tracheal aspirates from patients with clinical and radiological findings of VAP. The bacteria isolated most frequently were Pseudomonas aeruginosa (33.9%), Staphylococcus aureus (30.0%), Acinetobacter baumannii (26.1%), and Enterobacter species (4.3%). A. baumannii was more prevalent than in previous years. The results of antibiotic sensitivity testing suggested sulbactam/cefoperazone as the most appropriate drug for treating these patients. We suggest, however, that when staphylococcal pneumonia is suspected, a glycopeptide (vancomycin or teicoplanin) or combined trimethoprimsulfamethoxazole is used as first-line therapy until sensitivity results are obtained. In conclusion, development of antibiotic policies for individual hospitals can reduce high antibiotic resistance rates due to VAP.
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Affiliation(s)
- M Namiduru
- Department of Infectious Diseases, Medical Faculty, Gaziantep University, Gaziantep, Turkey
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