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Allahverdiyeva A, Ağaçfidan A, Dogan L, Önel M, Uysal HK, Medetalibeyoğlu A, Şenkal N, Alaskarov E, Meşe S. Evaluation of SARS-CoV-2-Positive Patients with Suspected Reinfection. Viruses 2023; 15:2222. [PMID: 38005899 PMCID: PMC10675471 DOI: 10.3390/v15112222] [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: 10/17/2023] [Revised: 11/02/2023] [Accepted: 11/03/2023] [Indexed: 11/26/2023] Open
Abstract
The aim of this study was to investigate the reinfection rates and characteristics of SARS-CoV-2 in individuals with SARS-CoV-2 RNA present in their clinical specimens for COVID-19. Our data from the COVID-19 Laboratory of Istanbul University were analyzed for 27,240 cases between 27 March 2020 to 8 February 2022. Demographic characteristics, vaccination statuses, comorbidities, and laboratory findings were evaluated in cases with suspected reinfection, as determined by the presence of SARS-CoV-2 RNA at a rate of 0.3% in clinical specimens. When comparing laboratory values, leukocyte counts were lower in the second and third infections compared with the first infection (p = 0.035), and neutrophil counts were lower in the second infection (p = 0.009). Symptoms varied, with coughing being common in the first infection and malaise being common in subsequent infections. These results suggest that it is important to continue to monitor reinfection rates and develop strategies to prevent reinfection. Our results also suggest that clinicians should be aware of the possibility of reinfection and monitor patients for recurrent symptoms.
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Affiliation(s)
- Aytaj Allahverdiyeva
- Institute of Health Sciences, Istanbul University, Istanbul 34126, Turkey;
- Department of Medical Microbiology, Azerbaijan Medical University, Baku 370022, Azerbaijan
| | - Ali Ağaçfidan
- Department of Medical Microbiology, Istanbul Faculty of Medicine, Istanbul University, Istanbul 34093, Turkey; (A.A.); (M.Ö.); (H.K.U.)
| | - Lerzan Dogan
- Institute of Health Sciences, Istanbul University, Istanbul 34126, Turkey;
| | - Mustafa Önel
- Department of Medical Microbiology, Istanbul Faculty of Medicine, Istanbul University, Istanbul 34093, Turkey; (A.A.); (M.Ö.); (H.K.U.)
| | - Hayriye Kırkoyun Uysal
- Department of Medical Microbiology, Istanbul Faculty of Medicine, Istanbul University, Istanbul 34093, Turkey; (A.A.); (M.Ö.); (H.K.U.)
| | - Alpay Medetalibeyoğlu
- Department of Internal Medicine, Istanbul Faculty of Medicine, Istanbul University, Istanbul 34093, Turkey; (A.M.); (N.Ş.)
| | - Naci Şenkal
- Department of Internal Medicine, Istanbul Faculty of Medicine, Istanbul University, Istanbul 34093, Turkey; (A.M.); (N.Ş.)
| | - Elvin Alaskarov
- Department of Otorhinolaryngology, Istanbul Medipol University, Istanbul 34230, Turkey
| | - Sevim Meşe
- Department of Medical Microbiology, Istanbul Faculty of Medicine, Istanbul University, Istanbul 34093, Turkey; (A.A.); (M.Ö.); (H.K.U.)
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Akgün Ö, Demirkan FG, Kavrul Kayaalp G, Erdemir M, Akay N, Çakmak F, Önel M, Keskindemirci G, Eker Ömeroğlu R, Gökçay EG, Aktay Ayaz N. Vaccination coverage of children with rheumatic diseases compared with healthy controls: a retrospective case-control study. Postgrad Med 2023; 135:824-830. [PMID: 37997766 DOI: 10.1080/00325481.2023.2287988] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2023] [Accepted: 11/22/2023] [Indexed: 11/25/2023]
Abstract
OBJECTIVE To reveal the vaccination status of patients with pediatric rheumatic disease (PedRD) and to compare this with healthy controls. METHODS The electronic health records of the Ministry of Health regarding the vaccination status of children with PedRD followed in a tertiary hospital were analyzed cross-sectionally and compared with their healthy controls. The missing vaccines were reported according to individual, age-appropriate schedule and causes of skipped vaccines in both groups were investigated with an online survey. RESULTS The vaccination rate of patients in the last examination was 71.4% (90/126) and 95.7% (110/115) in healthy controls (p < 0.001). Measles-mumps-rubella vaccine, diphtheria, the administration rates of the second dose of tetanus-acellular pertussis-inactivated polio and Haemophilus influenzae type B, chickenpox, and hepatitis A vaccines were significantly lower in patients than in controls (p values 0.004, 0.02, 0.01, 0.013, respectively). The pre-diagnosis incomplete vaccination proportion was significantly higher in the patient group (16.6%) than in healthy controls (4.3%) (p = 0.002). In the patient group, the proportion of incomplete live-attenuated vaccines after diagnosis (25%) was more than pre-diagnosis (61.1%) (p = 0.04), while the proportion of incomplete non-live vaccines before and after diagnosis was similar (47.2% and 50%, respectively) (p = 0.73). The major reasons for missed vaccines were physicians' recommendations (15.6%), the presence of PedRD diagnosis (12.5%), and the drugs used (12.5%). CONCLUSION Vaccination coverage of PedRD patients has been shown to lag behind the routine vaccination schedule (71.4%). In addition to new recommendations, electronic health system records for vaccination may be appropriate for the follow-up of these patients, and the addition of reminder alerts may be useful to reduce the rate of missed vaccinations.
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Affiliation(s)
- Özlem Akgün
- Department of Pediatric Rheumatology, İstanbul Faculty of Medicine, İstanbul University, İstanbul, Turkey
| | - Fatma Gül Demirkan
- Department of Pediatric Rheumatology, İstanbul Faculty of Medicine, İstanbul University, İstanbul, Turkey
| | - Gülşah Kavrul Kayaalp
- Department of Pediatric Rheumatology, İstanbul Faculty of Medicine, İstanbul University, İstanbul, Turkey
| | - Merve Erdemir
- Social Pediatrics Doctoral Program, Istanbul University Institute of Health Sciences Institute of Child Health, Istanbul, Turkey
| | - Nergis Akay
- Department of Pediatrics, Istanbul Faculty of Medicine, Istanbul University, Istanbul, Turkey
| | - Figen Çakmak
- Department of Pediatric Rheumatology, İstanbul Faculty of Medicine, İstanbul University, İstanbul, Turkey
| | - Mustafa Önel
- Department of Microbiology, Istanbul Faculty of Medicine, Istanbul University, Istanbul, Turkey
| | - Gonca Keskindemirci
- Department of Social Pediatrics, Institute of Child Health, Istanbul University, Istanbul, Turkey
- Division of Social Pediatrics, Department of Child Health and Diseases, Istanbul Faculty of Medicine, Istanbul University, Istanbul, Turkey
| | - Rukiye Eker Ömeroğlu
- Department of Pediatric Rheumatology, İstanbul Faculty of Medicine, İstanbul University, İstanbul, Turkey
| | - Emine Gülbin Gökçay
- Department of Social Pediatrics, Institute of Child Health, Istanbul University, Istanbul, Turkey
- Division of Social Pediatrics, Department of Child Health and Diseases, Istanbul Faculty of Medicine, Istanbul University, Istanbul, Turkey
| | - Nuray Aktay Ayaz
- Department of Pediatric Rheumatology, İstanbul Faculty of Medicine, İstanbul University, İstanbul, Turkey
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Kervancioglu Demirci E, Dursun M, Seviç E, Ergül RB, Önel M, Ağaçfidan A, Kadıoğlu A. Evidence for residual SARS-CoV-2 in corpus cavernosum of patients who recovered from COVID-19 infection. Andrology 2023; 11:1016-1022. [PMID: 36426580 DOI: 10.1111/andr.13351] [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: 09/27/2022] [Revised: 11/19/2022] [Accepted: 11/20/2022] [Indexed: 11/26/2022]
Abstract
BACKGROUND The COVID-19 is an ongoing health problem with millions of cases and deaths worldwide. Although the virus is transmitted with droplets through the respiratory system, the involvement of different organs has been reported. OBJECTIVES The pandemic caused urological procedures to be postponed when patient is infected with SARS-CoV-2. However, the reliability of 1 month postpone period and long-term complications of the virus, such as a possible erectile dysfunction (ED) is not clarified. We aimed to compare the corpus cavernosum of patients 1 and 7 months after COVID-19 infection with control patients who had not COVID-19 and search for SARS-CoV-2 in tissues using immunohistochemistry and electron microscopy. MATERIALS AND METHODS Three groups of subjects underwent penile prosthesis implantation and Nesbit procedure for Peyronie's disease 1 and 7 months after COVID-19 infection and control group without previous COVID-19 infection. We searched for SARS-CoV-2 in penile tissue using RT-PCR, electron microscopy and immunohistochemistry. RESULTS Electron microscopy and immunohistochemical staining showed SARS CoV-2 virus in the penile corpus cavernosum of patients 1 month after COVID-19 recovery. Immunohistochemical staining intensity correlated with the severity of previous infection. Transmission electron microscopy revealed intracellular virtual particles of about 80 nm with a typical morphology of prominent spikes and electron-dense dots of nucleocapsid in addition to vesicles filled with virus-like particles. Cells showed increased membrane trafficking. The 1 month after COVID-19 group showed an increased number of fibroblasts. The 7 months after COVID-19 group had similar morphology and immunoreactivity as control group. DISCUSSION This is the first study of late post-COVID examination of penis and the second study of early post-COVID examination of corpus cavernosum. For 1 month post-COVID patients, the aetiology of ED could be the viral infection that is also affecting corpora cavernosa. We hypothesize that viral infection affects the endocytic and exocytic pathways, hence the metabolic activity of cells that can be the reason of altered functions in some post-COVID patients. CONCLUSION This study is important because it did not detect any virus residue in the tissue samples at the seventh month. In addition, we can say that the penile surgeries should be postponed more than 1 month after the COVID infection according to this study. But, there is a need for new studies with large series and high levels of evidence that can show how long the virus remains in the corpus cavernosum. Patients should be followed in this respect.
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Affiliation(s)
- Elif Kervancioglu Demirci
- Department of Histology and Embryology, Istanbul Faculty of Medicine, Istanbul University, Istanbul, Turkey
| | - Murat Dursun
- Department of Urology, Istanbul Faculty of Medicine, Istanbul University, Istanbul, Turkey
| | - Erva Seviç
- Department of Histology and Embryology, Istanbul Faculty of Medicine, Istanbul University, Istanbul, Turkey
| | - Rıfat Burak Ergül
- Department of Urology, Istanbul Faculty of Medicine, Istanbul University, Istanbul, Turkey
| | - Mustafa Önel
- Department of Microbiology, Istanbul Faculty of Medicine, Istanbul University, Istanbul, Turkey
| | - Ali Ağaçfidan
- Department of Microbiology, Istanbul Faculty of Medicine, Istanbul University, Istanbul, Turkey
| | - Ateş Kadıoğlu
- Department of Urology, Istanbul Faculty of Medicine, Istanbul University, Istanbul, Turkey
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Dogan L, Allahverdiyeva A, Önel M, Meşe S, Saka Ersin E, Anaklı İ, Sarıkaya ZT, Zengin R, Gucyetmez B, Yurtturan Uyar N, Özcan PE, Kocagöz AS, Uysal HK, Akinci İO, Ağaçfidan A. Is SARS-CoV-2 viral load a predictor of mortality in COVID-19 acute respiratory distress syndrome patients? J Int Med Res 2022; 50:3000605221137443. [DOI: 10.1177/03000605221137443] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/02/2022] Open
Abstract
Objective Viral load varies during infection and is higher during the initial stages of disease. Given the importance of the intensive care unit (ICU) in the late stages of COVID-19 infection, analyzing cycle threshold values to detect viral load upon ICU admission can be a clinically valuable tool for identifying patients with the highest mortality risk. Methods This was a retrospectively designed study. Patients older than 18 years who tested positive for SARS-CoV-2 PCR and had a PaO2/FiO2 ratio <200 were included in the study. The patient population was divided into two groups: survivors and non-survivors. Results Two hundred patients were included in the study. In non-survivors, age, relevant ICU admission scores, and procalcitonin levels were significantly higher whereas PaO2/FiO2 ratios and cycle threshold levels were significantly lower than in survivors. Conclusion Viral load at ICU admission has significant prognostic value. In combination with age, comorbidities, and severity scores, viral load may assist clinicians in identifying individuals who need more intensive monitoring. Increased awareness may improve outcomes by allowing the more effective monitoring and treatment of patients. More prospective studies are needed to determine how a high viral load worsens disease and how to avoid irreversible results.
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Affiliation(s)
- Lerzan Dogan
- Department of Medical Microbiology, Istanbul University, Istanbul, Turkey
- Intensive Care Unit, Acibadem Altunizade Hospital, Istanbul, Turkey
| | | | - Mustafa Önel
- Department of Medical Microbiology, Istanbul University, Istanbul, Turkey
| | - Sevim Meşe
- Department of Medical Microbiology, Istanbul University, Istanbul, Turkey
| | - Esra Saka Ersin
- Department of Anesthesiology and Reanimation, Istanbul University, Istanbul, Turkey
| | - İlkay Anaklı
- Department of Anesthesiology and Reanimation, Istanbul University, Istanbul, Turkey
| | - Zeynep Tuğçe Sarıkaya
- Department of Anesthesiology and Reanimation, Acibadem Mehmet Ali Aydinlar University, Istanbul, Turkey
| | - Rehile Zengin
- Department of Infectious Disease and Clinical Microbiology, Acibadem Altunizade Hospital, Istanbul, Turkey
| | - Bulent Gucyetmez
- Department of Anesthesiology and Reanimation, Acibadem Mehmet Ali Aydinlar University, Istanbul, Turkey
| | - Neval Yurtturan Uyar
- Department of Medical Microbiology, Acibadem Mehmet Ali Aydinlar University, Istanbul, Turkey
| | - Perihan Ergin Özcan
- Department of Anesthesiology and Reanimation, Istanbul University, Istanbul, Turkey
| | - Ayse Sesin Kocagöz
- Department of Infectious Disease and Clinical Microbiology, Acibadem Altunizade Hospital, Istanbul, Turkey
| | | | | | - Ali Ağaçfidan
- Department of Medical Microbiology, Istanbul University, Istanbul, Turkey
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Cömert RG, Cingöz E, Meşe S, Durak G, Tunaci A, Ağaçfidan A, Önel M, Ertürk ŞM. Radiological Findings in SARS-CoV-2 Viral Pneumonia Compared to Other Viral Pneumonias: A Single-Centre Study. Can J Infect Dis Med Microbiol 2022; 2022:2826524. [PMID: 36213436 PMCID: PMC9536981 DOI: 10.1155/2022/2826524] [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] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/14/2022] [Revised: 07/06/2022] [Accepted: 07/20/2022] [Indexed: 06/10/2023]
Abstract
BACKGROUND Thorax computed tomography (CT) imaging is widely used as a diagnostic method in the diagnosis of coronavirus disease 2019 (COVID-19)-related pneumonia. Radiological differential diagnosis and isolation of other viral agents causing pneumonia in patients have gained importance, particularly during the pandemic. AIMS We aimed to investigate whether there is a difference between CT images from patients with COVID-19-associated pneumonia compared to CT images of patients with pneumonia due to other viral agents and which finding may be more effective in diagnosis. Study Design. The study included 249 adult patients with pneumonia identified by thorax CT examination and with a positive COVID-19 RT-PCR test compared to 94 patients diagnosed with non-COVID-19 pneumonia (viral PCR positive but no bacterial or fungal agents detected in other cultures) between 2015 and 2019. CT images were retrospectively analyzed using the PACS system. CT findings were evaluated by two radiologists with 5 and 20 years of experience, in a blinded fashion, and the outcome was decided by consensus. METHODS Demographic data (age, gender, and known chronic disease) and CT imaging findings (percentage of involvement, number of lesions, distribution preference, dominant pattern, ground-glass opacity distribution pattern, nodule, tree in bud sign, interstitial changes, crazy paving sign, reversed halo sign, vacuolar sign, halo sign, vascular enlargement, linear opacities, traction bronchiectasis, peribronchial wall thickness, air trapping, pleural retraction, pleural effusion, pericardial effusion, cavitation, mediastinal/hilar lymphadenopathy, dominant lesion size, consolidation, subpleural curvilinear opacities, air bronchogram, and pleural thickening) of the patients were evaluated. CT findings were also evaluated with the RSNA consensus guideline and the CORADS scoring system. Data were divided into two main groups-non-COVID-19 and COVID-19 pneumonia-and compared statistically with chi-squared tests and multiple regression analysis of independent variables. RESULTS RSNA and CORADS classifications of CT scan images were able to successfully differentiate between positive and negative COVID-19 pneumonia patients. Statistically significant differences were found between the two patient groups in various categories including the percentage of involvement, number of lesions, distribution preference, dominant pattern, nodule, tree in bud, interstitial changes, crazy paving, reverse halo vascular enlargement, peribronchial wall thickness, air trapping, pleural retraction, pleural/pericardial effusion, cavitation, and mediastinal/hilar lymphadenopathy (p < 0.01). Multiple linear regression analysis of independent variables found a significant effect in reverse halo sign (β = 0.097, p < 0.05) and pleural effusion (β = 10.631, p < 0.05) on COVID-19 pneumonia patients. CONCLUSION The presence of reverse halo and absence of pleural effusion was found to be characteristic of COVID-19 pneumonia and therefore a reliable diagnostic tool to differentiate it from non-COVID-19 pneumonia.
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Affiliation(s)
- Rana Günöz Cömert
- Istanbul University, Istanbul Faculty of Medicine, Department of Radiology, Istanbul, Turkey
| | - Eda Cingöz
- Istanbul University, Istanbul Faculty of Medicine, Department of Radiology, Istanbul, Turkey
| | - Sevim Meşe
- Istanbul University, Istanbul Faculty of Medicine, Department of Medical Microbiology, Istanbul, Turkey
| | - Görkem Durak
- Istanbul University, Istanbul Faculty of Medicine, Department of Radiology, Istanbul, Turkey
| | - Atadan Tunaci
- Istanbul University, Istanbul Faculty of Medicine, Department of Radiology, Istanbul, Turkey
| | - Ali Ağaçfidan
- Istanbul University, Istanbul Faculty of Medicine, Department of Medical Microbiology, Istanbul, Turkey
| | - Mustafa Önel
- Istanbul University, Istanbul Faculty of Medicine, Department of Medical Microbiology, Istanbul, Turkey
| | - Şükrü Mehmet Ertürk
- Istanbul University, Istanbul Faculty of Medicine, Department of Radiology, Istanbul, Turkey
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Öksüz L, Hindilerden İY, Erciyestepe M, Önel M, Hindilerden F, Çağatay A, Nalçaci M, Ağaçfidan A. The association of CMV infection with bacterial and fungal infections in hematopoietic stem cell transplant recipients: a retrospective single-center study. New Microbiol 2022; 45:40-50. [PMID: 35403846] [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] [Subscribe] [Scholar Register] [Received: 04/11/2022] [Accepted: 04/11/2022] [Indexed: 06/14/2023]
Abstract
This study aims to evaluate the probable association between CMV infection and bacterial or fungalinfections in 91 consecutive adult patients who underwent autologous or allogeneic HSCT within aperiod of two years.The medical records of the patients were retrospectively reviewed. Blood cultures were evaluatedby an automated blood culture system. A quantitative real-time polymerase chain reaction was performedto detect CMV DNA.CMV infection and CMV disease were detected in 42 (46%) and six (6.6%) patients, respectively. Ofthe 158 microorganisms isolated, 115 (73%) were Gram-positive bacteria. Bacteremia and fungemiadeveloped in 55 (60%) and eight (8%) patients, respectively. Concurrent CMV infection and bacteremiawere detected in 17 (18.7%) patients and concurrent CMV infection and fungal infection weredetected in five (5.5%) patients. Graft versus host disease (GVHD) developed in 15 (50%) allogeneicHSCT recipients and two (2.2%) autologous HSCT recipients. Twenty-one (23%) patients including13 (43%) allogeneic and eight (13%) autologous HSCT recipients died.The most common infection is bacteremia, and it develops concurrently with CMV infection in approximatelyone-fifth of HSCT recipients. Gram-positive bacteria are more common in bacteremia.Further studies on the follow-up and treatment of infections after HSCT will improve post-HSCTsurvival rates.
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Affiliation(s)
- Lütfiye Öksüz
- Istanbul Faculty of Medicine, Department of Medical Microbiology, CAPA-ISTANBUL-TURKEY
| | - İpek Yönal Hindilerden
- Istanbul Faculty of Medicine, Department of Internal Diseases, Bone Marrow Transplantation Unit CAPA-ISTANBUL-TURKEY
| | - Mert Erciyestepe
- Istanbul Faculty of Medicine, Department of Internal Diseases, Bone Marrow Transplantation Unit CAPA-ISTANBUL-TURKEY
| | - Mustafa Önel
- Istanbul Faculty of Medicine, Department of Medical Microbiology, CAPA-ISTANBUL-TURKEY
| | - Fehmi Hindilerden
- University of Health Sciences Hamidiye School of Medicine Dr. Sadi Konuk Training and Research Hospital, BAKIRKOY-ISTANBUL-TURKEY
| | - Atahan Çağatay
- Istanbul Faculty of Medicine, Department of Internal Diseases, Infectious Diseases and Clinical Microbiology, CAPA-ISTANBUL-TURKEY
| | - Meliha Nalçaci
- Istanbul Faculty of Medicine, Department of Internal Diseases, Bone Marrow Transplantation Unit CAPA-ISTANBUL-TURKEY
| | - Ali Ağaçfidan
- Istanbul Faculty of Medicine, Department of Medical Microbiology, CAPA-ISTANBUL-TURKEY
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Bölükbaşı Y, Erköse Genç G, Orhun G, Kuşkucu MA, Çağatay A, Önel M, Öngen B, Ağaçfidan A, Esen F, Erturan Z. [First Case of COVID-19 Positive Candida auris Fungemia in Turkey]. MIKROBIYOL BUL 2021; 55:648-655. [PMID: 34666664 DOI: 10.5578/mb.20219716] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Candida auris is a species of fungus that has gained importance in recent years owing to its ability to cause hospital infections and epidemics, resistant to antifungal agents and disinfection processes and frequently misidentified by commercial systems. Hospital outbreaks caused by C.auris have been reported from some countries. It has been determined that C.auris has lower virulence than Candida albicans; however, it is associated with high mortality rates in immunocompromised individuals. An increase in the incidence of invasive fungal infections which can lead to serious complications and death, has been identified in severe coronavirus-2019 (COVID-19) patients or immunocompromised individuals with underlying disease. Studies demonstrated an increase in the frequency of C.auris isolation in COVID-19 patients with candidemia. In this report, the first case of COVID-19 positive C.auris fungemia detected in Turkey was presented. A 71-year-old male patient with a history of myocardial infarction, diabetes mellitus, donation of a single kidney and lobectomy surgery due to lung cancer was hospitalized in the pandemic thoracic surgery service due to the findings consistent with viral pneumonia on thoracic computed tomography. Favipiravir 2 x 600 mg and intravenous dexamethasone 1 x 6 mg therapy was administered. The patient tested positive for SARS-CoV-2 polymerase chain reaction, and severe involvement of the left lung was detected in the following days. Antibiotics were administered, followed by insertion of a right jugular vein catheter and initation of tocilizumab. The patient was transferred to the intensive care unit due to increased respiratory distress. Yeast growth was detected in the patient's hemoculture. The yeast strain could not be identified using API ID 32C (bioMerieux, France) (Sacchromyces kluyveri, Candida sake, unacceptable profile), but was identified as C.auris using the VITEK MALDI TOF MS (bioMerieux, France) (99.9%) system and confirmed by sequencing. The minimum inhibitor concentration values were detected as 3 µg/ml for amphotericin B; > 256 µg/ml for fluconazole; 0.19 µg/ml for voriconazole; 0.19 µg/ml for itraconazole; 0.016 µg/ml for posaconazole; 1 µg/ml for caspofungin and 0.094 µg/ml for anidulafungin by using the antibiotic gradient method. The patient's initial treatment comprised meropenem 3 x 1 g, vancomycin 2 x 1 g, caspofungin 1 x 70 mg, and continued as caspofungine 1 x 50 mg after the loading dose, and vancomycin 1 x 1 g/48 hours from the third day of treatment. The patient died on the ninth day after developing candidemia. The present case is the first case of fungemia caused by C.auris in a COVID-19 positive patient in Turkey, and it emphasizes the need of caution for fungemia due to C.auris in intensive care units in our country which has a high COVID-19 incidence.
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Affiliation(s)
- Yasemin Bölükbaşı
- Istanbul University Istanbul Faculty of Medicine, Department of Medical Microbiology, Istanbul, Turkey
| | - Gonca Erköse Genç
- Istanbul University Istanbul Faculty of Medicine, Department of Medical Microbiology, Istanbul, Turkey
| | - Günseli Orhun
- İstanbul University Istanbul Faculty of Medicine, Department of Anesthesiology and Reanimation, Istanbul, Turkey
| | - Mert Ahmet Kuşkucu
- Istanbul University-Cerrahpasa Cerrahpasa Faculty of Medicine, Department of Medical Microbiology, İstanbul, Turkey
| | - Atahan Çağatay
- İstanbul University Istanbul Faculty of Medicine, Department of Infectious Diseases and Clinical Microbiology, İstanbul, Turkey
| | - Mustafa Önel
- Istanbul University Istanbul Faculty of Medicine, Department of Medical Microbiology, Istanbul, Turkey
| | - Betigül Öngen
- Istanbul University Istanbul Faculty of Medicine, Department of Medical Microbiology, Istanbul, Turkey
| | - Ali Ağaçfidan
- Istanbul University Istanbul Faculty of Medicine, Department of Medical Microbiology, Istanbul, Turkey
| | - Figen Esen
- İstanbul University Istanbul Faculty of Medicine, Department of Anesthesiology and Reanimation, Istanbul, Turkey
| | - Zayre Erturan
- Istanbul University Istanbul Faculty of Medicine, Department of Medical Microbiology, Istanbul, Turkey
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Eren Sadioğlu R, Demir E, Evren E, Aktar M, Şafak S, Artan AS, Meşe S, Ağaçfidan A, Çınar G, Önel M, Karahan ZC, Şengül Ş, Keven K, Türkmen A. Antibody response to two doses of inactivated SARS-CoV-2 vaccine (CoronaVac) in kidney transplant recipients. Transpl Infect Dis 2021; 23:e13740. [PMID: 34606134 PMCID: PMC8646873 DOI: 10.1111/tid.13740] [Citation(s) in RCA: 12] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2021] [Revised: 09/13/2021] [Accepted: 09/19/2021] [Indexed: 12/17/2022]
Abstract
Background Coronavirus Disease‐19 (COVID‐19) has high mortality in kidney transplant recipients (KTR), and vaccination against severe acute respiratory syndrome‐coronavirus‐2 (SARS‐CoV‐2) is vital for this population. Although the humoral response to messenger RNA vaccines was shown to be impaired in KTR, there is a lack of data regarding the antibody response to inactivated vaccines. We investigated the antibody response to two consequent doses of the inactivated SARS‐CoV‐2 vaccine (CoronaVac; Sinovac Biotech, China). Methods A total of 118 patients from two centers were included. The levels of anti‐SARS‐CoV‐2 immunoglobulin‐G antibodies against the nucleocapsid and spike antigens were determined with enzyme immunoassay (DIA.PRO; Milano, Italy) before the vaccine and one month after the second dose of the vaccine. Thirty‐three patients were excluded due to antibody positivity in the serum samples obtained before vaccination. Results Eighty‐five patients, 47 of whom were female, with a mean age of 46 ± 12, were included in the statistical analysis. The maintenance immunosuppressive therapy comprised tacrolimus (88.2%), mycophenolate (63.6%), and low‐dose steroids (95.3%) in the majority of the patients. After a median of 31 days following the second dose of the vaccine, only 16 (18.8%) patients developed an antibody response. The median (IQR) antibody level was 52.5 IU/ml (21.5–96). Age (48 vs. 38, p = .005) and serum creatinine levels (1.14 vs. 0.91, p = .04) were higher in non‐responders and were also found to be independently associated with the antibody response (odds ratio (OR): 0.93, p = 0.012 and 0.15, p = 0.045, respectively) in multivariate analysis. Conclusion In this study, we found the antibody response to the inactivated vaccine to be considerably low (18.8%) in KTR. Increased age and impaired renal function were associated with worse antibody response. Based on the knowledge that mRNA vaccines yield better humoral responses, this special population might be considered for additional doses of mRNA vaccination.
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Affiliation(s)
- Rezzan Eren Sadioğlu
- Department of Nephrology, Ankara University School of Medicine, Ankara University, Ankara, Turkey
| | - Erol Demir
- Department of Nephrology, Istanbul School of Medicine, Istanbul University, Istanbul, Turkey
| | - Ebru Evren
- Department of Medical Microbiology, Ibni Sina Hospital Central Microbiology Laboratory, Ankara University School of Medicine, Ankara University, Ankara, Turkey
| | - Merve Aktar
- Department of Nephrology, Ankara University School of Medicine, Ankara University, Ankara, Turkey
| | - Seda Şafak
- Department of Nephrology, Istanbul School of Medicine, Istanbul University, Istanbul, Turkey
| | - Ayşe Serra Artan
- Department of Nephrology, Istanbul School of Medicine, Istanbul University, Istanbul, Turkey
| | - Sevim Meşe
- Department of Medical Microbiology, Istanbul School of Medicine, Istanbul University, Istanbul, Turkey
| | - Ali Ağaçfidan
- Department of Medical Microbiology, Istanbul School of Medicine, Istanbul University, Istanbul, Turkey
| | - Güle Çınar
- Department of Infectious Diseases and Clinical Microbiology, Ankara University School of Medicine, Ankara University, Ankara, Turkey
| | - Mustafa Önel
- Department of Medical Microbiology, Istanbul School of Medicine, Istanbul University, Istanbul, Turkey
| | - Zeynep Ceren Karahan
- Department of Medical Microbiology, Ibni Sina Hospital Central Microbiology Laboratory, Ankara University School of Medicine, Ankara University, Ankara, Turkey
| | - Şule Şengül
- Department of Nephrology, Ankara University School of Medicine, Ankara University, Ankara, Turkey
| | - Kenan Keven
- Department of Nephrology, Ankara University School of Medicine, Ankara University, Ankara, Turkey
| | - Aydın Türkmen
- Department of Nephrology, Istanbul School of Medicine, Istanbul University, Istanbul, Turkey
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Kaba Ö, Sarı Yanartaş M, Hançerli Törün S, Alakbarova K, Bayramoğlu Z, Önel M, Meşe S, Ağaçfidan A, Somer A. EXPERIENCE IN CHILDREN IN THE COVID-19 PANDEMIC OF A TERTIARY CENTER, IN ISTANBUL. jmed 2021. [DOI: 10.26650/iuitfd.2021.806433] [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: 11/20/2022] Open
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Köksal MO, Kaba Ö, Beka H, Önel M, Kara M, Hançerli Törün S, Meşe S, Somer A, Ağaçfidan A. Bir Üniversite Hastanesinde Çocuk Sağlığı ve Hastalıkları Kliniklerine Başvuran Hastalarda Mycoplasma pneumoniae Sıklığının Araştırılması. J Pediatr Inf 2021. [DOI: 10.5578/ced.20219901] [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: 11/15/2022]
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Köksal MO, Kaba Ö, Beka H, Önel M, Kara M, Hançerli Törün S, Meşe S, Somer A, Ağaçfidan A. Prevalence of Mycoplasma pneumoniae from Symptomatic Pediatric Patients Referred to a Child Outpatient Clinic of a University Hospital. J Pediatr Inf 2021. [DOI: 10.5578/ced.20219918] [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: 11/15/2022]
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Bakır A, Karabulut N, Alaçam S, Yaman M, Önel M, Ağaçfidan A. Evaluation of Signal/Cut-off Ratio by Anti-hepatitis Delta Virus Enzyme Immunoassay Method in the Diagnosis of Hepatitis Delta Virus Infection. Egypt J Immunol 2019. [DOI: 10.4274/vhd.galenos.2019.2019.0026] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
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Yolcu A, Karabulut N, Alaçam S, Önel M, Büyük M, Güllüoğlu M, Ağaçfidan A. Frequency of Hepatitis Delta Virus in Hepatitis B Surfaceantigen-positive Patients. Egypt J Immunol 2019. [DOI: 10.4274/vhd.galenos.2018-0018] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
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