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Bagci B, Bagci G, Buyuktuna SA, Elaldi N. Association of MCP-1 promotor polymorphism with disease severity of Crimean-Congo hemorrhagic fever. J Med Virol 2020; 92:2976-2982. [PMID: 32219866 DOI: 10.1002/jmv.25790] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [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: 02/25/2020] [Accepted: 03/18/2020] [Indexed: 12/30/2022]
Abstract
Crimean-Congo hemorrhagic fever (CCHF) is a thick-borne viral zoonotic disease. The pathogenesis and the reasons why cases have a mild or severe course in CCHF have not yet been explained. In this study, we investigated the relationship between promoter -2518 A/G single-nucleotide polymorphism (SNP) of the MCP-1 gene and the clinical course of CCHF. The MCP-1-2518 A/G SNP (rs1024611) frequency was examined in 128 virologically/serologically confirmed CCHF patients and 181 healthy controls by using the PCR-RFLP method. When CCHF patients and controls were compared, no significant difference was found between genotype distributions and allele frequencies of the -2518 A/G SNP of MCP-1 gene (P > .05). Compared to the AA genotype, both AG (P = .016; OR = 2.57) and GG genotype (P = .039; OR = 3.43) were found with significantly higher frequencies in mild/moderate cases than in severe cases. Compared to the AG + GG genotype, AA showed a significant risk for severe CCHF (60.0% vs 38.4%, P = .02; OR = 2.41). In contrast, the AG genotype showed a significant protective effect against severe disease compared to AA + GG genotype (29.1% vs 47.9%, P = .013; OR = 2.58). Compared to mild/moderate cases, the A allele was found to be significantly higher in severe cases (0.745 vs 0.623, P = .039; OR = 1.77). However, no significant relationship was found between fatal and nonfatal cases in terms of genotype or allele frequencies (P > .05). In conclusion, both -2518 AA genotype and A allele of MCP-1 were associated with disease severity, and the AG genotype had a protective effect against a severe disease course in CCHF patients.
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Affiliation(s)
- Binnur Bagci
- Department of Nutrition and Dietetics, Faculty of Health Sciences, Sivas Cumhuriyet University, Sivas, Turkey
| | - Gokhan Bagci
- Department of Medical Genetics, Faculty of Medicine, Sivas Cumhuriyet University, Sivas, Turkey
| | - Seyit Ali Buyuktuna
- Department of Infectious Diseases and Clinical Microbiology, Faculty of Medicine, Sivas Cumhuriyet University, Sivas, Turkey
| | - Nazif Elaldi
- Department of Infectious Diseases and Clinical Microbiology, Faculty of Medicine, Sivas Cumhuriyet University, Sivas, Turkey
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Demirtas E, Bakir M, Buyuktuna SA, Oksuz C, Oz M, Cebecioglu K, Unlusavuran M. Comparison of the Predictive Performances of qSOFA, APACHE II, and SGS for Evaluation of the Disease Prognosis of CCHF Patients at the Emergency Department. Jpn J Infect Dis 2020; 73:323-329. [PMID: 32350220 DOI: 10.7883/yoken.jjid.2019.507] [Citation(s) in RCA: 2] [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] [Indexed: 11/17/2022]
Abstract
In this study, we compared the predictive performances of quick sequential organ failure assessment (qSOFA), the acute physiology and chronic health evaluation (APACHE II) scores, and the severity grading score (SGS) for evaluation of the disease prognosis of patients with Crimean-Congo hemorrhagic fever (CCHF) at the emergency department. We recorded the qSOFA, SGS, and APACHE II scores at admission and at the 72nd and 120th hour in 97 patients admitted to the emergency department and diagnosed with CCHF. In our study, the area under a receiver operating characteristic curve values of qSOFA, SGS, and APACHE II at admission were found to be 0.640, 0.824, and 0.576, respectively. No statistical significance was found for a qSOFA score ≥ 2 at admission as a predictor of mortality. The use of qSOFA score for diseases with a mortal prognosis such as CCHF is insufficient in predicting the prognosis.
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Affiliation(s)
- Erdal Demirtas
- Department of Emergency Medicine, Faculty of Medicine, University of Sivas Cumhuriyet, Turkey
| | - Mehmet Bakir
- Department of Infectious Disease and Clinical Microbiology, Faculty of Medicine, University of Sivas Cumhuriyet, Turkey
| | - Seyit Ali Buyuktuna
- Department of Infectious Disease and Clinical Microbiology, Faculty of Medicine, University of Sivas Cumhuriyet, Turkey
| | - Caner Oksuz
- Department of Infectious Disease and Clinical Microbiology, Faculty of Medicine, University of Sivas Cumhuriyet, Turkey
| | - Murtaza Oz
- Department of Infectious Disease and Clinical Microbiology, Faculty of Medicine, University of Sivas Cumhuriyet, Turkey
| | - Kıvanc Cebecioglu
- Department of Emergency Medicine, Faculty of Medicine, University of Sivas Cumhuriyet, Turkey
| | - Meltem Unlusavuran
- Department of Biostatistics, Faculty of Medicine, University of Erciyes, Turkey
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Akcam FZ, Kaya O, Temel EN, Buyuktuna SA, Unal O, Yurekli VA. An investigation of the effectiveness against bacteriuria of silver-coated catheters in short-term urinary catheter applications: A randomized controlled study. J Infect Chemother 2019; 25:797-800. [PMID: 31030965 DOI: 10.1016/j.jiac.2019.04.004] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [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: 09/26/2018] [Revised: 03/03/2019] [Accepted: 04/11/2019] [Indexed: 01/02/2023]
Abstract
AIM The aim of this study was to investigate the effectiveness of antimicrobial-coated catheters against bacteriuria and urinary tract infection in patients who have urinary catheterization. METHODS Twenty eight and twenty six people similar in terms of demographic characteristics and primary and underlying diseases were randomly selected from patients undergoing short-time urinary catheterization in the intensive care unit. Silver-coated slicone foley catheters and normal slicone foley catheters were used for uninary catheterization in the first and second group of the patients respectively. Urine specimens were collected from patients at 2-day intervals and assessed in terms of bacteriuria. RESULTS Bacteriuria was found in 12 (46.2%) of the patients using normal catheters and 13 (46.4%) of those using silver-coated catheters throughout the monitoring period. No significant relationship was determined between use of different catheter types and bacteriuria (p = 0.98). The most common microorganism was identified as E. coli in the normal catheter group while microorganism other than E. coli was identified in the silver-coated catheter group. The prevalence of bacteriuria was statistically significantly higher in patients with a history of hospitalization in the previous 3 months (p = 0.028). CONCLUSION The use of silver-coated silicone catheters was not shown to have a protective effect against bacteriuria in this study. Further well-designed studies with larger case numbers are now needed to confirm whether history of hospitalization, which emerged as a statistically significant factor in this study, increases the prevalence of catheter-related bacteriuria.
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Affiliation(s)
- Fusun Zeynep Akcam
- Suleyman Demirel University, Department of Infectious Diseases and Clinical Microbiology, Isparta, Turkey.
| | - Onur Kaya
- Suleyman Demirel University, Department of Infectious Diseases and Clinical Microbiology, Isparta, Turkey.
| | - Esra Nurlu Temel
- Suleyman Demirel University, Department of Infectious Diseases and Clinical Microbiology, Isparta, Turkey.
| | - Seyit Ali Buyuktuna
- Cumhuriyet University, Department of Infectious Diseases and Clinical Microbiology, Sivas, Turkey.
| | - Onur Unal
- Suleyman Demirel University, Department of Infectious Diseases and Clinical Microbiology, Isparta, Turkey.
| | - Vedat Ali Yurekli
- Suleyman Demirel University, Department of Neurology, Isparta, Turkey.
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Engin A, Aydin H, Cinar Z, Buyuktuna SA, Bakir M. Apoptosis and its relation with clinical course in patients with Crimean-Congo hemorrhagic fever. J Med Virol 2019; 91:1385-1393. [PMID: 30905066 DOI: 10.1002/jmv.25467] [Citation(s) in RCA: 2] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2019] [Revised: 03/19/2019] [Accepted: 03/20/2019] [Indexed: 02/06/2023]
Abstract
Crimean-Congo hemorrhagic fever (CCHF) is a tick-mediated viral infection. Patients with CCHF may show various clinical presentations. The cause of this difference in the clinical course is not completely understood. Apoptosis is programmed cell death and plays an important role in regulating the immune system. Our knowledge of the role of apoptosis in CCHF disease is limited. We investigated the role of apoptosis and their relationship with the severity of the disease in CCHF. Thus, in 30 patients with CCHF and 30 healthy individuals, we analyzed the serum levels of cytochrome C, apoptotic protease activating factor-1 (Apaf 1), caspase 3, caspase 8, caspase 9, sFas, sFasL, perforin, granzyme B, and CK18 by enzyme-linked immunosorbent assay. This is the first study that research the serum levels of the mentioned apoptosis markers in adult patients with CCHF. We found that the serum levels of sFasL, cytochrome C, Apaf 1, caspase 3, caspase 8, caspase 9, perforin, granzyme B, and M30 were statistically significantly different in the acute phase of the disease compared with healthy individuals and patients in convalescent period. There was no association between the clinical severity of the disease and apoptosis markers. In conclusion, the results of our study suggested that the extrinsic and intrinsic apoptosis pathway play an important role in CCHF.
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Affiliation(s)
- Aynur Engin
- Department of Infectious Diseases and Clinical Microbiology, Cumhuriyet University School of Medicine, Sivas, Turkey
| | - Huseyin Aydin
- Department of Biochemistry, Cumhuriyet University School of Medicine, Sivas, Turkey
| | - Ziynet Cinar
- Department of Biostatistics, Cumhuriyet University School of Medicine, Sivas, Turkey
| | - Seyit Ali Buyuktuna
- Department of Infectious Diseases and Clinical Microbiology, Cumhuriyet University School of Medicine, Sivas, Turkey
| | - Mehmet Bakir
- Department of Infectious Diseases and Clinical Microbiology, Cumhuriyet University School of Medicine, Sivas, Turkey
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Leblebicioglu H, Sunbul M, Barut S, Buyuktuna SA, Ozkurt Z, Yapar D, Yilmaz G, Guner R, But A, Cicek Senturk G, Murat N, Ozaras R. Multi-center prospective evaluation of discharge criteria for hospitalized patients with Crimean-Congo Hemorrhagic Fever. Antiviral Res 2016; 133:9-13. [PMID: 27424492 DOI: 10.1016/j.antiviral.2016.07.010] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2016] [Revised: 07/12/2016] [Accepted: 07/13/2016] [Indexed: 10/21/2022]
Abstract
INTRODUCTION The information of discharge criteria in patients with Crimean-Congo Hemorrhagic Fever (CCHF) is limited. In this study, we aimed to determine the clinical and laboratory parameters used in discharging the patients by the experienced centers. MATERIALS AND METHODS The study was done in 9 reference centers of CCHF from May 1, 2015 to December 1, 2015 and included laboratory-confirmed patients with CCHF. The study was prospective, observational and non-interventional. RESULTS The study included 260 patients. Mean age was 51.3 ± 16.3 years; 158 (60.8%) were male. Mean hospital stay was 7 ± 2.6 days. The decision of discharging was taken considering clinical and laboratory findings. On discharge, no patients had fever or hemorrhage. The patients were followed-up clinically and a repeat CCHF PCR was not studied. All centers considered the following criteria for discharge: no fever and hemorrhage, improvement in clinical findings and laboratory studies. For all patients except one, platelet count was >50,000/mm(3) and had a tendency to increase. Prothrombin time and international normalized ratio (INR) were normal in 258 (99.6%) and 254 (98.1%) patients respectively. Alanine aminotransferase (ALT) was either normal or not higher than 10-fold and had a tendency to decrease in 259 (99.6%) patients. ALT and aspartate aminotransferase (AST) levels were not taken as discharge criteria with priority. During 30 days following the discharge, complication, relapse, or secondary transmission were not reported. CONCLUSIONS The discharging practice of the centers based on clinical and laboratory parameters seems safe considering no complications, relapses, or secondary infection thereafter. Current discharge practice of the centers composed of no fever and hemorrhage, improvement in clinical findings, platelet count of either >100,000/mm(3) or >50,000/mm(3) with a tendency to increase, and normal bleeding tests can be used as the criteria of discharge.
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Affiliation(s)
- Hakan Leblebicioglu
- Department of Infectious Diseases and Clinical Microbiology, Ondokuz Mayis University Medical School, Samsun, Turkey.
| | - Mustafa Sunbul
- Department of Infectious Diseases and Clinical Microbiology, Ondokuz Mayis University Medical School, Samsun, Turkey
| | - Sener Barut
- Department of Infectious Diseases and Clinical Microbiology, Gaziosmanpasa University Medical School, Tokat, Turkey
| | - Seyit Ali Buyuktuna
- Department of Infectious Diseases and Clinical Microbiology, Cumhuriyet University Medical School, Sivas, Turkey
| | - Zulal Ozkurt
- Department of Infectious Diseases and Clinical Microbiology, Ataturk University Medical School, Erzurum, Turkey
| | - Derya Yapar
- Department of Infectious Diseases and Clinical Microbiology, Hitit University Medical School, Corum, Turkey
| | - Gurdal Yilmaz
- Department of Infectious Diseases and Clinical Microbiology, Karadeniz Technical University Medical School, Samsun, Turkey
| | - Rahmet Guner
- Department of Infectious Diseases and Clinical Microbiology, Yildirim Beyazit University Medical School, Ankara, Turkey
| | - Ayse But
- Department of Infectious Diseases and Clinical Microbiology, Ankara Numune Education and Research Hospital, Ankara, Turkey
| | - Gonul Cicek Senturk
- Department of Infectious Diseases and Clinical Microbiology, Diskapi Yildirim Beyazit Education and Research Hospital, Ankara, Turkey
| | - Naci Murat
- Department of Industrial Engineering, Ondokuz Mayis University, Faculty of Engineering, Samsun, Turkey
| | - Resat Ozaras
- Department of Infectious Diseases and Clinical Microbiology, Istanbul University Cerrahpasa Medical School, Istanbul, Turkey
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