1
|
Ballı FN, Ekinci PB, Kurtaran M, Kara E, Dizman GT, Sönmezer MÇ, Hayran M, Demirkan K, Metan G. Battle of polymyxin induced nephrotoxicity: Polymyxin B versus colistin. Int J Antimicrob Agents 2024; 63:107035. [PMID: 37979889 DOI: 10.1016/j.ijantimicag.2023.107035] [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: 06/03/2023] [Revised: 11/08/2023] [Accepted: 11/09/2023] [Indexed: 11/20/2023]
Abstract
OBJECTIVES Nephrotoxicity is the most serious and common adverse effect that limits the use of polymyxins. This study compared polymyxin E (colistin) and polymyxin B regarding drug-related nephrotoxicity. METHODS This study was conducted as a retrospective cohort study in a university hospital between January 2020 and July 2022. Patients older than 18 years and who received colistin or polymyxin B were identified using electronic hospital records. Kidney disease improving global outcome criteria were used for assessing nephrotoxicity. RESULTS A total of 190 patients, 95 in both groups, were evaluated. The incidence of acute kidney injury during the treatment was higher in the colistin group [52.6% (n = 50) and 34.7% (n = 33), P = 0.013]. In patients who were exposed to high-dose, the rate of nephrotoxicity was higher in patients receiving colistin [25% (n = 3) vs. 76.9% (n = 10); P = 0.017]. Nephrotoxicity was reversible in 64.4% (n = 38) of patients and the reversibility rate was similar (70% and 52.6% for colistin and polymyxin; P = 0.248). In the multivariable analysis, colistin treatment [odds ratio (OR): 3.882, 95% confidence interval (95% CI) = (1.829-8.241)], concomitant vasopressor use (OR = 2.08, CI: 1.036-4.179), and age (OR=1.036, CI: 1.014-1.058) were found to be independent markers of nephrotoxicity. CONCLUSION Nephrotoxicity was more common in patients receiving high-dose colistin than polymyxin B. Therefore, the use of appropriate doses of colistin is important in terms of preventing nephrotoxicity. In addition, advancing age and concomitant use of vasopressors contribute to polymyxin-related nephrotoxicity.
Collapse
Affiliation(s)
- Fatma Nisa Ballı
- Department of Clinical Pharmacy, Gazi University Faculty of Pharmacy, Ankara, Türkiye; Department of Clinical Pharmacy, Hacettepe University Faculty of Pharmacy, Ankara, Türkiye.
| | - Pınar Bakır Ekinci
- Department of Clinical Pharmacy, Hacettepe University Faculty of Pharmacy, Ankara, Türkiye
| | - Melek Kurtaran
- Department of Clinical Pharmacy, Hacettepe University Faculty of Pharmacy, Ankara, Türkiye
| | - Emre Kara
- Department of Clinical Pharmacy, Hacettepe University Faculty of Pharmacy, Ankara, Türkiye
| | - Gülçin Telli Dizman
- Department of Infectious Diseases and Clinical Microbiology, Hacettepe University Faculty of Medicine, Ankara, Türkiye
| | - Meliha Çağla Sönmezer
- Department of Infectious Diseases and Clinical Microbiology, Hacettepe University Faculty of Medicine, Ankara, Türkiye
| | - Mutlu Hayran
- Department of Preventive Oncology, Hacettepe University Faculty of Medicine, Ankara, Türkiye
| | - Kutay Demirkan
- Department of Clinical Pharmacy, Hacettepe University Faculty of Pharmacy, Ankara, Türkiye
| | - Gökhan Metan
- Department of Infectious Diseases and Clinical Microbiology, Hacettepe University Faculty of Medicine, Ankara, Türkiye
| |
Collapse
|
2
|
Telli Dizman G, Metan G, Karahan G, Tanrıverdi ES, Hazırolan G, Otlu B, Sönmezer MÇ, Gül ND, Çınar B, Ünal S. Does marking as sterile mean really sterile? Stenotrophomonas maltophilia outbreak caused by a blood-gas injector containing liquid heparin. Infect Control Hosp Epidemiol 2023; 44:1683-1685. [PMID: 36775899 DOI: 10.1017/ice.2023.12] [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] [Indexed: 02/14/2023]
Abstract
An outbreak investigation was initiated after detecting an increase in the number of patients with Stenotrophomonas maltophilia bloodstream infections (SM-BSIs) througout the hospital. S. maltophilia was isolated from the cultures of blood-gas ınjectors containing liquid heparin. The incidence density of SM-BSIs decreased significantly after prohibiting the use of those injectors.
Collapse
Affiliation(s)
- Gülçin Telli Dizman
- Department of Infectious Diseases and Clinical Microbiology, Faculty of Medicine, Hacettepe University, Ankara, Turkey
- Infection Control Committee, Hospitals of Faculty of Medicine, Hacettepe University, Ankara, Turkey
| | - Gökhan Metan
- Department of Infectious Diseases and Clinical Microbiology, Faculty of Medicine, Hacettepe University, Ankara, Turkey
- Infection Control Committee, Hospitals of Faculty of Medicine, Hacettepe University, Ankara, Turkey
| | - Gizem Karahan
- Department of Infectious Diseases and Clinical Microbiology, Faculty of Medicine, Hacettepe University, Ankara, Turkey
| | - Elif Seren Tanrıverdi
- Department of Medical Microbiology, Molecular Microbiology Laboratory, İnönü University Faculty of Medicine, Malatya, Turkey
| | - Gülşen Hazırolan
- Department of Medical Microbiology, Faculty of Medicine, Hacettepe UniversityAnkara, Turkey
| | - Barış Otlu
- Department of Medical Microbiology, Molecular Microbiology Laboratory, İnönü University Faculty of Medicine, Malatya, Turkey
| | - Meliha Çağla Sönmezer
- Department of Infectious Diseases and Clinical Microbiology, Faculty of Medicine, Hacettepe University, Ankara, Turkey
| | - Nur Dilek Gül
- Infection Control Committee, Hospitals of Faculty of Medicine, Hacettepe University, Ankara, Turkey
| | - Burcu Çınar
- Infection Control Committee, Hospitals of Faculty of Medicine, Hacettepe University, Ankara, Turkey
| | - Serhat Ünal
- Department of Infectious Diseases and Clinical Microbiology, Faculty of Medicine, Hacettepe University, Ankara, Turkey
- Infection Control Committee, Hospitals of Faculty of Medicine, Hacettepe University, Ankara, Turkey
| |
Collapse
|
3
|
Telli Dizman G, Metan G, Zarakolu P, Tanrıverdi ES, Hazırolan G, Aytaç Ak H, Kılınçarslan D, Uzun M, Çelik Kavaklılar B, Arık Z, Otlu B, Ünal S. Cessation of Rectal Screening for Vancomycin-Resistant Enterococci: Experience from a Tertiary Care Hospital from Türkiye. Healthcare (Basel) 2023; 11:2641. [PMID: 37830678 PMCID: PMC10572918 DOI: 10.3390/healthcare11192641] [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: 08/14/2023] [Revised: 09/23/2023] [Accepted: 09/26/2023] [Indexed: 10/14/2023] Open
Abstract
OBJECTIVE Here, we compared the impact of different polices on the epidemiology of Vancomycin-resistant Enterococcus faecium bloodstream infections (VRE-BSIs) in a tertiary care hospital including two hospital buildings (oncology and adult hospitals) in the same campus. MATERIAL AND METHODS All patients who were hospitalized in high-risk units were screened weekly for VRE colonization via rectal swab between January 2006 and January 2013. After January 2013, VRE screening was only performed in cases of suspicion of VRE outbreak and during point prevalence studies to evaluate the epidemiology of VRE colonization. Contact precautions were in place for all VRE-positive patients. The incidence density rates of hospital-acquired (HA)-VRE-BSIs were compared between two periods. RESULTS While the rate of VRE colonization was higher in the second period (5% vs. 9.5% (p < 0.01) for the adult hospital, and 6.4% vs. 12% (p = 0.02 for the oncology hospital), there was no increase in the incidence rate HA-VRE BSIs after the cessation of routine rectal screening in either of the hospitals. CONCLUSION Screening policies should be dynamic and individualized according to the epidemiology of VRE as well as the workforce and cost. Periodical rectal screening of VRE can be discontinued if suspicion of an outbreak can be carefully monitored.
Collapse
Affiliation(s)
- Gülçin Telli Dizman
- Department of Infectious Diseases and Clinical Microbiology, Faculty of Medicine, Hacettepe University, Ankara 06800, Türkiye; (G.M.); (P.Z.); (M.U.); (S.Ü.)
- Infection Control Committee, Hacettepe University Hospitals, Ankara 06800, Türkiye; (H.A.A.); (D.K.)
| | - Gökhan Metan
- Department of Infectious Diseases and Clinical Microbiology, Faculty of Medicine, Hacettepe University, Ankara 06800, Türkiye; (G.M.); (P.Z.); (M.U.); (S.Ü.)
- Infection Control Committee, Hacettepe University Hospitals, Ankara 06800, Türkiye; (H.A.A.); (D.K.)
| | - Pınar Zarakolu
- Department of Infectious Diseases and Clinical Microbiology, Faculty of Medicine, Hacettepe University, Ankara 06800, Türkiye; (G.M.); (P.Z.); (M.U.); (S.Ü.)
| | - Elif Seren Tanrıverdi
- Molecular Microbiology Laboratory, Department of Medical Microbiology, Faculty of Medicine, İnönü University, Malatya 44280, Türkiye; (E.S.T.); (B.O.)
| | - Gülşen Hazırolan
- Department of Medical Microbiology, Faculty of Medicine, Hacettepe University, Ankara 06800, Türkiye;
| | - Hanife Aytaç Ak
- Infection Control Committee, Hacettepe University Hospitals, Ankara 06800, Türkiye; (H.A.A.); (D.K.)
| | - Dilek Kılınçarslan
- Infection Control Committee, Hacettepe University Hospitals, Ankara 06800, Türkiye; (H.A.A.); (D.K.)
| | - Mertcan Uzun
- Department of Infectious Diseases and Clinical Microbiology, Faculty of Medicine, Hacettepe University, Ankara 06800, Türkiye; (G.M.); (P.Z.); (M.U.); (S.Ü.)
| | - Başak Çelik Kavaklılar
- Department of Internal Medicine, Faculty of Medicine, Hacettepe University, Ankara 06800, Türkiye;
| | - Zafer Arık
- Department of Internal Medicine, Section of Oncology, Faculty of Medicine, Hacettepe University, Ankara 06800, Türkiye;
| | - Barış Otlu
- Molecular Microbiology Laboratory, Department of Medical Microbiology, Faculty of Medicine, İnönü University, Malatya 44280, Türkiye; (E.S.T.); (B.O.)
| | - Serhat Ünal
- Department of Infectious Diseases and Clinical Microbiology, Faculty of Medicine, Hacettepe University, Ankara 06800, Türkiye; (G.M.); (P.Z.); (M.U.); (S.Ü.)
- Infection Control Committee, Hacettepe University Hospitals, Ankara 06800, Türkiye; (H.A.A.); (D.K.)
| |
Collapse
|
4
|
Sertçelik A, Metan G, Telli Dizman G, Atılmış D, Şahan C, Kalaycı D, Alp A, Çakır B, Zarakolu P, Ünal S, Uzun Ö. Back to the First Days of the Pandemic: How Well Have We Done to Diagnose COVID-19 in Healthcare Workers? FLORA 2022. [DOI: 10.5578/flora.20229604] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
|
5
|
Telli Dizman G, Aguado JM, Fernández-Ruiz M. Risk of infection in patients with hematological malignancies receiving CAR T-cell therapy: systematic review and meta-analysis. Expert Rev Anti Infect Ther 2022; 20:1455-1476. [PMID: 36148506 DOI: 10.1080/14787210.2022.2128762] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [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: 12/24/2022]
Abstract
BACKGROUND Chimeric antigen receptor (CAR) T-cell therapy has emerged as a promising treatment option for relapsed or refractory B-cell malignancies and multiple myeloma. Underlying and treatment-related variables may contribute to the development of infectious complications. RESEARCH DESIGN AND METHODS We conducted a systematic review and meta-analysis on the incidence of overall and severe (grade ≥3) infection in patients with hematological malignancies receiving CAR T-cells. Secondary outcomes included the specific rates of bacterial, viral and invasive fungal infection (IFI), and infection-related mortality. PubMed, Embase and Web of Science databases were searched from inception to 27 May 2022. Sensitivity analysis were performed according to the type of malignancy and study design (randomized clinical trials [RCTs] or observational studies). RESULTS Forty-five studies (34 RCTs) comprising 3,591 patients were included. The pooled incidence rates of overall and severe infection were 33.8% (I2 = 96.31%) and 16.2% (I2 = 74.41%). The respiratory tract was the most common site of infection. Most events were bacterial or viral, whereas the occurrence of IFI was rare. The pooled attributable mortality was 1.8% (I2 = 43.44%). CONCLUSIONS Infection is a frequent adverse event in patients receiving CAR T-cell therapy. Further research should address specific risk factors in this population.
Collapse
Affiliation(s)
- Gülçin Telli Dizman
- Department of Infectious Disease and Clinical Microbiology, Hacettepe University School of Medicine, Ankara, Turkey
| | - José María Aguado
- Unit of Infectious Diseases, Hospital Universitario "12 de Octubre", Instituto de Investigación Sanitaria Hospital "12 de Octubre" (imas12), Madrid, Spain.,Centro de Investigación Biomédica en Red de Enfermedades Infecciosas (CIBERINFEC), Instituto de Salud Carlos III (ISCIII), Madrid, Spain.,Department of Medicine, School of Medicine, Universidad Complutense, Madrid, Spain
| | - Mario Fernández-Ruiz
- Unit of Infectious Diseases, Hospital Universitario "12 de Octubre", Instituto de Investigación Sanitaria Hospital "12 de Octubre" (imas12), Madrid, Spain.,Centro de Investigación Biomédica en Red de Enfermedades Infecciosas (CIBERINFEC), Instituto de Salud Carlos III (ISCIII), Madrid, Spain.,Department of Medicine, School of Medicine, Universidad Complutense, Madrid, Spain
| |
Collapse
|
6
|
Metan G, Demir Çuha M, Hazirolan G, Telli Dizman G, Tanriverdi ES, Otlu B, Tas Z, Zarakolu P, Arik Z, Topeli A, Akinci SB, Ünal S, Uzun Ö. The impact of COVID-19 pandemic on nosocomial multidrug-resistant bacterial bloodstream infections and antibiotic consumption in a tertiary care hospital. GMS Hyg Infect Control 2022; 17:Doc15. [PMID: 36157382 PMCID: PMC9487780 DOI: 10.3205/dgkh000418] [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] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/05/2022]
Abstract
We investigated the change in the epidemiology of nosocomial bloodstream infections (BSIs) caused by multidrug-resistant bacteria during Coronavirus Disease (COVID-19) and antibiotic consumption rates at a pandemic hospital and at the Oncology Hospital which operated as COVID-19-free on the same university campus. Significant increases in the infection density rate (IDRs) of BSIs caused by carbapenem-resistant Acinetobacter baumannii (CRAB) and ampicillin-resistant Enterococcus faecium (ARE) were detected at the pandemic hospital, whereas carbapenem-resistant Klebsiella pneumoniae BSIs were increased at the non-pandemic Oncology Hospital. Pulsed field gel electrophoresis showed a polyclonal outbreak of CRAB in COVID-19 intensive care units. Antibiotic consumption rates were increased for almost all antibiotics, and was most significant for meropenem at both of the hospitals. Increased IDRs of CRAB and ARE BSIs as well as an increased consumption rate of broad-spectrum antibiotics emphasize the importance of a multimodal infection prevention strategy combined with an active antibiotic stewardship program.
Collapse
Affiliation(s)
- Gökhan Metan
- Department of Infectious Diseases and Clinical Microbiology, Hacettepe University Faculty of Medicine, Ankara, Turkey,Infection Control Committee Hacettepe University Hospitals, Ankara, Turkey,*To whom correspondence should be addressed: Gökhan Metan, Hacettepe Üniversitesi Tıp Fakültesi Hastanesi İç Hastalıkları Binası Kat: 1, Enfeksiyon Hastalıkları ve Klinik Mikrobiyoloji Anabilim Dalı, Ankara, Turkey, E-mail: ,
| | - Mervenur Demir Çuha
- Department of Medical Microbiology, Hacettepe University Faculty of Medicine, Ankara, Turkey
| | - Gülsen Hazirolan
- Department of Medical Microbiology, Hacettepe University Faculty of Medicine, Ankara, Turkey
| | - Gülçin Telli Dizman
- Department of Infectious Diseases and Clinical Microbiology, Hacettepe University Faculty of Medicine, Ankara, Turkey,Infection Control Committee Hacettepe University Hospitals, Ankara, Turkey
| | - Elif Seren Tanriverdi
- Department of Medical Microbiology, İnönü University Faculty of Medicine, Malatya, Turkey
| | - Baris Otlu
- Department of Medical Microbiology, İnönü University Faculty of Medicine, Malatya, Turkey
| | - Zahit Tas
- Department of Infectious Diseases and Clinical Microbiology, Hacettepe University Faculty of Medicine, Ankara, Turkey
| | - Pinar Zarakolu
- Department of Infectious Diseases and Clinical Microbiology, Hacettepe University Faculty of Medicine, Ankara, Turkey
| | - Zafer Arik
- Division of Medical Oncology, Department of Internal Medicine, Hacettepe University Faculty of Medicine, Ankara, Turkey
| | - Arzu Topeli
- Section of Intensive Care Medicine, Department of Internal Medicine, Hacettepe University Faculty of Medicine, Ankara, Turkey
| | - Seda Banu Akinci
- Section of Intensive Care Medicine Department of Anesthesiology and Reanimation, Hacettepe University Faculty of Medicine, Ankara, Turkey
| | - Serhat Ünal
- Department of Infectious Diseases and Clinical Microbiology, Hacettepe University Faculty of Medicine, Ankara, Turkey,Infection Control Committee Hacettepe University Hospitals, Ankara, Turkey
| | - Ömrüm Uzun
- Department of Infectious Diseases and Clinical Microbiology, Hacettepe University Faculty of Medicine, Ankara, Turkey
| |
Collapse
|
7
|
Şener B, Kirbaş E, Sancak B, Gözalan A, Evren E, Karahan ZC, Zeytinoğlu A, Dinç B, Alp A, Dizman GT, Metan G, Birengel S, Gülten E, Taşbakan M, Ayhan M. PERFORMANCE EVALUATION OF SIX DIFFERENT SARS-CoV-2 ANTIBODY IMMUNOASSAYS: DISEASE SEVERITY AND SERUM SAMPLING TIME AFFECT THE SENSITIVITY. Jpn J Infect Dis 2022; 75:388-394. [PMID: 35354702 DOI: 10.7883/yoken.jjid.2021.636] [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: 11/17/2022]
Abstract
Comparative validation data and clinical performance data are essential for the reliable interpretation of SARS-CoV-2 antibody test results. This study aimed to assess the performance of six SARS-CoV-2 IgG immunoassays in different disease severity settings. Four automated chemiluminescence immunoassays Access (Beckman Coulter), Architect (Abbott), Atellica-IM (Siemens) and Elecsys (Roche) and two ELISA assays (SARS-CoV-2 IgG-S1-based and NCP IgG, Euroimmun) were evaluated in 143 patients and 50 pre-pandemic control sera. Accuracy and precision tests were performed for validation. Overall sensitivity differed between 73.38-88.65%, being higher in spike protein-based assays. Specificity was ≥ 98% in all immunoassays. IgG response was lower for the samples taken <20 days post-symptom onset (87.30%) than for the samples taken ≥20 days post-symptom onset (94.80%). Higher rate of antibody was detected in the clinically moderate disease group. In the asymptomatic and mild group more antibody positivity was detected with spike protein-based assays. Clinical performance of the immunoassays differs according to disease severity and antigen targeted; moderate disease leading to highest rate of IgG response. All the assays tested were eligible for the detection of SARS-CoV-2 IgG however, spike-based assays revealed relatively higher sensitivity than the nucleoprotein-based assays particularly in the asymptomatic and mild disease severity.
Collapse
Affiliation(s)
- Burçin Şener
- Department of Medical Microbiology, Faculty of Medicine, Hacettepe University, Turkey
| | - Ekin Kirbaş
- Department of Medical Microbiology, Faculty of Medicine, Hacettepe University, Turkey
| | - Banu Sancak
- Department of Medical Microbiology, Faculty of Medicine, Hacettepe University, Turkey
| | - Ayşegül Gözalan
- Department of Medical Microbiology, Faculty of Medicine, Alaaddin Keykubat University, Turkey
| | - Ebru Evren
- Department of Medical Microbiology, Faculty of Medicine, Ankara University, Turkey
| | - Zeynep Ceren Karahan
- Department of Medical Microbiology, Faculty of Medicine, Ankara University, Turkey
| | - Ayşın Zeytinoğlu
- Department of Medical Microbiology, Faculty of Medicine, Ege University, Turkey
| | - Bedia Dinç
- Medical Microbiology Laboratory, Ankara Bilkent City Hospital, Turkey
| | - Alpaslan Alp
- Department of Medical Microbiology, Faculty of Medicine, Hacettepe University, Turkey
| | - Gülçin Telli Dizman
- Department of Clinical Microbiology and Infectious Diseases, Faculty of Medicine, Hacettepe University, Turkey
| | - Gökhan Metan
- Department of Clinical Microbiology and Infectious Diseases, Faculty of Medicine, Hacettepe University, Turkey
| | - Serhat Birengel
- Department of Clinical Microbiology and Infectious Diseases, Faculty of Medicine, Ankara University, Turkey
| | - Ezgi Gülten
- Department of Clinical Microbiology and Infectious Diseases, Faculty of Medicine, Ankara University, Turkey
| | - Meltem Taşbakan
- Department of Clinical Microbiology and Infectious Diseases, Faculty of Medicine, Ege University, Turkey
| | - Müge Ayhan
- Department of Clinical Microbiology and Infectious Diseases, Ankara Bilkent City Hospital, Turkey
| |
Collapse
|
8
|
Ismayilov R, Koray N, İnal N, Telli Dizman G, Hazırolan G, Tanrıöver MD, Akova M. Pulmonary nocardiosis caused by Nocardia abscessus mimicking pulmonary thromboembolism in a patient with atypical anti-glomerular basement membrane glomerulonephritis. Tuberk Toraks 2021; 69:237-241. [PMID: 34256514 DOI: 10.5578/tt.20219813] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Nocardia species are opportunistic bacteria that are frequently contagious by inhalation. Recently, Nocardia abscessus has been described as a different species. We report a 54-year-old male who presented with acute pleuritic chest pain, mimicking pulmonary thromboembolism on the 5th day of discharge from the hospital. The patient was receiving immunosuppressive therapy for newly diagnosed atypical anti-glomerular basement membrane disease. Thorax computed tomography revealed a 17x19 mm soft tissue lesion in the lateral segment of the middle lobe of the right lung. After further examinations, a biopsy decision was made and Nocardia abscessus was isolated in the aerobic culture of the aspiration material.
Collapse
Affiliation(s)
- Rashad Ismayilov
- Department of Internal Medicine, Hacettepe University Faculty of Medicine, Ankara, Turkey
| | - Neslihan Koray
- Department of Internal Medicine, Hacettepe University Faculty of Medicine, Ankara, Turkey
| | - Neşe İnal
- Department of Medical Microbiology, Hacettepe University Faculty of Medicine, Ankara, Turkey
| | - Gülçin Telli Dizman
- Department of Infectious Diseases and Clinical Microbiology, Hacettepe University Faculty of Medicine, Ankara, Turkey
| | - Gülşen Hazırolan
- Department of Medical Microbiology, Hacettepe University Faculty of Medicine, Ankara, Turkey
| | - Mine Durusu Tanrıöver
- Department of Internal Medicine, Hacettepe University Faculty of Medicine, Ankara, Turkey
| | - Murat Akova
- Department of Infectious Diseases and Clinical Microbiology, Hacettepe University Faculty of Medicine, Ankara, Turkey
| |
Collapse
|
9
|
Özdemir A, Demir Çuha M, Telli Dizman G, Alp A, Metan G, Şener B. [SARS-CoV-2 Seroprevalence Among Healthcare Workers: Retrospective Analysis of the Data From A University Hospital in Turkey]. MIKROBIYOL BUL 2021; 55:223-232. [PMID: 33882653 DOI: 10.5578/mb.20219908] [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
COVID-19 infection caused by severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) continues to affect people as a global threat, and the number of cases is increasing every day. Healthcare workers who face potential COVID-19 exposure are at high risk of SARS-CoV-2 transmission. Estimating the prevalence of infection among healthcare professionals, determining the related risk factors and applying effective infection control measures are essential for the continuity of the health system. The aim of this study was to investigate the seroprevalence of SARS-CoV-2 among healthcare workers in our hospital who have participated extensively in the monitoring of COVID-19 patients. In the study, the anti-SARS-CoV-2 IgG antibody test results of 774 healthcare workers between March 24, 2020, and September 10, 2020 were analyzed retrospectively. Age, sex, profession, and the status of being diagnosed with COVID-19 before the antibody test were determined for the healthcare workers in the study. When the anti-SARS-CoV-2 IgG antibody results were evaluated, it was determined that 57 healthcare workers were positive, 708 healthcare workers were negative, and 9 healthcare workers were borderline. The seroprevalence among the workers of our hospital was found to be 7.4%. The antibody positivity rate was 75.6% in individuals diagnosed with COVID-19 by SARS-CoV-2 PCR (polymerase chain reaction) and/or thoracic computed tomography and it was found to be 3.5% in individuals without the diagnosis. The semi-quantitative antibody index values of the healthcare workers who were seropositive and diagnosed with COVID-19 before the test (n= 31) and those who did not (n= 26) were statistically compared and a significant difference was found between the two groups (p<0.01). In our study, the highest seropositivity was observed among residents (12.3%) and among nurses (11.1%), respectively. When the seropositivity rates of the residents and the nurses were compared with other occupational groups, the differences were found to be statistically significant (p= 0.04, p= 0.04, respectively). In conclusion, the seroprevalence of SARS-CoV-2 was determined as 7.4% among healthcare workers in a tertiary hospital with high patient admissions during the COVID-19 pandemic. Considering that SARS-CoV-2 seroprevalence was announced as 0.81% in the press release made by the Ministry of Health of Turkey in July 2020, it is seen that the rate of seroprevalence among health care workers is significantly larger than the community. Determination of the seroprevalence in the general population and large-scale studies are needed for risk assessment in healthcare professionals.
Collapse
Affiliation(s)
- Adem Özdemir
- Hacettepe University Faculty of Medicine, Department of Medical Microbiology, Ankara, Turkey
| | - Mervenur Demir Çuha
- Hacettepe University Faculty of Medicine, Department of Medical Microbiology, Ankara, Turkey
| | - Gülçin Telli Dizman
- Hacettepe University Faculty of Medicine, Department of Infectious Diseases and Clinical Microbiology, Ankara, Turkey
| | - Alpaslan Alp
- Hacettepe University Faculty of Medicine, Department of Medical Microbiology, Ankara, Turkey
| | - Gökhan Metan
- Hacettepe University Faculty of Medicine, Department of Infectious Diseases and Clinical Microbiology, Ankara, Turkey
| | - Burçin Şener
- Hacettepe University Faculty of Medicine, Department of Medical Microbiology, Ankara, Turkey
| |
Collapse
|
10
|
Karataş A, Malkan ÜY, Velet M, Demiroğlu H, Büyükaşık Y, Telli Dizman G, Inkaya AÇ, Erdoğdu B, Çınar OE, Aladağ E, Aksu S, Haznedaroğlu İC, Özcebe O, Sayınalp N, Göker H. The clinical course of COVID-19 in hematopoietic stem cell transplantation (HSCT) recipients. Turk J Med Sci 2021; 51:1647-1652. [PMID: 33878857 PMCID: PMC8569779 DOI: 10.3906/sag-2103-72] [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] [MESH Headings] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2021] [Accepted: 04/18/2021] [Indexed: 11/09/2022] Open
Abstract
Background/aim The disease caused by SARS-CoV-2 was named as COVID-19. There is as yet insufficient information about the effects of HSCT on the clinical course of COVID-19. In the present study, we aimed to investigate the clinical course of COVID-19 in patients who had undergone HSCT. Materials and methods We analyzed baseline characteristics, clinical course and findings of COVID-19, hospitalization and death rates, overall survival, and case fatality rates of HSCT recipients diagnosed with COVID-19 retrospectively. Results 57.6% of the patients underwent AHSCT, and 42.4% underwent allo-HSCT. 60.6%, 27.3%, and 12.1% of the patients had mild, moderate, and severe COVID-19 or critical illness, respectively. Overall, 45.5% were hospitalized, 12.1% required intensive care, and 9.1% necessitated invasive mechanical ventilation. The total CFR was 9.1% in HSCT recipients, 22.2% in patients with active hematologic malignancy, and 4.2% in patients without active hematologic malignancy. Conclusion It can be concluded that mortality of HSCT recipients is lower in patients whose primary disease is in remission compared to ones that are not in remission. Further studies with larger group patients are needed in order to delineate the effects of COVID-19 on HSCT patients.
Collapse
Affiliation(s)
- Ayşe Karataş
- Department of Internal Medicine, Division of Hematology, Faculty of Medicine, Hacettepe University, Ankara, Turkey
| | - Ümit Yavuz Malkan
- Department of Internal Medicine, Division of Hematology, Faculty of Medicine, Hacettepe University, Ankara, Turkey
| | - Mustafa Velet
- Department of Internal Medicine, Division of Hematology, Faculty of Medicine, Hacettepe University, Ankara, Turkey
| | - Haluk Demiroğlu
- Department of Internal Medicine, Division of Hematology, Faculty of Medicine, Hacettepe University, Ankara, Turkey
| | - Yahya Büyükaşık
- Department of Internal Medicine, Division of Hematology, Faculty of Medicine, Hacettepe University, Ankara, Turkey
| | - Gülçin Telli Dizman
- Department of Infectious Diseases, Faculty of Medicine, Hacettepe University, Ankara, Turkey
| | - Ahmet Çağkan Inkaya
- Department of Internal Medicine, Division of Hematology, Faculty of Medicine, University of Health Sciences, Dışkapı Yıldırım Beyazıt Training and Research Hospital, Ankara, Turkey
| | - Batuhan Erdoğdu
- Department of Internal Medicine, Division of Hematology, Faculty of Medicine, Hacettepe University, Ankara, Turkey
| | - Olgu Erkin Çınar
- Department of Internal Medicine, Division of Hematology, Faculty of Medicine, Hacettepe University, Ankara, Turkey
| | - Elifcan Aladağ
- Department of Infectious Diseases, Faculty of Medicine, Hacettepe University, Ankara, Turkey
| | - Salih Aksu
- Department of Internal Medicine, Division of Hematology, Faculty of Medicine, Hacettepe University, Ankara, Turkey
| | | | - Osman Özcebe
- Department of Internal Medicine, Division of Hematology, Faculty of Medicine, Hacettepe University, Ankara, Turkey
| | - Nilgün Sayınalp
- Department of Internal Medicine, Division of Hematology, Faculty of Medicine, Hacettepe University, Ankara, Turkey
| | - Hakan Göker
- Department of Internal Medicine, Division of Hematology, Faculty of Medicine, Hacettepe University, Ankara, Turkey
| |
Collapse
|