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1. Molecular Identification of HIV-1 in the Presence of Hepatitis B Virus and Hepatitis C Virus Co-infections

Author

Yasemin Heper, Murat Sayan, Başak Dokuzoğuz, Muge Ozguler, Saadet Yazici, Mustafa Kemal Çelen, Figen Sarigul Yildirim, Gülden Ersöz, Aydın Deveci, Servet Öztürk, Nurgul Ceran, Hülya Özkan Özdemir, Serhat Ünal, Taner Yildirmak, Selda Sayin Kutlu, Ayhan Akbulut, Atahan Cagatay, Alper Gunduz, Dilara Inan, Alper Şener, Ilkay Karaoglan, Dicle Üniversitesi, Tıp Fakültesi, Dahili Tıp Bilimleri Bölümü, Enfeksiyon Hastalıkları ve Klinik Mikrobiyoloji Ana Bilim Dalı, Çelen, Mustafa Kemal, OMÜ, Bursa Uludağ Üniversitesi/Tıp Fakültesi/Enfeksiyon Hastalıkları ve Klinik Mikrobiyoloji Anabilim Dalı., Heper, Yasemin, and AAH-6506-2021

Subjects
0301 basic medicine, hepatitis C virus, HBsAg, Turkey, genotype, polymerase chain reaction, retrospective study, viruses, lcsh:Medicine, RNA directed DNA polymerase inhibitor, HIV Infections, Hepacivirus, RNA directed DNA polymerase, Procedures, medicine.disease_cause, molecular epidemiology, Polymerase Chain Reaction, Turkey (republic), Western blotting, Viral Load, Dried Blood Spot Testing, Human Immunodeficiency Virus 1, 0302 clinical medicine, Turkey (bird), 030212 general & internal medicine, gene mutation, disease transmission, Hepatitis C virus, Coinfection, Etrospective study, adult, General Medicine, Hepatitis B, Resistance mutation, Hepatitis C, mixed infection, Co-infection, Medicine, general & internal, Impact, female, virus resistance, laboratory test, virus gene, proteinase, Original Article, Viral hepatitis, Hepatitis B virus, 030106 microbiology, prevalence, gene sequence, Infections, Pathophysiology, Virus, Article, 03 medical and health sciences, male, Human immunodeficiency virus infection, Virology, medicine, proteinase inhibitor, Adults, Pathogenicity, cross-sectional study, Humans, controlled study, human, infection risk, virus detection, Retrospective Studies, Hepatitis, business.industry, lcsh:R, nonnucleoside reverse transcriptase inhibitor, medicine.disease, major clinical study, enzyme linked immunosorbent assay, hepatitis B surface antigen, Cross-Sectional Studies, HIV-1, hepatitis B, General & internal medicine, hepatitis C, business
Abstract

Bu çalışma, 14-17 Eylül 2016 tarihleri arasında Lizbon[Portekiz]'de düzenlenen 19. Meeting of the European Society for Clinical Virology'de bildiri olarak sunulmuştur. Background: Because of their similar modes of transmission, the simultaneous infection of viral hepatitis and human immunodeficiency virus are increasingly seen as a big problem related to human health. Aims: To determine the drug mutations in hepatitis B virus and/or hepatitis C virus co-infected human immunodeficiency virus-1 patients in Turkey. Study Design: Retrospective cross-sectional study. Methods: The present study was conducted between 2010 and 2017. HBsAg, anti-hepatitis C virus, and anti-human immunodeficiency vim were tested with ELISA. All anti-human immunodeficiency virus positive results by ELISA were verified for anti-human immunodeficiency virus positivity by a Western blot test, and Antihuman immunodeficiency virus positive patients with HBsAg andior anti-hepatitis C virus positivity were included in the study. Subtyping and genotypic resistance analyses were performed by population sequencing of the viral protease and reverse transcriptase regions of the human immunodeficiency virus-1 pol gene. Results: We detected 3896 human immunodeficiency virus-1 positive patients whose sera were sent from numerous hospitals across the country to our polymerase chain reaction unit for detection of drug resistance mutations and whose molecular laboratory tests were completed. Viral hepatitis co-infections were detected in 4.3% (n=170) of patients. Hepatitis B virus and hepatitis C virus co-infection were observed in 3.2% and 0.5% of all human immunodeficiency virus-I infected patients, respectively. The major human immunodeficiency virus-1 subtype detected was group M, subtype B (62.9%). However, 13.5% of drug resistance mutation motifs were found in human immunodeficiency virus-1 genomes of patients included in the study. Conclusion: Due to similar transmission routes, HIV1 patients are at risk of hepatitis B and C virus co-infection. However, antiretroviral drug resistance mutation model is similar to patients with hepatitis negative. European Society for Clinical Virology

Published
2020

2. Influence of multidrug resistant organisms on the outcome of diabetic foot infection

Author

Nazan Tuna, Mucahit Yemisen, Filiz Pehlivanoglu, Oguz Karabay, Buket Erturk, Necla Tulek, Omer Coskun, Fatma Yilmaz, Nuray Uzun, Yasar Kucukardali, Nurgul Ceran, Kadriye Kart Yaşar, Oznur Ak, Turan Aslan, Taner Yildirmak, Nail Ozgunes, Lutfiye Mulazimoglu, Atahan Cagatay, Tuna Demirdal, Ayse Batirel, Fatma Sargin, Haluk Eraksoy, Ayten Kadanali, Gulsen Yoruk, Salih Atakan Nemli, Derya Öztürk, Oral Oncul, Gül Karagöz, Onder Ergonul, Nese Saltoglu, Yasemin Akkoyunlu, Meral Sonmezoglu, Hakan Ay, Cagla Sonmezer, Funda Şimşek, Gonul Sengoz, Serkan Surme, Ergönül, Mehmet Önder (ORCID 0000-0003-1935-9235 & YÖK ID 110398), Saltoğlu, Neşe, Tülek, Necla, Yemisen, Mücahit, Kadanalı, Ayten, Karagöz, Gül, Batırel, Ayşe, Ak, Öznür, Sönmezer, Cağla, Eraksoy, Haluk, Cağatay, Atahan, Sürme, Serkan, Nemli, Salih A., Demirdal, Tuna, Coşkun, Ömer, Öztürk, Derya, Ceran, Nurgül, Pehlivanoğlu, Filiz, Şengoz, Gönül, Aslan, Turan, Akkoyunlu, Yasemin, Öncül, Oral, Ay, Hakan, Mülazımoğlu, Lütfiye, Ertürk, Buket, Yılmaz, Fatma, Yörük, Gülşen, Uzun, Nuray, Şimşek, Funda, Yıldırmak, Taner, Yaşar, Kadriye Kart, Sönmezoğlu, Meral, Küçükkardalı, Yaşar, Tuna, Nazan, Karabay, Oğuz, Özgüneş, Nail, Sargın, Fatma, School of Medicine, Department of Infectious Diseases and Clinical Microbiology, Saltoglu, Nese, Ergonul, Onder, Tulek, Necla, Yemisen, Mucahit, Kadanali, Ayten, Karagoz, Gul, Batirel, Ayse, Ak, Oznur, Sonmezer, Cagla, Cagatay, Atahan, Surme, Serkan, Coskun, Omer, Ozturk, Derya, Ceran, Nurgul, Pehlivanoglu, Filiz, Sengoz, Gonul, Akkoyunlul, Yasemin, Oncul, Oral, Mulazimoglu, Lutfiye, Erturk, Buket, Yilmaz, Fatma, Yoruk, Gulsen, Simsek, Funda, Yildirmak, Taner, Yasar, Kadriye Kart, Sonmezoglu, Meral, kucukardali, Yasar, Karabay, Oguz, Ozgunes, Nail, Sargin, Fatma, and AKKOYUNLU, YASEMİN

Subjects
Male, Klebsiella, genetic structures, IMPACT, Klebsiella pneumoniae, MRSA, medicine.disease_cause, SOFT-TISSUE INFECTIONS, 0302 clinical medicine, Diabetic foot infection, 030212 general & internal medicine, Aged, 80 and over, biology, Fatality, Osteomyelitis, General Medicine, Middle Aged, Diabetic Foot, Drug Resistance, Multiple, Anti-Bacterial Agents, ULCERS, TRIALS, Infectious Diseases, Staphylococcus aureus, Pseudomonas aeruginosa, Infectious diseases, Female, Microbiology (medical), Adult, medicine.medical_specialty, SOCIETY, 030209 endocrinology & metabolism, ANTIBIOTIC-THERAPY, Patient Readmission, Amputation, Surgical, lcsh:Infectious and parasitic diseases, 03 medical and health sciences, Internal medicine, medicine, Escherichia coli, Humans, lcsh:RC109-216, STAPHYLOCOCCUS-AUREUS, Aged, business.industry, medicine.disease, biology.organism_classification, Diabetic foot, Multiple drug resistance, Patient Outcome Assessment, TURKEY, RISK-FACTORS, business, Staphylococcus, Saltoglu N., Ergonul O., TULEK N., Yemisen M., KADANALI A., KARAGOZ G., BATIREL A., AK O., SONMEZER C., Eraksoy H., et al., -Influence of multidrug resistant organisms on the outcome of diabetic foot infection-, INTERNATIONAL JOURNAL OF INFECTIOUS DISEASES, cilt.70, ss.10-14, 2018
Abstract

Objectives: We described the clinical outcomes of the diabetic patients who had foot infections with multidrug resistant organisms. Methods: We included the patients with diabetic foot infections (DFI) from 19 centers, between May 2011 and December 2015. Infection was defined according to IDSA DFI guidelines. Patients with severe infection, complicated moderate infection were hospitalized. The patients were followed-up for 6 months after discharge. Results: In total, 791 patients with DFI were included, 531(67%) were male, median age was 62 (19-90). Severe infection was diagnosed in 85 (11%) patients. Osteomyelitis was diagnosed in 291(36.8%) patients. 536 microorganisms were isolated, the most common microorganisms were S. aureus (20%), P. aeruginosa (19%) and E. coli (12%). Methicillin resistance (MR) rate among Staphylococcus aureus isolates was 31%. Multidrug resistant bacteria were detected in 21% of P. aeruginosa isolates. ESBL (+) Gram negative bacteria (GNB) was detected in 38% of E. coli and Klebsiella isolates. Sixty three patients (8%) were rehospitalized. Of the 791 patiens, 127 (16%) had major amputation, and 24 (3%) patients died. In multivariate analysis, significant predictors for fatality were; dialysis (OR: 8.3, Cl: 1.82-38.15, p = 0.006), isolation of Klebsiella spp. (OR:7.7, Cl: 1.24-47.96, p = 0.028), and chronic heart failure (OR: 3, Cl: 1.01-9.04, p = 0.05). MR Staphylococcus was detected in 21% of the rehospitalized patients, as the most common microorganism (p < 0.001). Conclusion: Among rehospitalized patients, methicillin resistant Staphylococcus infections was detected as the most common agent, and Klebsiella spp. infections were found to be significantly associated with fatality. (C) 2018 The Authors. Published by Elsevier Ltd on behalf of International Society for Infectious Diseases.

Published
2017

3. APOBEC3 Hypermutations in HIV-1 Infected Cases in Turkey

Author

Murat Sayan, Başak Dokuzoğuz, Funda Şimşek, Haluk Eraksoy, and Nurgul Ceran

Subjects
Adult, Male, Microbiology (medical), APOBEC, Pol genes, Turkey, medicine.medical_treatment, Human immunodeficiency virus (HIV), HIV Infections, Biology, medicine.disease_cause, Cytosine Deaminase, Pathogenesis, Young Adult, Proviruses, Antiretroviral Therapy, Highly Active, Cytidine Deaminase, medicine, Humans, APOBEC Deaminases, Aged, Infectivity, Protease, General Immunology and Microbiology, Direct sequencing, Middle Aged, Viral Load, Virology, Reverse transcriptase, CD4 Lymphocyte Count, Infectious Diseases, pol Gene Products, Human Immunodeficiency Virus, HIV-1, RNA, Viral, Female, Somatic Hypermutation, Immunoglobulin, Algorithms
Abstract

Host genetic factors may play an effective role on the human immunodeficiency virus (HIV) pathogenesis. APOBEC3 (apolipoprotein B mRNA editing enzyme catalytic polypeptide like-3) proteins are cellular antiviral proteins which inhibits HIV replication in the absence of vif (virion infectivity factor). In this study, we aimed to determine the APOBEC 3G/F hypermutations in HIV-1 strains isolated in Turkey. A total of 515 HIV-1 infected patients between June 2009 - February 2012 were included in the study. Three hundred ninety four cases were newly diagnosed antiretroviral-naive patients [349 male, 45 female; median age (range): 37.1 (2-69) years; median CD4+ T-cell count (range): 340 (1-1660) mm3; median HIV-RNA load (range): 5.76 + E5 (8.7 + E2-9.4 + E6) IU/ml] and 121 were under HAART therapy [99 male, 22 female; median age (range): 40.7 (20-70) years; median CD4+ T-cell count (range): 195 (6-720) mm3; median HIV-RNA load (range): 5.4 + E5 (1.37 + E3-1.07 + E7) IU/ml]. APOBEC 3G/F hypermutations in HIV-1 pol sequences (reverse transcriptase; codons 41-238 and protease; codons 1-99) analysed by nested RT-PCR and direct sequencing techniques. APOBEC 3G/F hypermutations have been determined by using of HIVdb-Stanford algorithm. The prevalence of overall APOBEC 3G/F hypermutations was 2.5% (13/515) in HIV-1 pol gene sequences in study group, and the rates were 2% (8/394) and 4.1% (5/121) in antiretroviral naive and treatment groups, respectively. However, the location and marker hypermutations of determined APOBEC in the HIV-1 pol gene sequences were RT and 3G in the Turkish patients. The hypermutated HIV-1 strains identified in HIV-1 infected patients may facilitate our understanding the nature and the consequences of HIV-1 infections. Moreover, investigations of the motif and frequency of APOBEC 3G/F hypermutations in HIV-1 proviral DNA samples and understanding their relationships with HIV-1 subtypes in Turkish patients would be beneficial.

Published
2013
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4. HIV-1 Transmitted Drug Resistance Mutations in Newly Diagnosed Antiretroviral-Naive Patients in Turkey

Author

Nuriye Tasdelen Fisgin, Dilara Inan, Selda Sayin Kutlu, Atahan Cagatay, Fatma Sargin, Suda Tekin Koruk, Ilkay Karaoglan, Nurgul Ceran, Ayşe Inci, Murat Sayan, Volkan Korten, Bahadir Ceylan, Figen Kaptan, Aysel Kocagul Celikbas, Taner Yildirmak, Ayşe Willke, Halis Akalin, Kadriye Kart Yaşar, Dilek Yildiz Sevgi, Mustafa Kemal Çelen, Sayan, Murat, Sargin, Fatma, Inan, Dilara, Sevgi, Dilek Y., Celikbas, Aysel K., Yasar, Kadriye, Kaptan, Figen, Kutlu, Selda, Fisgin, Nuriye T., Inci, Ayse, Ceran, Nurgul, Karaoglan, Ilkay, Cagatay, Atahan, Celen, Mustafa K., Koruk, Suda T., Ceylan, Bahadir, Yildirmak, Taner, Akalin, Halis, Korten, Volkan, Willke, Ayse, Uludağ Üniversitesi/Tıp Fakültesi/Enfeksiyon Hastalıkları Anabilim Dalı., Akalın, Halis, and AAU-8952-2020

Subjects
Anti-HIV agents, Male, Turkey, Human immunodeficiency virus 1, Drug resistance, viral, RNA directed DNA polymerase inhibitor, HIV Infections, thymidine derivative, RNA directed DNA polymerase, THERAPY, RECOMMENDATIONS, 0302 clinical medicine, Reverse transcriptase inhibitors, genetics, Child, RNA, viral, Mutation, education.field_of_study, Nonnucleoside reverse transcriptase inhibitor, adult, transmission, Antiviral resistance, virus transmission, cohort analysis, priority journal, Infectious diseases, Cohort analysis, anti human immunodeficiency virus agent, Human, Virus RNA, Immunology, Major clinical study, Article, Virus transmission, 03 medical and health sciences, virus RNA, Human immunodeficiency virus infection, SURVEILLANCE, Genetics, Transmission, Humans, human, education, HIV protease inhibitors, 030112 virology, Virology, major clinical study, Human immunodeficiency virus proteinase, HIV-1, UPDATE, Gene expression, HIV-1-INFECTED PERSONS, Pol Genes, Human Immunodeficiency Virus 1, Quasispecies, 0301 basic medicine, antivirus agent, Human immunodeficiency virus (HIV), Gene Expression, Drug resistance, medicine.disease_cause, preschool child, Turkey (republic), HIV Protease, Prevalence, EPIDEMIOLOGY, 030212 general & internal medicine, Priority journal, child, Reverse-transcriptase inhibitor, virus mutation, Human immunodeficiency virus infected patient, Resistance mutation, HIV Reverse Transcriptase, female, Reverse Transcriptase Inhibitors, RNA, Viral, Female, medicine.drug, HIV infections, Adult, Human immunodeficiency virus proteinase inhibitor, Virus mutation, Anti-HIV Agents, Population, Growth, development and aging, Newly diagnosed, World health organization, antiviral resistance, HIV protease, Drug Resistance, Viral, medicine, Antivirus agent, growth, development and aging, Drug effects, Anti-HIV Agents/therapeutic use, CD4 Lymphocyte Count, Drug Resistance, Viral/*genetics, HIV Infections/diagnosis/drug therapy/*epidemiology/transmission, HIV Protease/*genetics/metabolism, HIV Protease Inhibitors/therapeutic use, HIV Reverse Transcriptase/*genetics/metabolism, HIV-1/drug effects/*genetics/growth & development, RNA, Viral/genetics, Reverse Transcriptase Inhibitors/therapeutic use, Turkey/epidemiology, business.industry, CD4 lymphocyte count, HIV Protease Inhibitors, nonnucleoside reverse transcriptase inhibitor, Human immunodeficiency virus 1 infection, Reverse transcriptase, HIV reverse transcriptase, Thymidine derivative, Metabolism, Preschool child, drug effects, world health organization, business, Anti human immunodeficiency virus agent, metabolism
Abstract

HIV-1 replication is rapid and highly error-prone. Transmission of a drug-resistant HIV-1 strain is possible and occurs within the HIV-1-infected population. In this study, we aimed to determine the prevalence of transmitted drug resistance mutations (TDRMs) in 1,306 newly diagnosed untreated HIV-1-infected patients from 21 cities across six regions of Turkey between 2010 and 2015. TDRMs were identified according to the criteria provided by the World Health Organization's 2009 list of surveillance drug resistance mutations. The HIV-1 TDRM prevalence was 10.1% (133/1,306) in Turkey. Primary drug resistance mutations (K65R, M184V) and thymidine analogue-associated mutations (TAMs) were evaluated together as nucleos(t)ide reverse transcriptase inhibitor (NRTI) mutations. NRTI TDRMs were found in 8.1% (107/1,306) of patients. However, TAMs were divided into three categories and M41L, L210W, and T215Y mutations were found for TAM1 in 97 (7.4%) patients, D67N, K70R, K219E/Q/N/R, T215F, and T215C/D/S mutations were detected for TAM2 in 52 (3.9%) patients, and M41L + K219N and M41L + T215C/D/S mutations were detected for the TAM1 + TAM2 profile in 22 (1.7%) patients, respectively. Nonnucleoside reverse transcriptase inhibitor-associated TDRMs were detected in 3.3% (44/1,306) of patients (L100I, K101E/P, K103N/S, V179F, Y188H/L/M, Y181I/C, and G190A/E/S) and TDRMs to protease inhibitors were detected in 2.3% (30/1,306) of patients (M46L, I50V, I54V, Q58E, L76V, V82A/C/L/T, N83D, I84V, and L90M). In conclusion, long-term and large-scale monitoring of regional levels of HIV-1 TDRMs informs treatment guidelines and provides feedback on the success of HIV-1 prevention and treatment efforts. © Copyright 2016, Mary Ann Liebert, Inc. 2016.

Published
2016

5. Neurobrucellosis: clinical, diagnostic, therapeutic features and outcome. Unusual clinical presentations in an endemic region

Author

Asuman Inan, Hulya Tireli, Nurgul Ceran, Paşa Göktaş, Recai Turkoglu, Derya Ozturk Engin, and Ilknur Erdem

Subjects
Adult, Male, Microbiology (medical), Pediatrics, medicine.medical_specialty, Adolescent, diagnosis, Pseudotumor cerebri, Hearing loss, lcsh:QR1-502, serology, Sagittal Sinus Thrombosis, Brucellosis, lcsh:Microbiology, Transverse myelitis, lcsh:Infectious and parasitic diseases, neurobrucellosis, Young Adult, Central Nervous System Bacterial Infections, medicine, Humans, lcsh:RC109-216, Prospective Studies, Aged, Medicine(all), neuroimaging, business.industry, Middle Aged, medicine.disease, Magnetic Resonance Imaging, Anti-Bacterial Agents, Surgery, Infectious Diseases, Female, medicine.symptom, Tomography, X-Ray Computed, Complication, business, Vasculitis, Meningitis
Abstract

Brucellosis is a zoonotic infection and has endemic characteristics. Neurobrucellosis is an uncommon complication of this infection. The aim of this study was to present unusual clinical manifestations and to discuss the management and outcome of a series of 18 neurobrucellosis cases. Initial clinical manifestations consist of pseudotumor cerebri in one case, white matter lesions and demyelinating syndrome in three cases, intracranial granuloma in one case, transverse myelitis in two cases, sagittal sinus thrombosis in one case, spinal arachnoiditis in one case, intracranial vasculitis in one case, in addition to meningitis in all cases. Eleven patients were male and seven were female. The most prevalent symptoms were headache (83%) and fever (44%). All patients were treated with rifampicin, doxycycline plus trimethoprim-sulfamethoxazole or ceftriaxone. Duration of treatment (varied 3-12 months) was determined on basis of the CSF response. In four patients presented with left mild sequelae including aphasia, hearing loss, hemiparesis. In conclusion, although mortality is rare in neurobrucellosis, its sequelae are significant. In neurobrucellosis various clinical and neuroradiologic signs and symptoms can be confused with other neurologic diseases. In inhabitants or visitors of endemic areas, neurobrucellosis should be kept in mind in cases that have unusual neurological manifestations. Keywords: neurobrucellosis, serology, diagnosis, neuroimaging

Published
2011
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6. Comment on 'Changes in acute viral hepatitis epidemiology in the Turkish adult population: A multicenter study'

Author

Fatma Yılmaz Karadağ, Serpil Erol, Nurgul Ceran, Funda Kocak, Zehra Karacaer, Ilknur Esen Yildiz, Ayse Albayrak, Selma Tosun, Canan Demir, Ercan Yenilmez, Serhat Uysal, Fatma Kaçar, Mehmet Parlak, Gül Karagöz, S. Sahin, Uğur Kostakoğlu, Ayten Kadanali, Irem Altas, Nuretdin Kuzhan, Ozgur Dagli, Rıza Aytaç Çetinkaya, Özlem Aydin, Pınar Ergen, Ayse Batirel, Arzu Altunçekiç Yildirim, Gül Durmuş, Derya Bayırlı Turan, and Türkkan Öztürk Kaygusuz

Subjects
Male, Adult, Turkish population, medicine.medical_specialty, Pediatrics, Adolescent, Hepatitis, Viral, Human, Turkey, Turkish, 030231 tropical medicine, Adult population, medicine.disease_cause, acute viral hepatitis, 03 medical and health sciences, Young Adult, 0302 clinical medicine, Internal medicine, Epidemiology, medicine, Humans, 030212 general & internal medicine, Young adult, Fulminant hepatitis, Letter to the Editor, Aged, Retrospective Studies, Hepatitis B virus, Hepatitis, Aged, 80 and over, business.industry, Gastroenterology, Length of Stay, Middle Aged, Hepatitis A, Hepatitis B, medicine.disease, language.human_language, Vaccination, Multicenter study, Acute Disease, language, Female, epidemiology, Original Article, Viral hepatitis, business
Abstract

Background/aims The present study aimed to determine the changes in the epidemiology of hepatitis in recent years in an adult Turkish population. Materials and methods Overall, 852 patients with acute viral hepatitis from 17 centers were included in this study. Their sociodemographic characteristics, clinical courses, treatments, and laboratory findings were retrospectively analyzed. Results The most commonly found microorganisms were the hepatitis B virus (55.2%) and hepatitis A virus (37.6%), and the types of acute viral hepatitis differed significantly according to the age group (p≤0.001). The most frequently reported symptom was fatigue (73.7%), and the most common complications were cholecystitis (0.4%) and fulminant hepatitis (0.4%). The median hospital stay was 9 days (range 1-373). In total, 40.8% patients with acute hepatitis B virus developed immunity. Conclusion In Turkey, there are significantly large adolescent and adult populations susceptible to acute viral hepatitis. Therefore, larger vaccination programs covering these age groups should be implemented.

Published
2018
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7. A randomized comparative study of single-dose fosfomycin and 5-day ciprofloxacin in female patients with uncomplicated lower urinary tract infections

Author

Nurgul Ceran, Duygu Mert, Funda Yuksel Kocdogan, Ilknur Erdem, Seyfi Ozyurek, Pasa Goktas, and Riza Adalati

Subjects
Adult, Microbiology (medical), medicine.medical_specialty, Adolescent, medicine.drug_class, Urinary system, Antibiotics, Enterobacter, Microbial Sensitivity Tests, Urine, Fosfomycin, Gastroenterology, Drug Administration Schedule, Young Adult, Pharmacotherapy, Ciprofloxacin, Internal medicine, Escherichia coli, medicine, Humans, Pharmacology (medical), Escherichia coli Infections, Aged, Antiinfective agent, biology, business.industry, Enterobacteriaceae Infections, Middle Aged, bacterial infections and mycoses, biology.organism_classification, Anti-Bacterial Agents, Surgery, Treatment Outcome, Infectious Diseases, Urinary Tract Infections, Female, business, medicine.drug
Abstract

Uncomplicated lower urinary tract infections (UTIs) are the most frequent infections in females. Increased resistance rates against commonly used antibiotics have led to the use of novel antimicrobials. The aim of the present study was to evaluate the bacteriological and clinical effects of single-dose fosfomycin trometamol (FMT) and 5-day ciprofloxacin in females with uncomplicated UTIs. In this randomized comparative study, 260 female patients between 18 and 65 years of age enrolled, of whom 142 completed the study. The most frequently isolated bacterial pathogen in the urine cultures of patients were Escherichia coli (82.3%) and Enterobacter spp. (8.4%). FMT sensitivity was 94% and ciprofloxacin sensitivity was 59% in Escherichia coli; in comparison, FMT sensitivity was 75% and ciprofloxacin sensitivity was 50% in Enterobacter spp. The MIC90 for FMT was 4 μg/ml. Of the 142 patients, 77 were treated with FMT and 65 were treated with ciprofloxacin. The clinical remission rate was 83% in the FMT group and 81% in the ciprofloxacin group; the bacterial eradication rate was 83% in the FMT group and 78% in the ciprofloxacin group, and there was no significant difference between the two study groups. In conclusion, a single dose of FMT (at 3 g) was as effective as ciprofloxacin, at 500 mg twice a day for 5 days, in the treatment of uncomplicated lower UTIs. It was concluded that the use of FMT as a first-line treatment in the empirical treatment of uncomplicated UTIs might have a positive impact on the problem of resistance to other antibiotics.

Published
2010
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8. Bacterial brain abscesses: prognostic value of an imaging severity index

Author

Nurgul Ceran, Ilknur Erdem, Gamze Kilicoglu, Mustafa Kemal Demir, Paşa Göktaş, Mehmet Zafer Berkman, and Tayfun Hakan

Subjects
Adult, Male, medicine.medical_specialty, Adolescent, Brain Abscess, Severity of Illness Index, Statistics, Nonparametric, Central nervous system disease, Midline shift, Severity of illness, medicine, Humans, Glasgow Coma Scale, Radiology, Nuclear Medicine and imaging, Child, Brain abscess, Aged, Retrospective Studies, Aged, 80 and over, Coma, medicine.diagnostic_test, business.industry, Brain, Magnetic resonance imaging, General Medicine, Middle Aged, Prognosis, medicine.disease, Magnetic Resonance Imaging, humanities, Surgery, Exact test, Child, Preschool, Female, Radiology, medicine.symptom, Tomography, X-Ray Computed, business, hormones, hormone substitutes, and hormone antagonists
Abstract

AIM: To assess the correlation between imaging findings [computed tomography (CT) or magnetic resonance imaging (MRI)] and neurological status before and after the treatment of bacterial brain abscesses. MATERIALS AND METHODS: CT and MRI images of 96 patients with brain abscesses were retrospectively evaluated in terms of the number, location and size of lesions, and the presence and extent of perilesional oedema and midline shift. An imaging severity index (ISI) based on these different radiological parameters was calculated. Initial Glasgow Coma Scale (GCS) scores and ISI were assessed and the prognostic value of these two indices was calculated. The Pearson correlation test, Mann-Whitney test, Chi-square test, receiver-operating characteristic (ROC) analysis, together with comparison of ROC analyses and Fisher's exact test were used. RESULTS: There was a negative correlation between ISI and the initial GCS values: ISI increased as the GCS score decreased, indicating an inverse relationship (r=-0.51, p

Published
2007
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9. Antituberculosis drug resistance patterns in adults with tuberculous meningitis:results of haydarpasa-iv study

Author

Umit Savasci, Ebru Kurşun, Serkan Oncu, Melanie Catroux, Oğuz Reşat Sipahi, Arjan Harxhi, Rok Čivljak, Yves Hansmann, Bojana Beović, Alper Şener, Nazif Elaldi, Uner Kayabas, Haluk Vahaboglu, Gonul Sengoz, Sukran Kose, Ayşe Seza Inal, Mucahit Yemisen, Nuri Özkütük, Olga Dulovic, Selma Alabay, Emine Parlak, Asuman Inan, B. Lakatos, Recep Tekin, Gorana Dragovac, Soline Simeon, Mustafa Sunbul, Branislava Savic, Seniha Senbayrak, Aysegul Ulu-Kilic, Oral Oncul, Yasemin Cag, Gulden Yilmaz, Hakan Erdem, Hanefi Cem Gul, Emel Yilmaz, Isik Somuncu Johansen, Katell Andre, Özcan Deveci, Nurgul Ceran, Derya Ozturk-Engin, CHU Pontchaillou [Rennes], Centre hospitalier universitaire de Poitiers (CHU Poitiers), Service de maladies infectieuses et tropicales, Hôpital de Hautepierre [Strasbourg], Ege Üniversitesi, Çukurova Üniversitesi, OMÜ, [Senbayrak, Seniha -- Ozturk-Engin, Derya -- Ceran, Nurgul -- Inan, Asuman] Haydarpasa Numune Training & Res Hosp, Dept Infect Dis & Clin Microbiol, Istanbul, Turkey -- [Ozkutuk, Nuri] Celal Bayar Univ, Sch Med, Dept Med Microbiol, Manisa, Turkey -- [Erdem, Hakan -- Gul, Hanefi Cem -- Savasci, Umit] Gulhane Mil Med Acad, Dept Infect Dis & Clin Microbiol, Ankara, Turkey -- [Johansen, Isik Somuncu] Odense Univ Hosp, Dept Infect Dis Q, DK-5000 Odense, Denmark -- [Civljak, Rok] Univ Zagreb, Sch Med, Dept Infect Dis, Dr Fran Mihaljev Univ Hosp Infect Dis, Zagreb 41001, Croatia -- [Inal, Ayse Seza] Cukurova Univ, Sch Med, Dept Infect Dis & Clin Microbiol, Adana, Turkey -- [Kayabas, Uner] Inonu Univ, Sch Med, Dept Infect Dis & Clin Microbiol, Malatya, Turkey -- [Kursun, Ebru] Baskent Univ, Sch Med, Dept Infect Dis & Clin Microbiol, Adana, Turkey -- [Elaldi, Nazif] Cumhuriyet Univ, Sch Med, Dept Infect Dis & Clin Microbiol, Sivas, Turkey -- [Savic, Branislava] Univ Belgrade, Natl Reference Lab TB, Inst Microbiol & Immunol, Fac Med, Belgrade, Serbia -- [Simeon, Soline] Univ Hosp Pontchaillou, Dept Infect & Trop Dis, Rennes, France -- [Yilmaz, Emel] Uludag Univ, Sch Med, Dept Infect Dis & Clin Microbiol, Bursa, Turkey -- [Dulovic, Olga] Univ Belgrade, Clin Infect & Trop Dis, Clin Ctr Serbia, Fac Med, Belgrade, Serbia -- [Lakatos, Botond] St Laszlo Hosp, Dept Infect Dis, Budapest, Hungary -- [Sipahi, Oguz Resat] Ege Univ, Dept Infect Dis & Clin Microbiol, Sch Med, Izmir, Turkey -- [Sunbul, Mustafa] Ondokuz Mayis Univ, Sch Med, Dept Infect Dis & Clin Microbiol, Samsun, Turkey -- [Yemisen, Mucahit] Istanbul Univ, Cerrahpasa Med Sch, Dept Infect Dis & Clin Microbiol, Istanbul, Turkey -- [Alabay, Selma -- Ulu-Kilic, Aysegul] Erciyes Univ, Sch Med, Dept Infect Dis & Clin Microbiol, Kayseri, Turkey -- [Beovic, Bojana] Univ Med Ctr, Dept Infect Dis, Ljubljana, Slovenia -- [Cag, Yasemin] Lutfi Kirdar Training & Res Hosp, Dept Infect Dis & Clin Microbiol, Istanbul, Turkey -- [Catroux, Melanie] Univ Poitiers Hosp, Dept Infect Dis, Poitiers, France -- [Dragovac, Gorana] Univ Novi Sad, Fac Med, Dept Prevent & Control Dis, IPH Vojvodina, Novi Sad 21000, Serbia -- [Deveci, Ozcan -- Tekin, Recep] Dicle Univ, Sch Med, Dept Infect Dis & Clin Microbiol, Diyarbakir, Turkey -- [Sengoz, Gonul] Haseki Training & Res Hosp, Dept Infect Dis & Clin Microbiol, Istanbul, Turkey -- [Andre, Katell] Dax Hosp, Dept Infect Dis, Dax, France -- [Harxhi, Arjan] Univ Hosp Ctr Tirana, Infect Dis Serv, Tirana, Albania -- [Hansmann, Yves] Univ Hosp, Dept Infect Dis, Strasbourg, France -- [Oncu, Serkan] Adnan Menderes Univ, Sch Med, Dept Infect Dis & Clin Microbiol, Aydin, Turkey -- [Kose, Sukran] Tepecik Training & Res Hosp, Dept Infect Dis & Clin Microbiol, Izmir, Turkey -- [Oncul, Oral] GATA Haydarpasa Training Hosp, Dept Infect Dis & Clin Microbiol, Istanbul, Turkey -- [Parlak, Emine] Ataturk Univ, Sch Med, Dept Infect Dis & Clin Microbiol, Erzurum, Turkey -- [Sener, Alper] Onsekiz Mart Univ, Sch Med, Dept Infect Dis & Clin Microbiol, Canakkale, Turkey -- [Yilmaz, Gulden] Ankara Univ, Sch Med, Dept Infect Dis & Clin Microbiol, TR-06100 Ankara, Turkey -- [Vahaboglu, Haluk] Medeniyet Univ, Goztepe Training & Res Hosp, Dept Infect Dis & Clin Microbiol, Istanbul, Turkey, Inal, Ayse Seza -- 0000-0002-1182-7164, johansen, isik somuncu -- 0000-0002-2189-9823, Elaldi, Nazif -- 0000-0002-9515-770X, VAHABOGLU, Haluk -- 0000-0001-8217-1767, and Civljak, Rok -- 0000-0001-8766-7438

Subjects
Male, [SDV]Life Sciences [q-bio], Resistance, Antitubercular Agents, Drug resistance, urologic and male genital diseases, Medical microbiology, MDR, Prevalence, heterocyclic compounds, Cerebrospinal Fluid, Aged, 80 and over, biology, General Medicine, Middle Aged, 3. Good health, Europe, Infectious Diseases, Tuberculosis, Meningeal, Female, Meningitis, medicine.drug, Microbiology (medical), Adult, medicine.medical_specialty, Tuberculosis, Adolescent, Tuberculous meningitis, Mycobacterium tuberculosis, Young Adult, Internal medicine, Drug Resistance, Bacterial, medicine, Isoniazid, Humans, Ethambutol, Aged, Retrospective Studies, business.industry, Research, biochemical phenomena, metabolism, and nutrition, medicine.disease, biology.organism_classification, bacterial infections and mycoses, Survival Analysis, Immunology, business, Rifampicin
Abstract

WOS: 000364000400001, PubMed ID: 26538030, Background: Tuberculous meningitis (TBM) caused by Mycobacterium tuberculosis resistant to antituberculosis drugs is an increasingly common clinical problem. This study aimed to evaluate drug resistance profiles of TBM isolates in adult patients in nine European countries involving 32 centers to provide insight into the empiric treatment of TBM. Methods: Mycobacterium tuberculosis was cultured from the cerebrospinal fluid (CSF) of 142 patients and was tested for susceptibility to first-line antituberculosis drugs, streptomycin (SM), isoniazid (INH), rifampicin (RIF) and ethambutol (EMB). Results: Twenty of 142 isolates (14.1 %) were resistant to at least one antituberculosis drug, and five (3.5 %) were resistant to at least INH and RIF, [multidrug resistant (MDR)]. The resistance rate was 12, 4.9, 4.2 and 3.5 % for INH, SM, EMB and RIF, respectively. The monoresistance rate was 6.3, 1.4 and 0.7 % for INH, SM and EMB respectively. There was no monoresistance to RIF. The mortality rate was 23.8 % in fully susceptible cases while it was 33.3 % for those exhibiting monoresistance to INH, and 40 % in cases with MDR-TBM. In compared to patients without resistance to any firstline drug, the relative risk of death for INH-monoresistance and MDR-TBM was 1.60 (95 % CI, 0.38-6.82) and 2.14 (95 % CI, 0: 34-13: 42), respectively. Conclusion: INH-resistance and MDR rates seemed not to be worrisome in our study. However, considering their adverse effects on treatment, rapid detection of resistance to at least INH and RIF would be most beneficial for designing anti-TB therapy. Still, empiric TBM treatment should be started immediately without waiting the drug susceptibility testing.

Published
2015
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10. Hamsi scoring in the prediction of unfavorable outcomes from tuberculous meningitis: results of Haydarpasa-II study

Author

Sukran Kose, Branislava Savic, Selma Alabay, Emine Parlak, Recep Tekin, Ayhan Akbulut, Gulden Yilmaz, Haluk Vahaboglu, Nataša Popović, Özcan Deveci, Akram Al-Mahdawi, Hanefi Cem Gul, Canan Agalar, Serkan Oncu, Soline Simeon, Seniha Senbayrak, Hulya Tireli, Mehmet Bitirgen, Catalina Luca, Bahar Kandemir, Sylviane Defres, Oguz Karabay, Oğuz Reşat Sipahi, Ghaydaa A. Shehata, Alper Şener, Aysegul Ulu-Kilic, Saim Dayan, Nazif Elaldi, Mihai Nechifor, Ayşe Seza Inal, Mucahit Yemisen, Filiz Pehlivanoglu, Asuman Inan, B. Lakatos, Mustafa Namiduru, Nurgul Ceran, Muge Ozguler, Alexandru Crisan, Ahmet Karakaş, Jean-Paul Stahl, Gamze Kilicoglu, Mustafa Sunbul, Elif Sahin-Horasan, Hakan Erdem, Gorana Dragovac, Valerija Kirova, Ahmad Khalifa, Emel Yilmaz, Bruno Cacopardo, Gonul Sengoz, Hacer Deniz Ozkaya, Ebru Kurşun, Serda Gulsun, Rok Čivljak, Bojana Beović, Melanie Catroux, Oral Oncul, Isabelle Masse-Chabredier, Isik Somuncu Johansen, Katell Andre, Kadriye Kart Yaşar, Derya Ozturk-Engin, Uner Kayabas, Stéphane Chadapaud, Mehmet Parlak, Arjan Harxhi, Yves Hansmann, Ondokuz Mayıs Üniversitesi, Çukurova Üniversitesi, [Erdem, Hakan -- Oncul, Oral] GATA Haydarpasa Training Hosp, Dept Infect Dis & Clin Microbiol, Istanbul, Turkey -- [Erdem, Hakan] GATA Haydarpasa AH, Enfeksiyon Hastaliklari Servisi, Istanbul, Turkey -- [Ozturk-Engin, Derya -- Inan, Asuman -- Ceran, Nurgul -- Senbayrak, Seniha] Haydarpasa Numune Training & Res Hosp, Dept Infect Dis & Clin Microbiol, Istanbul, Turkey -- [Tireli, Hulya] Haydarpasa Numune Training & Res Hosp, Dept Neurol, Istanbul, Turkey -- [Kilicoglu, Gamze] Haydarpasa Numune Training & Res Hosp, Dept Radiol, Istanbul, Turkey -- [Defres, Sylviane] Univ Liverpool, Inst Infect & Global Hlth, Liverpool L69 3BX, Merseyside, England -- [Defres, Sylviane] Royal Liverpool & Broadgreen Univ Hosp NHS Trust, Trop Infect Dis Unit, Liverpool, Merseyside, England -- [Gulsun, Serda] Diyarbakir Training & Res Hosp, Dept Infect Dis & Clin Microbiol, Diyarbakir, Turkey -- [Sengoz, Gonul -- Pehlivanoglu, Filiz] Haseki Training & Res Hosp, Dept Infect Dis & Clin Microbiol, Istanbul, Turkey -- [Crisan, Alexandru] Victor Babes Univ Med & Pharm, Dept Infect Dis, Timisoara, Romania -- [Johansen, Isik Somuncu] Odense Univ Hosp, Dept Infect Dis Q, DK-5000 Odense, Denmark -- [Nechifor, Mihai] Gr T Popa Univ Med & Pharm, Dept Pharmacol, Iasi, Romania -- [Al-Mahdawi, Akram] Baghdad Teaching Hosp, Dept Neurol, Baghdad, Iraq -- [Civljak, Rok] Univ Zagreb, Sch Med, Dr Fran Mihaljev Univ Hosp Infect Dis, Dept Infect Dis, Zagreb 41000, Croatia -- [Ozguler, Muge -- Akbulut, Ayhan] Firat Univ, Sch Med, Dept Infect Dis & Clin Microbiol, TR-23169 Elazig, Turkey -- [Savic, Branislava] Univ Belgrade, Fac Med, Inst Microbiol & Immunol, Natl Reference Lab TB, Belgrade, Serbia -- [Cacopardo, Bruno] Univ Catania, Dept Clin & Mol Biomed, Infect Dis Sect, Catania, Italy -- [Inal, Ayse Seza] Cukurova Univ, Sch Med, Dept Infect Dis & Clin Microbiol, Adana, Turkey -- [Namiduru, Mustafa] Gaziantep Univ, Sch Med, Dept Infect Dis & Clin Microbiol, Gaziantep, Turkey -- [Dayan, Saim -- Tekin, Recep -- Deveci, Ozcan] Dicle Univ, Sch Med, Dept Infect Dis & Clin Microbiol, Diyarbakir, Turkey -- [Kayabas, Uner] Inonu Univ, Sch Med, Dept Infect Dis & Clin Microbiol, Malatya, Turkey -- [Parlak, Emine -- Parlak, Mehmet] Ataturk Univ, Sch Med, Dept Infect Dis & Clin Microbiol, Erzurum, Turkey -- [Khalifa, Ahmad] Damascus Hosp, Dept Neurol, Damascus, Syria -- [Kursun, Ebru] Baskent Univ, Sch Med, Dept Infect Dis & Clin Microbiol, Adana, Turkey -- [Sipahi, Oguz Resat] Ege Univ, Sch Med, Dept Infect Dis & Clin Microbiol, Izmir, Turkey -- [Yemisen, Mucahit] Istanbul Univ, Cerrahpasa Med Sch, Dept Infect Dis & Clin Microbiol, Istanbul, Turkey -- [Bitirgen, Mehmet -- Kandemir, Bahar] Necmettin Erbakan Univ, Sch Med, Dept Infect Dis & Clin Microbiol, Konya, Turkey -- [Popovic, Natasa] Clin Ctr Serbia, Clin Infect & Trop Dis, Belgrade, Serbia -- [Luca, Catalina] Gr T Popa Univ Med & Pharm, Dept Infect Dis, Iasi, Romania -- [Stahl, Jean Paul] Univ Grenoble 1, Dept Infect Dis, Grenoble, France -- [Stahl, Jean Paul] Univ Hosp Grenoble, Grenoble, France -- [Simeon, Soline] Univ Hosp Pontchaillou, Dept Infect & Trop Dis, Rennes, France -- [Ulu-Kilic, Aysegul -- Alabay, Selma] Erciyes Univ, Sch Med, Dept Infect Dis & Clin Microbiol, Kayseri, Turkey -- [Yasar, Kadriye] Bakirkoy Dr Sadi Konuk Training & Res Hosp, Dept Infect Dis & Clin Microbiol, Istanbul, Turkey -- [Yilmaz, Gulden] Ankara Univ, Sch Med, Dept Infect Dis & Clin Microbiol, TR-06100 Ankara, Turkey -- [Yilmaz, Emel] Uludag Univ, Sch Med, Dept Infect Dis & Clin Microbiol, Bursa, Turkey -- [Beovic, Bojana] Univ Med Ctr, Dept Infect Dis, Ljubljana, Slovenia -- [Catroux, Melanie] Univ Poitiers Hosp, Dept Infect Dis, Poitiers, France -- [Lakatos, Botond] St Laszlo Hosp, Dept Infect Dis, Budapest, Hungary -- [Sunbul, Mustafa] Ondokuz Mayis Univ, Sch Med, Dept Infect Dis & Clin Microbiol, Samsun, Turkey -- [Sahin-Horasan, Elif] Mersin Univ, Sch Med, Dept Infect Dis & Clin Microbiol, Istanbul, Turkey -- [Kose, Sukran] Tepecik Training & Res Hosp, Dept Infect Dis & Clin Microbiol, Izmir, Turkey -- [Shehata, Ghaydaa] Assiut Univ Hosp, Dept Neurol & Psychiat, Assiut, Egypt -- [Andre, Katell] Dax Hosp, Dept Infect Dis, Dax, France -- [Dragovac, Gorana] Univ Novi Sad, Fac Med, IPH Vojvodina, Dept Prevent & Control Dis, Novi Sad 21000, Serbia -- [Gul, Hanefi Cem -- Karakas, Ahmet] Gulhane Mil Med Acad, Dept Infect Dis & Clin Microbiol, Ankara, Turkey -- [Chadapaud, Stephane] Marie Jose Treffot Hosp, Dept Infect Dis, Hyeres, France -- [Hansmann, Yves] Univ Hosp, Dept Infect Dis, Strasbourg, France -- [Harxhi, Arjan] Univ Hosp Ctr Tirana, Infect Dis Serv, Tirana, Albania -- [Kirova, Valerija] Univ Clin Infect Dis & Febrile Condit, Skopje, Macedonia -- [Masse-Chabredier, Isabelle] Aurillac Hosp, Dept Infect Dis, Aurillac, France -- [Oncu, Serkan] Adnan Menderes Univ, Sch Med, Dept Infect Dis & Clin Microbiol, Aydin, Turkey -- [Sener, Alper] Onsekiz Mart Univ, Sch Med, Dept Infect Dis & Clin Microbiol, Canakkale, Turkey -- [Elaldi, Nazif] Cumhuriyet Univ, Sch Med, Dept Infect Dis & Clin Microbiol, Sivas, Turkey -- [Ozkaya, Hacer Deniz] Karsiyaka State Hosp, Dept Infect Dis & Clin Microbiol, Izmir, Turkey -- [Karabay, Oguz] Sakarya Univ, Sch Med, Dept Infect Dis & Clin Microbiol, Sakarya, Turkey -- [Agalar, Canan] Fatih Sultan Mehmet Training & Res Hosp, Dept Infect Dis & Clin Microbiol, Istanbul, Turkey -- [Vahaboglu, Haluk] Medeniyet Univ, Goztepe Training & Res Hosp, Dept Infect Dis & Clin Microbiol, Istanbul, Turkey, Inal, Ayse Seza -- 0000-0002-1182-7164, Ghaydaa, Shehata -- 0000-0002-3631-893X, Civljak, Rok -- 0000-0001-8766-7438, Karabay, Oguz -- 0000-0003-0502-432X, VAHABOGLU, Haluk -- 0000-0001-8217-1767, Karakas, Ahmet -- 0000-0002-0553-8454, Elaldi, Nazif -- 0000-0002-9515-770X, johansen, isik somuncu -- 0000-0002-2189-9823, Stahl, Jean Paul -- 0000-0002-0086-3557, Kart Yasar, Kadriye -- 0000-0003-2963-4894, Erdem, H, Ozturk-Engin, D, Tireli, H, Kilicoglu, G, Defres, S, Gulsun, S, Sengoz, G, Crisan, A, Johansen, IS, Inan, A, Nechifor, M, Al-Mahdawi, A, Civljak, R, Ozguler, M, Savic, B, Ceran, N, Cacopardo, B, Inal, AS, Namiduru, M, Dayan, S, Kayabas, U, Parlak, E, Khalifa, A, Kursun, E, Sipahi, OR, Yemisen, M, Akbulut, A, Bitirgen, M, Popovic, N, Kandemir, B, Luca, C, Parlak, M, Stahl, JP, Pehlivanoglu, F, Simeon, S, Ulu-Kilic, A, Yasar, K, Yilmaz, G, Yilmaz, E, Beovic, B, Catroux, M, Lakatos, B, Sunbul, M, Oncul, O, Alabay, S, Sahin-Horasan, E, Kose, S, Shehata, G, Andre, K, Dragovac, G, Gul, HC, Karakas, A, Chadapaud, S, Hansmann, Y, Harxhi, A, Kirova, V, Masse-Chabredier, I, Oncu, S, Sener, A, Tekin, R, Elaldi, N, Deveci, O, Ozkaya, HD, Karabay, O, Senbayrak, S, Agalar, C, Vahaboglu, H, Sakarya Üniversitesi/Tıp Fakültesi/Dahili Tıp Bilimleri Bölümü, and Parlak, Erkan

Subjects
Adult, Male, Pediatrics, medicine.medical_specialty, International Cooperation, Logistic regression, Sensitivity and Specificity, Severity of Illness Index, Tuberculous meningitis, Cohort Studies, Sequelae, Predictive Value of Tests, Surveys and Questionnaires, Outcome Assessment, Health Care, Severity of illness, medicine, Tuberculosis, Meningitis, Death, Outcome, Sequela, Humans, Tuberculosis, Meningitis, Death, Outcome, Sequelae, Clinical Trials as Topic, business.industry, Middle Aged, medicine.disease, Hydrocephalus, Logistic Models, Treatment Outcome, Neurology, Tuberculosis, Meningeal, Predictive value of tests, Female, Neurosciences & Neurology, Neurology (clinical), Nervous System Diseases, business, Cohort study
Abstract

WOS: 000353295400011, PubMed ID: 25634680, Predicting unfavorable outcome is of paramount importance in clinical decision making. Accordingly, we designed this multinational study, which provided the largest case series of tuberculous meningitis (TBM). 43 centers from 14 countries (Albania, Croatia, Denmark, Egypt, France, Hungary, Iraq, Italy, Macedonia, Romania, Serbia, Slovenia, Syria, Turkey) submitted data of microbiologically confirmed TBM patients hospitalized between 2000 and 2012. Unfavorable outcome was defined as survival with significant sequela or death. In developing our index, binary logistic regression models were constructed via 200 replicates of database by bootstrap resampling methodology. The final model was built according to the selection frequencies of variables. The severity scale included variables with arbitrary scores proportional to predictive powers of terms in the final model. The final model was internally validated by bootstrap resampling. A total of 507 patients' data were submitted among which 165 had unfavorable outcome. Eighty-six patients died while 119 had different neurological sequelae in 79 (16 %) patients. The full model included 13 variables. Age, nausea, vomiting, altered consciousness, hydrocephalus, vasculitis, immunosuppression, diabetes mellitus and neurological deficit remained in the final model. Scores 1-3 were assigned to the variables in the severity scale, which included scores of 1-6. The distribution of mortality for the scores 1-6 was 3.4, 8.2, 20.6, 31, 30 and 40.1 %, respectively. Altered consciousness, diabetes mellitus, immunosuppression, neurological deficits, hydrocephalus, and vasculitis predicted the unfavorable outcome in the scoring and the cumulative score provided a linear estimation of prognosis.

Published
2015
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11. Bacterial brain abscesses: An evaluation of 96 cases

Author

Paşa Göktaş, Nurgul Ceran, Ilknur Erdem, Tayfun Hakan, and Mehmet Zafer Berkman

Subjects
Adult, Male, Microbiology (medical), medicine.medical_specialty, Adolescent, medicine.drug_class, Antibiotics, Anti-Inflammatory Agents, Brain Abscess, Dexamethasone, Central nervous system disease, Meningismus, medicine, Humans, Child, Abscess, Brain abscess, Aged, Aged, 80 and over, medicine.diagnostic_test, business.industry, Gold standard, Infant, Magnetic resonance imaging, Bacterial Infections, Middle Aged, medicine.disease, Anti-Bacterial Agents, Surgery, Treatment Outcome, Infectious Diseases, Child, Preschool, Female, Neurosurgery, business
Abstract

Summary Objectives Although the decline of the morbidity and mortality in recent years, brain abscess is still one of the most important problems in Neurosurgery. Methods Ninety-six patients with brain abscess are analysed retrospectively, that treated between 1988 and 2001, according to age, the clinical symptoms, etiologic factors, infecting organisms, prognostic factors, localization, diagnostic and treatment methods and outcome. Results Seventy-two patients treated with aspiration (streotactic aspiration in 12 cases), 14 patients with excision. Ten patients treated medically alone. Seven patients in the aspiration group and one patient in the excision group were died. Cure without any morbidity obtained in 55 patients. A significant correlation determined with initial neurologic grade, meningismus, high fever (>38.50), leucocytosis (>20.000/mm 3 ) and mortality. There were no significant correlation the age groups and outcome, treatment groups and location of abscess, period of treatment, number of abscess, outcome according to GOS and factor, treatment period and received antibiotic. Conclusions In appropriate cases, medical treatment can be successful alone but surgery, aspiration, is gold standard for brain abscesses. In that way, definite diagnosis is obtained and pathogen is identified and cure is obtained in a short time.

Published
2006
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12. The microbiological diagnosis of tuberculous meningitis: results of Haydarpasa-1 study

Author

Ebru Kurşun, Derya Ozturk-Engin, Branislava Savic, Rok Čivljak, Bojana Beović, Mehmet Parlak, Elif Sahin-Horasan, Oguz Karabay, Selma Alabay, Emine Parlak, Esmeray Mutlu Yilmaz, Ahmad Khalifa, Uner Kayabas, Saim Dayan, Hakan Erdem, Sukran Kose, V Kirova, Jean-Paul Stahl, Gonul Sengoz, Bruno Cacopardo, Canan Agalar, Arjan Harxhi, Gorana Cosic, Yves Hansmann, Catalina Luca, Alpaslan Alp, Aysegul Ulu-Kilic, Mehmet Bitirgen, Kadriye Kart Yaşar, Özcan Deveci, Isik Somuncu Johansen, Mustafa Namiduru, Katell Andre, I Masse-Chabredier, H. Cem Gul, Serkan Oncu, Mustafa Sunbul, Akram Al-Mahdawi, Ayhan Akbulut, Gulden Yilmaz, Serda Gulsun, Oral Oncul, S Chadapaud, Soline Simeon, Melanie Catroux, Oğuz Reşat Sipahi, Recep Tekin, Ayşe Seza Inal, Mucahit Yemisen, Filiz Pehlivanoglu, Olga Dulovic, Asuman Inan, B. Lakatos, Bahar Kandemir, Nazif Elaldi, Ghaydaa A. Shehata, Ahmet Karakaş, Alper Şener, Mihai Nechifor, Muge Ozguler, Alexandru Crisan, Nurgul Ceran, Çukurova Üniversitesi, OMÜ, Ege Üniversitesi, [Erdem, H. -- Oncul, O.] GATA Haydarpasa Training Hosp, Dept Infect Dis & Clin Microbiol, Istanbul, Turkey -- [Ozturk-Engin, D. -- Inan, A. -- Ceran, N.] Haydarpasa Numune Training & Res Hosp, Dept Infect Dis & Clin Microbiol, Istanbul, Turkey -- [Elaldi, N.] Cumhuriyet Univ Sch Med, Dept Infect Dis & Clin Microbiol, Sivas, Turkey -- [Gulsun, S.] Diyarbakir Training & Res Hosp, Dept Infect Dis & Clin Microbiol, Diyarbakir, Turkey -- [Sengoz, G. -- Pehlivanoglu, F.] Haseki Training & Res Hosp, Dept Infect Dis & Clin Microbiol, Istanbul, Turkey -- [Crisan, A.] Victor Babes Univ Med & Pharm, Dept Infect Dis, Timisoara, Romania -- [Johansen, I. S.] Odense Univ Hosp, Dept Infect Dis Q, DK-5000 Odense, Denmark -- [Nechifor, M.] Gr T Popa Univ Med & Pharm, Dept Pharmacol, Iasi, Romania -- [Al-Mahdawi, A.] Baghdad Teaching Hosp, Dept Neurol, Baghdad, Iraq -- [Civljak, R.] Univ Zagreb Sch Med, Dr Fran Mihaljev Univ Hosp Infect Dis, Dept Infect Dis, Zagreb, Croatia -- [Ozguler, M. -- Akbulut, A.] Firat Univ Sch Med, Dept Infect Dis & Clin Microbiol, Elazig, Turkey -- [Savic, B.] Univ Belgrade, Inst Microbiol & Immunol, Natl Reference Lab TB, Fac Med, Belgrade, Serbia -- [Cacopardo, B.] Univ Catania, Infect Dis Sect, Dept Clin & Mol Biomed, Catania, Italy -- [Inal, A. S.] Cukurova Univ Sch Med, Dept Infect Dis & Clin Microbiol, Adana, Turkey -- [Namiduru, M.] Gaziantep Univ Sch Med, Dept Infect Dis & Clin Microbiol, Gaziantep, Turkey -- [Dayan, S. -- Tekin, R. -- Deveci, O.] Dicle Univ Sch Med, Dept Infect Dis & Clin Microbiol, Diyarbakir, Turkey -- [Kayabas, U.] Inonu Univ Sch Med, Dept Infect Dis & Clin Microbiol, Malatya, Turkey -- [Parlak, E. -- Parlak, M.] Ataturk Univ Sch Med, Dept Infect Dis & Clin Microbiol, Erzurum, Turkey -- [Khalifa, A.] Damascus Hosp, Dept Neurol, Damascus, Syria -- [Kursun, E.] Baskent Univ Sch Med, Dept Infect Dis & Clin Microbiol, Adana, Turkey -- [Sipahi, O. R.] Ege Univ Sch Med, Dept Infect Dis & Clin Microbiol, Izmir, Turkey -- [Yemisen, M.] Istanbul Univ Cerrahpasa Sch Med, Dept Infect Dis & Clin Microbiol, Istanbul, Turkey -- [Bitirgen, M. -- Kandemir, B.] Necmettin Erbakan Univ Sch Med, Dept Infect Dis & Clin Microbiol, Konya, Turkey -- [Dulovic, O.] Univ Belgrade, Clin Infect & Trop Dis, Clin Ctr Serbia, Fac Med, Belgrade, Serbia -- [Luca, C.] Gr T Popa Univ Med & Pharm, Dept Infect Dis, Iasi, Romania -- [Stahl, J. P.] Joseph Fourier Univ & Univ Hosp Grenoble, Dept Infect Dis, Grenoble, France -- [Simeon, S.] Univ Hosp Pontchaillou, Dept Infect & Trop Dis, Rennes, France -- [Ulu-Kilic, A. -- Alabay, S.] Erciyes Univ Sch Med, Dept Infect Dis & Clin Microbiol, Kayseri, Turkey -- [Yasar, K.] Bakrkoy Dr Sadi Konuk Training & Res Hosp, Dept Infect Dis & Clin Microbiol, Istanbul, Turkey -- [Yilmaz, G.] Ankara Univ Sch Med, Dept Infect Dis & Clin Microbiol, Ankara, Turkey -- [Yilmaz, E.] Uludag Univ Sch Med, Dept Infect Dis & Clin Microbiol, Bursa, Turkey -- [Beovic, B.] Univ Med Ctr, Dept Infect Dis, Ljubljana, Slovenia -- [Catroux, M.] Univ Poitiers Hosp, Dept Infect Dis, Poitiers, France -- [Lakatos, B.] St Laszlo Hosp, Dept Infect Dis, Budapest, Hungary -- [Sunbul, M.] Ondokuz Mayis Univ Sch Med, Dept Infect Dis & Clin Microbiol, Samsun, Turkey -- [Sahin-Horasan, E.] Mersin Univ Sch Med, Dept Infect Dis & Clin Microbiol, Mersin, Turkey -- [Kose, S.] Tepecik Training & Res Hosp, Dept Infect Dis & Clin Microbiol, Izmir, Turkey -- [Shehata, G.] Assiut Univ Hosp, Dept Neurol & Psychiat, Assiut, Egypt -- [Andre, K.] Dax Hosp, Dept Infect Dis, Dax, France -- [Alp, A.] Hacettepe Univ, Sch Med, Deparment Med Microbiol, Ankara, Turkey -- [Cosic, G.] Univ Novi Sad, Fac Med, Dept Prevent & Control Dis, IPH Vojvodina, Novi Sad, Serbia -- [Gul, H. Cem -- Karakas, A.] Gulhane Mil Med Acad, Dept Infect Dis & Clin Microbiol, Ankara, Turkey -- [Chadapaud, S.] Marie Jose Treffot Hosp, Dept Infect Dis, Hyeres, France -- [Hansmann, Y.] Univ Hosp, Dept Infect Dis, Strasbourg, France -- [Harxhi, A.] Univ Hosp Ctr Tirana, Infect Dis Serv, Tirana, Albania -- [Kirova, V.] Univ Clin Infect Dis & Febrile Condit, Skopje, Macedonia -- [Masse-Chabredier, I.] Aurillac Hosp, Dept Infect Dis, Aurillac, France -- [Oncu, S.] Adnan Menderes Univ Sch Med, Dept Infect Dis & Clin Microbiol, Aydin, Turkey -- [Sener, A.] Onsekiz Mart Univ Sch Med, Dept Infect Dis & Clin Microbiol, Canakkale, Turkey -- [Karabay, O.] Sakarya Univ Sch Med, Dept Infect Dis & Clin Microbiol, Sakarya, Turkey -- [Agalar, C.] Fatih Sultan Mehmet Training & Res Hosp, Dept Infect Dis & Clin Microbiol, Istanbul, Turkey, Inal, Ayse Seza -- 0000-0002-1182-7164, Ghaydaa, Shehata -- 0000-0002-3631-893X, johansen, isik somuncu -- 0000-0002-2189-9823, Karabay, Oguz -- 0000-0003-0502-432X, Karakas, Ahmet -- 0000-0002-0553-8454, Kart Yasar, Kadriye -- 0000-0003-2963-4894, Stahl, Jean Paul -- 0000-0002-0086-3557, Elaldi, Nazif -- 0000-0002-9515-770X, ALP, ALPASLAN -- 0000-0001-7856-7590, and Civljak, Rok -- 0000-0001-8766-7438

Subjects
Microbiology (medical), Adult, Male, medicine.medical_specialty, Adolescent, QUANTIFERON-TB GOLD, diagnosis, Adenosine Deaminase, Culture, Tuberculous meningitis, 03 medical and health sciences, Young Adult, 0302 clinical medicine, Internal medicine, Diagnosis, medicine, Tuberculosis, Humans, Meningitis, 030212 general & internal medicine, Precision Medicine, Aged, Retrospective Studies, culture, meningitis, PCR, tuberculosis, Aged, 80 and over, Bacteriological Techniques, business.industry, General Medicine, Mycobacterium tuberculosis, Middle Aged, medicine.disease, 3. Good health, Surgery, Löwenstein–Jensen medium, Infectious Diseases, Early Diagnosis, Tuberculosis, Meningeal, Positive culture, Female, business, 030217 neurology & neurosurgery, Interferon-gamma Release Tests
Abstract

WOS: 000345825900004, PubMed ID: 24849547, We aimed to provide data on the diagnosis of tuberculous meningitis (TBM) in this largest case series ever reported. The Haydarpasa-1 study involved patients with microbiologically confirmed TBM in Albania, Croatia, Denmark, Egypt, France, Hungary, Iraq, Italy, Macedonia, Romania, Serbia, Slovenia, Syria and Turkey between 2000 and 2012. A positive culture, PCR or Ehrlich-Ziehl-Neelsen staining (EZNs) from the cerebrospinal fluid (CSF) was mandatory for inclusion of meningitis patients. A total of 506 TBM patients were included. The sensitivities of the tests were as follows: interferon- release assay (Quantiferon TB gold in tube) 90.2%, automated culture systems (ACS) 81.8%, Lowenstein Jensen medium (L-J) 72.7%, adenosine deaminase (ADA) 29.9% and EZNs 27.3%. CSF-ACS was superior to CSF L-J culture and CSF-PCR (p

Published
2013
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13. Diagnosis of chronic brucellar meningitis and meningoencephalitis: the results of the Istanbul-2 study

Author

Ilkay Karaoglan, Bilgul Mete, Bahri Teker, Nurgul Ceran, Mustafa Namiduru, Hakan Erdem, V. Turban, Selçuk Kiliç, Ahmet Karakaş, Emine Alp, Saim Dayan, Asim Ulcay, Tuna Demirdal, Mustafa Kasim Karahocagil, Hava Yilmaz, Hanefi Cem Gül, Saygin Nayman-Alpat, Bahadir Ceylan, G. Pappas, Gürdal Yilmaz, Aysun Yalci, Burçin Şener, Salman Shaheer Ahmed, Recep Tekin, Aysegul Ulu-Kilic, Ayse Batirel, A Seza Inal, Funda Yetkin, Cengiz Han Açikel, V. Kecik-Bosnak, Asuman Inan, Zeliha Kocak Tufan, Umit Savasci, Suda Tekin-Koruk, Aygul Dogan-Celik, Çukurova Üniversitesi, and OMÜ

Subjects
Adult, Male, Serum, Microbiology (medical), medicine.medical_specialty, Pathology, Adolescent, diagnosis, Detailed data, Sensitivity and Specificity, Gastroenterology, Brucellosis, Meningitis, Bacterial, Serology, neurobrucellosis, Young Adult, Cerebrospinal fluid, Meningoencephalitis, Internal medicine, Diagnosis, medicine, Humans, Blood culture, Meningitis, Chronic, CSF albumin, Aged, Cerebrospinal Fluid, medicine.diagnostic_test, Clinical Laboratory Techniques, business.industry, meningitis, meningoencephalitis, General Medicine, Middle Aged, medicine.disease, Agglutination (biology), Infectious Diseases, Chronic Disease, Female, Neurobrucellosis, business
Abstract

Tufan, Zeliha Kocak/0000-0002-3294-014X; demirdal, tuna/0000-0002-9046-5666; Inal, Ayse Seza/0000-0002-1182-7164; ULCAY, ASIM/0000-0003-0531-0668; Pappas, Georgios/0000-0002-8425-6091; Mete, Bilgul/0000-0001-9091-6087; Karakas, Ahmet/0000-0002-0553-8454 WOS: 000314656100004 PubMed: 23210984 No detailed data exist in the literature on the accurate diagnosis of chronic brucellar meningitis or meningoencephalitis. A multicentre retrospective chart review was performed at 19 health centres to determine sensitivities of the diagnostic tests. This study included 177 patients. The mean values of CSF biochemical test results were as follows: CSF protein, 330.64 +/- 493.28mg/dL; CSF/ blood-glucose ratio, 0.35 +/- 0.16; CSF sodium, 140.61 +/- 8.14mMt; CSF leucocyte count, 215.99 +/- 306.87. The sensitivities of the tests were as follows: serum standard tube agglutination (STA), 94%; cerebrospinal fluid (CSF) STA, 78%; serum Rose Bengal test (RBT), 96%; CSF RBT, 71%; automated blood culture, 37%; automated CSF culture, 25%; conventional CSF culture, 9%. The clinician should use every possible means to diagnose chronic neurobrucellosis. The high seropositivitiy in brucellar blood tests must facilitate the use of blood serology. Although STA should be preferred over RBT in CSF in probable neurobrucellosis other than the acute form of the disease, RBT is not as weak as expected. Moreover, automated culture systems should be applied when CSF culture is needed.

Published
2013

14. Efficacy And Tolerability Of Antibiotic Combinations In Neurobrucellosis: Results Of The Istanbul Study

Author

Ayşe Seza Inal, Dilara Inan, Saim Dayan, Murat Dizbay, Gaye Usluer, Emel Yilmaz, Gürkan Mert, Nail Ozgunes, Başak Dokuzoğuz, Behice Kurtaran, Serhat Ünal, Mile Bosilkovski, Hakan Erdem, Sibel Gundes, Suzan Sacar, Maria Teresa Adeva-Bartolome, Ghaydaa A. Shehata, Hanefi Cem Gul, Mustafa Kasim Karahocagil, Suda Tekin-Koruk, Ahmet Karakaş, Bahadir Ceylan, Zeliha Kocak-Tufan, Levent Gorenek, Nazif Elaldi, Oğuz Reşat Sipahi, Hava Yilmaz, Nurgul Ceran, Yasar Bayindir, Asim Ulcay, Nese Saltoglu, Kenan Ugurlu, Yeşim Taşova, Funda Yetkin, Aysegul Ulu-Kilic, Rahmet Guner, Laila Abdel-Baky, Necla Eren-Tulek, Mustafa Kemal Çelen, Selim Kilic, Hakan Leblebicioglu, Saygin Nayman-Alpat, Vedat Turhan, İç Hastalıkları, Erdem, H., Kasimpasa Hospital, Department of Infectious Diseases and Clinical Microbiology (IDCM), Istanbul, Turkey -- Ulu-Kilic, A., Erciyes School of Medicine, Department of IDCM, Kayseri, Turkey -- Kilic, S., Gulhane Medical Academy, Department of Public Health, Ankara, Turkey -- Karahocagil, M., Yüzüncü Yil School of Medicine, Department of IDCM, Van, Turkey -- Shehata, G., Assiut University Hospital, Department of Neurology and Psychiatry, Assiut, Egypt -- Eren-Tulek, N., Ankara Training and Research Hospital, Ankara, Turkey -- Yetkin, F., Inonu School of Medicine, Department of IDCM, Malatya, Turkey -- Celen, M.K., Dicle School of Medicine, Department of IDCM, Diyarbakir, Turkey -- Ceran, N., Haydarpasa Numune Training and Research Hospital, Department of IDCM, Istanbul, Turkey -- Gul, H.C., Gulhane School of Medicine, Department of IDCM, Ankara, Turkey -- Mert, G., Gulhane School of Medicine, Department of IDCM, Ankara, Turkey -- Tekin-Koruk, S., Harran School of Medicine, Department of IDCM, Sanliurfa, Turkey -- Dizbay, M., Gazi School of Medicine, Department of IDCM, Ankara, Turkey -- Inal, A.S., Cukurova School of Medicine, Department of IDCM, Adana, Turkey -- Nayman-Alpat, S., Osmangazi School of Medicine, Department of IDCM, Eskisehir, Turkey -- Bosilkovski, M., Skopje Medical Faculty, Department of Infectious Diseases and Febrile Conditions, Skopje, Macedonia -- Inan, D., Akdeniz School of Medicine, Department of IDCM, Antalya, Turkey -- Saltoglu, N., Cerrahpasa School of Medicine, Department of IDCM, Istanbul, Turkey -- Abdel-Baky, L., Assiut University Hospital, Department of Tropical Medicine and Fever, Assiut, Egypt -- Adeva-Bartolome, M.T., Hospital Recoletas Zamora, Zamora, Spain -- Ceylan, B., Istanbul Training and Research Hospital, Department of IDCM, Istanbul, Turkey -- Sacar, S., Pamukkale School of Medicine, Department of IDCM, Denizli, Turkey -- Turhan, V., Haydarpasa Gulhane, Training and Research Hospital, Department of IDCM, Istanbul, Turkey -- Yilmaz, E., Uluda? School of Medicine, Department of IDCM, Bursa, Turkey -- Elaldi, N., Cumhuriyet School of Medicine, Department of IDCM, Sivas, Turkey -- Kocak-Tufan, Z., Ankara Training and Research Hospital, Ankara, Turkey -- U?urlu, K., Ankara Numune Training and Research Hospital, Department of IDCM, Ankara, Turkey -- Dokuzo?uz, B., Ankara Ataturk Training and Research Hospital, Department of IDCM, Ankara, Turkey -- Yilmaz, H., Ondokuz Mayis School of Medicine, Department of IDCM, Samsun, Turkey -- Gundes, S., Kocaeli School of Medicine, Department of IDCM, Kocaeli, Turkey -- Guner, R., Skopje Medical Faculty, Department of Infectious Diseases and Febrile Conditions, Skopje, Macedonia -- Ozgunes, N., Goztepe Training and Research Hospital, Department of IDCM, Istanbul, Turkey -- Ulcay, A., Kasimpasa Hospital, Department of Infectious Diseases and Clinical Microbiology (IDCM), Istanbul, Turkey -- Unal, S., Hacettepe University, Department of Internal Medicine, Ankara, Turkey -- Dayan, S., Dicle School of Medicine, Department of IDCM, Diyarbakir, Turkey -- Gorenek, L., Haydarpasa Gulhane, Training and Research Hospital, Department of IDCM, Istanbul, Turkey -- Karakas, A., Gulhane School of Medicine, Department of IDCM, Ankara, Turkey -- Tasova, Y., Cukurova School of Medicine, Department of IDCM, Adana, Turkey -- Usluer, G., Skopje Medical Faculty, Department of Infectious Diseases and Febrile Conditions, Skopje, Macedonia -- Bayindir, Y., Inonu School of Medicine, Department of IDCM, Malatya, Turkey -- Kurtaran, B., Cukurova School of Medicine, Department of IDCM, Adana, Turkey -- Sipahi, O.R., Ege School of Medicine, Department of IDCM, Izmir, Turkey -- Leblebiciogluz, H., Ondokuz Mayis School of Medicine, Department of IDCM, Samsun, Turkey, Ege Üniversitesi, OMÜ, Uludağ Üniversitesi/Tıp Fakültesi/Enfeksiyon Hastalıkları ve Klinik Mikrobiyoloji Anabilim Dalı., and Yılmaz, Emel

Subjects
Nervous-system brucellosis, Male, Turkey, Antibiotics, Medical record review, Olfactory nerve disease, Meningoencephalitis, Esophagitis, Pharmacology (medical), Trimethoprim-sulfamethoxazole combination, Treatment outcome, Doxycycline, Depression, Vestibulocochlear nerve disease, Comparative effectiveness, Management, Retrospective study, Drug Therapy, Combination, Rifampin, Human, medicine.medical_specialty, Major clinical study, Side effect, Clinical Therapeutics, Oculomotor nerve disease, Microbiology, Article, Treatment duration, Brain ischemia, Drug substitution, Pharmacotherapy, Hypoglossal nerve disease, Brucellosis, Agglutination Tests, Zoonosis, Humans, Brain hematoma, Aged, Retrospective Studies, Pharmacology, Abducens nerve disease, Antibiotic therapy, medicine.disease, Brucella, Trimethoprim, Cotrimoxazole, Regimen, ComputingMethodologies_PATTERNRECOGNITION, Brucellar meningoencephalitis, Drug eruption, Bacterial meningitis, Administration, Oral, Turkey (republic), Recurrence, Nausea and vomiting, Diagnosis, Clinical protocol, Visual disorder, Treatment Failure, Pharmacology & Pharmacy, Relapse, Priority journal, Drug tolerability, Drug withdrawal, Ceftriaxone, Middle Aged, Anti-Bacterial Agents, Paresis, Brain abscess, ComputingMilieux_MANAGEMENTOFCOMPUTINGANDINFORMATIONSYSTEMS, Infectious Diseases, Tolerability, Gastritis, Injections, Intravenous, Female, InformationSystems_MISCELLANEOUS, Meningitis, Hydrocephalus, medicine.drug, Adult, Adolescent, medicine.drug_class, Optic nerve disease, Therapeutic features, Facial nerve disease, Bacterial-meningitis, Polyneuropathy, Internal medicine, Trimethoprim, Sulfamethoxazole Drug Combination, medicine, Subarachnoid hemorrhage, Rifampicin, business.industry, ComputerSystemsOrganization_COMPUTER-COMMUNICATIONNETWORKS, Brucellar meningitis, Thrombocytopenia, Surgery, Drug efficacy, Drug treatment failure, Aminotransferase blood level, business, Controlled study
Abstract

PubMed ID: 22155822, No data on whether brucellar meningitis or meningoencephalitis can be treated with oral antibiotics or whether an intravenous extended-spectrum cephalosporin, namely, ceftriaxone, which does not accumulate in phagocytes, should be added to the regimen exist in the literature. The aim of a study conducted in Istanbul, Turkey, was to compare the efficacy and tolerability of ceftriaxone-based antibiotic treatment regimens with those of an oral treatment protocol in patients with these conditions. This retrospective study enrolled 215 adult patients in 28 health care institutions from four different countries. The first protocol (P1) comprised ceftriaxone, rifampin, and doxycycline. The second protocol (P2) consisted of trimethoprim-sulfamethoxazole, rifampin, and doxycycline. In the third protocol (P3), the patients started with P1 and transferred to P2 when ceftriaxone was stopped. The treatment period was shorter with the regimens which included ceftriaxone (4.40 ± 2.47 months in P1, 6.52 ± 4.15 months in P2, and 5.18 ± 2.27 months in P3) (P = 0.002). In seven patients, therapy was modified due to antibiotic side effects. When these cases were excluded, therapeutic failure did not differ significantly between ceftriaxone-based regimens (n = 5/166, 3.0%) and the oral therapy (n = 4/42, 9.5%) (P = 0.084). The efficacy of the ceftriaxone-based regimens was found to be better (n = 6/166 [3.6%] versus n = 6/42 [14.3%]; P = 0.017) when a composite negative outcome (CNO; relapse plus therapeutic failure) was considered. Accordingly, CNO was greatest in P2 (14.3%, n = 6/42) compared to P1 (2.6%, n = 3/117) and P3 (6.1%, n = 3/49) (P = 0.020). Seemingly, ceftriaxone-based regimens are more successful and require shorter therapy than the oral treatment protocol. Copyright © 2012, American Society for Microbiology. All Rights Reserved.

Published
2012

15. Diagnostic and therapeutic role of ct-guided stereotactic surgery in the management of intracranial tuberculomas

Author

Mehmet Erşahin, Nurgul Ceran, Fugen Aker, Zafer Berkman, Erdogan Ayan, Osman Ekinci, and Tayfun Hakan

Subjects
Adult, Male, Microsurgery, medicine.medical_specialty, Time Factors, Stereotactic biopsy, Stereotactic surgery, Adolescent, Biopsy, medicine.medical_treatment, Stereotaxic Techniques, Lesion, Young Adult, Seizures, medicine, Humans, Child, Aged, medicine.diagnostic_test, Brain Neoplasms, business.industry, Motor Cortex, Gold standard (test), Middle Aged, Surgery, Treatment Outcome, Tuberculoma, Intracranial, Stereotaxic technique, Female, Tuberculoma, Neurology (clinical), medicine.symptom, Tomography, X-Ray Computed, business, Follow-Up Studies
Abstract

Aim CT-guided stereotactic methods have long been used for the diagnosis and treatment of intracranial masses. Intracranial tuberculoma is a rare form of extrapulmonary tuberculosis. Histological confirmation is the gold standard for a correct diagnosis. However, histopathological diagnosis and excision of these lesions have advantages over open surgical methods. This study presents our experience on the use of stereotactic biopsy and excision in the management of intracranial tuberculomas. Material and methods Thirteen patients with intracranial masses underwent stereotactic procedures for tissue samples to establish histopathological diagnosis. In 6 suitable patients, stereotactic microsurgical excision was performed for both diagnostic and therapeutic purposes, whereas only stereotactic biopsy was conducted in the remaining subjects. Results The tuberculoma diagnosis was established in 12 out of 13 cases (92%). Seizure control was achieved in all patients admitted with a history of seizures. There was no procedure-related mortality, none of the patients suffered permanent disability and most procedures were uneventful. Total resection without any residual mass was done. All patients responded to antituberculous treatment with complete lesion disappearance. Conclusion These findings suggest that CT-guided stereotactic surgery of intracranial tuberculomas has advantages over other methods, with a potential to become the first-line modality, particularly as a diagnostic tool, in the management of these lesions.

Published
2010
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16. Incidence, etiology and risk factors associated with mortality of nosocomial candidemia in a tertiary care hospital in Istanbul, Turkey

Author

Ipek Genc, Naz Oguzoglu, Asuman Inan, Paşa Göktaş, Ilknur Erdem, Derya Ozturk Engin, Asu Özgültekin, Fatma Kaya, and Nurgul Ceran

Subjects
Adult, Male, Pediatrics, medicine.medical_specialty, Etiology, Adolescent, Turkey, Epidemiology, Hospitals, University, Albicans, Young Adult, fluids and secretions, Age Distribution, Risk Factors, hemic and lymphatic diseases, Rates, Unit, Medicine, Humans, Mortality, Intensive-Care, Sex Distribution, Aged, Aged, 80 and over, Cross Infection, Surveillance, business.industry, Predictors, Incidence (epidemiology), Incidence, Istanbul turkey, Candidemia, General Medicine, Tertiary care hospital, Hospital Bed Capacity, 500 and over, Length of Stay, Middle Aged, equipment and supplies, bacterial infections and mycoses, Nosocomial candidemia, Blood-Stream Infections, Intensive Care Units, Socioeconomic Factors, Female, Trends, business
Abstract

Objective: The aim of this study was to determine the incidence, etiology and risk factors for mortality of patients with nosocomial candidemia. Subjects and Methods: This observational study was performed at Haydarpasa Numune Training and Research Hospital, a tertiary care hospital with 750 beds, between the years 2004 and 2007. Fifty defined cases with a nosocomial bloodstream infection caused by Candida species were included in the study. All demographic, microbiological and clinical records for each patient were collected using a standardized form. Blood culture was performed by automated blood culture system, and those samples positive for yeast were subcultured on Sabouraud agar. Results: The mean incidence density of nosocomial candidemia was 0.58/10,000 patient-days/year (range 0.17–1.4). Candidemia episodes increased from 0.17/10,000 to 1.4/10,000 patient-days/year (p < 0.0001). Candida albicans and non-albicans Candida accounted for 15 (30%) and 35 (70%) cases, respectively. The overall mortality was 56% and was significantly associated with stayingin the intensive care unit (odds ratio: 3.667, 95% confidence interval: 1.07–12.54, p = 0.034). Conclusion: This study showed that there was a significantly increased trend in the incidence of candidemia with high mortality during the study period.

Published
2009

17. Incidence, etiology, and antibiotic resistance patterns of gram-negative microorganisms isolated from patients with ventilator-associated pneumonia in a medical-surgical intensive care unit of a teaching hospital in istanbul, Turkey (2004-2006)

Author

Ilknur Erdem, Asu Ozgultekin, Asuman Sengoz Inan, Emine Dincer, Guldem Turan, Nurgul Ceran, Derya Ozturk Engin, Seniha Senbayrak Akcay, Nur Akgun, and Pasa Goktas

Subjects
Microbiology (medical), Adult, Aged, 80 and over, Male, Adolescent, Turkey, Incidence, Pneumonia, Ventilator-Associated, General Medicine, Microbial Sensitivity Tests, Middle Aged, Anti-Bacterial Agents, Intensive Care Units, Infectious Diseases, Child, Preschool, Drug Resistance, Bacterial, Gram-Negative Bacteria, Humans, Female, Child, Gram-Negative Bacterial Infections, Hospitals, Teaching, Aged
Abstract

The identification of microorganisms causing ventilator-associated pneumonia (VAP) is important for formulating appropriate therapies. In this study, we report the incidence, etiology, and antibiotic resistance patterns of Gram-negative microorganisms isolated from patients diagnosed with VAP in our medical-surgical intensive care unit (ICU) during the years 2004-2006. VAP was diagnosed by using the clinical criteria of the Centers for Disease Control and Prevention. Antibiotic resistance patterns of isolated microorganisms were defined by standard methods. The VAP incidence rate was 22.6/1,000 ventilator days. The most frequently isolated pathogens were Acinetobacter spp., methicillin-resistant Staphylococcus aureus, and Pseudomonas aeruginosa. Ninety percent of Acinetobacter spp. isolates were resistant to ceftazidime, 64% to imipenem, and 80% to ciprofloxacin. Fifty-nine percent of P. aeruginosa isolates were resistant to ceftazidime, 32% to imipenem, and 62% to ciprofloxacin. Cefoperazone-sulbactam was the most active agent against Acinetobacter spp. In conclusion, the incidence of VAP and the prevalence of multidrug-resistant microorganisms are quite high in our ICU. Comparison of the resistance rates of isolates demonstrates that certain antibiotic agents are more effective than others.

Published
2008

18. The virulence factors and antibiotic sensitivities of Escherichia coli isolated from recurrent urinary tract infections

Author

Serda, Gulsun, Naz, Oguzoglu, Asuman, Inan, and Nurgul, Ceran

Subjects
Adult, Male, Virulence, Drug Resistance, Microbial, Microbial Sensitivity Tests, Middle Aged, Sensitivity and Specificity, Severity of Illness Index, Anti-Bacterial Agents, Recurrence, Risk Factors, Urinary Tract Infections, Escherichia coli, Humans, Female, Probability
Abstract

We determined the antibiotic sensitivities of uropathogenic Escherichia coli (UPEC) strains isolated from the urine of patients who have recurrent urinary tract infections (UTIs).Our study was carried out between November 2000 and January 2002 at the Infectious Diseases Clinic, Istanbul Haydarpasa Numune Hospital, Istanbul, Turkey. We compared the virulence factors (fimbrial adhesion, hemolysin production, motility property) of 50 strains of Escherichia coli (E. coli) isolated from urine with the same properties of 25 strains of E. coli isolated from stool specimens of healthy individuals. In addition, we detected the virulence factors of UPEC strains using a microbiological and biochemical methods and by using disk diffusion method, we were able to investigate the sensitivity of the strains to the antimicrobials.We found the level of mannose-resistant (MR) fimbriae bearing in the UPEC strains to be significantly higher than that in the controls (odds ratio=10.27, p0.001). The difference in mannose-resistant hemoagglutination (MRHA) and mannose sensitive hemoagglutination (MSHA) bearing levels in UPEC strains were rather high. This difference was regarded as significant in terms of showing the virulence of fimbriae bearing strains (odds ratio=29.03, p0.001).Our study demonstrates that strains with MR fimbriae have a rather high virulence (p0.001), and that a combination of MR+MS fimbriae increased that virulence (p0.001). As MR strains have a greater adhesive property, the determination of MR fimbriae bearing as high shows that fimbriae bearing plays an important role in widespread and resistant strains, especially in recurrent UTIs such as in our study. In addition, hemolysin capability was also a virulence factor in recurrent UTIs (p0.01). In addition, the sensitivity of the strains to the antimicrobials appeared in the following order; imipenem 93%, norfloxacin 89%, ciprofloxacin 85%, netilmicin 80%, amikacin 78%, ceftriaxone 74%, gentamicin 72%, nitrofurantoin 71%, ampicillin-sulbactam 60%, amoxicillin-clavulanate 58%, Trimethoprim/sulfamethoxazole 45%, ampicillin 35%.

Published
2005

19. Assessment of the requisites of microbiology based infectious disease training under the pressure of consultation needs

Author

Tuba Sari, Aysegul Ulu-Kilic, İbrahim Koruk, Haluk Vahaboglu, Yasar Bayindir, Necla Eren-Tulek, Cigdem Ataman-Hatipoglu, Hakan Erdem, Bilgul Mete, Serhat Birengel, Selma Tosun, Yeşim Taşova, Bulent Ahmet Besirbellioglu, Nurbanu Sezak, Serhat Uysal, Yeşim Alpay, Hakan Leblebicioglu, Saygin Nayman-Alpat, Melahat Cengiz, Halil Kurt, Tuna Demirdal, Sibel Yilmaz, Oğuz Reşat Sipahi, Behiye Yucesoy-Dede, Hava Yilmaz, Esma Yeniiz, Sercan Ulusoy, Nurgul Ceran, Hurrem Bodur, Behice Kurtaran, Canan Agalar, Dilek Arman, Gaye Usluer, Rahmet Guner, Nazif Elaldi, Husrev Diktas, Gürkan Mert, Suzan Sacar, Nebahat Dikici, Dilara Inan, Asim Ulcay, Hüseyin Aytaç Erdem, Derya Tozlu-Keten, Serkan Oncu, Selçuk Kaya, Oral Oncul, Murat Dizbay, Emel Yilmaz, Suda Tekin-Koruk, Oguz Karabay, Erdem, H., Kasimpasa Hospital, Department of Infectious Diseases and Clinical Microbiology (IDCM), Istanbul, Turkey -- Tekin-Koruk, S., Harran University, School of Medicine, Department of IDCM, Sanliurfa, Turkey -- Koruk, I., Harran University, School of Medicine, Department of Public Health, Sanliurfa, Turkey -- Tozlu-Keten, D., Gazi University, School of Medicine, Department of IDCM, Ankara, Turkey -- Ulu-Kilic, A., Erciyes University, School of Medicine, Department of IDCM, Ankara, Turkey -- Oncul, O., Gulhane Haydarpasa Hospital, Department of IDCM, Istanbul, Turkey -- Guner, R., Ataturk Training and Research Hospital, Department of IDCM, Ankara, Turkey -- Birengel, S., Ankara University, School of Medicine, Department of IDCM, Ankara, Turkey -- Mert, G., Gulhane Medical Academy, Department of IDCM, Ankara, Turkey -- Nayman-Alpat, S., Osmangazi School of Medicine, Department of IDCM, Eskisehir, Turkey -- Eren-Tulek, N., Ankara Training and Research Hospital, Department of IDCM, Ankara, Turkey -- Demirdal, T., Kocatepe School of Medicine, Department of IDCM, Afyon, Turkey -- Elaldi, N., Cumhuriyet School of Medicine, Department of IDCM, Sivas, Turkey -- Ataman-Hatipoglu, C., Ankara Training and Research Hospital, Department of IDCM, Ankara, Turkey -- Yilmaz, E., Uludag School of Medicine, Department of IDCM, Bursa, Turkey -- Mete, B., Cerrahpasa School of Medicine, Department of IDCM, Istanbul, Turkey -- Kurtaran, B., Cukurova School of Medicine, Department of IDCM, Adana, Turkey -- Ceran, N., Haydarpasa Numune Training and Research Hospital, Istanbul, Turkey -- Karabay, O., Sakarya School of Medicine, Department of IDCM, Sakarya, Turkey -- Inan, D., Akdeniz School of Medicine, Department of IDCM, Antalya, Turkey -- Cengiz, M., Maltepe School of Medicine, Department of IDCM, Istanbul, Turkey -- Sacar, S., Pamukkale School of Medicine, Department of IDCM, Denizli, Turkey -- Yucesoy-Dede, B., Uskudar State Hospital, Department of IDCM, Istanbul, Turkey -- Yilmaz, S., Ataturk School of Medicine, Department of IDCM, Erzurum, Turkey -- Agalar, C., Kirikkale School of Medicine, Department of IDCM, Kirikkale, Turkey -- Bayindir, Y., Inonu School of Medicine, Department of IDCM, Malatya, Turkey -- Alpay, Y., Cengiz Gokcek State Hospital, Department of IDCM, Gaziantep, Turkey -- Tosun, S., Manisa State Hospital, Department of IDCM, Manisa, Turkey -- Yilmaz, H., Ondokuzmayis School of Medicine, Department of IDCM, Samsun, Turkey -- Bodur, H., Numune Training and Research Hospital, Department of IDCM, Ankara, Turkey -- Erdem, H.A., Ege School of Medicine, Department of IDCM, Izmir, Turkey -- Dikici, N., Selcuklu School of Medicine, Department of IDCM, Konya, Turkey -- Dizbay, M., Gazi University, School of Medicine, Department of IDCM, Ankara, Turkey -- Oncu, S., Adnan Menderes School of Medicine, Department of IDCM, Aydin, Turkey -- Sezak, N., Manisa State Hospital, Department of IDCM, Manisa, Turkey -- Sari, T., Ankara Training and Research Hospital, Department of IDCM, Ankara, Turkey -- Sipahi, O.R., Ege School of Medicine, Department of IDCM, Izmir, Turkey -- Uysal, S., Ege School of Medicine, Department of IDCM, Izmir, Turkey -- Yeniiz, E., Girne Military Hospital, Department of IDCM, Girne, Turkey -- Kaya, S., Karadeniz School of Medicine, Department of IDCM, Trabzon, Turkey -- Ulcay, A., Kasimpasa Hospital, Department of Infectious Diseases and Clinical Microbiology (IDCM), Istanbul, Turkey -- Kurt, H., Ankara University, School of Medicine, Department of IDCM, Ankara, Turkey -- Besirbellioglu, B.A., Gulhane Medical Academy, Department of IDCM, Ankara, Turkey -- Vahaboglu, H., Kocaeli School of Medicine, Department of IDCM, Kocaeli, Turkey -- Tasova, Y., Cukurova School of Medicine, Department of IDCM, Adana, Turkey -- Usluer, G., Osmangazi School of Medicine, Department of IDCM, Eskisehir, Turkey -- Arman, D., Gazi University, School of Medicine, Department of IDCM, Ankara, Turkey -- Diktas, H., Gulhane Haydarpasa Hospital, Department of IDCM, Istanbul, Turkey -- Ulusoy, S., Ege School of Medicine, Department of IDCM, Izmir, Turkey -- Leblebicioglu, H., Ondokuzmayis School of Medicine, Department of IDCM, Samsun, Turkey, Uludağ Üniversitesi/Tıp Fakültesi/Enfeksiyon Hastalıkları ve Klinik Mikrobiyoloji Anabilim Dalı., Yılmaz, Emel, Maltepe Üniversitesi, and Ege Üniversitesi

Subjects
Male, Pathology, Pulmonology, Turkey, Infectious disease, clinical microbiology, training, consultation, Resistance, lcsh:QR1-502, lcsh:Microbiology, Turkey (republic), Antimicrobial therapy, Medical microbiology, Endocrinology, Septic shock, Organization and management, Urologic surgery, Pulmonary Medicine, Medicine, Internal medicine, Referral and Consultation, Orthopedic surgery, Infectious Disease Medicine, Gastroenterology, General Medicine, Hematology, Patient referral, Clinical microbiology, ComputingMilieux_MANAGEMENTOFCOMPUTINGANDINFORMATIONSYSTEMS, Infectious Diseases, Neurology, Nephrology, Female, Education, Medical, Continuing, Medical emergency, InformationSystems_MISCELLANEOUS, Infection, Eye surgery, Needs Assessment, Human, Risk, Adult, Medical education, Microbiology (medical), medicine.medical_specialty, education, Cardiology, Neurosurgery, One Health Initiative, Curricula, University Teacher, Major clinical study, Dermatology, Microbiology, Article, lcsh:Infectious and parasitic diseases, Disease course, Education, Sepsis, otorhinolaryngologic diseases, Training, Humans, lcsh:RC109-216, Appropriateness, General surgery, Cross-sectional study, Consultation, business.industry, Research, lcsh:RM1-950, ComputerSystemsOrganization_COMPUTER-COMMUNICATIONNETWORKS, Methodology, medicine.disease, Professional knowledge, Specialists, stomatognathic diseases, lcsh:Therapeutics. Pharmacology, ComputingMethodologies_PATTERNRECOGNITION, Cross-Sectional Studies, Infectious disease (medical specialty), business, Clinical skills
Abstract

PubMed ID: 22177310, Background: Training of infectious disease (ID) specialists is structured on classical clinical microbiology training in Turkey and ID specialists work as clinical microbiologists at the same time. Hence, this study aimed to determine the clinical skills and knowledge required by clinical microbiologists.Methods: A cross-sectional study was carried out between June 1, 2010 and September 15, 2010 in 32 ID departments in Turkey. Only patients hospitalized and followed up in the ID departments between January-June 2010 who required consultation with other disciplines were included.Results: A total of 605 patients undergoing 1343 consultations were included, with pulmonology, neurology, cardiology, gastroenterology, nephrology, dermatology, haematology, and endocrinology being the most frequent consultation specialties. The consultation patterns were quite similar and were not affected by either the nature of infections or the critical clinical status of ID patients.Conclusions: The results of our study show that certain internal medicine subdisciplines such as pulmonology, neurology and dermatology appear to be the principal clinical requisites in the training of ID specialists, rather than internal medicine as a whole. © 2011 Erdem et al; licensee BioMed Central Ltd.

Published
2011

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