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1. Identifying risk factors for blood culture negative infective endocarditis: An international ID-IRI study

Author: Mine Filiz, Hakan Erdem, Handan Ankarali, Edmond Puca, Yvon Ruch, Lurdes Santos, Teresa Fasciana, Anna M. Giammanco, Nesrin Ghanem-Zoubi, Xavier Argemi, Yves Hansmann, Rahmet Guner, Gilda Tonziello, Jean-Philippe Mazzucotelli, Najada Como, Sukran Kose, Ayse Batirel, Asuman Inan, Necla Tulek, Abdullah Umut Pekok, Ejaz Ahmed Khan, Atilla Iyisoy, Meliha Meric-Koc, Ayse Kaya-Kalem, Pedro Palma Martins, Imran Hasanoglu, André Silva-Pinto, Nefise Oztoprak, Raquel Duro, Fahad Almajid, Mustafa Dogan, Nicolas Dauby, Jesper Damsgaard Gunst, Recep Tekin, Deborah Konopnicki, Nicola Petrosillo, Ilkay Bozkurt, Jamal Wadi Al Ramahi, Corneliu Popescu, Ilker Inanc Balkan, Safak Ozer-Balin, Tatjana Lejko Zupanc, Antonio Cascio, Irina Magdalena Dumitru, Aysegul Erdem, Gulden Ersoz, Meltem Tasbakan, Oday Abu Ajamieh, Fatma Sirmatel, Simin Florescu, Serda Gulsun, Hacer Deniz Ozkaya, Sema Sari, Selma Tosun, Meltem Avci, Yasemin Cag, Guven Celebi, Ayse Sagmak-Tartar, Sumeyra Karakus, Alper Sener, Arjeta Dedej, Serkan Oncu, Rosa Fontana Del Vecchio, Derya Ozturk-Engin, and Canan Agalar
Subjects: Infective endocarditis, Blood culture negative endocarditis, Rheumatic heart disease, Prosthetic valves, Cardiac disorders, Infectious and parasitic diseases, RC109-216
Abstract: Background: Blood culture-negative endocarditis (BCNE) is a diagnostic challenge, therefore our objective was to pinpoint high-risk cohorts for BCNE. Methods: The study included adult patients with definite endocarditis. Data were collected via the Infectious Diseases International Research Initiative (ID-IRI). The study analysing one of the largest case series ever reported was conducted across 41 centers in 13 countries. We analysed the database to determine the predictors of BCNE using univariate and logistic regression analyses. Results: Blood cultures were negative in 101 (11.65 %) of 867 patients. We disclosed that as patients age, the likelihood of a negative blood culture significantly decreases (OR 0.975, 95 % CI 0.963–0.987, p
Published: 2024
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2. The diagnostic utility of the 'Thwaites’ system' and 'lancet consensus scoring system' in tuberculous vs. non-tuberculous subacute and chronic meningitis: multicenter analysis of 395 adult patients

Author: Tarek Sulaiman, Sai Medi, Hakan Erdem, Seniha Senbayrak, Derya Ozturk-Engin, Asuman Inan, Rok Civljak, Mihai Nechifor, Ayhan Akbulut, Alexandru Crisan, Muge Ozguler, Mustafa Namiduru, Branislava Savic, Olga Dulovic, Filiz Pehlivanoglu, Gonul Sengoz, Kadriye Yasar, Ayse Seza Inal, Emine Parlak, Isik Somuncu Johansen, Ebru Kursun, Mehmet Parlak, Emel Yilmaz, Gulden Yilmaz, Hanefi Cem Gul, Oral Oncul, Soline Siméon, Pierre Tattevin, Aysegul Ulu-Kilic, Selma Alabay, Bojana Beovic, Melanie Catroux, Yves Hansmann, Arjan Harxhi, Alper Sener, Hacer Deniz Ozkaya, Yasemin Cağ, Canan Agalar, Haluk Vahaboglu, Berna Kaya Ugur, and Rodrigo Hasbun
Subjects: Tuberculous, Subacute, Meningitis, Thwaites, Lancet, Criteria, Infectious and parasitic diseases, RC109-216
Abstract: Abstract Background Tuberculous meningitis (TBM) represents a diagnostic and management challenge to clinicians. The “Thwaites’ system” and “Lancet consensus scoring system” are utilized to differentiate TBM from bacterial meningitis but their utility in subacute and chronic meningitis where TBM is an important consideration is unknown. Methods A multicenter retrospective study of adults with subacute and chronic meningitis, defined by symptoms greater than 5 days and less than 30 days for subacute meningitis (SAM) and greater than 30 days for chronic meningitis (CM). The “Thwaites’ system” and “Lancet consensus scoring system” scores and the diagnostic accuracy by sensitivity, specificity, and area under the curve of receiver operating curve (AUC-ROC) were calculated. The “Thwaites’ system” and “Lancet consensus scoring system” suggest a high probability of TBM with scores ≤4, and with scores of ≥12, respectively. Results A total of 395 patients were identified; 313 (79.2%) had subacute and 82 (20.8%) with chronic meningitis. Patients with chronic meningitis were more likely caused by tuberculosis and had higher rates of HIV infection (P
Published: 2020
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3. Central nervous system infections in the absence of cerebrospinal fluid pleocytosis

Author: Hakan Erdem, Derya Ozturk-Engin, Yasemin Cag, Seniha Senbayrak, Asuman Inan, Esra Kazak, Umit Savasci, Nazif Elaldi, Haluk Vahaboglu, and Rodrigo Hasbun
Subjects: Infectious and parasitic diseases, RC109-216
Abstract: Previous multicenter/multinational studies were evaluated to determine the frequency of the absence of cerebrospinal fluid pleocytosis in patients with central nervous system infections, as well as the clinical impact of this condition. It was found that 18% of neurosyphilis, 7.9% of herpetic meningoencephalitis, 3% of tuberculous meningitis, 1.7% of Brucella meningitis, and 0.2% of pneumococcal meningitis cases did not display cerebrospinal fluid pleocytosis. Most patients were not immunosuppressed. Patients without pleocytosis had a high rate of unfavorable outcomes and thus this condition should not be underestimated. Keywords: CSF, Pleocytosis, Leukocyte, Meningitis, Encephalitis
Published: 2017
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4. Development and validation of a modified quick SOFA scale for risk assessment in sepsis syndrome.

Author: Yasemin Cag, Oguz Karabay, Oguz Resat Sipahi, Firdevs Aksoy, Gul Durmus, Ayse Batirel, Oznur Ak, Zeliha Kocak-Tufan, Aynur Atilla, Nihal Piskin, Turkay Akbas, Serpil Erol, Derya Ozturk-Engin, Hulya Caskurlu, Ugur Onal, Haluk Erdogan, Aslıhan Demirel, Arzu Dogru, Rezan Harman, Aziz Ahmad Hamidi, Derya Karasu, Fatime Korkmaz, Pınar Korkmaz, Fatma Civelek Eser, Yalcin Onem, Sinem Cesur, Musa Salmanoglu, İlknur Erdem, Hüsrev Diktas, and Haluk Vahaboglu
Subjects: Medicine, Science
Abstract: Sepsis is a severe clinical syndrome owing to its high mortality. Quick Sequential Organ Failure Assessment (qSOFA) score has been proposed for the prediction of fatal outcomes in sepsis syndrome in emergency departments. Due to the low predictive performance of the qSOFA score, we propose a modification to the score by adding age. We conducted a multicenter, retrospective cohort study among regional referral centers from various regions of the country. Participants recruited data of patients admitted to emergency departments and obtained a diagnosis of sepsis syndrome. Crude in-hospital mortality was the primary endpoint. A generalized mixed-effects model with random intercepts produced estimates for adverse outcomes. Model-based recursive partitioning demonstrated the effects and thresholds of significant covariates. Scores were internally validated. The H measure compared performances of scores. A total of 580 patients from 22 centers were included for further analysis. Stages of sepsis, age, time to antibiotics, and administration of carbapenem for empirical treatment were entered the final model. Among these, severe sepsis (OR, 4.40; CIs, 2.35-8.21), septic shock (OR, 8.78; CIs, 4.37-17.66), age (OR, 1.03; CIs, 1.02-1.05) and time to antibiotics (OR, 1.05; CIs, 1.01-1.10) were significantly associated with fatal outcomes. A decision tree demonstrated the thresholds for age. We modified the quick Sequential Organ Failure Assessment (mod-qSOFA) score by adding age (> 50 years old = one point) and compared this to the conventional score. H-measures for qSOFA and mod-qSOFA were found to be 0.11 and 0.14, respectively, whereas AUCs of both scores were 0.64. We propose the use of the modified qSOFA score for early risk assessment among sepsis patients for improved triage and management of this fatal syndrome.
Published: 2018
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5. Evaluation of the implementation of WHO infection prevention and control core components in Turkish health care facilities: results from a WHO infection prevention and control assessment framework (IPCAF)—based survey

Author: Emel Azak, Ahmet Sertcelik, Gulden Ersoz, Guven Celebi, Fatma Eser, Ayse Batirel, Yasemin Cag, Zeynep Ture, Derya Ozturk Engin, Meltem Arzu Yetkin, Sedat Kaygusuz, Aslıhan Candevir, Ermira Tartari, Jordi Rello, Emine Alp, and THIRG, Turkish Hospital Infection Research Group
Subjects: Infection prevention and control, IPC core components, Health care-associated infections, Antimicrobial resistance, Workload, Infectious and parasitic diseases, RC109-216
Abstract: Abstract Background The core components (CCs) of infection prevention and control (IPC) from World Health Organization (WHO) are crucial for the safety and quality of health care. Our objective was to examine the level of implementation of WHO infection prevention and control core components (IPC CC) in a developing country. We also aimed to evaluate health care-associated infections (HAIs) and antimicrobial resistance (AMR) in intensive care units (ICUs) in association with implemented IPC CCs. Methods Members of the Turkish Infectious Diseases and Clinical Microbiology Specialization Association (EKMUD) were invited to the study via e-mail. Volunteer members of any healt care facilities (HCFs) participated in the study. The investigating doctor of each HCF filled out a questionnaire to collect data on IPC implementations, including the Infection Prevention and Control Assessment Framework (IPCAF) and HAIs/AMR in ICUs in 2021. Results A total of 68 HCFs from seven regions in Türkiye and the Turkish Republic of Northern Cyprus participated while 85% of these were tertiary care hospitals. Fifty (73.5%) HCFs had advanced IPC level, whereas 16 (23.5%) of the 68 hospitals had intermediate IPC levels. The hospitals’ median (IQR) IPCAF score was 668.8 (125.0) points. Workload, staffing and occupancy (CC7; median 70 points) and multimodal strategies (CC5; median 75 points) had the lowest scores. The limited number of nurses were the most important problems. Hospitals with a bed capacity of > 1000 beds had higher rates of HAIs. Certified IPC specialists, frequent feedback, and enough nurses reduced HAIs. The most common HAIs were central line-associated blood stream infections. Most HAIs were caused by gram negative bacteria, which have a high AMR. Conclusions Most HCFs had an advanced level of IPC implementation, for which staffing was an important driver. To further improve care quality and ensure everyone has access to safe care, it is a key element to have enough staff, the availability of certified IPC specialists, and frequent feedback. Although there is a significant decrease in HAI rates compared to previous years, HAI rates are still high and AMR is an important problem. Increasing nurses and reducing workload can prevent HAIs and AMR. Nationwide “Antibiotic Stewardship Programme” should be initiated.
Published: 2023
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6. Hepatosplenic Bartonella henselae Infection in an Immunocompetent Patient

Author: Servet Ozturk, Derya Ozturk Engin, Semra Toprak Kavas, Adnan Somay, Onur Çolak, and Canan Ağalar
Subjects: Bartonella henselae, biology, business.industry, Medicine, business, biology.organism_classification, Virology
Published: 2021
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7. Survival in rhino-orbito-cerebral mucormycosis: An international, multicenter ID-IRI study

Author: Yasemin Cag, Hakan Erdem, Mehmet Gunduz, Suheyla Komur, Handan Ankarali, Serap Ural, Meltem Tasbakan, Pierre Tattevin, Anil Tombak, Derya Ozturk-Engin, Ayse Sagmak Tartar, Ayse Batirel, Recep Tekin, Fazilet Duygu, Hulya Caskurlu, Behice Kurtaran, Bulent Durdu, Demet Haciseyitoglu, Jordi Rello, Fatma Sirmatel, Antonio Cascio, Botond Lakatos, Serkan Oncu, Ayse Willke, Edmond Puca, Meliha Meric Koc, Pinar Korkmaz, Oguz Karabay, Rahmet Guner, Selmin Dirgen Caylak, Sema Keceli, Salih Cesur, Sirin Menekse, Pinar Ergen, Mehmet Sezai Tasbakan, Ayşegül Erdem, Yakup Cag, Emine Akcay, Teresa Fasciana, Anna Giammanco, Rabia Burçin Girgin, Canan Agalar, Haluk Vahaboglu, Istanbul Medeniyet University (IMU), Ankara University School of Medicine [Turkey], Cukurova University, Izmir Katip Celebi University (IKCU), Ege university, CHU Pontchaillou [Rennes], ARN régulateurs bactériens et médecine (BRM), Université de Rennes (UR)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Structure Fédérative de Recherche en Biologie et Santé de Rennes ( Biosit : Biologie - Santé - Innovation Technologique ), Mersin University, Firat University, Dicle University, Vall d’Hebron Research Institute (VHIR), Centre Hospitalier Universitaire de Nîmes (CHU Nîmes), None, Cag Y., Erdem H., Gunduz M., Komur S., Ankarali H., Ural S., Tasbakan M., Tattevin P., Tombak A., Ozturk-Engin D., Tartar A.S., Batirel A., Tekin R., Duygu F., Caskurlu H., Kurtaran B., Durdu B., Haciseyitoglu D., Rello J., Sirmatel F., Cascio A., Lakatos B., Oncu S., Willke A., Puca E., Koc M.M., Korkmaz P., Karabay O., Guner R., Caylak S.D., Keceli S., Cesur S., Menekse S., Ergen P., Tasbakan M.S., Erdem A., Akcay E., Fasciana T., Giammanco A., Girgin R.B., Agalar C., and Vahaboglu H.
Subjects: Adult, Antifungal Agents, Surveillance, Neutropenia, Epidemiology, Mucormycosi, Infections, Hospital-acquired infection, Rhino-orbito-cerebral mucormycosis, Zygomycosis, [SDV.MP]Life Sciences [q-bio]/Microbiology and Parasitology, Debridement, Risk Factors, Diagnosis, Orbital Diseases, Internal Medicine, Humans, Mucormycosis, Rhino-orbito-cerebral mucormycosi, Eye Infections, Fungal, Retrospective Studies
Abstract: International audience; BACKGROUND: Mucormycosis is an emerging aggressive mold infection. This study aimed to assess the outcome of hospitalized adults with rhino-orbito-cerebral mucormycosis (ROCM). The secondary objective was to identify prognostic factors in this setting. METHODS: This study was an international, retrospective, multicenter study. Patients’ data were collected from 29 referral centers in 6 countries. All qualified as "proven cases" according to the EORTC/MSGERC criteria. RESULTS: We included 74 consecutive adult patients hospitalized with ROCM. Rhino-orbito-cerebral type infection was the most common presentation (n = 43; 58.1%) followed by rhino-orbital type (n = 31; 41.9%). Twenty (27%) had acquired nosocomial bacterial infections. A total of 59 (79.7%) patients (16 in combination) received appropriate antifungal treatment with high-doses of liposomal amphotericin B. Fifty-six patients (75.7%) underwent curative surgery. Thirty-five (47.3%) required intensive care unit admission (27; 36.5% under mechanical ventilation). Hospital survival was 56.8%, being reduced to 7.4% in patients with invasive mechanical ventilation. A multivariate binary backward logistic regression model identified confusion at admission (OR 11.48), overlapping hospital-acquired infection (OR 10.27), use of antifungal treatment before diagnosis (OR 10.20), no surgical debridement (OR 5.92), and the absence of prior sinusitis (OR 6.32) were independently associated with increased risk for death. CONCLUSION: Today, ROCM still has high mortality rate. Improving source control, rational therpy, and preventing nosocomial infections may improve survival in this severe infection.
Published: 2022
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8. Microorganisms Isolated From the Bile of the Patients who have Undergone Cholecystectomy and Their Antibiotic Resistance Pattern: Multicenter Prospective Study

Author: Derya Ozturk-Engin, Canan Agalar, Yasemin Cag, Fatma Kesmez Can, Ilker Inanc Balkan, Oguz Karabay, Seniha Senbayrak, Busra Meral Çetinkaya, Mehmet Timuçin Aydın, Kadir Tomas, Esra Disci, Ali Surmelioglu, Orhan Alimoglu, Ozgur Ekinci, Emrah Akın, Mehmet Köroglu, Mehmet Velidedeoglu, Handan Ankaralı, Esra Kocoglu, Mirkhaliq Javadov, Berrin Papilla-Kundaktepe, Naz Oguzoglu, Erkan Ozmen, Ramazan Donmez, Ertunç Mega, Sebahat Aksaray, and Fatih Agalar
Subjects: Microbiology (medical), Escherichia coli, Bile, Humans, Cholecystectomy, Drug Resistance, Microbial, Microbial Sensitivity Tests, Prospective Studies, Microbiology, Anti-Bacterial Agents
Abstract: Background Gallbladder and biliary tract infections are diseases with high mortality rates if they are not treated properly. Microbiological evaluation of perioperatively collected samples both ensures proper treatment of patients and guides empirical treatment due to the determination of microorganism susceptibility. Aim This study aimed to isolate the microorganisms in bile cultures from patients who underwent cholecystectomy and to determine sensitivity results of these microorganisms. Methods This study was a multi-center and prospective design, included 360 patients, and was performed between 2019 and 2020. Culture results of bile taken during cholecystectomy were evaluated. Results Bacterial growth was found in the bile cultures of 84 out of 360 (23.3%) patients. Patients were divided into two groups according to whether they had risk factors for resistant microorganisms or not. While Escherichia coli (n = 11, 13%), Enterococcus spp. (n = 8, 9.5%), and Enterobacter spp. (n=4, 4.7%) were detected most frequently in patients without risk. Staphylococcus spp. (n = 17, 20.2%), Enterococcus spp., (n = 16, 19%), and E. coli (n = 8, 9.5%) were the most frequently found microorganism in risky patients. Bile culture positivity was higher in males (p = 0.001), > 60 years (p = 0.010), history of biliary disease (p = 0.002), underwent biliary surgery before cholecystectomy (p = 0.002), having biliary instrumentation (p = 0.014), operation performed concurrently with a cholecystectomy (p = 0.001), and presence of complications (p = 0.001). Conclusions Our study shows that when starting empirical antibiotic treatment for bile ducts, whether patients are at risk for the development of resistant bacterial infection should be evaluated after which antibiotic selection should be made accordingly.
Published: 2022
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9. Parents' Attitudes Toward COVID-19 Vaccination and Childhood Vaccines During the COVID-19 Pandemic

Author: Şemsinur Karabela, Selman Aktaş, Yasemin Cag, Yakup Cag, Güven Bektemür, Derya Ozturk-Engin, and Kadriye Kart-Yasar
Subjects: Parents, medicine.medical_specialty, 2019-20 coronavirus outbreak, Health Knowledge, Attitudes, Practice, COVID-19 Vaccines, Coronavirus disease 2019 (COVID-19), Parents attitudes, business.industry, Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), Vaccination, Public Health, Environmental and Occupational Health, MEDLINE, COVID-19, Attitude, Family medicine, Pandemic, medicine, Humans, business, Child, Pandemics
Published: 2021

10. The Epidemiology, Clinical Manifestations, Radiology, Microbiology, Treatment, and Prognosis of Echinococcosis: Results of NENEHATUN Study

Author: Şenay Öztürk Durmaz, Serpil Erol, Ayşe Ertürk, Canan Agalar, Ali Bilal Ulas, Mehmet Parlak, Derya Ozturk Engin, Ferhan Kerget, Pinar Sen, Tuna Demirdal, Esma Kepenek Kurt, Esra Laloglu, Meltem Taşbakan, Deniz Akyol, Emine Parlak, Handan Alay, Umut Pekok, and Hüsnü Pullukçu
Subjects: Adult, Male, medicine.medical_specialty, Turkey, albendazole, serology, Enzyme-Linked Immunosorbent Assay, Microbiology, Zoonotic disease, Serology, Albendazole, Health problems, Echinococcosis, Virology, Diagnosis, parasitic diseases, Epidemiology, medicine, Cystic Echinococcosis, Animals, Humans, Intensive care medicine, Children, Retrospective Studies, Hydatid Cyst, Echinococcus granulosus, business.industry, Middle Aged, medicine.disease, Prognosis, Infectious Diseases, Liver, epidemiology, Female, business, Echinococcus species, medicine.drug
Abstract: Aim: Echinococcosis, caused by Echinococcus species, is an important zoonotic disease causing major health problems in humans and animals. Herein, we aimed to evaluate the epidemiology, clinical and laboratory parameters, radiological, serological, pathological, and treatment protocols of followed-up cases of hydatidosis. Methods: A total of 550 patients diagnosed with hydatid cyst disease were included in this study. Patients who were positive for one or more of the enzyme-linked immunosorbent assay or indirect hemagglutination test, pathological results, or radiological findings were examined. The data analyzed were collected from nine centers between 2008 and 2020. Records were examined retrospectively. Results: Among the patients, 292 (53.1%) were women and 258 (46.9%) were men. The patients' mean age was 44.4 +/- 17.4 years. A history of living in rural areas was recorded in 57.4% of the patients. A total of 435 (79.1%) patients were symptomatic. The most common symptoms were abdominal pain in 277 (50.4%), listlessness in 244 (44.4%), and cough in 140 (25.5%) patients. Hepatomegaly was found in 147 (26.7%), and decreased breath sounds were observed in 124 (22.5%) patients. Radiological examination was performed in all cases and serological methods were also applied to 428 (77.8%) patients. The most frequently applied serological test was IHA (37.8%). A single cyst has been found in 66% patients. Hepatic involvement occurred in 327 (59.4%), pulmonary involvement was found in 128 (23.3%), whereas both of them were recorded in 43 (7.8%) patients. Splenic involvement was only detected in nine (1.6%) patients. Echinococcus granulosus (72.5%) was most frequently detected. Cyst diameters of 56.9% of the patients were in the range of 5-10 cm. A total of 414 (75.2%) patients received albendazole as an antiparasitic. Mortality was noted in nine (1.6%) patients. Conclusion: Echinococcosis is an important public health problem in Turkey. It can affect the social, economic, and political structures of the community. Public education and awareness are extremely important.
Published: 2021

11. The diagnostic utility of the 'Thwaites' system' and 'lancet consensus scoring system' in tuberculous vs. non-tuberculous subacute and chronic meningitis: multicenter analysis of 395 adult patients

Author: Berna Kaya Ugur, Arjan Harxhi, Yves Hansmann, Alper Şener, Melanie Catroux, Mihai Nechifor, Hanefi Cem Gül, Haluk Vahaboglu, Selma Alabay, Emel Yilmaz, Emine Parlak, Hacer Deniz Ozkaya, Kadriye Kart Yaşar, Isik Somuncu Johansen, Soline Simeon, Seniha Senbayrak, Canan Agalar, Pierre Tattevin, Ayhan Akbulut, Gulden Yilmaz, Ayşe Seza Inal, Filiz Pehlivanoglu, Olga Dulovic, Asuman Inan, Oral Oncul, Yasemin Cag, Alexandru Crişan, Derya Ozturk-Engin, Mehmet Parlak, Rodrigo Hasbun, Ebru Kurşun, Rok Čivljak, Bojana Beović, Mustafa Namiduru, Hakan Erdem, Aysegul Ulu-Kilic, Branislava Savic, Gonul Sengoz, Tarek Sulaiman, Muge Ozguler, Sai Medi, The University of Texas Health Science Center at Houston (UTHealth), Zagreb School of Medicine [Zagreb, Croatia] (Dubrava University Hospital), University of Zagreb, University of Medicine and Pharmacy 'Grigore T.Popa' Iasi (UMF lasi), Firat University, Victor Babeş University of Medicine and Pharmacy (UMFT), Gaziantep University, University of Belgrade [Belgrade], Cukurova University, Atatürk Üniversitesi, Odense University Hospital [Odense, Denmark], Başkent University Hospital [Adana, Turkey], Uludağ Üniversitesi = Uludag University, Gulhane Training and Research Hospital, Istanbul University, CHU Pontchaillou [Rennes], ARN régulateurs bactériens et médecine (BRM), Université de Rennes 1 (UR1), Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Structure Fédérative de Recherche en Biologie et Santé de Rennes ( Biosit : Biologie - Santé - Innovation Technologique ), Erciyes University, University Medical Centre Ljubljana [Ljubljana, Slovenia] (UMCL), Centre hospitalier universitaire de Poitiers (CHU Poitiers), CHU Strasbourg, University of Tirana, Çanakkale Onsekiz Mart University (COMU), Istanbul Medeniyet University [Istanbul, Turquie] (IMU), National Center for Research Resources United States Department of Health and Human ServicesNational Institutes of Health (NIH) - USA NIH National Center for Research Resources (NCRR) [NIH-1 K23 RR018929-01A2], Grant A Starr Foundation, and Université de Rennes (UR)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Structure Fédérative de Recherche en Biologie et Santé de Rennes ( Biosit : Biologie - Santé - Innovation Technologique )
Subjects: Male, AIDS-Related Opportunistic Infections/diagnosis, [SDV]Life Sciences [q-bio], Tuberculous, urologic and male genital diseases, 0302 clinical medicine, Medicine, 030212 general & internal medicine, CSF albumin, Cryptococcus neoformans/immunology, Aged, 80 and over, Meningitis, Viral/cerebrospinal fluid, Cryptococcosis, Middle Aged, Meningitis, Viral, 3. Good health, Infectious Diseases, Mycobacterium tuberculosis/genetics, Research Design, Tuberculosis, Meningeal, Area Under Curve, Thwaites, HIV/genetics, Female, Meningitis, Research Article, Adult, medicine.medical_specialty, Subacute, Adolescent, CSF glucose, 030231 tropical medicine, Cryptococcosis/diagnosis, Sensitivity and Specificity, Tuberculous meningitis, lcsh:Infectious and parasitic diseases, Diagnosis, Differential, Lancet, Young Adult, 03 medical and health sciences, Meningitis, Fungal/cerebrospinal fluid, Internal medicine, Humans, lcsh:RC109-216, Retrospective Studies, Aged, AIDS-Related Opportunistic Infections, Receiver operating characteristic, business.industry, Glasgow Coma Scale, HIV, Retrospective cohort study, Mycobacterium tuberculosis, medicine.disease, Criteria, Meningitis, Fungal, Tuberculosis, Meningeal/cerebrospinal fluid, Chronic Disease, Cryptococcus neoformans, Etiology, business
Abstract: BackgroundTuberculous meningitis (TBM) represents a diagnostic and management challenge to clinicians. The“Thwaites’ system” and “Lancet consensus scoring system” are utilized to differentiate TBM from bacterial meningitis but their utility in subacute and chronic meningitis where TBM is an important consideration is unknown.MethodsA multicenter retrospective study of adults with subacute and chronic meningitis, defined by symptoms greater than 5 days and less than 30 days for subacute meningitis (SAM) and greater than 30 days for chronic meningitis (CM). The “Thwaites’ system” and “Lancet consensus scoring system” scores and the diagnostic accuracy by sensitivity, specificity, and area under the curve of receiver operating curve (AUC-ROC) were calculated. The “Thwaites’ system” and “Lancet consensus scoring system” suggest a high probability of TBM with scores ≤4, and with scores of ≥12, respectively.ResultsA total of 395 patients were identified; 313 (79.2%) had subacute and 82 (20.8%) with chronic meningitis. Patients with chronic meningitis were more likely caused by tuberculosis and had higher rates of HIV infection (P P P ConclusionBoth criteria can be helpful in distinguishing TBM from bacterial meningitis, but only the Lancet consensus scoring system can help differentiate TBM from meningitis caused by fungal, viral and unknown etiologies even though significant overlap occurs and the overall diagnostic accuracy of both criteria were either poor or fair.
Published: 2020
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12. The factors affecting inadequate empirical antimicrobial therapy and clinical course in upper urinary tract infections of the elderly patients

Author: Derya Ozturk Engin, Pinar Korkmaz, Rezan Harman, Behice Kurtaran, Asuman Inan, Kenan Uğurlu, Mehmet Umut Çayiröz, Umit Savasci, Aslıhan Demirel, Hale Turan Özden, Aslıhan Burcu Yikilgan, Yeşim Kürekçi, Yesim Uygun Kizmaz, Ayten Kadanali, Zeynep Sule Cakar, Alper Şener, Pınar Firat, Fulya Bayindir Bilman, Burcu Ozdemir, Şule Özdemir Armağan, Buket Erturk Sengel, Nur Cancan Gürsul, Gülay Okay, Mehmet Emirhan Işık, Sabahat Çağan Aktaş, Duru Mistanoğlu Özatağ, Canan Ağalar, Fatma Kaçar, Hülya Kuşoğlu, Ayşe But, Ilknur Erdem, Hasan Naz, Özgür Dağli, Gül Durmuş, Fatma Yilmaz Karadağ, Büşra Ergüt Sezer, Ferit Kuşcu, Selma Ateş, Elif Tukenmez Tigen, Ilyas Dokmetas, Elif Doyuk Kartal, Aziz Ahmad Hamidi, and Funda Kocak
Subjects: Microbiology (medical), medicine.medical_specialty, Infectious Diseases, General Immunology and Microbiology, Multicenter study, business.industry, Internal medicine, medicine, Clinical course, Antimicrobial, business, Upper urinary tract
Published: 2020
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13. Cranial imaging findings in neurobrucellosis: results of Istanbul-3 study

Author: Ayşe Seza Inal, Kaan Meric, Filiz Pehlivanoglu, Meltem Avci, Oğuz Reşat Sipahi, Asuman Inan, Derya Ozturk-Engin, Hanefi Cem Gul, Selçuk Kaya, Esmeray Mutlu-Yilmaz, Selma Tosun, Ayten Kadanali, Sibel Bolukcu, Tumer Guven, Elif Sahin-Horasan, Emel Yilmaz, Abdullah Umut Pekok, Fatma Sirmatel, Canan Agalar, Celal Ayaz, Mustafa Kasim Karahocagil, Ayse Batirel, Hasan Karsen, Secil Deniz, Hakan Erdem, Asli Haykir-Solay, Nefise Oztoprak, Asim Ulcay, Gonul Sengoz, Mahmut Sunnetcioglu, Ayhan Akbulut, Nazif Elaldi, Selma Ates-Guler, Mehmet Ulug, Recep Tekin, Affan Denk, Yasemin Cag, Mustafa Namiduru, Emine Parlak, Sukran Kose, Rodrigo Hasbun, Mustafa Kemal Çelen, Tuna Demirdal, Seniha Senbayrak, Huseyin Turgut, Kadriye Kart Yaşar, Ali İrfan Baran, Uludağ Üniversitesi/Tıp Fakültesi/Enfeksiyon Hastalıkları ve Klinik Mikrobiyoloji Anabilim Dalı., Yılmaz, Emel, Çukurova Üniversitesi, [Erdem, Hakan] Gulhane Mil Med Acad, Dept Infect Dis & Clin Microbiol, Ankara, Turkey -- [Senbayrak, Seniha -- Deniz, Secil -- Ozturk-Engin, Derya -- Inan, Asuman] Haydarpasa Numune Training & Res Hosp, Dept Infect Dis & Clin Microbiol, Istanbul, Turkey -- [Meric, Kaan] Haydarpasa Numune Training & Res Hosp, Dept Radiol, Istanbul, Turkey -- [Batirel, Ayse] Dr Lutfi Kirdar Training & Res Hosp, Dept Infect Dis & Clin Microbiol, Istanbul, Turkey -- [Karahocagil, Mustafa Kasim -- Baran, Ali Irfan -- Sunnetcioglu, Mahmut] Yuzuncu Yil Univ, Sch Med, Dept Infect Dis & Clin Microbiol, Van, Turkey -- [Hasbun, Rodrigo] Univ Texas Hlth Sci Ctr Houston, Sch Med, Dept Infect Dis, Houston, TX 77030 USA -- [Sengoz, Gonul -- Pehlivanoglu, Filiz] Haseki Training & Res Hosp, Dept Infect Dis & Clin Microbiol, Istanbul, Turkey -- [Karsen, Hasan] Harran Univ, Sch Med, Dept Infect Dis & Clin Microbiol, Sanliurfa, Turkey -- [Kaya, Seluk] Karadeniz Tech Univ, Sch Med, Dept Infect Dis & Clin Microbiol, Trabzon, Turkey -- [Inal, Ayse Seza] Cukurova Univ, Sch Med, Dept Infect Dis & Clin Microbiol, Adana, Turkey -- [Pekok, Abdullah Umut] Private Erzurum Sifa Hosp, Dept Infect Dis & Clin Microbiol, Erzurum, Turkey -- [Celen, Mustafa Kemal -- Tekin, Recep -- Ayaz, Celal] Dicle Univ, Sch Med, Dept Infect Dis & Clin Microbiol, Diyarbakir, Turkey -- [Ulug, Mehmet] Private Umit Hosp, Dept Infect Dis & Clin Microbiol, Eskisehir, Turkey -- [Demirdal, Tuna] Katip Celebi Univ, Sch Med, Dept Infect Dis & Clin Microbiol, Izmir, Turkey -- [Namiduru, Mustafa] Gaziantep Univ, Sch Med, Dept Infect Dis & Clin Microbiol, Gaziantep, Turkey -- [Guven, Tumer] Ankara Atatrk Training & Res Hosp, Dept Infect Dis & Clin Microbiol, Ankara, Turkey -- [Parlak, Emine] Ataturk Univ, Sch Med, Dept Infect Dis & Clin Microbiol, Erzurum, Turkey -- [Bolukcu, Sibel -- Sipahi, Oguz Resat] Bezmi Alem Vakif Univ, Sch Med, Dept Infect Dis & Clin Microbiol, Istanbul, Turkey -- [Avci, Meltem -- Tosun, Selma] Izmir Bozyaka Training & Res Hosp, Dept Infect Dis & Clin Microbiol, Izmir, Turkey -- [Yasar, Kadriye] Bakirkoy Dr Sadi Konuk Training & Res Hosp, Dept Infect Dis & Clin Microbiol, Istanbul, Turkey -- [Yilmaz, Emel] Uludag Univ, Sch Med, Dept Infect Dis & Clin Microbiol, Bursa, Turkey -- [Ates-Guler, Selma] Sutcu Imam Univ, Sch Med, Dept Infect Dis & Clin Microbiol, Kahramanmaras, Turkey -- [Mutlu-Yilmaz, Esmeray] Samsun Training & Res Hosp, Dept Infect Dis & Clin Microbiol, Samsun, Turkey -- [Sirmatel, Fatma] Abant Izzet Baysal Univ, Sch Med, Dept Infect Dis & Clin Microbiol, Bolu, Turkey -- [Sahin-Horasan, Elif] Mersin Univ, Sch Med, Dept Infect Dis & Clin Microbiol, Mersin, Turkey -- [Akbulut, Ayhan -- Denk, Affan] Firat Univ, Sch Med, Dept Infect Dis & Clin Microbiol, Elazig, Turkey -- [Oztoprak, Nefise] Antalya Training & Res Hosp, Dept Infect Dis & Clin Microbiol, Antalya, Turkey -- [Cag, Yasemin] Medeniyet Univ, Goztepe Training & Res Hosp, Dept Infect Dis & Clin Microbiol, Istanbul, Turkey -- [Kadanali, Ayten] Umraniye Training & Res Hosp, Dept Infect Dis & Clin Microbiol, Istanbul, Turkey -- [Turgut, Huseyin] Pamukkale Univ, Sch Med, Dept Infect Dis & Clin Microbiol, Denizli, Turkey -- [Gul, Hanefi Cem -- Ulcay, Asim] GATA Haydarpasa Training Hosp, Dept Infect Dis & Clin Microbiol, Istanbul, Turkey -- [Haykir-Solay, Asli] Igdir State Hosp, Dept Infect Dis & Clin Microbiol, Igdir, Turkey -- [Kose, Sukran] Tepecik Training & Res Hosp, Dept Infect Dis & Clin Microbiol, Izmir, Turkey -- [Agalar, Canan] Fatih Sultan Mehmet Training & Res Hosp, Dept Infect Dis & Clin Microbiol, Istanbul, Turkey -- [Elaldi, Nazif] Cumhuriyet Univ, Sch Med, Dept Infect Dis & Clin Microbiol, Sivas, Turkey, Inal, Ayse Seza -- 0000-0002-1182-7164, ayaz, celal -- 0000-0002-9060-1090, and Kart Yasar, Kadriye -- 0000-0003-2963-4894
Subjects: Nervous-system brucellosis, Male, Pathology, Turkey, Glucose blood level, 0302 clinical medicine, middle aged, nuclear magnetic resonance imaging, granuloma, brain edema, protein cerebrospinal fluid level, neuroimaging, adult, General Medicine, Case Report, Agglutination Tests, Zoonosis, Nuclear magnetic resonance imaging, aged, Protein cerebrospinal fluid level, Diagnostic imaging, brain infection, Human, Microbiology (medical), medicine.medical_specialty, diagnostic imaging, 030106 microbiology, Major clinical study, Microbiology, Article, 03 medical and health sciences, x-ray computed tomography, Humans, human, lymphocyte count, Polyradiculopathy, radiculopathy, Aged, X-ray computed tomography, microbiology, medicine.disease, major clinical study, Brucella, glucose blood level, Glucose, Arachnoiditis, cerebrospinal fluid level, Brain edema, Lymphocyte count, polyneuropathy, 030217 neurology & neurosurgery, 0301 basic medicine, Physiology, Turkey (republic), computer assisted tomography, Cerebrospinal fluid, Diagnosis, Prevalence, glucose, Radiculopathy, brain disease, CSF albumin, cranial nerve, Cranial nerve, Brain Diseases, Granuloma, Cerebrospinal fluid level, medicine.diagnostic_test, White matter, spinal root, Brain infection, Middle Aged, Magnetic Resonance Imaging, brain abscess, Brain abscess, female, Infectious Diseases, brucellosis, young adult, Female, Neurobrucellosis, hydrocephalus, white matter, Polyneuropathy, Hydrocephalus, Adult, Adolescent, Brain Diseases/diagnostic imaging/*pathology, Brucella/physiology, Brucellosis/diagnostic imaging/*epidemiology/microbiology/pathology, Neuroimaging, Tomography, X-Ray Computed, Turkey/epidemiology, Young Adult, Brucellosis, Cerebral edema, Computer assisted tomography, medicine, controlled study, Meningitis, Brain disease, Inflammation, business.industry, Protein, Magnetic resonance imaging, Computerized tomography, arachnoiditis, physiology, DiagnosisInflammation, pathology, Involvement, protein, Spinal root, business, Controlled study
Abstract: WOS: 000388827200008, PubMed ID: 27138335, Objective Neuroimaging abnormalities in central nervous system (CNS) brucellosis are not well documented. The purpose of this study was to evaluate the prevalence of imaging abnormalities in neurobrucellosis and to identify factors associated with leptomeningeal and basal enhancement, which frequently results in unfavorable outcomes. Methods Istanbul-3 study evaluated 263 adult patients with CNS brucellosis from 26 referral centers and reviewed their 242 magnetic resonance imaging (MRI) and 226 computerized tomography (CT) scans of the brain. Results A normal CT or MRI scan was seen in 143 of 263 patients (54.3 %). Abnormal imaging findings were grouped into the following four categories: (a) inflammatory findings: leptomeningeal involvements (44), basal meningeal enhancements (30), cranial nerve involvements (14), spinal nerve roots enhancement (8), brain abscesses (7), granulomas (6), and arachnoiditis (4). (b) White-matter involvement: white-matter involvement (32) with or without demyelinating lesions (7). (c) Vascular involvement: vascular involvement (42) mostly with chronic cerebral ischemic changes (37). (d) Hydrocephalus/cerebral edema: hydrocephalus (20) and brain edema (40). On multivariate logistic regression analysis duration of symptoms since the onset (OR 1.007; 95 % CI 1-28, p = 0.01), polyneuropathy and radiculopathy (OR 5.4; 95 % CI 1.002-1.013, p = 0.044), cerebrospinal fluid (CSF)/serum glucose rate (OR 0.001; 95 % CI 000-0.067, p = 0.001), and CSF protein (OR 2.5; 95 % CI 2.32.7, p = 0.0001) were associated with diffuse inflammation. Conclusions In this study, 45 % of neurobrucellosis patients had abnormal neuroimaging findings. The duration of symptoms, polyneuropathy and radiculopathy, high CSF protein level, and low CSF/serum glucose rate were associated with inflammatory findings on imaging analyses.
Published: 2016
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14. Portraying infective endocarditis

Author: Ilker Inanc Balkan, Najada Como, André Silva-Pinto, Antonio Cascio, Canan Agalar, Meliha Meric-Koc, Tatjana Lejko Zupanc, Oday Abu Ajamieh, Simin Aysel Florescu, Selma Tosun, Meltem Taşbakan, Asuman Inan, Rosa Fontana Del Vecchio, Edmond Puca, Güven Çelebi, Ayse Sagmak-Tartar, Abdullah Umut Pekok, Yasemin Cag, Gülden Ersöz, Sumeyra Karakus, Safak Ozer-Balin, Jamal Wadi, Sukran Kose, Yves Hansmann, Hacer Deniz Ozkaya, Nefise Oztoprak, Hakan Erdem, Serkan Oncu, Jesper Damsgaard Gunst, Yvon Ruch, Aysegul Erdem, Gilda Tonziello, Ayse Batirel, Rahmet Guner, Irina Magdalena Dumitru, Lurdes Santos, Raquel Duro, Nesrin Ghanem-Zoubi, Arjeta Dedej, Serda Gulsun, Mustafa Dogan, Necla Tulek, Alper Şener, Pedro Palma Martins, Ilkay Bozkurt, Deborah Konopnicki, Fatma Sirmatel, Xavier Argemi, Meltem Avci, Fahad Almajid, Recep Tekin, Nicola Petrosillo, Corneliu Petru Popescu, Ayse Kaya-Kalem, Imran Hasanoglu, Atilla Iyisoy, Jean Philippe Mazzucotelli, Ejaz Ahmed Khan, Sema Sarı, Derya Ozturk-Engin, Nicolas Dauby, Erdem H., Puca E., Ruch Y., Santos L., Ghanem-Zoubi N., Argemi X., Hansmann Y., Guner R., Tonziello G., Mazzucotelli J.-P., Como N., Kose S., Batirel A., Inan A., Tulek N., Pekok A.U., Khan E.A., Iyisoy A., Meric-Koc M., Kaya-Kalem A., Martins P.P., Hasanoglu I., Silva-Pinto A., Oztoprak N., Duro R., Almajid F., Dogan M., Dauby N., Gunst J.D., Tekin R., Konopnicki D., Petrosillo N., Bozkurt I., Wadi J., Popescu C., Balkan I.I., Ozer-Balin S., Zupanc T.L., Cascio A., Dumitru I.M., Erdem A., Ersoz G., Tasbakan M., Ajamieh O.A., Sirmatel F., Florescu S., Gulsun S., Ozkaya H.D., Sari S., Tosun S., Avci M., Cag Y., Celebi G., Sagmak-Tartar A., Karakus S., Sener A., Dedej A., Oncu S., Del Vecchio R.F., Ozturk-Engin D., Agalar C., Virulence Bactérienne Précoce : fonctions cellulaires et contrôle de l'infection aigüe et subaigüe, Université de Strasbourg (UNISTRA), Virulence bactérienne précoce : fonctions cellulaires et contrôle de l'infection aiguë et subaiguë, Nanomédecine Régénérative (NanoRegMed), Université de Strasbourg (UNISTRA)-Institut National de la Santé et de la Recherche Médicale (INSERM), MERİÇ KOÇ, MELİHA, İÜC, Cerrahpaşa Tıp Fakültesi, Dahili Tıp Bilimleri Bölümü, Uşak Üniversitesi, Zonguldak Bülent Ecevit Üniversitesi, BAİBÜ, Tıp Fakültesi, Dahili Tıp Bilimleri Bölümü, Sırmatel, Fatma, and OMÜ
Subjects: Male, Internationality, Aucun, Infective endocarditi, medicine.disease_cause, Medical microbiology, 80 and over, Blood culture, Hospital Mortality, Aged, 80 and over, medicine.diagnostic_test, biology, Endocarditis, Bacterial, General Medicine, Sciences bio-médicales et agricoles, Middle Aged, Staphylococcal Infections, Sciences du Vivant [q-bio]/Microbiologie et Parasitologie, Viridans Streptococci, Catheter, Infectious Diseases, [SDV.MP]Life Sciences [q-bio]/Microbiology and Parasitology, Staphylococcus aureus, Infective endocarditis, Aortic Valve, Mitral Valve, Female, Microbiology (medical), Adult, medicine.medical_specialty, Prosthesis-Related Infections, Adolescent, aureus, Young Adult, Internal medicine, medicine, Humans, results of multinational ID-IRI study-, EUROPEAN JOURNAL OF CLINICAL MICROBIOLOGY & INFECTIOUS DISEASES, cilt.38, ss.1753-1763, 2019 [Erdem H., Puca E., Ruch Y., Santos L., Ghanem-Zoubi N., Argemi X., Hansmann Y., Guner R., Tonziello G., Mazzucotelli J., et al., -Portraying infective endocarditis], Prosthetic, Aged, Native Valve Endocarditis, Bacteria, business.industry, Endocarditis, Bacterial, medicine.disease, biology.organism_classification, S. aureus, Viridans streptococci, business, Native
Abstract: Infective endocarditis is a growing problem with many shifts due to ever-increasing comorbid illnesses, invasive procedures, and increase in the elderly. We performed this multinational study to depict definite infective endocarditis. Adult patients with definite endocarditis hospitalized between January 1, 2015, and October 1, 2018, were included from 41 hospitals in 13 countries. We included microbiological features, types and severity of the disease, complications, but excluded therapeutic parameters. A total of 867 patients were included. A total of 631 (72.8%) patients had native valve endocarditis (NVE), 214 (24.7%) patients had prosthetic valve endocarditis (PVE), 21 (2.4%) patients had pacemaker lead endocarditis, and 1 patient had catheter port endocarditis. Eighteen percent of NVE patients were hospital-acquired. PVE patients were classified as early-onset in 24.9%. A total of 385 (44.4%) patients had major embolic events, most frequently to the brain (n = 227, 26.3%). Blood cultures yielded pathogens in 766 (88.4%). In 101 (11.6%) patients, blood cultures were negative. Molecular testing of vegetations disclosed pathogens in 65 cases. Overall, 795 (91.7%) endocarditis patients had any identified pathogen. Leading pathogens (Staphylococcus aureus (n = 267, 33.6%), Streptococcus viridans (n = 149, 18.7%), enterococci (n = 128, 16.1%), coagulase-negative staphylococci (n = 92, 11.6%)) displayed substantial resistance profiles. A total of 132 (15.2%) patients had cardiac abscesses; 693 (79.9%) patients had left-sided endocarditis. Aortic (n = 394, 45.4%) and mitral valves (n = 369, 42.5%) were most frequently involved. Mortality was more common in PVE than NVE (NVE (n = 101, 16%), PVE (n = 49, 22.9%), p = 0.042)., SCOPUS: ar.j, info:eu-repo/semantics/published
Published: 2019
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15. Predictors of unfavorable outcome in neurosyphilis: Multicenter ID-IRI Study

Author: Seniha Senbayrak, Derya Ozturk-Engin, Alper Şener, Saygin Nayman-Alpat, B. Lakatos, Selçuk Kaya, Fatma Sirmatel, Hakan Erdem, Rodrigo Hasbun, Pınar Ergen, Shu-Hua Wang, Gonul Cicek-Senturk, Umit Savasci, Fahad Almajid, Recep Tekin, Xavier Argemi, Mustafa Kemal Çelen, Ilker Inanc Balkan, Marie Gheno, Gonul Sengoz, Pierre Tattevin, Yasemin Cag, Andrea Gombos, Hulya Tireli, Ahmet Çağkan İnkaya, Canan Agalar, Abdullah Umut Pekok, Sukran Kose, Haluk Vahaboglu, Enora Ouamara-Digue, Nuray Uzun, and Figen Kaptan
Subjects: Adult, Male, 0301 basic medicine, Microbiology (medical), medicine.medical_specialty, 030106 microbiology, Asymptomatic, Cohort Studies, Central nervous system disease, Neurosyphilis, 03 medical and health sciences, 0302 clinical medicine, Internal medicine, Diplopia, medicine, Humans, 030212 general & internal medicine, Paresis, business.industry, Headache, General Medicine, Length of Stay, Middle Aged, medicine.disease, Anti-Bacterial Agents, Penicillin, Treatment Outcome, Infectious Diseases, Tabes dorsalis, Ceftriaxone, Female, Syphilis, medicine.symptom, business, medicine.drug
Abstract: Neurosyphilis (NS) has different clinical manifestations and can appear during any stage of syphilis. We aimed to identify the factors affecting poor outcome in NS patients. Patients with positive cerebrospinal fluid Venereal Disease Research Laboratory test, and positive serological serum treponemal or nontreponemal tests were classified as definite NS. The data of 141 patients with definite NS were submitted from 22 referral centers. Asymptomatic NS, syphilitic meningitis, meningovascular syphilis, tabes dorsalis, general paresis, and taboparesis were detected in 22 (15.6%), 67 (47.5%), 13 (9.2%), 10 (7%), 13 (9.2%), and 16 patients (11.3%), respectively. The number of HIV-positive patients was 43 (30.4%). The most common symptoms were headache (n = 55, 39%), fatigue (n = 52, 36.8%), and altered consciousness (50, 35.4%). Tabetic symptoms were detected in 28 (19.8%), paretic symptoms in 32 (22.6%), and vascular symptoms in 39 patients (27.6%). Eye involvement was detected in 19 of 80 patients (23.7%) who underwent eye examination and ear involvement was detected in eight of 25 patients (32%) who underwent ear examination. Crystallized penicillin was used in 109 (77.3%), procaine penicillin in seven (4.9%), ceftriaxone in 31 (21.9%), and doxycycline in five patients (3.5%). According to multivariate regression analysis, while headache was a protective factor in NS patients, double vision was significantly associated to poor outcome. We concluded that double vision indicated unfavorable outcome among NS patients. A high clinical suspicion is needed for the diagnosis NS. As determined in our study, the presence of headache in syphilitic patients can help in early diagnosis of central nervous system disease.
Published: 2019

16. Radiological data in microbiologically confirmed central nervous system tuberculosis

Author: Hakan Erdem, Gonul Sengoz, Seniha Senbayrak, Gamze Kilicoglu, Yasemin Cag, Hulya Tireli, and Derya Ozturk-Engin
Subjects: 0301 basic medicine, Microbiology (medical), Adult, Male, Pathology, medicine.medical_specialty, Tuberculosis, Adolescent, Databases, Factual, 030106 microbiology, Central nervous system, 03 medical and health sciences, Young Adult, 0302 clinical medicine, Medicine, Humans, Retrospective Studies, business.industry, General Medicine, Mycobacterium tuberculosis, Middle Aged, Tuberculosis, Central Nervous System, medicine.disease, Magnetic Resonance Imaging, Infectious Diseases, medicine.anatomical_structure, Radiological weapon, Female, business, Tomography, X-Ray Computed, 030217 neurology & neurosurgery
Published: 2018

17. Development and validation of a modified quick SOFA scale for risk assessment in sepsis syndrome

Author: Hulya Caskurlu, Zeliha Kocak-Tufan, Nihal Piskin, Derya Ozturk-Engin, Musa Salmanoglu, Haluk Erdoğan, Fatma Eser, Oğuz Reşat Sipahi, Uğur Önal, Arzu Dogru, Husrev Diktas, Ilknur Erdem, Türkay Akbaş, Haluk Vahaboglu, Serpil Erol, Firdevs Aksoy, Oznur Ak, Aslıhan Demirel, Rezan Harman, Pinar Korkmaz, Yalcin Onem, Yasemin Cag, Ayse Batirel, Gül Durmuş, Aynur Atilla, Sinem Cesur, Aziz Ahmad Hamidi, Fatime Korkmaz, Oguz Karabay, Derya Karasu, Zonguldak Bülent Ecevit Üniversitesi, and Ege Üniversitesi
Subjects: Male, 0301 basic medicine, Emergency Medical Services, Critical Care and Emergency Medicine, Decision Analysis, Turkey, Physiology, Organ Dysfunction Scores, Epidemiology, lcsh:Medicine, Definitions, Pathology and Laboratory Medicine, 01 natural sciences, Cohort Studies, DEFINITIONS, 010104 statistics & probability, Antibiotics, Medicine and Health Sciences, Clinical endpoint, CRITERIA, EPIDEMIOLOGY, INFLAMMATORY RESPONSE SYNDROME, lcsh:Science, Aged, 80 and over, Multidisciplinary, Inflammatory Response Syndrome, Antimicrobials, Drugs, Middle Aged, Hospitals, Systemic Inflammatory Response Syndrome, Body Fluids, Blood, Engineering and Technology, Female, Anatomy, Pathogens, Management Engineering, Research Article, Cohort study, medicine.medical_specialty, 030106 microbiology, Research and Analysis Methods, Microbiology, Risk Assessment, Sepsis, 03 medical and health sciences, Signs and Symptoms, Diagnostic Medicine, Microbial Control, Internal medicine, medicine, Humans, 0101 mathematics, Aged, Retrospective Studies, Pharmacology, PATHOGENS, Septic shock, business.industry, Decision Trees, lcsh:R, Biology and Life Sciences, Retrospective cohort study, medicine.disease, Triage, Criteria, Health Care, Systemic inflammatory response syndrome, Severe Sepsis, Health Care Facilities, lcsh:Q, business
Abstract: WOS: 000446000200057, PubMed ID: 30256855, Sepsis is a severe clinical syndrome owing to its high mortality. Quick Sequential Organ Failure Assessment (qSOFA) score has been proposed for the prediction of fatal outcomes in sepsis syndrome in emergency departments. Due to the low predictive performance of the qSOFA score, we propose a modification to the score by adding age. We conducted a multicenter, retrospective cohort study among regional referral centers from various regions of the country. Participants recruited data of patients admitted to emergency departments and obtained a diagnosis of sepsis syndrome. Crude in-hospital mortality was the primary endpoint. A generalized mixed-effects model with random intercepts produced estimates for adverse outcomes. Model-based recursive partitioning demonstrated the effects and thresholds of significant covariates. Scores were internally validated. The H measure compared performances of scores. A total of 580 patients from 22 centers were included for further analysis. Stages of sepsis, age, time to antibiotics, and administration of carbapenem for empirical treatment were entered the final model. Among these, severe sepsis (OR, 4.40; CIs, 2.35-8.21), septic shock (OR, 8.78; CIs, 4.37-17.66), age (OR, 1.03; CIs, 1.02-1.05) and time to antibiotics (OR, 1.05; CIs, 1.01-1.10) were significantly associated with fatal outcomes. A decision tree demonstrated the thresholds for age. We modified the quick Sequential Organ Failure Assessment (mod-qSOFA) score by adding age (> 50 years old = one point) and compared this to the conventional score. H-measures for qSOFA and mod-qSOFA were found to be 0.11 and 0.14, respectively, whereas AUCs of both scores were 0.64. We propose the use of the modified qSOFA score for early risk assessment among sepsis patients for improved triage and management of this fatal syndrome.
Published: 2018

18. Infections after Transrectal Prostate Biopsy: Report of Fourteen Cases

Author: Derya Ozturk Engin, Ihsan Karaman, Seniha Senbayrak Akcay, Yusuf Benek, Asuman Inan, Ilknur Erdem, Seyfi Özyürek, Ipek Talas, and Naz Oguzoglu
Subjects: medicine.medical_specialty, Prostate biopsy, medicine.diagnostic_test, medicine.drug_class, business.industry, Urinary system, Urine, medicine.disease, Quinolone, Surgery, Sepsis, medicine.anatomical_structure, Prostate, Internal medicine, medicine, Transrectal ultrasonography, Blood culture, business
Abstract: After prostate biopsy, serious and life-threatening infections of resistant strains can develop and therefore fluoroquinolones for prophylaxis is widely used. This study aimed to examine infections in patients undergoing transrectal prostate biopsy with quinolone prophylaxis and to review the articles reported in this respect. Patients and Methods: In this study, 14 cases who followed for the development of infection after transrectal ultrasonography guided prostate biopsy between the years 2005-2010 at the Department of Infectious Diseases and Clinical Microbiology of Haydarpasa Numune Training and Research Hospital were retrospectively evaluated. Results: Ten patients (%71.4) developed sepsis, 3 patients (21.4%) urinary tract infection (UTI), and 1 patient (7.1%) acute bacterial prostatitis. In seven out of 14 patients (50%) bacteria growth was in blood culture, in 12 patients (85.7%) was in urine and in 5 patients (35.7%) was in both. E. coli was identified as the causative agent in all of the cases being the rate of extended spectrum of 􀀁-lactamases (ESBL) in E. coli strains was 42.8%, quinolone resistance 92.8 %. Conclusion: This study suggested that fluoroquinolone resistant E. coli should be considered as an important causative agent in infections after transrectal prostate biopsy.
Published: 2015
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19. Seroprevalence and Risk Factors for Epstein-Barr Virus Infection in Adults

Author: Serpil Erol, Zeynel Abidin Demir, Derya Ozturk Engin, Seyfi Özyürek, Asuman Inan, Jale Altintaş, and Seniha Senbayrak
Subjects: Microbiology (medical), Adult, General Immunology and Microbiology, seroprevalence, business.industry, lcsh:R, lcsh:Medicine, medicine.disease, socieoeconomical status, Virology, lcsh:Infectious and parasitic diseases, Infectious Diseases, hemic and lymphatic diseases, medicine, Seroprevalence, risk factors, lcsh:RC109-216, Epstein-Barr virus infections, business, Epstein–Barr virus infection
Abstract: Introduction: Epstein-Barr virus (EBV), also known as human herpesvirus 4, is the causative agent of infectious mononucleosis. Infection with EBV is associated with multiple malignancies. The aim of this study was to determine the seroprevalence and risk factors for seropositivity. Materials and Methods: This study was conducted in Haydarpaşa Numune Training and Research Hospital in İstanbul between August 2012 and October 2012. Epstein-Barr virus viral capsid antigen IgG antibody was measured using ELISA in 500 cases. Age, gender, occupation, education level, family income, the area and type of residence, and chronic illness of the participants were also evaluated. Differences between risk groups were statistically analyzed. Results: The mean age of the 500 study participants was 47.7±19.1 (15-87) years and 289 (57.8%) were male. Mean EBV seropositivity was 96.4%, and 91% of the cases became seropositive for EBV by 15 years of age. No significant associations with age, gender, occupation, education level, family income, area and type of residence, and chronic illness were detected. Conclusion: Epstein-Barr virus seropositivity rates were very high and about 91% of the cases become seropositive for EBV by 15 years of age. There was no significant relationship between risk factors and seroprevalence of EBV.
Published: 2017

20. Antibiotic Resistance Trends and The ESBL Prevalence of Escherichia coli and Klebsiella spp Urinary Isolates in In-and Outpatients in a Tertiary Care Hospital in Istanbul, 2004 - 2012

Author: Efe Serkan Boz, Ismail Davarci, Seniha Senbayrak, Naz Cobanoglu, Asuman Inan, Ozgur Dagli, Derya Ozturk Engin, Simin Cevan, Sebahat Aksaray, and Nilgun Dosoglu
Subjects: 0301 basic medicine, Microbiology (medical), medicine.drug_class, business.industry, Incidence (epidemiology), Urinary system, 030106 microbiology, Antibiotics, Urine, medicine.disease_cause, Microbiology, Klebsiella spp, 03 medical and health sciences, 0302 clinical medicine, Infectious Diseases, Antibiotic resistance, medicine, 030212 general & internal medicine, Agar diffusion test, business, Escherichia coli
Abstract: Background: Extended spectrum beta-lactamase (ESBL) producing organisms causing urinary tract infections are increasing in incidence and becoming a serious health problem due to their resistance to large number of antibiotics. Objectives: To investigate the ESBL prevalence of Escherichia coli and Klebsiella spp. which are isolated from urine samples for both in and outpatients with their resistance profiles. Methods: From 2004 to 2012, a total of 13975 isolates (12897 E. coli, 1078 Klebsiella spp.) were included in this study. The antibiotic susceptibility was tested using Kirby–Bauer disk diffusion method and Vitek2 System (bioMerieux, France) according to CLSI. Results: Our data showed a significant increasing in ESBL prevalence from 12.5% to 44.7% (P < 0.001) for inpatients; from 9.6% to 22.8% (P < 0.001) for outpatients in E. coli and from 25% to 60.5% (P < 0.003) for inpatients; from 12% to 25% (P < 0.095) for outpatients in Klebsiella spp. For E. coli, the increase was significantly high in both of males and females (P < 0.001). However, for Klebsiella spp. it was significantly high in male patients (P < 0.001). The resistance rates of antibiotics for the ESBL producing E. coli, and Klebsiella spp. showed a significant increase. These rates were higher than 70% for fluoroquinolones, amoxicillin-clavulanic acid and trimethoprim-sulfamethoxazole. Even carbepenem resistance reached to 7% in the outpatients and 15% in inpatients for ESBL producing Klebsiella spp. Conclusions: Our study demonstrated a significant increase in the prevalence of ESBL producing E. coli and Klebsiella spp. and a remarkable carbapenem resistance trend in the ESBL producing Klebsiella spp. isolated from urine samples.
Published: 2017
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21. The investigation of related factors for vancomycin resistant enterococcus colonization of inpatients at internal medicine service

Author: Derya Ozturk Engin, Funda Muserref Turkmen, Ismail Davarci, and Pinar Zehra Davarci
Subjects: medicine.medical_specialty, Univariate analysis, business.industry, General Medicine, biochemical phenomena, metabolism, and nutrition, bacterial infections and mycoses, medicine.disease_cause, Intensive care unit, Glycopeptide, law.invention, Metronidazole, law, Internal medicine, medicine, Vancomycin, Vancomycin-resistant Enterococcus, Colonization, Risk factor, business, medicine.drug
Abstract: Aim: Enterococci are located in the intestinal flora of animals and humans and have become a major cause of healthcare-associated infections over the years. In this study, related factors were investigated for the isolation of vancomycin-resistant enterococci (VRE) from rectal swab specimens of patients admitted to the internal medicine service.Material and Methods: TRectal swab samples were obtained from 316 patients. VITEK-2 (bioMerieux, Marcy l’Etoile, France) automated system was used for identification of enterococci. Vancomycin susceptibility was studied by Kirby-Bauer disc diffusion method. Resistant strains were confirmed by vancomycin E-test (bioMerieux).Results: VRE was growth in 70 (22.2%) of 316 patients included in the study. According to the univariate analysis results which comparing patients who were colonized with VRE to the control group; These were found, the duration of hospitalization for VRE colonized patients was significantly longer, the usage of glycopeptide and metronidazole increased the VRE colonization and VRE colonized patients were found to have more parenteral feeding. It was determined that hemoglobin, thyroxine and albumin values of patients colonized with VRE were lower. According to the logistic regression analysis, patients with VRE colonization had a higher rate of history in the intensive care unit and higher gamma glutamyl transferase value. Conclusion: It was determined that the hospitalization history in intensive care unit is a risk factor for VRE colonization and especially in patients transported from intensive care unit. Patients colonized with VRE have been found to have higher GGT values and new research on this topic is considered to be needed.
Published: 2020
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22. 337. The Use of Adjunctive Steroids in 438 Adults With Herpes Simplex Virus Encephalitis

Author: Selçuk Kaya, Xavier Argemi, Hakan Erdem, Yasemin Cag, Jesper Damsgaard Gunst, Anne Lisbeth Bohr, Derya Ozturk-Engin, Mario Poljak, Matjaž Jereb, Rodrigo Hasbun, Bruno Baršić, Pierre Tattevin, Lenka Baštáková, Sylviane Defres, Signe Maj Sørensen, and Lykke Larsen
Subjects: Coma, Pediatrics, medicine.medical_specialty, Simplexvirus, Weight measurement scales, food.ingredient, medicine.diagnostic_test, business.industry, Treatment outcome, Glasgow Coma Scale, Herpes simplex virus encephalitis, Magnetic resonance imaging, medicine.disease, 3. Good health, Abstracts, Infectious Diseases, food, B. Poster Abstracts, Oncology, Medicine, medicine.symptom, business, Encephalitis
Abstract: Background Herpes simplex virus (HSV) encephalitis is associated with adverse clinical outcomes in 50% of patients. The use and impact of adjunctive steroids in improving the prognosis of this devastating disease is unknown. Methods A multicenter international retrospective study of adults (age >15 years) with confirmed HSV encephalitis. An adverse clinical outcome was defined as death or survived with sequelae. Results A total of 438 adults with HSV encephalitis were enrolled. The mean age was 50.58 years (15.94, SD), 226 (51.6%) were female and 59 (13.5%) were immunosuppressed. New onset seizures were seen in 91 (20.8%) patients and the median Glasgow coma scale was 14 (13–15, IQR). A total of 73 (16.6%) patients received adjunctive steroids during their hospitalization. Adjunctive steroids were given more frequently to patients with fever (84.5% vs. 66.7%, P = 0.003), seizures (38.3% vs. 17.3%, P < 0.001), abnormalities on MRI (77.7% vs. 61.8%, P = 0.017), lower mean Glasgow coma scales (10.42 vs. 11.3, P = 0.013) and it was also associated with a longer length of stay (median duration of 23 days vs. 20 days, P = 0.012). Adjunctive steroids were not associated with an impact on adverse clinical outcomes (46.6% vs. 46.9%, P = 0.95). Conclusion Adjunctive steroids in HSV encephalitis are used more commonly in the sicker patients and are not associated with a benefit in clinical outcomes. Disclosures All authors: No reported disclosures.
Published: 2018
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23. Compliance with Guidelines for Practices of Perioperative Antimicrobial Prophylaxis: A Multicenter Survey

Author: Oguz Karabay, Derya Ozturk Engin, Bahri Teker, Aziz Ogutlu, Ilknur Esen Yildiz, Serpil Öztürk Özkan, Funda Kocak, Aslıhan Demirel, Ilker Inanc Balkan, Serap Gencer, Fatma Ekşi Polat, Aygul Dogan Celik, Muhammed Emin Doğan, Hava Yilmaz, Alper Şener, Mesut Yilmaz, Aynur Engin, Bülent Durdu, İstanbul Medipol Üniversitesi, Tıp Fakültesi, Dahili Tıp Bilimleri Bölümü, Enfeksiyon Hastalıkları ve Klinik Mikrobiyoloji Ana Bilim Dalı, and Sivas Cumhuriyet Üniversitesi
Subjects: perioperative,antimicrobia,prophylaxis, lcsh:R5-920, lcsh:Internal medicine, Prophylaxis, lcsh:R, lcsh:Medicine, General Medicine, Antimikrobiyal, Perioperatif, Health Care Sciences and Services, Profilaksi, antimicrobia, Antimicrobial, Perioperative, Sağlık Bilimleri ve Hizmetleri, lcsh:Medicine (General), lcsh:RC31-1245, Perioperatif,antimikrobiyal,profilaksi, Cerrahi
Abstract: Amaç: Bu çalışmada perioperatif antimikrobiyal profilaksi (PAP) uygulamalarında güncel rehberlere uyum oranlarını ve bu oranları etkileyen faktörleri belirlemeyi amaçladık.Gereç ve Yöntemler: 30 Mayıs - 30 Haziran 2013 tarihleri arasında 15 farklı merkezde uygulanan ankete yedi farklı branştan 410 cerrah katıldı. Çoktan seçmeli ve açık uçlu 40 soru içeren anketler yüz yüze görüşme yöntemiyle uygulandı. Bulgular: Katılımcıların ortalama yaşı 38,01±9,1, %83,4'ü erkek idi. Ankete katılan cerrahların %46,2'si "kurumlarında cerrahi profilaksi rehberi varlığı hakkında bilgisi olmadığını," %34'ü ise "rehberin bulunduğunu ve profilaksi uygulamalarının rehbere uygun olduğunu" belirtti. Ankete katılan cerrahların %56,1'inin kurum içinde cerrahi profilaksi konusunda herhangi bir eğitim toplantısına katılmadığı, son üç yıl içinde cerrahi profilaksi eğitimi alanlarda rehbere uyumun istatistiksel olarak daha yüksek olduğu belirlendi (p, Aim: We aimed to determine the rates of compliance with current guidelines for practices of perioperative antimicrobial prophylaxis (PAP) and the factors affecting these rates.Materials and Methods: Four hundred and ten surgeons from seven different branches attended the survey conducted between May 30 and June 30, 2013, in fifteen different centers. A 40-question questionnaire consisting of multiple choice and open-ended questions was prepared and applied by interviewing the surgeons. Results: The mean age was 38.01 ± 9.1 years; and 83.4% of the participants were male. Of the surveyed surgeons 46.2% stated that they had no information about the existence of any guidelines for surgical prophylaxis in their institutions and 34% stated that institutional guidelines were available and their prophylaxis practices were in accordance with them. Surgeons who were trained on surgical prophylaxis within the last three years were found to have a statistically higher (p
Published: 2017

24. Cytomegalovirus pneumonia in a patient with systemic lupus erythematosus

Author: Seyfi Özyürek, Asuman Inan, Ilknur Erdem, Belma Akbaba Bağcı, Funda Muserref Turkmen, and Derya Ozturk Engin
Subjects: Ganciclovir, Leukopenia, Cytomegalovirus pneumonia, medicine.diagnostic_test, Cyclophosphamide, business.industry, lcsh:QR1-502, virus diseases, Pharmaceutical Science, medicine.disease, lcsh:Microbiology, Systemic lupus erythematosus, Bronchoalveolar lavage, Complementary and alternative medicine, Antigen, Immunology, medicine, Prednisolone, pneumonia, Pharmacology (medical), medicine.symptom, business, cytomegalovirus, Infiltration (medical), medicine.drug
Abstract: We presented an interstitial pneumonia case developed due to very rarely seen cytomegalovirus (CMV) in a 66 year-old female patient who had systemic lupus erythematosus (SLE). This patient who was on prednisolone and cyclophosphamide developed high fever, dyspnea and rales in lungs, high CRP, leukopenia, and thrombocytopenia after 11 days of cyclophosphamide treatment. Interstitial infiltration was detected in thoracic tomography. CMV antigen and CMV-DNA by RT-PCR were positive in blood. It was considered as CMV pneumonia. Ganciclovir treatment was started. CMV antigen became negative in the 14th days of the treatment. Clinical improvement was observed at the same time. It is necessary to remember CMV as the agents responsible for causing pneumonia due to high mortality in immunosuppressive host such as SLE. In the blood CMV antigen and CMV DNA investigation may contribute to the diagnosis in that bronchoalveolar lavage cannot be performed. J Microbiol Infect Dis 2011; 1(2): 80-83
Published: 2011
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25. 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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26. Mediterranean Spotted Fever:Report of Two Cases

Author: Derya Ozturk Engin, Paşa Göktaş, Asuman Inan, Figen Kuloğlu, Nurgul Ceran, and Şule Çakar
Subjects: General Medicine
Published: 2011
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27. Contents Vol. 19, 2010

Author: Nurgul Ceran, Nobuyuki Taniguchi, Abdalla A. Abed, L. Wen, Mehmet Ali Sungur, Hikmet Yorgun, A. Prakash, Xin Huang, Mehmet Ali Nahit Sendur, Derya Ozturk Engin, Cumhur Kilincer, Mustafa Kemal Hamamcioglu, Kyoji Okada, Lülüfer Tamer, Xingli Li, Mengshi Chen, Naz Oguzoglu, Xiaofang Luo, Asuma Sengoz Inan, Ugur Atik, M.J. Patil, Toshiyuki Yamada, Shiyun Tan, Khalifa Al Benwan, Sean H. Adams, M.Z. Haider, Fariborz Ghaffarpasand, Linmarie Ludeman, Hakan Aksoy, A.D. Adekile, V.K. Ghosh, Cuijuan Qian, Aliasghar Karimi, Ahmet Hakan Ateş, Ali Ünlü, R.Y. Zhan, Fatma Kaya, Ilknur Erdem, Benjamin Abuaku, Shuichi Chida, Ipek Genc, Nehir Sucu, Mazen M. Zaharna, X.F. Yang, Harumi Koibuchi, Tracey Bailey, Paşa Göktaş, D.H. Nagore, Ibtisam E. Tothill, Afshin Borhani Haghighi, Hiroyuki Nagasawa, Lokman Ayaz, Ali Oto, Ali Amiri, Asu Özgültekin, Fiona Macdonald, Christian Sandrock, Kazuhiko Kotani, Hiroyuki Tsuchie, Noura Al Sweih, Emmanuel Nna, Ergun Baris Kaya, Fadel A. Sharif, Junyu Wang, Hongzhuan Tan, Kudret Aytemir, Michiaki Miyamoto, Yoichi Shimada, and Vincent O. Rotimi
Subjects: Traditional medicine, business.industry, Medicine, Physiology, General Medicine, business
Published: 2010
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28. Distribution of Tuberculomas and Vasculitic Lesions in Microbiologically Confirmed Central Nervous System Tuberculosis

Author: Hulya Tireli, Hakan Erdem, Seniha Senbayrak, Umit Savasci, Gamze Kilicoglu, and Derya Ozturk-Engin
Subjects: Pathology, medicine.medical_specialty, Infectious Diseases, medicine.anatomical_structure, Tuberculosis, Oncology, business.industry, Central nervous system, medicine, Distribution (pharmacology), Tuberculoma, business, medicine.disease
Published: 2016
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29. Managing atypical and typical herpetic central nervous system infections: results of a multinational study

Author: Signe Maj Sørensen, Jean-Paul Stahl, Seher Ayten Coskuner, Pierre Tattevin, Mauro Maresca, Sibel Bolukcu, Oğuz Reşat Sipahi, Rosa Fontana, Lykke Larsen, Xavier Argemi, Lenka Baštáková, Guillaume Béraud, Mario Poljak, Gamze Kilicoglu, Matjaž Jereb, Bruno Baršić, Akram Al-Mahdawi, Nevin Ince, Isik Somuncu Johansen, Filiz Pehlivanoglu, Sylviane Defres, Hasan Karsen, Yasemin Akkoyunlu, Asuman Inan, Souha S. Kanj, Hava Yilmaz, Nazif Elaldi, Elif Sahin-Horasan, Jesper Damsgaard Gunst, Emine Parlak, Hulya Tireli, Hakan Erdem, Anne Lisbeth Bohr, Fatime Korkmaz, Oguz Karabay, Haluk Vahaboglu, Gulden Yilmaz, Ghaydaa A. Shehata, Süheyla Kömür, Stephen L. Leib, Mahtab Chehri, Salih Atakan Nemli, Abdullah Umut Pekok, Sukran Kose, Derya Ozturk-Engin, Seniha Senbayrak, Mehmet Ulug, Gulistan Halac, Mustafa Sunbul, Gonul Sengoz, Selçuk Kaya, Ahmad Sharif-Yakan, Yasemin Cag, Institute of Microbiology and Immunology, Centre d'Investigation Clinique [Rennes] (CIC), Université de Rennes 1 (UR1), Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES)-Hôpital Pontchaillou-Institut National de la Santé et de la Recherche Médicale (INSERM), Service des maladies infectieuses et réanimation médicale [Rennes] = Infectious Disease and Intensive Care [Rennes], CHU Pontchaillou [Rennes], Fonction, structure et inactivation d'ARN bactériens, Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Structure Fédérative de Recherche en Biologie et Santé de Rennes ( Biosit : Biologie - Santé - Innovation Technologique ), Evaluation des technologies de santé et des pratiques médicales - ULR 2694 (METRICS), Centre Hospitalier Régional Universitaire [Lille] (CHRU Lille)-Université de Lille, Centre hospitalier universitaire de Poitiers (CHU Poitiers), Centre Hospitalier Universitaire [Grenoble] (CHU), Cumhuriyet Universitesi, AKKOYUNLU, YASEMİN, Institute of Microbiology and Immunology - Inštitut za mikrobiologijo in imunologijo [Ljubljana, Slovenia], Université de Rennes (UR)-Hôpital Pontchaillou-Institut National de la Santé et de la Recherche Médicale (INSERM), Université de Rennes (UR)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Structure Fédérative de Recherche en Biologie et Santé de Rennes ( Biosit : Biologie - Santé - Innovation Technologique ), Université de Lille-Centre Hospitalier Régional Universitaire [Lille] (CHRU Lille), Ege Üniversitesi, [Cag, Y.] Dr Lutfi Kirdar Training & Res Hosp, Dept Infect Dis & Clin Microbiol, Istanbul, Turkey -- [Erdem, H.] Gulhane Mil Med Acad, Dept Infect Dis & Clin Microbiol, Ankara, Turkey -- [Leib, S.] Univ Bern, Inst Infect Dis, CH-3012 Bern, Switzerland -- [Defres, S.] Univ Liverpool, Inst Infect & Global Hlth, Liverpool L69 3BX, Merseyside, England -- [Defres, S.] Royal Liverpool & Broadgreen Univ Hosp NHS Trust, Trop Infect Dis Unit, Liverpool, Merseyside, England -- [Kaya, S.] Karadeniz Tech Univ, Sch Med, Dept Infect Dis & Clin Microbiol, Trabzon, Turkey -- [Larsen, L. -- Johansen, I. S.] Odense Univ Hosp, Dept Infect Dis Q, Odense, Denmark -- [Poljak, M.] Univ Ljubljana, Inst Microbiol & Immunol, Fac Med, Ljubljana, Slovenia -- [Ozturk-Engin, D. -- Bolukcu, S. -- Inan, A. -- Senbayrak, S.] Haydarpasa Numune Training & Res Hosp, Dept Infect Dis & Clin Microbiol, Istanbul, Turkey -- [Barsic, B.] Univ Zagreb, Dr Fran Mihaljev Univ Hosp Infect Dis, Dept Infect Dis, Sch Med, Zagreb, Croatia -- [Argemi, X.] Nouvel Hop Civil, Dept Infect Dis, Strasbourg, France -- [Sorensen, S. M.] Aalborg Univ Hosp, Dept Infect Dis, Aalborg, Denmark -- [Bohr, A. L.] Rigshosp, Copenhagen Univ Hosp, Inst Inflammat Res, Dept Infect Dis & Rheumatol, Copenhagen, Denmark -- [Tattevin, P.] Univ Hosp Pontchaillou, Dept Infect & Trop Dis, Rennes, France -- [Gunst, J. D.] Aarhus Univ Hosp, Dept Infect Dis, Aarhus, Denmark -- [Bastakova, L.] Masaryk Univ, Fac Hosp Brno, Dept Infect Dis, Fac Med, Brno, Czech Republic -- [Jereb, M.] Univ Med Ctr, Dept Infect Dis, Ljubljana, Slovenia -- [Karabay, O.] Sakarya Univ, Dept Infect Dis & Clin Microbiol, Sch Med, Sakarya, Turkey -- [Pekok, A. U.] Private Erzurum Sifa Hosp, Dept Infect Dis & Clin Microbiol, Erzurum, Turkey -- [Sipahi, O. R.] Ege Univ, Dept Infect Dis & Clin Microbiol, Sch Med, Izmir, Turkey -- [Chehri, M.] Hvidovre Univ Hosp, Dept Infect Dis, Copenhagen, Denmark -- [Beraud, G.] Univ Poitiers Hosp, Dept Infect Dis, Poitiers, France -- [Shehata, G.] Assiut Univ Hosp, Dept Neurol & Psychiat, Assiut, Egypt -- [Fontana, R. -- Maresca, M.] Univ Catania, Infect Dis Sect, Dept Clin & Mol Biomed, Catania, Italy -- [Karsen, H.] Harran Univ, Sch Med, Dept Infect Dis & Clin Microbiol, Sanliurfa, Turkey -- [Sengoz, G. -- Pehlivanoglu, F.] Haseki Training & Res Hosp, Dept Infect Dis & Clin Microbiol, Istanbul, Turkey -- [Sunbul, M. -- Yilmaz, H.] Ondokuz Mayis Univ, Dept Infect Dis & Clin Microbiol, Sch Med, Samsun, Turkey -- [Yilmaz, G.] Ankara Univ, Sch Med, Dept Infect Dis & Clin Microbiol, Ankara, Turkey -- [Sharif-Yakan, A. -- Kanj, S.] Amer Univ Beirut, Med Ctr, Beirut, Lebanon -- [Parlak, E.] Ataturk Univ, Sch Med, Dept Infect Dis & Clin Microbiol, Erzurum, Turkey -- [Korkmaz, F.] Konya Training & Res Hosp, Dept Infect Dis & Clin Microbiol, Konya, Turkey -- [Komur, S.] Cukurova Univ, Sch Med, Dept Infect Dis & Clin Microbiol, Adana, Turkey -- [Kose, S.] Tepecik Training & Res Hosp, Dept Infect Dis & Clin Microbiol, Izmir, Turkey -- [Ulug, M.] Private Umit Hosp, Dept Infect Dis & Clin Microbiol, Eskisehir, Turkey -- [Coskuner, S. A.] Izmir Bozyaka Training & Res Hosp, Dept Infect Dis & Clin Microbiol, Izmir, Turkey -- [Stahl, J. P.] Univ Grenoble 1, Grenoble, France -- [Stahl, J. P.] Univ Hosp Grenoble, Dept Infect Dis, Grenoble, France -- [Ince, N.] Duzce Univ, Dept Infect Dis & Clin Microbiol, Sch Med, Duzce, Turkey -- [Akkoyunlu, Y.] Bezmi Alem Vakif Univ, Sch Med, Dept Infect Dis & Clin Microbiol, Istanbul, Turkey -- [Halac, G.] Bezmi Alem Vakif Univ, Sch Med, Dept Neurol, Istanbul, Turkey -- [Sahin-Horasan, E.] Mersin Univ, Dept Infect Dis & Clin Microbiol, Sch Med, Mersin, Turkey -- [Tireli, H.] Haydarpasa Numune Training & Res Hosp, Dept Neurol, Istanbul, Turkey -- [Kilicoglu, G.] Haydarpasa Numune Training & Res Hosp, Dept Radiol, Istanbul, Turkey -- [Al-Mahdawi, A.] Baghdad Teaching Hosp, Dept Neurol, Baghdad, Iraq -- [Nemli, S. A.] Katip Celebi Univ, Dept Infect Dis & Clin Microbiol, Sch Med, Izmir, Turkey -- [Vahaboglu, H.] Medeniyet Univ, Goztepe Training & Res Hosp, Dept Infect Dis & Clin Microbiol, Istanbul, Turkey -- [Elaldi, N.] Cumhuriyet Univ, Dept Infect Dis & Clin Microbiol, Sch Med, Sivas, Turkey, Ghaydaa, Shehata -- 0000-0002-3631-893X, VAHABOGLU, Haluk -- 0000-0001-8217-1767, Kanj, Souha -- 0000-0001-6413-3396, Beraud, Guillaume -- 0000-0002-4705-0916, Gunst, Jesper -- 0000-0002-3787-0259, Stahl, Jean Paul -- 0000-0002-0086-3557, johansen, isik somuncu -- 0000-0002-2189-9823, Larsen, Lykke -- 0000-0002-4113-4182, Karabay, Oguz -- 0000-0003-0502-432X, OMÜ, Cag, Y, Erdem, H, Leib, S, Defres, S, Kaya, S, Larsen, L, Poljak, M, Ozturk-Engin, D, Barsic, B, Argemi, X, Sorensen, SM, Bohr, AL, Tattevin, P, Gunst, JD, Bastakova, L, Jereb, M, Johansen, IS, Karabay, O, Pekok, AU, Sipahi, OR, Chehri, M, Beraud, G, Shehata, G, Fontana, R, Maresca, M, Karsen, H, Sengoz, G, Sunbul, M, Yilmaz, G, Yilmaz, H, Sharif-Yakan, A, Kanj, S, Parlak, E, Pehlivanoglu, F, Korkmaz, F, Komur, S, Kose, S, Ulug, M, Bolukcu, S, Coskuner, SA, Stahl, JP, Ince, N, Akkoyunlu, Y, Halac, G, Sahin-Horasan, E, Tireli, H, Kilicoglu, G, Al-Mahdawi, A, Nemli, SA, Inan, A, Senbayrak, S, Vahaboglu, H, Elaldi, N, Sakarya Üniversitesi/İlahiyat Fakültesi/Temel İslam Bilimleri Bölümü, Kaya, Süleyman, Karabay, Oğuz, and Çukurova Üniversitesi
Subjects: Male, Pathology, [SDV]Life Sciences [q-bio], encephalitis, Electroencephalography, medicine.disease_cause, Polymerase Chain Reaction, 0302 clinical medicine, Cerebrospinal fluid, 030212 general & internal medicine, Cerebrospinal Fluid, Aged, 80 and over, medicine.diagnostic_test, Atypical presentation, Brain, meningitis, General Medicine, Middle Aged, Magnetic Resonance Imaging, 3. Good health, Infectious Diseases, medicine.anatomical_structure, results of a multinational study-, Clinical Microbiology And Infection, cilt.22, ss.568-569, 2016 [Akkoyunlu Y., Çağ Y., -Managing atypical and typical herpetic central nervous system infections], Female, Presentation (obstetrics), Encephalitis, Adult, Microbiology (medical), medicine.medical_specialty, Adolescent, Central nervous system, Microbiology, Young Adult, 03 medical and health sciences, Internal medicine, medicine, Journal Article, Humans, Aged, Retrospective Studies, managing, Diagnostic Tests, Routine, business.industry, Magnetic resonance imaging, medicine.disease, herpes simplex virus, Herpes simplex virus, Concomitant, DNA, Viral, Encephalitis, Herpes Simplex, business, 030217 neurology & neurosurgery
Abstract: WOS: 000379252100027, PubMed ID: 27085724, There have been many studies pertaining to the management of herpetic meningoencephalitis (HME), but the majority of them have focussed on virologically unconfirmed cases or included only small sample sizes. We have conducted a multicentre study aimed at providing management strategies for HME. Overall, 501 adult patients with PCR-proven HME were included retrospectively from 35 referral centres in 10 countries; 496 patients were found to be eligible for the analysis. Cerebrospinal fluid (CSF) analysis using a PCR assay yielded herpes simplex virus (HSV)-1 DNA in 351 patients (70.8%), HSV-2 DNA in 83 patients (16.7%) and undefined HSV DNA type in 62 patients (12.5%). A total of 379 patients (76.4%) had at least one of the specified characteristics of encephalitis, and we placed these patients into the encephalitis presentation group. The remaining 117 patients (23.6%) had none of these findings, and these patients were placed in the nonencephalitis presentation group. Abnormalities suggestive of encephalitis were detected in magnetic resonance imaging (MRI) in 83.9% of the patients and in electroencephalography (EEG) in 91.0% of patients in the encephalitis presentation group. In the nonencephalitis presentation group, MRI and EEG data were suggestive of encephalitis in 33.3 and 61.9% of patients, respectively. However, the concomitant use of MRI and EEG indicated encephalitis in 96.3 and 87.5% of the cases with and without encephalitic clinical presentation, respectively. Considering the subtle nature of HME, CSF HSV PCR, EEG and MRI data should be collected for all patients with a central nervous system infection. (C) 2016 European Society of Clinical Microbiology and Infectious Diseases. Published by Elsevier Ltd. All rights reserved.
Published: 2016
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30. Hydrocephalus and vasculitis delay therapeutic responses in tuberculous meninigitis: Results of Haydarpasa-III study

Author: Serpil Erol, Canan Agalar, Serkan Oncu, Seniha Senbayrak, Alper Şener, Mihai Nechifor, Gorana Dragovac, Muge Ozguler, Bahar Kandemir, Özcan Deveci, Alexandru Crisan, Rodrigo Hasbun, Nazif Elaldi, Recep Tekin, Gamze Kilicoglu, Hulya Tireli, Kadriye Kart Yaşar, Nurgul Ceran, Aysegul Ulu-Kilic, Oğuz Reşat Sipahi, Gürkan Mert, Derya Ozturk-Engin, Rok Čivljak, Branislava Savic, Katell Andre, Yasemin Cag, Mustafa Namiduru, Mustafa Sunbul, Gonul Sengoz, Oral Oncul, Hakan Erdem, Ayhan Akbulut, Serap Gencer, Selma Alabay, Ayşe Seza Inal, Mucahit Yemisen, Filiz Pehlivanoglu, Olga Dulovic, Asuman Inan, B. Lakatos, Hanefi Cem Gul, Ondokuz Mayıs Üniversitesi, Çukurova Üniversitesi, [Cag, Yasemin] Istanbul Medeniyet Univ, Sch Med, Dept Infect Dis & Clin Microbiol, Istanbul, Turkey -- [Ozturk-Engin, Derya -- Ceran, Nurgul -- Kilicoglu, Gamze -- Tireli, Hulya -- Senbayrak, Seniha -- Inan, Asuman -- Erol, Serpil] Haydarpasa Numune Training & Res Hosp, Dept Infect Dis & Clin Microbiol, Istanbul, Turkey -- [Gencer, Serap] Dr Lutfi Kirdar Training & Res Hosp, Dept Infect Dis & Clin Microbiol, Istanbul, Turkey -- [Hasbun, Rodrigo] Univ Texas Hlth Sci Ctr Houston, Sch Med, Dept Infect Dis, Houston, TX 77030 USA -- [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 -- [Savic, Branislava] Univ Belgrade, Inst Microbiol & Immunol, Natl Reference Lab TB, Fac Med, Belgrade, Serbia -- [Yasar, Kadriye] Bakirkoy Dr Sadi Konuk Training & Res Hosp, Dept Infect Dis & Clin Microbiol, Istanbul, Turkey -- [Inal, Ayse S.] Cukurova Univ, Sch Med, Dept Infect Dis & Clin Microbiol, Adana, Turkey -- [Civljak, Rok] Univ Zagreb, Sch Med, Dr Fran Mihaljev Univ Hosp Infect Dis, Dept Infect Dis, Zagreb, Croatia -- [Tekin, Recep -- Deveci, Ozcan] Dicle Univ, Sch Med, Dept Infect Dis & Clin Microbiol, Diyarbakir, Turkey -- [Elaldi, Nazif] Cumhuriyet Univ, Sch Med, Dept Infect Dis & Clin Microbiol, Sivas, Turkey -- [Ulu-Kilic, Aysegul -- Alabay, Selma] Erciyes Univ, Sch Med, Dept Infect Dis & Clin Microbiol, Kayseri, Turkey -- [Ozguler, Muge -- Akbulut, Ayhan] Firat Univ, Sch Med, Dept Infect Dis & Clin Microbiol, Elazig, Turkey -- [Namiduru, Mustafa] Gaziantep Univ, Sch Med, Dept Infect Dis & Clin Microbiol, Gaziantep, Turkey -- [Sunbul, Mustafa] Ondokuz Mayis Univ, Sch Med, Dept Infect Dis & Clin Microbiol, Samsun, Turkey -- [Sipahi, Oguz R.] Ege Univ, Sch Med, Dept Infect Dis & Clin Microbiol, Izmir, Turkey -- [Dulovic, Olga] Clin Ctr Serbia, Clin Infect & Trop Dis, Belgrade, Serbia -- [Sener, Alper] Onsekiz Mart Univ, Sch Med, Dept Infect Dis & Clin Microbiol, Canakkale, Turkey -- [Lakatos, Botond] St Laszlo Hosp, Dept Infect Dis, Budapest, Hungary -- [Andre, Katell] Dax Hosp, Dept Infect Dis, Dax, France -- [Yemisen, Mucahit] Istanbul Univ, Cerrahpasa Med Sch, Dept Infect Dis & Clin Microbiol, Istanbul, Turkey -- [Oncu, Serkan] Adnan Menderes Univ, Sch Med, Dept Infect Dis & Clin Microbiol, Aydin, Turkey -- [Nechifor, Mihai] Gr T Popa Univ Med & Pharm, Dept Infect Dis, Iasi, Romania -- [Dragovac, Gorana] Univ Novi Sad, IPH Vojvodina, Fac Med, Dept Prevent & Control Dis, Novi Sad, Serbia -- [Gul, Hanefi C. -- Mert, Gurkan -- Erdem, Hakan] Gulhane Mil Med Acad, Dept Infect Dis & Clin Microbiol, Ankara, Turkey -- [Oncul, Oral] Istanbul Univ, Dept Infect Dis & Clin Microbiol, Istanbul Fac Med, Istanbul, Turkey -- [Kandemir, Bahar] Necmettin Erbakan Univ, Sch Med, Dept Infect Dis & Clin Microbiol, Konya, Turkey -- [Agalar, Canan] Fatih Sultan Mehmet Training & Res Hosp, Dept Infect Dis & Clin Microbiol, Istanbul, Turkey, Inal, Ayse Seza -- 0000-0002-1182-7164, Gencer, Serap -- 0000-0002-3217-6305, GENCER, SERAP -- 0000-0002-3217-6305, Civljak, Rok -- 0000-0001-8766-7438, and Kart Yasar, Kadriye -- 0000-0003-2963-4894
Subjects: Vasculitis, medicine.medical_specialty, Pediatrics, Time Factors, Multivariate analysis, Tuberculosis, Antitubercular Agents, Gastroenterology, Tuberculous meningitis, Clinical, 03 medical and health sciences, 0302 clinical medicine, Internal medicine, medicine, Humans, Meningitis, Retrospective Studies, 030203 arthritis & rheumatology, response, business.industry, Response, meningitis, Retrospective cohort study, Prognosis, medicine.disease, Hydrocephalus, Treatment Outcome, tuberculosis, Neurology, Multicenter study, Tuberculosis, Meningeal, Neurology (clinical), business, 030217 neurology & neurosurgery
Abstract: WOS: 000384527500014, PubMed ID: 27625226, Aims: There is no report on the factors affecting the resolution of symptoms related to meningitis during treatment of tuberculous meningitis (TBM). Thus, we examined the factors associated with early therapeutic responses. Materials and Methods: This multicenter study included 507 patients with microbiologically confirmed TBM. However, 94 patients eligible for the analysis were included in this study from 24 centers. Six out of 94 patients died and the statistical analysis was performed with 88 survivors. Early and late responder groups were compared in the statistical analysis. P < 0.05 were considered to show a significant difference. Results: In the multivariate analysis, the presence of vasculitis (P = 0.029, OR = 10.491 [95% CI, 1.27u86.83]) was found to be significantly associated with a delayed fever response whereas hydrocephalus was associated with altered mental status for 9 days duration (P = 0.005, OR = 5.740 [95% CI, 1.68u19.57]). According to linear regression analysis, fever was significantly persisting (7 days) in the presence of vasculitis (17.5 vs. 7, P< 0.001) and hydrocephalus (11 vs. 7, P = 0.029). Hydrocephalus was significantly associated with persisting headache (21 vs. 12, P = 0.025), delayed recovery of consciousness (19.5 vs. 7, P = 0.001), and a delay in complete recovery (21 vs. 14, P = 0.007) in the linear regression analysis. Following institution of treatment, the complaints seemed to disappear in up to 2 weeks among TBM survivors. Conclusions: In the absence of hydrocephalus or vasculitis, one week of anti-tuberculosis treatment seems to be adequate for the resolution of TBM symptoms. Hydrocephalus and vasculitis delay the resolution of TBM symptoms in response to antimycobacterial treatment.
Published: 2016
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31. Neurosyphilis: Results of a Multicentric Infectious Diseases International Research Initiative (ID-IRI) Study

Author: Seniha Senbayrak, Rodrigo Hasbun, Umit Savasci, Hulya Tireli, Derya Ozturk-Engin, and Hakan Erdem
Subjects: 0301 basic medicine, International research, medicine.medical_specialty, business.industry, 030106 microbiology, medicine.disease, Neurosyphilis, 03 medical and health sciences, 0302 clinical medicine, Infectious Diseases, Oncology, Family medicine, medicine, 030212 general & internal medicine, business
Published: 2016
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32. Other Foci of Infections in Community Acquired Central Nervous System Infections

Author: Hakan Erdem, Yasemin Cag, Seniha Senbayrak, Derya Ozturk Engin, Asuman Inan, Umit Savasci, Ergenekon Karagoz, Haluk Vahaboglu, and The IDIRI study group
Subjects: International research, Pediatrics, medicine.medical_specialty, business.industry, Central nervous system, Herpetic meningoencephalitis, medicine.disease, Omics, Tuberculous meningitis, medicine.anatomical_structure, Immunology, medicine, business, Meningitis, Encephalitis, Medical literature
Abstract: The data related to the distribution of other focal infections in central nervous system (CNS) infection patients is inconsistent in medical literature. Infectious Diseases International Research Initiative (ID-IRI) has been carrying on multicenter and multinational studies since 2008 and provided bulk of information on pneumococcal meningitis, brucellar meningitis, tuberculous meningitis, and herpetic meningoencephalitis as the largest case series in the literature. In this study, the databases of ID-IRI studies were reanalyzed and one fourth of pneumococcal and brucellar meningitis patients, and slightly less than half of tuberculous meningitis patients had another focal involvement out of CNS. Herpetic meningoencephalitis had only 7% coexistent other focal involvement. Consequently, the treating clinician should not undervalue the presence of another site of involvement in a CNS infection patient. Hence, diagnostic and therapeutic interventions for other site of involvement in due course of CNS infectious diseases should seriously be taken into consideration.
Published: 2016
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33. 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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34. Predictors for limb loss among patient with diabetic foot infections: an observational retrospective multicentric study in Turkey

Author: Gonul Sengoz, Nazan Tuna, U. Tozalgan, Funda Şimşek, Oguz Karabay, Kadriye Kart Yaşar, Meral Sonmezoglu, Asli Vatan, Fahri Yilmaz, B. Erturk, M. Ozyazar, Onder Ergonul, Fatma Sargin, Serdar Özer, Yasar Kucukardali, Atahan Cagatay, Nurgul Ceran, Hakan Ay, Ayse Batirel, Yasemin Akkoyunlu, Mucahit Yemisen, Filiz Pehlivanoglu, Derya Ozturk Engin, Ayten Kadanali, Lutfiye Mulazimoglu, Haluk Eraksoy, Oral Oncul, Taner Yildirmak, Nuray Uzun, Nail Ozgunes, Oznur Ak, Gül Karagöz, Nese Saltoglu, Turan Aslan, AKKOYUNLU, YASEMİN, Saltoglu, N., Yemisen, M., Ergonul, O., Kadanali, A., Karagoz, G., Batirel, A., Ak, O., Eraksoy, H., Cagatay, A., Vatan, A., Sengoz, G., Pehlivanoglu, F., Aslan, T., Akkoyunlu, Y., Engin, D., Ceran, N., Erturk, B., Mulazimoglu, L., Oncul, O., Ay, H., Sargin, F., Ozgunes, N., Simsek, F., Yildirmak, T., Tuna, N., Karabay, O., Yasar, K., Uzun, N., Kucukardali, Y., Sonmezoglu, M., Yilmaz, F., Tozalgan, U., Ozer, S., and Ozyazar, M.
Subjects: Male, Microbiology (medical), medicine.medical_specialty, Turkey, medicine.medical_treatment, Antimicrobial resistance, Amputation, Surgical, Risk Factors, Diabetes mellitus, Internal medicine, OSTEOMYELITIS, MANAGEMENT, medicine, Humans, EPIDEMIOLOGY, infections, LOWER-EXTREMITY AMPUTATION, Aged, Retrospective Studies, an observational retrospective multicentric study in Turkey-, CLINICAL MICROBIOLOGY AND INFECTION, cilt.21, ss.659-664, 2015 [Saltoglu N., Yemisen M., Ergonul O., KADANALI A., KARAGOZ G., BATIREL A., AK O., Eraksoy H., Cagatay A., Vatan A., et al., -Predictors for limb loss among patient with diabetic foot infections], medicine.diagnostic_test, Vascular disease, business.industry, General Medicine, Middle Aged, medicine.disease, limb loss, Diabetic foot, Gram-negative, Surgery, Infectious Diseases, Amputation, Erythrocyte sedimentation rate, Cellulitis, Etiology, Female, business, diabetic foot, Retinopathy
Abstract: We aimed to investigate the predictors for limb loss among patients with diabetes who have complicated skin/soft-tissue infections. In this observational study, consecutive patients with diabetic foot infection (DFI) from 17 centres in Turkey, between May 2011 and May 2013 were included. The Turkish DFI Working Group performed the study. Predictors of limb loss were investigated by multivariate analysis. In total, 455 patients with DFI were included. Median age was 61 years, 68% were male, 65% of the patients were hospitalized, 52% of the patients had used antibiotics within the last month, and 121(27%) had osteomyelitis. Of the 208 microorganisms isolated, 92 (44.2%) were Gram-positive cocci and 114 (54.8%) were Gram-negative rods (GNR). The most common GNR was Pseudomonas; the second was Escherichia coli, with extended spectrum beta-lactamase positivity of 33%. Methicillin-resistant Staphylococcus species were found in 14% (29/208). Amputations were performed in 126/455 (28%) patients, 44/126 (34%) of these were major amputations. In multivariate analysis, significant predictors for limb loss were, male gender (OR 1.75, 95% Cl 1.04-2.96, p 0.034), duration of diabetes >20 years (OR 1.9, 95% Cl 1.18-3.11, p 0.008), infected ulcer versus cellulitis (OR 1.9, 95% Cl 1.11-3.18, p 0.019), history of peripheral vascular disease (OR 2, 95% Cl 1.26-3.27, p 0.004), retinopathy (OR 2.25, 95% Cl 1.19-4.25, p 0.012), erythrocyte sedimentation rate >70 mm/hr (OR 1.6, 95% Cl 1.01-2.68, p 0.05), and infection with GNR (OR 1.8, 95% Cl 1.08-3.02, p 0.02). Multivariate analysis revealed that, besides the known risk factors such as male gender, duration of diabetes >20 years, infected ulcers, history of peripheral vascular disease and retinopathy, detection of GNR was a significant predictor of limb loss. Clinical Microbiology and Infection (C) 2015 European Society of Clinical Microbiology and Infectious Diseases. Published by Elsevier Ltd. All rights reserved.
Published: 2015

35. Results of a multinational study suggest the need for rapid diagnosis and early antiviral treatment at the onset of herpetic meningoencephalitis

Author: Pierre Tattevin, Salih Atakan Nemli, Hasan Karsen, Mustafa Sunbul, Rosa Fontana Del Vecchio, Akram Al-Mahdawi, Mahtab Chehri, Süheyla Kömür, Sylviane Defres, Bruno Baršić, Signe Maj Sørensen, Seniha Senbayrak, Ghaydaa A. Shehata, Nevin Ince, Abdullah Umut Pekok, Selçuk Kaya, Yasemin Akkoyunlu, Gulden Yilmaz, Jean-Paul Stahl, Lykke Larsen, Lenka Baštáková, Gonul Sengoz, Jesper Damsgaard Gunst, Guillaume Béraud, Emine Parlak, Hakan Erdem, Sukran Kose, Oğuz Reşat Sipahi, Hava Yilmaz, Filiz Pehlivanoglu, Xavier Argemi, Asuman Inan, Hulya Tireli, Haluk Vahaboglu, Elif Sahin-Horasan, Souha S. Kanj, Gamze Kilicoglu, Fatime Korkmaz, Anne Lisbeth Bohr, Oguz Karabay, Mehmet Ulug, Gulistan Halac, Derya Ozturk-Engin, Seher Ayten Coskuner, Mario Poljak, Mauro Maresca, Sibel Bolukcu, Ahmad Sharif-Yakan, Yasemin Cag, Isik Somuncu Johansen, Matjaž Jereb, Ege Üniversitesi, AKKOYUNLU, YASEMİN, Erdem, H, Cag, Y, Ozturk-Engin, D, Defres, S, Kaya, S, Larsen, L, Poljak, M, Barsic, B, Argemi, X, Sorensen, SM, Bohr, AL, Tattevin, P, Gunst, JD, Bastakova, L, Jereb, M, Johansen, IS, Karabay, O, Pekok, AU, Sipahi, OR, Chehri, M, Beraud, G, Shehata, G, Del Vecchio, RF, Maresca, M, Karsen, H, Sengoz, G, Sunbul, M, Yilmaz, G, Yilmaz, H, Sharif-Yakan, A, Kanj, SS, Parlak, E, Pehlivanoglu, F, Korkmaz, F, Komur, S, Kose, S, Ulug, M, Bolukcu, S, Coskuner, SA, Ince, N, Akkoyunlu, Y, Halac, G, Sahin-Horasan, E, Tireli, H, Kilicoglu, G, Al-Mandawi, A, Nemli, SA, Inan, A, Senbayrak, S, Stahl, JP, Vahaboglu, H, Sakarya Üniversitesi/İlahiyat Fakültesi/Temel İslam Bilimleri Bölümü, Kaya, Süleyman, Karabay, Oğuz, Çukurova Üniversitesi, and OMÜ
Subjects: Adult, Male, medicine.medical_specialty, Referral, Antiviral Agents, Internal medicine, medicine, ERDEM H., CAG Y., OZTURK-ENGIN D., Defres S., KAYA S., LARSEN L., POLJAK M., BARSIC B., ARGEMI X., SORENSEN S. M. , et al., -Results of a Multinational Study Suggest the Need for Rapid Diagnosis and Early Antiviral Treatment at the Onset of Herpetic Meningoencephalitis-, ANTIMICROBIAL AGENTS AND CHEMOTHERAPY, cilt.59, ss.3084-3089, 2015, Confidence Intervals, Humans, Pharmacology (medical), Pharmacology & Pharmacy, Antiviral treatment, Retrospective Studies, Pharmacology, business.industry, Herpetic meningoencephalitis, Glasgow Coma Scale, Retrospective cohort study, Odds ratio, Middle Aged, medicine.disease, Confidence interval, 3. Good health, Surgery, Infectious Diseases, Treatment Outcome, Female, Encephalitis, Herpes Simplex, business, Encephalitis
Abstract: WOS: 000358623200015, PubMed ID: 25779579, Data in the literature regarding the factors that predict unfavorable outcomes in adult herpetic meningoencephalitis (HME) cases are scarce. We conducted a multicenter study in order to provide insights into the predictors of HME outcomes, with special emphasis on the use and timing of antiviral treatment. Samples from 501 patients with molecular confirmation from cerebrospinal fluid were included from 35 referral centers in 10 countries. Four hundred thirty-eight patients were found to be eligible for the analysis. Overall, 232 (52.9%) patients experienced unfavorable outcomes, 44 died, and 188 survived, with sequelae. Age (odds ratio [OR], 1.04; 95% confidence interval [CI], 1.02 to 1.05), Glasgow Coma Scale score (OR, 0.84; 95% CI, 0.77 to 0.93), and symptomatic periods of 2 to 7 days (OR, 1.80; 95% CI, 1.16 to 2.79) and >7 days (OR, 3.75; 95% CI, 1.72 to 8.15) until the commencement of treatment predicted unfavorable outcomes. The outcome in HME patients is related to a combination of therapeutic and host factors. This study suggests that rapid diagnosis and early administration of antiviral treatment in HME patients are keys to a favorable outcome.
Published: 2015
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36. Antibiotic use and cost in a teaching hospital in İstanbul

Author: Seniha Senbayrak Akcay, Ozgur Dagli, Asuman Inan, Derya Ozturk Engin, Seyfi Özyürek, and Emin Karagül
Subjects: Carat, Pediatrics, medicine.medical_specialty, medicine.drug_class, business.industry, Antibiotics, lcsh:QR1-502, Pharmaceutical Science, Odds ratio, Appropriate use, Confidence interval, lcsh:Microbiology, Teaching hospital, Antibiotics,rational use,cost, Surgical prophylaxis, Complementary and alternative medicine, Internal medicine, cost, medicine, rational use, Pharmacology (medical), Antibiotic use, business
Abstract: Objectives: The aims of this study were to determine the usage patterns and the cost of antibiotics, along with the evaluation of the effects of infectious diseases (ID) specialists on appropriate antimicrobial use in hospitalized patients. Materials and methods: A one-day, cross-sectional study was conducted in a major tertiary hospital and data on the use of antibiotics were collected by using a standard form. The appropriateness of the antibiotic usage was evaluated using the Council for Appropriate and Rational Antibiotic Therapy (CARAT) criteria; and the consumption and daily cost of antibiotics were determined. Results: On the study day, antibiotics were prescribed in 199 (35.6%) of 553 hospitalized patients, in 109 (32.9%) on the surgical and 90 patients (40.5%) on the medical wards. The total empirical antibiotic use was more frequent (49.7%) than prophylactic (29.1%) and culture-based therapy (21.2%). In 44 patients (22.1%) the antibiotics were used inappropriately; any of these antibiotics needed the approval of ID specialist. The inappropriate usage was more common in prophylactic therapy (46.5%) than empirical (16.1%) and specific antibiotic administration (2.3%). ID consultation rates were significantly higher in the appropriate antibiotic administrations (69.6%) than in the inappropriate group [(6.8%, p
Published: 2015

37. High-level resistance to aminoglycoside, vancomycin, and linezolid in enterococci strains

Author: Gulcin Baldir, Asuman Inan, Metin Kucukercan, Derya Ozturk Engin, Seniha Senbayrak Akcay, Seyfi Özyürek, and Sebahat Aksaray
Subjects: Enterococcus avium, vancomycin, lcsh:QR1-502, Pharmaceutical Science, linezolid, Enterococcus spp.,vancomycin,linezolid,aminoglycoside,resistance, Enterococcus faecalis, lcsh:Microbiology, Microbiology, Enterococcus spp,vankomisin,linezolid,aminoglikozid,direnç, resistance, chemistry.chemical_compound, Health Care Sciences and Services, medicine, Pharmacology (medical), Sağlık Bilimleri ve Hizmetleri, biology, Teicoplanin, Enterococcus spp, biochemical phenomena, metabolism, and nutrition, bacterial infections and mycoses, biology.organism_classification, Enterococcus durans, Complementary and alternative medicine, chemistry, Streptomycin, Linezolid, Vancomycin, aminoglycoside, medicine.drug, Enterococcus faecium
Abstract: Amaç: Bu çalışmada, enterokok suşlarının antibiyotik duyarlılık oranlarının saptanması, vankomisin duyarlı enterokok (VSE) ve vankomisin dirençli enterokok (VRE) suşlarındaki yüksek düzey aminoglikozid direncinin karşılaştırılması amaçlandı. Yöntemler: Haydarpaşa Numune Eğitim ve Araştırma Hastanesi kliniklerinden gönderilen örneklerden, laboratuvarımızda izole edilen 100 adet VRE, 100 adet VSE suşu çalışma kapsamına alındı.Bulgular: VRE suşlarının tümü Enterococcus faecium olarak tanımlanmış olup, VSE suşlarının ise %53’ü Enterococcus faecalis, %42’si E. faecium, %3’ü Enterococcus durans, %2’si Enterococcus avium olarak tespit edildi. VRE suşlarının tümünde yüksek düzey vankomisin direnci (MİK, >256 µg/ml) belirlendi, teikoplanin MİK değerleri incelendiğinde beş suş orta duyarlı (MİK, 16µg/ml), 95 suş dirençli (MİK, >32 µg/ml) olarak saptandı. VRE suşlarından biri linezolid dirençli (MİK, 12 µg/ml), biri ise orta duyarlı (MİK, 4 µg/ml) olarak saptandı, diğer suşlar duyarlı (MİK, Objective: This study sought to identify antibiotic susceptibility rates of enterococcal strains, and to compare the high-level resistance to aminoglycosides (HLAR) in vancomycin-sensitive enterococcal species (VSE) and vancomycin-resistant enterococcal species (VRE). Materials and Methods: The study included 100 VRE and 100 VSE strains recovered from the samples sent to laboratory from various departments of Haydarpasa Numune Training and Research Hospital. Results: All VRE strains were defined as Enterococcus faecium, although of the VSE strains, 53% were identified to be as Enterococcus faecalis, 42% E. faecium, 3% Enterococcus durans, and 2% Enterococcus avium. High-level resistance to vancomycin (MIC, >256 µg/ml) was determined in all VRE strains and when analyzing MIC values for teicoplanin, five strains were found to be moderately susceptible (MIC, 16 µg/ml) and 95 strains were resistant (MIC, >32 µg/ml). Of the VRE strains, one was linezolid-resistant (MIC, 12 µg/ml) and the other was intermediately susceptible (MIC, 4 µg/ml) and remainders were evaluated to be susceptible (MIC
Published: 2015

38. 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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39. Comparison of colistin monotherapy and non-colistin combinations in the treatment of multi-drug resistant Acinetobacter spp. bloodstream infections: A Multicenter retrospective analysis

Author: Tumer Guven, Nilgün Altın, Serife Akalin, Nefise Oztoprak, Derya Ozturk Engin, Salih Hosoglu, Davut Ozdemir, Fatma Aybala Altay, N. Turker, Aysegul Ulu Kilic, Ibak Gonen, Aygul Dogan Celik, Vedat Turhan, Oguz Karabay, Salih Cesur, Ozlem Alici, Bülent Durdu, Mustafa Dogan, Ilker Inanc Balkan, Nural Bekiroglu, Canan Agalar, Ferhat Arslan, Emine Alp, Mustafa Kasim Karahocagil, Fazilet Duygu, Serdar Özer, Ayse Batirel, Bahar Ormen, Ertugrul Guclu, Nurbanu Sezak, Turan Aslan, Aynur Engin, Cigdem Ataman Hatipoglu, Hava Yilmaz, DURDU, BÜLENT, [Balkan, Ilker Inanc] Istanbul Univ, Cerrahpasa Med Fac, Istanbul, Turkey -- [Batirel, Ayse -- Ozer, Serdar] Kartal Dr Lutfi Kirdar Educ & Res Hosp, Istanbul, Turkey -- [Agalar, Canan -- Alici, Ozlem] Fatih Sultan Mehmet Educ & Res Hosp, Istanbul, Turkey -- [Arslan, Ferhat] Istanbul Medipol Univ, Fac Med, Istanbul, Turkey -- [Aslan, Turan] Bezmi Alem Univ, Fac Med, Istanbul, Turkey -- [Engin, Derya Ozturk] Haydarpasa Numune Educ & Res Hosp, Istanbul, Turkey -- [Bekiroglu, Nural] Marmara Univ, Fac Med, Istanbul, Turkey -- [Durdu, Bulent] Bakirkoy Sadi Konuk Educ & Res Hosp, Istanbul, Turkey -- [Turhan, Vedat] GATA Haydarpasa Educ & Res Hosp, Istanbul, Turkey -- [Karabay, Oguz -- Guciu, Ertugrul] Sakarya Univ, Fac Med, Sakarya, Turkey -- [Akalin, Serife] Pamukkale Univ, Fac Med, Denizli, Turkey -- [Alp, Emine -- Kilic, Aysegul Ulu] Erciyes Univ, Fac Med, Kayseri, Turkey -- [Altay, Fatma Aybala] Diskapi Educ & Res Hosp, Ankara, Turkey -- [Altin, Nilgun -- Cesur, Salih] Ankara Etlik Educ & Res Hosp, Ankara, Turkey -- [Celik, Aygul Dogan] Trakya Univ, Fac Med, Edirne, Turkey -- [Dogan, Mustafa] Namik Kemal Univ, Fac Med, Tekirdag, Turkey -- [Duygu, Fazilet] Gaziosmanpasa Univ, Fac Med, Tokat, Turkey -- [Engin, Aynur] Cumhuriyet Univ, Fac Med, Sivas, Turkey -- [Gonen, Ibak] Suleyman Demirel Univ, Fac Med, TR-32200 Isparta, Turkey -- [Guven, Tumer] Ankara Ataturk Educ & Res Hosp, Ankara, Turkey -- [Hatipogiu, Cigdem Ataman] Ankara Educ & Res Hosp, Ankara, Turkey -- [Hosoglu, Salih] Dicle Univ, Fac Med, Diyarbakir, Turkey -- [Karahocagil, Mustafa Kasim] Yuzuncu Yil Univ, Fac Med, Van, Turkey -- [Ormen, Bahar] Izmir Ataturk Educ & Res Hosp, Izmir, Turkey -- [Ozdemir, Davut -- Sezak, Nurbanu -- Turker, Nesrin] Duzce Univ, Educ & Res Hosp, Duzce, Turkey -- [Oztoprak, Nefise] Antalya Educ & Res Hosp, Antalya, Turkey -- [Yilmaz, Hava] Ondokuz Mayis Univ, Fac Med, Samsun, Turkey, Durdu, Bulent -- 0000-0002-0244-4006, Karabay, Oguz -- 0000-0003-0502-432X, altay, fatma aybala -- 0000-0002-7149-2968, OMÜ, Balkan, Ilker Inanc, Batirel, Ayse, Karabay, Oguz, Agalar, Canan, Akalin, Serife, Alici, Ozlem, Alp, Emine, Altay, Fatma Aybala, Altin, Nilgun, Arslan, Ferhat, Aslan, Turan, Bekiroglu, Nural, Cesur, Salih, Celik, Aygul Dogan, Dogan, Mustafa, Durdu, Bulent, Duygu, Fazilet, Engin, Aynur, Engin, Derya Ozturk, Gonen, Ibak, Guciu, Ertugrul, Guven, Tumer, Hatipogiu, Cigdem Ataman, Hosoglu, Salih, Karahocagil, Mustafa Kasim, Kilic, Aysegul Ulu, Ormen, Bahar, Ozdemir, Davut, Ozer, Serdar, Oztoprak, Nefise, Sezak, Nurbanu, Turhan, Vedat, Turker, Nesrin, Yilmaz, Hava, Balkan, II, Batirel, A, Karabay, O, Agalar, C, Akalin, S, Alici, O, Alp, E, Altay, FA, Altin, N, Arslan, F, Aslan, T, Bekiroglu, N, Cesur, S, Celik, AD, Dogan, M, Durdu, B, Duygu, F, Engin, A, Engin, DO, Gonen, I, Guciu, E, Guven, T, Hatipogiu, CA, Hosoglu, S, Karahocagil, MK, Kilic, AU, Ormen, B, Ozdemir, D, Ozer, S, Oztoprak, N, Sezak, N, Turhan, V, Turker, N, Yilmaz, H, Sakarya Üniversitesi/Tıp Fakültesi/Dahili Tıp Bilimleri Bölümü, Karabay, Oğuz, and Güçlü, Ertuğrul
Subjects: Male, Kaplan Meier method, Turkey, retrospective study, proportional hazards model, Antibiotics, Bacteremia, Comorbidity, Tertiary Care Centers, middle aged, chi square distribution, Pharmacology (medical), colistin, comparative study, APACHE, Aged, 80 and over, OUTCOMES, Acinetobacter/*drug effects/pathogenicity, Acinetobacter Infections/*drug therapy/microbiology/mortality, Adolescent, Adult, Aged, Anti-Bacterial Agents/adverse effects/*therapeutic use, Bacteremia/*drug therapy/microbiology/mortality, Chi-Square Distribution, Colistin/adverse effects/*therapeutic use, Drug Resistance, Multiple, Bacterial, Drug Therapy, Combination, Female, Humans, Kaplan-Meier Estimate, Length of Stay, Middle Aged, Multivariate Ana, adult, Remission Induction, Appropriate, clinical trial, ANTIMICROBIAL THERAPY, multi drug resistant Acinetobacter spp, antiinfective agent, Pitt bacteremia score, aged, Impact, multivariate analysis, Sulbactam, risk factor, monotherapy, pathogen clearance, Baumannii Bacteremia, hospitalization, Acinetobacter Infections, medicine.medical_specialty, bloodstream infection, Article, multidrug resistance, multidrug resistant Acinetobacter bloodstream infection, human, treatment failure, Retrospective Studies, Pharmacology, Proportional hazards model, microbiology, medicine.disease, major clinical study, mortality, disease assessment, drug efficacy, multicenter study, RISK-FACTORS, TIGECYCLINE, Colistin, Acinetobacter infection, Pediatrics, BAUMANNII BACTEREMIA, Time Factors, IMPACT, very elderly, Critically-Ill Patients, Turkey (republic), Risk Factors, time factor, Risk-Factors, pathogenicity, Pharmacology & Pharmacy, Univariate analysis, biology, Acinetobacter, MATCHED COHORT, Anti-Bacterial Agents, Blood stream infection, female, Treatment Outcome, young adult, tertiary care center, CRITICALLY-ILL PATIENTS, Charlson Comorbidity Index, medicine.drug, Research Article, combination drug therapy, medicine.drug_class, Outcomes, Young Adult, remission, length of stay, Internal medicine, Gram-Negative Bacteria, medicine, follow up, controlled study, GRAM-NEGATIVE BACTERIA, A Multicenter retrospective analysis-, INDIAN JOURNAL OF PHARMACOLOGY, cilt.47, ss.95-100, 2015 [Balkan I. I. , BATIREL A., Karabay O., AGALAR C., Akalin S., ALICI O., Alp E., ALTAY F. A. , ALTIN N., Arslan F., et al., -Comparison of colistin monotherapy and non-colistin combinations in the treatment of multi-drug resistant Acinetobacter spp. bloodstream infections], Proportional Hazards Models, Antimicrobial Therapy, business.industry, Retrospective cohort study, Multi drug resistant Acinetobacter spp, biology.organism_classification, drug effects, Multivariate Analysis, business
Abstract: WOS: 000349144300018, PubMed ID: 25821319, Objectives: To compare the efficacy of colistin (COL) monotherapy versus non-COL based combinations in the treatment of bloodstream infections (BSIs) due to multidrug resistant Acinetobacter spp.(MDR-A) . Materials and Methods: Retrospective data of 107 MDR-A BSI cases from 27 tertiary centers in Turkey were included. Primary End-Point: 14-day mortality. Secondary End-Points: Microbial eradication and clinical improvement. Results: Thirty-six patients in the COL monotherapy (CM) group and 71 in the non-COL based combinations (NCC) group were included in the study. Mean age was 59.98 20 years (range: 18-89) and 50.5% were male. Median duration of follow-up was 40 days (range: 9-297). The 14-day survival rates were 52.8% in CM and 47.23% in NCC group (P = 0.36). Microbiological eradication was achieved in 69% of CM and 83% of NCC group (P = 0.13). Treatment failure was detected in 22.9% of cases in both CM and NCC groups. Univariate analysis revealed that mean age (P = 0.001), Charlson comorbidity index (P = 0.03), duration of hospital stay before MDR-A BSI (P = 0.04), Pitt bacteremia score (P = 0.043) and Acute Physiology and Chronic Health Evaluation II score (P = 0.05) were significant in terms of 14-day mortality. Advanced age (P = 0.01) and duration of hospital stay before MDR-A BSI (P = 0.04) were independently associated with 14-day mortality in multivariate analysis. Conclusion: No significant difference was detected between CM and non-COL based combinations in the treatment of MDR-A BSIs in terms of efficacy and 14-day mortality.
Published: 2015

40. Risk Factors and Seroprevalence of Hepatitis B, C, and D Virus in Hemodialysis Patients in Istanbul

Author: İnci Alp, Derya Ozturk Engin, Nurgul Ceran, Naz Oğuzoğlu, Nazım Denizli, Asuman Inan, and Seyfi Özyürek
Subjects: Microbiology (medical), Hemodialysis patients, HBsAg, viruses, Hepatitis C virus, medicine.medical_treatment, lcsh:Medicine, medicine.disease_cause, Virus, lcsh:Infectious and parasitic diseases, medicine, risk factors, lcsh:RC109-216, Hepatitis B virus, General Immunology and Microbiology, seroprevalence, Transmission (medicine), business.industry, lcsh:R, virus diseases, Hepatitis B, medicine.disease, Virology, digestive system diseases, Infectious Diseases, Hepatitis D virus, Hemodialysis, hepatitis B, hepatitis C, business
Abstract: Introduction: Hemodialysis units pose a risk for transmission of hepatitis viruses. In this study, we aimed to detect the prevalence of hepatitis B virus (HBV), hepatitis C virus (HCV), and hepatitis D virus (HDV) in our hospital’s hemodialysis unit and to determine the risk factors for transmission of hepatitis viruses. Materials and Methods: In Haydarpasa Numune Training and Research Hospital Hemodialysis Unit, hepatitis B surface antigen (HBsAg), hepatitis B core IgG antibody (anti-HBcIgG), hepatitis B surface antibody (anti-HBs), antibody to hepatitis C virus (anti- HCV), and anti-delta total were studied by enzyme-linked immunosorbent assay (ELISA) method in the serum samples of 50 hemodialysis patients. Risk factors for transmission of hepatitis virus were identified in hemodialysis patients. As a control group, 50 healthy individuals were included. Result: In hemodialysis patients, HBsAg was determined as 6% and anti-HCV as 28%, whereas anti-HDV positivity was not detected. HBsAg, anti-HBcIgG, and anti-HBs frequencies did not show statistically significant differences between the two groups, while anti-HCV frequency was found to be significantly higher in hemodialysis patients (p= 0.001). The mean age of HBsAg-positive hemodialysis patients was found significantly lower than that of HBsAg-negative hemodialysis patients (p= 0.045). Similarly, anti-HCV-positive hemodialysis patients had a statistically lower mean age compared to anti-HCV-negative hemodialysis patients (p< 0.004). Increase in hemodialysis duration and amount of blood transfusion were shown statistically to not affect anti-HBcIgG positivity. Anti-HCV positivity was found statistically significantly higher in patients undergoing hemodialysis for more than 10 years (p= 0.003). Conclusion: In hemodialysis patients, transmission of hepatitis viruses will decrease with promotion of the use of erythropoietin instead of blood transfusion and implementation of alternative methods of dialysis.
Published: 2014

41. Unusual central nervous system involvement of rheumatoid arthritis: successful treatment with steroid and azathioprine

Author: Derya Ozturk Engin, Ilknur Erdem, Seyfi Özyürek, Seval Pehlevan Masatlıoğlu, and Asuman Inan
Subjects: Male, medicine.medical_specialty, Prednisolone, Immunology, Arthritis, Azathioprine, Gastroenterology, Arthritis, Rheumatoid, Rheumatology, Central Nervous System Diseases, Internal medicine, Biopsy, medicine, Humans, Immunology and Allergy, Rheumatoid factor, Meningitis, Aseptic, Glucocorticoids, Aged, medicine.diagnostic_test, business.industry, medicine.disease, Antirheumatic Agents, Rheumatoid arthritis, Drug Therapy, Combination, business, Meningitis, medicine.drug
Abstract: Central nervous system involvement of rheumatoid arthritis (RA) frequently develops in patients who had a long-term history of RA, irrespective of the disease activity of systemic arthritis, and it has a high mortality rate despite treatment. Since clinical symptoms and radiologic signs are rather nonspecific, in short of doing biopsy, the diagnosis of rheumatoid meningitis is one of exclusion. However, the strongly positive rheumatoid factor in the cerebrospinal fluid is quite specific. We here report a 70-year-old man who had not been diagnosed as RA before he was admitted with neurological findings, who was diagnosed as RA later and successfully treated with prednisolone and azathioprine.
Published: 2009
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42. The interrelations of radiologic findings and mechanical ventilation in community acquired pneumonia patients admitted to the intensive care unit: a multicentre retrospective study

Author: Gokay Gungor, Aykut Cilli, Ahmet Karakaş, Hulya Turkan, Oral Oncul, Dilek Özcengiz, Nalan Adiguzel, Asuman Inan, Özcan Erdemli, Hakan Leblebicioglu, Ömer Yilmaz, Ozgur Senturk, Zeliha Kocak-Tufan, Nefise Oztoprak, Hayati Bilgiç, Aygul Dogan-Celik, Zuhal Karakurt, Yakup Tomak, Gulden Yilmaz, Derya Ozturk-Engin, Ünase Büyükkoçak, Canturk Tasci, Sibel Temur, Hakan Erdem, Demet Tok, Fatma Yilmaz-Karadag, Ozlem Yazicioglu-Mocin, Hafize Oksuz, Kırıkkale Üniversitesi, Erdem, H., Kocak-Tufan, Z., Yilmaz, O., Karakurt, Z., Cilli, A., Turkan, H., Leblebicioglu, H., Yeditepe Üniversitesi, Çukurova Üniversitesi, Erdem, H, Kocak-Tufan, Z, Yilmaz, O, Karakurt, Z, Cilli, A, Turkan, H, Yazicioglu-Mocin, O, Adiguzel, N, Gungor, G, Tasci, C, Yilmaz, G, Oncul, O, Dogan-Celik, A, Erdemli, O, Oztoprak, N, Tomak, Y, Inan, A, Tok, D, Temur, S, Oksuz, H, Senturk, O, Buyukkocak, U, Yilmaz-Karadag, F, Ozturk-Engin, D, Ozcengiz, D, Karakas, A, Bilgic, H, Leblebicioglu, H, Sakarya Üniversitesi/Tıp Fakültesi/Cerrahi Tıp Bilimleri Bölümü, Tomak, Yakup, and Maltepe Üniversitesi
Subjects: Adult, Male, Microbiology (medical), medicine.medical_specialty, Adolescent, Thoracic, medicine.medical_treatment, MEDLINE, Imaging, law.invention, Young Adult, Community-acquired pneumonia, law, Radiography, Pneumoniae, Critical care, Intensive care, medicine, Humans, Young adult, Intensive care medicine, Lung, Aged, Retrospective Studies, Aged, 80 and over, Mechanical ventilation, business.industry, Research, Retrospective cohort study, Pneumonia, General Medicine, Middle Aged, medicine.disease, Respiration, Artificial, Intensive care unit, respiratory tract diseases, Community-Acquired Infections, Intensive Care Units, Infectious Diseases, Female, Radiography, Thoracic, Tomography, X-Ray Computed, business
Abstract: WOS: 000330050000001, PubMed ID: 24400646, Background: We evaluated patients admitted to the intensive care units with the diagnosis of community acquired pneumonia (CAP) regarding initial radiographic findings. Methods: A multicenter retrospective study was held. Chest x ray (CXR) and computerized tomography (CT) findings and also their associations with the need of ventilator support were evaluated. Results: A total of 388 patients were enrolled. Consolidation was the main finding on CXR (89%) and CT (80%) examinations. Of all, 45% had multi-lobar involvement. Bilateral involvement was found in 40% and 44% on CXR and CT respectively. Abscesses and cavitations were rarely found. The highest correlation between CT and CXR findings was observed for interstitial involvement. More than 80% of patients needed ventilator support. Noninvasive mechanical ventilation (NIV) requirement was seen to be more common in those with multi-lobar involvement on CXR as 2.4-fold and consolidation on CT as 47-fold compared with those who do not have these findings. Invasive mechanical ventilation (IMV) need increased 8-fold in patients with multi-lobar involvement on CT. Conclusion: CXR and CT findings correlate up to a limit in terms of interstitial involvement but not in high percentages in other findings. CAP patients who are admitted to the ICU are severe cases frequently requiring ventilator support. Initial CT and CXR findings may indicate the need for ventilator support, but the assumed ongoing real practice is important and the value of radiologic evaluation beyond clinical findings to predict the mechanical ventilation need is subject for further evaluation with large patient series.
Published: 2014
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43. Comparison of colistin-carbapenem, colistin-sulbactam, and colistin plus other antibacterial agents for the treatment of extremely drug-resistant Acinetobacter baumannii bloodstream infections

Author: Turan Aslan, Cigdem Ataman Hatipoglu, Emine Alp, S. Cesur, Davut Ozdemir, N. Turker, Nilgün Altın, Ertugrul Guclu, Aysegul Ulu Kilic, Ilker Inanc Balkan, Salih Hosoglu, Nurbanu Sezak, Hava Yilmaz, Nefise Oztoprak, Tumer Guven, Serdar Özer, Bahar Ormen, Ayse Batirel, Derya Ozturk Engin, Aynur Engin, Ozlem Alici, Nuray Bekiroglu, Fazilet Duygu, Canan Agalar, Ibak Gonen, Mustafa Kasim Karahocagil, Oguz Karabay, Aygul Dogan Celik, Serife Akalin, Bülent Durdu, Mustafa Dogan, Ferhat Arslan, Fatma Aybala Altay, Vedat Turhan, Ondokuz Mayıs Üniversitesi, [Batirel, A. -- Ozer, S.] Kartal Dr Lutfi Kirdar Educ & Res Hosp, TR-34890 Istanbul, Turkey -- [Balkan, I. I.] Istanbul Univ, Cerrahpasa Med Fac, Istanbul, Turkey -- [Karabay, O. -- Guclu, E.] Sakarya Univ, Fac Med, Sakarya, Turkey -- [Agalar, C. -- Alici, O.] Fatih Sultan Mehmet Educ & Res Hosp, Istanbul, Turkey -- [Akalin, S.] Pamukkale Univ, Fac Med, Denizli, Turkey -- [Alp, E. -- Kilic, A. U.] Erciyes Univ, Fac Med, Kayseri, Turkey -- [Altay, F. A.] Diskapi Educ & Res Hosp, Ankara, Turkey -- [Altin, N. -- Cesur, S.] Ankara Etlik Educ & Res Hosp, Ankara, Turkey -- [Arslan, F.] Istanbul Medipol Univ, Fac Med, Istanbul, Turkey -- [Aslan, T.] Bezmi Alem Univ, Fac Med, Istanbul, Turkey -- [Bekiroglu, N.] Marmara Univ, Fac Med, Istanbul, Turkey -- [Celik, A. D.] Trakya Univ, Fac Med, Edirne, Turkey -- [Dogan, M.] Namik Kemal Univ, Fac Med, Tekirdag, Turkey -- [Durdu, B.] Bakirkoy Sadi Konuk Educ & Res Hosp, Istanbul, Turkey -- [Duygu, F.] Gaziosmanpasa Univ, Fac Med, Tokat, Turkey -- [Engin, A.] Cumhuriyet Univ, Fac Med, Sivas, Turkey -- [Engin, D. O.] Haydarpasa Numune Educ & Res Hosp, Istanbul, Turkey -- [Gonen, I.] Suleyman Demirel Univ, Fac Med, TR-32200 Isparta, Turkey -- [Guven, T.] Ankara Ataturk Educ & Res Hosp, Ankara, Turkey -- [Hatipoglu, C. A.] Ankara Educ & Res Hosp, Ankara, Turkey -- [Hosoglu, S.] Dicle Univ, Fac Med, Diyarbakir, Turkey -- [Karahocagil, M. K.] Yuzuncu Yil Univ, Fac Med, Van, Turkey -- [Ormen, B.] Izmir Ataturk Educ & Res Hosp, Izmir, Turkey -- [Ozdemir, D. -- Sezak, N. -- Turker, N.] Duzce Univ, Educ & Res Hosp, Duzce, Turkey -- [Oztoprak, N.] Antalya Educ & Res Hosp, Antalya, Turkey -- [Turhan, V.] GATA Haydarpasa Educ & Res Hosp, Istanbul, Turkey -- [Yilmaz, H.] Ondokuz Mayis Univ, Fac Med, Samsun, Turkey, altay, fatma aybala -- 0000-0002-7149-2968, Karabay, Oguz -- 0000-0003-0502-432X, Durdu, Bulent -- 0000-0002-0244-4006, and DURDU, BÜLENT
Subjects: Acinetobacter baumannii, Male, retrospective study, Bacteremia, intensive care unit, law.invention, meropenem, amikacin, neurotoxicity, middle aged, colistin, comparative study, health care economics and organizations, APACHE, APACHE II, adult, clinical trial, General Medicine, Sulbactam, Pitt bacteremia score, microbial sensitivity test, aged, priority journal, risk factor, drug withdrawal, monotherapy, Drug Therapy, Combination, tigecycline, Acinetobacter Infections, Colistin Plus, Microbiology (medical), survival rate, medicine.medical_specialty, education, drug combination, bloodstream infection, Microbial Sensitivity Tests, gentamicin, piperacillin plus tazobactam, concurrent infection, Colistin-Sulbactam, multidrug resistance, Humans, human, drug dose reduction, propensity score, Aged, Retrospective Studies, scoring system, treatment response, social sciences, Length of Stay, major clinical study, mortality, drug efficacy, multicenter study, Carbapenems, Colistin, eradication therapy, loading drug dose, Tigecycline, rifampicin, law, Risk Factors, Drug Resistance, Multiple, Bacterial, biology, Mortality rate, nephrotoxicity, article, Middle Aged, carbapenem derivative, Intensive care unit, aminoglycoside antibiotic agent, humanities, Infectious Diseases, female, Treatment Outcome, Colistin-Carbapenem, Female, Charlson Comorbidity Index, medicine.drug, Adult, sultamicillin, doripenem, netilmicin, carbapenem, length of stay, Internal medicine, medicine, nonhuman, business.industry, isolation and purification, Acinetobacter, biology.organism_classification, Surgery, Antibacterial, drug effects, business, human activities, imipenem
Abstract: 23rd European Congress of Clinical Microbiology and Infectious Diseases (ECCMID) -- 41394 -- Berlin, GERMANY, WOS: 000338723600006, PubMed ID: 24532009, The purpose of this investigation was to compare the efficacy of colistin-based therapies in extremely drug-resistant Acinetobacter spp. bloodstream infections (XDR-ABSI). A retrospective study was conducted in 27 tertiary-care centers from January 2009 to August 2012. The primary end-point was 14-day survival, and the secondary end-points were clinical and microbiological outcomes. Thirty-six and 214 patients [102 (47.7 %): colistin-carbapenem (CC), 69 (32.2 %): colistin-sulbactam (CS), and 43 (20.1 %: tigecycline): colistin with other agent (CO)] received colistin monotherapy and colistin-based combinations, respectively. Rates of complete response/cure and 14-day survival were relatively higher, and microbiological eradication was significantly higher in the combination group. Also, the in-hospital mortality rate was significantly lower in the combination group. No significant difference was found in the clinical (p = 0.97) and microbiological (p = 0.92) outcomes and 14-day survival rates (p = 0.79) between the three combination groups. Neither the timing of initial effective treatment nor the presence of any concomitant infection was significant between the three groups (p > 0.05) and also for 14-day survival (p > 0.05). Higher Pitt bacteremia score (PBS), Acute Physiology and Chronic Health Evaluation II (APACHE II) score, Charlson comorbidity index (CCI), and prolonged hospital and intensive care unit (ICU) stay before XDR-ABSI were significant risk factors for 14-day mortality (p = 0.02, p = 0.0001, p = 0.0001, p = 0.02, and p = 0.01, respectively). In the multivariable analysis, PBS, age, and duration of ICU stay were independent risk factors for 14-day mortality (p < 0.0001, p < 0.0001, and p = 0.001, respectively). Colistin-based combination therapy resulted in significantly higher microbiological eradication rates, relatively higher cure and 14-day survival rates, and lower in-hospital mortality compared to colistin monotherapy. CC, CS, and CO combinations for XDR-ABSI did not reveal significant differences with respect to 14-day survival and clinical or microbiological outcome before and after propensity score matching (PSM). PBS, age, and length of ICU stay were independent risk factors for 14-day mortality.
Published: 2014

44. The features of infectious diseases departments and anti-infective practices in France and Turkey: A cross-sectional study

Author: Meltem Taşbakan, Jean-Paul Stahl, D. Akduman, Hakan Erdem, E. Haustraete, A. Canestri, Huseyin Turgut, Serkan Oncu, Ömer Evirgen, Alper Şener, Aynur Engin, Salih Hosoglu, C. Bernigaud, L. Toko-Tchuindzie, E. Curlier, Birsen Mutlu, Haluk Vahaboglu, Emine Alp, Derya Ozturk Engin, V. Corbin, Xavier Argemi, A. Barrelet, Ilker Inanc Balkan, Levent Gorenek, I. Pierre, Gaye Usluer, S. Patrat-Delon, Christophe Rioux, Yasemin Heper, Aysun Yalci, Nazif Elaldi, M. Hopoglu, C. Fourcade, S. Sırrı Kiliç, Hava Yilmaz, Emine Parlak, Murat Akova, E. Demonchy, Volkan Korten, S. Greffe, Asuman Inan, D. Bruley, Selçuk Kaya, Zonguldak Bülent Ecevit Üniversitesi, [Erdem, H. -- Gorenek, L.] GATA Haydarpasa Training Hosp, Dept Infect Dis & Clin Microbiol, Istanbul, Turkey -- [Stahl, J. P.] Univ Grenoble 1, Dept Infect Dis, Grenoble, France -- [Stahl, J. P.] Univ Hosp Grenoble, Grenoble, France -- [Inan, A. -- Engin, D. O.] Haydarpasa Numune Training & Res Hosp, Dept Infect Dis & Clin Microbiol, Istanbul, Turkey -- [Kilic, S.] Gulhane Mil Med Acad, Dept Publ Hlth, Ankara, Turkey -- [Akova, M.] Hacettepe Univ, Sch Med, Infect Dis Unit, Ankara, Turkey -- [Rioux, C.] Hop Xavier Bichat, Dept Infect Dis, Paris, France -- [Pierre, I.] Hop Raymond Poincare, Dept Infect Dis, Garches, France -- [Canestri, A.] Tenon Univ Hosp, Dept Infect Dis, Paris, France -- [Haustraete, E.] Univ Hosp, Dept Infect Dis, Caen, France -- [Parlak, E.] Ataturk Univ, Sch Med, Dept Infect Dis & Clin Microbiol, Erzurum, Turkey -- [Argemi, X.] Nouvel Hop Civil, Dept Infect Dis, Strasbourg, France -- [Bruley, D.] Univ Hosp, Dept Infect Dis, Grenoble, France -- [Alp, E.] Erciyes Univ, Sch Med, Dept Infect Dis & Clin Microbiol, Kayseri, Turkey -- [Greffe, S.] Hosp Ambroise Pare, Dept Internal Med, Boulogne, France -- [Hosoglu, S.] Dicle Univ, Sch Med, Dept Infect Dis & Clin Microbiol, Diyarbakir, Turkey -- [Patrat-Delon, S.] Univ Hosp, Dept Infect Dis, Rennes, France -- [Heper, Y.] Uludag Univ, Sch Med, Dept Infect Dis & Clin Microbiol, Bursa, Turkey -- [Tasbakan, M.] Ege Univ, Sch Med, Dept Infect Dis & Clin Microbiol, Izmir, Turkey -- [Corbin, V.] Univ Hosp, Dept Infect Dis, Clermont Ferrand, France -- [Hopoglu, M.] Inonu Univ, Sch Med, Dept Infect Dis & Clin Microbiol, Malatya, Turkey -- [Balkan, I. I.] Istanbul Univ, Cerrahpasa Med Sch, Dept Infect Dis & Clin Microbiol, Istanbul, Turkey -- [Mutlu, B.] Kocaeli Univ, Sch Med, Dept Infect Dis & Clin Microbiol, Kocaeli, Turkey -- [Demonchy, E.] Univ Hosp, Dept Infect Dis, Nice, France -- [Yilmaz, H.] Ondokuz Mayis Univ, Sch Med, Dept Infect Dis & Clin Microbiol, Samsun, Turkey -- [Fourcade, C.] Univ Nimes Hosp, Dept Infect Dis, F-30006 Nimes, France -- [Toko-Tchuindzie, L.] Gen Hosp, Dept Infect Dis, Belfort, France -- [Kaya, S.] Karadeniz Tech Univ, Sch Med, Dept Infect Dis & Clin Microbiol, Trabzon, Turkey -- [Engin, A. -- Elaldi, N.] Cumhuriyet Univ, Sch Med, Dept Infect Dis & Clin Microbiol, Sivas, Turkey -- [Yalci, A.] Ankara Univ, Sch Med, Dept Infect Dis & Clin Microbiol, TR-06100 Ankara, Turkey -- [Bernigaud, C.] Gen Hosp, Dept Infect Dis, Chalon Sur Saone, France -- [Vahaboglu, H.] Medeniyet Univ, Goztepe Training & Res Hosp, Dept Infect Dis & Clin Microbiol, Istanbul, Turkey -- [Curlier, E.] Univ Hosp, Dept Infect Dis, Besancon, France -- [Akduman, D.] Bulent Ecevit Univ, Sch Med, Dept Infect Dis & Clin Microbiol, Zonguldak, Turkey -- [Barrelet, A.] Andre Mignot Hosp, Dept Internal & Infect Dis, Versailles, France -- [Oncu, S.] Adnan Menderes Univ, Sch Med, Dept Infect Dis & Clin Microbiol, Aydin, Turkey -- [Korten, V.] Marmara Univ, Sch Med, Dept Infect Dis & Clin Microbiol, Istanbul, Turkey -- [Usluer, G.] Osmangazi Univ, Sch Med, Dept Infect Dis & Clin Microbiol, Eskisehir, Turkey -- [Turgut, H.] Pamukkale Univ, Sch Med, Dept Infect Dis & Clin Microbiol, Denizli, Turkey -- [Sener, A.] Onsekiz Mart Univ, Sch Med, Dept Infect Dis & Clin Microbiol, Canakkale, Turkey -- [Evirgen, O.] Mustafa Kemal Univ, Sch Med, Dept Infect Dis & Clin Microbiol, Antakya, Turkey, Andrade, Hugo -- 0000-0001-6781-6125, KORTEN, VOLKAN -- 0000-0002-9991-814X, AKOVA, MURAT -- 0000-0002-6904-9473, Stahl, Jean Paul -- 0000-0002-0086-3557, VAHABOGLU, Haluk -- 0000-0001-8217-1767, Elaldi, Nazif -- 0000-0002-9515-770X, Ondokuz Mayıs Üniversitesi, Erdem, H., Stahl, J. P., Inan, A., Kilic, S., Akova, M., Rioux, C., Pierre, I., Canestri, A., Haustraete, E., Engin, D. O., Parlak, E., Argemi, X., Bruley, D., Alp, E., Greffe, S., Hosoglu, S., Patrat-Delon, S., Heper, Y., Tasbakan, M., Corbin, V., Hopoglu, M., Balkan, I. I., Mutlu, B., Demonchy, E., Yilmaz, H., Fourcade, C., Toko-Tchuindzie, L., Kaya, S., Engin, A., Yalci, A., Bernigaud, C., Vahaboglu, H., Curlier, E., Akduman, D., Barrelet, A., Oncu, S., Korten, V., Usluer, G., Turgut, H., Sener, A., Evirgen, O., Elaldi, N., and Gorenek, L.
Subjects: Acinetobacter baumannii, Male, Turkey, Cross-sectional study, syphilis, intensive care unit, quinolone derivative, law.invention, room ventilation, sepsis, Tertiary Care Centers, metronidazole, middle aged, colistin, Leptospira, soft tissue infection, adult, hand sanitizer, General Medicine, bacterial endocarditis, hospital bed capacity, clinical practice, antiinfective agent, aged, Aspergillus, cholangitis, priority journal, disease severity, tigecycline, gastroenteritis, hospitalization, Microbiology (medical), medicine.medical_specialty, infectious arthritis, Staphylococcus aureus, Plasmodium falciparum, abscess, Haemophilus, Legionella, surgical infection, Crimean Congo hemorrhagic fever, Corynebacterium, ward, Communicable Diseases, Human immunodeficiency virus infection, cross-sectional study, Humans, Creutzfeldt Jakob disease, human, procedures, Mycobacterium intracellulare avium, cephalosporin derivative, infection prevention, medicine.disease, Brucella, major clinical study, infection, Cross-Sectional Studies, upper respiratory tract infection, HOSPITALS, Measles virus, ampicillin, aminoglycoside, virus hepatitis, waste management, urinary tract infection, Enterovirus infection, Pediatrics, Turkish, colitis, hospital hygiene, Tigecycline, rifampicin, Aggregatibacter actinomycetemcomitans, antimicrobial therapy, Turkey (republic), Medical microbiology, law, central nervous system infection, Streptococcus infection, Epidemiology, Infection control, hospital laboratory, Candida, skin infection, antibiotic prophylaxis, article, Hepatitis B, carbapenem derivative, POINT PREVALENCE, Intensive care unit, INTENSIVE-CARE UNITS, infection control, Anti-Bacterial Agents, hospital patient, Infectious Diseases, female, tuberculosis, brucellosis, Pseudomonas aeruginosa, language, standards, protective equipment, tertiary care center, disease surveillance, France, Neisseria, diabetic foot, medicine.drug, infectious diseases ward, health care personnel, malaria, nurse, RNA virus infection, Bacillus cereus, ciprofloxacin, cholecystitis, medicine, bone infection, measles, pneumonia, cytomegalovirus infection, Treponema pallidum, Clostridium, doxycycline, business.industry, patient care, Streptococcus, Campylobacter, Mycobacterium tuberculosis, vaccination, language.human_language, cotrimoxazole, penicillin derivative, Cryptococcus, Family medicine, hospital bed utilization, septic shock, hepatitis B, hepatitis C, business, hospital waste, Enterococcus
Abstract: WOS: 000340538700017, PubMed ID: 24789652, The aim of this study was to assess the infectious diseases (ID) wards of tertiary hospitals in France and Turkey for technical capacity, infection control, characteristics of patients, infections, infecting organisms, and therapeutic approaches. This cross-sectional study was carried out on a single day on one of the weekdays of June 17-21, 2013. Overall, 36 ID departments from Turkey (n = 21) and France (n = 15) were involved. On the study day, 273 patients were hospitalized in Turkish and 324 patients were followed in French ID departments. The numbers of patients and beds in the hospitals, and presence of an intensive care unit (ICU) room in the ID ward was not different in both France and Turkey. Bed occupancy in the ID ward, single rooms, and negative pressure rooms were significantly higher in France. The presence of a laboratory inside the ID ward was more common in Turkish ID wards. The configuration of infection control committees, and their qualifications and surveillance types were quite similar in both countries. Although differences existed based on epidemiology, the distribution of infections were uniform on both sides. In Turkey, anti-Gram-positive agents, carbapenems, and tigecycline, and in France, cephalosporins, penicillins, aminoglycosides, and metronidazole were more frequently preferred. Enteric Gram-negatives and hepatitis B and C were more frequent in Turkey, while human immunodeficiency virus (HIV) and streptococci were more common in France (p < 0.05 for all significances). Various differences and similarities existed in France and Turkey in the ID wards. However, the current scene is that ID are managed with high standards in both countries.
Published: 2014

45. Predictors of fatality in pandemic influenza A (H1N1) virus infection among adults

Author: Turan Aslan, Nese Saltoglu, Derya Ozturk Engin, Bahadir Ceylan, Eren Gulhan, Funda Şimşek, Servet Alan, Fatman Sargın, Ali Ihsan Dokucu, Arzu Kantürk, Oznur Ak, Onder Ergonul, Selim Badur, Paşa Göktaş, Nur Benzonana, Kenan Midilli, Taner Yildirmak, Haluk Eraksoy, Serdar Özer, Saadet Yazici, Muzaffer Fincanci, Oral Oncul, Nail Ozgunes, Mustafa Ozyurt, Nuray Uzun, Meral Akcay Ciblak, Ozcan Nazlican, Ilker Inanc Balkan, Alper Gunduz, Serap Gencer, Asuman Inan, Ergönül, Mehmet Önder (ORCID 0000-0003-1935-9235 & YÖK ID 110398), Alan, Servet, Ak, Öznur, Sargın, Fatman, Kanturk, Arzu, Gündüz, Alper, Engin, Derya, Öncül, Oral, Balkan, İlker İnanç, Ceylan, Bahadır, Benzonana, Nur, Yazıcı, Saadet, Şimşek, Funda, Uzun, Nuray, İnan, Asuman, Gülhan, Eren, Cıblak, Meral, Midilli, Kenan, Özyurt, Mustafa, Badur, Selim, Gencer, Serap, Nazlıcan, Özcan, Özer, Serdar, Özgüneş, Nail, Yıldırmak, Taner, Aslan, Turan, Göktaş, Paşa, Saltoğlu, Neşe, Fincancı, Muzaffer, Dokucu, Ali Ihsan, Eraksoy, Haluk, School of Medicine, and Department of Infectious Diseases and Public Health
Subjects: Adult, Male, Pathology, medicine.medical_specialty, Multivariate analysis, Turkey, Neuraminidase, Medicine, Infectious diseases, medicine.disease_cause, Antiviral Agents, Disease Outbreaks, Influenza A Virus, H1N1 Subtype, Oseltamivir, Pregnancy, Internal medicine, Influenza, Human, Case fatality rate, Pandemic, Odds Ratio, Influenza A virus, Humans, Zanamivir, Cross Infection, Clinical-Features, United-States, Epidemiologic features, Hospitalized-Patients, Risk-Factors, South-Korea, China, Pneumonia, Failure, Illness, biology, business.industry, Outbreak, Odds ratio, Middle Aged, Hospitalization, Infectious Diseases, Multivariate Analysis, biology.protein, Human mortality from H5N1, Female, influenza, business, Research Article
Abstract: Background: The fatality attributed to pandemic influenza A H1N1 was not clear in the literature. We described the predictors for fatality related to pandemic influenza A H1N1 infection among hospitalized adult patients. Methods: This is a multicenter study performed during the pandemic influenza A H1N1 [A(H1N1) pdm09] outbreak which occurred in 2009 and 2010. Analysis was performed among laboratory confirmed patients. Multivariate analysis was performed for the predictors of fatality. Results: In the second wave of the pandemic, 848 adult patients were hospitalized because of suspected influenza, 45 out of 848 (5.3%) died, with 75% of fatalities occurring within the first 2 weeks of hospitalization. Among the 241 laboratory confirmed A(H1N1) pdm09 patients, the case fatality rate was 9%. In a multivariate logistic regression model that was performed for the fatalities within 14 days after admission, early use of neuraminidase inhibitors was found to be protective (Odds ratio: 0.17, confidence interval: 0.03-0.77, p = 0.022), nosocomial infections (OR: 5.7, CI: 1.84-18, p = 0.013), presence of malignant disease (OR: 3.8, CI: 0.66-22.01, p = 0.133) significantly increased the likelihood of fatality. Conclusions: Early detection of the infection, allowing opportunity for the early use of neuraminidase inhibitors, was found to be important for prevention of fatality. Nosocomial bacterial infections and underlying malignant diseases increased the rate of fatality.
Published: 2014

46. Mortality Indicators In Pneumococcal Meningitis: Therapeutic Implications

Author: Mustafa Gökhan Gözel, Füsun Zeynep Akçam, Nefise Oztoprak, Asim Ulcay, Derya Ozturk-Engin, Gonul Sengoz, Gunay Tuncer-Ertem, Saygin Nayman-Alpat, Yasemin Ersoy, Gülden Ersöz, Nazif Elaldi, Ayse Sagmak-Tartar, Oğuz Reşat Sipahi, Selçuk Kaya, Recep Tekin, Emsal Aydin, Hava Yilmaz, Nail Ozgunes, Alper Şener, Sibel Gundes, Ayşegül Yeşilkaya, Tumer Guven, Hakan Erdem, Birsen Cetin, Derya Seyman, Vedat Turhan, Oznur Ak, Kadriye Kart Yaşar, Ahmet Karakaş, Oral Oncul, Ahmet Çağkan İnkaya, Gonul Cicek-Senturk, Yasemin Akkoyunlu, Oguz Karabay, Hakan Leblebicioglu, Ilker Inanc Balkan, Aysegul Ulu-Kilic, Mustafa Hatipoglu, Aysun Yalci, Husrev Diktas, Ayşe Ertürk, Filiz Pehlivanoglu, Selma Alabay, Asuman Inan, Umit Savasci, Alper Gunduz, Ayhan Akbulut, Fatma Sirmatel, Haluk Vahaboglu, Esra Kazak, Saim Dayan, Sukran Kose, Selma Tosun, Abdullah Umut Pekok, İç Hastalıkları, BAİBÜ, Tıp Fakültesi, Dahili Tıp Bilimleri Bölümü, Sırmatel, Fatma, [Erdem, Hakan -- Hatipoglu, Mustafa -- Oncul, Oral -- Turhan, Vedat -- Ulcay, Asim] GATA Haydarpasa Training Hosp, Dept Infect Dis & Clin Microbiol, Istanbul, Turkey -- [Elaldi, Nazif -- Gozel, Mustafa G.] Cumhuriyet Univ, Sch Med, Dept Infect Dis & Clin Microbiol, Sivas, Turkey -- [Oztoprak, Nefise -- Seyman, Derya] Antalya Training & Res Hosp, Dept Infect Dis & Clin Microbiol, Antalya, Turkey -- [Sengoz, Gonul -- Pehlivanoglu, Filiz] Haseki Training & Res Hosp, Dept Infect Dis & Clin Microbiol, Istanbul, Turkey -- [Ak, Oznur] Lutfi Kirdar Training & Res Hosp, Dept Infect Dis & Clin Microbiol, Istanbul, Turkey -- [Kaya, Selcuk] Karadeniz Tech Univ, Sch Med, Dept Infect Dis & Clin Microbiol, Trabzon, Turkey -- [Inan, Asuman -- Ozturk-Engin, Derya] Haydarpasa Numune Training & Res Hosp, Dept Infect Dis & Clin Microbiol, Istanbul, Turkey -- [Nayman-Alpat, Saygin] Osmangazi Univ Sch Med, Dept Infect Dis & Clin Microbiol, Eskisehir, Turkey -- [Ulu-Kilic, Aysegul -- Alabay, Selma] Erciyes Univ, Sch Med, Dept Infect Dis & Clin Microbiol, Kayseri, Turkey -- [Pekok, Abdullah Umut] Private Erzurum Sifa Hosp, Dept Infect Dis & Clin Microbiol, Erzurum, Turkey -- [Gunduz, Alper] Sisli Etfal Training & Res Hosp, Dept Infect Dis & Clin Microbiol, Istanbul, Turkey -- [Yasar, Kadriye] Bakirkoy Dr Sadi Konuk Training & Res Hosp, Dept Infect Dis & Clin Microbiol, Istanbul, Turkey -- [Yilmaz, Hava -- Leblebicioglu, Hakan] Ondokuz Mayis Univ, Sch Med, Dept Infect Dis & Clin Microbiol, Samsun, Turkey -- [Cicek-Senturk, Gonul] Diskapi Yildirim Beyazit Training & Res Hosp, Dept Infect Dis & Clin Microbiol, Ankara, Turkey -- [Akcam, Fusun Z.] Suleyman Demirel Univ, Sch Med, Dept Infect Dis & Clin Microbiol, TR-32200 Isparta, Turkey -- [Inkaya, Ahmet C.] Hacettepe Univ, Sch Med, Dept Infect Dis & Clin Microbiol, Ankara, Turkey -- [Kazak, Esra] Uludag Univ, Sch Med, Dept Infect Dis & Clin Microbiol, Bursa, Turkey -- [Sagmak-Tartar, Ayse -- Akbulut, Ayhan] Firat Univ, Sch Med, Dept Infect Dis & Clin Microbiol, TR-23169 Elazig, Turkey -- [Tekin, Recep -- Dayan, Saim] Dicle Univ, Sch Med, Dept Infect Dis & Clin Microbiol, Diyarbakir, Turkey -- [Ersoy, Yasemin] Inonu Univ, Sch Med, Dept Infect Dis & Clin Microbiol, Malatya, Turkey -- [Sipahi, Oguz Resat] Ege Univ, Sch Med, Dept Infect Dis & Clin Microbiol, Izmir, Turkey -- [Guven, Tumer] Ankara Ataturk Training & Res Hosp, Dept Infect Dis & Clin Microbiol, Ankara, Turkey -- [Tuncer-Ertem, Gunay] Ankara Numune Training & Res Hosp, Dept Infect Dis & Clin Microbiol, Ankara, Turkey -- [Balkan, Ilker I.] Istanbul Univ, Cerrahpasa Med Sch, Dept Infect Dis & Clin Microbiol, Istanbul, Turkey -- [Cetin, Birsen] Koc Univ, Sch Med, Dept Infect Dis & Clin Microbiol, Istanbul, Turkey -- [Ersoz, Gulden] Mersin Univ, Sch Med, Dept Infect Dis & Clin Microbiol, Mersin, Turkey -- [Karakas, Ahmet] Gulhane Mil Med Acad, Dept Infect Dis & Clin Microbiol, Ankara, Turkey -- [Ozgunes, Nail -- Vahaboglu, Haluk] Medeniyet Univ, Goztepe Training & Res Hosp, Dept Infect Dis & Clin Microbiol, Istanbul, Turkey -- [Sener, Alper] Onsekiz Mart Univ, Sch Med, Dept Infect Dis & Clin Microbiol, Canakkale, Turkey -- [Yesilkaya, Aysegul] Baskent Univ, Sch Med, Dept Infect Dis & Clin Microbiol, TR-06490 Ankara, Turkey -- [Erturk, Ayse] Recep Tayyip Erdogan Univ, Sch Med, Dept Dept Infect Dis & Clin Microbiol, Rize, Turkey -- [Gundes, Sibel] Kocaeli Univ, Sch Med, Dept Dept Infect Dis & Clin Microbiol, Izmit, Turkey -- [Karabay, Oguz] Sakarya Univ, Sch Med, Dept Infect Dis & Clin Microbiol, Sakarya, Turkey -- [Sirmatel, Fatma] Abant Izzet Baysal Univ, Sch Med, Dept Infect Dis & Clin Microbiol, Bolu, Turkey -- [Tosun, Selma] Izmir Bozyaka Training & Res Hosp, Dept Infect Dis & Clin Microbiol, Izmir, Turkey -- [Yalci, Aysun] Ankara Univ, Sch Med, Dept Infect Dis & Clin Microbiol, TR-06100 Ankara, Turkey -- [Akkoyunlu, Yasemin] Bezmi Alem Vakif Univ, Sch Med, Dept Infect Dis & Clin Microbiol, Istanbul, Turkey -- [Aydin, Emsal] Kafkas Univ, Sch Med, Dept Infect Dis & Clin Microbiol, Kars, Turkey -- [Diktas, Husrev] Mil Hosp, Dept Infect Dis & Clin Microbiol, Tatvan, Turkey -- [Kose, Sukran -- Savasci, Umit] Tepecik Training & Res Hosp, Dept Infect Dis & Clin Microbiol, Izmir, Turkey -- Dept Infect Dis & Clin Microbiol, Sarikamis Mil Hosp, Kars, Turkey, Yesilkaya, Aysegul -- 0000-0003-0225-6416, Leblebicioglu, Hakan -- 0000-0002-6033-8543, VAHABOGLU, Haluk -- 0000-0001-8217-1767, Elaldi, Nazif -- 0000-0002-9515-770X, Gozel, Mustafa Gokhan -- 0000-0001-5187-7388, Kart Yasar, Kadriye -- 0000-0003-2963-4894, Karakas, Ahmet -- 0000-0002-0553-8454, Karabay, Oguz -- 0000-0003-0502-432X, Ersoy, Yasemin -- 0000-0001-5730-6682, hatipoglu, mustafa -- 0000-0001-9910-1650, Gunduz, Alper -- 0000-0001-9154-844X, HATİBOĞLU, MUSTAFA AZİZ, Ege Üniversitesi, and OMÜ
Subjects: Microbiology (medical), Streptococcus Pneumoniae, Adult, Male, medicine.medical_specialty, Adolescent, Turkey, Penicillin Resistance, Resistance, Microbial Sensitivity Tests, Penicillins, medicine.disease_cause, Cohort Studies, Young Adult, Vancomycin, Internal medicine, Streptococcus pneumoniae, medicine, Humans, Meningitis, Mortality, Intensive care medicine, pneumococcal meningitis, Aged, Retrospective Studies, Aged, 80 and over, business.industry, Meningitis, Pneumococcal, Ceftriaxone, General Medicine, Odds ratio, Middle Aged, medicine.disease, Penicillin, Confidence interval, Anti-Bacterial Agents, Cephalosporins, Treatment Outcome, Infectious Diseases, Drug Therapy, Combination, Female, business, Cohort study, medicine.drug
Abstract: WOS: 000329981700003, PubMed ID: 24211227, Background: The aim of this study was to delineate mortality indicators in pneumococcal meningitis with special emphasis on therapeutic implications. Methods: This retrospective, multicenter cohort study involved a 15-year period (1998-2012). Culture-positive cases (n = 306) were included solely from 38 centers. Results: Fifty-eight patients received ceftriaxone plus vancomycin empirically. The rest were given a third-generation cephalosporin alone. Overall, 246 (79.1%) isolates were found to be penicillin-susceptible, 38 (12.2%) strains were penicillin-resistant, and 22 (7.1%) were oxacillin-resistant (without further minimum inhibitory concentration testing for penicillin). Being a critical case (odds ratio (OR) 7.089, 95% confidence interval (CI) 3.230-15.557) and age over 50 years (OR 3.908, 95% CI 1.820-8.390) were independent predictors of mortality, while infection with a penicillin-susceptible isolate (OR 0.441, 95% CI 0.195-0.996) was found to be protective. Empirical vancomycin use did not provide significant benefit (OR 2.159, 95% CI 0.949-4.912). Conclusions: Ceftriaxone alone is not adequate in the management of pneumococcal meningitis due to penicillin-resistant pneumococci, which is a major concern worldwide. Although vancomycin showed a trend towards improving the prognosis of pneumococcal meningitis, significant correlation in statistical terms could not be established in this study. Thus, further studies are needed for the optimization of pneumococcal meningitis treatment. (C) 2013 The Authors. Published by Elsevier Ltd on behalf of International Society for Infectious Diseases. All rights reserved.
Published: 2014

47. Update on treatment options for spinal brucellosis

Author: Serkan Dayan, Özcan Deveci, Ali Karakas, Serda Gulsun, Ayten Kadanali, Burcu Ceylan, Türker Türker, Ayşe Seza Inal, Vedat Turhan, Elif Sahin Horasan, Recep Tekin, Asuman Inan, Derya Ozturk Engin, Hakan Erdem, Gül Karagöz, Özlem Ak, Uner Kayabas, Selma Alabay, Esra Kazak, Fazilet Duygu, Hanefi Cem Gul, Oguz Karabay, Hayati Demiraslan, Nese Saltoglu, Nazif Elaldi, Çiğdem Kader, Ahmet Sener, Aysegul Ulu-Kilic, Hale Turan, Mehtap Aydin, Tıp Fakültesi, Ulu-Kilic, A, Karakas, A, Erdem, H, Turker, T, Inal, AS, Ak, O, Turan, H, Kazak, E, Inan, A, Duygu, F, Demiraslan, H, Kader, C, Sener, A, Dayan, S, Deveci, O, Tekin, R, Saltoglu, N, Aydin, M, Horasan, ES, Gul, HC, Ceylan, B, Kadanali, A, Karabay, O, Karagoz, G, Kayabas, U, Turhan, V, Engin, D, Gulsun, S, Elaldi, N, Alabay, S, Sakarya Üniversitesi/Tıp Fakültesi/Dahili Tıp Bilimleri Bölümü, Karabay, Oğuz, [Ulu-Kilic, A. -- Demiraslan, H.] Erciyes Univ, Sch Med, Dept Infect Dis & Clin Microbiol IDCM, Kayseri, Turkey -- [Karakas, A. -- Gul, H. C.] Gulhane Mil Med Acad, Dept IDCM, Ankara, Turkey -- [Erdem, H. -- Turhan, V.] GATA Haydarpasa Training Hosp, Dept IDCM, Istanbul, Turkey -- [Turker, T.] Gulhane Mil Med Acad, Dept Publ Hlth, Ankara, Turkey -- [Inal, A. S.] Cukurova Sch Med, Dept IDCM, Adana, Turkey -- [Ak, O.] Dr Lutfi Kirdar Training & Res Hosp, Dept IDCM, Istanbul, Turkey -- [Turan, H.] Baskent Univ, Sch Med, Dept IDCM, Konya, Turkey -- [Kazak, E.] Uludag Univ, Sch Med, Dept IDCM, Bursa, Turkey -- [Inan, A. -- Engin, D.] Haydarpasa Numune Training & Res Hosp, Dept IDCM, Istanbul, Turkey -- [Duygu, F.] Gaziosmanpasa Univ, Sch Med, Dept IDCM, Tokat, Turkey -- [Kader, C.] Bozok Univ, Sch Med, Dept IDCM, Yozgat, Turkey -- [Sener, A.] Bozok Univ, Sch Med, Dept IDCM, Yozgat, Turkey -- [Dayan, S. -- Deveci, O. -- Tekin, R.] Dicle Univ, Sch Med, Dept IDCM, Diyarbakir, Turkey -- [Saltoglu, N.] Istanbul Univ, Cerrahpasa Med Sch, Dept IDCM, Istanbul, Turkey -- [Aydin, M.] Balikesir Univ, Sch Med, Dept IDCM, Balikesir, Turkey -- [Horasan, E. S.] Mersin Univ, Sch Med, Dept IDCM, Mersin, Turkey -- [Ceylan, B.] Bezmialem Vakif Univ, Dept IDCM, Istanbul, Turkey -- [Kadanali, A. -- Karagoz, G.] Umraniye Training & Res Hosp, Dept IDCM, Istanbul, Turkey -- [Karabay, O.] Sakarya Univ, Sch Med, Dept IDCM, Sakarya, Turkey -- [Kayabas, U.] Inonu Univ, Sch Med, Dept IDCM, Malatya, Turkey -- [Gulsun, S.] Diyarbakir Training & Res Hosp, Dept IDCM, Diyarbakir, Turkey -- [Elaldi, N.] Cumhuriyet Univ, Sch Med, Dept IDCM, Sivas, Turkey -- [Alabay, S.] Erciyes Univ, Sch Med, Dept IDCM, Kayseri, Turkey, Inal, Ayse Seza -- 0000-0002-1182-7164, Karakas, Ahmet -- 0000-0002-0553-8454, Karabay, Oguz -- 0000-0003-0502-432X, and Elaldi, Nazif -- 0000-0002-9515-770X
Subjects: Adult, Male, Microbiology (medical), Spondylodiscitis, Adolescent, Epidural abscess, Brucellosis, Young Adult, Ulu-Kilic A., Karakas A., Erdem H., Turker T., Inal A. S. , Ak O., Turan H., Kazak E., Inan A., Duygu F., et al., -Update on treatment options for spinal brucellosis-, CLINICAL MICROBIOLOGY AND INFECTION, cilt.20, 2014, medicine, Humans, Abscess, Aged, Retrospective Studies, spondylitis, spondylodiscitis, treatment, Aged, 80 and over, Doxycycline, business.industry, General Medicine, Middle Aged, medicine.disease, Anti-Bacterial Agents, Treatment, Aminoglycosides, Treatment Outcome, Infectious Diseases, Tolerability, Streptomycin, Anesthesia, Drug Therapy, Combination, Female, Rifampin, business, spinal brucellosis, Rifampicin, medicine.drug, Spondylitis
Abstract: WOS: 000329585200001, PubMed ID: 24118178, We evaluated the efficacy and tolerability of antibiotic regimens and optimal duration of therapy in complicated and uncomplicated forms of spinal brucellosis. This is a multicentre, retrospective and comparative study involving a total of 293 patients with spinal brucellosis from 19 health institutions. Comparison of complicated and uncomplicated spinal brucellosis was statistically analysed. Complicated spinal brucellosis was diagnosed in 78 (26.6%) of our patients. Clinical presentation was found to be significantly more acute, with fever and weight loss, in patients in the complicated group. They had significantly higher leukocyte and platelet counts, erythrocyte sedimentation rates and C-reactive protein levels, and lower haemoglobulin levels. The involvement of the thoracic spine was significantly more frequent in complicated cases. Spondylodiscitis was complicated, with paravertebral abscess in 38 (13.0%), prevertebral abscess in 13 (4.4%), epidural abscess in 30 (10.2%), psoas abscess in 10 (3.4%) and radiculitis in 8 (2.7%) patients. The five major combination regimens were: doxycycline 200mg/day, rifampicin 600mg/day and streptomycin 1g/day; doxycycline 200mg/day, rifampicin 600mg/day and gentamicin 5mg/kg; doxycycline 200mg/day and rifampicin 600mg/day; doxycycline 200mg/day and streptomycin 1g/day; and doxycycline 200mg/day, rifampicin 600mg/day and ciprofloxacin 1g/day. There were no significant therapeutic differences between these antibiotic groups; the results were similar regarding the complicated and uncomplicated groups. Patients were mostly treated with doxycycline and rifampicin with or without an aminoglycoside. In the former subgroup, complicated cases received antibiotics for a longer duration than uncomplicated cases. Early recognition of complicated cases is critical in preventing devastating complications. Antimicrobial treatment should be prolonged in complicated spinal brucellosis in particular.
Published: 2014

48. 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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49. Withdrawal of Staphylococcus aureus from intensive care units in Turkey

Author: Saim Dayan, Nail Ozgunes, Hasan Ucmak, Turan Aslan, Begin Altun, Adem Albayrak, Nefise Oztoprak, Selçuk Kaya, Tuna Demirdal, Salman Shaheer Ahmed, Fehmi Tabak, Iftihar Koksal, Hanefi Cem Gul, Yasemin Ersoy, Yeşim Taşova, Oral Oncul, Mehmet Bitirgen, Ibak Gonen, Murat Dizbay, Selma Karabey, Hakan Erdem, Nazif Elaldi, Fatma Sirmatel, İbrahim Erayman, Oznur Ak, Oguz Karabay, Birsen Cetin, Emel Azak, Bilgin Arda, Ercan Yenilmez, Hakan Leblebicioglu, Tumer Guven, Ayşe Willke, Recep Tekin, Saban Esen, Asim Ulcay, Davut Ozdemir, Serhat Ünal, Asuman Inan, Zeliha Kocak Tufan, Ilker Inanc Balkan, Sukran Kose, Filiz Akata, Aygul Dogan-Celik, Fatma Nurhayat Bayazit, Ayhan Akbulut, Gulden Yilmaz, Ömer Karaşahin, Derya Ozturk-Engin, Gokay Gungor, Güven Çelebi, Serkan Oncu, Levent Gorenek, Halis Akalin, Aysegul Ulu-Kilic, Aslihan Candevir, Hale Turan, [Erdem, Hakan -- Oncul, Oral -- Yenilmez, Ercan -- Gorenek, Levent -- Ulcay, Asim] GATA Haydarpasa Training Hosp, Dept Infect Dis & Clin Microbiol, Istanbul, Turkey -- [Dizbay, Murat -- Karasahin, Omer] Gazi Univ, Sch Med, Dept Infect Dis & Clin Microbiol, Ankara, Turkey -- [Karabey, Selma] Istanbul Univ, Istanbul Sch Med, Dept Publ Hlth, Istanbul, Turkey -- [Kaya, Selcuk -- Koksal, Iftihar] Karadeniz Tech Univ, Sch Med, Dept Infect Dis & Clin Microbiol, Trabzon, Turkey -- [Demirdal, Tuna] Katip Celebi Univ, Sch Med, Dept Infect Dis & Clin Microbiol, Izmir, Turkey -- [Inan, Asuman -- Ozturk-Engin, Derya] Haydarpasa Numune Training & Res Hosp, Dept Infect Dis & Clin Microbiol, Istanbul, Turkey -- [Erayman, Ibrahim -- Bitirgen, Mehmet] Selcuk Univ, Meram Sch Med, Dept Infect Dis & Clin Microbiol, Konya, Turkey -- [Ak, Oznur] Lutfi Kirdar Kartal Training & Res Hosp, Dept Infect Dis & Clin Microbiol, Istanbul, Turkey -- [Ulu-Kilic, Aysegul -- Ahmed, Salman Shaheer] Erciyes Univ, Sch Med, Dept Infect Dis & Clin Microbiol, Kayseri, Turkey -- [Akbulut, Ayhan] Firat Univ, Sch Med, Dept Infect Dis & Clin Microbiol, TR-23169 Elazig, Turkey -- [Elaldi, Nazif] Cumhuriyet Univ, Sch Med, Dept Infect Dis & Clin Microbiol, Sivas, Turkey -- [Yilmaz, Gulden] Ankara Univ, Sch Med, Dept Infect Dis & Clin Microbiol, TR-06100 Ankara, Turkey -- [Candevir, Aslihan -- Tasova, Yesim] Cukurova Univ, Sch Med, Dept Infect Dis & Clin Microbiol, Adana, Turkey -- [Gul, Hanefi Cem] Gulhane Mil Med Acad, Dept Infect Dis & Clin Microbiol, Ankara, Turkey -- [Gonen, Ibak] Suleyman Demirel Univ, Sch Med, Dept Infect Dis & Clin Microbiol, TR-32200 Isparta, Turkey -- [Aslan, Turan] Bezmi Alem Univ, Sch Med, Dept Infect Dis & Clin Microbiol, Istanbul, Turkey -- [Azak, Emel -- Willke, Ayse] Kocaeli Univ, Sch Med, Dept Infect Dis & Clin Microbiol, Kocaeli, Turkey -- [Tekin, Recep -- Dayan, Saim] Dicle Univ, Sch Med, Dept Infect Dis & Clin Microbiol, Izmir, Turkey -- [Tufan, Zeliha Kocak] Ankara Numune Training & Res Hosp, Dept Infect Dis & Clin Microbiol, Ankara, Turkey -- [Arda, Bilgin] Ege Univ, Sch Med, Dept Infect Dis & Clin Microbiol, Izmir, Turkey -- [Gungor, Gokay] Sureyyapasa Chest Dis & Thorac Surg Educ & Res Ho, Resp Intens Care Unit, Istanbul, Turkey -- [Cetin, Birsen] Koc Univ, Sch Med, Dept Infect Dis & Clin Microbiol, Istanbul, Turkey -- [Kose, Sukran] Izmir Tepecik Training & Res Hosp, Dept Infect Dis & Clin Microbiol, Izmir, Turkey -- [Turan, Hale] Baskent Univ, Sch Med, Dept Infect Dis & Clin Microbiol, Konya, Turkey -- [Akalin, Halis] Uludag Univ, Sch Med, Dept Infect Dis & Clin Microbiol, Bursa, Turkey -- [Karabay, Oguz] Sakarya Univ, Sch Med, Dept Infect Dis & Clin Microbiol, Sakarya, Turkey -- [Dogan-Celik, Aygul -- Tabak, Fehmi] Trakya Univ, Sch Med, Dept Infect Dis & Clin Microbiol, Edirne, Turkey -- [Albayrak, Adem -- Esen, Saban -- Leblebicioglu, Hakan] Ondokuz Mayis Univ, Sch Med, Dept Infect Dis & Clin Microbiol, Samsun, Turkey -- [Guven, Tumer] Ataturk Training & Res Hosp, Dept Infect Dis & Clin Microbiol, Ankara, Turkey -- [Celebi, Guven] Bulent Ecevit Univ, Sch Med, Dept Infect Dis & Clin Microbiol, Zonguldak, Turkey -- [Ozgunes, Nail] Medeniyet Univ, Sch Med, Dept Infect Dis & Clin Microbiol, Istanbul, Turkey -- [Ersoy, Yasemin] Inonu Univ, Sch Med, Dept Infect Dis & Clin Microbiol, Malatya, Turkey -- [Sirmatel, Fatma] Abant Izzet Baysal Univ, Sch Med, Dept Infect Dis & Clin Microbiol, Bolu, Turkey -- [Oztoprak, Nefise] Antalya Training & Res Hosp, Dept Infect Dis & Clin Microbiol, Antalya, Turkey -- [Balkan, Ilker Inanc -- Tabak, Fehmi] Istanbul Univ, Cerrahpasa Med Sch, Dept Infect Dis & Clin Microbiol, Istanbul, Turkey -- [Bayazit, Fatma Nurhayat] Fatih Univ, Sch Med, Dept Infect Dis & Clin Microbiol, Ankara, Turkey -- [Ucmak, Hasan] Sutcu Imam Univ, Sch Med, Dept Infect Dis & Clin Microbiol, Kahramanmaras, Turkey -- [Oncu, Serkan] Adnan Menderes Univ, Sch Med, Dept Infect Dis & Clin Microbiol, Aydin, Turkey -- [Ozdemir, Davut] Duzce Univ, Sch Med, Dept Infect Dis & Clin Microbiol, Duzce, Turkey -- [Altun, Begin -- Unal, Serhat] Hacettepe Univ Ankara, Fac Med, Dept Med, Infect Dis Unit, Ankara, Turkey, Leblebicioglu, Hakan -- 0000-0002-6033-8543, UNAL, SERHAT -- 0000-0003-1184-4711, Candevir, Aslihan -- 0000-0001-9340-516X, Tufan, Zeliha Kocak -- 0000-0002-3294-014X, Gungor, Gokay -- 0000-0003-2294-489X, Elaldi, Nazif -- 0000-0002-9515-770X, Karabay, Oguz -- 0000-0003-0502-432X, Ersoy, Yasemin -- 0000-0001-5730-6682, Dizbay, Murat -- 0000-0003-4120-0781, Erdem, H, Dizbay, M, Karabey, S, Kaya, S, Demirdal, T, Koksal, I, Inan, A, Erayman, I, Ak, O, Ulu-Kilic, A, Karasahin, O, Akbulut, A, Elaldi, N, Yilmaz, G, Candevir, A, Gul, HC, Gonen, I, Oncul, O, Aslan, T, Azak, E, Tekin, R, Tufan, ZK, Yenilmez, E, Arda, Sakarya Üniversitesi/Tıp Fakültesi/Dahili Tıp Bilimleri Bölümü, Karabay, Oğuz, Akbulut Uludağ, Ahsen, Zonguldak Bülent Ecevit Üniversitesi, Ondokuz Mayıs Üniversitesi, Arda, B, Gungor, G, Cetin, B, Kose, S, Turan, H, Akalin, H, Karabay, O, Dogan-Celik, A, Albayrak, A, Guven, T, Celebi, G, Ozgunes, N, Ersoy, Y, Sirmatel, F, Oztoprak, N, Balkan, II, Bayazit, FN, Ucmak, H, Oncu, S, Ozdemir, D, Ozturk-Engin, D, Bitirgen, M, Tabak, F, Akata, F, Willke, A, Gorenek, L, Ahmed, SS, Tasova, Y, Ulcay, A, Dayan, S, Esen, S, Leblebicioglu, H, Altun, B, Unal, S, and Çukurova Üniversitesi
Subjects: Staphylococcus aureus, medicine.medical_specialty, Pediatrics, Turkey, Epidemiology, health care facilities, manpower, and services, Staphylococcus, education, Staphylococcal infections, medicine.disease_cause, Tertiary Care Centers, Intensive care, health services administration, medicine, Humans, Retrospective Studies, Cross Infection, biology, business.industry, Health Policy, Incidence (epidemiology), Incidence, Public Health, Environmental and Occupational Health, Retrospective cohort study, Staphylococcal Infections, Acinetobacter, medicine.disease, biology.organism_classification, Critical, Intensive Care Units, Infectious Diseases, Emergency medicine, Staphylococcus aureus infections, business
Abstract: WOS: 000326241700021, PubMed ID: 23663858, Background: In the past, Staphylococcus aureus infections have displayed various patterns of epidemiologic curves in hospitals, particularly in intensive care units (ICUs). This study aimed to characterize the current trend in a nationwide survey of ICUs in Turkey. Methods: A total of 88 ICUs from 36 Turkish tertiary hospitals were included in this retrospective study, which was performed during the first 3 months of both 2008 (period [P] 1) and 2011 (P2). A P value
Published: 2013

50. Management of Brucella endocarditis: results of the Gulhane study

Author: Saim Dayan, Hakan Erdem, Özcan Deveci, Ayşe Erbay, Esra Kazak, Sema Alp-Cavus, Ali Rıza Erbay, Elif Doyuk-Kartal, İbrahim Koruk, Rahmet Guner, Umit Savasci, Oğuz Reşat Sipahi, Behice Kurtaran, Yasemin Tezer-Tekce, Aysun Yalci, Serap Gencer, Mehmet Parlak, Derya Ozturk Engin, Necla Tulek, Mucahit Yemisen, Filiz Pehlivanoglu, Asuman Inan, Suda Tekin Koruk, Oral Oncul, Gokhan Guzel, Asim Ulcay, Nebahat Dikici, Çukurova Üniversitesi, [Koruk, Suda Tekin] Harran Univ, Sch Med, Dept Infect Dis & Clin Microbiol IDCM, Sanliurfa, Turkey -- [Erdem, Hakan -- Ulcay, Asim] Kasimpasa Hosp, Dept IDCM, Istanbul, Turkey -- [Koruk, Ibrahim] Harran Univ, Sch Med, Dept Publ Hlth, Sanliurfa, Turkey -- [Erbay, Ayse] Bozok Univ, Sch Med, Dept IDCM, Yozgat, Turkey -- [Tezer-Tekce, Yasemin] Turkiye Yuksek Ihtisas Training & Res Hosp, Dept IDCM, Ankara, Turkey -- [Erbay, Ali Riza] Bozok Univ, Sch Med, Dept Cardiol, Yozgat, Turkey -- [Dayan, Saim -- Deveci, Ozcan] Dicle Univ, Sch Med, Dept IDCM, Diyarbakir, Turkey -- [Inan, Asuman -- Engin, Derya Ozturk] Haydarpasa Numune Training & Res Hosp, Istanbul, Turkey -- [Guner, Rahmet] Ataturk Training & Res Hosp, Dept IDCM, Ankara, Turkey -- [Dikici, Nebahat] Selcuk Univ, Fac Selcuklu Med, Konya, Turkey -- [Doyuk-Kartal, Elif] Osmangazi Univ, Sch Med, Dept IDCM, Eskisehir, Turkey -- [Kurtaran, Behice] Cukurova Univ, Sch Med, Dept IDCM, Adana, Turkey -- [Pehlivanoglu, Filiz] Haseki Training & Res Hosp, Dept IDCM, Istanbul, Turkey -- [Sipahi, Oguz Resat] Ege Univ, Sch Med, Dept IDCM, Izmir, Turkey -- [Yalci, Aysun] Ankara Univ, Sch Med, Dept IDCM, TR-06100 Ankara, Turkey -- [Yemisen, Mucahit] Istanbul Univ, Cerrahpasa Med Sch, Dept IDCM, Istanbul, Turkey -- [Alp-Cavus, Sema] Dokuz Eylul Univ, Sch Med, Dept IDCM, Izmir, Turkey -- [Gencer, Serap] Dr Lutfi Kirdar Kartal Training & Res Hosp, Dept IDCM, Istanbul, Turkey -- [Guzel, Gokhan] Cumhuriyet Univ, Sch Med, Dept IDCM, Sivas, Turkey -- [Oncul, Oral] Gulhane Haydarpasa Hosp, Dept IDCM, Istanbul, Turkey -- [Parlak, Mehmet] Ataturk Univ, Sch Med, Dept IDCM, Erzurum, Turkey -- [Kazak, Esra] Uludag Sch Med, Dept IDCM, Bursa, Turkey -- [Tulek, Necla] Ankara Numune Training & Res Hosp, Dept IDCM, Ankara, Turkey -- [Savasci, Umit] Mil Hosp, IDCM Serv, Sarikamis, Turkey, Kurtaran, Behice -- 0000-0002-2081-4664, GENCER, SERAP -- 0000-0002-3217-6305, Gencer, Serap -- 0000-0002-3217-6305, Gozel, Mustafa Gokhan -- 0000-0001-5187-7388, Uludağ Üniversitesi/Tıp Fakültesi/Enfeksiyon Hastalıkları ve Klinik Mikrobiyoloji Anabilim Dalı., Kazak, Esra, and AAG-8459-2021
Subjects: Congestive heart failure, Male, Turkey, Bacterial endocarditis, Antibiotics, Pericardial effusion, Leukocyte Count, Ciprofloxacin, Diagnosis, Pharmacology (medical), Gentamicin, Heart valve prosthesis, Priority journal, Aged, 80 and over, Endocarditis, Ceftriaxone, Heart, General Medicine, Middle Aged, Bacterial-endocarditis, Risk-factors, Infectious Diseases, Treatment Outcome, Doxycycline, Aortic Valve, Streptomycin, Mitral Valve, Drug Therapy, Combination, Female, Tricuspid Valve, Aorta valve, Human, medicine.drug, Microbiology (medical), Adult, medicine.medical_specialty, medicine.drug_class, Brucella endocarditis, Major clinical study, Microbiology, Article, Brucellosis, Young Adult, Pharmacotherapy, medicine, Adults, Agglutination Tests, Zoonosis, Humans, Mortality, Rifampicin, Aged, Retrospective Studies, Pharmacology & pharmacy, business.industry, Retrospective cohort study, Endocarditis, Bacterial, medicine.disease, Valvular heart disease, Brucella, Cotrimoxazole, Heart surgery, Surgery, Aminoglycosides, Therapy, Infective endocarditis, Complication, business
Abstract: WOS: 000306663800009, PubMed ID: 22727531, Brucella endocarditis (BE) is a rare but life-threatening complication of human brucellosis. The aim of this study was to investigate the course of BE along with the therapeutic interrelations. A total of 53 patients with BE hospitalised in 19 health institutions between 2006 and 2011 were included in the Gulhane study. Diagnosis of brucellosis was established by either isolation of Brucella sp. or the presence of antibodies, and the definition of endocarditis was made according to Duke's criteria. There were four treatment groups: ceftriaxone combined with oral antibiotics (Group 1); aminoglycosides combined with oral antibiotics (Group 2); oral antibiotic combinations (Group 3); and aminoglycoside plus ceftriaxone combined with an oral antibiotic (Group 4). Involvement rates of the aortic, mitral and tricuspid valves were 49.1%, 43.4% and 5.7%, respectively. Thirty-two patients (60.4%) had an underlying cardiac valvular problem, including previous prosthetic valve replacement (n = 18). Medical treatment was provided to 32 patients (60.4%), whilst concordant medical and surgical approaches were provided to 21 patients (39.6%). Mortality in Group 1 was 15% (3/20), whilst in Group 2 it was 5.3% (1/19). In Group 3, 25.0% (3/12) of the cases died, whereas none of the cases in Group 4 died. In conclusion, mortality increased 47-fold with pericardial effusion and 25-fold due to congestive heart failure that developed after BE. Although mortality was lower in the aminoglycoside-containing arm (Groups 2 and 4), statistical analysis could not be performed owing to the small number of patients. (C) 2012 Elsevier B.V. and the International Society of Chemotherapy. All rights reserved.
Published: 2012

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