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14 results on '"Abdullah Umut Pekok"'

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. Self-reported antibiotic stewardship and infection control measures from 57 intensive care units: An international ID-IRI survey

Author

Rehab El-Sokkary, Hakan Erdem, Ravina Kullar, Abdullah Umut Pekok, Fatma Amer, Svjetlana Grgić, Biljana Carevic, Amani El-Kholy, Anna Liskova, Mehmet Özdemir, Ejaz Ahmed Khan, Yesim Uygun Kizmaz, Nenad Pandak, Nirav Pandya, Jurica Arapović, Rıdvan Karaali, Nefise Oztoprak, Michael M. Petrov, Rami Alabadla, Handan Alay, Jehan Ali El Kholy, Caroline Landelle, Reham Khedr, Dhruv Mamtora, Gorana Dragovac, Ricardo Fernandez, Emine Unal Evren, Lul Raka, Antonio Cascio, Nicolas Dauby, Ahsen Oncul, Safak Ozer Balin, Yasemin Cag, Natalia Dirani, Mustafa Dogan, Irina Magdalena Dumitru, Maha Ali Gad, Ilad Alavi Darazam, Behrouz Naghili, Rosa Fontana Del Vecchio, Monica Licker, Andrea Marino, Nasim Akhtar, Mostafa Kamal, Goffredo Angioni, Deana Medić, Aliye Esmaoğlu, Szabo Balint Gergely, André Silva-Pinto, Lurdes Santos, Ionela Larisa Miftode, Recep Tekin, Phunsup Wongsurakiat, Mumtaz Ali Khan, Yesim Kurekci, Hema Prakash Pilli, Krsto Grozdanovski, Egidia Miftode, Rusmir Baljic, Serhat Uysal, Haluk Vahabolgu, and Jordi Rello

Subjects
Multidrug resistance, Infection control, Stewardship, Low- and upper-middle and high income, MDROs, Pan drug resistance, Infectious and parasitic diseases, RC109-216, Public aspects of medicine, RA1-1270
Abstract

We explored the self-reported antibiotic stewardship (AS), and infection prevention and control (IPC) activities in intensive care units (ICUs) of different income settings. A cross-sectional study was conducted using an online questionnaire to collect data about IPC and AS measures in participating ICUs. The study participants were Infectious Diseases–International Research Initiative (IDI-IR) members, committed as per their institutional agreement form. We analyzed responses from 57 ICUs in 24 countries (Lower-middle income (LMI), n = 13; Upper-middle income (UMI), n = 33; High-income (HI), n = 11). This represented (~5%) of centers represented in the ID-IRI. Surveillance programs were implemented in (76.9%−90.9%) of ICUs with fewer contact precaution measures in LMI ones (p = 0.02); (LMI:69.2%, UMI:97%, HI:100%). Participation in regional antimicrobial resistance programs was more significantly applied in HI (p = 0.02) (LMI:38.4%,UMI:81.8%,HI:72.2%). AS programs are implemented in 77.2% of institutions with AS champions in 66.7%. Infectious diseases physicians and microbiologists are members of many AS teams (59%&50%) respectively. Unqualified healthcare professionals(42.1%), and deficient incentives(28.1%) are the main barriers to implementing AS. We underscore the existing differences in IPC and AS programs’ implementation, team composition, and faced barriers. Continuous collaboration and sharing best practices on APM is needed. The role of regional and international organizations should be encouraged. Global support for capacity building of healthcare practitioners is warranted.

Published
2022
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3. International Multicentre Study of Candida auris Infections

Author

Nirav Pandya, Yasemin Cag, Nenad Pandak, Abdullah Umut Pekok, Aruna Poojary, Folusakin Ayoade, Teresa Fasciana, Anna Giammanco, Hulya Caskurlu, Dhanji P. Rajani, Yogesh Kumar Gupta, Ilker Inanc Balkan, Ejaz Ahmed Khan, and Hakan Erdem

Subjects
Candida, C. auris, fungi, outbreak, nosocomial, resistance, Biology (General), QH301-705.5
Abstract

Background:Candida auris has emerged globally as a multi-drug resistant yeast and is commonly associated with nosocomial outbreaks in ICUs. Methods: We conducted a retrospective observational multicentre study to determine the epidemiology of C. auris infections, its management strategies, patient outcomes, and infection prevention and control practices across 10 centres from five countries. Results: Significant risk factors for C. auris infection include the age group of 61–70 years (39%), recent history of ICU admission (63%), diabetes (63%), renal failure (52%), presence of CVC (91%) and previous history of antibiotic treatment (96%). C. auris was commonly isolated from blood (76%). Echinocandins were the most sensitive drugs. Most common antifungals used for treatment were caspofungin (40%), anidulafungin (28%) and micafungin (15%). The median duration of treatment was 20 days. Source removal was conductedin 74% patients. All-cause crude mortality rate after 30 days was 37%. Antifungal therapy was associated with a reduction in mortality (OR:0.27) and so was source removal (OR:0.74). Contact isolation precautions were followed in 87% patients. Conclusions:C. auris infection carries a high risk for associated mortality. The organism is mainly resistant to most azoles and even amphotericin-B. Targeted antifungal therapy, mainly an echinocandin, and source control are the prominent therapeutic approaches.

Published
2021
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4. Classical fever of unknown origin in 21 countries with different economic development: an international ID-IRI study

Author

Hakan Erdem, Magdalena Baymakova, Sevil Alkan, Amel Letaief, Wissal Ben Yahia, Farouq Dayyab, Entela Kolovani, Svjetlana Grgic, Federica Cosentino, Imran Hasanoglu, Reham Khedr, Andrea Marino, Abdullah Umut Pekok, Fatma Eser, Jurica Arapovic, Hatice Rahmet Guner, Ionela-Larisa Miftode, Kostadin Poposki, Gamze Sanlidag, Alper Tahmaz, Oguz Resat Sipahi, Egidia Gabriela Miftode, Serkan Oncu, Meliha Cagla-Sonmezer, Syam Kumar Addepalli, Ilad Alavi Darazam, Hema Prakash Kumari, Meliha Meriç Koc, Meela Ranjith Kumar, Suresh Babu Sayana, Ahmed Ashraf Wegdan, Fatma Amer, Mehmet Resat Ceylan, Amani El-Kholy, Taylan Onder, Hamed Azhdari Tehrani, Atousa Hakamifard, Bircan Kayaaslan, Ghaydaa Shehata, Hulya Caskurlu, Nagwa Mostafa El-Sayed, Seyed Erfan Mortazavi, Mohammad Pourali, Umran Elbahr, Sholpan Kulzhanova, Tarkan Yetisyigit, Sahar Ahmed Saad, Yasemin Cag, Gulden Eser-Karlidag, Natalia Pshenichnaya, Maya Belitova, Nasim Akhtar, Fahad Al-Majid, Muge Ayhan, Mumtaz Ali Khan, Massimiliano Lanzafame, Mateja Jankovic Makek, Emmanuel Nsutebu, Antonio Cascio, Emine Kubra Dindar-Demiray, Emine Unal Evren, Rama Kalas, Ayşe Kaya Kalem, Rusmir Baljić, Aamer Ikram, Selcuk Kaya, Anna Liskova, Balint Gergely Szabo, Bilal Ahmad Rahimi, Esmeray Mutlu-Yilmaz, Alper Sener, and Jordi Rello

Subjects
Microbiology (medical), Fever of unknown origin, Infectious Diseases, Economic development, Fever, FUO, General Medicine, ID-IRI
Published
2023

5. Brucellosis in pregnancy: results of multicenter ID-IRI study

Author

Seval Bilgic-Atli, Hakan Erdem, Ayşe Erbay, Nicholas J. Beeching, Ergin Ayaslioglu, Recep Tekin, Mile Bosilkovski, S. Sahin, Mehmet Ulug, Tuna Demirdal, Serap Ural, Alper Şener, Tansu Yamazhan, Asuman Inan, Emsal Aydin, Selma Tosun, Asli Haykir-Solay, Serda Gulsun, Selçuk Kaya, Nazif Elaldi, Pınar Ergen, Abdullah Umut Pekok, Elif Sahin-Horasan, Murat Muhcu, Mustafa Kasim Karahocagil, Mahmut Sunnetcioglu, Ayten Kadanali, Yakup Cag, Ali Avci, Şafak Kaya, Kırıkkale Üniversitesi, and [Inan, Asuman] Haydarpasa Numune Training & Res Hosp, Dept Infect Dis & Clin Microbiol, Istanbul, Turkey -- [Erdem, Hakan] Gulhane Training & Res Hosp, Dept Infect Dis & Clin Microbiol, Ankara, Turkey -- [Elaldi, Nazif] Cumhuriyet Univ, Sch Med, Dept Infect Dis & Clin Microbiol, Sivas, Turkey -- [Gulsun, Serda -- Kaya, Safak -- Bilgic-Atli, Seval] Diyarbakir Training & Res Hosp, Dept Infect Dis & Clin Microbiol, Diyarbakir, Turkey -- [Karahocagil, Mustafa K.] Yuzuncu Yil Univ, Sch Med, Dept Infect Dis & Clin Microbiol, Van, Turkey -- [Pekok, Abdullah U.] Pendik Med Pk Hosp, Dept Infect Dis & Clin Microbiol, Istanbul, Turkey -- [Ulug, Mehmet] Private Umut Hosp, Dept Infect Dis & Clin Microbiol, Eskisehir, Turkey -- [Tekin, Recep] Dicle Univ, Sch Med, Dept Infect Dis & Clin Microbiol, Sivas, Turkey -- [Bosilkovski, Mile] Skopje Med Fac, Dept Infect Dis & Febrile Condit, Skopje, Macedonia -- [Haykir-Solay, Asli] Diskapi Yildirim Beyazit Training & Res Hosp, Dept Infect Dis & Clin Microbiol, Ankara, Turkey -- [Demirdal, Tuna -- Ural, Serap] Katip Celebi Univ, Sch Med, Dept Infect Dis & Clin Microbiol, Izmir, Turkey -- [Kaya, Selcuk] Karadeniz Tech Univ, Sch Med, Dept Infect Dis & Clin Microbiol, Trabzon, Turkey -- [Sener, Alper] Onsekiz Mart Univ, Sch Med, Dept Infect Dis & Clin Microbiol, Canakkale, Turkey -- [Tosun, Selma] Izmir Bozyaka Training & Res Hosp, Dept Infect Dis & Clin Microbiol, Izmir, Turkey -- [Aydin, Emsal] Kafkas Univ, Sch Med, Dept Infect Dis & Clin Microbiol, Kars, Turkey -- [Yamazhan, Tansu] Ege Univ, Sch Med, Dept Infect Dis & Clin Microbiol, Izmir, Turkey -- [Muhcu, Murat] GATA Haydarpasa Training Hosp, Dept Obstet & Gynecol, Istanbul, Turkey -- [Ayaslioglu, Ergin] Kirikkale Univ, Sch Med, Dept Infect Dis & Clin Microbiol, Kirikkale, Turkey -- [Erbay, Ayse] Bozok Univ, Sch Med, Dept Infect Dis & Clin Microbiol, Yozgat, Turkey -- [Ergen, Pinar] Medeniyet Univ, Goztepe Training & Res Hosp, Dept Infect Dis & Clin Microbiol, Istanbul, Turkey -- [Kadanali, Ayten] Umraniye Training & Res Hosp, Dept Radiol, Istanbul, Turkey -- [Sahin, Suzan] Dr Lutfi Kirdar Training & Res Hosp, Dept Infect Dis & Clin Microbiol, Istanbul, Turkey -- [Sahin-Horasan, Elif] Mersin Univ, Sch Med, Dept Infect Dis & Clin Microbiol, Mersin, Turkey -- [Avci, Ali] Katip Celebi Univ, Ataturk Training & Res Hosp, Dept Urol, Izmir, Turkey -- [Cag, Yakup] Turkish Hlth Sci Univ, Dr Lutfi Kirdar Training & Res Hosp, Dept Infect Dis & Clin Microbiol, Istanbul, Turkey -- [Beeching, Nicholas J.] Univ Liverpool Liverpool Sch Trop Med, Clin Sci, Liverpool, Merseyside, England

Subjects
Adult, 0301 basic medicine, Microbiology (medical), medicine.medical_specialty, Adolescent, Fever, Turkey, 030106 microbiology, Bacteremia, Oligohydramnios, Abortion, Brucellosis, Young Adult, 03 medical and health sciences, 0302 clinical medicine, Pregnancy, Abortus, Epidemiology, medicine, Humans, 030212 general & internal medicine, Pregnancy Complications, Infectious, Retrospective Studies, Intrauterine fetal demise, Obstetrics, business.industry, Infant, Newborn, General Medicine, Middle Aged, medicine.disease, Brucella, Abortion, Spontaneous, Low birth weight, Cross-Sectional Studies, Infectious Diseases, Risk factors, Splenomegaly, Cohort, Vomiting, Female, medicine.symptom, business
Abstract

WOS: 000471726700008, PubMed ID: 30989418, Brucellosis in pregnant women is reported to be associated with obstetric complications (OCs), and adequate data for human brucellosis during pregnancy are largely lacking. We performed this multicenter retrospective cross-sectional study to evaluate the epidemiology, clinical course, treatment responses, and outcomes of brucellosis among pregnant women. The study period comprised a 14-year period from January 2002 to December 2015. All consecutive pregnant women diagnosed with brucellosis in 23 participating hospitals were included. Epidemiological, clinical, laboratory, therapeutic, and outcome data along with the assessment data of the neonate were collected using a standardized questionnaire. Data of 242 patients were analyzed. The OC rate was 14.0% (34/242) in the cohort. Of the 242 women, 219 (90.5%) delivered at term, 3 (1.2%) had preterm delivery, 15 (6.2%) aborted, and 5 (2.1%) had intrauterine fetal demise. Seventeen (7.0%) of the newborns were considered as low birth weight. Spontaneous abortion (6.1%) was the commonest complication. There were no maternal or neonatal deaths and pertinent sequelae or complications were not detected in the newborns. Splenomegaly (p=0.019), nausea and/or vomiting (p41IU/L; p=0.025), oligohydramnios on ultrasonography (p=0.0002), history of taking medication other than Brucella treatment during pregnancy (p=0.027), and Brucella bacteremia (p=0.029) were the significant factors associated with OCs. We recommend that pregnant women with OC or with fever should be investigated for brucellosis if they live in or have traveled to an endemic area.

Published
2019
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6. Profiles of multidrug-resistant organisms among patients with bacteremia in intensive care units: an international ID-IRI survey

Author

Recep Tekin, Haluk Vahabolgu, Irina Magdalena Dumitru, Jordi Rello, Svjetlana Grgić, Dhruv Mamtora, Michael M. Petrov, Fatma A. Amer, Yesim Uygun-Kizmaz, Handan Alay, Monica Licker, Deana Medic, Rosa Fontana Del Vecchio, Anna Liskova, Yasemin Cag, Nefise Oztoprak, Phunsup Wongsurakiat, Abdullah Umut Pekok, Aliye Esmaoğlu, Nirav Pandya, Rusmir Baljic, Mustafa Dogan, Krsto Grozdanovski, Emine Unal Evren, Gorana Dragovac, Ahsen Oncul, Serhat Uysal, Jurica Arapović, Ricardo Fernandez, Yesim Kurekci, Lul Raka, Behrouz Naghili, Amani El-Kholy, Nenad Pandak, Natalia Dirani, Mehmet Özdemir, Ilad Alavi Darazam, Biljana Carevic, Andrea Marino, Maha Ali Gad, Caroline Landelle, Ravina Kullar, Egidia Miftode, Ejaz Ahmed Khan, Nicolas Dauby, Jehan El Kholy, Ionela Larisa Miftode, Hema Prakash Kumari Pilli, Lurdes Santos, Reham Khedr, Goffredo Angioni, Szabo Balint Gergely, Ridvan Karaali, Antonio Cascio, Nasim Akhtar, Mostafa Kamal, André Silva-Pinto, Mumtaz Ali Khan, Rehab H. El-Sokkary, Şafak Özer Balin, Hakan Erdem, Rami Alabadla, El-Sokkary R., Uysal S., Erdem H., Kullar R., Pekok A.U., Amer F., Grgic S., Carevic B., El-Kholy A., Liskova A., Ozdemir M., Khan E.A., Uygun-Kizmaz Y., Pandak N., Pandya N., Arapovic J., Karaali R., Oztoprak N., Petrov M.M., Alabadla R., Alay H., Kholy J.A.E., Landelle C., Khedr R., Mamtora D., Dragovac G., Fernandez R., Evren E.U., Raka L., Cascio A., Dauby N., Oncul A., Balin S.O., Cag Y., Dirani N., Dogan M., Dumitru I.M., Gad M.A., Darazam I.A., Naghili B., Del Vecchio R.F., Licker M., Marino A., Akhtar N., Kamal M., Angioni G., Medic D., Esmaoglu A., Gergely S.B., Silva-Pinto A., Santos L., Miftode I.L., Tekin R., Wongsurakiat P., Khan M.A., Kurekci Y., Pilli H.P., Grozdanovski K., Miftode E., Baljic R., Vahabolgu H., and Rello J.

Subjects
Male, 0301 basic medicine, Klebsiella pneumoniae, Drug Resistance, Infection control, Multidrug resistance, 0302 clinical medicine, Medical microbiology, Drug Resistance, Multiple, Bacterial, 80 and over, Medicine, 030212 general & internal medicine, Child, Aged, 80 and over, Cross Infection, biology, Microbial Sensitivity Test, Bacterial, Bacterial Infections, General Medicine, Middle Aged, Sciences bio-médicales et agricoles, Countries, Anti-Bacterial Agents, Acinetobacter baumannii, Europe, Intensive Care Units, Infectious Diseases, Child, Preschool, Female, Multiple, Microbiology (medical), Adult, medicine.medical_specialty, Adolescent, 030106 microbiology, Intensive Care Unit, Pan-drug resistance, Microbial Sensitivity Tests, Infections, Bacterial Infection, Young Adult, 03 medical and health sciences, Antibiotic resistance, Intensive care, Internal medicine, Anti-Bacterial Agent, Humans, Stewardship, XDR, Preschool, Aged, Cross-Sectional Studie, Bacteria, business.industry, Infant, biology.organism_classification, medicine.disease, Multiple drug resistance, Cross-Sectional Studies, Bacteremia, business, Low- and upper-middle and high income
Abstract

Evaluating trends in antibiotic resistance is a requisite. The study aimed to analyze the profile of multidrug-resistant organisms (MDROs) among hospitalized patients with bacteremia in intensive care units (ICUs) in a large geographical area. This is a 1-month cross-sectional survey for blood-borne pathogens in 57 ICUs from 24 countries with different income levels: lower-middle-income (LMI), upper-middle-income (UMI), and high-income (HI) countries. Multidrug-resistant (MDR), extensively drug-resistant (XDR), or pan-drug-resistant isolates were searched. Logistic regression analysis determined resistance predictors among MDROs. Community-acquired infections were comparable to hospital-acquired infections particularly in LMI (94/202; 46.5% vs 108/202; 53.5%). Although MDR (65.1%; 502/771) and XDR (4.9%; 38/771) were common, no pan-drug-resistant isolate was recovered. In total, 32.1% of MDR were Klebsiella pneumoniae, and 55.3% of XDR were Acinetobacter baumannii. The highest MDR and XDR rates were in UMI and LMI, respectively, with no XDR revealed from HI. Predictors of MDR acquisition were male gender (OR, 12.11; 95% CI, 3.025-15.585) and the hospital-acquired origin of bacteremia (OR, 2.643; 95%CI, 1.462-3.894), and XDR acquisition was due to bacteremia in UMI (OR, 3.344; 95%CI, 1.189-5.626) and admission to medical-surgical ICUs (OR, 1.481; 95% CI, 1.076-2.037). We confirm the urgent need to expand stewardship activities to community settings especially in LMI, with more paid attention to the drugs with a higher potential for resistance. Empowering microbiology laboratories and reports to direct prescribing decisions should be prioritized. Supporting stewardship in ICUs, the mixed medical-surgical ones in particular, is warranted.

Published
2021

7. 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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8. 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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9. 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

10. Tuberculous and brucellosis meningitis differential diagnosis

Author

Sibel Bolukcu, Asli Haykir-Solay, Fatma Sirmatel, Melanie Catroux, Secil Deniz, Recep Tekin, Huseyin Turgut, Nefise Oztoprak, Hakan Erdem, Saygin Nayman-Alpat, Levent Gorenek, Selçuk Kaya, Serap Gencer, Meltem Avci, Mahmut Sunnetcioglu, Mustafa Namiduru, Mehmet Ulug, Kadriye Kart Yaşar, Gokhan Karaahmetoglu, Yves Hansmann, Tumer Guven, Rok Čivljak, Tuna Demirdal, Celal Ayaz, Mustafa Kemal Çelen, Isik Somuncu Johansen, Ayse Batirel, Ayten Kadanali, Oğuz Reşat Sipahi, Gonul Sengoz, Emel Yilmaz, Rodrigo Hasbun, Selma Ates-Guler, Ali İrfan Baran, Yasemin Cag, Hasan Karsen, Affan Denk, Emine Parlak, Ayşe Seza Inal, Filiz Pehlivanoglu, Hanefi Cem Gul, Ayhan Akbulut, Elif Sahin-Horasan, Soline Simeon, Seniha Senbayrak, Esmeray Mutlu-Yilmaz, Sukran Kose, Selma Tosun, Abdullah Umut Pekok, Mustafa Kasim Karahocagil, and Çukurova Üniversitesi

Subjects
Adult, Male, medicine.medical_specialty, Tuberculosis, Scoring system, Turkey, retrospective study, urologic and male genital diseases, Article, Brucellosis, Tuberculous meningitis, Meningitis, Bacterial, Diagnosis, Differential, Young Adult, Internal medicine, differential diagnosis, middle aged, Diagnosis, medicine, Humans, agglutination test, controlled study, Meningitis, human, Retrospective Studies, business.industry, Public Health, Environmental and Occupational Health, meningoencephalitis, scoring system, Meningoencephalitis, medicine.disease, major clinical study, Surgery, female, Infectious Diseases, priority journal, tuberculous meningitis, Tuberculosis, Meningeal, Etiology, Differential diagnosis, business, cerebrospinal fluid culture
Abstract

PubMedID: 25801665 SummaryBackground The Thwaites and Lancet scoring systems have been used in the rapid diagnosis of tuberculous meningitis (TBM). However, brucellar meningoencephalitis (BME) has similar characteristics with TBM. The ultimate aim of this study is to infer data to see if BME should be included in the differential diagnosis of TBM when these two systems suggest the presence of TBM. Method BME and TBM patients from 35 tertiary hospitals were included in this study. Overall 294 adult patients with BME and 190 patients with TBM were enrolled. All patients involved in the study had microbiological confirmation for either TBM or BME. Finally, the Thwaites and Lancet scoring systems were assessed in both groups. Results The Thwaites scoring system more frequently predicted BME cases (n = 292, 99.3%) compared to the TBM group (n = 182, 95.8%) (P = 0.017). According to the Lancet scoring system, the mean scores for BME and TBM were 9.43 ± 1.71 and 11.45 ± 3.01, respectively (P < 0.001). In addition, TBM cases were classified into "probable" category more significantly compared to BME cases, and BME cases were categorized into the "possible" category more frequently. Conclusions When the Thwaites or Lancet scoring systems indicate TBM, brucellar etiology should also be taken into consideration particularly in endemic countries. © 2015 Elsevier Ltd. All rights reserved.

Published
2015
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11. 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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12. 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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13. 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

14. Predicting unfavourable outcome in herpetic meningoencephalitis

Author

Hakan Erdem, Yasemin Cag, Gokhan Karaahmetoglu, Kaya, S., Lykke Larsen, Mario Poljak, Bruno Barsic, Xavier Argemi, Sørensen, S., Derya Ozturk-Engin, Bohr, A., Pierre Tattevin, Gunst, J., Lenka Baštáková, Matjaž Jereb, isik somuncu johansen, Oguz Karabay, Abdullah Umut Pekok, Oğuz Reşat Sipahi, and Haluk Vahaboglu

Abstract

BACKGROUND: Herpetic meningoencephalitis is the most frequent form of sporadic fatal encephalitis in the world and accounts for 10- 20% of all viral encephalitides. There were studies assessing the outcomes particularly by comparing the efficacies of antiviral drugs in the past. To the best of our knowledge, no datum exists in the literature on the mortality indicators of HME patients with definite microbiological diagnosis. Thus, our study makes use of the largest case series ever reported in the literature to provide data for the predictors of unfavorable outcome in HME cases. METHODS: This multicenter study enrolled HME patients from referral participant centers in 10 countries (Croatia, Czech Republic, Denmark, Egypt, France, Iraq, Italy, Lebanon, Slovenia, and Turkey). The study had a retrospective design and included patients hospitalized between 2000 and 2013. Only the adult patients with HME over the age of 15 were enrolled. Dr Lütfi Kirdar Training and Research Hospital’s Review Board in Istanbul approved the study. The inclusion criteria were as follows: 1. Symptoms and/or signs of parenchymatous disease of the brain such as focal neurological signs, seizures, decreased consciousness or disorientation often concomitant with fever and pathological neuroradiology or neurophysiology findings 2. Positive CSF-PCR result for HSV-1 or HSV-2 or both. 3. The unlikely presence of another parenchymatous disease of the brain. Unfavorable Outcome included death and sequelae. RESULTS: In this study, 501 patients with microbiologically confirmed HME were enrolled from 35 referral centers in 10 countries [Turkey (n=144), Denmark (n=127), France (n=64), Slovenia (n=54), Croatia (n=32), Iraq (n=30), Czech Republic (n=23), Italy (n=12), Lebanon (n=8), Egypt (n=7)]. However, 438 patients were found to be eligible for outcome analysis and 63 HME cases were excluded due to missing data. In this study 44 (10 %) patients died and 188 (42.9 %) experienced unfavorable outcome. Hence, 232 (52.9 %) cases experienced unfavorable outcome. The results of multivariate analysis are presented in the table. The interrelation between the elapsed time since the onset of symptoms to anti-viral treatment and unfavorable outcome is presented in the figure. CONCLUSION: Advancing age, lower GCS scores, delayed start of antivirals exceeding one week in particular, and new onset of convulsions seem to increase unfavorable outcome in HME. Thus, it appears that both host and therapeutic parameters contribute to success in these cases. Table. Final model including independent predictors of unfavorable outcome 95% CIs OR [1] Low High p Age (years) 1.04 1.02 1.05 0.000 Glasgow coma scale 0.84 0.77 0.93 0.000 Elapsed time [2] >2 days 7 days 3.75 1.72 8.15 0.001 New onset convulsion [3] 1.61 0.93 2.76 0.088 constant 1.08 0.27 4.43 0.910 [1] OR, odds ratio [2] Elapsed time between unset of symptoms and administration of anti-viral treatment [3] Newly unset convulsion before hospital admission

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