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2. Prediction of unfavorable outcomes in cryptococcal meningitis: results of the multicenter Infectious Diseases International Research Initiative (ID-IRI) cryptococcal meningitis study

Author

Hakyemez, I. N., Erdem, H., Beraud, G., Lurdes, M., Silva-Pinto, A., Alexandru, C., Bishop, B., Mangani, F., Argemi, X., Poinot, M., Hasbun, R., Sunbul, M., Akcaer, M., Alp, S., Demirdal, T., Angamuthu, K., Amer, F., Ragab, E., Shehata, G. A., Ozturk-Engin, D., Ozgunes, N., Larsen, L., Zimmerli, S., Sipahi, O. R., Tukenmez Tigen, E., Celebi, G., Oztoprak, N., Yardimci, A. C., and Cag, Y.

Published
2018
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3. Genitourinary brucellosis: results of a multicentric study

Author

Erdem, H., Elaldi, N., Ak, O., Gulsun, S., Tekin, R., Ulug, M., Duygu, F., Sunnetcioglu, M., Tulek, N., Guler, S., Cag, Y., Kaya, S., Turker, N., Parlak, E., Demirdal, T., Ataman Hatipoglu, C., Avci, A., Bulut, C., Avci, M., Pekok, A., Savasci, U., Sozen, H., Tasbakan, M., Guven, T., Bolukcu, S., Cesur, S., Sahin-Horasan, E., Kazak, E., Denk, A., Gonen, I., Karagoz, G., Haykir Solay, A., Alici, O., Kader, C., Senturk, G., Tosun, S., Turan, H., Baran, A.I., Ozturk-Engin, D., Bozkurt, F., Deveci, O., Inan, A., Kadanali, A., Sayar, M.S., Cetin, B., Yemisen, M., Naz, H., Gorenek, L., and Agalar, C.

Published
2014
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4. Infections in travellers returning to Turkey from the Arabian peninsula: a retrospective cross-sectional multicenter study

Author

Erdem, H., Ak, O., Elaldi, N., Demirdal, T., Hargreaves, S., Nemli, S. A., Cag, Y., Ulug, M., Naz, H., Gunal, O., Sirmatel, F., Sipahi, O. R., Alpat, S. N., Ertem-Tuncer, G., Sozen, H., Evlice, O., Meric-Koc, M., Dogru, A., Koksaldi-Motor, V., Tekin, R., Ozdemir, D., Ozturk-Engin, D., Savasci, U., Karagoz, E., Cekli, Y., and Inan, A.

Published
2016
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5. Diagnosis of chronic brucellar meningitis and meningoencephalitis: the results of the Istanbul-2 study

Author

Erdem, H., Kilic, S., Sener, B., Acikel, C., Alp, E., Karahocagil, M., Yetkin, F., Inan, A., Kecik-Bosnak, V., Gul, H.C., Tekin-Koruk, S., Ceran, N., Demirdal, T., Yilmaz, G., Ulu-Kilic, A., Ceylan, B., Dogan-Celik, A., Nayman-Alpat, S., Tekin, R., Yalci, A., Turban, V., Karaoglan, I., Yilmaz, H., Mete, B., Batirel, A., Ulcay, A., Dayan, S., Seza Inal, A., Ahmed, S.S., Tufan, Z.K., Karakas, A., Teker, B., Namiduru, M., Savasci, U., and Pappas, G.

Published
2013
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6. Correction to: Prediction of unfavorable outcomes in cryptococcal meningitis: results of the multicenter infectious Diseases International Research Initiative (ID-IRI) cryptococcal meningitis study

Author

Hakyemez, I. N., Erdem, H., Beraud, G., Lurdes, M., Silva-Pinto, A., Alexandru, C., Bishop, B., Mangani, F., Argemi, X., Poinot, M., Hasbun, R., Sunbul, M., Akcaer, M., Alp, S., Demirdal, T., Angamuthu, K., Amer, F., Ragab, E., Shehata, G. A., Ozturk-Engin, D., Ozgunes, N., Larsen, L., Zimmerli, S., Sipahi, O. R., Tukenmez Tigen, E., Celebi, G., Oztoprak, N., Yardimci, A. C., and Cag, Y.

Published
2018
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7. Liver involvement in patients with brucellosis: results of the Marmara study

Author

Ozturk-Engin, D., Erdem, H., Gencer, S., Kaya, S., Baran, A. I., Batirel, A., Tekin, R., Celen, M. K., Denk, A., Guler, S., Ulug, M., Turan, H., Pekok, A. U., Mermut, G., Kaya, S., Tasbakan, M., Tulek, N., Cag, Y., Inan, A., Yalci, A., Ataman-Hatipoglu, C., Gonen, I., Dogan-Celik, A., Bozkurt, F., Gulsun, S., Sunnetcioglu, M., Guven, T., Duygu, F., Parlak, E., Sozen, H., Tosun, S., Demirdal, T., Guclu, E., Karabay, O., Uzun, N., Gunal, O., Diktas, H., Haykir-Solay, A., Erbay, A., Kader, C., Aydin, O., Erdem, A., Elaldi, N., Kadanali, A., Yulugkural, Z., Gorenek, L., Altındis, M., Bolukcu, S., Agalar, C., and Ormeci, N.

Published
2014
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9. Diagnostic value of combined serum biomarkers for the evaluation of liver fibrosis in chronic hepatitis C infection: A multicenter, noninterventional, observational study

Author

Köksal, I., Yilmaz, G., Parlak, M., Demirdal, T., Kinikli, S., Candan, M., Kaya, A., Akhan, S., Aydoǧdu, Ö., Turgut, Hüseyin, Gürbüz, Y., Daǧli, Ö., Gökal, A.A., Güner, R., Kuruüzüm, Z., Tarakçi, H., Beslen, N., Erdoǧan, S., Özdener, F., Duyar, E., Inan, D., Leblebicioǧlu, H., Sehmen, E., Yuluǧkural, Z., Namiduru, M., Kökoǧlu, Ö.F., Baykam, N., Ural, O., Bostanci, F., Kaya, S., Kiliç, S., Önlen, Y., Özdemir, D., Tabak, F., and Yamazhan, T.

Subjects
Liver Cirrhosis, Male, Turkey, clinical evaluation, Biopsy, Hepacivirus, Turkey (republic), FibroTest, aspartate aminotransferase, Liver Function Tests, middle aged, statistics and numerical data, APRI, liver fibrosis, Forns index, Fib-4, adult, clinical trial, Alanine Transaminase, biological marker, virology, aged, female, Liver, Area Under Curve, young adult, diagnostic value, Adolescent, area under the curve, alanine aminotransferase, disease classification, complication, Sensitivity and Specificity, Article, open study, blood, turkey (bird), chronic hepatitis C, Humans, Non-invasive serum biomarkers, liver function test, human, procedures, Aspartate Aminotransferases, liver biopsy, Platelet Count, scoring system, Hepatitis C, Chronic, major clinical study, Chronic hepatitis C infection, human tissue, multicenter study, observational study, pathology, aspartate aminotransferase blood level, Biomarkers
Abstract

Background/Aims: The hepatitis C virus (HCV) infection is important cause of chronic hepatitis. Liver biopsy is considered the gold standard for assessment of fibrosis but this procedure is an invasive procedure. We aimed to evaluate the diagnostic efficiency of non-invasive serum biomarkers, separately and in combinations, on liver fibrosis in treatment-naive chronic hepatitis C (CHC) patients. Materials and Methods: Two hundred and sixteen treatment-naive CHC patients were enrolled from 32 locations across Turkey in this open-labelled, non-interventional prospective observational study. FibroTest®, aspartate aminotransferase-to-platelet ratio index(APRI), aspartate aminotransferase and alanine aminotransferase ratio (AAR), fibrosis index based on four factors (FIB-4), Age-platelet(AP) index and Forns index were measured and compared with Metavir scores got from liver biopsies. Results: Data from 182 patients with baseline liver biopsy were suitable for analysis. One hundred and twenty patients (65.9%) had F0-F1 fibrosis and 62 patients (34.1%) had F2-F4 fibrosis. APRI 0.732 area under the curve(AUC) indicated advanced fibrosis with 69% sensitivity and 77% specificity. FIB-4 0.732 AUC and FibroTest 0.715 AUC indicated advanced fibrosis with 69% and 78.4% sensitivity, and 75% and 71.4% specificity, respectively. The combined use of tests also led to an increase in AUC and specificity. Combinations of FibroTest with APRI and/or FIB-4, and FIB-4 with APRI were optimal for the evaluation of liver fibrosis. Conclusion: Fibrotest, FIB-4, APRI, AP index and Forns index exhibit good diagnostic performance for determining liver fibrosis in CHC patients, and the use of at least two tests together will increase their diagnostic value still further. © Copyright 2018 by The Turkish Society of Gastroenterology.

Published
2018

10. liver fibrosis in chronic hepatitis C infection: A multicenter

Author

Koksal, I, Yilmaz, G, Parlak, M, Demirdal, T, Kinikli, S, Candan, M, Kaya, A, Akhan, S, Aydogdu, O, Turgut, H, Gurbuz, Y, Dagli, O, Gokal, AA, Guner, R, Kuruuzum, Z, Tarakci, H, Beslen, N, Erdogan, S, and Ozdener, F

Subjects
Chronic hepatitis C infection, liver fibrosis, FibroTest, APRI, Forns, index, Fib-4, non-invasive serum biomarkers
Abstract

Background/Aims: The hepatitis C virus (HCV) infection is important cause of chronic hepatitis. Liver biopsy is considered the gold standard for assessment of fibrosis but this procedure is an invasive procedure. We aimed to evaluate the diagnostic efficiency of non-invasive serum biomarkers, separately and in combinations, on liver fibrosis in treatment-naive chronic hepatitis C (CHC) patients. Materials and Methods: Two hundred and sixteen treatment-naive CHC patients were enrolled from 32 locations across Turkey in this open-labelled, non-interventional prospective observational study. FibroTest (R), aspartate aminotransferase-to-platelet ratio index(A-PRI), aspartate aminotransferase and alanine aminotransferase ratio (AAR), fibrosis index based on four factors (FIB-4), Age-platelet(AP) index and Forns index were measured and compared with Metavir scores got from liver biopsies. Results: Data from 182 patients with baseline liver biopsy were suitable for analysis. One hundred and twenty patients (65.9%) had F0-F1 fibrosis and 62 patients (34.1%) had F2-F4 fibrosis. APRI 0.732 area under the curve(AUC) indicated advanced fibrosis with 69% sensitivity and 77% specificity. FIB-4 0.732 AUC and FibroTest 0.715 AUC indicated advanced fibrosis with 69% and 78.4% sensitivity, and 75% and 71.4% specificity, respectively. The combined use of tests also led to an increase in AUC and specificity. Combinations of FibroTest with APRI and/or FIB-4, and FIB-4 with APRI were optimal for the evaluation of liver fibrosis. Conclusion: Fibrotest, FIB-4, APRI, AP index and Forns index exhibit good diagnostic performance for determining liver fibrosis in CHC patients, and the use of at least two tests together will increase their diagnostic value still further.

Published
2018

11. Diagnostic value of combined serum biomarkers for the evaluation of liver fibrosis in chronic hepatitis C infection: A multicenter, noninterventional, observational study

Author

Köksal İ, Yılmaz G, Parlak M, Demirdal T, Kınıklı S, Candan M, Kaya A, Akhan S, Aydoğdu Ö, Turgut H, Gürbüz Y, Dağlı Ö, Gökal AA, Güner R, Kuruüzüm Z, Tarakçı H, Beslen N, Erdoğan S, Özdener F, and Study Group TCHC

Subjects
Adolescent, Adult, Aged, Alanine Transaminase/blood, Area Under Curve, Aspartate Aminotransferases/blood, Biomarkers/blood, Biopsy, Female, Hepacivirus, Hepatitis C, Chronic/*blood/complications/virology, Humans, Liver/pathology/virology, Liver Cirrhosis/*diagnosis/virology, Liver Function Tests/methods/*statistics & numerical data, Male, Middle Aged, Platelet Count, Sensitivity and Specificity, Turkey, Young Adult
Abstract

BACKGROUND/AIMS: The hepatitis C virus (HCV) infection is important cause of chronic hepatitis. Liver biopsy is considered the gold standard for assessment of fibrosis but this procedure is an invasive procedure. We aimed to evaluate the diagnostic efficiency of non-invasive serum biomarkers, separately and in combinations, on liver fibrosis in treatment-naive chronic hepatitis C (CHC) patients. MATERIALS AND METHODS: Two hundred and sixteen treatment-naive CHC patients were enrolled from 32 locations across Turkey in this open-labelled, non-interventional prospective observational study. FibroTest®, aspartate aminotransferase-to-platelet ratio index(APRI), aspartate aminotransferase and alanine aminotransferase ratio (AAR), fibrosis index based on four factors (FIB-4), Age-platelet(AP) index and Forns index were measured and compared with Metavir scores got from liver biopsies. RESULTS: Data from 182 patients with baseline liver biopsy were suitable for analysis. One hundred and twenty patients (65.9%) had F0-F1 fibrosis and 62 patients (34.1%) had F2-F4 fibrosis. APRI 0.732 area under the curve(AUC) indicated advanced fibrosis with 69% sensitivity and 77% specificity. FIB-4 0.732 AUC and FibroTest 0.715 AUC indicated advanced fibrosis with 69% and 78.4% sensitivity, and 75% and 71.4% specificity, respectively. The combined use of tests also led to an increase in AUC and specificity. Combinations of FibroTest with APRI and/or FIB-4, and FIB-4 with APRI were optimal for the evaluation of liver fibrosis. CONCLUSION: Fibrotest, FIB-4, APRI, AP index and Forns index exhibit good diagnostic performance for determining liver fibrosis in CHC patients, and the use of at least two tests together will increase their diagnostic value still further.

Published
2018

12. Central nervous system infections in the absence of cerebrospinal fluid pleocytosis

Author

Erdem, H., Ozturk-Engin, D., Cag, Y., Senbayrak, S., Inan, A., Kazak, E., Savasci, U., Elaldi, N., Vahaboglu, H., Hasbun, R., Nechifor, M., Tireli, H., Kilicoglu, G., Defres, S., Gulsun, S., Ceran, N., Crisan, A., Johansen, I.S., Namiduru, M., Dayan, S., Kayabas, U., Parlak, E., Khalifa, A., Kursun, E., Sipahi, O.R., Yemisen, M., Akbulut, A., Bitirgen, M., Popovic, N., Kandemir, B., Luca, C., Parlak, M., Stahl, J.P., 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, H.C., Karakas, A., Chadapaud, S., Hansmann, Y., Harxhi, A., Kirova, V., Masse-Chabredier, I., Oncu, S., Sener, A., Tekin, R., Deveci, O., Ozkaya, H.D., Karabay, O., Agalar, C., Gencer, S., Karahocagil, M.K., Karsen, H., Kaya, S., Pekok, A.U., Celen, M.K., Deniz, S., Ulug, M., Demirdal, T., Guven, T., Bolukcu, S., Avci, M., Nayman-Alpat, S., Yaşar, K., Pehlivanoʇlu, F., Ates-Guler, S., Mutlu-Yilmaz, E., Tosun, S., Sirmatel, F., Batirel, A., Öztoprak, N., Kadanali, A., Turgut, H., Baran, A.I., Karaahmetoglu, G., Sunnetcioglu, M., Haykir-Solay, A., Denk, A., Ayaz, C., Gorenek, L., Larsen, L., Poljak, M., Barsic, B., Argemi, X., Sørensen, S.M., Bohr, A.L., Tattevin, P., Gunst, J.D., Baštáková, L., Jereb, M., Chehri, M., Beraud, G., Del Vecchio, R.F., Maresca, M., Yilmaz, H., Sharif-Yakan, A., Kanj, S.S., Korkmaz, F., Komur, S., Coskuner, S.A., Ince, N., Akkoyunlu, Y., Halac, G., Nemli, S.A., Ak, O., Gunduz, A., Gozel, M.G., Hatipoglu, M., Cicek-Senturk, G., Akcam, F.Z., Inkaya, A.C., Sagmak-Tartar, A., Ersoy, Y., Tuncer-Ertem, G., Balkan, I.I., Cetin, B., Ersoz, G., Ozgunes, N., Yesilkaya, A., Erturk, A., Gundes, S., Turhan, V., Yalci, A., Aydin, E., Diktas, H., Ulcay, A., Seyman, D., and Leblebicioglu, H.

Subjects
protein cerebrospinal fluid level, Male, pleocytosis, Meningitis, Pneumococcal, Leukocytosis, herpes simplex encephalitis, CSF, Leukocyte, brucella meningitis, Article, cerebrospinal fluid, clinical feature, female, Central Nervous System Infections, tuberculous meningitis, Tuberculosis, Meningeal, central nervous system infection, middle aged, neurosyphilis, Encephalitis, Humans, pathology, Meningitis, human, pneumococcal meningitis
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. © 2017 The Author(s)

Published
2017

13. Prediction of unfavorable outcomes in cryptococcal meningitis: results of the multicenter Infectious Diseases International Research Initiative (ID-IRI) cryptococcal meningitis study

Author

Hakyemez, I. N., primary, Erdem, H., additional, Beraud, G., additional, Lurdes, M., additional, Silva-Pinto, A., additional, Alexandru, C., additional, Bishop, B., additional, Mangani, F., additional, Argemi, X., additional, Poinot, M., additional, Hasbun, R., additional, Sunbul, M., additional, Akcaer, M., additional, Alp, S., additional, Demirdal, T., additional, Angamuthu, K., additional, Amer, F., additional, Ragab, E., additional, Shehata, G. A., additional, Ozturk-Engin, D., additional, Ozgunes, N., additional, Larsen, L., additional, Zimmerli, S., additional, Sipahi, O. R., additional, Tukenmez Tigen, E., additional, Celebi, G., additional, Oztoprak, N., additional, Yardimci, A. C., additional, and Cag, Y., additional

Published
2017
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14. Transverse myelitis associated with toxocariasis and the importance of locally produced antibodies for diagnosis [Toksokariyaza Bagli Bir Transvers Miyelit Olgusu ve Tanida Yerel Antikor Üretiminin Önemi]

Author

Ural S., Özer B., Gelal F., DiRiM Erdogan D., Sezak N., Balik R., Demirdal T., Korkmaz M., and Ege Üniversitesi

Subjects
ComputingMilieux_MANAGEMENTOFCOMPUTINGANDINFORMATIONSYSTEMS, ComputingMethodologies_PATTERNRECOGNITION, ComputerSystemsOrganization_COMPUTER-COMMUNICATIONNETWORKS, Transverse myelitis, Toxocara canis, InformationSystems_MISCELLANEOUS, Neurotoxocariasis
Abstract

PubMed ID: 27525404, Toxocariasis caused by Toxocara canis or less frequently by T.catis is a common parasitic infection worldwide. Clinical spectrum in humans can vary from asymptomatic infection to serious organ disfunction depending on the load of parasite, migration target of the larva and the inflammatory response of the host. Transverse myelitis (TM) due to toxocariasis is an uncommon illness identified mainly as case reports in literature. In this report, a case of TM who was diagnosed as neurotoxocariasis by serological findings has been presented. A 44-year-old male patient complained with backache was diagnosed as TM in a medical center in which he has admitted two years ago, and treated with pregabalin and nonsteroidal drugs for six months. Because of the progression of the lesions he readmitted to another center and treated with high dose steroid therapy for three months. After six months of follow up, improvement has been achieved, however, since his symptoms reccurred in the following year he was admitted to our hospital. Magnetic resonance imaging (MRI) examination revealed a TM in a lower segment of spinal cord. He was suffering with weakness and numbness in the left lower extremity. There was no history of rural life or contact with cats or dogs in his anamnesis. Physical examination revealed normal cranial nerve functions, sensory and motor functions. There has been no pathological reflexes, and deep tendon reflexes were also normal. Laboratory findings yielded normal hemogram and biochemical tests, negative PPD and parasitological examination of stool were negative for cysts and ova. Viral hepatitis markers, anti-HIV, toxoplasma-lgM, CMV-IgM, rubella-IgM, EBV-VCA-IgM, VDRL, Brucella tube agglutination, echinococcus antibody, autoantibody tests and neuromyelitis optica test were negative. Examination of CSF showed 20 cells/mm3 (mononuclear cells), 45 mg/dl protein and normal levels of glucose and chlorine. In both serum and CSF samples of the patient Toxocaro-IgG antibodies were detected by Western blot (WB) assay. Low molecular weight bands (30-40 kDa) were detected in both of the samples by repeated WB testing. CSF revealed more intense bands suggesting local antibody production. Therefore the patient was diagnosed as neurotoxocariasis, and treated with steroid and mebendazole for six weeks. Clinical improvement was detected in the case and thoracic MRI revealed significant improvement in myelitis signs two months after treatment. In conclusion, toxocariasis should be considered in the differential diagnosis of TM although the involvement of central nervous system is rare and serological testing should be performed properly in the serum and CSF samples for the diagnosis.

Published
2016

15. study

Author

Erdem, H, Senbayrak, S, Meric, K, Batirel, A, Karahocagil, MK, Hasbun, R, Sengoz, G, Karsen, H, Kaya, S, Inal, AS, Pekok, AU, Celen, MK, Deniz, S, Ulug, M, Demirdal, T, Namiduru, M, Tekin, R, Guven, T, Parlak, E, Bolukcu, S, Avci, M, Sipahi, OR, Ozturk-Engin, D, Yasar, K, Pehlivanoglu, F, Yilmaz, E, Ates-Guler, S, Mutlu-Yilmaz, E, Tosun, S, Sirmatel, F, Sahin-Horasan, E, Akbulut, A, Oztoprak, N, Cag, Y, Kadanali, A, Turgut, H, Baran, AI, Gul, HC, Sunnetcioglu, M, Haykir-Solay, A, Denk, A, Inan, A, Ayaz, C, Ulcay, A, Kose, S, Agalar, C, and Elaldi, N

Subjects
Diagnosis, Inflammation, Neurobrucellosis, Computerized tomography, Magnetic resonance imaging
Abstract

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

16. [No title available]

Author

Karabay O., Hoşoğlu S., Güçlü E., Akalin Ş., Altay F.A., Aydin E., Ceylan B., Çelik A., Çelik İ., Demirdal T., Demirli K., Erben N., Erkorkmaz Ü., Erol S., Evirgen Ö., Gönen İ., Güner A.E., Güven T., Kadanali A., Koçoğlu M.E., Kökoğlu Ö.F., Küçükbayrak A., Sargin F., Sünnetçioğlu M., Şenol Ş., Taşbakan M.I., Tekin R., Turhan V., Yilmaz G., Dede B., and Ege Üniversitesi

Subjects
ComputingMilieux_MANAGEMENTOFCOMPUTINGANDINFORMATIONSYSTEMS, Antibiotic usage, ComputingMethodologies_PATTERNRECOGNITION, Antibiotic policy, ComputerSystemsOrganization_COMPUTER-COMMUNICATIONNETWORKS, Budget execution instructions, InformationSystems_MISCELLANEOUS, Antibiotic restriction, Specialist
Abstract

PubMed ID: 27511346, Background/aim: Broad-spectrum antibiotics have become available for use only with the approval of infectious disease specialists (IDSs) since 2003 in Turkey. This study aimed to analyze the tendencies of doctors who are not disease specialists (non-IDSs) towards the restriction of antibiotics. Materials and methods: A questionnaire form was prepared, which included a total of 22 questions about the impact of antibiotic restriction (AR) policy, the role of IDSs in the restriction, and the perception of this change in antibiotic consumption. The questionnaire was completed by each participating physician. Results: A total of 1906 specialists from 20 cities in Turkey participated in the study. Of those who participated, 1271 (67.5%) had ?5 years of occupational experience (junior specialists = JSs) and 942 (49.4%) of them were physicians. Specialists having >5 years of occupational experience in their branch expressed that they followed the antibiotic guidelines more strictly than the JSs (P < 0.05) and 755 of physicians (88%) and 720 of surgeons (84.6%) thought that the AR policy was necessary and useful (P < 0.05). Conclusion: This study indicated that the AR policy was supported by most of the specialists. Physicians supported this restriction policy more so than surgeons did. © TÜBITAK.

Published
2016

17. infections: A prospective multi-center study

Author

Hatipoglu, M, Mutluoglu, M, Turhan, V, Uzun, G, Lipsky, BA, Sevim, E, Demiraslan, H, Eryilmaz, E, Ozuguz, C, Memis, A, Ay, H, Arda, B, Uysal, S, Motor, VK, Kader, C, Erturk, A, Coskun, O, Duygu, F, Guler, S, Altay, FA, Ogutlu, A, Bolukcu, S, Yildiz, S, Kandemir, O, Aslaner, H, Polat, A, Karahocagil, MK, Yasar, KK, Sehmen, E, Kilic, S, Sunbul, M, Gencer, S, Bozkurt, F, Yanik, T, Oztoprak, N, Batirel, A, Sozen, H, Kilic, I, Celik, I, Ay, B, Tosun, S, Kadanali, A, Comoglu, S, Denk, A, Hosoglu, S, Aydin, O, Elaldi, N, Akalin, S, Kandemir, B, Akbulut, A, Demirdal, T, Balik, R, Azak, E, and Sengoz, G

Subjects
Antibiotic therapy, Diabetic foot, Guideline, Infection, Turkey
Abstract

Aim: Clinical practice guidelines for the management of diabetic foot infections developed by the Infectious Diseases Society of America (IDSA) are commonly used worldwide. The issue of whether or not these guidelines need to be adjusted for local circumstances, however, has seldom been assessed in large prospective trials. Methods: The Turk-DAY trial was a prospective, multi-center study in which infectious disease specialists from centers across Turkey were invited to participate (NCT02026830). Results: A total of 35 centers throughout Turkey enrolled patients in the trial. Overall, investigators collected a total of 522 specimens from infected diabetic foot wounds for culture from 447 individual patients. Among all isolates, 36.4% were gram-positive organisms, with Staphylococcus aureus the most common among these (11.4%). Gram-negative organisms constituted 60.2% of all the isolates, and the most commonly isolated gram-negative was Escherichia coli (15%). The sensitivity rates of the isolated species were remarkably low for several antimicrobials used in the mild infection group. Conclusions: Based on our findings, several of the antimicrobials frequently used for empirical treatment, including some also recommended in the IDSA guidelines, would not be optimal for treating diabetic foot infections in Turkey. Although the IDSA guideline recommendations may be helpful to guide empiric antimicrobial therapy of DFIs, they should be adjusted to local conditions. (C) 2016 Elsevier Inc. All rights reserved.

Published
2016

18. International Nosocomial Infection Control Consortium (INICC)

Author

Leblebicioglu, H, Erben, N, Rosenthal, VD, Sener, A, Uzun, C, Senol, G, Ersoz, G, Demirdal, T, Duygu, F, Willke, A, Sirmatel, F, Oztoprak, N, Koksal, I, Oncul, O, Gurbuz, Y, Guclu, E, Turgut, H, Yalcin, AN, Ozdemir, D, Kendirli, T, Aslan, T, Esen, S, Ulger, F, Dilek, A, Yilmaz, H, Sunbul, M, Ozgunes, I, Usluer, G, Otkun, M, Kaya, A, Kuyucu, N, Kaya, Z, Meric, M, Azak, E, Yylmaz, G, Kaya, S, Ulusoy, H, Haznedaroglu, T, Gorenek, L, Acar, A, Tutuncu, E, Karabay, O, Kaya, G, Sacar, S, Sungurtekin, H, Ugurcan, D, Turhan, O, Gumus, E, Dursun, O, Geyik, MF, Sahin, A, Erdogan, S, Ince, E, Karbuz, A, Ciftci, E, Tasyapar, N, and Gunes, M

Subjects
infection, Surgical wound infection, Developing countries, Hospital infection, Nosocomial infection, Health care-associated
Abstract

Background: Surgical site infections (SSIs) are a threat to patient safety; however, there were no available data on SSI rates stratified by surgical procedure (SP) in Turkey. Methods: Between January 2005 and December 2011, a cohort prospective surveillance study on SSIs was conducted by the International Nosocomial Infection Control Consortium (INICC) in 20 hospitals in 16 Turkish cities. Data from hospitalized patients were registered using the Centers for Disease Control and Prevention (CDC) National Healthcare Safety Network (NHSN) methods and definitions for SSIs. Surgical procedures (SPs) were classified into 22 types according to International Classification of Diseases, Ninth Revision criteria. Results: We recorded 1879 SSIs, associated with 41,563 SPs (4.3%; 95% confidence interval, 4.3-4.7). Among the results, the SSI rate per type of SP compared with rates reported by the INICC and CDC NHSN were 11.9% for ventricular shunt (vs 12.9% vs 5.6%); 5.3% for craniotomy (vs 4.4% vs 2.6%); 4.9% for coronary bypass with chest and donor incision (vs 4.5 vs 2.9); 3.5% for hip prosthesis (vs 2.6% vs 1.3%), and 3.0% for cesarean section (vs 0.7% vs 1.8%). Conclusions: In most of the 22 types of SP analyzed, our SSI rates were higher than the CDC NHSN rates and similar to the INICC rates. This study advances the knowledge of SSI epidemiology in Turkey, allowing the implementation of targeted interventions. Copyright (C) 2015 by the Association for Professionals in Infection Control and Epidemiology, Inc. Published by Elsevier Inc. All rights reserved.

Published
2015

19. Tuberculous and brucellosis meningitis differential diagnosis

Author

Erdem H, Senbayrak S, Gencer S, Hasbun R, Karahocagil MK, Sengoz G, Karsen H, Kaya S, Civljak R, Inal AS, Pekok AU, Celen MK, Deniz S, Ulug M, Demirdal T, Namiduru M, Tekin R, Guven T, Parlak E, Bolukcu S, Avci M, Sipahi OR, Nayman-Alpat S, Yaşar K, Pehlivanoğlu F, Yilmaz E, Ates-Guler S, Mutlu-Yilmaz E, Tosun S, Sirmatel F, Şahin-Horasan E, Akbulut A, Johansen IS, Simeon S, Batirel A, Öztoprak N, Cag Y, Catroux M, Hansmann Y, Kadanali A, Turgut H, Baran AI, Gul HC, Karaahmetoglu G, and Sunnetcioglu

Subjects
Adult, Brucellosis/*diagnosis/epidemiology, Diagnosis, Differential, Female, Humans, Male, Meningitis, Bacterial/diagnosis/epidemiology, Middle Aged, Retrospective Studies, Tuberculosis, Meningeal/*diagnosis/epidemiology, Turkey, Young Adult, urologic and male genital diseases
Abstract

BACKGROUND: 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.

Published
2015

20. Surgical site infection rates in 16 cities in Turkey: findings of the International Nosocomial Infection Control Consortium (INICC)

Author

Leblebicioglu, H., Erben, N., Rosenthal, V.D., Sener, A., Uzun, C., Senol, G., Ersoz, G., Demirdal, T., Duygu, F., Willke, A., Sirmatel, F., Oztoprak, N., Koksal, I., Oncul, O., Gurbuz, Y., Güçlü, E., Turgut, H., Yalcin, A.N., Ozdemir, D., Kendirli, T., Aslan, T., Esen, S., Ulger, F., Dilek, A., Yilmaz, H., Sunbul, M., Ozgunes, I., Usluer, G., Otkun, M., Kaya, A., Kuyucu, N., Kaya, Z., Meric, M., Azak, E., Yýlmaz, G., Kaya, S., Ulusoy, H., Haznedaroglu, T., Gorenek, L., Acar, A., Tutuncu, E., Karabay, O., Kaya, G., Sacar, S., Sungurtekin, H., Uğurcan, Doğaç, Turhan, O., Gumus, E., Dursun, O., Geyik, M.F., Şahin, A., Erdogan, S., Ince, E., Karbuz, A., Çiftçi, E., Taşyapar, N., and Güneş, M.

Subjects
Turkey, Surgical wound infection, Health careeassociated infection, prevalence, infection rate, surgical infection, Article, Turkey (republic), Developing countries, Cohort Studies, hip prosthesis, Nosocomial infection, coronary artery bypass graft, Humans, Hospital infection, human, Prospective Studies, hospital, Cities, cesarean section, craniotomy, clinical trial, cohort analysis, shunting, Hospitals, hospital patient, multicenter study, city, prospective study
Abstract

Background: Surgical site infections (SSIs) are a threat to patient safety; however, there were no available data on SSI rates stratified by surgical procedure (SP) in Turkey. Methods: Between January 2005 and December 2011, a cohort prospective surveillance study on SSIs was conducted by the International Nosocomial Infection Control Consortium (INICC) in 20 hospitals in 16 Turkish cities. Data from hospitalized patients were registered using the Centers for Disease Control and Prevention (CDC) National Healthcare Safety Network (NHSN) methods and definitions for SSIs. Surgical procedures (SPs) were classified into 22 types according to International Classification of Diseases, Ninth Revision criteria. Results: We recorded 1879 SSIs, associated with 41,563 SPs (4.3%; 95% confidence interval, 4.3-4.7). Among the results, the SSI rate per type of SP compared with rates reported by the INICC and CDC NHSN were 11.9% for ventricular shunt (vs 12.9% vs 5.6%); 5.3% for craniotomy (vs 4.4% vs 2.6%); 4.9% for coronary bypass with chest and donor incision (vs 4.5 vs 2.9); 3.5% for hip prosthesis (vs 2.6% vs 1.3%), and 3.0% for cesarean section (vs 0.7% vs 1.8%). Conclusions: In most of the 22 types of SP analyzed, our SSI rates were higher than the CDC NHSN rates and similar to the INICC rates. This study advances the knowledge of SSI epidemiology in Turkey, allowing the implementation of targeted interventions. Copyright © 2015 by the Association for Professionals in Infection Control and Epidemiology, Inc. Published by Elsevier Inc. All rights reserved.

Published
2015

21. Surgical site infection rates in 16 cities in Turkey: findings of the International Nosocomial Infection Control Consortium (INICC)

Author

Leblebicioglu H, Erben N, Rosenthal VD, Sener A, Uzun C, Senol G, Ersoz G, Demirdal T, Duygu F, Willke A, Sirmatel F, Oztoprak N, Koksal I, Oncul O, Gurbuz Y, Güçlü E, Turgut H, Yalcin AN, Ozdemir D, Kendirli T, Aslan T, Esen S, Ulger F, Dilek A, Yilmaz H, Sunbul M, Ozgunes I, Usluer G, Otkun M, Kaya A, Kuyucu N, Kaya Z, Meric M, Azak E, Yýlmaz G, Kaya S, Ulusoy H, Haznedaroglu T, Gorenek L, Acar A, Tutuncu E, Karabay O, Kaya G, Sacar S, Sungurtekin H, Uğurcan D, Turhan O, Gumus E, and Dursu

Subjects
Cities, Cohort Studies, Hospitals, Humans, Prevalence, Prospective Studies, Surgical Wound Infection/*epidemiology, Turkey/epidemiology
Abstract

BACKGROUND: Surgical site infections (SSIs) are a threat to patient safety; however, there were no available data on SSI rates stratified by surgical procedure (SP) in Turkey. METHODS: Between January 2005 and December 2011, a cohort prospective surveillance study on SSIs was conducted by the International Nosocomial Infection Control Consortium (INICC) in 20 hospitals in 16 Turkish cities. Data from hospitalized patients were registered using the Centers for Disease Control and Prevention (CDC) National Healthcare Safety Network (NHSN) methods and definitions for SSIs. Surgical procedures (SPs) were classified into 22 types according to International Classification of Diseases, Ninth Revision criteria. RESULTS: We recorded 1879 SSIs, associated with 41,563 SPs (4.3%; 95% confidence interval, 4.3-4.7). Among the results, the SSI rate per type of SP compared with rates reported by the INICC and CDC NHSN were 11.9% for ventricular shunt (vs 12.9% vs 5.6%); 5.3% for craniotomy (vs 4.4% vs 2.6%); 4.9% for coronary bypass with chest and donor incision (vs 4.5 vs 2.9); 3.5% for hip prosthesis (vs 2.6% vs 1.3%), and 3.0% for cesarean section (vs 0.7% vs 1.8%). CONCLUSIONS: In most of the 22 types of SP analyzed, our SSI rates were higher than the CDC NHSN rates and similar to the INICC rates. This study advances the knowledge of SSI epidemiology in Turkey, allowing the implementation of targeted interventions.

Published
2015

22. The place and the efficacy of infectious disease consultations in the hospitals

Author

Erdem, H., Kurtaran, B., Arun, O., Ylmaz, H., Çelebi, G., Özkaya, H.D., Kaya, S., Birengel, S., Güner, R., Demiroǧlu, Y.Z., Demirdal, T., Tekin-Koruk, S., Coşkun, O., Kazak, E., Çelen, M.K., Akova, M., Timurkaynak, F., Alpay, Y., Yilmaz, E., Saçar, Suzan, Aydin, A.F., Bodur, H., Elald, N., Inal, A.S., Saba, R., Tok, D., Aǧalar, C., Candevir, A., Parlak, M., Sipahi, O.R., Yilmaz, G., Koçak, N., Öncü, S., Sirmatel, F., Küçükardali, Y., Güzel-Tunçcan, O., Mete, B., Doyuk-Kartal, E., Ulcay, A., Şenol, E., Dayan, S., Leblebicioǧlu, H., Tabak, F., Gorenek, L., Ulusoy, S., Ayaz, C., Ergonul, O., Aksu, H.S.Z., and Erdem, H., Kasimpasa Hospital, Istanbul, Turkey -- Kurtaran, B., Department of Infectious Diseases, Cukurova University Faculty of Medicine, Balcali, Adana, Turkey -- Arun, O., Department of Gerontology, Akdeniz University, Antalya, Turkey -- Ylmaz, H., Ondokuz Mayis University School of Medicine, Samsun, Turkey -- Çelebi, G., Zonguldak Karaelmas University, School of Medicine, Zonguldak, Turkey -- Özkaya, H.D., Karsiyaka State Hospital, Izmir, Turkey -- Kaya, S., Karadeniz University School of Medicine, Trabzon, Turkey -- Birengel, S., Ankara University School of Medicine, Ankara, Turkey -- Güner, R., Ataturk Training and Research Hospital, Ankara, Turkey -- Demiro?lu, Y.Z., Baskent University School of Medicine, Adana, Turkey -- Demirdal, T., Kocatepe University School of Medicine, Afyon, Turkey -- Tekin-Koruk, S., Harran University School of Medicine, Sanliurfa, Turkey -- Coşkun, O., Gulhane Medical Academy, Ankara, Turkey -- Kazak, E., Cekirge State Hospital, Bursa, Turkey -- Çelen, M.K., Dicle University School of Medicine, Diyarbakir, Turkey -- Akova, M., Hacettepe University School of Medicine, Ankara, Turkey -- Timurkaynak, F., Baskent University School of Medicine, Ankara, Turkey -- Alpay, Y., Cengiz Gokcek State Hospital, Gaziantep, Turkey -- Yilmaz, E., Uludag University School of Medicine, Bursa, Turkey -- Saçar, S., Pamukkale University School of Medicine, Denizli, Turkey -- Aydin, A.F., Military Hospital, Izmir, Turkey -- Bodur, H., Numune Training and Research Hospital, Ankara, Turkey -- Elald, N., Cumhuriyet University School of Medicine, Sivas, Turkey -- Inal, A.S., Department of Infectious Diseases, Cukurova University Faculty of Medicine, Balcali, Adana, Turkey -- Saba, R., Akdeniz University School of Medicine, Antalya, Turkey -- Tok, D., Military Hospital, Kayseri, Turkey -- A?alar, C., Kirikkale University School of Medicine, Kirikkale, Turkey -- Candevir, A., Department of Infectious Diseases, Cukurova University Faculty of Medicine, Balcali, Adana, Turkey -- Parlak, M., Ataturk University School of Medicine, Erzurum, Turkey -- Sipahi, O.R., Ege University School of Medicine, Izmir, Turkey -- Yilmaz, G., Karadeniz University School of Medicine, Trabzon, Turkey -- Koçak, N., Military Hospital, Derince, Turkey -- Öncü, S., Adnan Menderes University School of Medicine, Aydin, Turkey -- Sirmatel, F., Izzet Baysal University School of Medicine, Bolu, Turkey -- Küçükardali, Y., Yeditepe University School of Medicine, Istanbul, Turkey -- Güzel-Tunçcan, O., Gazi University School of Medicine, Ankara, Turkey -- Mete, B., Istanbul University Cerrahpasa School of Medicine, Istanbul, Turkey -- Doyuk-Kartal, E., Osmangazi University School of Medicine, Eskisehir, Turkey -- Ulcay, A., Kasimpasa Hospital, Istanbul, Turkey -- Şenol, E., Gazi University School of Medicine, Ankara, Turkey -- Dayan, S., Dicle University School of Medicine, Diyarbakir, Turkey -- Leblebicio?lu, H., Ondokuz Mayis University School of Medicine, Samsun, Turkey -- Tabak, F., Istanbul University Cerrahpasa School of Medicine, Istanbul, Turkey -- Gorenek, L., Gulhane Medical Academy, Haydarpasa Hospital, Turkey -- Ulusoy, S., Ege University School of Medicine, Izmir, Turkey -- Ayaz, C., Dicle University School of Medicine, Diyarbakir, Turkey -- Ergonul, O., Marmara University School of Medicine, Istanbul, Turkey -- Aksu, H.S.Z., Department of Infectious Diseases, Cukurova University Faculty of Medicine, Balcali, Adana, Turkey

Subjects
fever, sultamicillin, teicoplanin, clinical effectiveness, medical specialist, vancomycin, patient referral, review, infectious disease specialist, piperacillin plus tazobactam, infection, ceftriaxone, leukocytosis, medical practice, ciprofloxacin, consultation, Infectious diseases, hospital infection, human, non infectious disease specialist, ceftazidime, teamwork, hospitals, imipenem
Abstract

Our study aims to determine the efficacy of infectious disease consultations and the interrelations between doctors in this social laboratory. This study was conducted at 34 centers located in 22 cities across Turkey and contributed by 210 infectious disease specialists (IDSs) and 970 non-infectious disease specialists (NIDSs), totaling 1180 medical doctors. Infectious disease specialists and NIDSs have separately contributed by responding to questionnaires designed specifically for the consultation process. It appears that a satisfactory collaboration has been established between IDSs and NIDSs during the consultation practices. There are some discrepancies in the perceptions of some of the NIDSs. These are the evaluation of patients holistically, the expectation of NIDSs in critical infection cases to start the therapy immediately, losing the support of drug companies by NIDSs, and the restriction of NIDSs in routine medical practice. On the other hand, NIDSs seem to have real problems in the diagnosis or treatment of infectious diseases. The consultation service provided by the IDSs in Turkey is widely accepted among other clinicians and appears to be of a crucial importance. Copyright © 2012 by Lippincott Williams & Wilkins., Kurtaran, B.; Department of Infectious Diseases, Cukurova University Faculty of Medicine, Balcali, Adana, Turkey; email: behicekurtaran@gmail.com

Published
2012

24. Relationship Between Liver Biopsy and Non-Invasive Biochemical Methods in Determination of Liver Fibrosis in Treatment-Naive Chronic Hepatitis C Patients; A Multicentre Study

Author

Koksal, I., Yilmaz, G., Parlak, M., Demirdal, T., Kinikli, S., Candan, M., Beslen, N., and Giresun Üniversitesi

Abstract

47th Annual Meeting of the European-Association-for-the-Study-of-the-Liver (EASL) -- APR 18-22, 2012 -- Barcelona, SPAIN demirdal, tuna/0000-0002-9046-5666 WOS: 000303241301407 … European Assoc Study Liver (EASL)

Published
2012

25. training under the pressure of consultation needs

Author

Erdem, H, Tekin-Koruk, S, Koruk, I, Tozlu-Keten, D, Ulu-Kilic, A, Oncul, O, Guner, R, Birengel, S, Mert, G, Nayman-Alpat, S, Eren-Tulek, N, Demirdal, T, Elaldi, N, Ataman-Hatipoglu, C, Yilmaz, E, Mete, B, Kurtaran, B, Ceran, N, Karabay, O, Inan, D, Cengiz, M, Sacar, S, Yucesoy-Dede, B, Yilmaz, S, Agalar, C, Bayindir, Y, Alpay, Y, Tosun, S, Yilmaz, H, Bodur, H, Erdem, HA, Dikici, N, Dizbay, M, Oncu, S, Sezak, N, Sari, T, Sipahi, OR, Uysal, S, Yeniiz, E, Kaya, S, Ulcay, A, Kurt, H, Besirbellioglu, BA, Vahaboglu, H, Tasova, Y, Usluer, G, Arman, D, Diktas, H, Ulusoy, S, and Leblebicioglu, H

Subjects
Infectious disease, clinical microbiology, training, consultation
Abstract

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

Published
2011

26. ANAEROBİK YUMUŞAK DOKU İNFEKSİYONLARININ TEDAVİSİ

Author

Demirdal, T. and Ağalar, C.

Subjects
Fen, Science, Anaerobic infection,Antimicrobial therapy,Hyperbaric oxygen, Anaerobik infeksiyonlar,Antimikrobiyal tedavi,Hiperbarik oksijen tedavisi
Abstract

The treatment of anaerobic infection needs to be prompt and appropriate in order to ensurerecovery. Management includes the use of hyperbaric oxygen, surgical methods and antimicrobial therapy. In the past five years, newer agents effective against anaerobic organisms were introduced. However antibiotic resistance is increasingly common against anaerobic bacteria. Hyperbaric oxygen therapy is often combined with antibiotic therapy for soft-tissue infections. The purpose of this paper was to accent treatment of anaerobic softtissue infections and new approaches., Anaerobik infeksiyonların tedavisi hızlı ve uygun olmalıdır. Tedavi yaklaşımı hiperbarikoksijen, cerrahi ve antimikrobiyal tedaviyi içerir. Son beş yıl içerisinde anaerobik infeksiyonlara etkili yeni ajanlar kullanıma sunulmuştur. Bununla birlikte anaerobik organizmalara karşı antibiyotik direnci gittikçe artmaktadır. Yumuşak doku infeksiyonlarında hiperbarik oksijen tedavisi sıklıkla antibiyotik tedavisi ile birlikte kullanılmaktadır. Bu makaledeki amacımız anaerobik yumuşak doku infeksiyonlarında yeni tedavi yaklaşımlarını vurgulamaktır.

Published
2005

34. Evaluation of bacteremias in a Turkish university hospital: 3-year outcomes.

Author

Demirdal T, Demirturk N, Cetinkaya Z, Tufan G, Demirdal, Tuna, Demirturk, Nese, Cetinkaya, Zafer, and Tufan, Gulnihal

Abstract

In this retrospective study, the investigators examined blood cultures from patients that had been diagnosed with bacteremias over a 3-y period. The study was conduced at Kocatepe University Hospital (Middle Anatolia, Turkey). Blood samples that arrived at the university's microbiology laboratory between 2002 and 2005 were evaluated retrospectively. These samples were classified as contamination, false positivity, community-acquired bacteremia (CAB), or hospital-acquired bacteremia (HAB). Patient age and sex, foci of bacteremia, present comorbidities, predisposing factors, pathogens, and mortality rates were evaluated. A total of 1783 blood cultures that had been drawn from 1441 patients during this 3-y period were examined retrospectively. Of 354 positive isolates, 61 (17.2%) were CABs and 293 (82.8%) were HABs. In HABs, the most commonly isolated microorganisms were Staphylococcus aureus (37.5%), coagulase-negative staphylococci (29.7%), and Escherichia coli (10.2%); in CABs, the most commonly isolated microorganisms were S aureus (29.5%), Brucella spp (26.2%), and E coli (24.6%). Crude mortality rates were determined to be 15.2% for HABs and 12.7% for CABs. This study yielded data on the most common foci of bacteremia, microbiologic factors, and the epidemiology associated with HABs and CABs. It is hoped that these data will enhance empirical antibiotic therapeutic approaches, thereby preventing delays in treatment and decreasing mortality rates associated with bacteremias. [ABSTRACT FROM AUTHOR]

Published
2007
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37. Genitourinary brucellosis: results of a multicentric study

Author

H. Erdem, N. Elaldi, O. Ak, S. Gulsun, R. Tekin, M. Ulug, F. Duygu, M. Sunnetcioglu, N. Tulek, S. Guler, Y. Cag, S. Kaya, N. Turker, E. Parlak, T. Demirdal, C. Ataman Hatipoglu, A. Avci, C. Bulut, M. Avci, A. Pekok, U. Savasci, H. Sozen, M. Tasbakan, T. Guven, S. Bolukcu, S. Cesur, E. Sahin-Horasan, E. Kazak, A. Denk, I. Gonen, G. Karagoz, A. Haykir Solay, O. Alici, C. Kader, G. Senturk, S. Tosun, H. Turan, A.I. Baran, D. Ozturk-Engin, F. Bozkurt, O. Deveci, A. Inan, A. Kadanali, M.S. Sayar, B. Cetin, M. Yemisen, H. Naz, L. Gorenek, C. Agalar, [Erdem, H. -- Gorenek, L.] GATA Haydarpasa Training Hosp, Dept Infect Dis & Clin Microbiol, Istanbul, Turkey -- [Elaldi, N.] Cumhuriyet Univ, Sch Med, Dept Infect Dis & Clin Microbiol, Sivas, Turkey -- [Ak, O. -- Cag, Y.] Lutfi Kirdar Training & Res Hosp, Dept Infect Dis & Clin Microbiol, Istanbul, Turkey -- [Gulsun, S. -- Kaya, S.] Diyarbakir Training & Res Hosp, Dept Infect Dis & Clin Microbiol, Diyarbakir, Turkey -- [Tekin, R. -- Bozkurt, F. -- Deveci, O.] Dicle Univ, Sch Med, Dept Infect Dis & Clin Microbiol, Diyarbakir, Turkey -- [Ulug, M.] Private Umit Hosp, Dept Infect Dis & Clin Microbiol, Eskisehir, Turkey -- [Duygu, F.] Gaziosmanpasa Univ, Sch Med, Dept Infect Dis & Clin Microbiol, Tokat, Turkey -- [Sunnetcioglu, M. -- Baran, A. I.] Yuzuncu Yil Univ, Sch Med, Dept Infect Dis & Clin Microbiol, Van, Turkey -- [Tulek, N. -- Hatipoglu, C. Ataman -- Bulut, C.] Ankara Numune Training & Res Hosp, Dept Infect Dis & Clin Microbiol, Ankara, Turkey -- [Guler, S.] Sutcu Imam Univ, Sch Med, Dept Infect Dis & Clin Microbiol, Kahramanmaras, Turkey -- [Turker, N. -- Demirdal, T.] Katip Celebi Univ, Sch Med, Dept Infect Dis & Clin Microbiol, Izmir, Turkey -- [Turker, N. -- Demirdal, T.] Ataturk Training & Res Hosp, Izmir, Turkey -- [Parlak, E.] Ataturk Univ, Sch Med, Dept Infect Dis & Clin Microbiol, Erzurum, Turkey -- [Avci, A.] Bingol Mil Hosp, Dept Urol, Bingol, Turkey -- [Avci, M. -- Tosun, S.] Izmir Bozyaka Training & Res Hosp, Dept Infect Dis & Clin Microbiol, Izmir, Turkey -- [Pekok, A.] Private Erzurum Sifa Hosp, Dept Infect Dis & Clin Microbiol, Erzurum, Turkey -- [Savasci, U.] Sarikamis Mil Hosp, Dept Infect Dis & Clin Microbiol, Kars, Turkey -- [Kaya, S.] Karadeniz Tech Univ, Sch Med, Dept Infect Dis & Clin Microbiol, Trabzon, Turkey -- [Sozen, H.] Sitki Kocman Univ, Sch Med, Dept Infect Dis & Clin Microbiol, Mugla, Turkey -- [Tasbakan, M.] Ege Univ, Sch Med, Dept Infect Dis & Clin Microbiol, Izmir, Turkey -- [Guven, T.] Yildirim Beyazit Univ, Ankara Ataturk Training & Res Hosp, Dept Infect Dis & Clin Microbiol, Ankara, Turkey -- [Bolukcu, S. -- Ozturk-Engin, D. -- Inan, A.] Haydarpasa Numune Training & Res Hosp, Dept Infect Dis & Clin Microbiol, Istanbul, Turkey -- [Cesur, S.] Turkish Publ Hlth Directorate, Div TB, Ankara, Turkey -- [Sahin-Horasan, E.] Mersin Univ, Sch Med, Dept Infect Dis & Clin Microbiol, Mersin, Turkey -- [Kazak, E.] Uludag Univ, Sch Med, Dept Infect Dis & Clin Microbiol, Bursa, Turkey -- [Denk, A.] Firat Univ, Sch Med, Dept Infect Dis & Clin Microbiol, TR-23169 Elazig, Turkey -- [Gonen, I.] Suleyman Demirel Univ, Sch Med, Dept Infect Dis & Clin Microbiol, TR-32200 Isparta, Turkey -- [Karagoz, G. -- Kadanali, A.] Umraniye Training & Res Hosp, Dept Infect Dis & Clin Microbiol, Istanbul, Turkey -- [Solay, A. Haykir] Igdir State Hosp, Dept Infect Dis & Clin Microbiol, Igdir, Turkey -- [Alici, O. -- Agalar, C.] Fatih Sultan Mehmet Training & Res Hosp, Dept Infect Dis & Clin Microbiol, Istanbul, Turkey -- [Kader, C.] Bozok Univ, Sch Med, Dept Infect Dis & Clin Microbiol, Yozgat, Turkey -- [Senturk, G. -- Sayar, M. S.] Diskapi Yildirim Beyazit Training & Res Hosp, Dept Infect Dis & Clin Microbiol, Ankara, Turkey -- [Turan, H.] Baskent Univ, Sch Med, Dept Infect Dis & Clin Microbiol, Konya, Turkey -- [Cetin, B.] Koc Univ, Sch Med, Dept Infect Dis & Clin Microbiol, Istanbul, Turkey -- [Yemisen, M.] Istanbul Univ Cerrahpasa, Sch Med, Dept Infect Dis & Clin Microbiol, Istanbul, Turkey -- [Naz, H.] Kocaeli State Hosp, Dept Infect Dis & Clin Microbiol, Kocaeli, Turkey, NAZ, HASAN -- 0000-0001-8523-4735, Elaldi, Nazif -- 0000-0002-9515-770X, Ege Üniversitesi, and MÜ

Subjects
Microbiology (medical), Infertility, Adult, Male, medicine.medical_specialty, Adolescent, Gastroenterology, Brucellosis, Young Adult, orchitis, Male Urogenital Diseases, Internal medicine, Medicine, Humans, epididymoorchitis, Orchiectomy, Abscess, Aged, Retrospective Studies, Aged, 80 and over, medicine.diagnostic_test, business.industry, Genitourinary system, General Medicine, Brucellae, Middle Aged, medicine.disease, Prognosis, Female Urogenital Diseases, Surgery, Infectious Diseases, Erythrocyte sedimentation rate, Orchitis, Female, Epididymitis, genitourinary, business
Abstract

WOS: 000346337000011, PubMed ID: 24831227, This study reviewed the clinical, laboratory, therapeutic and prognostic data on genitourinary involvement of brucellosis in this largest case series reported. This multicentre study pooled adult patients with genitourinary brucellar involvement from 34 centres treated between 2000 and 2013. Diagnosis of the disease was established by conventional methods. Overall 390 patients with genitourinary brucellosis (352 male, 90.2%) were pooled. In male patients, the most frequent involved site was the scrotal area (n=327, 83.8%), as epididymo-orchitis (n=204, 58%), orchitis (n=112, 31.8%) and epididymitis (n=11, 3.1%). In female patients, pyelonephritis (n=33/38, 86.8%) was significantly higher than in male patients (n=11/352, 3.1%; p

Published
2014

38. Antibiotic consumption in Turkish hospitals; a multi-centre point prevalence study

Author

Nefise Oztoprak, Serpil Erol, Fatma Aybala Altay, Aziz Ogutlu, İbrahim Erayman, Funda Kocak, Gülsüm Kaya, Vedat Turhan, Ayse Batirel, Salih Hosoglu, Bahri Teker, Mustafa Kasim Karahocagil, Ertugrul Guclu, Tuna Demirdal, Hamdi Sözen, Mustafa Yildirim, Oguz Karabay, Guclu, E, Ogutlu, A, Karabay, O, Demirdal, T, Erayman, I, Hosoglu, S, Turhan, V, Erol, S, Oztoprak, N, Batirel, A, Altay, FA, Kaya, G, Karahocagil, M, Sozen, H, Yildirim, M, Kocak, F, Teker, B, Sakarya Üniversitesi/Tıp Fakültesi/Dahili Tıp Bilimleri Bölümü, Güçlü, Ertuğrul, Öğütlü, Aziz, Karabay, Oğuz, Yıldırım, Mustafa, MÜ, Eğitim ve Araştırma Hastanesi, and Sözen, Hamdi

Subjects
0301 basic medicine, Pediatrics, medicine.medical_specialty, Consumption, Turkey, medicine.drug_class, 030106 microbiology, Cephalosporin, Antibiotics, 03 medical and health sciences, Hospital, Antibiotic resistance, Clavulanic acid, Intensive care, Ampicillin, medicine, Prevalence, Humans, Pharmacology (medical), Pharmacology & Pharmacy, Beta-Lactamase Inhibitors, Pharmacology, business.industry, Antibiotic, Sulbactam, Drug Utilization, Hospitals, Anti-Bacterial Agents, Infectious Diseases, Cross-Sectional Studies, Oncology, Antibiotic Stewardship, business, medicine.drug
Abstract

WOS: 000396680900004 PubMed ID: 27238248 This multi-centre study aimed to determine the antibiotic consumption in Turkish hospitals by point prevalence. Antibiotic consumption of 14 centres was determined using the DDD method. Among hospitalized patients, 44.8% were using antibiotics and the total antibiotic consumption was 674.5 DDD/1000 patient-days (DPD). 189.6 (28%) DPD of the antibiotic consumption was restricted while 484.9 (72%) DPD was unrestricted. Carbapenems (24%) and beta lactam/beta lactamase inhibitors (ampicillin-sulbactam or amoxicillin-clavulanate; 22%) were the most commonly used restricted and unrestricted antibiotics. Antibiotics were most commonly used in intensive care units (1307.7 DPD). Almost half of the hospitalized patients in our hospitals were using at least one antibiotic. Moreover, among these antibiotics, the most commonly used ones were carbapenems, quinolones and cephalosporins, which are known to cause collateral damage. We think that antibiotic resistance, which is seen at considerably high rates in our hospitals, is associated with this level of consumption.

Published
2017

39. Impact of antimicrobial drug restrictions on doctors? behaviors

Author

Serife Akalin, Mahmut Sunnetcioglu, Aygul Dogan Celik, Salih Hosoglu, Gürdal Yilmaz, Abdulkadir Küçükbayrak, Tumer Guven, Ibak Gonen, Serpil Erol, Oguz Karabay, Koçoğlu Me, Unal Erkorkmaz, Işıkgöz Taşbakan M, Omer Faruk Kokoglu, Ertugrul Guclu, Nurettin Erben, Demirli K, Tuna Demirdal, B. Dede, Fatma Aybala Altay, Ertan Aydin, Turhan, Güner Ae, Bahadir Ceylan, Ömer Evirgen, Recep Tekin, Ilhami Celik, Sebnem Senol, Fatma Sargin, Ayten Kadanali, BAİBÜ, Tıp Fakültesi, Temel Tıp Bilimleri Bölümü, Koçoğlu, Mücahide Esra, Küçükbayrak, Abdulkadir, Ege Üniversitesi, Karabay, O, Hosoglu, S, Guclu, E, Akalin, S, Altay, FA, Aydin, E, Ceylan, B, Celik, A, Celik, I, Demirdal, T, Demirli, K, Erben, N, Erkorkmaz, U, Erol, S, Evirgen, O, Gonen, I, Guner, AE, Guven, T, Kadanali, A, Kocoglu, ME, Kokoglu, OF, Kucukbayrak, A, Sargin, F, Sunnetcioglu, M, Senol, S, Isikgoz Tasbakan, M, Tekin, R, Turhan, V, Yilmaz, G, Dede, B, Sakarya Üniversitesi/Tıp Fakültesi/Dahili Tıp Bilimleri Bölümü, Karabay, Oğuz, Güçlü, Ertuğrul, Erkorkmaz, Ünal, and Hatay Mustafa Kemal Üniversitesi

Subjects
0301 basic medicine, Budget Execution İnstructions, medicine.medical_specialty, Antibiotic Usage, Turkey, medicine.drug_class, specialist, 030106 microbiology, Antibiotics, Disease, budget execution instructions, Specialist, 03 medical and health sciences, Antibiotic policy, antibiotic restriction, antibiotic usage, budget, Anti-Infective Agents, General & Internal Medicine, Physicians, Surveys and Questionnaires, Antibiotic Policy, medicine, Intensive care medicine, Cerrahi, business.industry, execution instructions, Anti-Infective Agents/*pharmacology, General Medicine, Antimicrobial drug, Infectious disease (medical specialty), Family medicine, Antibiotic policy,antibiotic restriction,antibiotic usage,budget execution instructions,specialist, business, Antibiotic Restriction
Abstract

Background/aim: Broad-spectrum antibiotics have become available for use only with the approval of infectious disease specialists (IDSs) since 2003 in Turkey. This study aimed to analyze the tendencies of doctors who are not disease specialists (non-IDSs) towards the restriction of antibiotics., Materials and methods: A questionnaire form was prepared, which included a total of 22 questions about the impact of antibiotic restriction (AR) policy, the role of IDSs in the restriction, and the perception of this change in antibiotic consumption. The questionnaire was completed by each participating physician., Results: A total of 1906 specialists from 20 cities in Turkey participated in the study. Of those who participated, 1271 (67.5%) had 5 years of occupational experience in their branch expressed that they followed the antibiotic guidelines more strictly than the JSs (P < 0.05) and 755 of physicians (88%) and 720 of surgeons (84.6%) thought that the AR policy was necessary and useful (P < 0.05)., Conclusion: This study indicated that the AR policy was supported by most of the specialists. Physicians supported this restriction policy more so than surgeons did.

Published
2016

40. Surgical site infection rates in 16 cities in Turkey: findings of the International Nosocomial Infection Control Consortium (INICC)

Author

Ahmet Şahin, Iftihar Koksal, Gaye Usluer, Hülya Sungurtekin, Tanıl Kendirli, Selçuk Kaya, Eylul Gumus, Gürdal Yýlmaz, Mehmet Faruk Geyik, Ertugrul Guclu, Nurettin Erben, Tuna Demirdal, Tuncer Haznedaroglu, Huseyin Turgut, Levent Gorenek, Erdal Ince, Melek Güneş, Hava Yilmaz, Necdet Kuyucu, Suzan Sacar, Alper Şener, Oguz Dursun, Nefise Oztoprak, Ahmet Dilek, Fatma Sirmatel, Ergin Çiftçi, Meliha Meric, Gulsume Kaya, Mustafa Sunbul, Metin Otkun, Emel Azak, Fatma Ülger, Gülden Ersöz, Yunus Gürbüz, Ayşe Willke, Sehnaz Kaya, Hakan Leblebicioglu, Oral Oncul, Davut Ozdemir, Nevin Taşyapar, Ali Acar, Ediz Tutuncu, Zeynep Kaya, Doğaç Uğurcan, Oguz Karabay, Victor D. Rosenthal, Fazilet Duygu, Saban Esen, Ali Kaya, Ata Nevzat Yalcin, Hülya Ulusoy, Gunes Senol, Adem Karbuz, Turan Aslan, Özge Turhan, Selvi Erdogan, Cengiz Uzun, Ilhan Ozgunes, Leblebicioglu, H, Erben, N, Rosenthal, VD, Sener, A, Uzun, C, Senol, G, Ersoz, G, Demirdal, T, Duygu, F, Willke, A, Sirmatel, F, Oztoprak, N, Koksal, I, Oncul, O, Gurbuz, Y, Guclu, E, Turgut, H, Yalcin, AN, Ozdemir, D, Kendirli, T, Aslan, T, Esen, S, Ulger, F, Dilek, A, Yilmaz, H, Sunbul, M, Ozgunes, I, Usluer, G, Otkun, M, Kaya, A, Kuyucu, N, Kaya, Z, Meric, M, Azak, E, Yylmaz, G, Kaya, S, Ulusoy, H, Haznedaroglu, T, Gorenek, L, Acar, A, Tutuncu, E, Karabay, O, Kaya, G, Sacar, S, Sungurtekin, H, Ugurcan, D, Turhan, O, Gumus, E, Dursun, O, Geyik, MF, Sahin, A, Erdogan, S, Ince, E, Karbuz, A, Ciftci, E, Tasyapar, N, Gunes, M, Sakarya Üniversitesi/Tıp Fakültesi/Dahili Tıp Bilimleri Bölümü, Güçlü, Ertuğrul, MERİÇ KOÇ, MELİHA, and Ondokuz Mayıs Üniversitesi

Subjects
Turkey, Epidemiology, Surgical wound infection, Health careeassociated infection, Turkey (republic), Cohort Studies, hip prosthesis, Nosocomial infection, Prospective Studies, hospital, Prospective cohort study, Health Policy, craniotomy, clinical trial, cohort analysis, Hospitals, hospital patient, Infectious Diseases, Cohort, Surgical site infection, Cohort study, prospective study, medicine.medical_specialty, Health care-associated infection, prevalence, education, infection rate, surgical infection, Article, Developing countries, coronary artery bypass graft, Internal medicine, medicine, Humans, Hospital infection, human, Cities, cesarean section, business.industry, Public Health, Environmental and Occupational Health, findings of the International Nosocomial Infection Control Consortium (INICC)-, AMERICAN JOURNAL OF INFECTION CONTROL, cilt.43, ss.48-52, 2015 [Leblebicioglu H., Erben N., ROSENTHAL V. D. , ŞENER A., UZUN C., SENOL G., Ersoz G., Demirdal T., DUYGU F., Willke A., et al., -Surgical site infection rates in 16 cities in Turkey], Nosocomial infection control, Confidence interval, shunting, Surgery, Clinical trial, multicenter study, city, business
Abstract

Yalcin, Ata Nevzat/0000-0002-7243-7354; dursun, oguz/0000-0001-5482-3780; Oncul, Oral/0000-0002-1681-1866; Leblebicioglu, Hakan/0000-0002-6033-8543; demirdal, tuna/0000-0002-9046-5666; Ciftci, Ergin/0000-0002-4955-160X; Erben, Nurettin/0000-0003-0373-0132; Kendirli, Tanil/0000-0001-9458-2803; Acar, Ali/0000-0003-2008-5112; Geyik, Mehmet Faruk/0000-0002-0906-0902; Dursun, Oguz/0000-0001-5482-3780; KAYA, ZEYNEP/0000-0002-8468-2103; KARABAY, OGUZ/0000-0003-1514-1685; Karabay, Oguz/0000-0003-0502-432X; Kaya, Sehnaz/0000-0003-0002-1517 WOS: 000347654600011 PubMed: 25564124 Background: Surgical site infections (SSIs) are a threat to patient safety; however, there were no available data on SSI rates stratified by surgical procedure (SP) in Turkey. Methods: Between January 2005 and December 2011, a cohort prospective surveillance study on SSIs was conducted by the International Nosocomial Infection Control Consortium (INICC) in 20 hospitals in 16 Turkish cities. Data from hospitalized patients were registered using the Centers for Disease Control and Prevention (CDC) National Healthcare Safety Network (NHSN) methods and definitions for SSIs. Surgical procedures (SPs) were classified into 22 types according to International Classification of Diseases, Ninth Revision criteria. Results: We recorded 1879 SSIs, associated with 41,563 SPs (4.3%; 95% confidence interval, 4.3-4.7). Among the results, the SSI rate per type of SP compared with rates reported by the INICC and CDC NHSN were 11.9% for ventricular shunt (vs 12.9% vs 5.6%); 5.3% for craniotomy (vs 4.4% vs 2.6%); 4.9% for coronary bypass with chest and donor incision (vs 4.5 vs 2.9); 3.5% for hip prosthesis (vs 2.6% vs 1.3%), and 3.0% for cesarean section (vs 0.7% vs 1.8%). Conclusions: In most of the 22 types of SP analyzed, our SSI rates were higher than the CDC NHSN rates and similar to the INICC rates. This study advances the knowledge of SSI epidemiology in Turkey, allowing the implementation of targeted interventions. Copyright (C) 2015 by the Association for Professionals in Infection Control and Epidemiology, Inc. Published by Elsevier Inc. All rights reserved.

Published
2015

41. Predictors of response to pegylated interferon treatment in HBeAg-negative patients with chronic hepatitis B

Author

Ömer Evirgen, Nail Ozgunes, Alper Gunduz, Mehmet Faruk Geyik, Serpil Erol, Hurrem Bodur, Neşe Demirtürk, Davut Ozdemir, Fatma Sargin, Ertugrul Guclu, Tuna Demirdal, Bahadir Ceylan, Ediz Tutuncu, Hasan Çetin Ekerbiçer, Kutbettin Demirdag, Nazan Tuna, Oguz Karabay, Saban Esen, Omer Faruk Kokoglu, Sıla Akhan, Mustafa Kasim Karahocagil, Selma Tosun, Guclu, E, Tuna, N, Karabay, O, Akhan, S, Bodur, H, Ceylan, B, Demirdal, T, Demirdag, K, Demirturk, N, Ekerbicer, H, Erol, S, Esen, S, Evirgen, O, Geyik, MF, Gunduz, A, Karahocagil, MK, Kokoglu, OF, Ozdemir, D, Ozgunes, N, Sargin, F, Tosun, S, Tutuncu, E, Sakarya Üniversitesi/Tıp Fakültesi/Dahili Tıp Bilimleri Bölümü, Güçlü, Ertuğrul, Karabay, Oğuz, Ekerbiçer, Hasan Çetin, Esen, Sinan, and OMÜ

Subjects
Male, Turkey, Gastroenterology, Polyethylene Glycols, Tertiary Care Centers, Pegylated interferon, Interferon, hepatitis B, interferon, sustained virological response, viral load, Medicine, Young adult, virus diseases, General Medicine, Hepatitis B, Middle Aged, Viral Load, Prognosis, Recombinant Proteins, Infectious Diseases, Treatment Outcome, Hbeag negative, Female, Viral load, medicine.drug, Adult, medicine.medical_specialty, Adolescent, Interferon alpha-2, Microbiology, Antiviral Agents, Young Adult, Hepatitis B, Chronic, Chronic hepatitis, Virology, Internal medicine, Humans, Aged, Retrospective Studies, business.industry, Interferon-alpha, Retrospective cohort study, medicine.disease, digestive system diseases, Surgery, DNA, Viral, Parasitology, business
Abstract

Geyik, Mehmet Faruk/0000-0002-0906-0902; demirdal, tuna/0000-0002-9046-5666; KARABAY, OGUZ/0000-0003-1514-1685; Karabay, Oguz/0000-0003-0502-432X; Gunduz, Alper/0000-0001-9154-844X WOS: 000352106600012 PubMed: 25500658 Introduction: Although pegylated interferons (pegIFNs) alpha-2a and alpha-2b have been used in chronic hepatitis B (CHB) treatment for many years, there are few studies concerning predictors of sustained virologic response (SVR) to pegIFN therapy. In this study, we aimed to investigate the predictors of response to pegIFN treatment in cases with HBeAg-negative CHB infection. Methodology: Seventeen tertiary care hospitals in Turkey were included in this study. Data from consecutively treated HBeAg-negative CHB patients, who received either pegIFN alpha-2a or alpha-2b, were collected retrospectively. SVR is defined as an HBV DNA concentration of less than 2,000 IU/mL six months after the completion of therapy Results: SVR was achieved in 40 (25%) of the 160 HBeAg-negative CHB patients. Viral loads in patients with SVR were lower compared to those with no SVR, beginning in the third month of treatment (p < 0.05). The number of cases with a decline of 1 log(10) IU/mL in viral load after the first month of treatment and with a serum HBV DNA level under 2,000 IU/mL after the third month of treatment was higher in cases with SVR (p < 0.05). The number of patients who had undetectable HBV DNA levels at week 48 among responders was significantly greater than among post-treatment virological relapsers (p < 0.05). Conclusions: Detection of a 1 log(10) decline in serum HBV DNA level at the first month of treatment and a serum HBV DNA level < 2000 IU/mL at the third month of therapy may be predictors of SVR.

Published
2014

42. Liver involvement in patients with brucellosis: results of the Marmara study

Author

D. Ozturk-Engin, H. Erdem, S. Gencer, S. Kaya, A. I. Baran, A. Batirel, R. Tekin, M. K. Celen, A. Denk, S. Guler, M. Ulug, H. Turan, A. U. Pekok, G. Mermut, M. Tasbakan, N. Tulek, Y. Cag, A. Inan, A. Yalci, C. Ataman-Hatipoglu, I. Gonen, A. Dogan-Celik, F. Bozkurt, S. Gulsun, M. Sunnetcioglu, T. Guven, F. Duygu, E. Parlak, H. Sozen, S. Tosun, T. Demirdal, E. Guclu, O. Karabay, N. Uzun, O. Gunal, H. Diktas, A. Haykir-Solay, A. Erbay, C. Kader, O. Aydin, A. Erdem, N. Elaldi, A. Kadanali, Z. Yulugkural, L. Gorenek, M. Altındis, S. Bolukcu, C. Agalar, N. Ormeci, Ozturk-Engin, D, Erdem, H, Gencer, S, Kaya, S, Baran, AI, Batirel, A, Tekin, R, Celen, MK, Denk, A, Guler, S, Ulug, M, Turan, H, Pekok, AU, Mermut, G, Tasbakan, M, Tulek, N, Cag, Y, Inan, A, Yalci, A, Ataman-Hatipoglu, C, Gonen, I, Sakarya Üniversitesi/İlahiyat Fakültesi/Temel İslam Bilimleri Bölümü, Kaya, Süleyman, [Ozturk-Engin, D. -- Inan, A. -- Bolukcu, S.] Haydarpasa Numune Training & Res Hosp, Dept Infect Dis & Clin Microbiol, Istanbul, Turkey -- [Erdem, H. -- Gorenek, L.] GATA Haydarpasa Training Hosp, Dept Infect Dis & Clin Microbiol, Istanbul, Turkey -- [Gencer, S. -- Batirel, A. -- Cag, Y.] Lutfi Kirdar Training & Res Hosp, Dept Infect Dis & Clin Microbiol, Istanbul, Turkey -- [Kaya, S. -- Gulsun, S.] Diyarbakir Training & Res Hosp, Dept Infect Dis & Clin Microbiol, Diyarbakir, Turkey -- [Baran, A. I. -- Sunnetcioglu, M.] Yuzuncu Yil Univ, Sch Med, Dept Infect Dis & Clin Microbiol, Van, Turkey -- [Tekin, R. -- Celen, M. K. -- Bozkurt, F.] Dicle Univ, Sch Med, Dept Infect Dis & Clin Microbiol, Diyarbakir, Turkey -- [Denk, A.] Firat Univ, Sch Med, Dept Infect Dis & Clin Microbiol, TR-23169 Elazig, Turkey -- [Guler, S.] Yenisehir State Hosp, Dept Infect Dis & Clin Microbiol, Kahramanmaras, Turkey -- [Ulug, M.] Private Umit Hosp, Dept Infect Dis & Clin Microbiol, Eskisehir, Turkey -- [Turan, H.] Baskent Univ, Sch Med, Dept Infect Dis & Clin Microbiol, Konya, Turkey -- [Pekok, A. U.] Private Erzurum Sifa Hosp, Dept Infect Dis & Clin Microbiol, Erzurum, Turkey -- [Mermut, G. -- Tosun, S.] Izmir Bozyaka Training & Res Hosp, Dept Infect Dis & Clin Microbiol, Izmir, Turkey -- [Kaya, S.] Karadeniz Tech Univ, Sch Med, Dept Infect Dis & Clin Microbiol, Trabzon, Turkey -- [Tasbakan, M.] Ege Univ, Sch Med, Dept Infect Dis & Clin Microbiol, Izmir, Turkey -- [Tulek, N. -- Ataman-Hatipoglu, C.] Ankara Numune Training & Res Hosp, Dept Infect Dis & Clin Microbiol, Ankara, Turkey -- [Yalci, A.] Ankara Univ, Sch Med, Dept Infect Dis & Clin Microbiol, TR-06100 Ankara, Turkey -- [Gonen, I.] Suleyman Demirel Univ, Sch Med, Dept Infect Dis & Clin Microbiol, TR-32200 Isparta, Turkey -- [Dogan-Celik, A. -- Yulugkural, Z.] Trakya Univ, Sch Med, Dept Infect Dis & Clin Microbiol, Edirne, Turkey -- [Guven, T.] Yildirim Beyazit Univ, Ankara Ataturk Training & Res Hosp, Dept Infect Dis & Clin Microbiol, Ankara, Turkey -- [Duygu, F. -- Gunal, O.] Gaziosmanpasa Univ, Sch Med, Dept Infect Dis & Clin Microbiol, Tokat, Turkey -- [Parlak, E.] Ataturk Univ, Dept Infect Dis & Clin Microbiol, Sch Med, Erzurum, Turkey -- [Sozen, H.] Sitki Kocman Univ, Sch Med, Dept Anesthesiol & Reanimat, Mugla, Turkey -- [Demirdal, T.] Katip Celebi Univ, Sch Med, Dept Infect Dis & Clin Microbiol, Izmir, Turkey -- [Guclu, E. -- Karabay, O.] Sakarya Univ, Dept Infect Dis & Clin Microbiol, Sch Med, Sakarya, Turkey -- [Uzun, N.] Sisli Etfal Training & Res Hosp, Dept Infect Dis & Clin Microbiol, Istanbul, Turkey -- [Diktas, H.] Tatvan Mil Hosp, Dept Infect Dis & Clin Microbiol, Istanbul, Turkey -- [Haykir-Solay, A.] Igdir State Hosp, Dept Infect Dis & Clin Microbiol, Igdir, Turkey -- [Erbay, A. -- Kader, C.] Bozok Univ, Sch Med, Dept Infect Dis & Clin Microbiol, Yozgat, Turkey -- [Aydin, O.] Medeniyet Univ, Dept Infect Dis & Clin Microbiol, Goztepe Training & Res Hosp, Istanbul, Turkey -- [Erdem, A.] Medeniyet Univ, Dept Pathol, Goztepe Training & Res Hosp, Istanbul, Turkey -- [Elaldi, N.] Cumhuriyet Univ, Sch Med, Dept Infect Dis & Clin Microbiol, Sivas, Turkey -- [Kadanali, A.] Umraniye Training & Res Hosp, Dept Infect Dis & Clin Microbiol, Istanbul, Turkey -- [Altindis, M.] Sakarya Univ, Sch Med, Dept Clin Microbiol, Sakarya, Turkey -- [Agalar, C.] Fatih Sultan Mehmet Training & Res Hosp, Dept Infect Dis & Clin Microbiol, Istanbul, Turkey -- [Ormeci, N.] Ankara Univ, Sch Med, Dept Gastroenterol, TR-06100 Ankara, Turkey, Gencer, Serap -- 0000-0002-3217-6305, Altindis, Mustafa -- 0000-0003-0411-9669, GENCER, SERAP -- 0000-0002-3217-6305, Elaldi, Nazif -- 0000-0002-9515-770X, and Karabay, Oguz -- 0000-0003-0502-432X

Subjects
Microbiology (medical), Adult, Male, medicine.medical_specialty, Anemia, Gastroenterology, Brucellosis, Hepatitis, Young Adult, Internal medicine, medicine, Animals, Humans, Leukocytosis, Transaminases, Retrospective Studies, Doxycycline, Leukopenia, business.industry, Bilirubin, General Medicine, Middle Aged, medicine.disease, Pancytopenia, Surgery, Anti-Bacterial Agents, Infectious Diseases, Treatment Outcome, Female, medicine.symptom, business, Rifampicin, medicine.drug
Abstract

WOS: 000336986700024, PubMed ID: 24557334, Brucellosis is a zoonotic disease that primarily affects the reticuloendothelial system. But, the extent of liver damage in due course of the disease is unclear. This study included 325 brucellosis patients with significant hepatobiliary involvement identified with microbiological analyses from 30 centers between 2000 and 2013. The patients with a parts per thousand yen5 times of the upper limit of normal for aminotransferases, total bilirubin level a parts per thousand yen2 mg/dl or local liver lesions were enrolled. Clinical hepatitis was detected in 284 patients (87.3 %) and cholestasis was detected in 215 (66.1 %) patients. Fatigue (91 %), fever (86 %), sweating (83 %), arthralgia (79 %), and lack of appetite (79 %) were the major symptoms. Laboratory tests showed anemia in 169 (52 %), thrombocytopenia in 117 (36 %), leukopenia in 81 (25 %), pancytopenia in 42 (13 %), and leukocytosis in 20 (6 %) patients. The most commonly used antibiotic combinations were doxycycline plus an aminoglycoside (n = 73), doxycycline plus rifampicin (n = 71), doxycycline plus rifampicin and an aminoglycoside (n = 27). The duration of ALT normalization differed significantly in three treatment groups (p < 0.001). The use of doxycycline and an aminoglycoside in clinical hepatitis showed better results compared to doxycycline and rifampicin or rifampicin, aminoglycoside, doxycycline regimens (p < 0.05). However, the length of hospital stay did not differ significantly between these three combinations (p > 0.05). During the follow-up, treatment failure occurred in four patients (1 %) and relapse was seen in three patients (0.9 %). Mortality was not observed. Hepatobiliary involvement in brucellosis has a benign course with suitable antibiotics and the use of doxycycline and an aminoglycoside regimen seems a better strategy in select patients.

Published
2014

43. 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

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

Author

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

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

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

Published
2011

46. Prevalence of Cardiovascular Disease and Comparison of Risk Category Predictions of Systemic Coronary Risk Evaluation Score-2 and 4 Other Cardiovascular Disease Risk Assessment Tools Among People Living with Human Immunodefficiency Virus in Türkiye.

Author

Tükenmez Tigen E, Gökengin D, Özkan Özdemir H, Akalın H, Kaya B, Deveci A, İnan A, İnan D, Altunsoy A, Özel AS, Karaoğlan İ, Eraksoy H, Demirdal T, Yıldırmak T, Birengel S, İnci A, Nazlı A, Kayaaslan B, Özan Köse S, Ataman Hatipoğlu Ç, Esen Y, Koç T, Gilik P, and Korten V

Abstract

Background: Cardiovascular disease (CVD) is a major cause of mortality among people living with HIV (PLWH). We aimed to assess the prevalence of diagnosed CVD and the risk of CVD among PLWH using 5 different tools., Methods: This retrospective, cross-sectional study was conducted in 20 tertiary centers in Türkiye between October 2021 and March 2022, among 1425 PLWH aged 40-75 years. About 82.7% were male, with a median age of 51. Web-based tools for each score were used for CVD risk calculations., Results: Of 1425 PLWH enrolled, 10.8% had confirmed CVD, and 1132 had their risk scores evaluated. Of those participants, 42.8% had a higher risk of CVD (10-year risk of atherosclerotic CVD risk score (ASCVD) above 7.5%), and according to the European Society of Cardiology systemic coronary risk evaluation 2 (SCORE2), 71.7% had a high- to very high-risk rate. The agreement between various CVD risk tools varied, with Framingham heart study risk score (FRS), modified FRS, data collection on adverse effects of anti-HIV drugs (DAD), and SCORE2 for high-risk countries showing overall agreement rates of 82%, 94%, 91%, and 36%, respectively, compared to ASCVD. According to the 2021 European and 2019 American Cardiology guidelines, 75.3% and 47.1% of PLWH would be eligible for lipid-lowering agents, respectively., Conclusion: The diagnosed CVD prevalence highlighted the importance of monitoring cardiovascular health and comorbidities in this population. SCORE2 identified a greater number of individuals at high/very high risk compared to other prediction tools. The implementation of CVD prevention through lipid-lowering therapy was far from desired levels in our cohort.

Published
2024
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47. In-vitro evaluation of different antimicrobial combinations with and without colistin against carbapenem-resistant Acinetobacter baumannii clinical isolates.

Author

Müderris T, Dursun Manyaslı G, Sezak N, Kaya S, Demirdal T, and Gül Yurtsever S

Subjects
Humans, Male, Female, Middle Aged, Aged, Adult, Drug Synergism, Aged, 80 and over, Drug Therapy, Combination methods, Meropenem pharmacology, Meropenem administration & dosage, Acinetobacter baumannii drug effects, Colistin pharmacology, Carbapenems pharmacology, Microbial Sensitivity Tests methods, Anti-Bacterial Agents pharmacology, Anti-Bacterial Agents administration & dosage, Acinetobacter Infections drug therapy, Acinetobacter Infections microbiology
Abstract

Background: Carbapenem-resistant Acinetobacter baumannii (CRAB) infections are one of the most common causes of nosocomial infections and have high mortality rates due to difficulties in treatment. In this study, the in vitro synergistic interactions of the colistin (CT)-meropenem (MEM) combination and patient clinical outcomes were compared in CRAB-infected patients that receive CT-MEM antimicrobial combination therapy. In addition, in vitro synergistic interactions of MEM-ertapenem (ETP), MEM-fosfomycin (FF) and CT-FF antimicrobial combinations were investigated. Finally, the epsilometer (E) test and checkerboard test results were compared and the compatibility of these two tests was evaluated., Methods: Twenty-one patients were included in the study. Bacterial identification was performed with MALDI-TOF, and antimicrobial susceptibility was assessed with an automated system. Synergy studies were performed using the E test and checkerboard method., Results: For the checkerboard method, the synergy rates for CT-MEM, MEM-FF, MEM-ETP and CT-FF were 100%, 52.3%, 23.8% and 28.5%, respectively. In the E test synergy tests, synergistic effects were detected for two isolates each in the CT-MEM and CT-FF combinations. Microbial eradication was achieved in nine (52.9%) of the 17 patients that received CT-MEM combination therapy. The agreement between the E test and the checkerboard test was 6.5%., Conclusions: A synergistic effect was found with the checkerboard method for the CT-MEM combination in all isolates in our study, and approximately 70% of the patients benefited from treatment with this combination. In addition, more than half of the isolates showed a synergistic effect for the MEM-FF combination. Combinations of CT-MEM and MEM-FF may be options for the treatment of CRAB infections. However, a comprehensive understanding of the potential of the microorganism to develop resistant mutants under applied exposures, as well as factors that directly affect antimicrobial activity, such as pharmacokinetics/pharmacodynamics, is essential for providing treatment advice. We found a low rate of agreement between the E test method and the checkerboard test method in our study, in contrast to the literature. Comprehensive studies that compare clinical results with methods are needed to determine the ideal synergy test and interpretation method., (© 2024. The Author(s).)

Published
2024
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48. Predictors of surgical management in diabetic foot infections.

Author

Demirdal T and Sen P

Subjects
Humans, Male, Middle Aged, Female, Retrospective Studies, Aged, Risk Factors, Adult, Diabetic Foot surgery, Amputation, Surgical statistics & numerical data, Debridement
Abstract

Objective: Early recognition of the need for surgical intervention is crucial in terms of limiting amputation level and decreasing mortality. We aimed to determine the risk factors for limb loss in patients with diabetic foot infection (DFI)., Method: Data of hospitalised patients with a DFI between 2010 and 2019 were collected retrospectively from their hospital records. Clinical and laboratory findings were analysed according to the type of treatment., Results: Data were collected for 401 patients, 280 (69.8%) of whom were male. The mean age was 59.6±11.1 years. Treatment modalities included: medical treatment (36.4%); debridement/drainage (21.9%); minor amputation (17.7%); and major amputation (23.9%). Forefoot infection (odds ratio (OR): 3.347; 95% confidence interval (Cl): 1.408-7.956) and peripheral arterial disease (OR: 4.990; 95% Cl: 1.225-20.324) were found to be significant in predicting limb loss, while duration of diabetes (≥20 years) and absence of forefoot infection were significant predictors of debridement/drainage. Subgroup analysis showed that high leukocyte levels (>16.4K/μl) and forefoot infections were independent predictors for major and minor amputation, respectively., Conclusion: The clinical parameters used in this study are simple, broadly available, cost-effective and promising for predicting limb loss in patients with DFI.

Published
2024
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49. The clinical features, treatment and prognosis of neutropenic fever and Coronavirus disease 2019 results of the multicentre teos study.

Author

Başkol Elik D, Kaya Ş, Alkan S, Demirdal T, Sener A, Kaya S, Güzel Tunçcan Ö, Kayaaslan B, Güner R, Eser F, Kahraman H, Birengel S, Sarıcaoğlu EM, Eroğlu E, Çölkesen F, Öztürk E, Berk Cam H, Mermutluoğlu Ç, Özer Balin Ş, Sincan G, Altın N, Sili U, Suntur BM, Arslan Gülen T, Deveci B, Saba R, İncecik Ş, Eser Karlıdağ G, Hakko E, Akdağ D, Erdem HA, Sipahi H, Çicek C, Taşbakan MS, Taşbakan M, Pullukçu H, Yamazhan T, Arda B, Ulusoy S, and Sipahi OR

Subjects
Humans, Female, Retrospective Studies, SARS-CoV-2, Prognosis, Shock, Septic, COVID-19, Neutropenia
Abstract

This multicentre (22 centres in Turkey) retrospective cohort study aimed to assess the clinical outcomes of patients with neutropenic fever and SARS-CoV-2 positivity. Study period was 15 March 2020-15 August 2021. A total of 170 cases (58 female, aged 59 ± 15.5 years) that fulfilled the inclusion criteria were included in the study. One-month mortality rate (OMM) was 44.8%. The logistic regression analysis showed the following significant variables for the mentioned dependent variables: (i) achieving PCR negativity: receiving a maximum of 5 days of favipiravir (p = 0.005, OR 5.166, 95% CI 1.639-16.280); (ii) need for ICU: receiving glycopeptide therapy at any time during the COVID-19/FEN episode (p = 0.001, OR 6.566, 95% CI 2.137-20.172), the need for mechanical ventilation (p < 0.001, OR 62.042, 95% CI 9.528-404.011); (iii) need for mechanical ventilation: failure to recover from neutropenia (p < 0.001, OR 17.869, 95% CI 3.592-88.907), receiving tocilizumab therapy (p = 0.028, OR 32.227, 95% CI 1.469-707.053), septic shock (p = 0.001, OR 15.4 96% CI 3.164-75.897), and the need for ICU (p < 0.001, OR 91.818, 95% CI 15.360-548.873), (iv) OMM: [mechanical ventilation (p = 0.001, OR 19.041, 95% CI 3.229-112.286) and septic shock (p = 0.010, OR 5.589,95% CI 1.509-20.700)]. Although it includes a relatively limited number of patients, our findings suggest that COVID-19 and FEN are associated with significant mortality and morbidity., (© 2024. The Author(s).)

Published
2024
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50. Are bacterial coinfections really rare in COVID-19 intensive care units?

Author

Karaca B, Aksun M, Karahan NA, Girgin S, Ormen B, Tuzen AS, Demirdal T, and Sencan A

Subjects
Humans, Retrospective Studies, Intensive Care Units, Prognosis, COVID-19 epidemiology, Coinfection epidemiology, Shock, Septic
Abstract

Objectives: There are limited data about nosocomial coinfections of COVID-19 cases monitored in the intensive care unit. This study aims to investigate coinfections in COVID-19 patients followed in an intensive care unit of a university hospital., Methods: This study analyzed retrospectively the data of coinfections of 351 COVID-19 patients in the period 28.02.2020-15.01.2021 in a tertiary care intensive care unit in a university hospital., Results: Bacterial coinfections were present in 216 of the 351 cases. One hundred and thirty of these cases were evaluated as nosocomial infections. On the third day the Sequential Organ Failure Assessment Score, usage of invasive mechanical ventilation and presence of septic shock were significantly higher in the coinfected group. The neutrophil/lymphocyte ratio, polymorphonuclear leukocyte count, procalcitonin, ferritin, and blood urea nitrogen values were significantly higher in the coinfection group. White blood cells (WBC) (OR: 1.075, 95% CI 1.032-1.121, p = 0.001) and ICU hospitalization day (OR: 1.114, 95% CI 1.063-1.167, p < 0.001) were found to be independent risk factors for coinfection in the multivariate logistic regression analysis. The rates of hospitalization day on the day of arrival, the 21st day, as well as total mortality (p = 0.004), were significantly higher in the coinfected group., Conclusion: Bacterial coinfections of COVID-19 patients in the intensive care unit remain a problem. Identifying the infectious agent, classifying colonizations and infections, and using the proper treatment of antibiotics are of great importance in the case management of COVID-19 patients in the intensive care unit., (© 2023. The Author(s).)

Published
2023
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