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1. Evaluation of tularaemia courses: a multicentre study from Turkey

Author

Erdem, H., Ozturk-Engin, D., Yesilyurt, M., Karabay, O., Elaldi, N., Celebi, G., Korkmaz, N., Guven, T., Sumer, S., Tulek, N., Ural, O., Yilmaz, G., Erdinc, S., Nayman-Alpat, S., Sehmen, E., Kader, C., Sari, N., Engin, A., Cicek-Senturk, G., Ertem-Tuncer, G., Gulen, G., Duygu, F., Ogutlu, A., Ayaslioglu, E., Karadenizli, A., Meric, M., Ulug, M., Ataman-Hatipoglu, C., Sirmatel, F., Cesur, S., Comoglu, S., Kadanali, A., Karakas, A., Asan, A., Gonen, I., Kurtoglu-Gul, Y., Altin, N., Ozkanli, S., Yilmaz-Karadag, F., Cabalak, M., Gencer, S., Umut Pekok, A., Yildirim, D., Seyman, D., Teker, B., Yilmaz, H., Yasar, K., Inanc Balkan, I., Turan, H., Uguz, M., Kilic, S., Akkoyunlu, Y., Kaya, S., Erdem, A., Inan, A., Cag, Y., Bolukcu, S., Ulu-Kilic, A., Ozgunes, N., Gorenek, L., Batirel, A., and Agalar, C.

Published
2014
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2. 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. The features of infectious diseases departments and anti-infective practices in France and Turkey: a cross-sectional study

Author

Erdem, H., Stahl, J. P., Inan, A., Kilic, S., Akova, M., Rioux, C., Pierre, I., Canestri, A., Haustraete, E., Engin, D. O., Parlak, E., Argemi, X., Bruley, D., Alp, E., Greffe, S., Hosoglu, S., Patrat-Delon, S., Heper, Y., Tasbakan, M., Corbin, V., Hopoglu, M., Balkan, I. I., Mutlu, B., Demonchy, E., Yilmaz, H., Fourcade, C., Toko-Tchuindzie, L., Kaya, S., Engin, A., Yalci, A., Bernigaud, C., Vahaboglu, H., Curlier, E., Akduman, D., Barrelet, A., Oncu, S., Korten, V., Usluer, G., Turgut, H., Sener, A., Evirgen, O., Elaldi, N., and Gorenek, L.

Published
2014
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5. 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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7. 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

8. 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

9. 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

10. 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

11. 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

12. report on device-associated infection rates in 19 cities of Turkey, data

Author

Leblebicioglu, H, Erben, N, Rosenthal, VD, Atasay, B, Erbay, A, Unal, S, Senol, G, Willke, A, Ozgultekin, A, Altin, N, Bakir, M, Oncul, O, Ersoz, G, Ozdemir, D, Yalcin, AN, Ozdemir, H, Yildizdas, D, Koksal, I, Aygun, C, Sirmatel, F, Sener, A, Tuna, N, Akan, OA, Turgut, H, Demiroz, AP, Kendirli, T, Alp, E, Uzun, C, Ulusoy, S, Arman, D, Ozgunes, I, Usluer, G, Kilic, A, Arsan, S, Cabadak, H, Sen, S, Gelebek, Y, Zengin, H, Topeli, A, Alper, Y, Meric, M, Azak, E, Inan, A, Turan, G, Haznedaroglu, T, Gorenek, L, Acar, A, Cesur, S, Engin, A, Kaya, A, Kuyucu, N, Geyik, MF, Aydin, OC, Erdogan, NS, Turhan, O, Gunay, N, Gumus, E, Dursun, O, Esen, S, Ulger, F, Dilek, A, Yilmaz, H, Sunbul, M, Gokmen, Z, Ozdemir, SI, Horoz, OO, Yylmaz, G, Kaya, S, Ulusoy, H, Kucukoduk, S, Ustun, C, Baysal, AI, Otkun, M, Tulunay, M, Oral, M, Unal, N, Cengiz, M, Yilmaz, L, Sacar, S, Sungurtekin, H, Ugurcan, D, Yetkin, MA, Bulut, C, Erdinc, FS, Hatipoglu, CA, Ince, E, Ciftci, E, Odek, C, Yaman, A, Karbuz, A, Aldemir, B, Kilic, AU, Arda, B, Bacakoglu, F, and Hizel, K

Subjects
infection, Urinary tract infection, Network, Ventilator-associated pneumonia, Catheter-associated urinary tract, health care facilities, manpower, and services, Central line-associated bloodstream infections, Bloodstream, VELOPING-COUNTRIES, MULTIDIMENSIONAL APPROACH, STRATEGY, IMPACT, INICC, International Nosocomial Infection Consortium, Turkey, Device-associated infection, Antibiotic resistance, Hospital infection, Nosocomial infection, Healthcare-associated
Abstract

Background: Device-associated healthcare-acquired infections (DA-HAI) pose a threat to patient safety, particularly in the intensive care unit (ICU). We report the results of the International Infection Control Consortium (INICC) study conducted in Turkey from August 2003 through October 2012. Methods: A DA-HAI surveillance study in 63 adult, paediatric ICUs and neonatal ICUs (NICUs) from 29 hospitals, in 19 cities using the methods and definitions of the U.S. NHSN and INICC methods. Results: We collected prospective data from 94,498 ICU patients for 647,316 bed days. Pooled DA-HAI rates for adult and paediatric ICUs were 11.1 central line-associated bloodstream infections (CLABSIs) per 1000 central line (CL)-days, 21.4 ventilator-associated pneumonias (VAPs) per 1000 mechanical ventilator (MV)-days and 7.5 catheter-associated urinary tract infections (CAUTIs) per 1000 urinary catheter-days. Pooled DA-HAI rates for NICUs were 30 CLABSIs per 1000 CL-days, and 15.8 VAPs per 1000 MV-days. Extra length of stay (LOS) in adult and paediatric ICUs was 19.4 for CLABSI, 8.7 for VAP and 10.1 for CAUTI. Extra LOS in NICUs was 13.1 for patients with CLABSI and 16.2 for patients with VAP. Extra crude mortality was 12% for CLABSI, 19.4% for VAP and 10.5% for CAUTI in ICUs, and 15.4% for CLABSI and 10.5% for VAP in NICUs. Pooled device use (DU) ratios for adult and paediatric ICUs were 0.54 for MV, 0.65 for CL and 0.88 for UC, and 0.12 for MV, and 0.09 for CL in NICUs. The CLABSI rate was 8.5 per 1,000 CL days in the Medical Surgical ICUs included in this study, which is higher than the INICC report rate of 4.9, and more than eight times higher than the NHSN rate of 0.9. Similarly, the VAP and CAUTI rates were higher compared with U. S. NHSN (22.3 vs. 1.1 for VAP; 7.9 vs. 1.2 for CAUTI) and with the INICC report (22.3 vs. 16.5 in VAP; 7.9 vs. 5.3 in CAUTI). Conclusions: DA-HAI rates and DU ratios in our ICUs were higher than those reported in the INICC global report and in the US NHSN report.

Published
2014

13. practices in France and Turkey: a cross-sectional study

Author

Erdem, H, Stahl, JP, Inan, A, Kilic, S, Akova, M, Rioux, C, Pierre, I, Canestri, A, Haustraete, E, Engin, DO, Parlak, E, Argemi, X, Bruley, D, Alp, E, Greffe, S, Hosoglu, S, Patrat-Delon, S, Heper, Y, Tasbakan, M, Corbin, V, Hopoglu, M, Balkan, II, Mutlu, B, Demonchy, E, Yilmaz, H, Fourcade, C, Toko-Tchuindzie, L, Kaya, S, Engin, A, Yalci, A, Bernigaud, C, Vahaboglu, H, Curlier, E, Akduman, D, Barrelet, A, Oncu, S, Korten, V, Usluer, G, Turgut, H, Sener, A, Evirgen, O, Elaldi, N, and Gorenek, L

Abstract

The aim of this study was to assess the infectious diseases (ID) wards of tertiary hospitals in France and Turkey for technical capacity, infection control, characteristics of patients, infections, infecting organisms, and therapeutic approaches. This cross-sectional study was carried out on a single day on one of the weekdays of June 17-21, 2013. Overall, 36 ID departments from Turkey (n = 21) and France (n = 15) were involved. On the study day, 273 patients were hospitalized in Turkish and 324 patients were followed in French ID departments. The numbers of patients and beds in the hospitals, and presence of an intensive care unit (ICU) room in the ID ward was not different in both France and Turkey. Bed occupancy in the ID ward, single rooms, and negative pressure rooms were significantly higher in France. The presence of a laboratory inside the ID ward was more common in Turkish ID wards. The configuration of infection control committees, and their qualifications and surveillance types were quite similar in both countries. Although differences existed based on epidemiology, the distribution of infections were uniform on both sides. In Turkey, anti-Gram-positive agents, carbapenems, and tigecycline, and in France, cephalosporins, penicillins, aminoglycosides, and metronidazole were more frequently preferred. Enteric Gram-negatives and hepatitis B and C were more frequent in Turkey, while human immunodeficiency virus (HIV) and streptococci were more common in France (p < 0.05 for all significances). Various differences and similarities existed in France and Turkey in the ID wards. However, the current scene is that ID are managed with high standards in both countries.

Published
2014

14. International Nosocomial Infection Control Consortium (INICC) national report on device-associated infection rates in 19 cities of Turkey, data summary for 2003-2012

Author

Leblebicioglu, H., Erben, N., Rosenthal, V.D., Atasay, B., Erbay, A., Unal, S., Senol, G., Willke, A., Özgültekin, A., Altin, N., Bakir, M., Oncul, O., Ersöz, G., Ozdemir, D., Yalcin, A.N., Özdemir, H., Yıldızdaş, D., Koksal, I., Aygun, C., Sirmatel, F., Sener, A., Tuna, N., Akan, Ö.A., Turgut, H., Demiroz, A.P., Kendirli, T., Alp, E., Uzun, C., Ulusoy, S., Arman, D., Ozgunes, I., Usluer, G., Kiliç, A., Arsan, S., Cabadak, H., Sen, S., Gelebek, Y., Zengin, H., Topeli, A., Alper, Y., Meric, M., Azak, E., İnan, A., Turan, G., Haznedaroglu, T., Gorenek, L., Acar, A., Cesur, S., Engin, A., Kaya, A., Kuyucu, N., Geyik, M.F., Aydın, Ö.Ç., Erdogan, N.S., Turhan, O., Gunay, N., Gumus, E., Dursun, O., Esen, S., Ulger, F., Dilek, A., Yilmaz, H., Sunbul, M., Gökmen, Z., Özdemir, S.İ., Horoz, O.O., Yýlmaz, G., Kaya, S., Ulusoy, H., Küçüködük, S., Ustun, C., Otkun, M., Tulunay, M., Oral, M., Ünal, N., Cengiz, M., Yilmaz, L., Sacar, S., Sungurtekin, H., Uğurcan, D., Yetkin, M.A., Bulut, C., Erdinc, F.S., Hatipoglu, C.A., İnce, E., Çiftçi, E., Ödek, Ç., Yaman, A., Karbuz, A., Aldemir, B., Kılıc, A.U., Arda, B., Bacakoglu, F., and Hizel, K.

Subjects
Male, Turkey, healthcare associated infection, Antibiotic resistance, health care facilities, manpower, and services, central venous catheter, Network, intensive care unit, preschool child, Turkey (republic), Cohort Studies, Nosocomial infection, newborn, device infection, Prevalence, Prospective Studies, Child, intensive care, catheter infection, Urinary tract infection, Cross Infection, adult, Pneumonia, Ventilator-Associated, INICC, cohort analysis, infection control, Device-associated infection, female, Equipment and Supplies, Child, Preschool, disease surveillance, devices, prospective study, Adolescent, Catheter-associated urinary tract infection, infection rate, Bloodstream infection, Article, critically ill patient, length of stay, Ventilator-associated pneumonia, Humans, Hospital infection, human, Healthcare-associated infection, urinary catheter, Infant, Newborn, Infant, International Nosocomial Infection Consortium, mechanical ventilator, major clinical study, mortality, Catheter-Related Infections, ventilator associated pneumonia, Central line-associated bloodstream infections
Abstract

Background: Device-associated healthcare-acquired infections (DA-HAI) pose a threat to patient safety, particularly in the intensive care unit (ICU). We report the results of the International Infection Control Consortium (INICC) study conducted in Turkey from August 2003 through October 2012. Methods: A DA-HAI surveillance study in 63 adult, paediatric ICUs and neonatal ICUs (NICUs) from 29 hospitals, in 19 cities using the methods and definitions of the U.S. NHSN and INICC methods. Results: We collected prospective data from 94,498 ICU patients for 647,316 bed days. Pooled DA-HAI rates for adult and paediatric ICUs were 11.1 central line-associated bloodstream infections (CLABSIs) per 1000 central line (CL)-days, 21.4 ventilator-associated pneumonias (VAPs) per 1000 mechanical ventilator (MV)-days and 7.5 catheter-associated urinary tract infections (CAUTIs) per 1000 urinary catheter-days. Pooled DA-HAI rates for NICUs were 30 CLABSIs per 1000 CL-days, and 15.8 VAPs per 1000 MV-days. Extra length of stay (LOS) in adult and paediatric ICUs was 19.4 for CLABSI, 8.7 for VAP and 10.1 for CAUTI. Extra LOS in NICUs was 13.1 for patients with CLABSI and 16.2 for patients with VAP. Extra crude mortality was 12% for CLABSI, 19.4% for VAP and 10.5% for CAUTI in ICUs, and 15.4% for CLABSI and 10.5% for VAP in NICUs. Pooled device use (DU) ratios for adult and paediatric ICUs were 0.54 for MV, 0.65 for CL and 0.88 for UC, and 0.12 for MV, and 0.09 for CL in NICUs. The CLABSI rate was 8.5 per 1,000 CL days in the Medical Surgical ICUs included in this study, which is higher than the INICC report rate of 4.9, and more than eight times higher than the NHSN rate of 0.9. Similarly, the VAP and CAUTI rates were higher compared with U.S. NHSN (22.3 vs. 1.1 for VAP; 7.9 vs. 1.2 for CAUTI) and with the INICC report (22.3 vs. 16.5 in VAP; 7.9 vs. 5.3 in CAUTI). Conclusions: DA-HAI rates and DU ratios in our ICUs were higher than those reported in the INICC global report and in the US NHSN report. © 2014 Leblebicioglu et al.

Published
2014

15. Neurobrucellosis: Results of the Istanbul Study

Author

Erdem, H, Ulu-Kilic, A, Kilic, S, Karahocagil, M, Shehata, G, Eren-Tulek, N, Yetkin, F, Celen, MK, Ceran, N, Gul, HC, Mert, G, Tekin-Koruk, S, Dizbay, M, Inal, AS, Nayman-Alpat, S, Bosilkovski, M, Inan, D, Saltoglu, N, Abdel-Baky, L, Adeva-Bartolome, MT, Ceylan, B, Sacar, S, Turhan, V, Yilmaz, E, Elaldi, N, Kocak-Tufan, Z, Ugurlu, K, Dokuzoguz, B, Yilmaz, H, Gundes, S, Guner, R, Ozgunes, N, Ulcay, A, Unal, S, Dayan, S, Gorenek, L, Karakas, A, Tasova, Y, Usluer, G, Bayindir, Y, Kurtaran, B, Sipahi, OR, and Leblebicioglu, H

Abstract

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

Published
2012

16. International nosocomial infection control consortium (INICC) report, data summary of 36 countries, for 2004-2009

Author

Rosenthal, V.D., Bijie, H., Maki, D.G., Mehta, Y., Apisarnthanarak, A., Medeiros, E.A., Leblebicioglu, H., Fisher, D., Álvarez-Moreno, C., Khader, I.A., Martínez, M.D.R.G., Cuellar, L.E., Navoa-Ng, J.A., Abouqal, R., Garcell, H.G., Mitrev, Z., García, M.C.P., Hamdi, A., Dueñas, L., Cancel, E., Gurskis, V., Rasslan, O., Ahmed, A., Kanj, S.S., Ugalde, O.C., Mapp, T., Raka, L., Meng, C.Y., Thu, L.T.A., Ghazal, S., Gikas, A., Narváez, L.P., Mejía, N., Hadjieva, N., Elanbya, M.O.G., Siritt, M.E.G., Jayatilleke, K., Frías, M.L., Churruarín, G., Sztokhamer, D., Flynn, L.P., Rausch, D., Spagnolo, A., Santero, B., Soroka, L.C., For-Ciniti, S., Blasco, M., Lezcano, C.B., Lastra, C.E., Bedoya, M.Á.F., Costamagna, A., Dheza, G.R., Ávalos, J., Álvarez, M., Bench-Etrit, G., Bonaventura, C., Caridi, M.Á., Messina, A., Ricci, B., Viegas, M., Di Núbila, B.M.A., Lan-Zetta, D., Fernández, L.J., Rossetti, M.A., Romani, A., Migazzi, C., Barolin, C., Martínez, E., Bernan, M.L., Bay, M.R., Diaz, F.R., Dominguez, C.B., Coria, G.E., Martinelli, M.E., Grinberg, G., Ferreira, I.B., Cechinel, R.B., Zanandrea, B.B., Rohnkohl, C., Regalin, M., Spessatto, J.L., Pasini, R.S., Ferla, S., Salomao, R., da Silva, M.Â.M., de Jesus Silva, C.H., Vilins, M., Blecher, S., Angelieri, D.B., Kuchenbecker, R.S., Pires, M.R., Santos, R.P., Kuplich, N.M., Siliprandi, E.M.O., Do-Amaral, A.P., Silva, C.P.R., Biancalana, M.L.N., Sánchez, T.E.G., Valente, R., Apolinário, D., Freitas, L.F.B., Dos Santos, M.C.I., Lopes, J.M.M., Valadares, P.C.P., Batista, J.P., Campos, M.A.-E.S., Moretti, M.L., Cardoso, L.G., Trabaos, A., Martins, I.S., Santos, P.T.D., Pinhejro, D.O.B.P., Abreu, J.S.D., Richtmann, R., Rodríguez, T., Baltieri, S.R., Moreira, M., Stadtlober, G.F., Cavaglieri, A.G., Karadimovm, D., Velinova, V., Qin, J.A., Juan, H., Fang, H.C., Gao, X., Lili, T., Yao, S., Hungmei, W., Bin, C., Ruisheng, L., Yang, Y., Yeguxiang, Ziqin, X., Mei, W.H., Chun, G.S., Yang, X., Gan, A., Zhang, A., Luo, J., Zhao, A., Li, F., Liu, B., Gao, M., Zhao, B., Wei, L., Wang, C., Fang, L., Yi, C., Xie, X., Ling, F., Wu, Y., Xu, F., Feng, F., Weng, F., Dong, G.-H., Ye, G., Yang, W., Yu, H., Yang, H.-I., Yan, H., Mao, A., Zhou, H., Chen, W., Gong, H., Tan, H., Liu, Y., Wu, H., Tang, D., Hao, J., Zhang, H., Wang, J., Qiu, Y., Yu, J., Gu, X., Jiang, J., Zhang, M., Miu, J., Zhao, W., Shi, J., Li, L., Duo, K., Cai, L., Liu, L., Hua, L., Shao, Q., An, Y., Lu, Q., Li, G., Sun, R., Zhang, W., Tao, Z., Wang, W., Shen, Y., Fan, W., Chen, H., Yao, X., Wen, H., Xiong, X., Xu, H., Liu, X., Huang, M., Wang, X., Shao, G., Yuan, Y., Cao, Y., Chen, Y., Chen, X., Gu, Y., Zhu, L., Huang, Y., Wang, M., Wang, Y., Mao, Y., Cheng, Y., Zhao, C., Sun, Y., Zhu, B., Cai, M., Zhang, Y., Xue, M., Zhou, Y., Zhang, R., Du, Y., Li, D., Ni, Y., Zhang, L., Zhong, Z., Zhu, G., Yu, Z., Cao, M., Song, Z., Xu, J., Tong, Z., Gu, P., Agudelo, J.G., Sussmann, O., Mojica, B.E., Rojas, C., Beltran, H., Paez, J., Gómez, W.V., Dajud, L., Mendoza, M., Arrieta, P., Osorio, L., Olarte, N., Valderrama, A., Muñoz, H.J., Guzmán, N.B., Ferrer, M.R., Villa, G.S., Guzmán, A.L., Linares, C., Cortés, L.M., Campo, L.F.R., Menco, A., Calderón, M.E.R., Parada, D.E.C., Fernandez, A.M.P., Martínez, I.F.P., Saleg, P.A.M., Vega, Y.L., Luengas, E.L., Ramos, C.R., Hernández, H.T., Gomez, D.Y., Gomez, B.M.V., Ruiz, M.G., Millán, J.C.T., López, M.U.T., Parada, E.C., Rochel, A.E.M., Hidalgo, R.F., Calzada, J.M.A., Muñoz, G., Argüello, A.R., Chinchilla, A.S., Fuentes, C.G., Pérez, C.M., Pino, O.R., González, O.D., González, D.F., de Wang, C.M.R., Severino, R., Tolari, G., Delgado, M., Vélez, J.W., Zapata, M.A.C., Valle, M.J., Guayasamín, S., Seliem, Z.S., El Kholy, A.A., Abdel-Aziz, D., Sabour, M.A.E., Kalil, M., Saeed, A., Gafarey, M.E., Fouad, L., Muhamed, T., Saeed, H., Casares, A.C.B., Machuca, L.J., Chaniotaki, K., Tsioutis, C., Bampalis, D., Gopinath, R., Ravindra, N., Karlekar, A., Sood, S., Verma, N., Sen, N., Subramani, K., Raj, J.P., Mathur, P., Kumar, S., Sahu, S., Govil, D., Jaggi, N., Bhatnagar, S., Myatra, S.N., Divatia, Kelkar, R., Biswas, S., Raut, S., Sampat, S., Kumar, R., Todi, S.K., Bhakta, A., Bhattacharjee, M., Ramachandran, B., Chakravarthy, M., Gokul, B.N., Sukanya, R., Pushparaj, L., Singh, S., Radhakrishnan, K., Udwadia, F.E., Ansari, R., Poojary, A., Koppikar, G., Bhandarkar, L., Jadhav, S., Dwivedy, A., Shetty, S., Binu, S., Pawar, M., Gupta, A., Saini, N., Kothari, V., Singhal, T., Shah, S., Rodrigues, C., Hegd, A., Kapadia, F., Mehta, P., Surase, P., Narayanan, S., Munshi, N., Padbidri, V., Dawhale, R., Jacobs, S.M., Khuri-Bulos, N., Mahafzah, A., Baftiu, N., Spahija, G., Zahreddine, N., Alamuddin, L., Kanafani, Z., Dagys, A., Kondratas, T., Kevalas, R., Anguseva, T., Ampova, V., Guroska, S.T.-C., Manikavasagam, J., Tan, L.H., Kaur, K., Assadian, O., Wolfram, R., Kaur, P., Oropeza, M.S., Ruiz, A.A., Campuzano, R., Brito, J.M., Serrato, I.P., López, M.S., Gómez, A.C., Morales, J.R., Rodríguez, J.E.V., Gallo, J.H.P., Almazán, F.A., Miramontes, G.I., Vázquez Olivas, M.D.R., Chávez, A.S., Espinoza, Y.A., Gallegos, L.A., González, D.J.S., Rochín, A.M., Félix, M.J.S., Peña, R.D., Gómez, A.B.Z., Gutiérrez, C.A.E., Novales, M.G.M., Herver, M.D.J., Gaytan, J.A., Olmeda, J.A.G., Martínez-Marroquín, M.Y., Hernández, A., García, E.O., Cervantes, R.V., Arteaga-Troncoso, G., Guerra Infante, F.M., Méndez, I.M., Burguete, M.C.C., Barkat, A., Bouazzaoui, N.L., Meryem, K., Madani, N., Zeggwagh, A.A., Abidi, K., Dendane, T., Khan, S.G., Ali, F., Hussain, Y., Butt, F., Fakir, A., Mahmood, S.F., Jamil, B., Memon, B.A., Bhutto, G.H., Alfaro, F.G., Alvarado, C., León, L.M.D., Navarro, R., Moreno, J.L., Cerrad, R., Sabogal, A.C., Goicochea, I.P., Sanchez, A.A., Alva, G.R., Ventura, J.G., Aguilar, M.R., Plasencia, N.S., Maldonado, E.F., Espichan, M.J.M., Echenique, L., Rosales, R., Bravo, L.I.C., Cáceres, M.L., Espinoza, T.A., López, F.S., Saldarriaga, M.E.C., Morvelí, E.U.V., Barriga, H., Villacorta, M.S., Barrios, S.C., Zegarra, S.L.T., Astete, N.S., Guevara, F.C., Mendoza, C.B., Ramírez, A.V., Pastrana, J.S., Wong, F.M.R., Ángeles, C.S., Tavera, Z.D., Ramirez, E., Vergara, C.E.L.H., Mendoza, L., Sosa, G.B., Chávez, C.M., Berba, R., Genuino, G.A.S., Consunji, R.J., Mantaring, J.B.V., III, Villanueva, V.D., Tolentino, M.C.V., Galapia, Y.A., Tambyah, P.A., Hakawi, A., Kaluarachchi, N.N., Samaraweera, G.A.-R., Sid Ahmed Ali, I.M., Satti, A.A., Jamulitrat, S., Thamlikitkul, V., Ben-Jaballah, N., Ammar, K., Öztürk, R., Dikmen, Y., Aygún, G., Ulusoy, S., Arda, B., Bacakoglu, F., Sardan, Y.C., Yildirim, G., Topeli, A., Akan, Ö.A., Tulunay, M., Oral, M., Ünal, N., Alp, E., Aygen, B., Sirmatel, F., Cengiz, M., Yilmaz, L., Özgültekin, A., Turan, G.-D., Akgün, N., Ozdemir, D., Guclu, E., Erdogan, S., Erben, N., Ozgunes, I., Usluer, G., Aygun, C., Küçüködük, S., Arman, D., Hizel, K., Uzun, C., Turgut, Hüseyin, Saçar, Suzan, Sungurtekin, Hülya, Uğurcan, Doğaç, Koksal, I., Yýlmaz, G., Kaya, S., Ulusoy, H., Ersoz, G., Kaya, A., Kuyucu, N., Esen, S., Ulger, F., Dilek, A., Yalcin, A.N., Turhan, O., Keskin, S., Gumus, E., Dursun, O., Kendirli, T., Ince, E., Cliftci, E., Özdemir, H., Demiroz, A.P., Yetkin, M.A., Bulut, C., Erdinc, F.S., Hatipoglu, C.A., Erbay, A., Willke, A., Meric, M., Azak, E., Oncul, O., Haznedaroglu, T., Gorenek, L., Acar, A., Silvera, E., Techera, S., Frachia, A., Algorta, G., Gil de Añez, Z.D., Bravo, L.M., Orozco, N., Mejías, E., Trang, D.T.V., Nga, T.T.K., and Zruong, P.H.

Subjects
meticillin, Staphylococcus aureus, Asia, Antibiotic resistance, Health care-associated infection, Catheter-associated urinary tract infection, Network, bloodstream infection, intensive care unit, Developing countries, South and Central America, Nosocomial infection, Escherichia coli, Ventilator-associated pneumonia, Hospital infection, human, ceftazidime, catheter infection, Urinary tract infection, nonhuman, bacterium isolate, article, developing country, infection control, mortality, Device-associated infection, Low-income countries, hospital bed, Europe, Klebsiella pneumoniae, Central line-associated bloodstream infection, Africa, Pseudomonas aeruginosa, Limited-resources countries, disease surveillance, ventilator associated pneumonia, hospitalization, prospective study
Abstract

The results of a surveillance study conducted by the International Nosocomial Infection Control Consortium (INICC) from January 2004 through December 2009 in 422 intensive care units (ICUs) of 36 countries in Latin America, Asia, Africa, and Europe are reported. During the 6-year study period, using Centers for Disease Control and Prevention (CDC) National Healthcare Safety Network (NHSN; formerly the National Nosocomial Infection Surveillance system [NNIS]) definitions for device-associated health care-associated infections, we gathered prospective data from 313,008 patients hospitalized in the consortium's ICUs for an aggregate of 2,194,897 ICU bed-days. Despite the fact that the use of devices in the developing countries' ICUs was remarkably similar to that reported in US ICUs in the CDC's NHSN, rates of device-associated nosocomial infection were significantly higher in the ICUs of the INICC hospitals; the pooled rate of central line-associated bloodstream infection in the INICC ICUs of 6.8 per 1,000 central line-days was more than 3-fold higher than the 2.0 per 1,000 central line-days reported in comparable US ICUs. The overall rate of ventilator-associated pneumonia also was far higher (15.8 vs 3.3 per 1,000 ventilator-days), as was the rate of catheter-associated urinary tract infection (6.3 vs. 3.3 per 1,000 catheter-days). Notably, the frequencies of resistance of Pseudomonas aeruginosa isolates to imipenem (47.2% vs 23.0%), Klebsiella pneumoniae isolates to ceftazidime (76.3% vs 27.1%), Escherichia coli isolates to ceftazidime (66.7% vs 8.1%), Staphylococcus aureus isolates to methicillin (84.4% vs 56.8%), were also higher in the consortium's ICUs, and the crude unadjusted excess mortalities of device-related infections ranged from 7.3% (for catheter-associated urinary tract infection) to 15.2% (for ventilator-associated pneumonia). Copyright © 2012 by the Association for Professionals in Infection Control and Epidemiology, Inc. Published by Elsevier Inc. All rights reserved.

Published
2012

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

Author

Meltem Taşbakan, Jean-Paul Stahl, D. Akduman, Hakan Erdem, E. Haustraete, A. Canestri, Huseyin Turgut, Serkan Oncu, Ömer Evirgen, Alper Şener, Aynur Engin, Salih Hosoglu, C. Bernigaud, L. Toko-Tchuindzie, E. Curlier, Birsen Mutlu, Haluk Vahaboglu, Emine Alp, Derya Ozturk Engin, V. Corbin, Xavier Argemi, A. Barrelet, Ilker Inanc Balkan, Levent Gorenek, I. Pierre, Gaye Usluer, S. Patrat-Delon, Christophe Rioux, Yasemin Heper, Aysun Yalci, Nazif Elaldi, M. Hopoglu, C. Fourcade, S. Sırrı Kiliç, Hava Yilmaz, Emine Parlak, Murat Akova, E. Demonchy, Volkan Korten, S. Greffe, Asuman Inan, D. Bruley, Selçuk Kaya, Zonguldak Bülent Ecevit Üniversitesi, [Erdem, H. -- Gorenek, L.] GATA Haydarpasa Training Hosp, Dept Infect Dis & Clin Microbiol, Istanbul, Turkey -- [Stahl, J. P.] Univ Grenoble 1, Dept Infect Dis, Grenoble, France -- [Stahl, J. P.] Univ Hosp Grenoble, Grenoble, France -- [Inan, A. -- Engin, D. O.] Haydarpasa Numune Training & Res Hosp, Dept Infect Dis & Clin Microbiol, Istanbul, Turkey -- [Kilic, S.] Gulhane Mil Med Acad, Dept Publ Hlth, Ankara, Turkey -- [Akova, M.] Hacettepe Univ, Sch Med, Infect Dis Unit, Ankara, Turkey -- [Rioux, C.] Hop Xavier Bichat, Dept Infect Dis, Paris, France -- [Pierre, I.] Hop Raymond Poincare, Dept Infect Dis, Garches, France -- [Canestri, A.] Tenon Univ Hosp, Dept Infect Dis, Paris, France -- [Haustraete, E.] Univ Hosp, Dept Infect Dis, Caen, France -- [Parlak, E.] Ataturk Univ, Sch Med, Dept Infect Dis & Clin Microbiol, Erzurum, Turkey -- [Argemi, X.] Nouvel Hop Civil, Dept Infect Dis, Strasbourg, France -- [Bruley, D.] Univ Hosp, Dept Infect Dis, Grenoble, France -- [Alp, E.] Erciyes Univ, Sch Med, Dept Infect Dis & Clin Microbiol, Kayseri, Turkey -- [Greffe, S.] Hosp Ambroise Pare, Dept Internal Med, Boulogne, France -- [Hosoglu, S.] Dicle Univ, Sch Med, Dept Infect Dis & Clin Microbiol, Diyarbakir, Turkey -- [Patrat-Delon, S.] Univ Hosp, Dept Infect Dis, Rennes, France -- [Heper, Y.] Uludag Univ, Sch Med, Dept Infect Dis & Clin Microbiol, Bursa, Turkey -- [Tasbakan, M.] Ege Univ, Sch Med, Dept Infect Dis & Clin Microbiol, Izmir, Turkey -- [Corbin, V.] Univ Hosp, Dept Infect Dis, Clermont Ferrand, France -- [Hopoglu, M.] Inonu Univ, Sch Med, Dept Infect Dis & Clin Microbiol, Malatya, Turkey -- [Balkan, I. I.] Istanbul Univ, Cerrahpasa Med Sch, Dept Infect Dis & Clin Microbiol, Istanbul, Turkey -- [Mutlu, B.] Kocaeli Univ, Sch Med, Dept Infect Dis & Clin Microbiol, Kocaeli, Turkey -- [Demonchy, E.] Univ Hosp, Dept Infect Dis, Nice, France -- [Yilmaz, H.] Ondokuz Mayis Univ, Sch Med, Dept Infect Dis & Clin Microbiol, Samsun, Turkey -- [Fourcade, C.] Univ Nimes Hosp, Dept Infect Dis, F-30006 Nimes, France -- [Toko-Tchuindzie, L.] Gen Hosp, Dept Infect Dis, Belfort, France -- [Kaya, S.] Karadeniz Tech Univ, Sch Med, Dept Infect Dis & Clin Microbiol, Trabzon, Turkey -- [Engin, A. -- Elaldi, N.] Cumhuriyet Univ, Sch Med, Dept Infect Dis & Clin Microbiol, Sivas, Turkey -- [Yalci, A.] Ankara Univ, Sch Med, Dept Infect Dis & Clin Microbiol, TR-06100 Ankara, Turkey -- [Bernigaud, C.] Gen Hosp, Dept Infect Dis, Chalon Sur Saone, France -- [Vahaboglu, H.] Medeniyet Univ, Goztepe Training & Res Hosp, Dept Infect Dis & Clin Microbiol, Istanbul, Turkey -- [Curlier, E.] Univ Hosp, Dept Infect Dis, Besancon, France -- [Akduman, D.] Bulent Ecevit Univ, Sch Med, Dept Infect Dis & Clin Microbiol, Zonguldak, Turkey -- [Barrelet, A.] Andre Mignot Hosp, Dept Internal & Infect Dis, Versailles, France -- [Oncu, S.] Adnan Menderes Univ, Sch Med, Dept Infect Dis & Clin Microbiol, Aydin, Turkey -- [Korten, V.] Marmara Univ, Sch Med, Dept Infect Dis & Clin Microbiol, Istanbul, Turkey -- [Usluer, G.] Osmangazi Univ, Sch Med, Dept Infect Dis & Clin Microbiol, Eskisehir, Turkey -- [Turgut, H.] Pamukkale Univ, Sch Med, Dept Infect Dis & Clin Microbiol, Denizli, Turkey -- [Sener, A.] Onsekiz Mart Univ, Sch Med, Dept Infect Dis & Clin Microbiol, Canakkale, Turkey -- [Evirgen, O.] Mustafa Kemal Univ, Sch Med, Dept Infect Dis & Clin Microbiol, Antakya, Turkey, Andrade, Hugo -- 0000-0001-6781-6125, KORTEN, VOLKAN -- 0000-0002-9991-814X, AKOVA, MURAT -- 0000-0002-6904-9473, Stahl, Jean Paul -- 0000-0002-0086-3557, VAHABOGLU, Haluk -- 0000-0001-8217-1767, Elaldi, Nazif -- 0000-0002-9515-770X, Ondokuz Mayıs Üniversitesi, Erdem, H., Stahl, J. P., Inan, A., Kilic, S., Akova, M., Rioux, C., Pierre, I., Canestri, A., Haustraete, E., Engin, D. O., Parlak, E., Argemi, X., Bruley, D., Alp, E., Greffe, S., Hosoglu, S., Patrat-Delon, S., Heper, Y., Tasbakan, M., Corbin, V., Hopoglu, M., Balkan, I. I., Mutlu, B., Demonchy, E., Yilmaz, H., Fourcade, C., Toko-Tchuindzie, L., Kaya, S., Engin, A., Yalci, A., Bernigaud, C., Vahaboglu, H., Curlier, E., Akduman, D., Barrelet, A., Oncu, S., Korten, V., Usluer, G., Turgut, H., Sener, A., Evirgen, O., Elaldi, N., and Gorenek, L.

Subjects
Acinetobacter baumannii, Male, Turkey, Cross-sectional study, syphilis, intensive care unit, quinolone derivative, law.invention, room ventilation, sepsis, Tertiary Care Centers, metronidazole, middle aged, colistin, Leptospira, soft tissue infection, adult, hand sanitizer, General Medicine, bacterial endocarditis, hospital bed capacity, clinical practice, antiinfective agent, aged, Aspergillus, cholangitis, priority journal, disease severity, tigecycline, gastroenteritis, hospitalization, Microbiology (medical), medicine.medical_specialty, infectious arthritis, Staphylococcus aureus, Plasmodium falciparum, abscess, Haemophilus, Legionella, surgical infection, Crimean Congo hemorrhagic fever, Corynebacterium, ward, Communicable Diseases, Human immunodeficiency virus infection, cross-sectional study, Humans, Creutzfeldt Jakob disease, human, procedures, Mycobacterium intracellulare avium, cephalosporin derivative, infection prevention, medicine.disease, Brucella, major clinical study, infection, Cross-Sectional Studies, upper respiratory tract infection, HOSPITALS, Measles virus, ampicillin, aminoglycoside, virus hepatitis, waste management, urinary tract infection, Enterovirus infection, Pediatrics, Turkish, colitis, hospital hygiene, Tigecycline, rifampicin, Aggregatibacter actinomycetemcomitans, antimicrobial therapy, Turkey (republic), Medical microbiology, law, central nervous system infection, Streptococcus infection, Epidemiology, Infection control, hospital laboratory, Candida, skin infection, antibiotic prophylaxis, article, Hepatitis B, carbapenem derivative, POINT PREVALENCE, Intensive care unit, INTENSIVE-CARE UNITS, infection control, Anti-Bacterial Agents, hospital patient, Infectious Diseases, female, tuberculosis, brucellosis, Pseudomonas aeruginosa, language, standards, protective equipment, tertiary care center, disease surveillance, France, Neisseria, diabetic foot, medicine.drug, infectious diseases ward, health care personnel, malaria, nurse, RNA virus infection, Bacillus cereus, ciprofloxacin, cholecystitis, medicine, bone infection, measles, pneumonia, cytomegalovirus infection, Treponema pallidum, Clostridium, doxycycline, business.industry, patient care, Streptococcus, Campylobacter, Mycobacterium tuberculosis, vaccination, language.human_language, cotrimoxazole, penicillin derivative, Cryptococcus, Family medicine, hospital bed utilization, septic shock, hepatitis B, hepatitis C, business, hospital waste, Enterococcus
Abstract

WOS: 000340538700017, PubMed ID: 24789652, The aim of this study was to assess the infectious diseases (ID) wards of tertiary hospitals in France and Turkey for technical capacity, infection control, characteristics of patients, infections, infecting organisms, and therapeutic approaches. This cross-sectional study was carried out on a single day on one of the weekdays of June 17-21, 2013. Overall, 36 ID departments from Turkey (n = 21) and France (n = 15) were involved. On the study day, 273 patients were hospitalized in Turkish and 324 patients were followed in French ID departments. The numbers of patients and beds in the hospitals, and presence of an intensive care unit (ICU) room in the ID ward was not different in both France and Turkey. Bed occupancy in the ID ward, single rooms, and negative pressure rooms were significantly higher in France. The presence of a laboratory inside the ID ward was more common in Turkish ID wards. The configuration of infection control committees, and their qualifications and surveillance types were quite similar in both countries. Although differences existed based on epidemiology, the distribution of infections were uniform on both sides. In Turkey, anti-Gram-positive agents, carbapenems, and tigecycline, and in France, cephalosporins, penicillins, aminoglycosides, and metronidazole were more frequently preferred. Enteric Gram-negatives and hepatitis B and C were more frequent in Turkey, while human immunodeficiency virus (HIV) and streptococci were more common in France (p < 0.05 for all significances). Various differences and similarities existed in France and Turkey in the ID wards. However, the current scene is that ID are managed with high standards in both countries.

Published
2014

22. Mortality indicators in community-acquired pneumonia requiring intensive care in Turkey

Author

Hayati Bilgiç, Ahmet Karakaş, Ozgur Senturk, Gokay Gungor, Zuhal Karakurt, Levent Gorenek, Hulya Turkan, Nalan Adiguzel, Yakup Tomak, Türker Türker, Anil Aktas Samur, Hakan Leblebicioglu, Guner Sonmez, Dilek Özcengiz, Umit Savasci, Hakan Erdem, Canturk Tasci, Erol Kılıç, Fatma Yilmaz-Karadag, Nefise Oztoprak, Sibel Temur, Özcan Erdemli, Aykut Cilli, Ugur Bilge, Asim Ulcay, Gülden Yilmaz, Aylin Ozgen-Alpaydın, Serhat Ünal, Oral Oncul, Hafize Oksuz, Burcu Karaboga, Ozlem Yazicioglu-Mocin, Murat Afyon, Husrev Diktas, Ünase Büyükkoçak, Nazif Elaldi, Aygul Dogan-Celik, Asuman Inan, Demet Tok, Çukurova Üniversitesi, Erdem, H., Turkan, H., Cilli, A., Karakas, A., Karakurt, Z., Bilge, U., Gorenek, L., Yeditepe Üniversitesi, Maltepe Üniversitesi, İç Hastalıkları, [Erdem, Hakan -- Oncul, Oral -- Ulcay, Asim -- Diktas, Husrev -- Gorenek, Levent] GATA Haydarpasa Training Hosp, Dept Infect Dis & Clin Microbiol, Istanbul, Turkey -- [Turkan, Hulya] Gulhane Mil Med Acad, Dept Anesthesiol & Reanimat, Ankara, Turkey -- [Cilli, Aykut -- Karaboga, Burcu] Akdeniz Univ, Sch Med, Dept Pulm Dis, TR-07058 Antalya, Turkey -- [Karakas, Ahmet] Gulhane Mil Med Acad, Dept Infect Dis & Clin Microbiol, Ankara, Turkey -- [Karakurt, Zuhal -- Yazicioglu-Mocin, Ozlem -- Adiguzel, Nalan -- Gungor, Gokay] Sureyyapasa Chest Dis & Thorac Surg Educ & Res Ho, Resp Intens Care Unit, Istanbul, Turkey -- [Bilge, Ugur -- Samur, Anil Aktas] Akdeniz Univ, Sch Med, Dept Biostat & Med Informat, TR-07058 Antalya, Turkey -- [Elaldi, Nazif] Cumhuriyet Univ, Sch Med, Dept Infect Dis & Clin Microbiol, Sivas, Turkey -- [Yilmaz, Gulden -- Bilgic, Hayati] Gulhane Mil Med Acad, Dept Pulm Dis, Ankara, Turkey -- [Yilmaz, Gulden] Ankara Numune Training & Res Hosp, Dept Infect Dis & Clin Microbiol, Ankara, Turkey -- [Dogan-Celik, Aygul] Trakya Univ, Sch Med, Dept Infect Dis & Clin Microbiol, Edirne, Turkey -- [Erdemli, Ozcan] Yuksek Ihtisas Training & Res Hosp, Dept Anesthesiol & Reanimat, Ankara, Turkey -- [Oztoprak, Nefise] Antalya Training & Res Hosp, Dept Infect Dis & Clin Microbiol, Antalya, Turkey -- [Tomak, Yakup] Sakarya Univ, Sch Med, Dept Anesthesiol & Reanimat, Adapazari, Turkey -- [Inan, Asuman] Haydarpasa Numune Training & Res Hosp, Dept Infect Dis & Clin Microbiol, Istanbul, Turkey -- [Tok, Demet] Celal Bayar Univ, Sch Med, Dept Anesthesiol & Reanimat, Manisa, Turkey -- [Temur, Sibel] Yeditepe Univ, Sch Med, Dept Anesthesiol & Reanimat, Istanbul, Turkey -- [Oksuz, Hafize] Sutcu Imam Univ, Sch Med, Dept Anesthesiol & Reanimat, Kahramanmaras, Turkey -- [Senturk, Ozgur] Maltepe Univ, Sch Med, Dept Anesthesiol & Reanimat, Istanbul, Turkey -- [Buyukkocak, Unase] Kirikkale Univ, Sch Med, Dept Anesthesiol & Reanimat, Kirikkale, Turkey -- [Yilmaz-Karadag, Fatma] Medeniyet Univ, Goztepe Training & Res Hosp, Dept Infect Dis & Clin Microbiol, Istanbul, Turkey -- [Ozcengiz, Dilek] Cukurova Univ, Sch Med, Dept Anesthesiol & Reanimat, Adana, Turkey -- [Turker, Turker] Gulhane Mil Med Acad, Dept Publ Hlth, Ankara, Turkey -- [Afyon, Murat] Kasimpasa Mil Hosp, Dept Infect Dis & Clin Microbiol, Istanbul, Turkey -- [Savasci, Umit] Sarikamis Mil Hosp, Dept Infect Dis & Clin Microbiol, Kars, Turkey -- [Ozgen-Alpaydin, Aylin] Dokuz Eylul Univ, Sch Med, Dept Pulmonol, Izmir, Turkey -- [Kilic, Erol] Kasimpasa Mil Hosp, Dept Pulmonol, Istanbul, Turkey -- [Leblebicioglu, Hakan] Ondokuz Mayis Univ, Sch Med, Dept Infect Dis & Clin Microbiol, Samsun, Turkey -- [Unal, Serhat] Hacettepe Univ, Sch Med, Infect Dis Unit, Ankara, Turkey -- [Sonmez, Guner] GATA Haydarpasa Training Hosp, Dept Radiol, Istanbul, Turkey, UNAL, SERHAT -- 0000-0003-1184-4711, Leblebicioglu, Hakan -- 0000-0002-6033-8543, Elaldi, Nazif -- 0000-0002-9515-770X, Gungor, Gokay -- 0000-0003-2294-489X, Karakas, Ahmet -- 0000-0002-0553-8454, OMÜ, Kırıkkale Üniversitesi, Erdem, H, Turkan, H, Cilli, A, Karakas, A, Karakurt, Z, Bilge, U, Yazicioglu-Mocin, O, Elaldi, N, Adiguzel, N, Gungor, G, Tasci, C, Yilmaz, G, Oncul, O, Dogan-Celik, A, Erdemli, O, Oztoprak, N, Tomak, Y, Inan, A, Karaboga, B, Tok, D, Temur, S, Oksuz, H, Senturk, O, Buyukkocak, U, Yilmaz-Karadag, F, Ozcengiz, D, Turker, T, Afyon, M, Samur, AA, Ulcay, A, Savasci, U, Diktas, H, Ozgen-Alpaydin, A, Kilic, E, Bilgic, H, Leblebicioglu, H, Unal, S, Sonmez, G, Gorenek, L, Sakarya Üniversitesi/Tıp Fakültesi/Cerrahi Tıp Bilimleri Bölümü, and Tomak, Yakup

Subjects
Microbiology (medical), Adult, Male, medicine.medical_specialty, Community-acquired pneumonia, Critical Care, Turkey, health care facilities, manpower, and services, Disease, law.invention, Young Adult, law, Internal medicine, Intensive care, Community-acquired, medicine, Odds Ratio, pneumonia, Humans, Intensive care unit, Hospital Mortality, Intensive care medicine, Outcome, Aged, Retrospective Studies, Aged, 80 and over, Cross Infection, medicine.diagnostic_test, business.industry, General Medicine, Odds ratio, Pneumonia, Middle Aged, medicine.disease, CAP, Confidence interval, Community-Acquired Infections, Patient Outcome Assessment, Intensive Care Units, Bronchoalveolar lavage, Infectious Diseases, Cross-Sectional Studies, ICU, Female, business
Abstract

WOS: 000324172200021, PubMed ID: 23664334, Background: Severe community-acquired pneumonia (SCAP) is a fatal disease. This study was conducted to describe an outcome analysis of the intensive care units (ICUs) of Turkey. Methods: This study evaluated SCAP cases hospitalized in the ICUs of 19 different hospitals between October 2008 and January 2011. The cases of 413 patients admitted to the ICUs were retrospectively analyzed. Results: Overall 413 patients were included in the study and 129 (31.2%) died. It was found that bilateral pulmonary involvement (odds ratio (OR) 2.5, 95% confidence interval (CI) 1.1-5.7) and CAP PIRO score (OR 2, 95% CI 1.3-2.9) were independent risk factors for a higher in-ICU mortality, while arterial hypertension (OR 0.3, 95% CI 0.1-0.9) and the application of non-invasive ventilation (OR 0.2, 95% CI 0.1-0.5) decreased mortality. No culture of any kind was obtained for 90 (22%) patients during the entire course of the hospitalization. Blood, bronchoalveolar lavage, and non-bronchoscopic lavage cultures yielded enteric Gram-negatives (n = 12), followed by Staphylococcus aureus (n = 10), pneumococci (n = 6), and Pseudomonas aeruginosa (n = 6). For 22% of the patients, none of the culture methods were applied. Conclusions: SCAP requiring ICU admission is associated with considerable mortality for ICU patients. Increased awareness appears essential for the microbiological diagnosis of this disease. (C) 2013 International Society for Infectious Diseases. Published by Elsevier Ltd. All rights reserved.

Published
2012

24. 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

25. 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

26. 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

27. 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

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

Author

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

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

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

Published
2012

29. Fever of unknown origin (FUO) on a land on cross-roads between Asia and Europa; a multicentre study from Turkey.

Author

Yenilmez E, Kakalicoglu D, Bozkurt F, Filiz M, Akkol Camurcu A, Damar Midik EO, Berk Cam H, Arkali E, Bilgic Atli S, Sahin A, Yorulmaz Goktas S, Erkan H, Ceylan MR, Kacar Eker M, Kaya H, Karacaer Z, Tural E, Dokmetas İ, Gorenek L, and Kose S

Subjects
Adult, Aged, Asia, Humans, Retrospective Studies, Turkey epidemiology, Fever of Unknown Origin epidemiology, Fever of Unknown Origin etiology, Still's Disease, Adult-Onset
Abstract

Aims: The differential diagnosis of Fever of Unknown Origin (FUO) is still a major clinical challenge despite the advances in diagnostic procedures. In this multicentre study, we aimed to reveal FUO aetiology and factors influencing the final diagnosis of FUO in Turkey., Methods: A total of 214 patients with FUO between the years 2015 and 2019 from 13 tertiary training and research hospitals were retrospectively evaluated., Results: The etiologic distribution of FUO was infections (44.9%), malignancies (15.42%), autoimmune/inflammatory (11.68%) diseases, miscellaneous diseases (8.41%) and undiagnosed cases (19.62%). Brucellosis (10.25%), extrapulmonary tuberculosis (6.54%) and infective endocarditis (6.54%) were the most frequent three infective causes. Solid malignancies (7.1%) and lymphoma (5.6%), adult-onset still's disease (6.07%) and thyroiditis (5.14%) were other frequent diseases. The aetiological spectrum did not differ in elderly people (P < .05). Infections were less frequent in Western (34.62%) compared with Eastern regions of Turkey (60.71%) (P < .001, OR: 0.31, 95% Cl: 0.19 to 0.60). The ratio of undiagnosed aetiology was significantly higher in elderly people (p: 0.046, OR: 2.34, 95% Cl: 1.00 to 5.48) and significantly lower in Western Turkey (P: .004, OR: 3.07, 95% Cl: 1.39 to 6.71)., Conclusions: Brucellosis, extrapulmonary tuberculosis and infective endocarditis remain to be the most frequent infective causes of FUO in Turkey. Solid tumours and lymphomas, AOSD and thyroiditis are the other common diseases. The aetiological spectrum did not differ in elderly people, on the other hand, infections were more common in Eastern Turkey. A considerable amount of aetiology remained undiagnosed despite the state-of-the-art technology in healthcare services., (© 2021 John Wiley & Sons Ltd.)

Published
2021
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30. A meta-analysis of antibiotic resistance rates in Pseudomonas aeruginosa isolated in blood cultures in Turkey between 2007 and 2017.

Author

Isik SA, Yenilmez E, Cetinkaya RA, Gorenek L, and Kose S

Abstract

Objective: The prevalence of Pseudomonas aeruginosa has remained stable in recent years, and resistant strains has increased dramatically. In this meta-analysis, we aimed to analyze the P. aeruginosa strains isolated from blood cultures in Turkey during the last 11 years and to reveal their antimicrobial susceptibility., Methods: Data collected between 2007 and 2017 were divided into two groups as Group-1; 2007-2011 and Group-2; 2012-2017. The differences in antibiotic resistance rates between Group-1 and Group-2 were analyzed. The study data were included according to PRISMA criteria, then meta-analysis was performed., Results: A total of 30 study data from 25 studies were included in the study. The prevalence rate of meropenem (MEM) resistance in P. aeruginosa in Turkey was 25.1% (95% Cl: 20.65-29.83) according to a meta-analysis of 637 isolates. MEM resistance rates in Group-1 and Group-2 were 23.4% (95% Cl: 18.34-28.99) and 29.3% (95% Cl: 21.23-38.23), respectively. The prevalence rate of imipenem (IMP) resistance in P. aeruginosa in Turkey was 26.8% (%95 Cl: 23.40-30.35) according to a meta-analysis of 1421 isolates. IMP resistance rates in Group-1 and Group-2 were 26.2% (95% Cl: 22.41-30.27) and 28.4% (95% Cl: 21.57-35.88), respectively. Ciprofloxacin (CIP) resistance rate was 27.04% (95% Cl: 21.88-32.52) in 1388 isolates. CIP resistance rates in Group-1 and Group-2 were 30.8% (95% Cl: 24.35-37.56) and 18.6% (95% Cl: 10.72-28.11), respectively. The prevalence rate of piperacillin-tazobactam (TZP) resistance in P. aeruginosa in Turkey was 29.2% (95% Cl: 21.058-38.088) according to a meta-analysis of 1030 isolates. TZP resistance rates in Group-1 and Group-2 were 26.1% (95% Cl: 17.76-35.31) and 38.2% (95% Cl: 18.48-60.27), respectively., Conclusion: There is a remarkable increase in resistance rates in P. aeruginosa to MEM and TZP in Turkey due to frequent use. Other antibiotics with antipseudomonal effect should be prioritized in the treatment of these infections., Competing Interests: Conflict of Interest: No conflict of interest was declared by the authors., (Copyright: © 2021 by Istanbul Northern Anatolian Association of Public Hospitals.)

Published
2021
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31. 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, Sunnetcioglu M, Haykir-Solay A, Denk A, Ayaz C, Kose S, and Gorenek L

Subjects
Adult, Brucellosis epidemiology, Diagnosis, Differential, Female, Humans, Male, Meningitis, Bacterial diagnosis, Meningitis, Bacterial epidemiology, Middle Aged, Retrospective Studies, Tuberculosis, Meningeal epidemiology, Turkey, Young Adult, Brucellosis diagnosis, Tuberculosis, Meningeal diagnosis
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., (Copyright © 2015 Elsevier Ltd. All rights reserved.)

Published
2015
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32. A surveillance of nosocomial candida infections: epidemiology and influences on mortalty in intensive care units.

Author

Karacaer Z, Oncul O, Turhan V, Gorenek L, and Ozyurt M

Subjects
Adolescent, Adult, Aged, Aged, 80 and over, Candidiasis mortality, Candidiasis therapy, Critical Illness therapy, Cross Infection mortality, Female, Humans, Length of Stay statistics & numerical data, Male, Middle Aged, Population Surveillance, Risk Factors, Turkey epidemiology, Young Adult, Candidiasis epidemiology, Critical Illness mortality, Cross Infection epidemiology, Hospital Mortality, Intensive Care Units statistics & numerical data
Abstract

Introduction: It was aimed to investigate the frequency of Candida infections (CI) in the intensive care units (ICU), to determine typing of candida to evaluate risk factors associated with CI and mortality, and to evaluate influence of CI on mortality., Methods: The prospective cohort study was carried out between Jan 1, 2009 and Dec 31, 2010 in ICUs, and the patients were observed with active surveillance. VITEK 2 Compact System (BioMerieux, France) kits were used for the identification of isolates from various clinical samples., Results: A total of 2362 patients had enrolled for 16135 patients-days into the study. During the study, 63 (27,5%) of patients developed 77 episodes of CI were observed. Of the patients; 54% were male, 46% were female. Duration of hospitalization (OR = 1,03, p = 0,007), hyperglycemia (OR = 17,93, p = 0,009), and co-infections (OR = 3,98, p = 0,001) were identified as independent risk factors for CI. The most common infections were bloodstream (53%). 77 of 135 candida strains was isolated as causative pathogens. C. albicans (63,6%) was the most frequent species. Overall mortality rate was 78%. The rates of mortality attributable to CI and candidemia were 27%, and 18,3% respectively. Species- specific mortality rates of C.albicans and C.tropicalis were determined as 12%. High APACHE II scores (OR = 1,37; p = 0,002), and the use of central venous catheter (OR = 9,01; p = 0,049) were assigned as independent risk factors for mortality., Conclusion: CI is an important problem in our hospital. CI and associated mortality can be prevented by controlling of risk factors. Updating of epidemiological data is required for successful antifungal treatment.

Published
2014
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33. Clinical usefulness of mean platelet volume and red blood cell distribution width to platelet ratio for predicting the severity of hepatic fibrosis in chronic hepatitis B virus patients.

Author

Karagoz E, Ulcay A, Tanoglu A, Kara M, Turhan V, Erdem H, Oncul O, and Gorenek L

Subjects
Adult, Aged, Alanine Transaminase blood, Area Under Curve, Aspartate Aminotransferases blood, Biomarkers blood, Biopsy, Clinical Enzyme Tests, Female, Hepatitis B e Antigens blood, Hepatitis B, Chronic blood, Hepatitis B, Chronic complications, Hepatitis B, Chronic pathology, Humans, Liver Cirrhosis blood, Liver Cirrhosis pathology, Liver Cirrhosis virology, Male, Middle Aged, Predictive Value of Tests, ROC Curve, Retrospective Studies, Severity of Illness Index, Young Adult, Erythrocyte Indices, Hepatitis B, Chronic diagnosis, Liver Cirrhosis diagnosis, Mean Platelet Volume
Abstract

Objective: Hepatitis B virus infection is still one of the leading causes of cirrhosis and hepatocellular carcinoma worldwide. Liver biopsy is the gold-standard method to assess the severity of liver fibrosis, but the invasive nature of this method limits its usage. Currently, noninvasive parameters are utilized to estimate liver histology. In the present study, we aimed to investigate the relationship between the severity of fibrosis and red blood cell distribution width (RDW), platelet distribution width (PDW), mean platelet volume (MPV), and MPV and red blood cell distribution width to platelet ratio (RPR) in patients with chronic hepatitis B (CHB)., Design: A total of 229 biopsy-proven naïve CHB cases were included in the study. The complete blood count variables including white blood cell, hemoglobin, hematocrit value, platelet count, RDW, MPV and PDW, as well as aspartate aminotransferase, alanine aminotransferase, total bilirubin, albumin, and other routine biochemical parameters were tested. Liver biopsy samples were examined using the Ishak scoring system. Data analyses were carried out using SPSS 15 software. Statistical significance was set at a P-value of less than 0.05., Results: Of the 229 cases, 210 (91.7%) were men and 19 (8.3%) were women. The mean age of the patients was 30.9 years, and 85 cases (37.1%) had HBeAg positivity. Fibrosis scores of 41 cases (17.9%) were greater than or equal to 3, whereas 188 cases (82.1%) had fibrosis scores less than 3. There was a significant difference between these two groups for MPV (group 1=7.98±1.20, group 2=8.77±1.44, P<0.05). There was also a significant difference between these two groups for RDW (P<0.05). The RDW value in group 1 patients was 11.83±0.89, whereas this value was 12.57±1.32 in group 2. Moreover, the RPR was significantly higher in group 2 than in group 1 (P<0.001). There was no significant difference between the groups for PDW. We have compared the receiver operating characteristic curves for the diagnostic performance of aspartate aminotransferase, alanine aminotransferase, platelet count, RDW, MPV, and RPR in identifying fibrosis in CHB and area under the curve values for these variables were 0.666, 0.463, 0.657, 0.672, 0.677, and 0.758, respectively., Conclusion: MPV and RDW values are significantly higher in hepatitis B virus-infected patients, associated with severity, and can be defined as independent predicting factors in hepatic fibrosis. Further studies are required to determine the associations between MPV and the severity of fibrosis in hepatitis B patients.

Published
2014
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34. The determination of carbapenem resistance in Escherichia coli and Pneumoniae isolates related to nosocomial infections and the evaluation of risk factors.

Author

Budak S, Oncul O, Aktas Z, Acar A, Ozyurt M, Turhan V, Erdem H, and Gorenek L

Subjects
Adult, Aged, Drug Resistance, Bacterial, Electrophoresis, Gel, Pulsed-Field, Escherichia coli drug effects, Escherichia coli enzymology, Escherichia coli isolation & purification, Female, Humans, Klebsiella pneumoniae drug effects, Klebsiella pneumoniae enzymology, Klebsiella pneumoniae isolation & purification, Male, Microbial Sensitivity Tests, Middle Aged, Polymerase Chain Reaction, Prospective Studies, Risk Factors, Anti-Bacterial Agents pharmacology, Carbapenems pharmacology, Cross Infection drug therapy, Cross Infection microbiology, Escherichia coli Infections drug therapy, Escherichia coli Infections microbiology, Klebsiella Infections drug therapy, Klebsiella Infections microbiology
Abstract

We aimed to investigate carbapenem resistance, resistance mechanisms, risk factors and epidemiological features of Escherichia coli and Klebsiella pneumoniae strains isolated from related infections in intensive care unit (ICU) patients. Carbapenemase activity was determined by MHT, MBL Etest and enzyme extraction methods. Presence of extended-spectrum beta-lactamase (ESBL) and carbapenemase-encoding genes were investigated by PCR and sequencing. Clonal relationship of the strains was investigated by pulse field gel-electrophoresis. Acquired AmpC and Qnr were investigated by PCR. Throughout this study, 1,657 patients, and 11,483 hospitalization days were followed by active surveillance in the ICU of our 1,000-bed training hospital. Out of 108 of 196 patients, 130 E. coli- and K. pneumoniae-related nosocomial infections were determined. Minimum inhibitory concentration (MIC) levels of ertapenem were > or = 1 mg/1 in 14 K. pneumoniae and 2 E. coli strains. The highest MIC level of carbapenem was found in K. pneumoniae and E. coli strains of > or = 128 mg/l and 8 mg/l, respectively. In the carbapenem resistant strains, KPC and MBL activity were not found. On the other hand, 14 strains of K. pneumoniae and one strain of E. coli exhibited OXA-48 beta-lactamase activity. Fifty-seven percent of K. pneumoniae isolates produced OXA-48 orginating from two clones and remaining isolates originated from different clones. Thus carbapenem resistance was determined as 22% and 3% in K. pneumoniae and E. coli strains, respectively. Invasive devices, duration of total parenteral nutrition, duration of hospitalization, presence of transfusions, ESBL and multiple drug resistance were found to be risk factors for carbapenem resistance.

Published
2014

35. Withdrawal of Staphylococcus aureus from intensive care units in Turkey.

Author

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, Kocak Tufan Z, Yenilmez E, 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, and Unal S

Subjects
Humans, Incidence, Intensive Care Units, Retrospective Studies, Tertiary Care Centers, Turkey epidemiology, Cross Infection epidemiology, Cross Infection microbiology, Staphylococcal Infections epidemiology, Staphylococcus aureus isolation & purification
Abstract

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 ≤.01 was considered significant., Results: Although overall rates of hospital-acquired infection (HAI) and device-associated infection densities were similar in P1 and P2, the densities of HAIs due to S aureus and methicillin-resistant S aureus (MRSA) were significantly lower in P2 (P < .0001). However, the proportion of HAIs due to Acinetobacter was significantly higher in P2 (P < .0001)., Conclusions: The incidence of S aureus infections is declining rapidly in Turkish ICUs, with potential impacts on empirical treatment strategies in these ICUs., (Copyright © 2013 Association for Professionals in Infection Control and Epidemiology, Inc. Published by Mosby, Inc. All rights reserved.)

Published
2013
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36. Mortality indicators in community-acquired pneumonia requiring intensive care in Turkey.

Author

Erdem H, Turkan H, Cilli A, Karakas A, Karakurt Z, Bilge U, Yazicioglu-Mocin O, Elaldi N, Adıguzel N, Gungor G, Taşcı C, Yilmaz G, Oncul O, Dogan-Celik A, Erdemli O, Oztoprak N, Tomak Y, Inan A, Karaboğa B, Tok D, Temur S, Oksuz H, Senturk O, Buyukkocak U, Yilmaz-Karadag F, Ozcengiz D, Turker T, Afyon M, Samur AA, Ulcay A, Savasci U, Diktas H, Ozgen-Alpaydın A, Kilic E, Bilgic H, Leblebicioglu H, Unal S, Sonmez G, and Gorenek L

Subjects
Adult, Aged, Aged, 80 and over, Community-Acquired Infections microbiology, Cross Infection microbiology, Cross Infection mortality, Cross-Sectional Studies, Female, Hospital Mortality, Humans, Intensive Care Units, Male, Middle Aged, Odds Ratio, Patient Outcome Assessment, Pneumonia microbiology, Retrospective Studies, Turkey, Young Adult, Community-Acquired Infections mortality, Critical Care, Pneumonia mortality
Abstract

Background: Severe community-acquired pneumonia (SCAP) is a fatal disease. This study was conducted to describe an outcome analysis of the intensive care units (ICUs) of Turkey., Methods: This study evaluated SCAP cases hospitalized in the ICUs of 19 different hospitals between October 2008 and January 2011. The cases of 413 patients admitted to the ICUs were retrospectively analyzed., Results: Overall 413 patients were included in the study and 129 (31.2%) died. It was found that bilateral pulmonary involvement (odds ratio (OR) 2.5, 95% confidence interval (CI) 1.1-5.7) and CAP PIRO score (OR 2, 95% CI 1.3-2.9) were independent risk factors for a higher in-ICU mortality, while arterial hypertension (OR 0.3, 95% CI 0.1-0.9) and the application of non-invasive ventilation (OR 0.2, 95% CI 0.1-0.5) decreased mortality. No culture of any kind was obtained for 90 (22%) patients during the entire course of the hospitalization. Blood, bronchoalveolar lavage, and non-bronchoscopic lavage cultures yielded enteric Gram-negatives (n=12), followed by Staphylococcus aureus (n=10), pneumococci (n=6), and Pseudomonas aeruginosa (n=6). For 22% of the patients, none of the culture methods were applied., Conclusions: SCAP requiring ICU admission is associated with considerable mortality for ICU patients. Increased awareness appears essential for the microbiological diagnosis of this disease., (Copyright © 2013 International Society for Infectious Diseases. Published by Elsevier Ltd. All rights reserved.)

Published
2013
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37. Orchiectomy performed in two patients with Brucella orchitis mimicking testicular tumour.

Author

Turhan V, Acar A, Ates F, Diktas H, Haholu A, Oncul O, and Gorenek L

Subjects
Brucellosis surgery, Diagnostic Errors, Humans, Male, Orchitis surgery, Young Adult, Brucellosis diagnosis, Orchiectomy, Orchitis diagnosis, Orchitis microbiology, Testicular Neoplasms diagnosis
Abstract

Brucellosis is a zoonosis caused by gram negative coccobacilli and it is an endemic infectious disease in Turkey. Infection is usually acquired as a result of direct contact with infected animals or by consuming milk or cheese freshly made from them. There exists a wide spectrum of clinical signs and symptoms in brucellosis. Many systems including musculoskeletal, gastrointestinal, cardiovascular and genitourinary may be involved in brucellosis. The genitourinary system is affected in 2% to 20% of the cases with brucellosis. The most common forms of brucellosis are epididymo-orchitis, testicular abscess and atrophy. The serum agglutination test to detect the presence of antibodies is a reliable test in patients with urogenital symptoms. Long-term and combined antibacterial therapy have been found to be effective in brucellosis. We present two cases undergoing orchiectomy because of testicular mass before the diagnosis of brucellosis was made.

Published
2013
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38. Intraabdominal abscess related fungaemia caused by Rhodotorula glutinis in a non-neutropenic cancer patient.

Author

Diktas H, Gulec B, Baylan O, Oncul O, Turhan V, Acar A, and Gorenek L

Subjects
Abdominal Abscess microbiology, Fungemia microbiology, Humans, Male, Middle Aged, Opportunistic Infections microbiology, Abdominal Abscess complications, Adenocarcinoma complications, Fungemia complications, Opportunistic Infections complications, Rhodotorula isolation & purification, Stomach Neoplasms complications
Abstract

Rhodotorula glutinis is a rare fungal infection that is especially observed in immune-compromised patients. It is common in the skin, faeces, nails, sputum, gastrointestinal system and adenoid tissue. However, the incidence of Rhodotorula glutinis is increased in both local and systemic infections in recent years. Presented here is a case of Rhodotorula glutinis fungaemia that isolated from subhepatic abscess formation and blood in a patient who was operated with Roux-en-Y technique due to gastric adenocarcinoma. Fungal sepsis is an important cause of fever resistant to antibiotic therapy that is often taken into marginal account. It should instead be particularly considered in patients with a history of intraabdominal surgery and non-neutropenic cancer patients. The case described illustrates an episode of systemic infection by Rhodotorula glutinis, correlated with the presence of intraabdominal abscess and without central venous catheters. This is the first case of fungaemia by Rhodotorula glutinis with an intraabdominal abscess source reported from Turkey.

Published
2013
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39. Efficacy and tolerability of antibiotic combinations in neurobrucellosis: results of the Istanbul study.

Author

Erdem H, Ulu-Kilic A, Kilic S, Karahocagil M, Shehata G, Eren-Tulek N, Yetkin F, Celen MK, Ceran N, Gul HC, Mert G, Tekin-Koruk S, Dizbay M, Inal AS, Nayman-Alpat S, Bosilkovski M, Inan D, Saltoglu N, Abdel-Baky L, Adeva-Bartolome MT, Ceylan B, Sacar S, Turhan V, Yilmaz E, Elaldi N, Kocak-Tufan Z, Ugurlu K, Dokuzoguz B, Yilmaz H, Gundes S, Guner R, Ozgunes N, Ulcay A, Unal S, Dayan S, Gorenek L, Karakas A, Tasova Y, Usluer G, Bayindir Y, Kurtaran B, Sipahi OR, and Leblebicioglu H

Subjects
Administration, Oral, Adolescent, Adult, Aged, Anti-Bacterial Agents therapeutic use, Brucella growth & development, Brucellosis microbiology, Ceftriaxone administration & dosage, Ceftriaxone therapeutic use, Doxycycline administration & dosage, Doxycycline therapeutic use, Drug Therapy, Combination, Female, Humans, Injections, Intravenous, Male, Meningitis microbiology, Meningoencephalitis drug therapy, Meningoencephalitis microbiology, Middle Aged, Recurrence, Retrospective Studies, Rifampin administration & dosage, Rifampin therapeutic use, Treatment Failure, Trimethoprim, Sulfamethoxazole Drug Combination administration & dosage, Trimethoprim, Sulfamethoxazole Drug Combination therapeutic use, Turkey, Anti-Bacterial Agents administration & dosage, Brucella drug effects, Brucellosis drug therapy, Meningitis drug therapy
Abstract

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

Published
2012
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40. Hantavirus infection in Istanbul, Turkey.

Author

Oncul O, Atalay Y, Onem Y, Turhan V, Acar A, Uyar Y, Caglayik DY, Ozkan S, and Gorenek L

Subjects
Adult, Antibodies, Viral blood, Fatal Outcome, Orthohantavirus classification, Orthohantavirus immunology, Humans, Immunoglobulin M blood, Intensive Care Units, Male, RNA, Viral blood, Turkey, Urine virology, Young Adult, Orthohantavirus genetics, Orthohantavirus isolation & purification, Hantavirus Infections diagnosis, Hantavirus Infections virology
Published
2011
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41. The significance of repeat testing in Turkish blood donors screened with HBV, HCV and HIV immunoassays and the importance of S/CO ratios in the interpretation of HCV/HIV screening test results and as a determinant for further confirmatory testing.

Author

Acar A, Kemahli S, Altunay H, Kosan E, Oncul O, Gorenek L, and Cavuslu S

Subjects
Cost-Benefit Analysis, False Negative Reactions, False Positive Reactions, Female, HIV Antibodies blood, HIV Infections blood, HIV Infections epidemiology, HIV Infections prevention & control, HIV-1 immunology, HIV-2 immunology, Hepatitis B blood, Hepatitis B epidemiology, Hepatitis B prevention & control, Hepatitis B Surface Antigens blood, Hepatitis C blood, Hepatitis C epidemiology, Hepatitis C prevention & control, Hepatitis C Antibodies blood, Humans, Male, Predictive Value of Tests, Reproducibility of Results, Sensitivity and Specificity, Turkey, Algorithms, Blood Donors psychology, Blood Donors statistics & numerical data, HIV Infections diagnosis, Hepatitis B diagnosis, Hepatitis C diagnosis, Immunoenzyme Techniques economics, Mass Screening economics, Mass Screening methods
Abstract

The purpose of this study was to investigate the intra-assay correlations amongst initial reactive and repeat screening results used in enzyme immunoassays (EIAs) for hepatitis B virus (HBV), hepatitis C virus (HCV) and HIV in blood donors. This study evaluated the value of using the power of the signal to cut-off (S/CO) ratio index for confirming anti-HCV/HIV reactive screening results, thereby touching upon the utility of S/CO indices in determining whether further confirmatory testing was necessary. Screening test results of the 72,695 blood donors were evaluated over a 1-year period. Correlation analysis among each initial test and retests was done by Pearson r test. Appropriate S/CO values to determine the need of the confirmation testing was investigated by ROC analyses. EIA intra-assay correlations were of statistical significance and were determined as follows: 0.948 for anti-HCV, 0.827 for anti-HIV and 0.948 for HBsAg. The threshold S/CO ratio values which predicted more than 95% of the confirmation test result were 3.8 for HCV and 5.6 for HIV. We were able to demonstrate a strong level of intra-assay correlation amongst EIAs, thereby eliminating the need for repetition of the screening test. Hence, we suggest that repeat screening should only be limited to HBV and HIV tests with low EIA S/CO ratios. Thus, using the power of the S/CO ratio in determining the need for HCV confirmation testing can be a cost-effective measure, especially if the S/CO value is >or=3.8.

Published
2010
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42. HBV, HCV and HIV seroprevalence among blood donors in Istanbul, Turkey: how effective are the changes in the national blood transfusion policies?

Author

Acar A, Kemahli S, Altunay H, Kosan E, Oncul O, Gorenek L, and Cavuslu S

Subjects
Blood Donors statistics & numerical data, HIV Antibodies blood, HIV Infections diagnosis, HIV Seroprevalence, Hepatitis B diagnosis, Hepatitis B Core Antigens blood, Hepatitis C diagnosis, Hepatitis C Antibodies blood, Humans, Immunoassay methods, Retrospective Studies, Seroepidemiologic Studies, Turkey epidemiology, Blood Donors legislation & jurisprudence, HIV Infections epidemiology, Health Policy, Hepatitis B epidemiology, Hepatitis C epidemiology
Abstract

The national blood transfusion policies have been changed significantly in recent years in Turkey. The purpose of this study was to determine the prevalence of HBV, HCV, and HIV in blood donors at the Red Crescent Center in Istanbul and to evaluate the effect of changes in the national blood transfusion policies on the prevalence of these infections. The screening results of 72695 blood donations at the Red Crescent Center in Istanbul between January and December 2007 were evaluated retrospectively. HBsAg, anti-HCV, and anti-HIV-1/2 were screened by microparticle enzyme immunoassay (MEIA) method. Samples found to be positive for anti-HIV 1/2 and anti-HCV were confirmed by Inno-Lia HCV Ab III and Inno-Lia HIV I/II Score, respectively. The seropositivity rates for HBsAg, anti-HCV, and anti-HIV-1/2 were determined as 1.76%, 0.07%, and 0.008%, respectively. Compared to the previously published data from Red Crescent Centers in Turkey, it was found that HBV and HCV seroprevalances decreased and HIV seroprevalance increased in recent years. In conclusion, we believe that the drop in HBV and HCV prevalence rates are likely multifactorial and may have resulted from more diligent donor questioning upon screening, a higher level of public awareness on viral hepatitis as well as the expansion of HBV vaccination coverage in Turkey. Another factor to contribute to the decreased prevalence of HCV stems from the use of more sensitive confirmation testing on all reactive results, thereby eliminating a fair amount of false positive cases. Despite similar transmission routes, the increase in HIV prevalence in contrast to HBV and HCV may be linked to the increase in AIDS cases in Turkey in recent years.

Published
2010
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43. Analysis of an outbreak of Salmonella enteritidis by repetitive-sequence-based PCR and pulsed-field gel electrophoresis.

Author

Kilic A, Bedir O, Kocak N, Levent B, Eyigun CP, Tekbas OF, Gorenek L, Baylan O, and Basustaoglu AC

Subjects
Adult, Eggs microbiology, Electrophoresis, Gel, Pulsed-Field, Genotype, Humans, Male, Polymerase Chain Reaction, Salmonella Food Poisoning diagnosis, Young Adult, Disease Outbreaks, Military Personnel, Salmonella Food Poisoning epidemiology, Salmonella enteritidis genetics, Salmonella enteritidis isolation & purification
Abstract

Objective: The aim of this study was to investigate a large food-borne outbreak associated with eggs contaminated by Salmonella Enteritidis in a military unit using pulse field gel electrophoresis (PFGE) and the Repetitive-sequence-based PCR (rep-PCR) employing the DiversiLab system., Materials and Methods: In mid-January 2008, a food-borne outbreak associated with S. Enteritidis occurred in a military unit located in the city centre of Isparta. A total of 2,469 patients were registered to six hospitals with gastrointestinal disease symptoms such as diarrhea and abdominal pain. Of those registered, 445 were hospitalized. S. Enteritidis was isolated from 276 stool samples and a blood sample of the hospitalized patients and from a food item. The PFGE patterns after XbaI digestion and rep-PCR profiles produced by the DiversiLab system were determined for eight randomly selected stool isolates, one blood isolate and one food isolate., Results: The PFGE patterns of all isolates were identical. The Rep-PCR profiles produced by using the DiversiLab system showed that all isolates were indistinguishable. The PFGE and rep-PCR interpretations were concordant for the S. Enteritidis isolates. All stool isolates, one blood isolate and one food isolate were susceptible to all antibiotics tested., Conclusion: This data suggest that the DiversiLab system may be a reasonable alternative to PFGE for investigation and control of S. Enteritidis outbreaks, since it is easy to use, rapid and does not require highly skilled operators.

Published
2010
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44. Invasive pulmonary aspergillosis after liver transplantation: rapid and complete response to combined and sequential antifungal therapy.

Author

Can MF, Yagci G, Gorenek L, Tozkoparan E, Ozerhan I, and Cetiner S

Subjects
Caspofungin, Drug Therapy, Combination, Echinocandins therapeutic use, Humans, Immunosuppression Therapy, Lipopeptides, Liver Transplantation, Male, Middle Aged, Pyrimidines therapeutic use, Radiography, Thoracic, Tomography, Emission-Computed, Triazoles therapeutic use, Voriconazole, Antifungal Agents therapeutic use, Aspergillosis drug therapy, Lung Diseases, Fungal drug therapy, Lung Diseases, Fungal microbiology
Abstract

Background: Invasive pulmonary aspergillosis is a rare, but severe and potentially fatal, complication after liver transplantation. There is no therapeutic regimen accepted worldwide for both initial and continuation therapy; nevertheless, several options have been proposed., Methods: Case report and review of the pertinent English-language literature., Results: In a patient with pulmonary aspergillosis after a liver transplant, combined and sequential therapy with caspofungin and voriconazole with termination of the immunosuppressive regimen and careful management were helpful to control the infection rapidly, possibly because of a positive drug interaction., Conclusion: In cases of invasive aspergillosis that are refractory to monotherapy, this regimen may be used in an attempt to overcome the infection.

Published
2008
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45. Management of neurobrucellosis: an assessment of 11 cases.

Author

Gul HC, Erdem H, Gorenek L, Ozdag MF, Kalpakci Y, Avci IY, Besirbellioglu BA, and Eyigun CP

Subjects
Adult, Anti-Bacterial Agents administration & dosage, Brucellosis cerebrospinal fluid, Brucellosis diagnosis, Ceftriaxone administration & dosage, Central Nervous System Bacterial Infections cerebrospinal fluid, Central Nervous System Bacterial Infections diagnosis, Doxycycline administration & dosage, Female, Humans, Male, Middle Aged, Rifampin administration & dosage, Trimethoprim, Sulfamethoxazole Drug Combination administration & dosage, Turkey, Brucellosis drug therapy, Central Nervous System Bacterial Infections drug therapy
Abstract

Objective: The central nervous system involvement of Brucellosis causes a hard to treat infection with multiple sequelae. The aim of this paper is to discuss the course of neurobrucellosis in response to therapy., Patients and Methods: Patients with neurobrucellosis were evaluated. The diagnosis was established by the isolation of bacteria, abnormal CSF findings and positive serology. Ceftriaxone, rifampicin, doxycycline and trimethoprim sulfamethoxazole were the antibiotic choices for these cases., Results: We present 11 cases with neurobrucellosis. None of our patients died, albeit one case has a critical situation due to subarachnoid hemorrhage and its' concordant sequelae. Only one of four patients with walking difficulty and two with hearing loss were normalized with therapy. Imaging techniques did not provide any specific contribution regarding the Brucella infection., Conclusions: Parenteral ceftriaxone should be used as an initial alternative in the management of neurobrucellosis. Although the therapy should be individualized, the duration of therapy should be a minimum of six months with suitable antibiotics.

Published
2008
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46. Paraplegia associated with brucellosis involving the anterior lumbrosacral nerve roots.

Author

Ulas UH, Hamamcioglu K, Eroglu E, Odabasi Z, Alanoglu E, Demirkaya S, Gorenek L, and Vural O

Subjects
Adult, Humans, Lumbosacral Region microbiology, Lumbosacral Region pathology, Magnetic Resonance Imaging methods, Male, Paraplegia physiopathology, Spinal Nerve Roots microbiology, Spinal Nerve Roots pathology, Brucellosis blood, Brucellosis cerebrospinal fluid, Lumbosacral Region physiopathology, Paraplegia diagnosis, Paraplegia microbiology, Spinal Nerve Roots physiopathology
Abstract

We report the case of a 21-year-old man with paraplegia due to brucellosis involvement of lumbosacral anterior roots. Lumbosacral magnetic resonance imaging showed contrast enhancement of anterior roots and the anterior part of duramater. Conduction block was found at the level of the lumbosacral anterior roots by electrophysiological studies, including magnetic stimulation study. Wright agglutination, Rose Bengal tests and bacterial culture obtained from cerebrospinal fluid confirmed the diagnosis of neurobrucellosis. Oral administration of ceftriaxon with additional rifampin was effective, and after 3 months of treatment, laboratory data resolved and clinical signs partially improved.

Published
2003
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47. Interferon therapy of Turkish patients with chronic hepatitis B virus infection.

Author

Besirbellioglu B, Gul C, Gorenek L, Eyigun CP, Hacibektasoglu A, and Van Thiel DH

Subjects
Adult, Alanine Transaminase blood, Female, Hepatitis B Surface Antigens analysis, Hepatitis B, Chronic blood, Humans, Male, Middle Aged, Treatment Outcome, Turkey, Antiviral Agents therapeutic use, Hepatitis B, Chronic therapy, Interferon-alpha therapeutic use
Abstract

Background/aims: The efficacy of alpha interferon therapy in Turkish individuals with chronic hepatitis B virus infection was examined., Methodology: Sixty-one patients (54 males and 7 females) were studied between 1992 and 1996. Their mean age was 33.4 years (range: 20-57). Each was treated with 4.5 million international units interferon alpha 3 times a week for 24 weeks. Serum alanine aminotransferase (ALT) levels and hepatitis B virus markers (HBsAg, HBeAg, anti-HBe, and HBV DNA) were monitored. A liver biopsy was obtained before and 6 months after the termination of interferon therapy., Results: Before treatment, the serum ALT level was elevated in all 61 subjects. Six months after the termination of therapy, 23 (38%) had a normal serum ALT level. In all patients, before the start of therapy and 6 months after the termination of therapy, HBsAg was detectable. In 36 (59%), HBeAg was present and anti-HBe was not detectable in serum before the initiation of therapy. In 12 (33%), the serum was negative for HBeAg and positive for anti-HBe 6 months after the termination of therapy. HBV DNA was detectable in all serum samples before the onset of therapy and disappeared in 14 (23%) patients, and continued to be undetectable 6 months after the termination of interferon therapy. Histological improvement defined by an improvement in the Knodell score of 2 points or more was observed in 38 (62%)., Conclusions: Interferon therapy eliminates serum markers of active hepatitis B virus infection (eAg and HBV DNA) and is associated with histological improvement in 30-60% of Turkish patients with chronic HBV infection. Interferon therapy did not eliminate sAg from the serum and the histologic improvement achieved was often incomplete.

Published
1999

48. The diagnosis and treatment of Clostridium difficile in antibiotic-associated diarrhea.

Author

Gorenek L, Dizer U, Besirbellioglu B, Eyigun CP, Hacibektasoglu A, and Van Thiel DH

Subjects
Adolescent, Adult, Aged, Azithromycin adverse effects, Diarrhea microbiology, Drug Therapy, Combination, Female, Humans, Lincomycin adverse effects, Male, Middle Aged, Penicillins adverse effects, Anti-Bacterial Agents adverse effects, Anti-Bacterial Agents therapeutic use, Antitrichomonal Agents therapeutic use, Diarrhea chemically induced, Diarrhea drug therapy, Enterocolitis, Pseudomembranous diagnosis, Enterocolitis, Pseudomembranous drug therapy, Ornidazole therapeutic use, Vancomycin therapeutic use
Abstract

Background/aims: This study was initiated to evaluate the role of C. difficile in diarrhea associated with the use of antibiotics, to determine which antibiotics are most often responsible, to characterize the response to several different treatment regimens, and to define the relapse rate as seen in a large teaching hospital in Turkey., Methodology: Three different patient groups were studied. The first group consisted of 154 individuals with antibiotic-associated diarrhea. The stools of all 154 cases were cultured on cycloserine-cefoxitin-fructose agar (CCFA). If any bacteria grew out, they were identified specifically as C. difficile using a commercially available latex agglutination kit specific for bacterial antigens of C. difficile (MicroScreen C. difficile Latex Slide Test; Merica Diagnostic Limited, Guilford, England). The presence of toxin-A (CDTA) was determined using a MicroScreen CDTA Enzyme Immunoassay kit., Results: The stools of 31 of these patients grew out enteric pathogens. Twenty-eight of these 31 were CCFA positive. Three different drug regimens (Ornidazole, Ornidazole + Cholestyramine, and Vancomycin) were used to treat these 28 C. difficile positive cases. The second group consisted of 37 hospitalized patients who had been in hospital for more than 30 days without any gastrointestinal symptoms. This group was used to identify the in-hospital carrier rate for C. difficile. Stools from these 37 cases were cultured on CCFA and were analyzed for the presence of CDTA by EIA. Colonization with C. difficile was detected in 4 cases. The third group consisted of 40 healthy subjects who served as a population-based control group. The stools obtained from these 40 cases were cultured on CCFA and analyzed for CDTA as were the stools for the other 2 groups. None were CDTA positive. One case was positive for the presence of non-toxigenic C. difficile., Conclusions: It can be concluded from these data that, in Turkey, C. difficile is responsible for 20% of antibiotic-associated diarrheas. Lincomycin, Azithromycin and Ampicillin were most often associated with the development of antibiotic-associated diarrhea. Ornidazole and Vancomycin were effective agents for C. difficile-associated diarrhea with the latter agent being associated with no relapses.

Published
1999

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