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

Author

Nese Saltoglu, Onder Ergonul, Necla Tulek, Mucahit Yemisen, Ayten Kadanali, Gul Karagoz, Ayse Batirel, Oznur Ak, Cagla Sonmezer, Haluk Eraksoy, Atahan Cagatay, Serkan Surme, Salih A. Nemli, Tuna Demirdal, Omer Coskun, Derya Ozturk, Nurgul Ceran, Filiz Pehlivanoglu, Gonul Sengoz, Turan Aslan, Yasemin Akkoyunlu, Oral Oncul, Hakan Ay, Lutfiye Mulazımoglu, Buket Erturk, Fatma Yilmaz, Gulsen Yoruk, Nuray Uzun, Funda Simsek, Taner Yildirmak, Kadriye Kart Yaşar, Meral Sonmezoglu, Yasar Küçükardali, Nazan Tuna, Oguz Karabay, Nail Ozgunes, and Fatma Sargın

Subjects
Infectious and parasitic diseases, RC109-216
Abstract

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

Published
2018
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2. Influence of multidrug resistant organisms on the outcome of diabetic foot infection

Author

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

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

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

Published
2017

3. First-line monotherapies of tenofovir and entecavir have comparable efficacies in hepatitis B treatment

Author

Nail Ozgunes, Levent Erdem, Bilgul Mete, Atahan Cagatay, Reşat Özaras, Kadir Gokturk, Bahadir Ceylan, Funda Kocak, Ebubekir Senates, Hayat Kumbasar Karaosmanoglu, Alper Gunduz, and Fehmi Tabak

Subjects
Adult, Male, Hepatitis B virus, Guanine, Adolescent, Tenofovir, First line, Organophosphonates, Pharmacology, Antiviral Agents, Virus, Cohort Studies, Young Adult, Hepatitis B, Chronic, Ozaras R., Mete B., Ceylan B., Ozgunes N., Gunduz A., Karaosmanoglu H., Cagatay A., Gokturk K., Erdem L., Kocak F., et al., -First-line monotherapies of tenofovir and entecavir have comparable efficacies in hepatitis B treatment-, EUROPEAN JOURNAL OF GASTROENTEROLOGY & HEPATOLOGY, cilt.26, ss.774-780, 2014, Drug Resistance, Viral, medicine, Humans, Hepatology, business.industry, Adenine, Gastroenterology, virus diseases, Treatment options, Entecavir, Middle Aged, Hepatitis B, medicine.disease, Virology, Treatment Outcome, Tolerability, Reverse Transcriptase Inhibitors, Female, business, Nucleoside, Follow-Up Studies, medicine.drug
Abstract

Hepatitis B virus (HBV) infection is a health problem worldwide. Current treatment options for chronic hepatitis B (CHB) are nucleoside or nucleotide analogues and pegylated interferons. Tenofovir and entecavir are much more commonly used as they have better efficacy, tolerability, and high genetic barriers to resistance.The aim of this study was to assess the efficacies of tenofovir and entecavir in previously untreated CHB patients in a treatment cohort.We included CHB patients in a cohort including previously untreated HBeAg-positive and HBeAg-negative patients from 10 centers in Istanbul, Turkey. The patients were compared in terms of baseline characteristics, decrease in alanine transaminase (ALT), decrease in HBV-DNA to undetectable levels, HBeAg loss and anti-HBe development (among baseline HBeAg-positive patients), interventions to therapy because of lack of efficacy, side effects, severe side effects, and side effects that required change in treatment.The study included 121 patients who were administered tenofovir and 130 patients who were administered entecavir. The majority of patients were men, with mild to moderate histology in both treatment groups. The mean duration of follow-up was 18 and 20 months for tenofovir and entecavir, respectively. Patients receiving both drugs showed comparable rates of HBeAg loss, rates of undetectable HBV-DNA levels, rates of ALT normalization, ALT decrease, and decrease in HBV-DNA. Both drugs were well tolerated.This study shows that although the baseline characteristics did not match, tenofovir and entecavir sustained comparable virological efficacies. More patients discontinued entecavir during follow-up. Both drugs provided effective viral control, with few side effects.

Published
2014

4. HIV-related Eye Disease in Patients Presenting to a Tertiary Care Government Hospital in Turkey

Author

Aylin Ardagil Akçakaya, Fariz Sadigov, Güzide Akçay, Fatma Sargin, Hasan Hasbi Erbil, Sevil Ari Yaylali, Asiye Aybar, and Nail Ozgunes

Subjects
Adult, Male, medicine.medical_specialty, Pediatrics, Turkey, genetic structures, Eye disease, Ocular Pathology, Population, Human immunodeficiency virus (HIV), Congenital cytomegalovirus infection, Eye Infections, Viral, Retinitis, HIV Infections, medicine.disease_cause, Prevalence, Humans, Immunology and Allergy, Medicine, education, education.field_of_study, AIDS-Related Opportunistic Infections, business.industry, virus diseases, Middle Aged, medicine.disease, eye diseases, CD4 Lymphocyte Count, HIV retinopathy, Surgery, Ophthalmology, Cross-Sectional Studies, Cytomegalovirus Retinitis, Female, business, Developed country
Abstract

Aim: To document the ocular involvement in HIV-infected individuals in Turkey and to compare the findings with those from other centers throughout the world.Methods: In this cross-sectional study, patients with HIV infection being monitored in a tertiary hospital in Istanbul were enrolled. Ocular examination was performed, and the prevalence of ocular manifestations determined.Results: In total, 93 patients were enrolled, of whom 37.6% had ocular pathology. HIV retinopathy was the most frequent retinal finding, affecting 8.6% of the enrolled patients, but none of the affected individuals had any ophthalmic complaints. There were no ocular lesions suggestive of cytomegalovirus (CMV) retinitis.Discussion: In contrast to the case in the developed world, sight-threatening infections are uncommon in Turkish HIV+ patients. The reasons for this are not clear, but it is possible that there are some genetic or environmental protective factors against CMV retinitis in the population studied.

Published
2012

5. Predictors for limb loss among patient with diabetic foot infections: an observational retrospective multicentric study in Turkey

Author

Gonul Sengoz, Nazan Tuna, U. Tozalgan, Funda Şimşek, Oguz Karabay, Kadriye Kart Yaşar, Meral Sonmezoglu, Asli Vatan, Fahri Yilmaz, B. Erturk, M. Ozyazar, Onder Ergonul, Fatma Sargin, Serdar Özer, Yasar Kucukardali, Atahan Cagatay, Nurgul Ceran, Hakan Ay, Ayse Batirel, Yasemin Akkoyunlu, Mucahit Yemisen, Filiz Pehlivanoglu, Derya Ozturk Engin, Ayten Kadanali, Lutfiye Mulazimoglu, Haluk Eraksoy, Oral Oncul, Taner Yildirmak, Nuray Uzun, Nail Ozgunes, Oznur Ak, Gül Karagöz, Nese Saltoglu, Turan Aslan, AKKOYUNLU, YASEMİN, Saltoglu, N., Yemisen, M., Ergonul, O., Kadanali, A., Karagoz, G., Batirel, A., Ak, O., Eraksoy, H., Cagatay, A., Vatan, A., Sengoz, G., Pehlivanoglu, F., Aslan, T., Akkoyunlu, Y., Engin, D., Ceran, N., Erturk, B., Mulazimoglu, L., Oncul, O., Ay, H., Sargin, F., Ozgunes, N., Simsek, F., Yildirmak, T., Tuna, N., Karabay, O., Yasar, K., Uzun, N., Kucukardali, Y., Sonmezoglu, M., Yilmaz, F., Tozalgan, U., Ozer, S., and Ozyazar, M.

Subjects
Male, Microbiology (medical), medicine.medical_specialty, Turkey, medicine.medical_treatment, Antimicrobial resistance, Amputation, Surgical, Risk Factors, Diabetes mellitus, Internal medicine, OSTEOMYELITIS, MANAGEMENT, medicine, Humans, EPIDEMIOLOGY, infections, LOWER-EXTREMITY AMPUTATION, Aged, Retrospective Studies, an observational retrospective multicentric study in Turkey-, CLINICAL MICROBIOLOGY AND INFECTION, cilt.21, ss.659-664, 2015 [Saltoglu N., Yemisen M., Ergonul O., KADANALI A., KARAGOZ G., BATIREL A., AK O., Eraksoy H., Cagatay A., Vatan A., et al., -Predictors for limb loss among patient with diabetic foot infections], medicine.diagnostic_test, Vascular disease, business.industry, General Medicine, Middle Aged, medicine.disease, limb loss, Diabetic foot, Gram-negative, Surgery, Infectious Diseases, Amputation, Erythrocyte sedimentation rate, Cellulitis, Etiology, Female, business, diabetic foot, Retinopathy
Abstract

We aimed to investigate the predictors for limb loss among patients with diabetes who have complicated skin/soft-tissue infections. In this observational study, consecutive patients with diabetic foot infection (DFI) from 17 centres in Turkey, between May 2011 and May 2013 were included. The Turkish DFI Working Group performed the study. Predictors of limb loss were investigated by multivariate analysis. In total, 455 patients with DFI were included. Median age was 61 years, 68% were male, 65% of the patients were hospitalized, 52% of the patients had used antibiotics within the last month, and 121(27%) had osteomyelitis. Of the 208 microorganisms isolated, 92 (44.2%) were Gram-positive cocci and 114 (54.8%) were Gram-negative rods (GNR). The most common GNR was Pseudomonas; the second was Escherichia coli, with extended spectrum beta-lactamase positivity of 33%. Methicillin-resistant Staphylococcus species were found in 14% (29/208). Amputations were performed in 126/455 (28%) patients, 44/126 (34%) of these were major amputations. In multivariate analysis, significant predictors for limb loss were, male gender (OR 1.75, 95% Cl 1.04-2.96, p 0.034), duration of diabetes >20 years (OR 1.9, 95% Cl 1.18-3.11, p 0.008), infected ulcer versus cellulitis (OR 1.9, 95% Cl 1.11-3.18, p 0.019), history of peripheral vascular disease (OR 2, 95% Cl 1.26-3.27, p 0.004), retinopathy (OR 2.25, 95% Cl 1.19-4.25, p 0.012), erythrocyte sedimentation rate >70 mm/hr (OR 1.6, 95% Cl 1.01-2.68, p 0.05), and infection with GNR (OR 1.8, 95% Cl 1.08-3.02, p 0.02). Multivariate analysis revealed that, besides the known risk factors such as male gender, duration of diabetes >20 years, infected ulcers, history of peripheral vascular disease and retinopathy, detection of GNR was a significant predictor of limb loss. Clinical Microbiology and Infection (C) 2015 European Society of Clinical Microbiology and Infectious Diseases. Published by Elsevier Ltd. All rights reserved.

Published
2015

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

Author

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

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

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

Published
2014

7. Epidemiological Profile of Naive HIV-1/AIDS Patients in Istanbul: The Largest Case Series from Turkey

Author

Bahadir Ceylan, Mucahit Yemisen, Nail Ozgunes, Fatma Sargin, Hayat Kumbasar Karaosmanoglu, Özlem Aydin, Alper Gunduz, Fehmi Tabak, Bilgul Mete, Resat Ozaras, and Dilek Yildiz

Subjects
Adult, Male, Pediatrics, medicine.medical_specialty, Adolescent, Turkey, HIV Infections, Disease, Hiv 1 aids, Young Adult, Age Distribution, Acquired immunodeficiency syndrome (AIDS), Risk Factors, Virology, Epidemiology, Prevalence, Humans, Mass Screening, Medicine, Sex Distribution, Aged, business.industry, Transmission (medicine), Middle Aged, Viral Load, University hospital, medicine.disease, CD4 Lymphocyte Count, Infectious Diseases, Male patient, HIV-1, Female, business, Viral load
Abstract

The aim of the study was to report the epidemiological profile of HIV-1 positive patients from, Istanbul, Turkey, which has one of the lowest HIV-1/AIDS prevalences in Europe. The patients were followed by ACTHIV-IST group which was established by the Infectious Diseases Departments of five teaching hospitals (three university hospitals and two public hospitals) in Istanbul, Turkey. The HIV-1positive patients were added to the standard patient files in all of the centers; these files were then transferred to the ACTHIV-IST database in the Internet. A total of 829 naiv-untreated HIV-1 positive patients were chosen from the database. The number of male patients was 700 (84.4%) and the mean age of the patients was 37 years (range, 17-79). In our study group 348 (42%) of the patients were married and 318 (38.7%) of the patients were single. The probable route of transmission was heterosexual intercourse in 437 (52.7%) patients and homosexual intercourse in 256 (30.9%) patients. In 519 (62.6%) patients the diagnose was made due to a screening test and in 241 (29.1%) patients, the diagnose was made due to an HIV-related/non-related disease. The mean CD4+ T cell number in 788 of the patients was 357.8/mm(3) (+/- 271.1), and the median viral load in 698 of the patients was 100,000 copies/mL (20-9,790,000). In Turkey, the number of HIV-1 positive patients is still low and to diagnose with a screening test is the most common way of diagnostic route.

Published
2014

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

Author

Turan Aslan, Nese Saltoglu, Derya Ozturk Engin, Bahadir Ceylan, Eren Gulhan, Funda Şimşek, Servet Alan, Fatman Sargın, Ali Ihsan Dokucu, Arzu Kantürk, Oznur Ak, Onder Ergonul, Selim Badur, Paşa Göktaş, Nur Benzonana, Kenan Midilli, Taner Yildirmak, Haluk Eraksoy, Serdar Özer, Saadet Yazici, Muzaffer Fincanci, Oral Oncul, Nail Ozgunes, Mustafa Ozyurt, Nuray Uzun, Meral Akcay Ciblak, Ozcan Nazlican, Ilker Inanc Balkan, Alper Gunduz, Serap Gencer, Asuman Inan, Ergönül, Mehmet Önder (ORCID 0000-0003-1935-9235 & YÖK ID 110398), Alan, Servet, Ak, Öznur, Sargın, Fatman, Kanturk, Arzu, Gündüz, Alper, Engin, Derya, Öncül, Oral, Balkan, İlker İnanç, Ceylan, Bahadır, Benzonana, Nur, Yazıcı, Saadet, Şimşek, Funda, Uzun, Nuray, İnan, Asuman, Gülhan, Eren, Cıblak, Meral, Midilli, Kenan, Özyurt, Mustafa, Badur, Selim, Gencer, Serap, Nazlıcan, Özcan, Özer, Serdar, Özgüneş, Nail, Yıldırmak, Taner, Aslan, Turan, Göktaş, Paşa, Saltoğlu, Neşe, Fincancı, Muzaffer, Dokucu, Ali Ihsan, Eraksoy, Haluk, School of Medicine, and Department of Infectious Diseases and Public Health

Subjects
Adult, Male, Pathology, medicine.medical_specialty, Multivariate analysis, Turkey, Neuraminidase, Medicine, Infectious diseases, medicine.disease_cause, Antiviral Agents, Disease Outbreaks, Influenza A Virus, H1N1 Subtype, Oseltamivir, Pregnancy, Internal medicine, Influenza, Human, Case fatality rate, Pandemic, Odds Ratio, Influenza A virus, Humans, Zanamivir, Cross Infection, Clinical-Features, United-States, Epidemiologic features, Hospitalized-Patients, Risk-Factors, South-Korea, China, Pneumonia, Failure, Illness, biology, business.industry, Outbreak, Odds ratio, Middle Aged, Hospitalization, Infectious Diseases, Multivariate Analysis, biology.protein, Human mortality from H5N1, Female, influenza, business, Research Article
Abstract

Background: The fatality attributed to pandemic influenza A H1N1 was not clear in the literature. We described the predictors for fatality related to pandemic influenza A H1N1 infection among hospitalized adult patients. Methods: This is a multicenter study performed during the pandemic influenza A H1N1 [A(H1N1) pdm09] outbreak which occurred in 2009 and 2010. Analysis was performed among laboratory confirmed patients. Multivariate analysis was performed for the predictors of fatality. Results: In the second wave of the pandemic, 848 adult patients were hospitalized because of suspected influenza, 45 out of 848 (5.3%) died, with 75% of fatalities occurring within the first 2 weeks of hospitalization. Among the 241 laboratory confirmed A(H1N1) pdm09 patients, the case fatality rate was 9%. In a multivariate logistic regression model that was performed for the fatalities within 14 days after admission, early use of neuraminidase inhibitors was found to be protective (Odds ratio: 0.17, confidence interval: 0.03-0.77, p = 0.022), nosocomial infections (OR: 5.7, CI: 1.84-18, p = 0.013), presence of malignant disease (OR: 3.8, CI: 0.66-22.01, p = 0.133) significantly increased the likelihood of fatality. Conclusions: Early detection of the infection, allowing opportunity for the early use of neuraminidase inhibitors, was found to be important for prevention of fatality. Nosocomial bacterial infections and underlying malignant diseases increased the rate of fatality.

Published
2014

9. Mortality Indicators In Pneumococcal Meningitis: Therapeutic Implications

Author

Mustafa Gökhan Gözel, Füsun Zeynep Akçam, Nefise Oztoprak, Asim Ulcay, Derya Ozturk-Engin, Gonul Sengoz, Gunay Tuncer-Ertem, Saygin Nayman-Alpat, Yasemin Ersoy, Gülden Ersöz, Nazif Elaldi, Ayse Sagmak-Tartar, Oğuz Reşat Sipahi, Selçuk Kaya, Recep Tekin, Emsal Aydin, Hava Yilmaz, Nail Ozgunes, Alper Şener, Sibel Gundes, Ayşegül Yeşilkaya, Tumer Guven, Hakan Erdem, Birsen Cetin, Derya Seyman, Vedat Turhan, Oznur Ak, Kadriye Kart Yaşar, Ahmet Karakaş, Oral Oncul, Ahmet Çağkan İnkaya, Gonul Cicek-Senturk, Yasemin Akkoyunlu, Oguz Karabay, Hakan Leblebicioglu, Ilker Inanc Balkan, Aysegul Ulu-Kilic, Mustafa Hatipoglu, Aysun Yalci, Husrev Diktas, Ayşe Ertürk, Filiz Pehlivanoglu, Selma Alabay, Asuman Inan, Umit Savasci, Alper Gunduz, Ayhan Akbulut, Fatma Sirmatel, Haluk Vahaboglu, Esra Kazak, Saim Dayan, Sukran Kose, Selma Tosun, Abdullah Umut Pekok, İç Hastalıkları, BAİBÜ, Tıp Fakültesi, Dahili Tıp Bilimleri Bölümü, Sırmatel, Fatma, [Erdem, Hakan -- Hatipoglu, Mustafa -- Oncul, Oral -- Turhan, Vedat -- Ulcay, Asim] GATA Haydarpasa Training Hosp, Dept Infect Dis & Clin Microbiol, Istanbul, Turkey -- [Elaldi, Nazif -- Gozel, Mustafa G.] Cumhuriyet Univ, Sch Med, Dept Infect Dis & Clin Microbiol, Sivas, Turkey -- [Oztoprak, Nefise -- Seyman, Derya] Antalya Training & Res Hosp, Dept Infect Dis & Clin Microbiol, Antalya, Turkey -- [Sengoz, Gonul -- Pehlivanoglu, Filiz] Haseki Training & Res Hosp, Dept Infect Dis & Clin Microbiol, Istanbul, Turkey -- [Ak, Oznur] Lutfi Kirdar Training & Res Hosp, Dept Infect Dis & Clin Microbiol, Istanbul, Turkey -- [Kaya, Selcuk] Karadeniz Tech Univ, Sch Med, Dept Infect Dis & Clin Microbiol, Trabzon, Turkey -- [Inan, Asuman -- Ozturk-Engin, Derya] Haydarpasa Numune Training & Res Hosp, Dept Infect Dis & Clin Microbiol, Istanbul, Turkey -- [Nayman-Alpat, Saygin] Osmangazi Univ Sch Med, Dept Infect Dis & Clin Microbiol, Eskisehir, Turkey -- [Ulu-Kilic, Aysegul -- Alabay, Selma] Erciyes Univ, Sch Med, Dept Infect Dis & Clin Microbiol, Kayseri, Turkey -- [Pekok, Abdullah Umut] Private Erzurum Sifa Hosp, Dept Infect Dis & Clin Microbiol, Erzurum, Turkey -- [Gunduz, Alper] Sisli Etfal Training & Res Hosp, Dept Infect Dis & Clin Microbiol, Istanbul, Turkey -- [Yasar, Kadriye] Bakirkoy Dr Sadi Konuk Training & Res Hosp, Dept Infect Dis & Clin Microbiol, Istanbul, Turkey -- [Yilmaz, Hava -- Leblebicioglu, Hakan] Ondokuz Mayis Univ, Sch Med, Dept Infect Dis & Clin Microbiol, Samsun, Turkey -- [Cicek-Senturk, Gonul] Diskapi Yildirim Beyazit Training & Res Hosp, Dept Infect Dis & Clin Microbiol, Ankara, Turkey -- [Akcam, Fusun Z.] Suleyman Demirel Univ, Sch Med, Dept Infect Dis & Clin Microbiol, TR-32200 Isparta, Turkey -- [Inkaya, Ahmet C.] Hacettepe Univ, Sch Med, Dept Infect Dis & Clin Microbiol, Ankara, Turkey -- [Kazak, Esra] Uludag Univ, Sch Med, Dept Infect Dis & Clin Microbiol, Bursa, Turkey -- [Sagmak-Tartar, Ayse -- Akbulut, Ayhan] Firat Univ, Sch Med, Dept Infect Dis & Clin Microbiol, TR-23169 Elazig, Turkey -- [Tekin, Recep -- Dayan, Saim] Dicle Univ, Sch Med, Dept Infect Dis & Clin Microbiol, Diyarbakir, Turkey -- [Ersoy, Yasemin] Inonu Univ, Sch Med, Dept Infect Dis & Clin Microbiol, Malatya, Turkey -- [Sipahi, Oguz Resat] Ege Univ, Sch Med, Dept Infect Dis & Clin Microbiol, Izmir, Turkey -- [Guven, Tumer] Ankara Ataturk Training & Res Hosp, Dept Infect Dis & Clin Microbiol, Ankara, Turkey -- [Tuncer-Ertem, Gunay] Ankara Numune Training & Res Hosp, Dept Infect Dis & Clin Microbiol, Ankara, Turkey -- [Balkan, Ilker I.] Istanbul Univ, Cerrahpasa Med Sch, Dept Infect Dis & Clin Microbiol, Istanbul, Turkey -- [Cetin, Birsen] Koc Univ, Sch Med, Dept Infect Dis & Clin Microbiol, Istanbul, Turkey -- [Ersoz, Gulden] Mersin Univ, Sch Med, Dept Infect Dis & Clin Microbiol, Mersin, Turkey -- [Karakas, Ahmet] Gulhane Mil Med Acad, Dept Infect Dis & Clin Microbiol, Ankara, Turkey -- [Ozgunes, Nail -- Vahaboglu, Haluk] Medeniyet Univ, Goztepe Training & Res Hosp, Dept Infect Dis & Clin Microbiol, Istanbul, Turkey -- [Sener, Alper] Onsekiz Mart Univ, Sch Med, Dept Infect Dis & Clin Microbiol, Canakkale, Turkey -- [Yesilkaya, Aysegul] Baskent Univ, Sch Med, Dept Infect Dis & Clin Microbiol, TR-06490 Ankara, Turkey -- [Erturk, Ayse] Recep Tayyip Erdogan Univ, Sch Med, Dept Dept Infect Dis & Clin Microbiol, Rize, Turkey -- [Gundes, Sibel] Kocaeli Univ, Sch Med, Dept Dept Infect Dis & Clin Microbiol, Izmit, Turkey -- [Karabay, Oguz] Sakarya Univ, Sch Med, Dept Infect Dis & Clin Microbiol, Sakarya, Turkey -- [Sirmatel, Fatma] Abant Izzet Baysal Univ, Sch Med, Dept Infect Dis & Clin Microbiol, Bolu, Turkey -- [Tosun, Selma] Izmir Bozyaka Training & Res Hosp, Dept Infect Dis & Clin Microbiol, Izmir, Turkey -- [Yalci, Aysun] Ankara Univ, Sch Med, Dept Infect Dis & Clin Microbiol, TR-06100 Ankara, Turkey -- [Akkoyunlu, Yasemin] Bezmi Alem Vakif Univ, Sch Med, Dept Infect Dis & Clin Microbiol, Istanbul, Turkey -- [Aydin, Emsal] Kafkas Univ, Sch Med, Dept Infect Dis & Clin Microbiol, Kars, Turkey -- [Diktas, Husrev] Mil Hosp, Dept Infect Dis & Clin Microbiol, Tatvan, Turkey -- [Kose, Sukran -- Savasci, Umit] Tepecik Training & Res Hosp, Dept Infect Dis & Clin Microbiol, Izmir, Turkey -- Dept Infect Dis & Clin Microbiol, Sarikamis Mil Hosp, Kars, Turkey, Yesilkaya, Aysegul -- 0000-0003-0225-6416, Leblebicioglu, Hakan -- 0000-0002-6033-8543, VAHABOGLU, Haluk -- 0000-0001-8217-1767, Elaldi, Nazif -- 0000-0002-9515-770X, Gozel, Mustafa Gokhan -- 0000-0001-5187-7388, Kart Yasar, Kadriye -- 0000-0003-2963-4894, Karakas, Ahmet -- 0000-0002-0553-8454, Karabay, Oguz -- 0000-0003-0502-432X, Ersoy, Yasemin -- 0000-0001-5730-6682, hatipoglu, mustafa -- 0000-0001-9910-1650, Gunduz, Alper -- 0000-0001-9154-844X, HATİBOĞLU, MUSTAFA AZİZ, Ege Üniversitesi, and OMÜ

Subjects
Microbiology (medical), Streptococcus Pneumoniae, Adult, Male, medicine.medical_specialty, Adolescent, Turkey, Penicillin Resistance, Resistance, Microbial Sensitivity Tests, Penicillins, medicine.disease_cause, Cohort Studies, Young Adult, Vancomycin, Internal medicine, Streptococcus pneumoniae, medicine, Humans, Meningitis, Mortality, Intensive care medicine, pneumococcal meningitis, Aged, Retrospective Studies, Aged, 80 and over, business.industry, Meningitis, Pneumococcal, Ceftriaxone, General Medicine, Odds ratio, Middle Aged, medicine.disease, Penicillin, Confidence interval, Anti-Bacterial Agents, Cephalosporins, Treatment Outcome, Infectious Diseases, Drug Therapy, Combination, Female, business, Cohort study, medicine.drug
Abstract

WOS: 000329981700003, PubMed ID: 24211227, Background: The aim of this study was to delineate mortality indicators in pneumococcal meningitis with special emphasis on therapeutic implications. Methods: This retrospective, multicenter cohort study involved a 15-year period (1998-2012). Culture-positive cases (n = 306) were included solely from 38 centers. Results: Fifty-eight patients received ceftriaxone plus vancomycin empirically. The rest were given a third-generation cephalosporin alone. Overall, 246 (79.1%) isolates were found to be penicillin-susceptible, 38 (12.2%) strains were penicillin-resistant, and 22 (7.1%) were oxacillin-resistant (without further minimum inhibitory concentration testing for penicillin). Being a critical case (odds ratio (OR) 7.089, 95% confidence interval (CI) 3.230-15.557) and age over 50 years (OR 3.908, 95% CI 1.820-8.390) were independent predictors of mortality, while infection with a penicillin-susceptible isolate (OR 0.441, 95% CI 0.195-0.996) was found to be protective. Empirical vancomycin use did not provide significant benefit (OR 2.159, 95% CI 0.949-4.912). Conclusions: Ceftriaxone alone is not adequate in the management of pneumococcal meningitis due to penicillin-resistant pneumococci, which is a major concern worldwide. Although vancomycin showed a trend towards improving the prognosis of pneumococcal meningitis, significant correlation in statistical terms could not be established in this study. Thus, further studies are needed for the optimization of pneumococcal meningitis treatment. (C) 2013 The Authors. Published by Elsevier Ltd on behalf of International Society for Infectious Diseases. All rights reserved.

Published
2014

11. A new model using platelet indices to predict liver fibrosis in patients with chronic hepatitis B infection

Author

Resat Ozaras, Onur Colak, Nail Ozgunes, Alper Gunduz, Yasemin Akkoyunlu, Bahadir Ceylan, Fehmi Tabak, Ayşe Inci, Muzaffer Fincanci, Bilgul Mete, Turan Aslan, Ebubekir Senates, and AKKOYUNLU, YASEMİN

Subjects
Adult, Liver Cirrhosis, Male, medicine.medical_specialty, Turkey, Comorbidity, Sensitivity and Specificity, Severity of Illness Index, Gastroenterology, Hepatitis B, Chronic, Risk Factors, Fibrosis, Internal medicine, Severity of illness, Prevalence, medicine, Humans, Mean platelet volume, Prothrombin time, medicine.diagnostic_test, Platelet Count, business.industry, Platelet Distribution Width, Reproducibility of Results, General Medicine, Odds ratio, Hepatitis B, Prognosis, medicine.disease, CEYLAN B., Mete B., FINCANCI M., ASLAN T., Akkoyunlu Y., Ozgunes N., Colak O., GUNDUZ A., Senates E., Ozaras R., et al., -A new model using platelet indices to predict liver fibrosis in patients with chronic hepatitis B infection-, WIENER KLINISCHE WOCHENSCHRIFT, cilt.125, ss.453-460, 2013, Confidence interval, Causality, Immunology, Female, business, Mean Platelet Volume
Abstract

We aimed to investigate whether mean platelet volume (MPV) and platelet distribution width (PDW) are variables determining the severity of liver fibrosis in patients with chronic HBV infection. Patients were divided into two groups with fibrosis scores of 0–2 and 3–6 (according to Ishac scoring system). Whether MPV and PDW were independent variables determining the severity of liver fibrosis score or not was investigated by comparing these groups. Of the 111 cases, 74 (66.7 %) were male (mean age 37.7 ± 11.6 years). Twenty-two of the cases (19.8 %) were HBeAg-positive. Fibrosis scores of 42 cases (37.8 %) were ≥ 3 and the remaining 69 cases had fibrosis scores

Published
2013

12. 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

13. 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

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