Emin Bulut

Sisli Etfal Training and Research Hospital, İstanbul, Istanbul, Turkey

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Publications (6)14.11 Total impact

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    ABSTRACT: Background: Hepatitis B virus (HBV) presents an important public health problem. Liver biopsy is currently the gold standard for assessing the degree of intrahepatic inflammation and for staging liver fibrosis. However, the value of liver biopsies is limited by sampling errors, understaging and interobserver variability in interpretation. There is, therefore, a need to identify novel, non-invasive serologic biomarkers for the development of new predictive models of fibrosis. Methods: We enrolled patients with chronic hepatitis B infection (CHB) and examined the relationships between serum soluble urokinase plasminogen activator receptor (suPAR) and interferon-induced protein-10 (IP-10), and the results of liver biopsies. Healthy volunteers with normal aminotransferase levels and negative serological results for HBV, hepatitis C virus and human immunodeficiency virus were recruited as controls. Results: Mean platelet volume, serum suPAR and IP-10 were significantly elevated in patients with CHB compared with controls. Median serum suPAR and IP-10 levels were significantly higher in patients with liver fibrosis compared with patients with mild fibrosis. There was no significant difference in mean platelet volume or aspartate aminotransferase-to-platelet ratio index scores between patients with mild and significant fibrosis. Conclusion: suPAR and IP-10 were able to distinguish between significant and mild fibrosis with good sensitivity and specificity, and may thus represent useful biomarkers for identifying patients with significant fibrosis.
    Wiener klinische Wochenschrift 11/2015; DOI:10.1007/s00508-015-0886-4 · 0.84 Impact Factor
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    ABSTRACT: Although a decreasing trend of tuberculosis (TB) was reported in Turkey, higher proportion of extrapulmonary tuberculosis (EPT) was revealed. In this retrospective study, clinical and laboratory data of 141 EPT patients were evaluated for a seven-year period by using descriptive statistics, and parametric and non-parametric tests where appropriate. The most frequent types of EPT were meningeal TB (23%) and TB lymphadenitis (21%), respectively. Other types of EPT were skeletal, miliary, peritoneal, abscess, genitourinarial, cutaneous and gastrointestinal involvement which ranged between 18% and 1%. Mean age was 42 and female/male ratio was almost equal. All patients were born in Turkey. Although all of them were permanent residents of Istanbul, 73% of the patients came from East and Southeast Region of Turkey. For the patients, being older than 40years old (p<0.01), having miliary TB (p<0.05) and high CRP levels (p<0.05) were found to be associated with mortality. EPT still remains as a significant morbidity and mortality reason in lower income populations and developing countries. In our study, although all patients were residents of Istanbul approximately two thirds of them have migrated from East and Southeast parts of the country. The relatively high prevelance of tuberculosis cases in Istanbul may be due to the permanent migration from other parts of the country. Early diagnosis and initiation of appropriate treatment are the keys for reducing morbidity and mortality in patients with EPT, particularly in the cases of older ages.
    European Journal of Internal Medicine 09/2013; 24(8). DOI:10.1016/j.ejim.2013.08.704 · 2.89 Impact Factor

  • The Pediatric Infectious Disease Journal 11/2011; 30(11):1012-3. DOI:10.1097/INF.0b013e3182276f7c · 2.72 Impact Factor
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    ABSTRACT: The Mycobacterium tuberculosis complex (MTBC) consists of a group of closely related species that differ in their epidemiological profiles, host ranges, pathogenicities, geographic distributions, and drug resistances. Identification of members in the MTBC is essential for monitoring the epidemiology of tuberculosis (TB) and implementing appropriate public health control measures. In this study, 188 consecutive MTBC clinical isolates from 2007 to 2010 were evaluated to determine the prevalence of MTBC species in Turkey. PCR and restriction fragment length polymorphism analysis (PCR-RFLP) of the gyrB gene were used, and results for species other than M. tuberculosis were confirmed using the GenoType MTBC assay (Hain Lifescience, Nehren, Germany). Most of the strains were found to be M. tuberculosis (94.1%). The prevalences of M. bovis and M. caprae were 4.3% and 1.6%, respectively. Only one M. bovis BCG strain was identified. Overall, the frequency of bovine tuberculosis in humans was 5.3%. We had assumed that bovine TB infection was under control in animal herds, but primary M. bovis infections in humans caused by transmission from infected animals are still an issue in Turkey. Our results indicate that the frequent identification of M. bovis in routine mycobacteriological laboratory work has further importance due to the well-known resistance of this species to pyrazinamide.
    Journal of clinical microbiology 09/2011; 49(11):3837-41. DOI:10.1128/JCM.01172-11 · 3.99 Impact Factor
  • Banu Bayraktar · Buket Toksoy · Emin Bulut ·
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    ABSTRACT: Widespread production of CTX-M type extended-spectrum beta-lactamases (ESBL) in Enterobacteriaceae strains which are resistant to extended-spectrum cephalosporins is the most remarkable example for rapid and global spread of plasmid mediated antimicrobial resistance in bacteria. Consecutive 200 ESBL producing Enterobacteriaceae strains out of 1640 isolates that were obtained from clinical samples (167 urine, 11 wound, 7 bronchoalveolar lavage, 3 peritoneal fluid, 2 cerebrospinal fluid, 2 biopsy, 2 tracheal aspirate, 2 conjunctiva, 1 abscess, 1 catheter) between February to July 2009 in our laboratory were included to this study. Among the 200 ESBL positive isolates 141 (70.5%) were Escherichia coli, 51 (26%) were Klebsiella pneumoniae, 5 (2.5%) were Enterobacter spp. and one of each (0.5%) Citrobacter freundii, Klebsiella oxytoca and Proteus mirabilis. ESBL positivity was 11% among the 123 community-acquired strains and 13% among the 77 hospital acquired strains, the statistical difference being insignificant (p > 0.05). The prevalence of bla(CTX-M) beta-lactamase genes were detected by multiplex polymerase chain reaction with the use of two general primer sets: CTX-MA1 and CTX-MA2 primers for the amplification of CTX-M-1, CTX-M-2 and CTX-M-9 enzymes group, and CTX825-F and CTX825-R primers for the amplification of CTX-M-8 and CTX-M-25 enzymes group. bla(CTX-M) genes were detected in 167 out of 200 strains (83.5%). CTX-M production rates in community and hospital acquired strains were found as 86.2% and 79.2%, respectively and no statistically significant difference was detected (p > 0.05). CTX-M producing strains were either E. coli (n = 132) or Klebsiella spp. (n = 35) and were expressing one of the enzymes from CTX-M-1, CTX-M-2 or CTX-M-9 groups. No strains carrying CTX-M-8 or CTX-M-25 group enzymes were detected. CTX-M production rates in ESBL producing E. coli strains in community and hospital were found as 92.5% and 95.7%, respectively, whereas the same rates for ESBL producing Klebsiella spp. strains were 67.8% and 66.7%. The difference between the CTX-M production rates of community and hospital acquired strains was not statistically significant (p > 0.05). In conclusion, CTX-M prevalence was found high in ESBL producing strains of both E. coli and Klebsiella spp. Since bla(CTX-M) gene acquisition usually results in the emergence of multiple drug-resistant Enterobacteriaceae strains, screening for CTX-M type ESBL production in the laboratory has an important impact on monitoring the resistant strains which have endemic potential.
    Mikrobiyoloji bülteni 04/2010; 44(2):187-96. · 0.65 Impact Factor
  • B. Bayraktar · B. Toksoy · E. Bulut ·

    Journal of Clinical Virology 09/2009; 46. DOI:10.1016/S1386-6532(09)70197-0 · 3.02 Impact Factor