Ayper Somer

Istanbul Medical University, İstanbul, Istanbul, Turkey

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Publications (37)90.27 Total impact

  • European Society for Paediatric Infectious Diseases (ESPID 2014)., Dublin, Ireland.; 05/2014
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    ABSTRACT: Background. IL-12Rβ1-deficient patients are prone to clinical disease caused by mycobacteria, Salmonella and other intramacrophagic pathogens, probably due to impaired IL-12-dependent IFN-γ production. About 25% of patients also display mucocutaneous candidiasis, probably due to impaired IL-23-dependent IL-17 immunity. The clinical features and outcome of candidiasis in these patients have not been described before. We report here the clinical signs of candidiasis in 35 patients with IL-12Rβ1 deficiency. Results. Most (n=71) of the 76 episodes of candidiasis were mucocutaneous. Isolated oropharyngeal candidiasis (OPC) was the most common presentation (59 episodes, 34 patients) and was recurrent or persistent in 26 patients. Esophageal candidiasis (n=7) was associated with proven OPC in two episodes, and cutaneous candidiasis (n=2) with OPC in one patient, whereas isolated vulvovaginal candidiasis (n=3) was not. Five episodes of proven invasive candidiasis were documented in four patients; one of these episodes was community-acquired in the absence of any other comorbid condition. The first episode of candidiasis occurred earlier in life (1.5±7.87 years) than infections with environmental mycobacteria (4.29 ±11.9 years), M. tuberculosis (4±3.12 years) or Salmonella species (4.58±4.17 years), or for other rare infections (3±11.67 years). Candidiasis was the first documented infection in 19 of the 35 patients, despite the vaccination of 10 of these 19 patients with live Bacille Calmette-Guerin. Conclusions. IL-12Rβ1-deficient patients may suffer from candidiasis, usually mucocutaneous, which is frequently recurrent or persistent. Candidiasis may be the first clinical manifestation in IL-12βR1-deficient patients.
    Clinical Infectious Diseases 11/2013; · 9.37 Impact Factor
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    ABSTRACT: Objective: The aim was to describe the clinical and epidemiologic characteristics of patients with lower res-piratory tract infection (LRTI) who were hospitalized to the Pediatric Infection Department in Istanbul due to respiratory viruses from October 2010 through May 2011. Material and Methods: Details of the 156 patients who were hospitalized were recorded. Respiratory viruses were con-firmed in specimens using real-time reverse transcriptase-polymerase-chain-reaction (RT PCR) assay. Results: Respiratory agents were detected in 48 (30.8%) of 156 children with LRTI. Fifty seven patients (36.5%) were female, 99 (63.5%) were male and the median age was 28.2 ±42.1 months. A single agent was identified in 41 (% 85) children, and multiple agents in 7 (%15). Influenza virus was the most common pathogen (31.2%), followed by rinovirus (20.8%), bocavi-rus (14.5%),coronavirus (10.4%), parainfluenza virus (8.3%), metapneumovirus (8.3%) and respiratory syncytial virus (6.2%). There were no statistically significant differences between the two groups (with isolated virus or no known viral etiology) with respect to symptoms, clinical findings, laboratory work-up, or radiological data except LDH level. Elevated levels of LDH in patients with respiratory virus were statistically significant. In addition, we showed a relationship between patients with the viral infection and peribronchial markings on chest X-ray (p = 0.017, OR 4071 CI :1.290-12, 843) and steroid therapy (p <0.001, OR 7870 CI :2.496-25, 000). Three patients (6.25%) received intensive care support and one patient with con-genital metabolic disease who was detected HMPV died. Conclusions: Diagnosis of respiratory viruses is essential not only for epidemiological data and for antiviral therapy because of easily able to achieve and increased diversity today. With all of influenza is major respiratory virus of LTRI and so vaccine program should evolve influenza vaccine for all children upper 6 months old. Comminity acquired pneumonia (CAP) in children is still the most important cause of mortality all over the word, espe-cially in developing countries. The overall incidence per 100 was 4 in children aged 0-5 years in industrialized countries, Northern European countries and the United States 1 while in developing countries 21-296 /100 child/year 2 . In our country, according to data from the Ministry of health, CAP is respon-sible of 48.4 % of deaths under 1 aged and % 42.1 deaths under 1-4 age group 3 . Bacterial pneumonia often occurs in the winter and spring months. Viral Surveillance results of respiratory viruses from all over the world have seasonal distribution., as shown by Figure 1 4
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    ABSTRACT: Background/aims: There is a paucity of data regarding pediatric liver transplant patients from Turkey and less so globally. We report here 7 pediatric cases with documented H1N1 nove Influenza A infection. Material and Methods: 7 pediatric liver transplant patients on immunesuppression, tested positive with PCR for 2009 H1N1 Influenza A, have been analyzed retrospectively. All patients were commenced oseltamivir treatment and 6 patients continued to take their immunosuppressive treatment. Results: All patients (n=7) survived H1N1 novel Influenza A infection without any sequela. 1 patient has been admitted to Intensive Care Unit and has been discharged without any sequela. There was no graft dysfunction or loss during the infection episode. Conclusion: 2009 H1N1 Influenza A infection did not cause any mortality among our patients. Oseltamivir treatment may have played a role for improving in our patients' condition. Immunosuppression can be continued in pediatric liver transplant patients with close monitoring of vital signs and graft function.
    The Turkish journal of gastroenterology: the official journal of Turkish Society of Gastroenterology 08/2012; 23(4):366-70. · 0.48 Impact Factor
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    ABSTRACT: Children under 2 years of age suffer from some of the highest rates of invasive pneumococcal disease (IPD) in the world. (Turkey) Rates of IPD had a decline after statewide introduction of the 7-valent pneumococcal conjugate vaccine (PCV7) in 2008. Introduction of PCV7, PCV10 and PCV13 vaccines resulted in elimination of IPD caused by vaccine serotypes, but was followed by increasing rates of IPD caused by nonvaccine serotypes. Although the heptavalent vaccine has demonstrated its ability to reduce the incidence of pneumococcal disease, its efficacy is limited due to the restricted number of serotypes included. We report a case involving a 3-month-old girl who developed meningitis with Streptococcus pneumoniae serotype 2 despite the use of heptavalent conjugate vaccine.; DOI: 10.5812/pedinfect.5314 Implication for health policy/practice/research/medical education: Children under 2 years of age suffer from some of the highest rates of invasive pneumococcal disease (IPD) in the world. (Turkey) Rates of IPD had a decline after state-wide introduction of the 7-valent pneumococcal conjugate vaccine (PCV7) in 2008. Introduc-tion of PCV7, PCV10 and PCV13 vaccines resulted in elimination of IPD caused by vaccine serotypes, but was followed by increasing rates of IPD caused by nonvaccine serotypes. It is possible that serotype 2 may be an invasive strain with low morbidity if the proper treatment is applied. More case reports are needed to confirm this comment.
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    ABSTRACT: Varicella can cause complications that are potentially serious and require hospitalization. Our current understanding of the causes and incidence of varicella-related hospitalization in Turkey is limited and sufficiently accurate epidemiological and economical information is lacking. The aim of this study was to estimate the annual incidence of varicella-related hospitalizations, describe the complications, and estimate the annual mortality and cost of varicella in children. VARICOMP is a multi-center study that was performed to provide epidemiological and economic data on hospitalization for varicella in children between 0 and 15 years of age from October 2008 to September 2010 in Turkey. According to medical records from 27 health care centers in 14 cities (representing 49.3% of the childhood population in Turkey), 824 children (73% previously healthy) were hospitalized for varicella over the 2-year period. Most cases occurred in the spring and early summer months. Most cases were in children under 5 years of age, and 29.5% were in children under 1 year of age. The estimated incidence of varicella-related hospitalization was 5.29-6.89 per 100,000 in all children between 0-15 years of age in Turkey, 21.7 to 28 per 100,000 children under 1 year of age, 9.8-13.8 per 100,000 children under 5 years of age, 3.96-6.52 per 100,000 children between 5 and 10 years of age and 0.42 to 0.71 per 100,000 children between 10 and 15 years of age. Among the 824 children, 212 (25.7%) were hospitalized because of primary varicella infection. The most common complications in children were secondary bacterial infection (23%), neurological (19.1%), and respiratory (17.5%) complications. Secondary bacterial infections (p < 0.001) and neurological complications (p < 0.001) were significantly more common in previously healthy children, whereas hematological complications (p < 0.001) were more commonly observed in children with underlying conditions. The median length of the hospital stay was 6 days, and it was longer in children with underlying conditions (<0.001). The median cost of hospitalization per patient was $338 and was significantly higher in children with underlying conditions (p < 0.001). The estimated direct annual cost (not including the loss of parental work time and school absence) of varicella-related hospitalization in children under the age of 15 years in Turkey was $856,190 to $1,407,006. According to our estimates, 882 to 1,450 children are hospitalized for varicella each year, reflecting a population-wide occurrence of 466-768 varicella cases per 100,000 children. In conclusion, this study confirms that varicella-related hospitalizations are not uncommon in children, and two thirds of these children are otherwise healthy. The annual cost of hospitalization for varicella reflects only a small part of the overall cost of this disease, as only a very few cases require hospital admission. The incidence of this disease was higher in children <1 year of age, and there are no prevention strategies for these children other than population-wide vaccination. Universal vaccination is therefore the only realistic option for the prevention of severe complications and deaths. The surveillance of varicella-associated complications is essential for monitoring of the impact of varicella immunization.
    European Journal of Pediatrics 12/2011; 171(5):817-25. · 1.91 Impact Factor
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    ABSTRACT: The aim of this study was to describe the clinical and epidemiological characteristics of pandemic influenza in hospitalized children. A total of 114 patients with suspected H1N1 virus infection were hospitalized, and nasal swabs were sent to National Influenza Reference Laboratory for confirmation of pandemic influenza A (H1N1) virus infection by rRT-PCR assay. Forty-six female and 68 male patients were included in the study. Age of the patients ranged from 40 days to 16 years. Clinical and/or radiological pneumonia were detected in 96% of all. Sixteen patients required mechanical ventilation due to hypoxemia. Previously healthy children required mechanical ventilation and oxygen therapy more than patients with chronic diseases. Elevated levels of CRP and LDH in patients with respiratory distress and patients who required mechanical ventilation were statistically significant. Our study showed that progress of pandemic influenza infection in previously healthy children is as severe as their counterparts with chronic underlying diseases.
    Journal of Tropical Pediatrics 06/2011; 57(3):213-6. · 1.01 Impact Factor
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    ABSTRACT: The prevalence of invasive fungal infections is increasing and the infections are becoming a major problem in immunocompromised children and neonates. Fortunately, there has been a recent surge in the development of new antifungal agents. Caspofungin, the first licensed echinocandin, is a novel class of antifungal and is approved for use in children 3 months of age or older for the treatment of invasive candidiasis, salvage therapy for invasive aspergillosis and as empirical therapy for febrile neutropenia. This article reviews the published data on the use of caspofungin in immunocompromised children and neonates with invasive fungal infections.
    Expert Review of Anticancer Therapy 03/2011; 9(3):347-55. · 3.22 Impact Factor
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    ABSTRACT: Invasive aspergillosis (IA) is currently an important cause of morbidity and mortality in hematopoietic stem cell transplant and solid organ transplant recipients. A high index of suspicion and careful clinical and radiological examinations are the keys to identifying infected patients early. Chest computerized axial tomography is extremely useful in diagnosing pulmonary aspergillosis. Microbiologic or histologic identification of infection, however, remain essential. Successful management of invasive fungal infections depends on timely and appropriate treatment. There are multiple variables associated with survival in transplant patients with IA. Understanding these prognostic factors may assist in the development of treatment algorithms and clinical trials. In contrast to adult patients, large prospective comparative studies have not been performed in pediatric patients with IA. Moreover, pediatric subgroups have not been analyzed in published studies that include a broader age range. Clinicians treating pediatric IA are largely left with the results of uncontrolled trials, observatory surveys, salvage therapy data and extrapolations from adult studies to guide their treatment choices. The aim of this article is to state the main characteristics of IA in both pediatric and adult populations.
    Expert Review of Anticancer Therapy 03/2011; 9(3):307-15. · 3.22 Impact Factor
  • B Budan, B Ekici, B Tatli, A Somer
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    ABSTRACT: Acute disseminated encephalomyelitis (ADEM) is an immune-mediated demyelinating disorder of the central nervous system which is usually precipitated by a viral infection or vaccination. A 3-month-old boy is reported who developed ADEM a week after full recovery from pertussis. MRI detected a high-intensity lesion extending from the pons to the mesencephalon, compatible with ADEM. Following the administration of intravenous immunoglobulins, the patient's clinical symptoms improved. This case report demonstrates that pertussis is capable of inducing an immune-mediated demyelinating disorder of the central nervous system.
    Annals of Tropical Paediatrics International Child Health 01/2011; 31(3):269-72. · 0.92 Impact Factor
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    ABSTRACT: In the last decade, autosomal recessive IL-12Rβ1 deficiency has been diagnosed in four children with severe tuberculosis from three unrelated families from Morocco, Spain, and Turkey, providing proof-of-principle that tuberculosis in otherwise healthy children may result from single-gene inborn errors of immunity. We aimed to estimate the fraction of children developing severe tuberculosis due to IL-12Rβ1 deficiency in areas endemic for tuberculosis and where parental consanguinity is common. We searched for IL12RB1 mutations in a series of 50 children from Iran, Morocco, and Turkey. All children had established severe pulmonary and/or disseminated tuberculosis requiring hospitalization and were otherwise normally resistant to weakly virulent BCG vaccines and environmental mycobacteria. In one child from Iran and another from Morocco, homozygosity for loss-of-function IL12RB1 alleles was documented, resulting in complete IL-12Rβ1 deficiency. Despite the small sample studied, our findings suggest that IL-12Rβ1 deficiency is not a very rare cause of pediatric tuberculosis in these countries, where it should be considered in selected children with severe disease. This finding may have important medical implications, as recombinant IFN-γ is an effective treatment for mycobacterial infections in IL-12Rβ1-deficient patients. It also provides additional support for the view that severe tuberculosis in childhood may result from a collection of single-gene inborn errors of immunity.
    PLoS ONE 01/2011; 6(4):e18524. · 3.53 Impact Factor
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    ABSTRACT: This study was performed to investigate the viral etiological agents, age distribution and clinical manifestations of lower respiratory tract infection (LRTI) in hospitalized children. The viral etiology and clinical findings in 147 children (1 month to 5 years of age) hospitalized with acute LRTI were evaluated. Cell culture was used for isolation of influenza viruses and direct fluorescent antibody assay for parainfluenza viruses (PIVs), respiratory syncytial virus (RSV) and adenoviruses (ADVs). Reverse-transcriptase polymerase chain reaction was employed for human metapneumovirus (hMPV). One hundred and six of all patients (72.1%) were male, and 116 children (79.8%) were < or = 2 years. A viral etiology was detected in 54 patients (36.7%). RSV was the most frequently isolated (30 patients, 55.6%), and PIV (27.8%), hMPV (13%), influenza-A (9.3%), and ADV (5.6%) were also shown. Dual infection was detected in six patients. There were no statistically significant differences between the two groups (with isolated virus or no known viral etiology) with respect to symptoms, clinical findings, laboratory work-up, or radiological data. Length of hospital stay was also not different. Determination of the etiology of acute LRTI in children less than 5 years of age seems impossible without performing virological work-up, whether viral or nonviral in origin.
    The Turkish journal of pediatrics 01/2011; 53(5):508-16. · 0.56 Impact Factor
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    ABSTRACT: This study aimed to determine the predictive value of intercostal and pulmonary artery Doppler flow patterns in the outcome of childhood pneumonia. Pneumonia was classified according to type of pleural effusion and the ultrasound features of consolidations. Doppler flow patterns of intercostal and pulmonary arteries were analysed and correlated with pneumonia type and hospital stay. Of 83 pneumonia cases, 55 were uncomplicated and 28 were complicated. Pleural effusion was present in 54 cases, with 29 non-septated and 25 septated cases. Patients with uncomplicated pneumonia did not have abnormal Doppler flow patterns, compared with 64% (18 of 28) of patients with complicated pneumonia. Doppler ultrasound patterns in childhood pneumonia were correlated with pneumonia type and may be predictive of pneumonia outcome.
    The Journal of international medical research 01/2011; 39(4):1536-40. · 0.96 Impact Factor
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    ABSTRACT: Interleukin-12 receptor β1 (IL-12Rβ1) deficiency is the most common form of Mendelian susceptibility to mycobacterial disease (MSMD). We undertook an international survey of 141 patients from 102 kindreds in 30 countries. Among 102 probands, the first infection occurred at a mean age of 2.4 years. In 78 patients, this infection was caused by Bacille Calmette-Guérin (BCG; n = 65), environmental mycobacteria (EM; also known as atypical or nontuberculous mycobacteria) (n = 9) or Mycobacterium tuberculosis (n = 4). Twenty-two of the remaining 24 probands initially presented with nontyphoidal, extraintestinal salmonellosis. Twenty of the 29 genetically affected sibs displayed clinical signs (69%); however 8 remained asymptomatic (27%). Nine nongenotyped sibs with symptoms died. Recurrent BCG infection was diagnosed in 15 cases, recurrent EM in 3 cases, recurrent salmonellosis in 22 patients. Ninety of the 132 symptomatic patients had infections with a single microorganism. Multiple infections were diagnosed in 40 cases, with combined mycobacteriosis and salmonellosis in 36 individuals. BCG disease strongly protected against subsequent EM disease (p = 0.00008). Various other infectious diseases occurred, albeit each rarely, yet candidiasis was reported in 33 of the patients (23%). Ninety-nine patients (70%) survived, with a mean age at last follow-up visit of 12.7 years ± 9.8 years (range, 0.5-46.4 yr). IL-12Rβ1 deficiency is characterized by childhood-onset mycobacteriosis and salmonellosis, rare recurrences of mycobacterial disease, and more frequent recurrence of salmonellosis. The condition has higher clinical penetrance, broader susceptibility to infections, and less favorable outcome than previously thought.
    Medicine 11/2010; 89(6):381-402. · 4.35 Impact Factor
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    ABSTRACT: The genetic etiologies of the hyper-IgE syndromes are diverse. Approximately 60% to 70% of patients with hyper-IgE syndrome have dominant mutations in STAT3, and a single patient was reported to have a homozygous TYK2 mutation. In the remaining patients with hyper-IgE syndrome, the genetic etiology has not yet been identified. We aimed to identify a gene that is mutated or deleted in autosomal recessive hyper-IgE syndrome. We performed genome-wide single nucleotide polymorphism analysis for 9 patients with autosomal-recessive hyper-IgE syndrome to locate copy number variations and homozygous haplotypes. Homozygosity mapping was performed with 12 patients from 7 additional families. The candidate gene was analyzed by genomic and cDNA sequencing to identify causative alleles in a total of 27 patients with autosomal-recessive hyper-IgE syndrome. Subtelomeric biallelic microdeletions were identified in 5 patients at the terminus of chromosome 9p. In all 5 patients, the deleted interval involved dedicator of cytokinesis 8 (DOCK8), encoding a protein implicated in the regulation of the actin cytoskeleton. Sequencing of patients without large deletions revealed 16 patients from 9 unrelated families with distinct homozygous mutations in DOCK8 causing premature termination, frameshift, splice site disruption, and single exon deletions and microdeletions. DOCK8 deficiency was associated with impaired activation of CD4+ and CD8+T cells. Autosomal-recessive mutations in DOCK8 are responsible for many, although not all, cases of autosomal-recessive hyper-IgE syndrome. DOCK8 disruption is associated with a phenotype of severe cellular immunodeficiency characterized by susceptibility to viral infections, atopic eczema, defective T-cell activation and T(h)17 cell differentiation, and impaired eosinophil homeostasis and dysregulation of IgE.
    The Journal of allergy and clinical immunology 12/2009; 124(6):1289-302.e4. · 12.05 Impact Factor
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    ABSTRACT: The hyper IgE syndrome (HIES) is characterized by abscesses, eczema, recurrent infections, skeletal and connective tissue abnormalities, elevated serum IgE, and diminished inflammatory responses. It exists as autosomal-dominant and autosomal-recessive forms that manifest common and distinguishing clinical features. A majority of those with autosomal-dominant HIES have heterozygous mutations in signal transducer and activator of transcription (STAT)-3 and impaired T(H)17 differentiation. To elucidate mechanisms underlying different forms of HIES. A cohort of 25 Turkish children diagnosed with HIES were examined for STAT3 mutations by DNA sequencing. Activation of STAT3 by IL-6 and IL-21 and STAT1 by IFN-alpha was assessed by intracellular staining with anti-phospho (p)STAT3 and -pSTAT1 antibodies. T(H)17 and T(H)1 cell differentiation was assessed by measuring the production of IL-17 and IFN-gamma, respectively. Six subjects had STAT3 mutations affecting the DNA binding, Src homology 2, and transactivation domains, including 3 novel ones. Mutation-positive but not mutation-negative subjects with HIES exhibited reduced phosphorylation of STAT3 in response to cytokine stimulation, whereas pSTAT1 activation was unaffected. Both patient groups exhibited impaired T(H)17 responses, but whereas STAT3 mutations abrogated early steps in T(H)17 differentiation, the defects in patients with HIES with normal STAT3 affected more distal steps. In this cohort of Turkish children with HIES, a majority had normal STAT3, implicating other targets in disease pathogenesis. Impaired T(H)17 responses were evident irrespective of the STAT3 mutation status, indicating that different genetic forms of HIES share a common functional outcome.
    The Journal of allergy and clinical immunology 09/2009; 124(2):342-8, 348.e1-5. · 12.05 Impact Factor
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    ABSTRACT: Although well-defined principles of rational antimicrobial use are available, inappropriate prescribing patterns are reported worldwide. Accurate information on the usage of antimicrobials, including factors associated with and influencing their use, is valuable for improving the quality of prescription practices. In this cross-sectional point prevalence survey, data on patients hospitalized in 12 different children's hospitals were collected on a single day. Appropriateness of prescription was compared between the types of antimicrobials prescribed, indications, wards, and presence of/consultation with an infectious disease physician (IDP). A total 711 of 1302 (54.6%) patients evaluated were receiving one or more antimicrobial drugs. The antimicrobial prescription rate was highest in pediatric intensive care (75.7%) and lowest in the surgery wards (37.0%). Of the 711 patients receiving antimicrobials, 332 patients (46.7%) were found to be receiving at least one inappropriately prescribed drug. Inappropriate use was most frequent in surgery wards (80.2%), while it was less common in oncology wards (31.8%; p<0.001). Respiratory tract infection was the most common indication for antimicrobial use (29.4%). Inappropriate use was more common in deep-seated infections (54.7%) and respiratory infections (56.5%). Fluoroquinolones were used inappropriately more than any other drugs (81.8%, p=0.021). Consultation with an IDP appears to increase appropriate antimicrobial use (p=0.008). Inappropriate antimicrobial use remains a common problem in Turkish pediatric hospitals. Consultation with an IDP and prescribing antimicrobial drugs according to microbiological test results could decrease the inappropriate use of antimicrobials.
    International journal of infectious diseases: IJID: official publication of the International Society for Infectious Diseases 05/2009; 14(1):e55-61. · 2.17 Impact Factor
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    ABSTRACT: The purpose of the present study was to investigate the phenotypic and genotypic characteristics and the probable clonal dissemination of 13 vancomycin-resistant enterococcus (VRE) strains isolated between February-August 2006 from 11 patients at the Hospital of Istanbul Faculty of Medicine. The in vitro activities of antibiotics were determined by disk diffusion method in accordance with the CLSI (Clinical and Laboratory Standards Institute) guidelines and the minimum inhibitory concentration (MIC) values by E-test. Multiplex polymerase chain reaction (PCR) was performed for detection of vanA, vanB and vanC genes and RAPD-PCR (Randomly amplified polymorphic DNA-PCR) for investigating a clonal relationship among the isolates. All isolates exhibited resistance to vancomycin, teicoplanin, ampicillin, and high-level resistance to streptomycin. VanA phenotype and the relevant vanA gene, characterised by resistance to both vancomycin and teicoplanin, were detected in all isolates which were all E. faecium. Molecular investigation by RAPD-PCR showed these strains to belong to four different patterns, each containing 1 to 5 isolates. According to these results, the spread of VRE within our hospital was considered as a polyclonal dissemination.
    Mikrobiyoloji bülteni 08/2007; 41(3):347-56. · 0.61 Impact Factor
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    ABSTRACT: To investigate the role of Mycoplasma pneumoniae and Chlamydia pneumoniae infection in pediatric pneumonia, in Istanbul, Turkey, we conducted a prospective study covering all the children between 2 months and 15 years hospitalized for community-acquired pneumonia. A total of 140 children (85 males, median age 2.5 years) with community-acquired pneumonia were enrolled. Acute and convalescent sera were tested for IgM and IgG antibodies to M. pneumoniae (enzyme-linked immunosorbent assay, Serion ELISA classic) and for IgM and IgG antibodies to C. pneumoniae (microimmunofluorescence, Savyon, Israel). Mycoplasma pneumoniae infection was diagnosed in 38 patients (27%) and C. pneumoniae infection in 7 (5%). In 2 children M. pneumoniae and C. pneumoniae co infection was observed. The average age of the M. pneumoniae cases was 5.3 years and that of the C. pneumoniae was 1.5 years. The average age of pneumonia cases caused by other pathogens was 3.4 years (p<0.05). No significant difference was observed in clinical onset, signs, symptoms and laboratory parameters in children with M. pneumoniae and C. pneumoniae infection and in those without M. pneumoniae and C. pneumoniae infection. The results of this study suggest a remarkable role for M. pneumoniae and C. pneumoniae in childhood community-acquired pneumonia, and the knowledge of the true prevalence of these two types of infections discovered in the community might lead to modifications in the present empirical treatment of bacterial pneumonia.
    Journal of Tropical Pediatrics 07/2006; 52(3):173-8. · 1.01 Impact Factor
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    ABSTRACT: Behçet's disease is a systemic vasculitic disease characterized mainly by recurrent oral and genital aphthous ulcers, uveitis and skin findings. Central nervous system involvement is a serious manifestation. A case of acute meningeal syndrome secondary to Behçet's disease is presented. Behçet's disease should always be considered in differential diagnosis of acute meningeal syndrome without signs of viral infection, particularly in the context of multisystem manifestations.
    The Journal of infection 05/2006; 52(4):e120-3. · 4.13 Impact Factor

Publication Stats

427 Citations
90.27 Total Impact Points

Institutions

  • 2011
    • Istanbul Medical University
      İstanbul, Istanbul, Turkey
  • 1995–2009
    • Istanbul University
      • • Department of Infectious Diseases
      • • Department of Family Medicine (Istanbul Medical Faculty)
      • • Department of Social Pediatrics
      İstanbul, Istanbul, Turkey
  • 1997–1998
    • Istanbul Occupational Diseases Hospital
      İstanbul, Istanbul, Turkey