Publications (23)26.63 Total impact
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Article: The diagnostic and prognostic significance of SCUBE1 levels in Crimean-Congo hemorrhagic fever.
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ABSTRACT: BACKGROUND: The new biochemical marker, signal peptide-CUB-EGF domain-containing protein 1 (SCUBE1), is secreted and cell surface glycoprotein expressed during early embryogenesis. The protein is found in platelet and endothelial cells. Crimean-Congo hemorrhagic fever (CCHF), which is caused by a tick-borne virus belonging to the Bunyaviridae family, may present with a mild clinical course or may exhibit a severe profile with potentially fatal hemorrhaging. The aim of this study was to determine the diagnostic and prognostic significance of SCUBE1 levels in CCHF. METHODS: This study was conducted with patients with CCHF. SCUBE1 levels in patients with CCHF were determined using an ELISA. RESULTS: SCUBE1 titers of CCHF patients were significantly higher compared to those of the control group (p=0.0001). SCUBE1 levels of patients with hemorrhage were significantly higher than those of patients without hemorrhage (p=0.0001). SCUBE1 values of patients who died were significantly higher than those of the survivors (p=0.012). CONCLUSIONS: SCUBE1 levels are a new biomarker that can be used in the differential diagnosis and monitoring of patients hospitalized with suspected CCHF. These levels are also significant as potential predictors of mortality.International journal of infectious diseases: IJID: official publication of the International Society for Infectious Diseases 04/2013; · 2.17 Impact Factor -
Article: Genitourinary infection prevalence among women who used an intrauterine device or oral contraceptives.
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ABSTRACT: PURPOSE: The study aimed at investigating genitourinary infection prevalence among women who used an intrauterine device (IUD) and oral contraceptives (OC) in relation with their socio-demographic characteristics. METHODS: The study was conducted at the Mother and Child Health and Family Planning center between October 2011 and February 2012 and included 81 women who used IUD, 84 who used OC, and 84 who did not use artificial contraceptive methods (coitus interraptus). RESULTS: It was found that there was a difference between the three groups in terms of urinary system infection (X (2) = 9.85, p = 0.000) and genital infection (X (2) = 8.29, p = 0.001). It was also observed that urinary infection was more common in the OC group, whereas genital infection was more common in the IUD group. In urinary culture, it was seen that Enterobacter species was the most common microorganism among the group who used an IUD, while Escherichia coli was the most common microorganism in the group who used OC and the control. In vaginal cultures, Candida albicans was determined to be the first isolated microorganism among the group who used OC, IUD, and the control. CONCLUSION: It is believed that the most significant reason for genitourinary infections among women was inadequate hygiene practices rather than use of different contraception methods.Archives of Gynecology 04/2013; · 0.91 Impact Factor -
Article: Treatment of Gram-positive left-sided infective endocarditis with daptomycin.
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ABSTRACT: The aim of this study was to evaluate the effectiveness of daptomycin in left-sided infective endocarditis (IE) patients. Fourteen patients with left heart endocarditis, monitored with a diagnosis of IE based on modified Duke criteria between July 2010 and May 2011, and receiving daptomycin as monotherapy, were enrolled. The success of daptomycin in these patients was revealed with improvements in microbiological, biochemical, and radiologic findings, as well as physical examination findings. Patient average age was 63.5 ± 14.2 years (36-80 years); 8 (57 %) were men and 6 (43 %) women. The pathogens methicillin-resistant Staphylococcus aureus (71.5 %), Streptococcus mutans (21.5 %), and methicillin-sensitive Staphylococcus aureus (7 %) were isolated from our patients. Daptomycin was used in initial treatment in 5 (36 %) patients; treatment was subsequently modified to daptomycin in 9 (64 %) patients as a consequence of drug serum level insufficiency, agent sensitivity to the drug administered, or drug side effects. Thirteen patients were discharged in a healthy condition, with successful surgical treatment in 5 (36 %). Only 1, an 80-year-old IE patient, was lost from advanced cardiac failure. No significant side effects were seen in any patient receiving daptomycin. The most frequent side effects were minimal rises in serum CPK levels during treatment; these values returned to normal after treatment. Daptomycin can be used successfully in left heart endocarditis with no significant side effects. Studies involving a wider patient series are now needed to support the use of daptomycin in left heart endocarditis.Journal of Infection and Chemotherapy 01/2013; · 1.80 Impact Factor -
Article: Can hantavirus infections be predicted on admission to hospital?
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ABSTRACT: The aim of this study was to investigate the predictive factors which contribute to diagnosis of hantavirus infection. One hundred patients from rural areas hospitalized with a preliminary diagnosis of hantavirus infection from different hospitals in Turkey were investigated. Hantavirus infection was confirmed in 20 patients (Group 1) using immunofluorescence and immunoblot assays at the Refik Saydam National Public Health Agency. Hantaviruses were not detected in the serum of the remaining 80 patients, other infectious and non-infectious diseases being diagnosed in this group (Group 2). Patients' demographic characteristics and clinical and laboratory data on admission were examined and compared between the two groups. Fever, proteinuria, hematuria, lethargy-weakness, and nausea-vomiting were the most frequent symptoms and findings in Group 1, seen in almost all patients. Proteinuria, hematuria, muscle pain, diarrhea/abdominal pain, hypotension, shock, and sweating were observed at significantly higher levels in Group 1 compared to Group 2. Serum urea, creatinine, uric acid, lactate dehydrogenase (LDH), aspartate transaminase (AST), alkaline phosphatase (ALP), and C-reactive protein (CRP) were significantly higher, but serum platelet counts were lower in Group 1 patients. Area beneath the receiver operating characteristics (ROC) curve analysis was used to calculate the discriminative ability of various laboratory values to identify patients with hantavirus infection. This analysis revealed that, serum CRP had a 100% negative predictive value, whilst, platelet, and creatinine had 75% and 70% positive predictive values for the diagnosis of hantavirus infection. In summary, laboratory markers used in clinical practice are of great importance predicting hantavirus infections. J. Med. Virol. 84:1790-1796, 2012. © 2012 Wiley Periodicals, Inc.Journal of Medical Virology 11/2012; 84(11):1790-6. · 2.82 Impact Factor -
Article: The diagnostic and prognostic significance of soluble urokinase plasminogen activator receptor in systemic inflammatory response syndrome.
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ABSTRACT: This study was intended to investigate the value of suPAR, C-reactive protein (CRP) and procalcitonin (PCT) in the determination and prognosis of systemic inflammatory response syndrome (SIRS) patients. The study was performed among patients with at least two SIRS criteria. PCT, CRP and suPAR were analyzed from the blood specimens taken. Eighty-five patients were enrolled in the SIRS group (44 bacteremia, 20 urinary tract infection, 12 pneumonia and 9 non-infection), and 53 individuals in the control group. A significant correlation was determined between suPAR, PCT and CRP values in both groups (P<0.0001). A suPAR cutoff value of 2.8ng/mL was associated with an NPV of 87% and PPV of 91%, with 92% sensitivity and 85% specificity. A relatively high suPAR level that might predict fatality was also determined in fatal cases (P=0.001). suPAR possesses high sensitivity and specificity levels in terms of differential diagnosis, and high suPAR levels can predict fatality.Clinical biochemistry 07/2011; 44(14-15):1227-30. · 2.02 Impact Factor -
Article: [Fatal sino-orbital aspergillosis in an immunocompetent case].
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ABSTRACT: The paranasal sinus infections caused by Aspergillus spp. are usually presented clinically with mild symptoms, however they may lead to invasive disease and mortality especially in immunocompromised individuals. In this report a fatal case of sino-orbital aspergillosis developed in an immunocompetent patient has been presented. Seventy-four years old female patient was admitted to the hospital with the complaints of fever and progressively increasing headache that continued for 15 days. Due to the development of nausea, vomiting, loss of consciousness and stiff neck in the following days, cerebrospinal fluid (CSF) sample was obtained. Direct microscopic examination of the Gram and acidfast staining of the CSF sample revealed no microorganisms, no growth was detected in CSF culture and PCR amplification was negative for Herpes simplex virus and Mycobacterium tuberculosis. Since no response was achieved by empirical ceftriaxone, ampicillin and conventional anti-tuberculosis treatment and tachypnea, proptosis and progressive respiratory failure developed in the patient, she was transferred to the intensive care unit. The radiological examination revealed soft tissue lesion filling the sphenoid sinus, extending to the nasal cavity and suprasellar cistern, destruction of bones, dilated orbital vein, cavernous sinus thrombosis and infarction on left cerebral peduncule. Patient was operated and pus and fungus ball were aspirated from the openings of both sphenoid sinuses. Gomori methenamine silver, periodic acid-Schiff and haematoxylin-eosine staining of the operational material exhibited dichotomously branching hyphae. The patient was diagnosed as invasive sino-orbital aspergillosis based on the clinical, radiological and histopathological findings. Despite antifungal therapy and surgical debridement, the patient died. It should always be kept in mind that aspergillosis can develop in immuncompetent individuals. Delay in diagnosis and treatment may lead to fatality. Thus multidiciplinary approach is necessary for early diagnosis and successful treatment of aspergillus infections.Mikrobiyoloji bülteni 07/2011; 45(3):546-52. · 0.40 Impact Factor -
Article: [Comparative evaluation of in vitro activities of carbapenems against gram-negative pathogens: Turkish data of COMPACT study].
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ABSTRACT: The aim of this study was to determine the in vitro activities of doripenem, imipenem, and meropenem against clinical gram-negative isolates. A total of 596 clinical isolates were obtained from intensive care unit (ICU) and non-ICU patients in 10 centers over Turkey between September-December 2008. The origin of the isolates was patients with nosocomial pneumonia (42.4%), bloodstream infections (%40.4), and complicated intraabdominal infections (17.1%). Of the isolates, 51.8% were obtained from ICU patients. The study isolates consisted of Pseudomonas spp. in 49.8%, Enterobacteriaceae in 40.3%, and other gram-negative agents in 9.9%. The minimum inhibitory concentrations (MIC) for doripenem, imipenem and meropenem were determined for all isolates in each center using Etest® strips (AB Biodisk, Solna, Sweden). Of the isolates, 188 (31.5%) were resistant to at least one of the carbapenems. MIC50 of doripenem against Pseudomonas spp. Was 1 mg/L which was similar to that of meropenem and two-fold lower than imipenem. Susceptibility to carbapenems in P.aeruginosa was 64% for doripenem at an MIC level of 2 mg/L, 53.9% and 63% for imipenem and meropenem at an MIC level of 4 mg/L, respectively. Doripenem and meropenem showed similar activity with the MIC90 of 0.12 mg/L whereas imipenem was four-fold less active at 0.5 mg/L. Against other gramnegative pathogens, mostly Acinetobacter spp., MIC50 was 8 mg/L for doripenem and 32 mg/L for other two carbapenems. P.aeruginosa isolates were inhibited 84.2% with doripenem and 72.1% with meropenem at the MIC level of 8 mg/L. Doripenem generally showed similar or slightly better activity than meropenem and better activity than imipenem against pathogens collected in this study. Against Pseudomonas spp., doripenem was the most active of the three carbapenems. Doripenem and meropenem were equally active against Enterobacteriaceae and at least four-fold more active than imipenem. It was concluded that doripenem seemed to be a promising agent in the treatment of nosocomial pneumonia, blood stream infections and intraabdominal infections particularly in patients who were under risk of developing antimicrobial resistance.Mikrobiyoloji bülteni 04/2011; 45(2):197-209. · 0.40 Impact Factor -
Article: [Urogenital myiasis caused by Psychoda albipennis].
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ABSTRACT: Myiasis is a cause of urogenital parasitosis. In this study, a 29 year-old male patient who was admitted to our hospital with urinary discharge of worms has been presented. Larvae were examined parasitologically and urogenital myiasis caused by Psychoda albipennis larvae was diagnosed. No other pathological findings were detected in the patient and the symptoms resolved spontaneously within a few days. Despite the fact that urinary myiasis is very rare in humans, it should be considered in patients with urinary complaints. Apparently, a quick recovery without treatment is possible in most cases.Turkiye parazitolojii dergisi / Turkiye Parazitoloji Dernegi = Acta parasitologica Turcica / Turkish Society for Parasitology 01/2011; 35(3):172-4. -
Article: The first Crimean-Congo hemorrhagic fever case in the winter season from Turkey.
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ABSTRACT: Turkey is one of the countries in which Crimean-Congo hemorrhagic fever is frequently seen and most of the cases are reported between April and August. We describe the first case of Crimean-Congo hemorrhagic fever in the winter season, when Hyalomma tick activity is absent, from Turkey.Intervirology 01/2011; 54(3):144-5. · 2.34 Impact Factor -
Article: [Hantavirus infection: two case reports from a province in the Eastern Black Sea Region, Turkey].
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ABSTRACT: Hantaviruses which are the members of Bunyaviridae, differ from other members of this family since they are transmitted to humans by rodents. More than 200.000 cases of hantavirus infections are reported annually worldwide. Hantaviruses can lead to two different types of infection in humans, namely, hemorrhagic fever with renal syndrome (HFRS) and hantavirus pulmonary syndrome (HPS). HFRS is the most common type of hantavirus infection in Europe and Asia and the most common virus types are Dobrava, Puumala, Hantaan and Seoul. A total of 25 hantavirus suspected cases have been reported from the Western Black Sea region of Turkey and 12 of these were confirmed serologically as "Puumala" subtype. Serological tests such as indirect immunofluorescence assay (IFA), are used for diagnosis and typing of the hantaviruses, however, since cross-reactions are common between the subtypes, the results of these tests should be confirmed by other methods. In this report two cases with hantavirus infection defined serologically were presented. Two male patients, 55 and 50 years old, respectively, living in Giresun province of Eastern Black Sea region, Turkey, were admitted to the State Hospital with the complaints of fever, sweating and diarrhoea without blood or mucus. Since thrombocytopenia and renal failure were detected in these two cases, they were transferred to the University Hospital. Presence of fever, thrombocytopenia and renal failure, with no laboratory findings of a bacterial infection and no growth of microoorganisms in the clinical specimens, admittance of the patients during summer and history of being present in the fields, necessitated to rule out leptospirosis, Crimean Kongo hemorrhagic fever and hantavirus infection which were all endemic in our area. Further investigation of the serum samples at the National Reference Virology Laboratory by IFA (Hantavirus Mosaic-1, Euroimmun, Germany) revealed hantavirus IgM and IgG antibodies ≥ 1:100 titer and the results were confirmed by immunoblot test (Hantavirus Profile 1 EUROLINE IgG and IgM, Euroimmun, Germany). Hantavirus Dobrava subtype was determined in both of the cases. Reverse transcriptase real-time PCR (Hantavirus Renal Syndrome General-type I&II Real Time RT-PCR; Shanghai ZJ Bio-Tech, China) revealed negative result. The first case was discharged with complete cure, however, the second case died. These cases which were the first cases from the Eastern Black Sea Region emphasized that hantavirus infections should be taken into consideration in patients presenting with fever, thrombocytopenia and renal function disturbance.Mikrobiyoloji bülteni 07/2010; 44(3):479-87. · 0.40 Impact Factor -
Article: Etiological agents of community-acquired pneumonia in adult patients in Turkey; a multicentric, cross-sectional study.
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ABSTRACT: This cross-sectional study was intended to investigate the etiology of community-acquired pneumonia (CAP) in adult patients receiving no prior antibiotic therapy. Etiological agents were identified in 137 (62.8%) of 218 patients, the most frequent being Streptococcus pneumoniae (14.7%), Mycoplasma pneumoniae (13.8%) and respiratory syncytial virus (10.1%). A single pathogen was detected in 50.9% of cases and mixed pathogens in 11.9%. Typical pathogens were determined in 35.8% of cases, atypical pathogens in 20.2% and viral pathogens in 20.6%. Chronic obstructive pulmonary disease was a common (42.7%) comorbidity. S. pneumoniae was the most common pathogen in adult patients with CAP. Atypical pathogens were more common in patients < 65 years old, M. pneumoniae being the most common in this age group. Our results suggest that initial empiric antibiotic treatment in patients with CAP should cover S. pneumoniae and M. pneumoniae in Turkey.Tuberkuloz ve toraks 01/2010; 58(2):119-27. -
Article: Incidence and risk factors for bloodstream infections stemming from temporary hemodialysis catheters
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ABSTRACT: Aim: Catheter-related bloodstream infection (CR-BSI) is considered as an important complication of hemodialysis catheters. The purpose of this prospective study was to evaluate the incidence and risk factors of temporary hemodialysis catheter-related bloodstream infection. Materials and methods: Prospective data related to temporary hemodialysis catheters inserted in our institution were collected for duration of three years. The risk factors of CR-BSI of patients between the CR-BSI group and the control group were compared. Results: A total of 248 temporary hemodialysis catheters were inserted in 201 patients and remained in situ for a cumulative total of 5192 catheter days. There were 3254 dialysis sessions. CR-BSI was found in 63 cases. CR-BSI rate was 12.1/1000 catheter-days and 19.4/1000 dialysis sessions. In multivariate analysis, acute renal disease (OR = 2.29), administration of antibiotics at the time of catheterization (OR = 2.09), insertion in the femoral vein (OR = 2.14), emergency situation for catheter insertion (OR = 2.41), high number of catheter manipulation (OR = 2.49), and inadequate hand hygiene prior to catheter manipulations (OR = 3.02) were found to be risk factors of CR-BSI. The most frequently isolated microorganisms were coagulase-negative staphylococci (31.3%), S. aureus (26.9%), Enterococcus spp. (10.4%), and Pseudomonas aeruginosa (9.0%). Conclusion: This prospective study of temporary hemodialysis catheters has shown high rates of infectious complications. The education of both the patients and medical staff in prevention of CR-BSI is important. Geçici hemodiyaliz kateterlerinden kaynaklanan kan dolaşımı infeksiyonlarının risk faktörleri ve insidansı Amaç: Kateter ilişkili kan dolaşımı infeksiyonu (KİKDİ) hemodiyaliz kateterlerinin önemli komplikasyonu olarak sayılmaktadır. Bu prospektif çalışmanın amacı geçici hemodiyaliz kateterleri ile ilişkikili kan dolaşımı infeksiyonlarının risk faktörleri ve insidansını değerlendirmektir. Yöntem ve gereç: Kurumumuzda takılan geçici hemodiyaliz kateterleri ile ilişkili prospektif bilgiler üç yıllık sürede toplandı. KİKDİ risk faktörleri gelişen grup ve kontrol grubunda karşılaştırıldı. Bulgular: İkiyüzbir hastaya toplam 248 geçici hemodiyaliz kateteri takıldı ve 5192 kateter günü takip edildi. Hastalara 3254 dializ seansı uygulandı. Atmışüç vakada KİKDİ tespit edildi. KİKDİ hızı 12.1/1000 kateter günü ve 19.4/1000 dializ seansı idi. Çok değişkenli analizde akut böbrek yetmezliği (OR = 2,29), kateterizasyon sırasında antibiyotik alıyor olma (OR = 2.09), kateterin femoral vene takılması (OR = 2.14), acil şartlarda kateter takılması (OR = 2.41), yüksek sayıda kateter manüplasyonu (OR = 2.49) ve kateter manüplasyonu öncesi yetersiz el hijyeni (OR = 3.02) KİKDİ risk faktörleri olarak bulundu. En sık izole edilen mikroorganizmalar coagulase-negative staphylococci (% 31,3), S. aureus (% 26,9), Enterococcus spp. (% 10,4) ve Pseudomonas aeruginosa (% 9) idi.835 Turk J Med Sci. 01/2010; -
Article: Suitable Empiric Antibiotic Therapy Saves Life in Nosocomial Pneumonia Caused by Stenotrophomonas maltophilia
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ABSTRACT: Aim: Stenotrophomonas maltophilia is a nosocomial pathogen of increasing importance. Empiric antibiotic therapy for S. maltophilia infection is difficult because the microorganism is resistant to a number of agents typically used for health care associated infections, thus potentially increasing mortality. This study investigates 23 nosocomial pneumonia cases caused by S. maltophilia, the antibacterial sensitivity of the bacterium and the effect on mortality of suitable empiric therapy. Materials and methods: Twenty-three patients with nosocomial pneumonia caused by S. maltophilia between January 2000 and December 2006 at the Karadeniz Technical University Hospital were retrospectively investigated. Results: Suitable empiric therapy was used with 12 patients (52.2%), but the therapies administered to the other 11 patients were inappropriate for S. maltophilia infection. Eight (72.7%) of the patients who were not given suitable empiric antibiotherapy died (P = 0.002). Conclusion: The appropriate empiric antibiotic was administered to only 12 of the patients. The mortality rate among those patients to whom appropriate empiric antibiotics were not administered was high, proving that suitable empiric therapy is vitally important. Due to the increase in mortality, it is essential to initiate appropriate empiric therapy by carefully evaluating the risk factors for S. maltophilia in nosocomial pneumonia and taking sputum and bronchoalveolar lavage specimens without delay. S. maltophilia'nın neden olduğu hastane kaynaklı pnömonide uygun ampirik antibiyotik tedavisi yaşam kurtarır Amaç: Stenotrophomonas maltophilia önemi giderek artan bir hastane patojenidir. S. maltophilia infeksiyonunda ampirik antibiyotik tedavisi zordur. Bu mikroorganizma sağlık bakımı ile ilişkili infeksiyonlarda kullanılan çok sayıda ajana dirençlidir ve bu nedenle de mortalite artmaktadır. Bu çalışma S. maltophilia'nın neden olduğu 23 hastane kaynaklı pnömoni vakasını, bakterinin antibakteriyel duyarlılığını ve uygun ampirik tedavinin mortalite üzerine etkisini incelemektedir. Yöntem ve gereç: Karadeniz Teknik Üniversitesi Hastanesinde Ocak 2000 ve Aralık 2006 tarihleri arasında S. maltophilia'nın neden olduğu 23 hastane kaynaklı pnömoni hastası retrospektif olarak değerlendirildi. Bulgular: Uygun ampirik tedavi 12 (% 52,2) hastaya uygulandı. Diğer 11 hasta için uygulanan tedavi S. maltophilia infeksiyonu için uygun değildi. Uygun ampirik antibiyoterapi almayan hastaların sekizi (% 72,7) öldü (P = 0,002). Sonuç: Uygun ampirik antibiyotik yalnız 12 hastaya uygulandı. Uygun ampirik antibiyotik uygulanmayan bu hastalar arasında mortalite oranı yüksekti. Bu da uygun ampirik tedavinin hayati önemli olduğunun kanıtıdır. Mortalitedeki yükseklik nedeniyle hastane kaynaklı pnömonide balgam ve bronkoalveolar lavaj örneği gecikme olmaksızın alınarak ve S. maltophilia için risk faktörleri dikkatlice değerlendirilerek uygun ampirik tedavinin başlanması gereklidir.Turk J Med Sci. 01/2010; 40:99-103. -
Article: Crimean-Congo hemorrhagic fever cases in the eastern Black Sea Region of Turkey: demographic, geographic, climatic, and clinical characteristics
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ABSTRACT: Aim: Crimean–Congo hemorrhagic fever (CCHF) is a disease that is known since 1944 affecting many people across the world and causing a high mortality rate. The aim of this study was to determine the epidemiological and clinical characteristics of the CCHF cases in our region. Materials and methods: The present study was conducted in patients with CCHF who were hospitalized between 2004 and 2006 at Karadeniz Technical University. Demographic, geographic, climatic, and clinical characteristics of all patients were investigated. Results: A total of 102 patients with confirmed CCHF were investigated in this study. All of the patients were from rural areas. Eighty-seven patients (85.2%) were livestock workers. None of the cases was from the region where mountain range faced the sea and all cases were from areas of Harşit, Kelkit, and Çoruh valleys situated at 1100-2265 m above sea level where the mountain ranges ceased to separate the sea and inner regions and streams reached the sea. Conclusion: CCHF case series have been reported from Turkey as well and particularly Middle Anatolia and northeastern regions have been determined as endemic areas recently. Population of those regions mostly earns their life from livestock breeding and agriculture, which increases the risk of exposure to ticks and development of CCHF. Therefore, especially in cases coming from regions categorized as endemic, it has been concluded that mortality can be reduced by carefully taken medical history and practice of rapid medical treatment and replacement therapies in consideration of CCHF pre-diagnosis. Türkiye'nin Doğu Karadeniz bölgesindeki kırım-kongo kanamalı ateş vakaları: demografik, coğrafik, iklimsel ve klinik özellikler Amaç: Kırım-Kongo Kanamalı Ateşi (KKKA) 1944 yılından beri bilinen, dünyada birçok insanı etkileyen ve mortalite oranı yüksek olan bir hastalıktır. Bu çalışmanın amacı bölgemizdeki KKKA olgularının epidemiyolojik ve klinik özelliklerini belirlemekti. Yöntem ve gereç: Sunulan çalışma Karadeniz Teknik Üniversitesinde 2004-2006 yılları arasında hastanede yatırılan KKKA'lı hastalarda yapıldı. Hastaların demografik, coğrafik, iklimsel ve klinik özellikleri incelendi. Bulgular: Bu çalışmada KKKA'li toplam 102 hasta incelendi. Hastaların hepsi kırsal kesimde yaşıyor ve %85.2'si hayvancılık yapıyordu. Hiçbir vaka sıradağların denize bakan yüzeyindeki bölgeden olmayıp, vakaların deniz ile iç bölgeleri ayıran sıradağların kesildiği ve akarsuların denize ulaştığı Harşit, Kelkit ve Çoruh Vadileri'ndeki denizden yükseklikleri 1100-2265 m arasındaki yerleşim alanlarından geldiği tespit edildi.829 Turk J Med Sci. 01/2010; -
Article: [A case of Brucella prostatitis misdiagnosed as prostate carcinoma].
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ABSTRACT: Brucellosis is a major public health problem in Turkey and all over the world. Joint pain, night sweats, anorexia, weakness, loss of weight and headache are the basic symptoms of brucellosis and the illness can affect many organs. Genitourinary involvement is reported in 2-20% of cases, epididimoorchitis being the most frequent complication, however, prostatic involvement is far more uncommon. In this paper, a case of Brucella prostatitis misdiagnosed as prostate carcinoma has been presented. A 50-years-old man who was a microbiology laboratory staff has been admitted to our outpatient clinic with the complaints of joint pain, weakness, fever, urgency, difficulty and pain during urination. Since prostate specific antigen (PSA) was 23.6 ng/ml (normal value < 4 ng/ml) and free PSA (fPSA) was 3.89 ng/ml (normal value < 1 ng/ml), needle biopsy from the prostate was performed. Blood cultures performed by BACTEC 9200 (Becton Dickinson, Sparks, Md.) system yielded Brucella melitensis, and the pathological examination of the prostate biopsy revealed prostatic hyperplasia and prostatitis. Brucella standard tube agglutination titer was 1/320. Upon the diagnosis of Brucella prostatitis the patient was treated with a combination of 200 mg doxycycline and 600 mg rifampicin daily for 6 months. During the follow-up period no complication was detected in the patient and the PSA level decreased to 1.57 ng/ml and fPSA to 0.43 ng/ml. This case was reported to withdraw attention to prostatic involvement during brucellosis. Elevated PSA values with the signs and symptoms of brucellosis in endemic areas should be evaluated accordingly and appropriate therapy should be initiated without any delay.Mikrobiyoloji bülteni 07/2009; 43(3):493-7. · 0.40 Impact Factor -
Article: A survey of antibiotic resistance in Streptococcus pneumoniae and Haemophilus influenzae in Turkey, 2004 2005.
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ABSTRACT: To determine the prevalence of antimicrobial resistance among Streptococcus pneumoniae and Haemophilus influenzae isolated in Turkey as part of Survey Of Antibiotic Resistance, a surveillance programme in the Africa and Middle East region examining the antimicrobial susceptibility of key bacterial pathogens involved in community-acquired respiratory tract infections (CARTIs). Susceptibility was evaluated against a range of antimicrobial agents using disc diffusion and Etest methods. Six centres in five cities collected 301 S. pneumoniae and 379 H. influenzae isolates between October 2004 and November 2005. Among S. pneumoniae, the prevalence of isolates with intermediate susceptibility (MICs 0.12-1 mg/L) and resistance to penicillin (MICs >or=2 mg/L) was 24.6% and 7.6%, respectively; there was a wide variation between cities (2.4% to 36.9% intermediate and 0% to 23.8% resistant phenotypes). Macrolide-azalide resistance rates exceeded those of penicillin resistance in all cities. Overall, 5.0% of isolates were co-resistant to penicillin and erythromycin and 10.0% were multidrug-resistant (joint resistance to erythromycin, co-trimoxazole and tetracycline). Agents tested to which over 90% of countrywide S. pneumoniae isolates remained susceptible were amoxicillin/clavulanate (98.7%), chloramphenicol (94.7%) and cefprozil (90.6%). Overall, the percentage of H. influenzae isolates producing beta-lactamase was 5.5%, differing widely across the country with the highest prevalence of beta-lactamase production detected in Trabzon (14.0%) and no beta-lactamase-positive isolates found in Izmir. H. influenzae had the highest per cent susceptibility to amoxicillin/clavulanate (99.5%) and ofloxacin (99.2%) while >20% were resistant to co-trimoxazole. Prevalence of penicillin and macrolide-azalide resistance among S. pneumoniae appears to be on the increase in Turkey while overall beta-lactamase production in H. influenzae remains relatively low. To adequately monitor the spread of drug-resistant phenotypes among these two important CARTI pathogens, ongoing collection of resistance surveillance data is required-where possible locally as resistance patterns can vary substantially between cities and institutions.Journal of Antimicrobial Chemotherapy 09/2007; 60(3):587-93. · 5.07 Impact Factor -
Article: [Isolation of Brucella melitensis from ejaculate culture of a brucellosis patient with epididymoorchitis].
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ABSTRACT: Brucellosis is a significant public health problem particularly in developing countries. People are frequently infected through milk, milk products, urine and pregnancy material of animals with brucellosis. Epididymoorchitis is the most frequent genitourinary complication of brucellosis and is often unilateral. In this report, a 35 years old male patient who was diagnosed as epididymoorchitis based on clinical presentation, laboratory findings and imaging techniques, has been presented. Brucella melitensis was isolated from blood, bone marrow and ejaculate cultures of the patient. The patient was treated with rifampicine and doxycycline combination therapy for six weeks and no complication has developed in the one year follow-up period. In areas where brucellosis is endemic, such as our country, Brucella infection should be considered in the differential diagnosis of epididymoorchitis and in addition to blood and bone marrow cultures, ejaculate cultures should also be evaluated.Mikrobiyoloji bülteni 08/2007; 41(3):465-8. · 0.40 Impact Factor -
Article: [Liver abscess and infective endocarditis cases caused by Ruminococcus productus].
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ABSTRACT: The genus Ruminococcus which are anaerobe Gram positive cocci, previously classified as Peptostreptococcus, may colonize the upper respiratory tract, gastrointestinal tract, vagina and skin of humans and animals. In this report a case of liver abscess and a case of infective endocarditis caused by Ruminoccocus productus, which is very rarely encountered in the clinical practice were presented. The first case was a 32 years old male who was admitted to the hospital in 2002, with the complaints of fever lasting for 20 days and pain while breathing. The abdominal ultrasonography revealed the presence of a liver abscess, and the drainage material from the abscess yielded Ruminococcus productus, identified in BACTEC 9200 (Becton Dickinson, Sparks, Md) anaerobe system. As the isolate was found to be sensitive to penicilin, the empirical gentamicin and ampicillin/sulbactam therapy was continued. The second case was a 25 years old male who was admitted to the hospital in 2005, with the signs of fever lasting for 3-4 months, chills, bone and joint pains. As multiple vegetations were detected in echocardiography, blood cultures were collected and empirical therapy with ceftriaxone and gentamicin was initiated with the preliminary diagnosis of infective endocarditis. Bacteria which were isolated from blood cultures by BACTEC 9200 system have been identified as R. productus. As this strain was also sensitive to penicillin, the empirical therapy was changed to penicilin and gentamicin. These two cases indicated that R. productus should be considered in complicated infections even if it is a rarely isolated species from the clinical samples.Mikrobiyoloji bülteni 11/2006; 40(4):389-95. · 0.40 Impact Factor -
Article: [Prospective evaluation of blood cultures in Medical Faculty Hospital of Blacksea Technical University].
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ABSTRACT: In this study, the rate of blood culture contamination, bacterial pathogens and their antimicrobial susceptibilities causing nosocomial and community acquired bloodstream infections were investigated prospectively during the period February 2003 to February 2004. In the study period, among the 5994 blood culture samples obtained from 3114 patients, 1091 (18%) yielded positive results. Seventy-four of them (1.2%) were evaluated as false positive, 514 (9%) were pseudobacteremia or contamination. According to patients' clinical features, 503 (8%) blood culture samples were associated with blood stream infections, and 358 of them (71%) were primary episodes. Twohundred and ninetyfour of primary episodes (82%) were hospital acquired and 64 were community acquired bloodstream infections. Staphylococcus aureus was the most frequently isolated agent in the hospital and community acquired bloodstream infections at the rates of 16% and 20%, respectively. In hospital acquired blood stream infections, Escherichia coil (9%) and Pseudomonas aeruginosa (8%); in community acquired bloodstream infections Streptococcus spp (17%) and E. coli (15%) were the other most frequently isolated bacterial agents. Methicillin resistance of S. aureus isolates was determined as 54% in hospital acquired blood stream infections and 25% in community acquired blood stream infections.Mikrobiyoloji bülteni 11/2005; 39(4):455-64. · 0.40 Impact Factor -
Article: [Salmonella enterica serotypes and Salmonella infections: a multicenter study covering ten provinces in Turkey].
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ABSTRACT: In order to find the distinctive features of Salmonellae and Salmonella infections in Turkey, 620 Salmonellae strains, isolated from various clinical samples (481 stool, 108 blood, 12 urine, 3 bone marrow, 3 cerebrospinal fluid, 9 pus, and one from each of the bile, pleural fluid, wound, catheter samples) in 13 clinical microbiology laboratories of 10 provinces in Turkey (Ankara, Antalya, Bursa, Edirne, Eskişehir, Istanbul, Izmir, Kayseri, Konya and Trabzon) between July 1, 2000 and June 30, 2002, were serotyped. Among the patients 43% were female, 57% were male, 63.2% were from outpatient clinics and 36.8% were hospitalized patients. Seventy eight percent of the patients had gastroenteritis, 10.7% had septicemia/local infection, 9.8% had typhoid/paratyphoid fever and 1.5% were carriers. Incidence of gastroenteritis was higher in 0-5 years age group (p<0.001). Of the 620 Salmonella enterica isolates, 47.7% were S. Enteritidis, 34.7% S. Typhimurium, 6% S. Paratyphi B, 2.9% S. Typhi, 0.2% S. paratyphi A, 6.1% serogroup C1, and 2.4% serogroup C2. S. Enteritidis was the most common serotype in all provinces except for Kayseri, where S. Typhimurium was found to be the most common serotype (68.2%). Overall, the most frequently isolated serotype was S. Enteritidis, also being the most common serotype in stool and blood cultures. During the surveillance period two outbreaks have occurred, the first one by S. Enteritidis strains in Edirne, and the second one by S. Typhimurium strains in Kayseri. As a result, Salmonella infections are still a common health problem in Turkey, and active surveillance of Salmonella infections has vital importance.Mikrobiyoloji bülteni 08/2004; 38(3):173-86. · 0.40 Impact Factor
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2012
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Karadeniz Technical University
Trabzon, Trabzon, Turkey
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2002
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Kirikkale University
- Department of Infectious Diseases and Clinical Microbiology
Kırıkkale, Kirikkale, Turkey
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