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Browsing by Author "Asan, Ali"

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    Changes in Antimicrobial Resistance and Outcomes of Health Care-Associated Infections
    (2021) Aydin, Mehtap; Azak, Emel; Bilgin, Huseyin; Menekse, Sirin; Asan, Ali; Mert, Habibe Tulin Elmaslar Habibe Tulin Elmaslar; Yulugkural, Zerrin; Altunal, Lutfiye Nilsun; Hatipoglu, Cigdem Ataman; Ertem, Gunay Tuncer; Altunok, Elif Sargin; Demirkaya, Melike Hamiyet; Ceviker, Sevil Alkan Sevil Alkan; Akgul, Fethiye; Memis, Zeynep; Konya, Petek; Azap, Alpay; Aydin, Gule; Korkmaz, Derya; Karakoc, Zehra Cagla; Yapar, Derya; Karakecili, Faruk; Gunal, Ozgur; Keske, Siran; Kapmaz, Mahir; Kader, Cigdem; Demirel, Aslihan; Ergonul, Onder; 33586014
    To describe the change in the epidemiology of health care-associated infections (HAI), resistance and predictors of fatality we conducted a nationwide study in 24 hospitals between 2015 and 2018. The 30-day fatality rate was 22% in 2015 and increased to 25% in 2018. In BSI, a significant increasing trend was observed for Candida and Enterococcus. The highest rate of 30-day fatality was detected among the patients with pneumonia (32%). In pneumonia, Pseudomonas infections increased in 2018. Colistin resistance increased and significantly associated with 30-day fatality in Pseudomonas infections. Among S. aureus methicillin, resistance increased from 31 to 41%.
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    Factors Affecting Responsiveness to Hepatitis B Immunization in Dialysis Patients
    (2017) Asan, Ali; Demirhan, Huriye; Sorkun, Hulya Cetin; Ozkan, Sevgi; Aydin, Mehtap; Akin, Davut; Tatar, Bengu; Catak, Binali; Sener, Alper; Kose, Sukran; https://orcid.org/0000-0003-4044-9366; 28620716; HLX-0937-2023
    Hepatitis B virus (HBV) and hepatitis C virus (HCV) infections are widespread health problems all over the world and have high morbidity and mortality. Hemodialysis patients are more frequently exposed to these viruses as they have poor immune system and frequently undergo parenteral interventions. The vaccination against HBV prevents infection and it has been recommended for the prevention of HBV infection in all susceptible dialysis patients. This study aimed to determine the seroprevalence of HBV and HCV infections and analyzed the factors affecting inadequate response to HBV vaccine in dialysis patients. The data for 584 dialysis patients that were followed up at seven dialysis centers were analyzed. The patients received four doses of 40 mu g recombinant hepatitis B vaccine at 0, 1, 2, and 6 months and were tested for anti-HBs titer after one month of completion of vaccination. If patients showed a titer of anti-HBs < 10 IU/mL, an additional 40 mu g in four vaccine doses was administered immediately and they were retested for the anti-HBs following the same schedule. The patients were divided into two groups: responders and non-responders. HBsAg and anti-HCV seroprevalence was 3.4% and 10.3%, respectively. After vaccination schedule, 264 (83.5%) patients had antibody response to HBV vaccine and 52 (16.5%) had no response. Hepatitis B vaccine unresponsiveness is more common in the patients with hepatitis C positivity (p = 0.011), BMI > 30 (p = 0.019), over the age of 65 years (p = 0.009), and duration of dialysis treatment > 5 years (p = 0.001). There was no statistically significant difference between gender, causes of renal disease, erythropoietin treatment, and the type of dialysis. Hepatitis C infection, obesity, being elderly, and having long hemodialysis period reduced the hepatitis B vaccination response in hemodialysis patients.
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    The Impact of Vaccination Among Hospitalized Patients with the Diagnosis of COVID-19
    (2023) Yildiz, Yesim; Ozger, Hasan Selcuk; Acar, Ali; Seremet-Keskin, Aysegul; Binay, Umut Devrim; Unlu, Gulten; Bayram, Halim; Asan, Ali; Akca, Mustafa Ozgur; Karamanlioglu, Dilek; Inan, Osman; Kaya, Safak; Yildirim, Cigdem; Arslan, Yusuf; Komur, Suheyla; Saygideger, Yasemin; Kandemir, Fatma Ozlem; Yasar, Simge; Akdemir-Kalkan, Irem; Tekin-Tas, Zeynep; Sakiz, Ayse; Bayindir, Yasar; Ozer, Ayse Belin; Mete, Ayse Ozlem; Erol, Cigdem; Mermutluoglu, Cigdem; Kadiroglu, Ali Kemal; Azap, Alpay; Senol, Esin
    Objective: We aimed to investigate the vaccination status and the risk factors for the intensive care unit (ICU) support need of the laboratory -confirmed breakthrough COVID-19 infection inpatients. Materials and Methods: This multi -center point -prevalence study was conducted on inpatients, divided into two groups as 'fully' and 'partially' vaccinated according to COVID-19 vaccination status. Results: Totally 516 patients were included in the study. The median age was 65 (55-77), and 53.5% (n=276) of the patients were male. Hypertension (41.9%, n=216), diabetes mellitus (DM) (31.8%, n=164), and coronary artery disease (CAD) (16.3%, n=84) were the predominant comorbidities. Patients were divided into two groups ICU (n=196) and non -ICU (n=301). Hypertension (p=0.026), DM (p=0.048), and congestive heart failure (CHF) (p=0.005) were significantly higher in ICU patients and the median age was younger among non -ICU patients (p=0.033). Of patients, 16.9% (n=87) were fully vaccinated, and this group's need for ICU support was statistically significantly lower (p=0.021). Conclusion: We conclude that older age, hypertension, DM, CHF, and being partially vaccinated were associated with the need for ICU support. Therefore, all countries should continuously monitor post -vaccination breakthrough COVID-19 infections to determine the national booster vaccine administration approach that will provide vulnerable individuals the highest protection. Corresponding Yesim ysmyldz6@gmail.com Accepted: Suggested Yildiz Seremet-Keskin Study Society and
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    Molecular Characterization of Drug Resistance in Hepatitis B Viruses Isolated from Patients with Chronical Infection in Turkey
    (2018) Aydin, Mehtap; Asan, Ali; Sayan, Murat; Akhan, Sila; Koruk, Suda Tekin; Aygen, Bilgehan; Sirmatel, Fatma; Eraksoy, Haluk; Tuna, Nazan; Kose, Sukran; Kaya, Ali; Tulek, Necla Eren; Demir, Nazlim Aktug; Mistik, Resit; Ormen, Bahar; Korkmaz, Fatime; Yildirmak, Taner; Ural, Onur; Turgut, Huseyin; Gunal, Ozgur; Demirtuk, Nese
    Background: Hepatitis B virus (HBV) has a high mutation rate due to its unusual replication strategy leading to the production of a large number of virions with single and double mutations. The mutations, in turn, are associated with the development of drug resistance to nucleos(t)ide analogs (NUCs) in patients before and during NUCs therapy. Objectives: The current study aimed at investigating the molecular characterization of HBV in Turkish patients with chronic hepatitis B (CHB) infection. Methods: Polymerase chain reaction (PCR) amplification and direct sequencing procedures were used to analyze mutations. The detected drug resistance mutations were divided into the nucleos(t) ide analogs primary, partial, and compensatory resistance groups. The amino acid substitutions of hepatitis B surface antigen (HBsAg) were categorized into antiviral drug - associated potential vaccine-escape mutations (ADAPVEMs) and typical HBsAg amino acid substitutions, which included hepatitis B hyperimmunoglobulin (HBIg) - selected escape mutation, vaccine escape mutation, hepatitis B misdiagnosis, and immune - selected amino acid substitutions. Results: The number of patients included in the study was 528 out of which 271 (51.3%) were treatment - naive and 351 (66.3%) were hepatitis B e antigen (HBeAg) - negative. Moreover, 325 (61.6%) were males with a mean age of 38 years (range: 18 - 69). Primary, partial, and compensatory resistance to NUCs was reported in 174 (32.9%) patients. Six different ADAPVEM motifs were determined in both treatment - naive and treatment - experienced patients, namely, sF161L/rtI169X, sE164D/rtV173L, sL172L/rtA181T, sL173F/rtA181V, sS195M/rtM204V, and sS196L/rtM204I. The prevalence of ADAPVEMs and typical HBsAg escape mutations was 5.3% (n = 28) and 34.8% (n = 184), respectively. Conclusions: The analysis of drug resistance should constitute a fundamental part of the follow - up period of patients with CHB undergone treatment with NUCs. The surveillance of development of drug resistance mutations, while receiving treatment for hepatitis B is of paramount importance to monitor and control the emerging resistance.
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    The Relationship Between COVID-19 Severity and Bacillus Calmette-Guerin (BCG)/ Mycobacterium Tuberculosis Exposure History in Healthcare Workers: A Multi-Center Study
    (2021) Torun, Serife; Ozkaya, Sevket; Sen, Nazan; Kanat, Fikret; Karaman, Irem; Yosunkaya, Sebnem; Sengoren Dikis, Ozlem; Asan, Ali; Aydogan Eroglu, Selma; Semih Atal, Sefa; Ayten, Omer; Aksel, Nimet; Ermis, Hilal; Ozcelik, Neslihan; Demirelli, Meryem; Kara, Iskender; Sumer, Sua; Marakoglu, Kamile; Uzer, Fatih; Uyar, Yasin; Cicek, Tuba; Unsal, Zuhal E.; Vatansev, Husamettin; Botan Yildirim, Berna; Kuruoglu, Tuba; Atilla, Aynur; Ersoy, Yasemin; Kandemir, Bahar; Durduran, Yasemin; Goksin Cihan, Fatma; Demirbas, Nur; Yildirim, Fatma; Tatar, Dursun; Akcay, M. Sule; 0000-0002-6530-6153; 0000-0002-8697-4919; 34014806; ABF-1652-2021
    The COVID-19 pandemic has brought countries' health services into sharp focus. It was drawn to our group's attention that healthcare workers (HCWs) had a lower mortality rate against higher COVID-19 incidence compared to the general population in Turkey. Since risk of exposure to tuberculosis bacillus among healthcare workers are higher than the population, we aimed to investigate if there is a relationship between BCG and Mycobacterium tuberculosis exposure history with COVID-19 severity in infected HCWs. This study was conducted with 465 infected HCWs from thirty-three hospitals to assess the relationship between COVID-19 severity (according to their hospitalization status and the presence of radiological pneumonia) and BCG and Mycobacterium tuberculosis exposure history. HCWs who required hospital admission had significantly higher rates of chronic diseases, radiological pneumonia, and longer working hours in the clinics. Higher rates of history of contact and care to tuberculosis patients, history of tuberculosis, and BCG vaccine were observed in hospitalized HCWs. HCWs who had radiological pneumonia had a significantly increased ratio of history of care to tuberculosis patients and a higher family history of tuberculosis. The findings from our study suggest that the lower mortality rate despite the more severe disease course seen in infected HCWs might be due to frequent exposure to tuberculosis bacillus and the mortality-reducing effects of the BCG vaccine.

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