Browsing by Author "Azap, Ozlem Kurt"

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Candidaemia among Adult Solid Organ Transplant Recipients
(2018) Yesilkaya, Aysegul; Demirkaya, Melike H.; Ozalp, Onur; Soy, Ebru H. Ayvazoglu; Azap, Ozlem Kurt; Arslan, Hande; Haberal, Mehmet; https://orcid.org/0000-0003-0225-6416; https://orcid.org/0000-0003-4284-2225; https://orcid.org/0000-0002-0993-9917; https://orcid.org/0000-0002-3171-8926; https://orcid.org/0000-0002-5708-7915; https://orcid.org/0000-0002-3462-7632; A-8902-2013; GMW-6437-2022; AAC-5566-2019; AAK-4089-2021; ABG-7034-2021; AAJ-8097-2021
Comparision of Influenza and Covid-19 Infections in Solid Organ Transplant Recipients
(2022) Yalcin, Tugba Yanik; Yuce, Gulbahar Darilmaz; Soy, Ebru H. Ayvazoglu; Azap, Ozlem Kurt; Arslan, Hande; Haberal, Mehmet; 0000-0002-3462-7632; AAJ-8097-2021; JBS-4193-2023
Early Bloodstream Infections Among Solid Organ Transplant Recipients
(2016) Yesilkaya, Aysegul; Soy, Ebru; Ok, Mehtap Akcil; Azap, Ozlem Kurt; Arslan, Hande; Moray, Gokhan; Sezgin, Atilla; Berdan, Fatos; Haberal, Mehmet; https://orcid.org/0000-0002-0993-9917; https://orcid.org/0000-0002-3171-8926; https://orcid.org/0000-0002-5708-7915; https://orcid.org/0000-0003-2498-7287; https://orcid.org/0000-0002-3462-7632; AAC-5566-2019; AAZ-8170-2020; AAK-4089-2021; ABG-7034-2021; AAE-1041-2021; AAJ-8097-2021
Emerging Escherichia coli O25b/ST131 Clone Predicts Treatment Failure in Urinary Tract Infections
(2015) Can, Fusun; Azap, Ozlem Kurt; Seref, Ceren; Ispir, Pelin; Arslan, Hande; Ergonul, Onder; 25378460
Background. We described the clinical predictive role of emerging Escherichia coli O25b/sequence type 131 (ST131) in treatment failure of urinary tract infection. Methods. In this prospective observational cohort study, the outpatients with acute cystitis with isolation of E. coli in their urine cultures were assessed. All the patients were followed up for clinical cure after 10 days of treatment. Detection of the E. coli O25:H4/ST131 clone was performed by multiplex polymerase chain reaction (PCR) for phylogroup typing and using PCR with primers for O25b rfb and allele 3 of the pabB gene. Results. In a cohort of patients with diagnosis of acute urinary cystitis, 294 patients whose urine cultures were positive with a growth of >10(4) colony-forming units/mL of E. coli were included in the study. In empiric therapy, ciprofloxacin was the first choice of drug (27%), followed by phosphomycin (23%), trimethoprim-sulfamethoxazole (TMP-SMX) (9%), and cefuroxime (7%). The resistance rate was 39% against ciprofloxacin, 44% against TMP-SMX, and 25% against cefuroxime. Thirty-five of 294 (12%) isolates were typed under the O25/ST131 clone. The clinical cure rate was 85% after the treatment. In multivariate analysis, detection of the O25/ST131 clone (odds ratio [ OR], 4; 95% confidence interval [ CI], 1.51-10.93; P = .005) and diabetes mellitus (OR, 2.1; 95% CI,.99-4.79; P = .05) were found to be significant risk factors for the treatment failure. In another multivariate analysis performed among quinolone-resistant isolates, treatment failure was 3 times more common among the patients who were infected with ST131 E. coli (OR, 3; 95% CI, 1.27-7.4; P = .012). Conclusions. In urinary tract infections, the E. coli ST131 clone seems to be a consistent predictor of treatment failure.
A Fine Line Between A Major Surgery and Medical Therapy: The Diagnosis of Sternal Tuberculosis
(2014) Yesilkaya, Aysegul; Azap, Ozlem Kurt; Kilic, Dalokay; Arslan, Hande; Uner, Halit; https://orcid.org/0000-0003-0225-6416; https://orcid.org/0000-0002-3171-8926; https://orcid.org/0000-0002-5708-7915; https://orcid.org/0000-0002-5388-4183; A-8902-2013; AAK-4089-2021; H-7700-2019; ABG-7034-2021; HOH-1335-2023
Tuberculosis involving the sternum is rare. The most common symptoms at the early stage are chest pain and palpable masses on the sternum. Cutaneous fistulas, spontaneous fracture of sternum and extrasternal spread may develop in cases with late diagnosis. In this article, we report a 53-year-old male case admitted with a one-month history of chest pain and two palpable masses on his lower sternal part of chest in whom the diagnosis of sternal tuberculosis was confirmed by histopathologically and rnicrobiologically. The masses were reduced in size with two-month anti-tubercular therapy. The nine-month duration of the therapy produced satisfactory results without any adverse reactions.
Herpes Zoster Infections in Solid-Organ Transplant Recipients
(2023) Sari, Nuran; Erol, Cigdem; Yalcin, Tugba Yanik; Azap, Ozlem Kurt; Arslan, Hande; Karakaya, Emre; Altinel, Cemile Tugba; Sezgin, Atilla; Incekas, Caner; Haberal, Mehmet; 0000-0002-4879-7974; 37885293; AAD-5466-2021
Objectives: Herpes zoster infections can be complicated and mortal in solid-organ transplant recipients. In our study, we investigated herpes zoster infections in solid-organ transplant recipients.Materials and Methods: Until June 2022, our center has performed 3342 kidney, 708 liver, and 148 heart transplants. Herpes zoster infections were investigated in 1050 adult solid-organ transplant recipients from January 1, 2011, to June 31, 2022. We studied 44 patients diagnosed with herpes zoster infections.Results: Of the 44 patients with herpes zoster, 32 had kidney, 7 had heart, and 5 had liver transplant procedures. Crude incidence rate was 5.2%.,with 9.7% being heart, 5.1% being kidney, and 3.9% being liver transplant recipients; 72.7% were male patients. The median age was 47.5 years, and 61% of patients were aged >45 years. Postherpetic neuralgia was significantly higher in patients older than 45 years (P = .006). The median duration to infection posttransplant was 16.5 months. The dermatomes of patients were 43.2% thoracic. Sacral dermatome involvement was significantly higher in heart transplant patients than in other transplant recipients (P = .015). We reviewed specific findings of the Tzanck test in 36.4% of the patients. There was concomitant infection in 15.9% of the patients, and 6.8% had pneumonia. Acute neuritis was more common in kidney transplant recipients (65.6%). The mean duration of acute neuritis/neuralgia was longest in liver transplant recipients (13.5 months; P = .047). Postherpetic neuralgia was detected as high as 24%.Conclusions: Early specific and supportive treatment is important for transplant recipients with herpes zoster infections. Appropriate antiviral prophylaxis regimens and vaccination strategies for varicella zoster (chickenpox) and herpes zoster infections should be implemented in the vaccination schedule of solid -organ transplant candidates to prevent herpes zoster infections and complications.
In vitro Susceptibility of Tigecycline against Multidrug-Resistant Gram-Negative Strains: Etest versus Agar Dilution
(2014) Ozkok, Sezen; Togan, Turhan; Yesilkaya, Aysegul; Timurkaynak, Funda; Azap, Ozlem Kurt; Arslan, Hande; https://orcid.org/0000-0003-0225-6416; https://orcid.org/0000-0002-3171-8926; https://orcid.org/0000-0002-5708-7915; 25791941; A-8902-2013; AAK-4089-2021; ABG-7034-2021
Background and Aim: Tigecycline is a semi-synthetic tetracycline with activity against most multidrug-resistant (MDR) bacteria. Methods: We studied in vitro activity of tigecycline by agar dilution (AD) and Etest methods to evaluate their correlation. The study included 206 isolates of extended-spectrum beta-lactamase (ESBL)-producing Escherichia coli, Klebsiella pneumoniae and MDR Acinetobacter baumannii recovered from blood cultures of patients of Baskent University between 2008 and 2010. Results: ESBL-producing E. coli had MIC50 /MIC90 values of 0.5/0.5 mu g/ml by AD and 0.25/0.5 mu g/ml by Etest. ESBL-producing K. pneumoniae had MIC50 /MIC90 values of 1/2 mu g/ml by AD and 0.75/2 mu g/ml by Etest, whereas MDR A. baumannii had MIC50 /MIC90 values of 4/4 mu g/ml by AD and 2/4 mu g/ml by Etest. The correlation between AD and Etest was weak for ESBL-producing E. coli and strong for ESBL-producing K. pneumoniae and MDR A. baumannii. Tigecycline MIC values for ESBL-producing E. coli were lower than the tigecycline concentration, while they were higher than the concentrations attainable by treatment doses for A. baumannii. Conclusion: Tigecycline is an appropriate agent in the treatment of E. coli bacteremia, but it is not for treating A. baumannii bacteremia. Tigecycline could be used for K. pneumoniae bacteremia treatment after determining its MIC value. Determining the MIC value by gold-standard methods is more appropriate due to the correlation between Etest and AD at high MIC values. (C) 2015 S. Karger AG, Basel
Investigation of HIV/AIDS Knowledge Levels and Approaches to the Disease of Başkent University Faculty of Medicine, Dentistry and Engineering Students
(2023) Sari, Nuran; Bilgic, Suveyda; Aydogan, Doga; Akici, Nur Ilayda; Yavuz, Esma Yagmur; Kuscu, Nur Selin; Ardebili, Yasaman; Colak, Meric Yavuz; Azap, Ozlem Kurt; 0000-0002-3171-8926; 0000-0002-0294-6874; 0009-0000-4043-3765; 0000-0002-3165-4520; AAK-4089-2021; AAA-4360-2021
Introduction: The number of HIV/AIDS patients is increasing in the world and in our country. It is thought that university students play an important role in developing social awareness necessary for the control of infectious diseases. This study aims to investigate the knowledge level of university students, determine their attitudes towards the disease, and evaluate their behavioral patterns to provide guidance for future studies, training and practices.Materials and Methods: Our research is a descriptive, cross-sectional field study. A survey including questions about HIV/AIDS trans- mission routes, disease recognition, attitudes and behaviors was prepared and delivered to the students of our university's faculty of medicine, dentistry and engineering via an online system. The survey data conducted between February 14, 2022 and April 1, 2022 was recorded and analyzed in the SPSS 25 statistical package program.Results: A total of 233 students participated in the survey, 76 from the faculty of engineering, 121 from the faculty of medicine, and 36 from the faculty of dentistry. 159 of the students are women and 73 are men. The average age was found to be 22.8 +/- 1.9 years. Between the students of the faculty of engineering and the group studying in the field of health; There was a significant difference in knowing the HIV/AIDS difference, ways of protection and disease agent (p< 0.05). In addition, questions about the ways of HIV transmission; There is a significant difference between the two groups regarding genetic transmission, use of the same forks and knives, towels, public toilets, kissing, sneezing, shaking hands, and contamination from swimming pools (p< 0.05). Knowledge that it can be transmitted through blood transfusion, using the same razor and needle, getting a tattoo, pregnancy and birth was found to be significantly lower in the faculty of engineering (p< 0.05). Additionally, 14.5% of the faculty of engineering students thought that they could be protected from HIV/AIDS by exercising regularly and 36.8% thought that they were vaccinated against HIV/AIDS (p< 0.05).To the question of whether HIV/AIDS patients pose a threat to society, 33.5% of students studying in the field of health and 34.2% of students of the faculty of engineering answered yes. The rate of those who want to learn more about HIV/AIDS is 86% in the field of health and 80.3% in the faculty of engineering.Conclusion: In our study, it was also observed that although university students had a certain level of knowledge about HIV/AIDS, they had incomplete and wrong attitudes and behaviors. Necessary training on infectious diseases of public concern must cover all departments.
A Predictive Model of Mortality in Patients With Bloodstream Infections due to Carbapenemase-Producing Enterobacteriaceae
(2016) Azap, Ozlem Kurt; 27712635
Objective: To develop a score to predict mortality in patients with bloodstream infections (BSIs) due to carbapenemase-producing Enterobacteriaceae (CPE). Patients and Methods: A multinational retrospective cohort study (INCREMENT project) was performed from January 1, 2004, through December 31, 2013. Patients with clinically relevant monomicrobial BSIs due to CPE were included and randomly assigned to either a derivation cohort (DC) or a validation cohort (VC). The variables were assessed on the day the susceptibility results were available, and the predictive score was developed using hierarchical logistic regression. The main outcome variable was 14-day all-cause mortality. The predictive ability of the model and scores were measured by calculating the area under the receiver operating characteristic curve. The sensitivity, specificity, positive predictive value, negative predictive value, and accuracy were calculated for different cutoffs of the score. Results: The DC and VC included 314 and 154 patients, respectively. The final logistic regression model of the DC included the following variables: severe sepsis or shock at presentation (5 points); Pitt score of 6 or more (4 points); Charlson comorbidity index of 2 or more (3 points); source of BSI other than urinary or biliary tract (3 points); inappropriate empirical therapy and inappropriate early targeted therapy (2 points). The score exhibited an area under the receiver operating characteristic curve of 0.80 (95% CI, 0.74-0.85) in the DC and 0.80 (95% CI, 0.73-0.88) in the VC. The results for 30-day all-cause mortality were similar. Conclusion: A validated score predictive of early mortality in patients with BSIs due to CPE was developed. (C) 2016 Mayo Foundation for Medical Education and Research
The Prevalence, Etiologic Agents and Risk Factors for Urinary Tract Infection Among Spinal Cord Injury Patients
(2014) Togan, Turhan; Azap, Ozlem Kurt; Durukan, Elif; Arslan, Hande
Background: Urinary tract infections (UTIs) are important causes of morbidity and mortality in patients with spinal cord injury and 22% of patients with acute spinal cord injury develop UTI during the first 50 days. Objectives: The aim of this study was to determine the prevalence, etiologic agents and risk factors for asymptomatic bacteriuria and symptomatic urinary tract infections in patients with spinal cord injury. Patients and Methods: This was a prospective investigation of spinal cord injury patients with asymptomatic bacteriuria and symptomatic urinary tract infections in Baskent University Medical Faculty Ayas Rehabilitation Center and Ankara Physical Therapy and Rehabilitation Center between January 2008 and December 2010. The demographic status, clinical and laboratory findings of 93 patients with spinal cord injury were analyzed in order to determine the risk factors for asymptomatic or symptomatic bacteriuria Results: Sixty three (67.7%) of 93 patients had asymptomatic bacteriuria and 21 (22.6%) had symptomatic urinary tract infection. Assessment of the frequency of urinary bladder emptying methods revealed that 57 (61.3%) of 93 patients employed permanent catheters and 24 (25.8%) employed clean intermittent catheterization. One hundred and thirty-five (48.0%) of 281 strains isolated form asymptomatic bacteriuria attacks and 16 (66.6%) of 24 strains isolated from symptomatic urinary tract infection attacks, totaling 151 strains, had multidrug resistance (P > 0.05). One hundred (70.4%) of 142 Escherichia coli strains and 19 (34.5%) of 55 Klebsiella spp strains proliferated in patients with asymptomatic bacteriuria; 8 (80%) of 10 E. coli strains and 4 (80%) of 5 Klebsiella spp. strains were multidrug resistant. Conclusions: The most common infectious episode among spinal cord injury patients was found to be urinary tract infection. E. coli was the most common microorganism isolated from urine samples. Antibiotic use in the previous 2 weeks or 3 months, hospitalization during the last one-year and previous diagnosis of urinary tract infection were the risk factors identified for the development of infections with multi-drug resistant isolates. Urinary catheterization was found to be the only independent risk factor contributing to symptomatic urinary tract infection.
Promoters of Colistin Resistance in Acinetobacter Baumannii Infections
(2019) Nurtop, Elif; Bilman, Fulya Bayindir; Menekse, Sirin; Azap, Ozlem Kurt; Gonen, Mehmet; Ergonul, Onder; Can, Fusun; https://orcid.org/0000-0002-3171-8926; 30964377; AAK-4089-2021
Objectives: We aimed to describe the mechanisms of colistin resistance in Acinetobacter baumannii. Materials and Methods: Twenty-nine patients diagnosed with colistin-resistant A. baumannii infection were included to the study. The mutations in pmrCAB, lpxA, lpxC, and lpxD genes, expression of pmrCAB, carbapenemases, and mcr-1 positivity were studied. Results: Twenty-seven (93%) of the patients received IV colistin therapy during their stay, and the case fatality rate was 45%. All mutations in pmrC and pmrB were found to be accompanied with a mutation in lpxD. The most common mutations were I42V and L150F in pmrC (65%), E117K in lpxD (65%), and A138T in pmrB (58.6%). The colistin minimum inhibitory concentrations (MICs) of the isolates having any of these four mutations were higher than the isolates with no mutations (p < 0.001). The two most common mutations in pmrC (I42V and L150F) were found to be associated with higher expressions of pmrA and pmrC and higher colistin MIC values (p = 0.010 and 0.031). All isolates were bla(OXA-23) positive. Conclusion: Coexistence of the lpxD mutation along with mutations in pmrCAB indicates synergistic function of these genes in development of colistin resistance in A. baumannii.
Screening of Recipients Prior to Liver and Heart Transplantation
(2018) Yesilkaya, Aysegul; Ozalp, Onur; Demirkaya, Melike H.; Azap, Ozlem Kurt; Arslan, Hande; Haberal, Mehmet; https://orcid.org/0000-0003-0225-6416; https://orcid.org/0000-0003-4284-2225; https://orcid.org/0000-0002-3171-8926; https://orcid.org/0000-0002-5708-7915; https://orcid.org/0000-0002-3462-7632; A-8902-2013; GMW-6437-2022; AAK-4089-2021; ABG-7034-2021; AAJ-8097-2021
Urinary Tract Infections in Renal Transplant Recipients
(2016) Demirkaya, Melike Hamiyet; Yesilkaya, Aysegul; Azap, Ozlem Kurt; Arslan, Hande; Haberal, Mehmet; https://orcid.org/0000-0002-3171-8926; https://orcid.org/0000-0002-5708-7915; AAK-4089-2021; ABG-7034-2021