Browsing by Author "Erol, Cigdem"

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Booster Shots and Additional Doses for COVID-19 in Solid Organ Recipients
(2022) Erol, Cigdem; Sari, Nuran; Yalcin, Tugba Yanik; Akdur, Aydincan; Arslan, Hande; Haberal, Mehmet; 0000-0002-2535-2534; 0000-0002-3462-7632; AAJ-1219-2021; AAJ-8097-2021
Ceftazidime - Avibactam susceptibility among carbapenem-resistant Enterobacterales in a pilot study in Turkey
(2021) Erol, Cigdem; Azap, Ozlem; 0000-0002-2535-2534; 34324428; AAJ-1219-2021
This study aimed to detect carbapenemase genes and to determine the in vitro susceptibility of Ceftazidime-Avibactam (CZA) in Enterobacterales isolates. Carbapenemase genes were detected by polymerase chain reaction. CZA sensitivity of isolates was evaluated with broth microdilution (BMD) and disk diffusion methods. A total of 318 carbapenem-resistant Enterobacterales isolates were included. Most of the isolates (n = 290, 91.2%) were identified as Klebsiella pneumoniae. The most common carbapenemase type was OXA-48 (n = 82, 27.6%). CZA susceptibility was evaluated in 84 isolates with OXA-48 and KPC carbapenemase activity. Both BMD and disk diffusion methods revealed that 95.2% of the isolates were sensitive to CZA; whereas, 4 (4.76%) isolates were resistant to CZA. Among colistin resistant isolates, 96.5% (n = 80) of them were susceptible to CZA. Our study demonstrated high in vitro efficacy of CZA in Enterobacterales isolates producing OXA-48 carbapenemase. High susceptibility rates against colistin resistant isolates which generally are also pan drug resistant, makes CZA a promising therapeutic choice for difficult-to-treat infections. Due to its high correlation with the BMD, disk diffusion method is a suitable and more practical method in detecting CZA in vitro activity.
Clinical Features of SARS-CoV-2 Infection in Patients Undergoing Solid-Organ Transplant: Baskent University Experience
(2023) Yuce, Gulbahar Darilmaz; Ulubay, Gaye; Tek, Korhan; Bozbas, Serife Savas; Erol, Cigdem; Buyukasik, Piril; Haberal, Kemal Murat; Arslan, Ayse Hande; Akcay, Muserref Sule; Haberal, Mehmet; 0000-0002-2535-2534; 34635037; AAJ-1219-2021
Objectives: The clinical features and treatment approaches, outcomes, and mortality predictors of COVID-19 in solid-organ transplant recipients have not been well defined. This study investigated the clinical features of COVID-19 infection in solid-organ transplant recipients at our center in Turkey. Materials and Methods: Our study included 23 solid-organ transplant recipients and 336 nontransplant individuals (143 previously healthy and 193 patients with at least 1 comorbidity) who were hospitalized due to COVID-19 disease in our hospital between March 2020 and January 2021. Demographic, clinical, and laboratory data of patients were compared. We used SPSS version 20.0 for statistical analysis. All groups were compared using chi-square and Mann-Whitney U tests. P <.05 was considered statistically significant. Results: Mean age of solid-organ transplant recipients was 49.8 +/- 13.7 years (78.3% men, 21.7% women). Among the 23 recipients, 17 (73.9%) were kidney and 6 (26.1%) were liver transplant recipients. Among nontransplant individuals, 88.7% (n = 298) had mild/moderate disease and 11.3% (n = 38) had severe disease. Among transplant recipients, 78.3% (n = 18) had mild/moderate disease and 21.7% (n = 5) had severe disease (P =.224). Transplant recipients had greater requirements for nasal oxygen (P =.005) and noninvasive mechanical ventilation (P =.003) and had longer length of intensive care unit stay (P =.030) than nontransplant individuals. No difference was found between the 2 groups in terms of mortality (P =.439). However, a subgroup analysis showed increased mortality in transplant recipients versus previously healthy patients with COVID-19 (P <.05). Secondary infections were major causes of mortality in transplant recipients. Conclusions: COVID-19 infection resulted in higher mortality in solid- organ transplant recipients versus that shown in healthy patients. More attention on secondary infections is needed in transplant recipients to reduce mortality.
The Clinical Outcomes of Covid-19 Disease in Patients with Solid Organ Transplantation
(2021) Yuce, Gulbahar Darilmaz; Ulubay, Gaye; Karakaya, Emre; Tek, Korhan; Akdur, Aydincan; Bozbas, Serife Savas; Gedik, Ender; Kupeli, Elif; Erol, Cigdem; Arslan, Hande; Akcay, Sule; Haberal, Mehmet; https://orcid.org/0000-0002-4879-7974; https://orcid.org/0000-0002-8726-3369; https://orcid.org/0000-0002-2535-2534; https://orcid.org/0000-0002-5708-7915; https://orcid.org/0000-0002-3462-7632; JBS-4193-2023; AAD-5466-2021; AAA-3068-2021; AAJ-1219-2021; ABG-7034-2021; AAJ-8097-2021
The Clinical Outcomes Of Covid-19 Disease In Patients With Solıid Organ Transplantation
(2021) Yuce, Gulbahar Darilmaz; Ulubay, Gaye; Karakaya, Emre; Tek, Korhan; Akdur, Aydincan; Bozbas, Serife Savas; Gedik, Ender; Kupeli, Elif; Erol, Cigdem; Arslan, Hande; Akcay, Sule; Haberal, Mehmet; 0000-0002-8726-3369; 0000-0002-2535-2534; 0000-0002-5708-7915; 0000-0002-3462-7632; AAA-3068-2021; AAJ-1219-2021; ABG-7034-2021; AAJ-8097-2021
Comparison of in vitro activities of plazomicin and other aminoglycosides against clinical isolates of Klebsiella pneumoniae and Escherichia coli
(2021) Ince, Gizem; Mirza, Hasan Cenk; Guclu, Aylin Uskudar; Gumus, Hale; Erol, Cigdem; Basustaoglu, Ahmet; 0000-0001-9071-9606; 0000-0002-1872-028X; 0000-0002-2535-2534; 0000-0002-8853-3893; 34499728; AAJ-2108-2021; AAU-6196-2020; AAJ-1219-2021; F-1232-2015
Objectives: To compare the in vitro activity of plazomicin and two older aminoglycosides (gentamicin and amikacin) against 180 isolates of Escherichia coli and Klebsiella pneumoniae, including subsets of 60 non-ESBL-producing, 60 ESBL-producing and 60 carbapenem-resistant (46 carrying bla(OXA-48), 11 carrying bla(NDM) and 3 carrying bla(OXA-48) and bla(NDM)) strains. Methods: MICs of plazomicin, gentamicin and amikacin were determined by a gradient diffusion method. Gentamicin and amikacin MICs were interpreted according to CLSI criteria and EUCAST breakpoint tables. Plazomicin MICs were interpreted using FDA-defined breakpoints. Results: All non-ESBL-producing and ESBL-producing isolates were susceptible to plazomicin. The plazomicin susceptibility rate (71.7%) in carbapenem-resistant isolates was significantly higher than those observed for gentamicin (45%) and amikacin (56.7% and 51.7% according to CLSI and EUCAST breakpoints, respectively). Gentamicin, amikacin and plazomicin susceptibility rates (35.6% for gentamicin; 44.4% and 37.8% for amikacin according to CLSI and EUCAST breakpoints, respectively; 64.4% for plazomicin) in carbapenem-resistant K. pneumoniae were significantly lower than those observed for carbapenem-resistant E. coli isolates (73.3% for gentamicin; 93.3% for amikacin and plazomicin). Gentamicin, amikacin and plazomicin susceptibility rates for bla(NDM)-positive isolates were lower than those observed for bla(OXA-48)-positive isolates, but differences were not statistically significant. Among the isolates that were non-susceptible to both gentamicin and amikacin, the plazomicin susceptibility rate was less than 30%. Conclusions: Although plazomicin showed excellent in vitro activity against carbapenem-susceptible isolates, the plazomicin resistance rate increased to 35.6% among carbapenem-resistant K. pneumoniae and further increased to 45.5% among bla(NDM)-positive isolates.
COVID-19 Clinical Outcomes, Coinfection and Secondary Infections in Solid Organ Transplant Recipients
(2022) Yalcin, Tugba Yanik; Erol, Cigdem; Karakaya, Emre; Arslan, Hande; Haberal, Mehmet; 0000-0002-2535-2534; 0000-0002-4879-7974; 0000-0002-3462-7632; AAJ-1219-2021; AAD-5466-2021; AAJ-8097-2021
Cytomegalovirus Viremia in Solid-Organ Transplant Patients in the First Year After Transplantation
(2022) Erol, Cigdem; Akdur, Aydincan; Arslan, Hande; Haberal, Mehmet; https://orcid.org/0000-0002-2535-2534; https://orcid.org/0000-0002-3462-7632; 35384821; AAJ-1219-2021; AAJ-8097-2021
Objectives: Cytomegalovirus infection is an important problem for transplantation. Although effective antivirals for prophylaxis or preemptive therapy have reduced the severity and consequences of infection, cytomegalovirus viremia and cytomegalovirusrelated disease are still matters for patients and for graft survival. The aim of our study was to determine the frequency of cytomegalovirus infections during the first year after transplant. Materials and Methods: In this study, we analyzed the data of 252 liver and kidney transplant patients who had procedures between May 2016 and May 2020. Demographic and laboratory data of patients were recorded retrospectively and analyzed with the SPSS version 25 statistical program. Results: Our study included 35 liver (14%) and 217 kidney transplant recipients. The ratio of male to female was 3.8, and the median age was 41 years (range, 18-71 years). In our study group, there were 32 patients (12.7%) with cytomegalovirus DNAemia, 13 patients (5%) with cytomegalovirus syndrome, and 6 patients (2.4%) with cytomegalovirus endorgan diseases. Four patients were diagnosed with gastrointestinal disease with histopathology, and 2 patients were diagnosed with cytomegalovirus pneumonia with bronchoscopy and radiology. The mortality rate was 0.8% in the first year. Conclusions: Cytomegalovirus reactivations in the first year after transplant play a critical role on graft survival in solid- organ transplant. Regular follow-up of cytomegalovirus DNAemia is crucial for modifying prophylactic and preemptive antiviral regimens.
Differences in Antibody Responses Between an Inactivated SARS-CoV-2 Vaccine and the BNT162b2 mRNA Vaccine in Solid-Organ Transplant Recipients
(2021) Erol, Cigdem; Yalcin, Tugba Yanik; Sari, Nuran; Bayraktar, Nilufer; Soy, Ebru Ayvazoglu; Colak, Meric Yavuz; Azap, Ozlem; Arslan, Hande; Haberal, Mehmet; 0000-0002-3462-7632; 0000-0002-2535-2534; 0000-0002-0993-9917; 0000-0002-5708-7915; 0000-0001-5996-8639; 0000-0002-3165-4520; 34951350; AAJ-1219-2021; AAC-5566-2019; AAJ-8097-2021; ABG-7034-2021; AAA-4708-2022
Objectives: Vaccination against SARS-CoV-2 may reduce COVID-19 mortality and complications in solidorgan transplant recipients, and we evaluated the associated antibody responses and adverse effects in this high-risk population. Materials and Methods: This prospective observational study (April-June 2021) included 10 liver and 38 kidney transplant recipients who received 2 vaccine doses (Sinovac, n = 31; or BioNTech, n = 17) and 56 healthy adults (Sinovac), all of whom provided 3 blood samples (prevaccination, 4 weeks after first dose, and 4-6 weeks after second dose) for quantitative tests (Abbott Quant assay for immunoglobulin G antibodies against SARS-CoV-2 spike protein). Type I error was alpha = .05 in all statistical analyses (SPSS, version 25). Results: We analyzed demographic data, antibody responses, and adverse events after 2 doses of SARS-CoV-2 vaccine, compared immune responses from solidorgan transplant recipients (median age, 36.5 years) versus healthy patients (median age, 37.5 years), and observed significantly higher seropositivity in healthy versus transplant patients after Sinovac vaccination (100% vs 67.5%; P = .001). However, we observed no significant seropositive differences for Sinovac versus BioNTech second doses in transplant recipients. Median SARS-CoV-2 immunoglobulin G level after second dose was significantly higher in BioNTech (1388.6 AU/mL) versus Sinovac patients (136.6 AU/mL) (P = .012). The seropositivity difference between the 2 vaccines was significant in participants 24 to 44 years old (P = .040). The rate of at least 1 side effect was 82.4% (n = 14) for BioNTech vaccine and 32.3% (n = 10) for Sinovac vaccine, and the difference was statistically significant. The most common side effect was arm pain (significantly higher in BioNTech group). Conclusions: Solid-organ transplant recipients demonstrated inadequate vaccine responses (higher risk of complications and mortality) versus healthy patients. Furthermore, immune responses may differ between vaccines. Therefore, additional vaccine doses and strict control measures remain crucial.
Epidemiology and Risk Factors of 28-Day Mortality of Hospital-Acquired Bloodstream Infection in Turkish Intensive Care Units: A Prospective Observational Cohort Study
(2023) Erol, Cigdem; 37264485; AAJ-1219-2021
Synopsis Objectives To uncover clinical epidemiology, microbiological characteristics and outcome determinants of hospital-acquired bloodstream infections (HA-BSIs) in Turkish ICU patients. Methods The EUROBACT II was a prospective observational multicontinental cohort study. We performed a subanalysis of patients from 24 Turkish ICUs included in this study. Risk factors for mortality were identified using multivariable Cox frailty models. Results Of 547 patients, 58.7% were male with a median [IQR] age of 68 [55-78]. Most frequent sources of HA-BSIs were intravascular catheter [182, (33.3%)] and lower respiratory tract [175, (32.0%)]. Among isolated pathogens (n = 599), 67.1% were Gram-negative, 21.5% Gram-positive and 11.2% due to fungi. Carbapenem resistance was present in 90.4% of Acinetobacter spp., 53.1% of Klebsiella spp. and 48.8% of Pseudomonas spp. In monobacterial Gram-negative HA-BSIs (n = 329), SOFA score (aHR 1.20, 95% CI 1.14-1.27), carbapenem resistance (aHR 2.46, 95% CI 1.58-3.84), previous myocardial infarction (aHR 1.86, 95% CI 1.12-3.08), COVID-19 admission diagnosis (aHR 2.95, 95% CI 1.25-6.95) and not achieving source control (aHR 2.02, 95% CI 1.15-3.54) were associated with mortality. However, availability of clinical pharmacists (aHR 0.23, 95% CI 0.06-0.90) and source control (aHR 0.46, 95% CI 0.28-0.77) were associated with survival. In monobacterial Gram-positive HA-BSIs (n = 93), SOFA score (aHR 1.29, 95% CI 1.17-1.43) and age (aHR 1.05, 95% CI 1.03-1.08) were associated with mortality, whereas source control (aHR 0.41, 95% CI 0.20-0.87) was associated with survival. Conclusions Considering high antimicrobial resistance rate, importance of source control and availability of clinical pharmacists, a multifaceted management programme should be adopted in Turkish ICUs.
Evaluation of Clinical Approach and Outcomes Staphylococcus aureus Bacteremia
(2023) Yanik Yalcin, Tugba; Erol, Cigdem; Demirkaya, Melike Hamiyet; Durukan, Elif; Kurt Azap, Ozlem; 0000-0002-3171-8926; 0000-0001-5996-8639; 0000-0002-8579-5564; 0000-0002-2535-2534; 38633900; AAK-4089-2021; AAA-4708-2022; AAJ-8621-2021; AAJ-1219-2021
Objective: Despite appropriate treatment and early diagnosis methods, Staphylococcus aureus bacteremia (SAB) is still associated with a high mortality rate. This study aims to evaluate the clinical features and approaches to SAB and to analyze the parameters that may affect 7-day and 30-day mortality. Materials and Methods: Adult patients with SAB data between 2011 and 2018 were evaluated retrospectively. Clinical data, patient demographics, and 7-day and 30-day mortality rates were obtained from their medical records.Results: In total, 144 patients were included in the study; 57.6% (83/144) of patients were men, and the mean age was 65.2 +/- 16.5 years. The most common source of infection was the central-line catheter (38.9%), followed by intra-abdominal (21%), respiratory (16.7), infective endocarditis (5.6%), and osteoarticular foci (2.1%). Fifteen percent (15%) of the strains were methicillin resistant. Transthoracic echocardiography (TTE) was performed for 80.6% (116/144) patients. Infectious diseases specialist consultation within 96 hours from blood culture signal was requested in 79.9%. Overall, 7-day mortality was 11.8%, and 30-day mortality was 21.5%. Staying in intensive care units (ICU) increased the risk of 30-day mortality by 1.1 times, and respiratory-focused SAB increased the risk by 4.3 times.Conclusion: SAB is still a big threat. Staphylococcal pneumonia remains a severe infection. Several prognostic factors influence mortality. Identifying the source, ensuring source control, and appropriate initial therapy as soon as possible are critical for reducing mortality and morbidity in SAB.
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.
Immunogenicity after two doses of inactivated virus vaccine in healthcare workers with and without previous COVID-19 infection: Prospective observational study
(2021) Yalcin, Tugba Y.; Topcu, Deniz, I; Sari, Nuran; Erol, Cigdem; Azap, Ozlem K.; Arslan, Hande; 0000-0002-3165-4520; 0000-0001-5996-8639; 0000-0002-2535-2534; 0000-0002-5708-7915; 0000-0002-3171-8926; 34468990; ABA-1149-2021; AAA-4708-2022; AAJ-1219-2021; ABG-7034-2021; AAK-4089-2021
Vaccines have been seen as the most important solution for ending the coronavirus disease 2019 (COVID-19) pandemic. The aim of this study is to evaluate the antibody levels after inactivated virus vaccination. We included 148 healthcare workers (74 with prior COVID-19 infection and 74 with not). They received two doses of inactivated virus vaccine (CoronaVac). Serum samples were prospectively collected three times (Days 0, 28, 56). We measured SARS-CoV-2 IgGsp antibodies quantitatively and neutralizing antibodies. After the first dose, antibody responses did not develop in 64.8% of the participants without prior COVID-19 infection. All participants had developed antibody responses after the second dose. We observed that IgGsp antibody titers elicited by a single vaccine dose in participants with prior COVID-19 infection were higher than after two doses of vaccine in participants without prior infection (geometric mean titer: 898 and 607 AU/ml). IgGsp antibodies, participants with prior COVID-19 infection had higher antibody levels as geometric mean titers at all time points (p < 0.001). We also found a positive correlation between IgGsp antibody titers and neutralizing capacity (r(s) = 0.697, p < 0.001). Although people without prior COVID-19 infection should complete their vaccination protocol, the adequacy of a single dose of vaccine is still in question for individuals with prior COVID-19. New methods are needed to measure the duration of protection of vaccines and their effectiveness against variants as the world is vaccinated. We believe quantitative IgGsp values may reflect the neutralization capacity of some vaccines.
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
LAST TWO INFLUENZA SEASON: EVALUATION OF SOLID ORGAN TRANSPLANT RECIPIENTS
(2020) Yalcin, Tugba Yanik; Erol, Cigdem; Sari, Nuran; Arslan, Hande; Karakaya, Emre; Haberal, Mehmet A.
New challenges for management of COVID-19 patients: Analysis of MDCT based "Automated pneumonia analysis program"
(2021) Sezer, Rahime; Esendagli, Dorina; Erol, Cigdem; Hekimoglu, Koray; 34307790
Purpose: The aim of this study is to define the role of an "Automated Multi Detector Computed Tomography (MDCT) Pneumonia Analysis Program" as an early outcome predictor for COVID-19 pneumonia in hospitalized patients. Materials and Methods: A total of 96 patients who had RT-PCR proven COVID-19 pneumonia diagnosed by non contrast enhanced chest MDCT and hospitalized were enrolled in this retrospective study. An automated CT pneumonia analysis program was used for each patient to see the extent of disease. Patients were divided into two clinical subgroups upon their clinical status as good and bad clinical course. Total opacity scores (TOS), intensive care unit (ICU) entry, and mortality rates were measured for each clinical subgroups and also laboratory values were used to compare each subgroup. Results: Left lower lobe was the mostly effected side with a percentage of 78.12 % and followed up by right lower lobe with 73.95 %. TOS, ICU entry, and mortality rates were higher in bad clinical course subgroup. TOS values were also higher in patients older than 60 years and in patients with comorbidities including, Hypertension (HT), Diabetes Mellitus (DM), Chronic Obstructive Pulmonary Disease (COPD), Chronic Heart Failure (CHF) and malignancy. Conclusion: Automated MDCT analysis programs for pneumonia are fast and an objective way to define the disease extent in COVID-19 pneumonia and it is highly correlated with the disease severity and clinical outcome thus providing physicians with valuable knowledge from the time of diagnosis.
Ophthalmologic Examination and Echocardiography Should be the Essential Components of Candidemia Bundle
(2023) Erol, Cigdem; Sari, Nuran; Yanik Yalcin, Tugba; Yesilkaya, Aysegul; Asena, Leyla; Gur Gungor, Sirel; Kurt Azap, Ozlem; 0000-0002-6848-203X; 0000-0001-5996-8639; 0000-0002-2535-2534; 0000-0001-6178-8362; 0000-0002-3171-8926; 0000-0002-3165-4520; 38633906; E-5914-2016; AAA-4708-2022; AAJ-1219-2021; AAD-5967-2021; AAK-4089-2021
Objective: Candidemia is the most common form of invasive candidiasis, and it is associat-ed with end-organ involvement, prolonged hospitalization, increased mortality, and higher healthcare costs. Candidemia can lead to metastatic heart and ocular infections. This study aimed to define the incidence, characteristics, and mortality of candidemia episodes and compare the data with our center's previous results.Materials and Methods: In this single-center retrospective observational study, we enrolled 250 patients over 18 years diagnosed with candidemia between January 2015 and December 2020. We obtained patients' demographic, clinical, laboratory, and therapeutic data from medical records. An ophthalmologic examination and screening with echocardiography were carried out within the first week after candidemia diagnosis.Results: There were 275 candidemia episodes from 250 patients. The incidence of candidem-ia was 2.8/1000 admissions and 5.68/ 10,000 inpatient days, higher than our previous results (1.23/1000 and 3.29/10,000). The median age was 65 (interquartile range [IQR]=52-75) years. Malignancies were the most frequent comorbidity (50%). The most common type was Candida albicans (n=115, 41.8%). Candida glabrata (n=61, 22.2%) was common, particularly in surgical patients, patients with malignancy, and critically ill patients. There was Infectious disease consultation in 93.3% (257) episodes. The ophthalmoscopic examination was made in 145 episodes (52.7%), and ophthalmitis was detected in 16 (11.0%). Echocardiography was per-formed in 139 (50.5%) episodes; one case had an endocarditis diagnosis. The 30-day mortal-ity was 44.7% (n=123). Mortality rates in C. glabrata and Candida krusei infections were high-er (54.1% and 66.7). The factors related to mortality were intensive care unit requirement (p=0.0001), chronic liver disease (p=0.005), corticosteroid usage (p=0.0001), previous antibiotic usage (p=0.013), multiple antibiotic usage (p=0.020), and CVC related candidemia (p=0.010).Conclusion: Because of the life-threatening complications such as endocarditis, increased mortality rates, and higher healthcare costs, systematic and comprehensive candidemia bundle applications would be effective strategies for providing an effective antifungal stew-ardship program.
Relationship between chest computed tomography findings and clinical conditions of coronavirus disease (COVID-19): A multicentre experience
(2021) Yilmaz Demirci, Nilgun; Ugras Dikmen, Asiye; Tasci, Canturk; Dogan, Deniz; Arslan, Yakup; Ocal, Nesrin; Tasar, Mustafa; Bozlar, Ugur; Artuk, Cumhur; Yilmaz, Gulden; Karacaer, Zehra; Avci, Ismail Yasar; Tuncer Ertem, Gunay; Erdinc, Fatma Sebnem; Kinikli, Sami; Altun Demircan, Serife; Ergun, Elif; Nercis Kosar, Pinar; Karakoc, Ayse Esra; Gokcek, Atila; Aloglu, Melike; Gulgosteren, Sevtap; Atikcan, Sukran; Akcay, Sule; Erol, Cigdem; Hekimoglu, Koray; Cerit, Mahi Nur; Erbas, Gonca; Ozger, Hasan Selcuk; Bozdayi, Gulendam; Senol, Esin; Yurdakul, Ahmet Selim; Yilmaz, Aydin; 0000-0002-2535-2534; 0000-0002-0805-0841; 34105857; AAJ-1219-2021; AAD-9097-2021
Aims This study aimed to investigate the clinical and chest computed tomography (CT) features associated with clinical parameters for coronavirus disease (COVID-19) in the capital of Turkey, Ankara. Materials and methods Epidemiological, clinical features, laboratory findings and radiological characteristics of 1563 hospitalised patients with COVID-19 in Ankara were collected, reviewed and analysed in this study. The risk factors associated with disease severity were investigated. Results Non-severe (1214; 77.7%) and severe cases (349; 22.3%) were enrolled in the study. Compared with the non-severe group, the severe group were significantly older and had more comorbidities (ie, hypertension, diabetes mellitus, cardiovascular disease and chronic kidney disease). Smoking was more common in the severe group. Severe patients had higher respiratory rates and higher incidences of cough and dyspnoea compared with non-severe patients. Compared with the non-severe patients, the severe patients had increased C-reactive protein (CRP), procalcitonin, neutrophil to lymphocyte ratio (NLR) and CRP/albumin ratio and decreased albumin. The occurrence rates of consolidation, subpleural sparing, crazy-paving pattern, cavity, halo sign, reversed halo sign, air bronchogram, pleural thickening, micronodule, subpleural curvilinear line and multilobar and bilateral involvement in the CT finding of the severe patients were significantly higher than those of the non-severe patients. Conclusions Many factors are related to the severity of COVID-19, which can help clinicians judge the severity of the patient and evaluate the prognosis. This cohort study revealed that male sex, age (>= 55 years), patients with any comorbidities, especially those with cardiovascular disease, dyspnoea, increased CRP, D-dimer and NLR, and decreased lymphocyte count and CT findings of consolidation and multilobar involvement were predictors of severe COVID-19.
Relationship between chest CT findings and clinical conditions of COVID-19: A multicentre experience
(2021) Akcay, Sule; Erol, Cigdem; Hekimoglu, Koray
TEN YEAR CHALLENGE: HOW THE ETIOLOGY AND RESISTANCE PATTERNS OF BLOOD STREAM INFECTIONS IN SOLID ORGAN TRANSPLANTATION RECIPIENTS HAVE CHANGED?
(2020) Erol, Cigdem; Yanik, Tugba Yanik; Sari, Nuran; Karakaya, Emre; Arslan, Hande; Haberal, Mehmet A.