Browsing by Author "Sener, Alper"

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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.
The Role of Pneumococcal Pneumonia among CommunityAcquired Pneumonia in Adult Turkish Population: TurkCAP Study
(2021) Senol, Esin; Cilli, Aykut; Gunen, Hakan; Sener, Alper; Dumlu, Ridvan; Odemis, Ayse; Topcu, Ayse Fusun; Yildiz, Yesim; Guner, Rahmet; Ozhasenekler, Ayhan; Mutlu, Birsen; Kokturk, Nurdan; Sevimli, Nurgul; Baykam, Nurcan; Yapar, Derya; Ekin, Selami; Polatli, Mehmet; Gok, Sebnem Eren; Kilinc, Oguz; Sayiner, Abdullah; Karasahin, Omer; Cuhadaroglu, Caglar; Kocagoz, Ayse Sesin; Togan, Turhan; Arpag, Huseyin; Kati, Hakan; Koksal, Iftihar; Aksoy, Firdevs; Hasanoglu, Canan; 35110252
OBJECTIVE: To evaluate the rate of pneumococcal pneumonia (PP) among patients with community-acquired pneumonia (CAP) in Turkey and to investigate and compare features of PP and non-PP CAP patients. MATERIAL AND METHODS: This multicenter, non-interventional, prospective, observational study included adult CAP patients (age = 18 years). Diagnosis of PP was based on the presence of at least 1 positive laboratory test result for Streptococcus pneumoniae (blood culture or sputum culture or urinary antigen test [UAT]) in patients with radiographic findings of pneumonia. RESULTS: Four hundred sixty-five patients were diagnosed with CAP, of whom 59 (12.7%) had PP. The most common comorbidity was chronic obstructive pulmonary disease (30.1%). The mean age, smoking history, presence of chronic neurological disease, and CURB-65 score were significantly higher in PP patients, when compared to non-PP patients. In PP patients, 84.8% were diagnosed based ony on the UAT. The overall rate of PP patients among CAP was calculated as 22.8% considering the UAT sensitivity ratio of 63% (95% confidence interval: 45-81). The rate of intensive care treatment was higher in PP patients (P =.007). While no PP patients were vaccinated for pneumococcus, 3.8% of the non-PP patients were vaccinated (P =.235). Antibiotic use in the preceding 48 hours was higher in the non-PP group than in the PP group (31.8% vs. 11.1%, P =.002). The CURB-65 score and the rate of patients requiring inpatient treatment according to this score were higher in the PP group. CONCLUSION: The facts that PP patients were older and required intensive care treatment more frequently as compared to non-PP patients underline the burden of PP.
Treatment of ventilator-associated pneumonia (VAP) caused by Acinetobacter: results of prospective and multicenter ID-IRI study
(2020) Erdem, Hakan; Cag, Yasemin; Gencer, Serap; Uysal, Serhat; Karakurt, Zuhal; Harman, Rezan; Aslan, Emel; Mutlu-Yilmaz, Esmeray; Karabay, Oguz; Uygun, Yesim; Ulug, Mehmet; Tosun, Selma; Dogru, Arzu; Sener, Alper; Dogan, Mustafa; Hasbun, Rodrigo; Durmus, Gul; Turan, Hale; Batirel, Ayse; Duygu, Fazilet; Inan, Asuman; Akkoyunlu, Yasemin; Celebi, Guven; Ersoz, Gulden; Guven, Tumer; Dagli, Ozgur; Guler, Selma; Meric-Koc, Meliha; Oncu, Serkan; Rello, Jordi; 31502120
Ventilator-associated pneumonia (VAP) due to Acinetobacter spp. is one of the most common infections in the intensive care unit. Hence, we performed this prospective-observational multicenter study, and described the course and outcome of the disease. This study was performed in 24 centers between January 06, 2014, and December 02, 2016. The patients were evaluated at time of pneumonia diagnosis, when culture results were available, and at 72 h, at the 7th day, and finally at the 28th day of follow-up. Patients with coexistent infections were excluded and only those with a first VAP episode were enrolled. Logistic regression analysis was performed. A total of 177 patients were included; empiric antimicrobial therapy was appropriate (when the patient received at least one antibiotic that the infecting strain was ultimately shown to be susceptible) in only 69 (39%) patients. During the 28-day period, antibiotics were modified for side effects in 27 (15.2%) patients and renal dose adjustment was made in 38 (21.5%). Ultimately, 89 (50.3%) patients died. Predictors of mortality were creatinine level (OR, 1.84 (95% CI 1.279-2.657); p = 0.001), fever (OR, 0.663 (95% CI 0.454-0.967); p = 0.033), malignancy (OR, 7.095 (95% CI 2.142-23.500); p = 0.001), congestive heart failure (OR, 2.341 (95% CI 1.046-5.239); p = 0.038), appropriate empiric antimicrobial treatment (OR, 0.445 (95% CI 0.216-0.914); p = 0.027), and surgery in the last month (OR, 0.137 (95% CI 0.037-0.499); p = 0.003). Appropriate empiric antimicrobial treatment in VAP due to Acinetobacter spp. was associated with survival while renal injury and comorbid conditions increased mortality. Hence, early diagnosis and appropriate antibiotic therapy remain crucial to improve outcomes.