Browsing by Author "Yesilkaya, Aysegul"

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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
Diagnosis, treatment and prevention of infective endocarditis: Turkish consensus report-2019
(2020) Yavuz, Serap Simsek; Deniz, Denef Berzeg; Azap, Ozlem; Basaran, Seniha; Cag, Yasemin; Cagatay, Atahan; Cinar, Gule; Kaya, Sibel Dogan; Hizmali, Lokman; Isik, Mehmet Emirhan; Kilicaslan, Nirgul; Menekse, Sirin; Meric-Koc, Meliha; Ozturk, Serpil; Sensoy, Ayfer; Tezer-Tekce, Yasemin; Tukenmez-Tigen, Elif; Uygun-Kizmaz, Yesim; Velioglu-Ocalmaz, Mutlu Seyda; Yesilkaya, Aysegul; Yilmaz, Emel; Yilmaz, Neziha; Yilmaz-Karadag, Fatma; 0000-0002-0699-8890; 0000-0002-7635-8848; 0000-0002-3171-8926; 32147661; AAA-8899-2021; AAN-5897-2021; AAF-5652-2021; S-7343-2016; ABA-2413-2020; AAK-4089-2021
Infective endocarditis (IE) is a rare but still important as an infectious disease due to high rate of morbidity and substantial mortality. Although IE is not a notifiable disease in Turkey, and an incidence study has not been performed, the incidence may be higher than that in the developed countries due to frequent predisposing cardiac conditions and higher rates of nosocomial bacteremia, which may lead to IE in risk groups. IE generally affects the elderly in developed countries but it is frequently encountered among young individuals in Turkey. In order to reduce mortality and morbidity, it is critical to diagnose IE, to determine the causative agent, and to start treatment rapidly. Most patients cannot be diagnosed at the first visit, about half can be diagnosed after 3 months, and the disease often goes unnoticed. In patients diagnosed with IE, the rate of the identification of a causative organism is significantly lower in Turkey than that in developed countries. Some important microbiological diagnostic tests are not performed in most centers and several antimicrobials that are recommended as the first option for the treatment particularly antistaphylococcal penicillins, are unavailable in Turkey. These problems necessitate reviewing the epidemiological, laboratory, and clinical characteristics of IE in our country, as well as the current information about its diagnosis, treatment, and prevention together with local data. The diagnosis and treatment processes of IE should be standardized at every stage so that the management can be conducted in a setting in which physicians of various specialties are involved and is consistent with the current recommendations. The Study Group for Infective Endocarditis and Other Cardiovascular Infections of the Turkish Society of Clinical Microbiology and Infectious Diseases called for the collaboration of the relevant specialist organizations to establish a consensus report on the diagnosis, treatment, and prevention of IE in the context of current information and local data in Turkey.
The Distribution and Antimicrobial Susceptibility Profiles of Etiologic Agents Isolated From Bacteremia Episodes Among Immunocompromised Patients
(2017) Demirkaya, Melike Hamiyet; Yesilkaya, Aysegul; Akcil-Ok, Mehtap; Kurt-Azap, Ozlem; 0000-0002-3171-8926; AAK-4089-2021
Objective: Bacteremia is the leading cause of morbidity and mortality among immunocompromised patients. The aim of this study is to evaluate the etiology of bacteremia and the antibiotic susceptibilities of etiologic agents among immunocompromised patients followed up from January 1, 2012 to July 30, 2013. Methods: Immunocompromised patients, both inpatient and outpatient treated in our hospital, were followed prospectively. The definition of "immunocompromised patients" consisted of solid organ (kidney, liver) transplantation recipients and hemato-oncologic malignancy patients with a history of chemotherapy in the previous month before bacteremia. Results: This prospective study comprised of 167 bacteremia episodes of 130 consecutive immunocompromised patients. The most isolated group of bacteria was Gram-negative bacteria. Escherichia coli was the most commonly (30.8%) isolated bacteria and the second was coagulase-negative staphylococci (15.1%). Fifty one percent of the E. coli isolates were extended-spectrum beta-lactamasepositive. Acinetobacter baumannii was the second most common bacteria of Gram-negative agents and the ratio of multiple drug-resistant (MDR) isolates among Acinetobacter isolates was 73%. Conclusions: Gram-negative bacteria are the most common causative agents of bacteremia in immunocompromised patients in our hospital. The rising ratio of MDR A. baumannii is a striking problem which causes difficult-to-treat infections.
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
Effect of initial antifungal therapy on mortality among patients with bloodstream infections with different Candida species and resistance to antifungal agents: A multicentre observational study by the Turkish Fungal Infections Study Group
(2020) Dogan, Ozlem; Yesilkaya, Aysegul; Menekse, Sirin; Guler, Ozlem; Karakoc, Cagla; Cinar, Gule; Kapmaz, Mahir; Aydin, Mehtap; Keske, Siran; Sahin, Suzan; Haciseyitoglu, Demet; Yalcin, Demet; Tekin, Suda; Atac, Nazli; Albayrak, Ozgur; Aksu, Ekin Deniz; Can, Fusun; Ergonul, Onder; 32335275
This study aimed to describe the effect of initial antifungal therapy on patient mortality and to detail the current distribution and resistance patterns of Candida spp. among patients with candidaemia. A prospective observational study was performed among consecutive patients with candidaemia from 10 Turkish medical centres between January 2015 and November 2018. The primary outcome was 10-day mortality. Species were identified using MALDI-TOF/MS. A total of 342 patients with candidaemia were included, of which 175 (51.2%) were male and 68 (19.9%) were aged <18 years. The most common species were Candida albicans (47.4%), Candida parapsilosis (26.6%), Candida tropicalis (9.6%) and Candida glabrata (7.6%). Among all Candida spp., the 10-day case fatality rate (CFR) was 32.2%. The CFR was highest in patients with C. albicans (57.3%) and lowest in patients with C. parapsilosis (21.8%). The resistance rate to fluconazole was 13% in C. parapsilosis, with no significant effect on mortality. No resistance to echinocandins was detected. In the multivariate analysis, being in the ICU [OR = 2.1 (95% CI 1.32-3.57); P = 0.002], renal failure [OR = 2.4 (1.41-3.97); P = 0.001], total parenteral nutrition [OR = 2 (1.22-3.47); P = 0.006], C. albicans infection [OR = 1.7 (1.06-2.82); P = 0.027] and echinocandin as primary agent [OR = 0.6 (0.360.99); P = 0.047] were significantly associated with mortality. Candidaemia is a deadly infection. Fluconazole resistance is emerging, although it was not significantly related to mortality. Using an echinocandin as the primary agent could be life-saving. (c) 2020 Elsevier B.V. and International Society of Chemotherapy. All rights reserved.
Epidemiology, Species Distribution, Clinical Characteristics and Mortality of Candidaemia in A Tertiary Care University Hospital in Turkey, 2007-2014
(2017) Yesilkaya, Aysegul; Azap, Ozlem; Aydin, Mehtap; Ok, Mehtap Akcil; https://orcid.org/0000-0003-0225-6416; https://orcid.org/0000-0002-3171-8926; https://orcid.org/0000-0003-4044-9366; 28338249; A-8902-2013; AAK-4089-2021; HLX-0937-2023; AAZ-8170-2020
Candidaemia still continues to be a serious medical concern and the epidemiology of candidaemia varies according to geographical areas. We aim to determine the incidence, local epidemiology, Candida species distribution and crude mortality rates of candidaemia. We retrospectively evaluated candidaemia episodes in between January 2007 and August 2014. We compared demographic, clinical, microbiological findings and mortality rates of episodes caused by Candida albicans and non-albicans Candida species. Overall the candidaemia incidences were 1.23 episodes/1000 admissions. A significant negative slope among candidaemia episodes and years was determined. Overall C. albicans (54.6%) was the most common species followed by Candida glabrata, Candida tropicalis and Candida parapsilosis respectively. Preinfection hospital stay and length of hospital stay were statistically longer in patients with non-albicans Candida candidaemia than in patients with C.albicans candidaemia. The source of candidaemia was unknown in 52.5% of all episodes. Central venous catheters among non-albicans Candida candidaemia episodes and urinary system among C.albicans candidaemia episodes were common source of candidaemia compared to each other. Previous antifungal therapy preceding candidaemia and concomitant bacteraemia were significantly associated with non-albicans Candida candidaemia. Continuous local surveillance will preserve its pivotal importance in formulating empirical antifungal therapy and improving management of candidaemia.
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.
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
Mortality indicators in pneumococcal meningitis: therapeutic implications
(2014) Yesilkaya, Aysegul
Background: The aim of this study was to delineate mortality indicators in pneumococcal meningitis with special emphasis on therapeutic implications. Methods: This retrospective, multicenter cohort study involved a 15-year period (1998-2012). Culture-positive cases (n = 306) were included solely from 38 centers. Results: Fifty-eight patients received ceftriaxone plus vancomycin empirically. The rest were given a third-generation cephalosporin alone. Overall, 246 (79.1%) isolates were found to be penicillin-susceptible, 38 (12.2%) strains were penicillin-resistant, and 22 (7.1%) were oxacillin-resistant (without further minimum inhibitory concentration testing for penicillin). Being a critical case (odds ratio (OR) 7.089, 95% confidence interval (CI) 3.230-15.557) and age over 50 years (OR 3.908, 95% CI 1.820-8.390) were independent predictors of mortality, while infection with a penicillin-susceptible isolate (OR 0.441, 95% CI 0.195-0.996) was found to be protective. Empirical vancomycin use did not provide significant benefit (OR 2.159, 95% CI 0.949-4.912). Conclusions: Ceftriaxone alone is not adequate in the management of pneumococcal meningitis due to penicillin-resistant pneumococci, which is a major concern worldwide. Although vancomycin showed a trend towards improving the prognosis of pneumococcal meningitis, significant correlation in statistical terms could not be established in this study. Thus, further studies are needed for the optimization of pneumococcal meningitis treatment. (C) 2013 The Authors. Published by Elsevier Ltd on behalf of International Society for Infectious Diseases. All rights reserved.
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.
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