Tıp Fakültesi / Faculty of Medicine
Permanent URI for this collectionhttps://hdl.handle.net/11727/1403
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Item Evaluation of 28 Cases of Mucormycosis(2015) Kursun, Ebru; Turunc, Tuba; Demiroglu, Yusuf Ziya; Aliskan, Hikmet Eda; Arslan, Ayse Hande; 0000-0002-5708-7915; 0000-0001-9060-3195; 0000-0002-9866-2197; 0000-0001-7956-7306; 25590855; ABG-7034-2021; ADG-7352-2022; AAE-2282-2021; AAG-5020-2020; AAZ-9711-2021; GVT-0626-2022Mucormycosis is a rare but invasive fungal disease with high mortality. The present study aimed to retrospectively investigate the demographic characteristics, as well as the clinical, radiological and laboratory features and the results of treatment, in the patients followed in our hospital because of mucormycosis. The present study retrospectively evaluated 28 cases, which were followed in our hospital because of mucormycosis between January 2002 and July 2013. The clinical form was rhinocerebral in 27 cases (rhinoorbital in 12, nasal in 8 and rhinoorbitocerebral in 7) and disseminated in one case. With regard to predisposing factors, diabetes mellitus (n=20), haematological malignancy (n=6) and chronic renal insufficiency (n=5) were the leading concomitant diseases. Seventeen (61%) of 28 cases showed atypical clinical picture. With regard to the therapeutic outcomes; it was found that 14 (50%) cases died and six cases recovered with sequel. Today, when particularly the prevalence of immunosuppressive diseases and conditions are gradually increasing, the incidence of mucormycosis is also increased. Considering that the majority of our cases had atypical clinical involvement and complications, being familiar with the characteristics of this disease could be life-saving together with early diagnosis and treatment.Item Aspiration of An Interesting Foreign Body: Myiasis(2015) Ince, Emine; Oguzkurt, Pelin; Gezer, Hasan Ozkan; Aliskan, Hikmet Eda; Hicsonmez, Akgun; 0000-0001-9060-3195; 27735804; AAE-2282-2021; J-3197-2013Myiasis is a rare condition caused by the invasion of tissues by the larvae of flies. Many cases of myiasis involving various human organs have been reported. Tracheopulmonary or intratracheal myiasis is a very unusual and aberrant form of the disease in humans. We present a case of respiratory myiasis after aspiration of larvae by a healthy 8-month-old girl, which cannot be found in the English literature.Item Early Infections in Renal Transplant Recipients: Incidence, Risk Factors, and Causative Microorganisms(2015) Yabanoglu, Hakan; Aliskan, Hikmet Eda; Caliskan, Kenan; Arer, Ilker; Akdur, Aydincan; Yildirim, Sedat; Moray, Gokhan; Haberal, Mehmet; 0000-0002-1161-3369; 0000-0002-8726-3369; 0000-0002-5735-4315; 0000-0001-9060-3195; 0000-0002-8767-5021; 0000-0002-3462-7632; 0000-0003-0268-8999; 0000-0003-2498-7287; 26640902; AAJ-7865-2021; AAA-3068-2021; AAF-4610-2019; AAE-2282-2021; AAJ-7201-2021; AAJ-8097-2021; AAK-2011-2021; AAE-1041-2021Objectives: This study aimed to compare renal transplant recipients with and without infection with respect to demographic and clinical characteristics as well as risk factors; to determine the incidence of posttransplant infections; and to study the antibiotic resistance patterns of bacterial species identified as the causative organisms in posttransplant infections. Materials and Methods: This study included a total of 136 patients undergoing renal transplant in a 4-year period. The patients were categorized into 2 groups. The 2 groups were compared with each other with respect to general clinical and demographic variables and the number and frequency of infectious attacks within a 1-year follow-up, infection type, and antibiotic resistance patterns. Results: Ninety-two (67.6%) of the subjects were male and 44 (32.4%) were female. A total of 57 (41.9%) patients developed 128 infectious attacks. Urinary tract infections were the most common infections (42.1%). There was a significant correlation between a clinically relevant urinary culture proliferation and postoperative infection rate (P =.002). There was a significant correlation between antimicrobial resistance and the number of infectious attacks (P =.023). There was a significant correlation between the proliferation of Extended Spectrum Beta Lactamase-positive Enterobactericeae species and the number of infectious attacks (P =.000). Conclusions: Presence of a clinically relevant proliferation in the preoperative urinary culture, which was identified as a risk factor for infection, increased the number of infectious attacks. Moreover, Extended Spectrum Beta Lactamase-positive Enterobactericeae species increased the number of infections. These 2 principle results should be taken into account in patient management.Item IgG Neutralizing Antibodies to SARS-CoV-2 Among Healthcare Workers Who Frequently Encountered Patients with COVID-19(2022) Yesilagac, Hasan; Aliskan, Hikmet Eda; Gumus, Hatice Hale; Odemis, Ilker; Unsal, Zuhal Ekici; 0000-0003-2638-0163; 0000-0001-9071-9606; AAD-1638-2019; AAJ-2108-2021Introduction: Since the Severe acute respiratory syndrome Coronavirus-2 (SARS-CoV-2) first emerged in Wuhan, on 12 December 2019, it has spread rapidly across the world and developed into a pandemic. As healthcare workers are frequently in contact with Coronavirus disease-2019 (COVID-19) patients, they can be affected more often than the general population. In this study we aimed to investigate the SARS-CoV-2 seroprevalence and the IgG antibody levels among healthcare workers who frequently encountered COVID-19 patients in our hospital.Materials and Methods: In total, 182 healthcare workers were identified from database and their data was retrospectively analyzed. Participants with previous PCR positivity, pregnant, autoimmune disease history or immunosuppressive treatment history were excluded. Participants were grouped depending on their frequency of contact with COVID-19 patients (high and medium risk). All the samples were tested simultaneously for anti-SARS-CoV-2-IgG antibodies by the ELISA method. A chi-square test was used to compare categorical variables. A t-test and an ANOVA test were carried out to where appropriate.Results: Serological testing of 182 HCWs exposed to SARS-CoV-2 patients illustrated that 13.2% of them (24 out of 182) might have experienced an asymptomatic or subclinical SARS-CoV-2 infection. High risk participants, anosmia, and ageusia were statistically significant risk factors. The rate of detection of antibody positivity among doctors (p=0.030) and patients with anosmia, and ageusia (p=0.047) were found significantly higher than the others. In addition, SARS-CoV-2 antibody ratio results were found significantly higher in the groups of high risk participants (p=0.046), patients with clinical signs (p=0.008), myalgia (p=0.039), anosmia, and ageusia (p=0.025), respectively.Conclusion: Our study showed that serological testing is useful for determining asymptomatic or subclinical infections prevelance of SARS-CoV-2 among those with close contact with COVID-19 patients. Serological tests can be helpful determining the prevelance COVID-19 infection, especially among the HCWs.Item Diverse efficacy of CarbaNP test among OXA-48 carbapenemase producing Enterobacterales in an endemic region(2021) Istar, Elvan Hortac; Aliskan, Hikmet Eda; Gocmen, Julide Sedef; 0000-0001-9060-3195; 33661134; AAE-2282-2021After the first description of OXA-48 type carbapenemase, it has become endemic in Europe, Mediterranean and North African countries in a short time. OXA-48 carbapenemase is the most difficult type to determine and accurate diagnosis is crucial especially in endemic areas. The CarbaNP test was described as a rapid phenotypic evaluation method of carbapenemases activity. Sensitivity and specifity of this test were high within all carbapenemases genes. In our study, we evaluated the efficacy of CarbaNP test in routine laboratories located in an endemic area of OXA-48 producing Enterobacterales. A total of 53 Enterobacterales isolates were included in this study. Antimicrobial susceptibility of the isolates to imipenem, meropenem and ertapenem was determined. Polymerase Chain Reaction (PCR) was carried out for the detection of carbapenemases genes (bla(KPC), bla(NDM), bla(BIC), bla(IMP), bla(VIM), bla(SPM), bla(AIM), bla(DIM), bla(GIM), bla(SIM), and bla(OXA-48)). The Carba NP test was performed as in the protocol described previously. Altogether 31 isolates (58.4%) were bla(OXA-48) positive (18 Klebsiella pneumoniae, 8 Escherichia coli, 2 Serratia marcescens, 1 Enterobacter aerogenes, 1 Pantoea agglomerans and 1 Morganella morganii). Among these isolates 3 (5.6%) and 2 (3.7%) isolates were also positive for bla(VIM) and bla(SPM), respectively. The sensitivity and specifity of CarbaNP test were found 64.5, and 68.2% respectively. It was observed that determination of positive isolates is hard to distinguish and subjective. The CarbaNP test has suboptimal results and low of sensitivity and specifity for detection of OXA-48 producing Enterobacterales, and not suitable for detection of bla(OXA-48) positive isolates in routine laboratories in endemic areas.Item Evaluation of extensively drug-resistant gram-negative bacteremia among solid-organ transplant recipients: a multicenter study(2021) Yanik Yalcin, Tugba; Azap, Ozlem; Kose, Adam; Bayindir, Yasar; Saricaoglu, Elif Mukime; Cinar, Gule; Uygun Kizmaz, Yesim; Kursun, Ebru; Aliskan, Hikmet Eda; Tezer Tekce, Yasemin; Eren Kutsoylu, Oya Ozlem; Egeli, Tufan; Ari, Alpay; Albayrak, Yurdagul; Cabadak, Hatice; Deniz, Secil; Demir Onder, Kubra; Kizilates, Filiz; Ozger, Selcuk; Guzel Tunccan, Ozlem; Haberal, Mehmet; 0000-0001-9060-3195; 0000-0002-3462-7632; 33865241; AAE-2282-2021; AAJ-8097-2021Background/aim: The aim of this study is to evaluate the distribution, sources, clinical features, and mortality rates of bacteremia due to evaluation of extensively drug-resistant (XDR) gram negative among solid-organ transplant (SOT) recipients. Materials and methods: A retrospective study of SOT recipients with bacteremia due to XDR gram-negative pathogens in 11 centers between 2016 and 2018 was conducted. Patients' records were evaluated. Results: Of 171 bacteremia that occurred in 164 SOT recipients, 93 (56.7%) were liver, 46 (28%) kidney, 14 (8.5%) heart, and 11 (6.7%) lung recipients. Bacteremia episodes were recorded in the first year in 63.7% of the patients (n = 109), early-onset bacteremia was recorded in 45% (n = 77) of the episodes. In multivariate analysis, catheter-associated bacteremia was an independent risk factor for 7-day mortality (p = 0.037), and early-onset bacteremia was found as an independent risk factor for 30-day mortality (p = 0.017). Conclusion: Difficult-to-treat infections due to XDR bacteria in SOT recipients shadow the success of transplantation. Central venous catheters seem to be the main risk factor. Judicious use of medical devices is of pivotal importance.Item Tunnelled Central Venous Catheter-Related Problems in the Early Phase of Haematopoietic Stem Cell Transplantation and Effects on Transplant Outcome(2015) Yeral, Mahmut; Boga, Can; Oguzkurt, Levent; Aliskan, Hikmet Eda; Ozdogu, Hakan; Demiroglu, Yusuf Ziya; 25805675Objective: Haematopoietic stem cell recipients need central venous catheters (CVCs) for easy administration of intravenous fluid, medications, apheresis, or dialysis procedures. However, CVCs may lead to infectious or non-infectious complications such as thrombosis. The effect of these complications on transplantation outcome is not clear. This manuscript presents the complication rates of double-lumen tunnelled CVCs and their effect on transplantation outcome. Materials and Methods: Data from 111 consecutive patients, of whom 75 received autologous and 36 received allogeneic peripheral blood stem cell transplantations, were collected retrospectively. The data were validated by the Record Inspection Group of the related JACIE-accredited transplantation centre. Results: Thrombosis developed in 2.7% of recipients (0.9 per 1000 catheter days). Catheter-related infection was identified in 14 (12.6%) patients (3.6 per 1000 catheter days). Coagulase-negative Staphylococcus was the most common causative agent. Engraftment time, rate of 100-day mortality, and development of grade II-IV graft-versus-host disease were not found to be associated with catheter-related complications. Conclusion: These results indicate that adverse events related with tunnelled CVCs are manageable and have no negative effects on transplant outcome.Item Comparison of B.melitensis and B.abortus Bacteremias with Respect to Diagnostic Laboratory Tests(2015) Aliskan, Hikmet EdaAim: Brucellosis are most commonly caused by the Brucella species Brucella melitensis and Brucella abortus. This study was aimed to determine the differences in the routine diagnostic tests (serological tests and blood culture positivity) that differentiate bacteremias caused by B. melitensis and B. abortus. Material and Method: This study included a total of 42 patients from whose blood cultures Brucella sp. were isolated between January 2010 and April 2014. A 8-10 ml blood sample was put into BACTEC plus/Aerobic F culture bottles after being drawn from patients (n: 42) with suspected brucellosis. The obtained samples were incubated in BACTEC 9240 device (BD Diagnostic, Maryland, USA) for 21 days. Sera of the blood samples taken simultaneously with the blood culture were studied with the Rose Bengal and Standard Tube Agglutination (STA) tests. Results: In patients with acute brucellosis, B. melitensis and B. abortus species showed no significant differences with respect to time to positive signal in blood cultures (for hours p= 0.850; for days p= 0.696) and the mean time to positivity. The earliest signal in the device was delivered at day 2., 44th hour and the latest at day 6., 123rd hour. No significant difference was noted between the two species with respect to the mean time to positivity. Discussion: This study did not show any significant differences between B. melitensis (n=22) and B. abortus (n=20) bacteremias with respect to age, sex, time to blood culture positivity, and STA test titer level.Item Listeriosis in a Patient Undergoing Hemodialysis: A Case Report and Review of the Literature(2017) Tekkarismaz, Nihan; Ozelsancak, Ruya; Torun, Dilek; Aliskan, Hikmet Eda; 0000-0001-7631-7395; 0000-0001-9060-3195; 0000-0002-0788-8319; 0000-0002-6267-3695; AAD-9088-2021; AAE-2282-2021; AAD-5716-2021; AAD-9111-2021Listeria monocytogenes (L. monocytogenes) infection is an uncommon manifestation in patients with chronic renal failure. In this article, we present a case of L. monocytogenes bacteremia in a patient undergoing hemodialysis. In addition, we are also present the listeriosis cases in hemodialysis patients reported so far in the literature. The patient was a 58-year-old man who was undergoing hemodialysis and had been admitted to hospital with fever. On the 5th day of admission, L. monocytogenes was detected in his blood cultures. He responded dramatically to ampicillin treatment. Listeriosis is a disease that requires careful microbiological laboratory examination. If the patient cultures are not analyzed carefully, the disease can be misdiagnosed. Only early diagnosis and adequate treatment can ensure a good prognosis.