Tıp Fakültesi / Faculty of Medicine

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Author: search.filters.author.Azap, Ozlem Kurtsearch.filters.applied.f.rights: search.filters.rights.info:eu-repo/semantics/closedAccess

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    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.
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    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.
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    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
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    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
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    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.
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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
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    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
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    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
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    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
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    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