Tıp Fakültesi / Faculty of Medicine

Permanent URI for this collectionhttps://hdl.handle.net/11727/1403

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Author: search.filters.author.Durukan, ElifHas files: Yes

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    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.
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    The Evaluation of Vaccine Hesitancy and Refusal for Childhood Vaccines and the COVID-19 Vaccine in Individuals Aged Between 18 and 25 Years
    (2021) Durukan, Elif; Akdur, Recep; 0000-0002-9766-1117; 0000-0002-8579-5564; AAK-1044-2021; AAJ-8621-2021
    Objective: The aim of this study is to determine vaccine hesitancy and refusal for childhood vaccines and the Coronavirus disease-2019 (COVID-19) vaccine in individuals aged between 18 and 25 years and the affecting factors. Materials and Methods: In this descriptive study, an online questionnaire was implemented on 1.033 people aged between 18 and 25 years and living in Turkey between January 28, 2021, and February 19, 2021, by reaching them via e-mail and messaging applications. Results: Among the participants, 68.8% considered getting their children vaccinated, 11.4% were hesitant and 3.1% refused. Among the participants, 36.6% considered getting vaccinated against COVID-19, 34.8% hesitated and 28.6% refused. Hesitation/rejection of childhood vaccines increased with age and when negative information about childhood vaccines was obtained. The acceptance of the COVID-19 vaccine was higher in men, in those who assumed that the COVID-19 virus was of a natural origin, in those who obtained information on the COVID-19 vaccine from the Ministry of Health, and in those who made search in scientific papers. Conclusion: The rates of hesitation and rejection in the COVID-19 vaccines are quite high compared to childhood vaccines. It shows that participants are influenced by speculative news. Therefore, it is recommended that this age group be given trainings based on scientific evidence regarding both childhood vaccines and the benefits of the COVID-19 vaccine.
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    The Prevalence, Etiologic Agents and Risk Factors for Urinary Tract Infection Among Spinal Cord Injury Patients
    (2014) Togan, Turhan; Azap, Ozlem Kurt; Durukan, Elif; Arslan, Hande
    Background: Urinary tract infections (UTIs) are important causes of morbidity and mortality in patients with spinal cord injury and 22% of patients with acute spinal cord injury develop UTI during the first 50 days. Objectives: The aim of this study was to determine the prevalence, etiologic agents and risk factors for asymptomatic bacteriuria and symptomatic urinary tract infections in patients with spinal cord injury. Patients and Methods: This was a prospective investigation of spinal cord injury patients with asymptomatic bacteriuria and symptomatic urinary tract infections in Baskent University Medical Faculty Ayas Rehabilitation Center and Ankara Physical Therapy and Rehabilitation Center between January 2008 and December 2010. The demographic status, clinical and laboratory findings of 93 patients with spinal cord injury were analyzed in order to determine the risk factors for asymptomatic or symptomatic bacteriuria Results: Sixty three (67.7%) of 93 patients had asymptomatic bacteriuria and 21 (22.6%) had symptomatic urinary tract infection. Assessment of the frequency of urinary bladder emptying methods revealed that 57 (61.3%) of 93 patients employed permanent catheters and 24 (25.8%) employed clean intermittent catheterization. One hundred and thirty-five (48.0%) of 281 strains isolated form asymptomatic bacteriuria attacks and 16 (66.6%) of 24 strains isolated from symptomatic urinary tract infection attacks, totaling 151 strains, had multidrug resistance (P > 0.05). One hundred (70.4%) of 142 Escherichia coli strains and 19 (34.5%) of 55 Klebsiella spp strains proliferated in patients with asymptomatic bacteriuria; 8 (80%) of 10 E. coli strains and 4 (80%) of 5 Klebsiella spp. strains were multidrug resistant. Conclusions: The most common infectious episode among spinal cord injury patients was found to be urinary tract infection. E. coli was the most common microorganism isolated from urine samples. Antibiotic use in the previous 2 weeks or 3 months, hospitalization during the last one-year and previous diagnosis of urinary tract infection were the risk factors identified for the development of infections with multi-drug resistant isolates. Urinary catheterization was found to be the only independent risk factor contributing to symptomatic urinary tract infection.