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    Antibody Screening and Risk Assessment of Healthcare Professionals in the COVID-19 Pandemic
    (2021) Gumus, Hatice Hale; Demiroglu, Yusuf Ziya; Aliskan, Hikmet Eda; Odemis, İlker; Ceylan, Ozgur; Pocan, Ahmet Gurhan; Karagum, Ozlem; 0000-0001-9060-3195; 0000-0003-2638-0163; 0000-0002-9866-2197; 0000-0003-2638-0163; 0000-0001-6910-7250; 0000-0003-0681-8375; 0000-0003-3128-1602; 0000-0001-9071-9606; 34416802; AAE-2282-2021; AFK-3690-2022; AAX-9250-2021; AAZ-9711-2021; AAG-2486-2022; AAK-8276-2021; U-4084-2017; AAE-6310-2021; AAJ-2108-2021
    Globally 364102 healthcare professionals have been infected with severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) and 1253 of them died until 15 January 2021. Healthcare professionals serving at the forefront of combating the pandemic are in the high risk group. In our country, the data about coronavirus-2019 (COVID-19) among healthcare professionals are limited. The aim of this study was to investigate the anti-SARS-CoV-2 IgG seroprevalence in healthcare professionals, to evaluate the risks they encountered during work, and to examine their relationships with antibody positivity. A total of 572 healthcare professionals serving in various units of our hospital participated in our study and the presence of anti-nucleocapsid IgG was investigated by chemiluminescent microparticle immunoassay (SARS-CoV-2 IgG test, Abbott Laboratories Diagnostics, USA) method in serum samples collected between May 18, 2020 and June 30, 2020. The demographic characteristics, medical history, work conditions, medical procedures performed and possible risk factors were questioned with a questionnaire form. The average age of the participants was 33.5 +/- 9.2 (19-61) years, and 62.9% (360/572) of them were women. In our study, the anti-SARS-CoV-2 IgG seroprevalence was 3.7% (21/572). The association of the antibody positivity with age, gender and occupational status was not statistically significant (p> 0.05). Comorbid diseases which were significantly higher in seropositive healthcare professionals were hypertension (19%) and diabetes mellitus (14.3%) (p< 0.05). It was observed that antibody positivity was significantly higher in healthcare professionals working in high (52.4%) and medium risk (33.3%) areas, those who treat and/or examine patients with suspicious or positive COVID-19 (66.7%) and those who spend more than 30 minutes in COVID-19 patient rooms (76%) (p< 0.05). The symptoms associated with seropositivity in healthcare workers with a history of symptoms (46%) were loss of smell (23.5%), loss of taste (20.0%) and respiratory distress (16.7%) (p< 0.05). It was observed that the probability of being infected with SARS-CoV-2 increased 12 times if there was a colleague with COVID-19 in the hospital, four times if there was a patient in the house/lodging and six times if there was an infected person in the social environment (p< 0.05). The rate of those who had the flu vaccine among the participants was 10.8% (62/572) and 9.7% of them were found to be anti-SARS-CoV-2 IgG positive (p< 0.05, 95% CI= 1.31-9.48). The seropositivity was significantly higher in non-smokers (4.8 %) compared to smokers (0.0%) (p< 0.05). In our study, it was determined that the rate of seropositivity was 12 times higher in healthcare professionals who stated that they received hydroxychloroquine prophylaxis due to risky contact compared to those who did not receive prophylaxis (p< 0.05, 95% CI= 4.11-40.64). The ratio of the personnel who answered "always" to the frequency of wearing gloves, masks, goggles/face shields and overalls was 85.7%, 96.9%, 62.1% and 65.4%, respectively. In conclusion, regular and large-scale sero-epidemiological screening of healthcare professionals in the COVID-19 pandemic can contribute to the control of the pandemic by providing a better understanding of transmission dynamics and risk factors.
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    Determination of Biofilm Formation Properties of Methicillin Sensitive and Resistant Staphylococcus aureus Isolates by Conventional and Molecular Methods
    (2020) Hortac Istar, Elvan; Aliskan, Hikmet Eda; Basustaoglu, Ahmet; 0000-0002-2571-0637; 0000-0001-9060-3195; 32723278; AAI-8926-2021; AAE-2282-2021
    Biofilm-related infections are considered as among the foremost causes of treatment failure nowadays. One of the most common causes of biofilm-related infections is Staphylococcus aureus. It becomes extremely difficult to determine the appropriate treatment protocol while biofilm-related infections are coexisting with bacterial methicillin resistance. The aim of this study was to observe the potential of biofilm formation of methicillin-sensitive and -resistant S.aureus strains isolated from different clinical specimens and to determine reliable and effective methods for biofilm detection. A total of 200 S.aureus strains (100 methicillin-resistant and 100 methicillin-susceptible) isolated from 107 wound, 93 blood and catheter specimens, which were accepted as causative agents, included in the study. In order to determine the methicillin sensitivity, oxacillin minimal inhibitory concentration value obtained by an automated system and cefoxitin disc diffusion method were evaluated together. Biofilm formation was investigated by modified Christensen (MC), MTT, BioTimer and Congo Red Agar (CRA) methods, and the presence of ica operon responsible for biofilm formation was also observed by polymerase chain reaction. It has been shown that methicillin-resistant isolates produce biofilms in a shorter time and higher rate, and their biofilm structure is denser than methicillin-sensitive isolates in all MC, MTT and BioTimer methods. There was no difference between blood and wound isolates in biofilm formation. The most sensitive and specific conventional methods were MTT and BioTimer methods respectively. There was no significant difference between the isolates containing a gene region of icaADBC operon and the biofilm forming isolates according to MC, MTT, BioTimer and CCA methods. There was a high correlation between the presence of biofilm and ica positivity, and the tendency to form biofilm augmented as the number of ica genes increased. It has been emphasized that more virulent strains such as methicillin-resistant S.aureus have a higher tendency to form biofilm, and these two resistance mechanisms have been shown to support each other as cascade. ica detection may be an important reagent in itself for the detection of virulent strains, thus detection of the ica presence may be an early marker of treatment decisions, determination of protection strategies, and struggle with biofilm-related infections. In cases where molecular methods are not available, the existence of quick, easy-to-apply and reliable conventional methods to detect biofilm formation is extremely important. All conventional methods used in this study seem to be sufficient in this respect. MC and MTT methods stand out in terms of biofilm quantitation. BioTimer method is a very new and remarkable test used to detect biofilm formation. In conclusion, determining the potential of biofilm formation of colonizing or causative agents and taking essential precautions before interventional procedures will decrease biofilm related infections and related morbidity and mortality.
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    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; 25805675
    Objective: 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.
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    Comparison of B.melitensis and B.abortus Bacteremias with Respect to Diagnostic Laboratory Tests
    (2015) Aliskan, Hikmet Eda
    Aim: 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.
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    Antibiotic resistance of streptococcus pneumoniae and haemophilus influenzae isolated from respiratory tract specimens
    (2016) Aliskan, Hikmet Eda; Colakoglu, Sule; Gocmen, Julide Sedef
    Purpose: Streptococcus pneumoniae and Haemophilus influenzae are two of the major pathogens in respiratory infections, treatment is usually started empirically. The aim of this study was to detect in vitro resistance rates of S. pneumoniae and H. influenzae strains isolated from different lower respiratory clinical samples to the antibotics which are used for therapy of infections due to these pathogens. Material and Methods: Seventy seven S. pneumoniae and 117 H. influenzae strains, isolated from patients were included in the study. S. pneumoniae isolates which gave an inhibition zone diameter of > 20 mm for oxacillin were considered susceptible for penicilin. For the isolates which had an oxacillin zone diameter of <20 mm, MIC values of penicillin and cefotaxime were obtained by E-test method (bioMerieux, Marcy-l'Etoile, France). Results: Of 77 S. pneumoniae isolates, 24.6 % were resistant (MIC> 2 mg/l) and 31.1 % were intermediately resistant to parenteral penicillin. Resistance rates to antibiotics were as follows: erythromycin 40 %, trimethoprim/sulphametoxazole (TMP/SMX) 54.5 % and ofloxacin 6.4%. beta-lactamases were detected in 15.6% of the H. influenzae isolates by nitrocefin positivity. Conclusion: H. influenzae strains (8.6%) were identified as beta-lactamase negative ampicillin resistant (BLNAR) strains. Resistance rates for other antibiotics were as follows: ampicillin 28.6%, cefaclor 36.5%, cefuroxime 30.1%, clarithromycin 9.6%, cloramphenicol 7% and TMP-SMX 43.9%.
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    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-9111-2021
    Listeria 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.