Wos Açık Erişimli Yayınlar
Permanent URI for this collectionhttps://hdl.handle.net/11727/10754
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Item 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; 32335275This 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.Item Pericarditis due to an unusual microorganism in an immunocompromised patient(2019) Ozkalayci, Flora; Aydin, Mehtap; Altay, Hakan; Kocabas, Umut; Pehlivanoglu, Seckin; 0000-0001-6424-9399; 31483309; AAG-5856-2020A 77-year-old man with a past medical history of myelodysplastic syndrome, coronary artery disease, hypertension, and chronic atrial fibrillation presented at the hematology outpatient clinic with progressive shortness of breath, weakness, and chest and back pain. Echocardiography was performed and the patient was diagnosed with severe pericardial effusion near the right ventricle. Pericardial drainage was performed. Erysipelothrix rhusiopathiae was isolated from the pericardial fluid. Complications of respiratory and renal failure developed during follow-up. The clinical and laboratory findings of vegetation on the tricuspid valve, pericardial effusion, and atrial fibrillation with a low heart rate suggested possible pancarditis. A multidisciplinary treatment approach with the cardiology and infectious disease departments was critical to successful management of this case.Item HBsAg, Anti-HBs and Anti-HCV Seropositivity Rates among Pregnant Women Attending a University Hospital in Zonguldak(2015) Aynioglu, Aynur; Aynioglu, Oner; Akar, Tarik; Aydin, Mehtap; Altunok, Elif SarginObjective: To explore the HBV and HCV seroprevalence rates among pregnant women attending the Obstetric Outpatient Unit at the Medical Faculty of Zonguldak Bulent Ecevit University and to provide contributory data to the already existing data from the other geographical regions of Turkey. Materials and Methods: HBsAg, anti-HBs and anti-HCV seropositivity rates were retrospectively investigated among a total of 1084 pregnant women attending the Obstetric Outpatient Unit at the Medical Faculty of Zonguldak Bulent Ecevit University between January 2012 and January 2014 Serum assays were performed using a chemiluminescence immunoassay method according the manufacturer's instructions (Cobas e 411 Analyzer, Roche Diagnostics, Mannheim, Germany). Statistical analyses of the study data were performed using SPSS 18.0 software package (SPSS Inc., Chicago IL, USA). Results: The mean age of the 1084 pregnant participants was 29.12 +/- 5.48 years (min: 17, max: 46 y) and the average gestational age was 10.7 +/- 4.64 weeks. HBsAg, anti-HBs, and anti-HCV detection rates were 4% (n= 43), 7.3% (n= 79), and 0.6% (n= 7), respectively. With regard to age groups, HBsAg was positive in 3.1%, 3.7%, 4.4%, and 5.9% of the women who were below 20 years of age, between 21 and 30 years of age, between 31 and 40 years of age, and over 40 years of age, respectively. Conclusion: While similar rates of seroprevalence for HBsAg and anti-HCV were found as compared to the previous reports from Turkey, anti-HBs positivity rates were lower than that in most of the previous reports.Item Bloodstream Infections: Etiologic Agents and Their Antibiotic Resistance Rates(2016) Aydin, Mehtap; Kasikcioglu, Cemre; Nargiz-Kosucu, Sibel; Timurkaynak, Funda; Arslan, Hande; 0000-0002-5708-7915; ABG-7034-2021Objective: In this study, we aimed to investigate the etiological agents of bloodstream infections (BSIs) and their antibiotic resistance rates. Methods: The rates of antibiotic resistance of the microorganisms isolated from blood cultures in the microbiology laboratory between 2012 and 2013 were evaluated retrospectively. Blood cultures were performed by using BACTEC (TM) 9120 (Becton Dickinson, Sparks, MD, USA) automated system. Microorganisms that were isolated were identified by routine microbiological methods. Results: In our study, BSIs were most frequently detected in the cardiovascular surgery clinic. Out of 95 bacteria isolated from blood culture, 61 (64.2) were Gram-negative bacteria (46% enteric, 18% nonfermentative), 20 (21%) were Candida spp. and 14 (15%) were Gram-positive bacteria. The most effective antibiotics for enteric bacteria were found as colistin, followed by imipenem, meropenem and amikacin and for nonfermentative Gram-negative bacteria as colistin, cefepime, piperacillin-tazobactam, imipenem and amikacin. Conclusions: When the resistance rates were compared within two years, significant increases in resistance were observed for quinolones and ceftazidime in nonfermentative bacteria, and for carbapenems in enteric bacteria. Regular monitoring of etiological agents of BSIs and their antibiotic resistance rates will guide the selection of empiric therapy.Item Resveratrol Protects Sepsis-Induced Oxidative DNA Damage in Liver and Kidney of Rats(2016) Aydin, Mehtap; Aydin, Sevtap; Sahin, Tevfik Tolga; Bacanli, Merve; Taner, Gokce; Basaran, Arif Ahmet; Basaran, Nursen; 27994910Background: The increases of free radicals have been proposed to be involved in the pathogenesis of sepsis, which leads to multiple-organ dysfunction syndromes. The uses of antioxidants as a complementary tool in the medical care of oxidative stress-related diseases have attracted attention of researchers. Resveratrol (RV) has suggested being antioxidant, anti-proliferative, and anti-inflammatory effects in various experimental models and clinical settings. Aims: This study was undertaken to evaluate the protective effects of RV on oxidative DNA damage induced by sepsis in the liver and kidney tissues of Wistar albino rats. Study Design: Animal experimentation. Methods: Four experimental groups consisting of eight animals for each was created using a total of thirty-two male Wistar albino rats. Sham group was given 0.5 mL of saline intra-peritoneal (ip) only following laparatomy. Sepsis group was given 0.5 mL saline ip only following the induction of sepsis. RV-treated group was given a dose of 100 mg/kg ip RV in 0.5 mL saline following laparatomy. RV-treated sepsis group was given 100 mg/kg ip RV in 0.5 mL saline following the induction of sepsis. A model of sepsis was created by cecal ligation and puncture technique. In the liver and kidney tissues, oxidative stress parameters (malondialdehyde (MDA), reduced glutathione (GSH), superoxide dismutase (SOD), glutathione peroxidase (GPX)) and a proinflammatory cytokine (tumor necrosis factor alpha (TNF-alpha)), were evaluated spectrophotometrically and DNA damage was determined by the alkaline single cell gel electrophoresis (comet assay) technique using formamidopyrimidine DNA glycosylase protein. Results: In the RV-treated sepsis group, the levels of MDA and TNF-alpha were lower and GSH levels, SOD and GPX activities were higher than in the septic rats (p<0.05). RV treatment significantly reduced the sepsis-induced oxidative DNA damage in the liver and kidney cells (p<0.05). Conclusion: It is suggested that RV treatment might reduce the sepsis-induced oxidative DNA damages in sepsis-related diseases; however, there is a need for more studies to clear up the protective mechanisms of RV against sepsis.Item Complicated left-sided infective endocarditis in chronic hemodialysis patients: a case report(2017) Gulmez, Oyku; Aydin, Mehtap; 0000-0002-9429-5430; 28106022; ABC-7134-2021; AAE-6201-2021Infective endocarditis (IE) is a serious infectious condition with high morbidity and mortality in patients with end-stage renal disease (ESRD). It has been particularly associated with recurrent bacteremia due to vascular access via lumen catheters. The most common pathogen is Staphylococcus (S.) aureus, and most affected valve is mitral valve, which frequently calcified. Two patients with ESRD who received hemodialysis treatment via tunneled catheters, aged 56 and 88 years, were admitted with fever and high troponin level. Blood cultures revealed growth of S. aureus. Good quality transthoracic echocardiography (TTE) displayed calcified mitral and aortic valves with no vegetation or abscess formation. Myocardial necrosis as result of catheter infection was considered. Both patients had persistent positive blood cultures 3 and 5 days after initiation of antibiotic treatment. Therefore, transesophageal echocardiogram (TEE) was scheduled. Results revealed perivalvular abscess in the older patient, and highly mobile vegetation in the younger patient. The older patient refused surgery and died soon after due to refractory shock. Mitral valve surgery was planned for the other patient; however, she developed left ventricular failure and bleeding, and also subsequently died as result of refractory shock. Patient evaluations were particularly unfavorable: they had catheter infection as primary focus, and TTE did not detect vegetation or annular abscess. Diagnosis of IE in patients with ESRD using Duke criteria is problematic; we have to keep use of TEE in mind to detect vegetation or abscess formation when there is clinical suspicion regarding ESRD patients even after good quality TTE.Item Molecular Characterization of Drug Resistance in Hepatitis B Viruses Isolated from Patients with Chronical Infection in Turkey(2018) Aydin, Mehtap; Asan, Ali; Sayan, Murat; Akhan, Sila; Koruk, Suda Tekin; Aygen, Bilgehan; Sirmatel, Fatma; Eraksoy, Haluk; Tuna, Nazan; Kose, Sukran; Kaya, Ali; Tulek, Necla Eren; Demir, Nazlim Aktug; Mistik, Resit; Ormen, Bahar; Korkmaz, Fatime; Yildirmak, Taner; Ural, Onur; Turgut, Huseyin; Gunal, Ozgur; Demirtuk, NeseBackground: Hepatitis B virus (HBV) has a high mutation rate due to its unusual replication strategy leading to the production of a large number of virions with single and double mutations. The mutations, in turn, are associated with the development of drug resistance to nucleos(t)ide analogs (NUCs) in patients before and during NUCs therapy. Objectives: The current study aimed at investigating the molecular characterization of HBV in Turkish patients with chronic hepatitis B (CHB) infection. Methods: Polymerase chain reaction (PCR) amplification and direct sequencing procedures were used to analyze mutations. The detected drug resistance mutations were divided into the nucleos(t) ide analogs primary, partial, and compensatory resistance groups. The amino acid substitutions of hepatitis B surface antigen (HBsAg) were categorized into antiviral drug - associated potential vaccine-escape mutations (ADAPVEMs) and typical HBsAg amino acid substitutions, which included hepatitis B hyperimmunoglobulin (HBIg) - selected escape mutation, vaccine escape mutation, hepatitis B misdiagnosis, and immune - selected amino acid substitutions. Results: The number of patients included in the study was 528 out of which 271 (51.3%) were treatment - naive and 351 (66.3%) were hepatitis B e antigen (HBeAg) - negative. Moreover, 325 (61.6%) were males with a mean age of 38 years (range: 18 - 69). Primary, partial, and compensatory resistance to NUCs was reported in 174 (32.9%) patients. Six different ADAPVEM motifs were determined in both treatment - naive and treatment - experienced patients, namely, sF161L/rtI169X, sE164D/rtV173L, sL172L/rtA181T, sL173F/rtA181V, sS195M/rtM204V, and sS196L/rtM204I. The prevalence of ADAPVEMs and typical HBsAg escape mutations was 5.3% (n = 28) and 34.8% (n = 184), respectively. Conclusions: The analysis of drug resistance should constitute a fundamental part of the follow - up period of patients with CHB undergone treatment with NUCs. The surveillance of development of drug resistance mutations, while receiving treatment for hepatitis B is of paramount importance to monitor and control the emerging resistance.