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Item The Role of Pneumococcal Pneumonia among CommunityAcquired Pneumonia in Adult Turkish Population: TurkCAP Study(2021) Senol, Esin; Cilli, Aykut; Gunen, Hakan; Sener, Alper; Dumlu, Ridvan; Odemis, Ayse; Topcu, Ayse Fusun; Yildiz, Yesim; Guner, Rahmet; Ozhasenekler, Ayhan; Mutlu, Birsen; Kokturk, Nurdan; Sevimli, Nurgul; Baykam, Nurcan; Yapar, Derya; Ekin, Selami; Polatli, Mehmet; Gok, Sebnem Eren; Kilinc, Oguz; Sayiner, Abdullah; Karasahin, Omer; Cuhadaroglu, Caglar; Kocagoz, Ayse Sesin; Togan, Turhan; Arpag, Huseyin; Kati, Hakan; Koksal, Iftihar; Aksoy, Firdevs; Hasanoglu, Canan; 35110252OBJECTIVE: To evaluate the rate of pneumococcal pneumonia (PP) among patients with community-acquired pneumonia (CAP) in Turkey and to investigate and compare features of PP and non-PP CAP patients. MATERIAL AND METHODS: This multicenter, non-interventional, prospective, observational study included adult CAP patients (age = 18 years). Diagnosis of PP was based on the presence of at least 1 positive laboratory test result for Streptococcus pneumoniae (blood culture or sputum culture or urinary antigen test [UAT]) in patients with radiographic findings of pneumonia. RESULTS: Four hundred sixty-five patients were diagnosed with CAP, of whom 59 (12.7%) had PP. The most common comorbidity was chronic obstructive pulmonary disease (30.1%). The mean age, smoking history, presence of chronic neurological disease, and CURB-65 score were significantly higher in PP patients, when compared to non-PP patients. In PP patients, 84.8% were diagnosed based ony on the UAT. The overall rate of PP patients among CAP was calculated as 22.8% considering the UAT sensitivity ratio of 63% (95% confidence interval: 45-81). The rate of intensive care treatment was higher in PP patients (P =.007). While no PP patients were vaccinated for pneumococcus, 3.8% of the non-PP patients were vaccinated (P =.235). Antibiotic use in the preceding 48 hours was higher in the non-PP group than in the PP group (31.8% vs. 11.1%, P =.002). The CURB-65 score and the rate of patients requiring inpatient treatment according to this score were higher in the PP group. CONCLUSION: The facts that PP patients were older and required intensive care treatment more frequently as compared to non-PP patients underline the burden of PP.Item Could there be an association between chronic brucellosis and endothelial damage?(2015) Togan, Turhan; Ciftci, Ozgur; Turan, Hale; Narci, Huseyin; Gullu, Hakan; Arslan, Hande; 25596571Introduction: In this study, we examined the effects of Brucella infection on endothelial dysfunction. Flow-mediated dilatation (FMD) measurement is indicator of the endothelial function, and abnormal values indicating endothelial dysfunction are accepted as the first stage of atherosclerosis. Methodology: Twenty-four patients who had been treated for acute brucellosis two years before, and who had had no relapses in the follow-up, were prospectively included in the study, along with 30 healthy individuals in the control group. Results: While the highly sensitive Creactive protein (hs-CRP) value was 2.42 +/- 1.45 in the patient group, it was 1.72 +/- 0.61 in the control group (p = 0.025). While the FMD value was 3.50 +/- 1.58 in the patient group, it was 5.88 +/- 1.88 in the control group (p < 0.001). While the percentage increase in FMD was 9.88 +/- 4.92 in the patient group, it was 17.49 +/- 6.3 in the control group (p < 0.001). It was observed that FMD value, the percentage increase in FMD, and basal radius were correlated with hs-CRP (r = -0.644, p < 0.001; r = -0.558, p = 0.002; r = 0.444, p = 0.018, respectively). The carotid artery intima media thickness (IMT) value was found to be 0.61 +/- 0.17 in the patient group and 0.49 +/- 0.12 in the control group (p = 0.004). Conclusions: The abnormal FMD and IMT values observed in brucellosis patients might be an indicator of more frequent arterial dysfunction, increased cardiovascular risk, and atherosclerosis.Item The Impact of Acute Brucellosis on Mean Platelet Volume and Red Blood Cell Distribution(2015) Togan, Turhan; Narci, Huseyin; Turan, Hale; Ciftci, Ozgur; Kursun, Ebru; Arslan, Hande; 25825650Background: Brucellosis is an inflammatory disease which may infect any organs or systems in the body. Mean Platelet Volume (MPV) is one of the most frequently used surrogate markers of platelet function. It reveals the presence of disease activity in many inflammatory diseases. Red blood cell distribution width (RDW) is a parameter that measures variation in red blood cell size or red blood cell volume. Its predictive value approves inflammatory and infectious diseases. Objectives: The current study aimed to determine the assessment levels of red blood cell distribution in cases with acute brucellosis. Patients and Methods: The current study investigated whether MPV and RDW played any roles in acute brucellosis diagnosis. The study was conducted from 2008 to 2014 through prospective examination of the inflammatory markers found in adult patients with acute brucellosis. Results: The follow-up within the year after treatment was examined. The values of age, gender, leukocyte count, C-reactive protein, RDW and MPV were recorded. The study included 351 subjects, 250 of them in the acute brucellosis group and 101 in the control group. The mean MPV levels were 7.64 +/- 1.30 fL, and 7.67 +/- 1.29 fL in the acute brucellosis and control groups, respectively (P > 0.05). The mean CRP levels were 32.57 +/- 53.20 mg/dL, and 4.81 +/- 4.89 mg/dL in the acute brucellosis and control groups, respectively (P < 0.05). There was no statistically significant difference between the two groups regarding the RDW level and the mean leukocyte count (P > 0.05). Conclusions: While the CRP value was in patients with acute brucellosis in the current study, the MPV, RDW and leukocyte counts were within the normal range. CRP value remains the most valuable inflammatory marker in cases of acute brucellosis.Item The value of serum mean platelet volume in testicular torsion(2015) Cicek, Tufan; Togan, Turhan; Akbaba, Kaan; Narci, Huseyin; Aygun, Cem; 25762515Objective To compare the serum mean platelet volume (MPV) in patients with testicular torsion and healthy control subjects. Methods This retrospective study compared clinical and demographic data from patients who underwent surgery for testicular torsion and healthy controls. Testicular torsion was diagnosed with a physical examination and Doppler ultrasonography. Age, leukocyte count, platelet count and MPV were recorded for all participants. Results A total of 50 patients with testicular torsion and 51 healthy control subjects were enrolled. There was no significant difference in age and platelet count between the two groups. Patients with testicular torsion had a significantly higher leukocyte count and MPV, compared with controls. According to receiver operating characteristic curve analysis performed for the prediction of testicular torsion, the best cut-off point for MPV was 7.7fl (sensitivity 62%, specificity 96%), and the best cut-off point for leukocyte count was 9.5x10(9)/l (sensitivity 58%, specificity 80%). Conclusions The MPV may be useful as an ancillary test for the diagnosis of testicular torsion. Further studies are needed in order to confirm these preliminary results.Item An Unexpected Pseudomonas Luteola Bacteremia: Case Report(2015) Turan, Hale; Togan, TurhanPseudomonas luteola has rarely been reported as a human pathogen. It was showed in previous studies showed that P. luteola may cause septicemia, bacteremia, peritonitis, and endocarditis in patients with underlying disease or with indwelling devices. In this article we report a case of P. luteola bacteremia without any source. We successfully treated our patient with ceftriaxone and ciprofloxacin combination.Item Comparative Evaluation of Cases with Community-Acquired Infective Endocarditis and Health Care-Associated Infective Endocarditis(2015) Kursun, Ebru; Turunc, Tuba; Demiroglu, Yusuf Ziya; Togan, Turhan; Tekin, Goknur; Arslan, HandePurpose: The present study aimed to comparatively evaluate the cases with health care-associated infective endocarditis and the cases with community-acquired infective endocarditis. Material and Methods: Of the cases followed for infective endocarditis (IE), 21 (40 %) had health care-associated infective endocarditis and 31 (60 %) community-acquired infective endocarditis. Results: Comparing the cases with community acquired infective endocarditis and the cases with health care-associated infective endocarditis, it was determined that advanced age (58.0 +/- 15.1 years vs. 41.3 +/- 14.4 years, P=0.000), presence of chronic renal insufficiency (P=0.001) and diabetes mellitus (P=0.016) as concomitant diseases, being previously hospitalized (P=0.0001), hemodialysis in terms of diagnostic and therapeutic interventions (P=0.022), presence of central venous catheter (P=0.022), and undergone intervention for gastrointestinal system (P=0.060), as well as laboratory results including positive blood culture growth for S. aureus and Enterococcus (P=0.037), and complications such as development of embolic event (P=0.008), spondylodiscitis (P=0.034) and stroke (P=0.007) were statistically significantly more common in health care-associated infective endocarditis cases. Whilst mortality was higher in health care-associated infective endocarditis cases (28.6 %), it was determined that there was no statistically significant difference between the groups. Conclusion: Health care-associated infective endocarditis is a disease that is more common in the patients at advanced age, with concomitant disease and the history of exposing invasive procedures in the past for diagnostic and therapeutic purpose, and it is a disease with high morbidity and mortality that courses with serious complications.Item In Vitro Susceptibility of Tigecycline and Colistin Against Stenotrophomonas maltophilia(2018) Turan Özden, Hale; Togan, Turhan; Azap, ÖzlemIntroduction: Gram-negative bacillus Stenotrophomonas maltophilia is resistant to drugs (multi-drug resistance-MDR) and it can be isolated from nature. Treatment of the infections resulting from S. maltophilia could be problematic due to multi-resistance. Materials and Methods: 72 S. maltophilia strains isolated from clinical samples were included into the study. Sensitivity was determined using Tigecycline and Colistin E-test MIC method performed in the Clinical Microbiology laboratory of Baskent University, Medical Faculty between 2010 and 2014. Results: In our study, colistin MIC range was found as 0.016-8 mg/L. MIC50 and MIC90 values were determined respectively as 1.5 mg/L and 12 mg/L. Tigecycline MIC range was 0-96 mg/L, and MIC50 was 0.19 mg/L and MIC90 was 1.5 mg/L. Furthermore, one tigecycline resistant strain was detected. Conclusion: We believe that the determination of novel treatments and protocols and their standardization using multidisciplinary approaches can facilitate to cope with problematic and resistant nosocomial infections developed by S. maltophilia.