Mustafa Ozyurt | Gulhane Military Medical Academy (original) (raw)
Papers by Mustafa Ozyurt
Critical Care, 2005
Introduction Community-acquired pneumonia remains a common condition worldwide. It is associated ... more Introduction Community-acquired pneumonia remains a common condition worldwide. It is associated with significant morbidity and mortality. The aim of this study was to evaluate conditions that could predict a poor outcome. Design Retrospective analyse of 69 patients admitted to the ICU from 1996 to 2003. Demographic data included age, sex and medical history. Etiologic agents, multiorgan dysfunction, nosocomial infections, SAPS II and PORT scores were recorded for each patient. For statistical analysis we used a t test, chi-square test and Mann-Whitney U test on SPSS ® . A value of P less than 0.05 was considered significant. Results Forty-seven patients were male and 22 patients were female. Mean age was 52 years. Sixty-seven percent had serious pre-morbid conditions including pulmonary disease (34.8%), cardiac problems (36.2%), diabetes (13%) and chronic liver disease (5.8%); 40.6% were smokers, drug abusers or alcohol dependents. Sixtyeight patients required invasive mechanical ventilation. The average length of ventilation was 13.5 days, median 8 days. The mean SAPS II score was 40.14 and the mean PORT score was 141. The mortality rate was 27.5% (SAPS II estimated mortality, 35%). Complications reported were ARDS (40.6%), septic shock (34.8%), acute renal failure (2.9%), cardiac arrest (8.7%) and nosocomial infeccions (46.4%). Mortality rates were higher for previous hepatic (75%) and metabolic (33%) diseases. We found a close association between crude mortality and SAPS II score (P = 0.003) and development of complications (P = 0.0028). Respiratory dysfunction (P = 0.006) and septic shock (P = 0.022) were most significantly related to mortality. No significant differences were founded regarding age, comorbidities, PORT score, etiologic agents, nosocomial infections and length of invasive mechanical ventilation. Conclusions Previous hepatic chronic disease was strictly related to higher mortality as well as isolation of MRSA. ARDS and septic shock predicted a poor outcome. SAPS II score was the best severity indicator of mortality.
The Southeast Asian journal of tropical medicine and public health, 2014
We aimed to investigate carbapenem resistance, resistance mechanisms, risk factors and epidemiolo... more We aimed to investigate carbapenem resistance, resistance mechanisms, risk factors and epidemiological features of Escherichia coli and Klebsiella pneumoniae strains isolated from related infections in intensive care unit (ICU) patients. Carbapenemase activity was determined by MHT, MBL Etest and enzyme extraction methods. Presence of extended-spectrum beta-lactamase (ESBL) and carbapenemase-encoding genes were investigated by PCR and sequencing. Clonal relationship of the strains was investigated by pulse field gel-electrophoresis. Acquired AmpC and Qnr were investigated by PCR. Throughout this study, 1,657 patients, and 11,483 hospitalization days were followed by active surveillance in the ICU of our 1,000-bed training hospital. Out of 108 of 196 patients, 130 E. coli- and K. pneumoniae-related nosocomial infections were determined. Minimum inhibitory concentration (MIC) levels of ertapenem were > or = 1 mg/1 in 14 K. pneumoniae and 2 E. coli strains. The highest MIC level of ...
Mikrobiyoloji bülteni, 2005
This study was conducted to investigate the presence of methicillin and aminoglycoside resistance... more This study was conducted to investigate the presence of methicillin and aminoglycoside resistance encoding genes by multiplex-polymerase chain reaction (PCR) and by phenotypic methods in staphylococci isolated from inpatients' clinical specimens. The presence of aac(6')1aph(2"), aph(3')-IIIa and ant(4)-Ia genes encoding aminoglycoside modifying enzymes (AME) and mecA gene encoding methicillin resistance were genotypically investigated. A total of 19 S. aureus and 30 coagulase negative staphylococci (CNS) were tested. Thirty four (69.4%) of the isolates were found to be resistant to oxacillin with disk diffusion test, 33 (97%) of which were found to harbour mecA gene. The correspondance between oxacillin resistance and presence of mecA gene was found to be 100% in S. aureus isolates, while it was 95.7% in CNS. Twenty two (44.9%), 7 (14.3%) and 2 (4.1%) isolates were found to harbour aac(6')/aph(2"), aph(3')-IIIa and ant(4)-/a AME genes, respectively. At ...
Central European Journal of Medicine, 2008
... cagE and virB11 detection in patients with non-ulcer dyspepsia from Turkey: Correlation with ... more ... cagE and virB11 detection in patients with non-ulcer dyspepsia from Turkey: Correlation with histopathologic findings Ugur Ilga1, Mustafa Ozyurt1*, Sukru Yıldırım2, Koray Ergunay3, Nurittin Ardic1, Levent Demirturk4, Tuncer Haznedaroglu1 ...
The Indian journal of medical research, 2012
Translocation of bacteria from the gut is an important factor in the development of septic compli... more Translocation of bacteria from the gut is an important factor in the development of septic complications and mortality in acute pancreatitis (AP). The present study was designed to assess the effects of infliximab treatment on bacterial translocation (BT) in experimental acute necrotizing pancreatitis. Male Sprague-Dawley rats (n=45) were allocated into three groups. AP was induced in group II (positive control, n=15) and group III (Infliximab; n=15) by retrograde injection of taurocholate into the common biliopancreatic duct. Group I rats (Sham; n=15) received normal saline infusion into the common biliopancreatic duct as placebo. Groups I and II were treated by normal saline and group III was treated with infliximab intraperitoneally on 6, 30 and 54 h after induction of pancreatitis. All surviving animals were killed 60 h after the induction of pancreatitis, and specimens were collected for amylase measurement as well as histopathologic and microbiologic examinations. Oedema, acin...
Pan African Medical Journal, 2014
It was aimed to investigate the frequency of Candida infections (CI) in the intensive care units ... more It was aimed to investigate the frequency of Candida infections (CI) in the intensive care units (ICU), to determine typing of candida to evaluate risk factors associated with CI and mortality, and to evaluate influence of CI on mortality. The prospective cohort study was carried out between Jan 1, 2009 and Dec 31, 2010 in ICUs, and the patients were observed with active surveillance. VITEK 2 Compact System (BioMerieux, France) kits were used for the identification of isolates from various clinical samples. A total of 2362 patients had enrolled for 16135 patients-days into the study. During the study, 63 (27,5%) of patients developed 77 episodes of CI were observed. Of the patients; 54% were male, 46% were female. Duration of hospitalization (OR = 1,03, p = 0,007), hyperglycemia (OR = 17,93, p = 0,009), and co-infections (OR = 3,98, p = 0,001) were identified as independent risk factors for CI. The most common infections were bloodstream (53%). 77 of 135 candida strains was isolated as causative pathogens. C. albicans (63,6%) was the most frequent species. Overall mortality rate was 78%. The rates of mortality attributable to CI and candidemia were 27%, and 18,3% respectively. Species- specific mortality rates of C.albicans and C.tropicalis were determined as 12%. High APACHE II scores (OR = 1,37; p = 0,002), and the use of central venous catheter (OR = 9,01; p = 0,049) were assigned as independent risk factors for mortality. CI is an important problem in our hospital. CI and associated mortality can be prevented by controlling of risk factors. Updating of epidemiological data is required for successful antifungal treatment.
Mikrobiyoloji bülteni, 2011
Increasing multidrug resistance in nosocomial Enterococcus strains from all over the world recent... more Increasing multidrug resistance in nosocomial Enterococcus strains from all over the world recently enhances the need for further investigation of enterococci, especially their virulence factors. There are still many lacking parts about virulence factors of clinical enterococcus isolates. In this study, it was aimed to investigate the antibiotic resistance and the presence of potential virulence factors of 91 Enterococcus strains (59 E.faecalis, 31 E.faecium and 1 E.gallinarum) isolated from urine cultures of inpatients between January 2008-June 2010 in our hospital and also to evaluate whether a correlation existed between antibiotic resistance and potential virulence factors. The genes which encoded virulence factors of enterococci; aggregation substance (AS), enterococcal surface protein (ESP) and hyaluronidase (HYL) (asa1, esp, hyl respectively) were studied by molecular methods and haemolysin production and gelatinase activity were studied by phenotypic methods. Vancomycin resi...
Critical care (London, England), 2005
Acute pancreatitis is a local inflammatory process that leads to a systemic inflammatory response... more Acute pancreatitis is a local inflammatory process that leads to a systemic inflammatory response in the majority of cases. Bacterial contamination has been estimated to occur in 30-40% of patients with necrotizing pancreatitis. Development of pancreatic necrosis depends mainly on the degree of inflammation and on the microvascular circulation of the pancreatic tissue. Activated protein C (APC) is known to inhibit coagulation and inflammation, and to promote fibrinolysis in patients with severe sepsis. We investigated the effects of APC on histopathology, bacterial translocation, and systemic inflammation in experimental acute necrotizing pancreatitis. Forty-five male Sprague-Dawley rats were studied. Rats were randomly allocated to three groups. Acute pancreatitis was induced in group II (positive control; n = 15) and group III (treatment; n = 15) rats by retrograde injection of taurocholate into the common biliopancreatic duct. Group I rats (sham; n = 15) received an injection of ...
Parasitology International, 2008
Blastocystis is a very common unicellular intestinal parasite of ubiquitous occurrence. In order ... more Blastocystis is a very common unicellular intestinal parasite of ubiquitous occurrence. In order to describe the molecular epidemiology of Blastocystis infections in Turkey, 87 isolates from 69 symptomatic and 18 asymptomatic individuals were sequenced. Sequence data were phylogenetically analyzed and statistically tested against unmodifiable risk factors such as gender and age. Blastocystis-positive males were complaining mainly of gastroenteritis, whereas dyspepsia was the chief complaint among Blastocystis-positive females. Blastocystis sp. subtypes detected in the study included subtypes 1, 2, 3 and 4, subtype 3 being the most predominant (75.9%). No association was detected between Blastocystis sp. subtype and symptoms (p>0.365), or between infection intensity and symptoms (p>0.441). There was a tendency of subtype 2 isolates being more common among older study individuals, and subtype 2 isolates were significantly associated with higher parasite abundance (p=0.017). Compared to data from similar studies, the distribution of Blastocystis sp. isolates in Turkey was found to more or less reflect the one seen in other countries, and it was deduced that subtype 3 is generally by far the most common subtype infecting humans, followed by subtypes 1, 2 and 4.
Anaerobe, 2008
A total of 60 anaerobic strains were isolated from 322 clinical specimens. These isolates were te... more A total of 60 anaerobic strains were isolated from 322 clinical specimens. These isolates were tested for susceptibility to seven antibiotics (penicillin G, amoxicillin/clavulanic acid, cefoxitin, imipenem, chloramphenicol, metronidazole, clindamycin) by using ATB-ANA and Epsilometer test (E-test) strips and the results were compared with the gold standard agar dilution method. Imipenem was found as the most effective agent in vitro among the agents tested (100%). Susceptibility to penicillin G, amoxicillin/ clavulanic acid, cefoxitin, chloramphenicol, metronidazole and clindamycin are 36.7%, 83.3%, 88.3%, 96.6%, 85% and 90%, respectively. E-test has showed a good correlation (r ¼ 0.62, p ¼ 0.001) statistically with the results of agar dilution (total agreement for all antibiotics changing between 90.01% and 98.45%) and a moderate correlation (r ¼ 0.45, p ¼ 0.048) with the results of ATB-ANA method (total agreement for all antibiotics changing between 75.46% and 98.76%). However, the routine use of agar dilution procedure is concluded to be cumbersome, whereas E-test method offers a reliable alternative.
Central European Journal of Medicine, 2008
In this study, antimicrobial resistance profiles were determined for 748 isolates of Escherichia ... more In this study, antimicrobial resistance profiles were determined for 748 isolates of Escherichia coli from patients with acute nosocomial urinary tract infections (UTIs) at a Turkish Training Hospital. Thirteen antibiotics were included. Resistance to ampicillin alone (45.1%) and ciprofloxacin alone (20.6%) were the most commonly identified ‘single resistances’. Multiple resistance was found in 49.7% of the strains. The most common
BMC Infectious Diseases, 2014
Background: The fatality attributed to pandemic influenza A H1N1 was not clear in the literature.... more Background: The fatality attributed to pandemic influenza A H1N1 was not clear in the literature. We described the predictors for fatality related to pandemic influenza A H1N1 infection among hospitalized adult patients. Methods: This is a multicenter study performed during the pandemic influenza A H1N1 [A(H1N1)pdm09] outbreak which occurred in 2009 and 2010. Analysis was performed among laboratory confirmed patients. Multivariate analysis was performed for the predictors of fatality. Results: In the second wave of the pandemic, 848 adult patients were hospitalized because of suspected influenza, 45 out of 848 (5.3%) died, with 75% of fatalities occurring within the first 2 weeks of hospitalization. Among the 241 laboratory confirmed A(H1N1)pdm09 patients, the case fatality rate was 9%. In a multivariate logistic regression model that was performed for the fatalities within 14 days after admission, early use of neuraminidase inhibitors was found to be protective (Odds ratio: 0.17, confidence interval: 0.03-0.77, p = 0.022), nosocomial infections (OR: 5.7, CI: 1.84-18, p = 0.013), presence of malignant disease (OR: 3.8, CI: 0.66-22.01, p = 0.133) significantly increased the likelihood of fatality. Conclusions: Early detection of the infection, allowing opportunity for the early use of neuraminidase inhibitors, was found to be important for prevention of fatality. Nosocomial bacterial infections and underlying malignant diseases increased the rate of fatality.
Otolaryngology - Head and Neck Surgery, 2009
To identify Helicobacter pylori and major virulance factor, cagA, in patients with laryngeal dise... more To identify Helicobacter pylori and major virulance factor, cagA, in patients with laryngeal diseases and nasal polyps. STUDY DESIGN: Cross-sectional study with planned data collection. SETTING: The study was performed on fresh tissue samples from patients with 32 nasal polyps, 29 normal nasal mucosa, and 27 laryngeal diseases presenting to the Otolaryngology-Head and Neck Surgery department of a major military hospital in Istanbul, Turkey. SUBJECTS AND METHODS: Tissue specimens were evaluated by in-house polymerase chain reaction (PCR) and real-time PCR for bacterial DNA and by real-time PCR for cagA. The impact of commercial and in-house DNA extraction methods was also evaluated. RESULTS: H pylori DNA was detected only by real-time PCR in 59.4 percent of nasal polyps, 70.4 percent of nasal mucosa samples, and 58.6 percent of larynx samples. cagA was identified in 78.9, 89.5, and 82.4 percent of positive polyp, nasal mucosa, and larynx samples, respectively. No statistically significant differences were observed between groups. DNA purification methods were equally effective. CONCLUSİON: H pylori DNA is present in nasal polyp and larynx tissues as well as normal nasal mucosa, as detected by a sensitive real-time PCR assay. cagA-positive strains dominate in all groups.
Microbiological Research, 2006
Methicillin-resistant staphylococci may also be resistant to some other antibiotics as well as b-... more Methicillin-resistant staphylococci may also be resistant to some other antibiotics as well as b-lactams. In this study, co-existence of resistance to methicillin and aminoglycosides was genetically investigated in staphylococci. A total of 50 staphylococci from in-patients, 17 Staphylococcus aureus and 33 coagulase negative staphylococci (CNS) that contained mecA (gene encoding PBP 2a, an altered penicillinbinding protein) determined by polymerase chain reaction (PCR) were included in the study. Aminoglycoside modifying enzyme (AME) genes were investigated using multiplex-PCR. Aminocyclitol-6 0 -acetyltransferase-aminocyclitol-2 00 -phosphotransferase [aac(6 0 )/aph(2 00 )] gene (encoding bifunctional acetyltransferases/phosphotransferases) was determined in 66% of the isolates, aminocyclitol-4 0 -adenylytransferase (ant(4 0 )-Ia) gene (encoding phosphotransferases) in 24%, and aminocyclitol-3 0phosphotransferase (aph(3 0 )-IIIa) gene (encoding nucleotidyltransferases) in 8%. Two isolates contained all these three genes. Thirty-six (72%) isolates had at least one of these genes. Three CNS and one S. aureus isolates sensitive to oxacillin had the mecA gene. In conclusion, a high rate of aminoglycoside resistance was determined in methicillin-resistant staphylococci. The aac(6 0 )/aph(2 00 ) was the most frequently detected.
Journal of Hospital Infection, 2006
Journal of Gastroenterology, 2005
We aimed to investigate the effects of hyperbaric oxygen therapy on bacterial translocation and a... more We aimed to investigate the effects of hyperbaric oxygen therapy on bacterial translocation and acinar cell ultrastructure in a rat model of acute necrotizing pancreatitis. Forty-eight male Sprague-Dawley rats were randomly divided into three groups. Acute pancreatitis was induced in groups II and III. Groups I and II did not receive any treatment, and group III was treated with hyperbaric oxygen. All surviving animals were killed 48 h after the induction of pancreatitis. Bacterial translocation and histological and ultrastructural changes were determined. The incidence of bacterial translocation in group III was significantly lower in comparison with group II (P<0.001). Histopathological and ultrastructural injury scores were also significantly lower in group III (P<0.001 and P<0.04, respectively). Hyperbaric oxygen therapy displayed beneficial effects on pancreatic superinfection and or histopathological and ultrastructural changes in experimental necrotizing pancreatitis.
International Journal of Urology, 1999
Background: Chronic non-bacterial prostatitis (NBP) is the most common prostatitis syndrome. Prev... more Background: Chronic non-bacterial prostatitis (NBP) is the most common prostatitis syndrome. Prevention and cure are not possible because the cause of NBP is unknown. However, patients may benefit from supportive measures. The impact of the frequency of ejaculation alone on the course of NBP was evaluated in the present study. Methods: Thirty-four single male patients who avoided masturbation and extramarital sexual intercourse for personal and/or religious beliefs and who did not respond to a clinical trial of doxycycline hydrochloride therapy (200 mg daily for 4 weeks) directed against mycoplasmas, chlamydiae and ureaplasmas were enrolled in the study. They were encouraged to masturbate regularly at least twice a week and were re-evaluated at the end of a 6 month period, including a complete inquiry regarding their sexual function during this time. Response was assessed by a symptom severity index. Results: Clinical and laboratory re-evaluation could be performed in 28 patients. Of 18 patients who adhered to the recommendations, two (11%) experienced complete relief of symptoms, whereas six (33%) had marked improvement, six had moderate improvement and four (22%) did not benefit. In contrast, three of seven patients who masturbated less frequently reported partial improvement. Three patients who did not ejaculate other than during wet dreams had a worse prognosis. Conclusions: Young men who are single and suffering from NBP must be informed about their illness in detail and, if they are not doing so, they should be encouraged to ejaculate regularly, for example by masturbation in the absence of a sexual relationship with a partner. We believe that normal sexual activity decreases the incidence of NBP in some cases.
International Journal of Antimicrobial Agents, 2005
In this study, erythromycin [erm(A) and erm(C)] and tetracycline [tet(K) and tet(M)] resistance g... more In this study, erythromycin [erm(A) and erm(C)] and tetracycline [tet(K) and tet(M)] resistance genes were investigated by multiplex polymerase chain reaction (PCR) in a total of 56 methicillin-resistant (mecA+) staphylococcal hospital isolates, 28 of which were determined to be Staphylococcus aureus (MRSA) and the other 28 were coagulase-negative staphylococci (MRCNS). Internal control primers amplifying a specific fragment of 16S rDNA of staphylococci were included in the multiplex PCR protocol to ensure the efficacy of amplification and to determine any PCR inhibition. No resistance genes were detected in 5 of 56 (8.9%) isolates in the study. In the study, tet(K) genes were detected widely (42.9%) in MRCNS, whilst tet(M) genes were detected in MRSA (50.0%). Regarding the erythromycin resistance genes, whilst erm(A) genes were detected in most (71.4%) MRSA isolates, detection rates of erm(C) genes were the same (64.3%) both in MRCNS and MRSA. The resistance rates for tetracycline and erythromycin were 57.1% and 78.6%, respectively, in MRSA isolates. In conclusion, in this study, the multiplex PCR technique including an internal control is shown to be a fast, sensitive, reliable, practical, reproducible and economic technique for the detection of erythromycin and tetracycline resistance in staphylococcal isolates.
Hematology, 2009
Chronic lymphocytic leukemia (CLL) is characterized by a malignant clonal population of lymphocyt... more Chronic lymphocytic leukemia (CLL) is characterized by a malignant clonal population of lymphocytes, which are usually of the B cell lineage. Classical Rai and Binet staging of CLL is being superseded by new prognostic markers. The mutational status of the immunoglobulin variable region heavy-chain genes segregates the disease into more benign and more malignant versions, and has been confirmed as an important prognostic marker in prospective clinical trials. A search for surrogate markers for this assay has led to flow cytometric assays for CD38 and ZAP-70 expression. The human leukocyte antigen G (HLA-G) molecule exhibits limited tissue distribution and a low polymorphism that generate seven HLA-G isoforms. HLA-G exerts multiple immunoregulatory functions. Recent studies indicate an ectopic up-regulation in tumor cells that may favor their escape from anti-tumor immune responses. For this report we studied HLA-G in parallel with CD38 and ZAP-70 in B-cell chronic lymphocytic leukemia (B-CLL) patients. HLA-G expression was studied retrospectively in circulating B-CLL cells from 20 patients by flow cytometry using the anti-HLA-G specific monoclonal antibody MEM/G9. The proportion of leukemic cells expressing HLA-G varied from 1 to 34%. We detected a statistically significant correlation between HLA-G positive (>12%) expression and progression free survival (p=0.045), but no correlation with CD38 and ZAP-70. We also detected a statistically significant difference between Binet stage A; B and C (p=0.046) and a positive correlation between IL-10 and HLA-G (p=0.044). We conclude that positive HLA-G has an effect on progression - free survival, when compared with CD38 and ZAP-70.
Folia Microbiologica, 2008
Staphylococcal hospital isolates (n = 166) were tested in a touchdown multiplex-polymerase chain ... more Staphylococcal hospital isolates (n = 166) were tested in a touchdown multiplex-polymerase chain reaction assay for the identification of methicillin and mupirocin resistance and discrimination of S. aureus (femA gene) from coagulase negative staphylococci and other bacteria. All isolates harbored the 16SrDNA (Staphylococcus genus specific internal control) gene, and 130 (78 %) the mecA (methicillin resistance) gene. Fifty-seven (44 %) of these were determined as methicillin-resistant S. aureus, while the remaining 73 (56 %) were methicillin-resistant coagulase-negative staphylococci. Seventy-five (45 %) isolates harbored the ileS-2 (high-level mupirocin resistance) gene and were determined as mupirocin-resistant. This assay represents a simple, rapid, reliable approach for the detection and discrimination of methicillin-and mupirocin-resistant staphylococci.
Critical Care, 2005
Introduction Community-acquired pneumonia remains a common condition worldwide. It is associated ... more Introduction Community-acquired pneumonia remains a common condition worldwide. It is associated with significant morbidity and mortality. The aim of this study was to evaluate conditions that could predict a poor outcome. Design Retrospective analyse of 69 patients admitted to the ICU from 1996 to 2003. Demographic data included age, sex and medical history. Etiologic agents, multiorgan dysfunction, nosocomial infections, SAPS II and PORT scores were recorded for each patient. For statistical analysis we used a t test, chi-square test and Mann-Whitney U test on SPSS ® . A value of P less than 0.05 was considered significant. Results Forty-seven patients were male and 22 patients were female. Mean age was 52 years. Sixty-seven percent had serious pre-morbid conditions including pulmonary disease (34.8%), cardiac problems (36.2%), diabetes (13%) and chronic liver disease (5.8%); 40.6% were smokers, drug abusers or alcohol dependents. Sixtyeight patients required invasive mechanical ventilation. The average length of ventilation was 13.5 days, median 8 days. The mean SAPS II score was 40.14 and the mean PORT score was 141. The mortality rate was 27.5% (SAPS II estimated mortality, 35%). Complications reported were ARDS (40.6%), septic shock (34.8%), acute renal failure (2.9%), cardiac arrest (8.7%) and nosocomial infeccions (46.4%). Mortality rates were higher for previous hepatic (75%) and metabolic (33%) diseases. We found a close association between crude mortality and SAPS II score (P = 0.003) and development of complications (P = 0.0028). Respiratory dysfunction (P = 0.006) and septic shock (P = 0.022) were most significantly related to mortality. No significant differences were founded regarding age, comorbidities, PORT score, etiologic agents, nosocomial infections and length of invasive mechanical ventilation. Conclusions Previous hepatic chronic disease was strictly related to higher mortality as well as isolation of MRSA. ARDS and septic shock predicted a poor outcome. SAPS II score was the best severity indicator of mortality.
The Southeast Asian journal of tropical medicine and public health, 2014
We aimed to investigate carbapenem resistance, resistance mechanisms, risk factors and epidemiolo... more We aimed to investigate carbapenem resistance, resistance mechanisms, risk factors and epidemiological features of Escherichia coli and Klebsiella pneumoniae strains isolated from related infections in intensive care unit (ICU) patients. Carbapenemase activity was determined by MHT, MBL Etest and enzyme extraction methods. Presence of extended-spectrum beta-lactamase (ESBL) and carbapenemase-encoding genes were investigated by PCR and sequencing. Clonal relationship of the strains was investigated by pulse field gel-electrophoresis. Acquired AmpC and Qnr were investigated by PCR. Throughout this study, 1,657 patients, and 11,483 hospitalization days were followed by active surveillance in the ICU of our 1,000-bed training hospital. Out of 108 of 196 patients, 130 E. coli- and K. pneumoniae-related nosocomial infections were determined. Minimum inhibitory concentration (MIC) levels of ertapenem were > or = 1 mg/1 in 14 K. pneumoniae and 2 E. coli strains. The highest MIC level of ...
Mikrobiyoloji bülteni, 2005
This study was conducted to investigate the presence of methicillin and aminoglycoside resistance... more This study was conducted to investigate the presence of methicillin and aminoglycoside resistance encoding genes by multiplex-polymerase chain reaction (PCR) and by phenotypic methods in staphylococci isolated from inpatients' clinical specimens. The presence of aac(6')1aph(2"), aph(3')-IIIa and ant(4)-Ia genes encoding aminoglycoside modifying enzymes (AME) and mecA gene encoding methicillin resistance were genotypically investigated. A total of 19 S. aureus and 30 coagulase negative staphylococci (CNS) were tested. Thirty four (69.4%) of the isolates were found to be resistant to oxacillin with disk diffusion test, 33 (97%) of which were found to harbour mecA gene. The correspondance between oxacillin resistance and presence of mecA gene was found to be 100% in S. aureus isolates, while it was 95.7% in CNS. Twenty two (44.9%), 7 (14.3%) and 2 (4.1%) isolates were found to harbour aac(6')/aph(2"), aph(3')-IIIa and ant(4)-/a AME genes, respectively. At ...
Central European Journal of Medicine, 2008
... cagE and virB11 detection in patients with non-ulcer dyspepsia from Turkey: Correlation with ... more ... cagE and virB11 detection in patients with non-ulcer dyspepsia from Turkey: Correlation with histopathologic findings Ugur Ilga1, Mustafa Ozyurt1*, Sukru Yıldırım2, Koray Ergunay3, Nurittin Ardic1, Levent Demirturk4, Tuncer Haznedaroglu1 ...
The Indian journal of medical research, 2012
Translocation of bacteria from the gut is an important factor in the development of septic compli... more Translocation of bacteria from the gut is an important factor in the development of septic complications and mortality in acute pancreatitis (AP). The present study was designed to assess the effects of infliximab treatment on bacterial translocation (BT) in experimental acute necrotizing pancreatitis. Male Sprague-Dawley rats (n=45) were allocated into three groups. AP was induced in group II (positive control, n=15) and group III (Infliximab; n=15) by retrograde injection of taurocholate into the common biliopancreatic duct. Group I rats (Sham; n=15) received normal saline infusion into the common biliopancreatic duct as placebo. Groups I and II were treated by normal saline and group III was treated with infliximab intraperitoneally on 6, 30 and 54 h after induction of pancreatitis. All surviving animals were killed 60 h after the induction of pancreatitis, and specimens were collected for amylase measurement as well as histopathologic and microbiologic examinations. Oedema, acin...
Pan African Medical Journal, 2014
It was aimed to investigate the frequency of Candida infections (CI) in the intensive care units ... more It was aimed to investigate the frequency of Candida infections (CI) in the intensive care units (ICU), to determine typing of candida to evaluate risk factors associated with CI and mortality, and to evaluate influence of CI on mortality. The prospective cohort study was carried out between Jan 1, 2009 and Dec 31, 2010 in ICUs, and the patients were observed with active surveillance. VITEK 2 Compact System (BioMerieux, France) kits were used for the identification of isolates from various clinical samples. A total of 2362 patients had enrolled for 16135 patients-days into the study. During the study, 63 (27,5%) of patients developed 77 episodes of CI were observed. Of the patients; 54% were male, 46% were female. Duration of hospitalization (OR = 1,03, p = 0,007), hyperglycemia (OR = 17,93, p = 0,009), and co-infections (OR = 3,98, p = 0,001) were identified as independent risk factors for CI. The most common infections were bloodstream (53%). 77 of 135 candida strains was isolated as causative pathogens. C. albicans (63,6%) was the most frequent species. Overall mortality rate was 78%. The rates of mortality attributable to CI and candidemia were 27%, and 18,3% respectively. Species- specific mortality rates of C.albicans and C.tropicalis were determined as 12%. High APACHE II scores (OR = 1,37; p = 0,002), and the use of central venous catheter (OR = 9,01; p = 0,049) were assigned as independent risk factors for mortality. CI is an important problem in our hospital. CI and associated mortality can be prevented by controlling of risk factors. Updating of epidemiological data is required for successful antifungal treatment.
Mikrobiyoloji bülteni, 2011
Increasing multidrug resistance in nosocomial Enterococcus strains from all over the world recent... more Increasing multidrug resistance in nosocomial Enterococcus strains from all over the world recently enhances the need for further investigation of enterococci, especially their virulence factors. There are still many lacking parts about virulence factors of clinical enterococcus isolates. In this study, it was aimed to investigate the antibiotic resistance and the presence of potential virulence factors of 91 Enterococcus strains (59 E.faecalis, 31 E.faecium and 1 E.gallinarum) isolated from urine cultures of inpatients between January 2008-June 2010 in our hospital and also to evaluate whether a correlation existed between antibiotic resistance and potential virulence factors. The genes which encoded virulence factors of enterococci; aggregation substance (AS), enterococcal surface protein (ESP) and hyaluronidase (HYL) (asa1, esp, hyl respectively) were studied by molecular methods and haemolysin production and gelatinase activity were studied by phenotypic methods. Vancomycin resi...
Critical care (London, England), 2005
Acute pancreatitis is a local inflammatory process that leads to a systemic inflammatory response... more Acute pancreatitis is a local inflammatory process that leads to a systemic inflammatory response in the majority of cases. Bacterial contamination has been estimated to occur in 30-40% of patients with necrotizing pancreatitis. Development of pancreatic necrosis depends mainly on the degree of inflammation and on the microvascular circulation of the pancreatic tissue. Activated protein C (APC) is known to inhibit coagulation and inflammation, and to promote fibrinolysis in patients with severe sepsis. We investigated the effects of APC on histopathology, bacterial translocation, and systemic inflammation in experimental acute necrotizing pancreatitis. Forty-five male Sprague-Dawley rats were studied. Rats were randomly allocated to three groups. Acute pancreatitis was induced in group II (positive control; n = 15) and group III (treatment; n = 15) rats by retrograde injection of taurocholate into the common biliopancreatic duct. Group I rats (sham; n = 15) received an injection of ...
Parasitology International, 2008
Blastocystis is a very common unicellular intestinal parasite of ubiquitous occurrence. In order ... more Blastocystis is a very common unicellular intestinal parasite of ubiquitous occurrence. In order to describe the molecular epidemiology of Blastocystis infections in Turkey, 87 isolates from 69 symptomatic and 18 asymptomatic individuals were sequenced. Sequence data were phylogenetically analyzed and statistically tested against unmodifiable risk factors such as gender and age. Blastocystis-positive males were complaining mainly of gastroenteritis, whereas dyspepsia was the chief complaint among Blastocystis-positive females. Blastocystis sp. subtypes detected in the study included subtypes 1, 2, 3 and 4, subtype 3 being the most predominant (75.9%). No association was detected between Blastocystis sp. subtype and symptoms (p>0.365), or between infection intensity and symptoms (p>0.441). There was a tendency of subtype 2 isolates being more common among older study individuals, and subtype 2 isolates were significantly associated with higher parasite abundance (p=0.017). Compared to data from similar studies, the distribution of Blastocystis sp. isolates in Turkey was found to more or less reflect the one seen in other countries, and it was deduced that subtype 3 is generally by far the most common subtype infecting humans, followed by subtypes 1, 2 and 4.
Anaerobe, 2008
A total of 60 anaerobic strains were isolated from 322 clinical specimens. These isolates were te... more A total of 60 anaerobic strains were isolated from 322 clinical specimens. These isolates were tested for susceptibility to seven antibiotics (penicillin G, amoxicillin/clavulanic acid, cefoxitin, imipenem, chloramphenicol, metronidazole, clindamycin) by using ATB-ANA and Epsilometer test (E-test) strips and the results were compared with the gold standard agar dilution method. Imipenem was found as the most effective agent in vitro among the agents tested (100%). Susceptibility to penicillin G, amoxicillin/ clavulanic acid, cefoxitin, chloramphenicol, metronidazole and clindamycin are 36.7%, 83.3%, 88.3%, 96.6%, 85% and 90%, respectively. E-test has showed a good correlation (r ¼ 0.62, p ¼ 0.001) statistically with the results of agar dilution (total agreement for all antibiotics changing between 90.01% and 98.45%) and a moderate correlation (r ¼ 0.45, p ¼ 0.048) with the results of ATB-ANA method (total agreement for all antibiotics changing between 75.46% and 98.76%). However, the routine use of agar dilution procedure is concluded to be cumbersome, whereas E-test method offers a reliable alternative.
Central European Journal of Medicine, 2008
In this study, antimicrobial resistance profiles were determined for 748 isolates of Escherichia ... more In this study, antimicrobial resistance profiles were determined for 748 isolates of Escherichia coli from patients with acute nosocomial urinary tract infections (UTIs) at a Turkish Training Hospital. Thirteen antibiotics were included. Resistance to ampicillin alone (45.1%) and ciprofloxacin alone (20.6%) were the most commonly identified ‘single resistances’. Multiple resistance was found in 49.7% of the strains. The most common
BMC Infectious Diseases, 2014
Background: The fatality attributed to pandemic influenza A H1N1 was not clear in the literature.... more Background: The fatality attributed to pandemic influenza A H1N1 was not clear in the literature. We described the predictors for fatality related to pandemic influenza A H1N1 infection among hospitalized adult patients. Methods: This is a multicenter study performed during the pandemic influenza A H1N1 [A(H1N1)pdm09] outbreak which occurred in 2009 and 2010. Analysis was performed among laboratory confirmed patients. Multivariate analysis was performed for the predictors of fatality. Results: In the second wave of the pandemic, 848 adult patients were hospitalized because of suspected influenza, 45 out of 848 (5.3%) died, with 75% of fatalities occurring within the first 2 weeks of hospitalization. Among the 241 laboratory confirmed A(H1N1)pdm09 patients, the case fatality rate was 9%. In a multivariate logistic regression model that was performed for the fatalities within 14 days after admission, early use of neuraminidase inhibitors was found to be protective (Odds ratio: 0.17, confidence interval: 0.03-0.77, p = 0.022), nosocomial infections (OR: 5.7, CI: 1.84-18, p = 0.013), presence of malignant disease (OR: 3.8, CI: 0.66-22.01, p = 0.133) significantly increased the likelihood of fatality. Conclusions: Early detection of the infection, allowing opportunity for the early use of neuraminidase inhibitors, was found to be important for prevention of fatality. Nosocomial bacterial infections and underlying malignant diseases increased the rate of fatality.
Otolaryngology - Head and Neck Surgery, 2009
To identify Helicobacter pylori and major virulance factor, cagA, in patients with laryngeal dise... more To identify Helicobacter pylori and major virulance factor, cagA, in patients with laryngeal diseases and nasal polyps. STUDY DESIGN: Cross-sectional study with planned data collection. SETTING: The study was performed on fresh tissue samples from patients with 32 nasal polyps, 29 normal nasal mucosa, and 27 laryngeal diseases presenting to the Otolaryngology-Head and Neck Surgery department of a major military hospital in Istanbul, Turkey. SUBJECTS AND METHODS: Tissue specimens were evaluated by in-house polymerase chain reaction (PCR) and real-time PCR for bacterial DNA and by real-time PCR for cagA. The impact of commercial and in-house DNA extraction methods was also evaluated. RESULTS: H pylori DNA was detected only by real-time PCR in 59.4 percent of nasal polyps, 70.4 percent of nasal mucosa samples, and 58.6 percent of larynx samples. cagA was identified in 78.9, 89.5, and 82.4 percent of positive polyp, nasal mucosa, and larynx samples, respectively. No statistically significant differences were observed between groups. DNA purification methods were equally effective. CONCLUSİON: H pylori DNA is present in nasal polyp and larynx tissues as well as normal nasal mucosa, as detected by a sensitive real-time PCR assay. cagA-positive strains dominate in all groups.
Microbiological Research, 2006
Methicillin-resistant staphylococci may also be resistant to some other antibiotics as well as b-... more Methicillin-resistant staphylococci may also be resistant to some other antibiotics as well as b-lactams. In this study, co-existence of resistance to methicillin and aminoglycosides was genetically investigated in staphylococci. A total of 50 staphylococci from in-patients, 17 Staphylococcus aureus and 33 coagulase negative staphylococci (CNS) that contained mecA (gene encoding PBP 2a, an altered penicillinbinding protein) determined by polymerase chain reaction (PCR) were included in the study. Aminoglycoside modifying enzyme (AME) genes were investigated using multiplex-PCR. Aminocyclitol-6 0 -acetyltransferase-aminocyclitol-2 00 -phosphotransferase [aac(6 0 )/aph(2 00 )] gene (encoding bifunctional acetyltransferases/phosphotransferases) was determined in 66% of the isolates, aminocyclitol-4 0 -adenylytransferase (ant(4 0 )-Ia) gene (encoding phosphotransferases) in 24%, and aminocyclitol-3 0phosphotransferase (aph(3 0 )-IIIa) gene (encoding nucleotidyltransferases) in 8%. Two isolates contained all these three genes. Thirty-six (72%) isolates had at least one of these genes. Three CNS and one S. aureus isolates sensitive to oxacillin had the mecA gene. In conclusion, a high rate of aminoglycoside resistance was determined in methicillin-resistant staphylococci. The aac(6 0 )/aph(2 00 ) was the most frequently detected.
Journal of Hospital Infection, 2006
Journal of Gastroenterology, 2005
We aimed to investigate the effects of hyperbaric oxygen therapy on bacterial translocation and a... more We aimed to investigate the effects of hyperbaric oxygen therapy on bacterial translocation and acinar cell ultrastructure in a rat model of acute necrotizing pancreatitis. Forty-eight male Sprague-Dawley rats were randomly divided into three groups. Acute pancreatitis was induced in groups II and III. Groups I and II did not receive any treatment, and group III was treated with hyperbaric oxygen. All surviving animals were killed 48 h after the induction of pancreatitis. Bacterial translocation and histological and ultrastructural changes were determined. The incidence of bacterial translocation in group III was significantly lower in comparison with group II (P<0.001). Histopathological and ultrastructural injury scores were also significantly lower in group III (P<0.001 and P<0.04, respectively). Hyperbaric oxygen therapy displayed beneficial effects on pancreatic superinfection and or histopathological and ultrastructural changes in experimental necrotizing pancreatitis.
International Journal of Urology, 1999
Background: Chronic non-bacterial prostatitis (NBP) is the most common prostatitis syndrome. Prev... more Background: Chronic non-bacterial prostatitis (NBP) is the most common prostatitis syndrome. Prevention and cure are not possible because the cause of NBP is unknown. However, patients may benefit from supportive measures. The impact of the frequency of ejaculation alone on the course of NBP was evaluated in the present study. Methods: Thirty-four single male patients who avoided masturbation and extramarital sexual intercourse for personal and/or religious beliefs and who did not respond to a clinical trial of doxycycline hydrochloride therapy (200 mg daily for 4 weeks) directed against mycoplasmas, chlamydiae and ureaplasmas were enrolled in the study. They were encouraged to masturbate regularly at least twice a week and were re-evaluated at the end of a 6 month period, including a complete inquiry regarding their sexual function during this time. Response was assessed by a symptom severity index. Results: Clinical and laboratory re-evaluation could be performed in 28 patients. Of 18 patients who adhered to the recommendations, two (11%) experienced complete relief of symptoms, whereas six (33%) had marked improvement, six had moderate improvement and four (22%) did not benefit. In contrast, three of seven patients who masturbated less frequently reported partial improvement. Three patients who did not ejaculate other than during wet dreams had a worse prognosis. Conclusions: Young men who are single and suffering from NBP must be informed about their illness in detail and, if they are not doing so, they should be encouraged to ejaculate regularly, for example by masturbation in the absence of a sexual relationship with a partner. We believe that normal sexual activity decreases the incidence of NBP in some cases.
International Journal of Antimicrobial Agents, 2005
In this study, erythromycin [erm(A) and erm(C)] and tetracycline [tet(K) and tet(M)] resistance g... more In this study, erythromycin [erm(A) and erm(C)] and tetracycline [tet(K) and tet(M)] resistance genes were investigated by multiplex polymerase chain reaction (PCR) in a total of 56 methicillin-resistant (mecA+) staphylococcal hospital isolates, 28 of which were determined to be Staphylococcus aureus (MRSA) and the other 28 were coagulase-negative staphylococci (MRCNS). Internal control primers amplifying a specific fragment of 16S rDNA of staphylococci were included in the multiplex PCR protocol to ensure the efficacy of amplification and to determine any PCR inhibition. No resistance genes were detected in 5 of 56 (8.9%) isolates in the study. In the study, tet(K) genes were detected widely (42.9%) in MRCNS, whilst tet(M) genes were detected in MRSA (50.0%). Regarding the erythromycin resistance genes, whilst erm(A) genes were detected in most (71.4%) MRSA isolates, detection rates of erm(C) genes were the same (64.3%) both in MRCNS and MRSA. The resistance rates for tetracycline and erythromycin were 57.1% and 78.6%, respectively, in MRSA isolates. In conclusion, in this study, the multiplex PCR technique including an internal control is shown to be a fast, sensitive, reliable, practical, reproducible and economic technique for the detection of erythromycin and tetracycline resistance in staphylococcal isolates.
Hematology, 2009
Chronic lymphocytic leukemia (CLL) is characterized by a malignant clonal population of lymphocyt... more Chronic lymphocytic leukemia (CLL) is characterized by a malignant clonal population of lymphocytes, which are usually of the B cell lineage. Classical Rai and Binet staging of CLL is being superseded by new prognostic markers. The mutational status of the immunoglobulin variable region heavy-chain genes segregates the disease into more benign and more malignant versions, and has been confirmed as an important prognostic marker in prospective clinical trials. A search for surrogate markers for this assay has led to flow cytometric assays for CD38 and ZAP-70 expression. The human leukocyte antigen G (HLA-G) molecule exhibits limited tissue distribution and a low polymorphism that generate seven HLA-G isoforms. HLA-G exerts multiple immunoregulatory functions. Recent studies indicate an ectopic up-regulation in tumor cells that may favor their escape from anti-tumor immune responses. For this report we studied HLA-G in parallel with CD38 and ZAP-70 in B-cell chronic lymphocytic leukemia (B-CLL) patients. HLA-G expression was studied retrospectively in circulating B-CLL cells from 20 patients by flow cytometry using the anti-HLA-G specific monoclonal antibody MEM/G9. The proportion of leukemic cells expressing HLA-G varied from 1 to 34%. We detected a statistically significant correlation between HLA-G positive (>12%) expression and progression free survival (p=0.045), but no correlation with CD38 and ZAP-70. We also detected a statistically significant difference between Binet stage A; B and C (p=0.046) and a positive correlation between IL-10 and HLA-G (p=0.044). We conclude that positive HLA-G has an effect on progression - free survival, when compared with CD38 and ZAP-70.
Folia Microbiologica, 2008
Staphylococcal hospital isolates (n = 166) were tested in a touchdown multiplex-polymerase chain ... more Staphylococcal hospital isolates (n = 166) were tested in a touchdown multiplex-polymerase chain reaction assay for the identification of methicillin and mupirocin resistance and discrimination of S. aureus (femA gene) from coagulase negative staphylococci and other bacteria. All isolates harbored the 16SrDNA (Staphylococcus genus specific internal control) gene, and 130 (78 %) the mecA (methicillin resistance) gene. Fifty-seven (44 %) of these were determined as methicillin-resistant S. aureus, while the remaining 73 (56 %) were methicillin-resistant coagulase-negative staphylococci. Seventy-five (45 %) isolates harbored the ileS-2 (high-level mupirocin resistance) gene and were determined as mupirocin-resistant. This assay represents a simple, rapid, reliable approach for the detection and discrimination of methicillin-and mupirocin-resistant staphylococci.