Nurcan Baykam | Hitit University (original) (raw)

Papers by Nurcan Baykam

Turkish Journal of Infection, 2000

Mycobacterium avium subsp. hominissuis is an environmental bacterium causing opportunistic infect... more Mycobacterium avium subsp. hominissuis is an environmental bacterium causing opportunistic infections in swine, resulting in economic losses. Additionally, the zoonotic aspect of such infections is of concern. In the southeastern region of Norway in 2009 and 2010, an increase in condemnation of pig carcasses with tuberculous lesions was seen at the meat inspection. The use of peat as bedding in the herds was suspected to be a common factor, and a project examining pigs and environmental samples from the herds was initiated. Lesions detected at meat inspection in pigs originating from 15 herds were sampled. Environmental samples including peat from six of the herds and from three peat production facilities were additionally collected. Samples were analysed by culture and isolates genotyped by MLVA analysis. Mycobacterium avium subsp. hominissuis was detected in 35 out of 46 pigs, in 16 out of 20 samples of peat, and in one sample of sawdust. MLVA analysis demonstrated identical isolates from peat and pigs within the same farms. Polyclonal infection was demonstrated by analysis of multiple isolates from the same pig. To conclude, the increase in condemnation of porcine carcasses at slaughter due to mycobacteriosis seemed to be related to untreated peat used as bedding.

İnfeksiyon Dergisi, 2000

... MYCOBACTERİUM TUBERCULOSİS SUŞLARINDA AMİKASİN VE SİPROFLOKSASİN DUYARLILIĞI GÖNÜL ASLAN, ŞAH... more ... MYCOBACTERİUM TUBERCULOSİS SUŞLARINDA AMİKASİN VE SİPROFLOKSASİN DUYARLILIĞI GÖNÜL ASLAN, ŞAHİN DİREKEL, FEZA OTAĞ, EMİNE AKDENİZLİ, GÜROL ... ÇİMEN ÖZIŞIK, ZELİHA ARSLAN, ATTİLA SAYGI, KEREM OCAK, ZEYNEP ÖZLEN TÜMER ...

Journal of the International Association of Providers of AIDS Care, May 21, 2007

The authors describe the epidemiologic and clinical characteristics of 97 human immunodeficiency ... more The authors describe the epidemiologic and clinical characteristics of 97 human immunodeficiency virus (HIV)-infected patients, who were followed between 1993 and 2006. Seventytwo percent of the patients were male, and median age at diagnosis was 36 years (range, 13-71 years). The mean years of survival was 3, and maximum length of life after diagnosis was 9 years. The most common professions were truck drivers, workers, and housewives. Forty-six percent of the males had a history of working abroad. Heterosexual intercourse was the most common (84%) route of transmission. Seventy-four percent of the women acquired infection from their husbands. In Turkey, less educated or uneducated and poor men are the primary target of the HIV infection usually by sexual contact with foreign women. Considering the low education status of the patients, appropriate education programs should be developed to prevent the dissemination of HIV infection. Because a significant number of patients were diagnosed at very late stages, the physicians and other health care workers should be educated on the clinical pictures of HIV/AIDS.

Pamukkale tıp dergisi, 2023

To investigate the frequency of MBLs in Pseudomonas and Acinetobacter species with E-test, to det... more To investigate the frequency of MBLs in Pseudomonas and Acinetobacter species with E-test, to determine the risk factors and to evaluate the demographic and clinical features of infected patients. Materials and methods: Imipenem or meropenem resistance of Pseudomonas and Acinetobacter isolated from several clinical samples with conventional methods were evaluated with imipenem EDTA E-test and the presence of Metallo-β-lactameses MBL was examined. Several isolates were screened for VIM-1, VIM-2, IMP-1, and IMP-2 with a PCR test. Results: Of 46 carbapenem resistant Acinetobacter isolates, 41 (89%), as well as of 19 carbapenem resistant Pseudomonas isolates, 5 (26%) had MBL positivity with imipenem-EDTA E-test. A history of Intensive Care Unit stay, mechanical ventilation and cephalosporin use were found to be significant risk factors with respect to MBL production. Conclusion: Detection of MBL production in Acinetobacter and Pseudomonas species especially in ICU patients is of prime importance to control infection rapidly and effectively, which contribute to prevention of outbreaks.

Tropical Biomedicine, Dec 31, 2022

Crimean-Congo haemorrhagic fever (CCHF) is a severe human infection which can lead to fatal conse... more Crimean-Congo haemorrhagic fever (CCHF) is a severe human infection which can lead to fatal consequences. Acute CCHF patients were previously shown to exhibit frequencies of regulatory T-cell (T reg) but lower T reg-mediated suppressive activities than the healthy counterparts. This study aims is to investigate the phosphorylation levels of Foxp3 protein (master regulator of T reg cells) in CCHF patients. Blood samples collected from 18 CCHF patients and nine healthy volunteers were used to isolate peripheral blood mononuclear cells (PBMCs). Total and phosphorylated Foxp3 expression levels in the isolated PBMC samples were monitored by western blot and quantified using ImageJ software. Total Foxp3 expression levels in CCHF patients displayed decreasing trend, but not significantly. In contrast, significantly lower expression levels of phosphorylated Foxp3 were reported in CCHF patients. Our results suggest a possible association between Foxp3 dephosphorylation and CCHF pathogenesis. Nevertheless, more studies are required to evaluate the effect of Foxp3 dephosphorylation on T reg function, which would not only help to enlighten the CCHF pathogenesis but also contribute to the development of effective treatment strategies.

Intensive Care Medicine

In the critically ill, hospital-acquired bloodstream infections (HA-BSI) are associated with sign... more In the critically ill, hospital-acquired bloodstream infections (HA-BSI) are associated with significant mortality. Granular data are required for optimizing management, and developing guidelines and clinical trials. Methods: We carried out a prospective international cohort study of adult patients (≥ 18 years of age) with HA-BSI treated in intensive care units (ICUs) between June 2019 and February 2021. Results: 2600 patients from 333 ICUs in 52 countries were included. 78% HA-BSI were ICU-acquired. Median Sequential Organ Failure Assessment (SOFA) score was 8 [IQR 5; 11] at HA-BSI diagnosis. Most frequent sources of infection included pneumonia (26.7%) and intravascular catheters (26.4%). Most frequent pathogens were Gram-negative bacteria (59.0%), predominantly Klebsiella spp. (27.9%), Acinetobacter spp. (20.3%), Escherichia coli (15.8%), and Pseudomonas spp. (14.3%). Carbapenem resistance was present in 37.8%, 84.6%, 7.4%, and 33.2%, respectively. Difficult-to-treat resistance (DTR) was present in 23.5% and pan-drug resistance in 1.5%. Antimicrobial therapy was deemed adequate within 24 h for 51.5%. Antimicrobial resistance was associated with longer delays to adequate antimicrobial therapy. Source control was needed in 52.5% but not achieved in 18.2%. Mortality was 37.1%, and only 16.1% had been discharged alive from hospital by day-28. Conclusions: HA-BSI was frequently caused by Gram-negative, carbapenem-resistant and DTR pathogens. Antimicrobial resistance led to delays in adequate antimicrobial therapy. Mortality was high, and at day-28 only a minority of the patients were discharged alive from the hospital. Prevention of antimicrobial resistance and focusing on adequate antimicrobial therapy and source control are important to optimize patient management and outcomes.

Infectious Diseases and Clinical Microbiology

Leptospirosis can present with severe cases such as polymyositis, peripheral neuropathy, and rare... more Leptospirosis can present with severe cases such as polymyositis, peripheral neuropathy, and rarely, Guillain-Barré Syndrome (GBS). This paper reports a case who presented with dysarthria and GBS. A female patient presented with complaints of weakness, dizziness, diarrhea, and dysarthric. Her assessments included muscle strength globally 4/5 and deep tendon reflexes as hypoactive. An electromyographic examination was performed with the increase of weakness in the lower extremities, which indicated findings compatible with GBS. Antibodies against Leptospira biflexa serovar Patoc 1 at 1/400 titer were detected in the microscopic agglutination test (MAT). Neurological involvement in leptospirosis cases can range from meningoencephalitis to GBS. Keywords: dysarthria, Guillain-Barré syndrome, leptospirosis, acute kidney failure

DergiPark (Istanbul University), Mar 12, 2022

Crimean-Congo hemorrhagic fever (CCHF) is a disease effecting multiple organ systems by microvasc... more Crimean-Congo hemorrhagic fever (CCHF) is a disease effecting multiple organ systems by microvascular damage and deterioration of hemostasis. Even though the main diagnosis relies on reverse transcriptase-polymerase chain reaction (rt-PCR), it is also known that thrombocytopenia, and/or leukopenia, elevated levels of alanine aminotranferase (ALT), aspartate aminotransferase (AST), lactate dehydrogenase and creatine kinase may be determined. In this study, our aim was to analyse the patients who were hospitalized with suspected CCHF and consequently undergone PCR testing. PCR (+) and PCR (-) patients were compared according to their laboratory results obtained in the emergency department (ED). In a 2-year period, a total of 150 (female/male: 47/103) patients of any age hospitalized with the suspicion of CCHF were involved into the study. The patients were divided into 2 groups according to their rt-PCR results as PCR (+) (and PCR (-) patients. Two groups were compared according to the laboratory results obtained in the ED. The most common complaint on admission was weakness (n=111, 74%) followed by fever (n=95, 63.3%) and headache (n=16, 10.7%). Ribavirin therapy was administered to 62 patients (41.3%). In 62 patients, PCR test was positive (41.3%). When PCR (+) and PCR (-) groups were compared according to the laboratory results obtained in the ED, number of patients with high AST/ALT, thrombocytopenia, low fibrinogen and aPTT levels were significantly higher in PCR (+) group. The diagnosis of CCHF is a challenging issue which requires high suspicion, particularly in the endemic regions. High AST/ALT, thrombocytopenia, low fibrinogen and aPTT levels determined in the ED should raise the suspect for the possibility of PCR positivity.

Journal of Experimental and Clinical Medicine

Early diagnosis in COVID-19 is essential in terms of treatment and prevention of contagiousness. ... more Early diagnosis in COVID-19 is essential in terms of treatment and prevention of contagiousness. In this study, we aimed to find an alternative diagnosis method by using fewer laboratory parameters in the early diagnosis of COVID-19 disease by creating a fast, easily accessible, cost-effective index and has a diagnostic accuracy rate of over 90%. All patients over the age of 18 who applied to Hitit University Erol Olçok Training and Research Hospital Emergency COVID Outpatient Clinic with a pre-diagnosis of COVID-19 between March and April 2020 were evaluated retrospectively. Patients were divided into two groups as COVID-19 positive and COVID-19 negative. It was aimed to create a HITIT-19 index by evaluating the cases according to the clinical and laboratory results. Between March and April 2020 (in the first peak of the pandemic), 1586 patients were applied to the Emergency COVID-19 outpatient clinic with a pre-diagnosis of COVID-19. According to COVID-19 RT-PCR, card test, and CT...

Pamukkale Medical Journal

Purpose: To investigate the frequency of MBLs in Pseudomonas and Acinetobacter species with E-tes... more Purpose: To investigate the frequency of MBLs in Pseudomonas and Acinetobacter species with E-test, to determine the risk factors and to evaluate the demographic and clinical features of infected patients. Materials and methods: Imipenem or meropenem resistance of Pseudomonas and Acinetobacter isolated from several clinical samples with conventional methods were evaluated with imipenem EDTA E-test and the presence of Metallo-β-lactameses MBL was examined. Several isolates were screened for VIM-1, VIM-2, IMP-1, and IMP-2 with a PCR test. Results: Of 46 carbapenem resistant Acinetobacter isolates, 41 (89%), as well as of 19 carbapenem resistant Pseudomonas isolates, 5 (26%) had MBL positivity with imipenem-EDTA E-test. A history of Intensive Care Unit stay, mechanical ventilation and cephalosporin use were found to be significant risk factors with respect to MBL production. Conclusion: Detection of MBL production in Acinetobacter and Pseudomonas species especially in ICU patients is o...

Türk Hijyen ve Deneysel Biyoloji Dergisi, 2017

Pathogens and Global Health, 2021

We aimed to decide which scoring system is the best for the evaluation of the course of Crimean-C... more We aimed to decide which scoring system is the best for the evaluation of the course of Crimean-Congo Hemorrhagic Fever (CCHF) by comparing scoring systems such as qSOFA (quick Sequential Organ Failure Assessment), SOFA (Sequential Organ Failure Assessment), APACHE II (Acute Physiology and Chronic Health Evaluation II) and SGS (Severity Grading System) in centers where patients with CCHF were monitored. The study was conducted with patients diagnosed with CCHF in five different centers where the disease was encountered most commonly. Patients having proven PCR and/or IgM positivity for CCHF were included in the study. The scores of the scoring systems on admission, at the 72nd hour and at the 120th hour were calculated and evaluated. The data of 388 patients were obtained from five centers and evaluated. SGS, SOFA and APACHE II were the best scoring systems in predicting mortality on admission. All scoring systems were significant in predicting mortality at the 72nd and 120th hours. On admission, there was a correlation between the qSOFA, SOFA and APACHE II scores and the SGS scores in the group of survivors. All scoring systems had a positive correlation in the same direction. The correlation coefficients were strong for qSOFA and SOFA, but poor for APACHE II. A one-unit rise in SGS increased the probability of death by 12.818 times. qSOFA did not provide significant results in predicting mortality on admission. SGS, SOFA and APACHE II performed best at admission and at the 72nd and 120th hours.

Introduction: People who inject drugs (PWID) should be treated in order to eliminate hepatitis C ... more Introduction: People who inject drugs (PWID) should be treated in order to eliminate hepatitis C virus (HCV) in the world. Aims: The aim of this study was to compare direct acting antivirals (DAAs) treatment of HCV for PWID and non-PWID in real life setting. Materials and methods: We performed a prospective, non-randomized, observational multi-center cohort study in 37 centers. All patients treated with DAAs therapy between April 1, 2017 to February 28, 2019 were included. In total, 2,713 patients were included in the study among which 250 were PWID and 2,463 were non-PWID. Besides patient characteristics, treatment response, follow-up and side effects of treatment were also analyzed. Results: Genotype 1a and 3 were more prevalent in PWID infected patients (20.4% vs 9.9% and 46.8% vs 5.3%). The number of naïve patients was higher in PWID (90.7% vs 60.0%), while the number of patients with cirrhosis was higher in non-PWID (14.1% vs 3.7%). The loss of follow up was higher in PWID (29....