Alpay Azap - Academia.edu (original) (raw)
Papers by Alpay Azap
The incidence of …, 2005
The incidence of Moraxella catarrhalis, Streptococcus pneumoniae, Haemoph ilusinfluenzae in acute... more The incidence of Moraxella catarrhalis, Streptococcus pneumoniae, Haemoph ilusinfluenzae in acute exacerbation of chronic obstructive pulmonary disease ... Kemal Osman Memikoğlu1, Alpay Azap1, Özlem Kurt2, Tuncay Hasip Sözen1, Mehmet Emin Tekeli1
Herpes virüs ailesinin bir üyesi olan Varisellazoster virusu (VZV), suçiçeği ve zona olmak üzere ... more Herpes virüs ailesinin bir üyesi olan Varisellazoster virusu (VZV), suçiçeği ve zona olmak üzere iki farklı klinik tabloya neden olur. Her iki tablo da immün sistemi sağlam olan kişilerde ve genç insanlarda ılımlı seyreden infeksiyonlardır. Fakat immün yetmezlikli hastalar ve yaşlılarda ağır seyidi infeksiyon ve kompikasyon gelişme riski fazladır. Organ nakli ve kortikosteroid kullanımı gibi immün baskılanmaya neden olan klinik uygulamaların artmasıyla birlikte VZV infeksiyonları daha önemli hale gelmiştir. Bu makalede VZV infeksiyonlarının klinik seyri, komplikasyonları, korunma ve tedavi yöntemleri derlenmiştir. Anahtar Kelimeler: Post herpetik Nevralji, Suçiçeği, Varisella-zoster Virüs, Zona zoster. SUMMARY Varicella-zoster Virüs Infections Varicella-zoster virüs (VZV) causes two distinct clinical entities: Varicella or chickenpox and herpes zoster or shingles. Both entities have a benign clinical course in immunocompetent and young individuals. But immunocompromised and elderly are at greater risk for severe infection and complications. As immunosuppressive clinical modalities such as organ transplantation and corticosteroid therapy have been vvidely used, the imponance of VZV infections has increased. Clinical course, complications, prevention and treatment of VZV infections have been reviewed in this article. Varicella-zoster virüs, Zona zoster. Varicella-Zoster virusu herpes virüs ailesinin bir üyesidir. Herpes virüs ailesinin genel özelliklerini taşır. Herpes virüs ailesinin genel özellikleri: Herpes virüs ailesi büyük (150-200nm), zarflı, DNA virüsleridir. 4 temel yapısal elemandan oluşurlar. 1) Zarf (envelop): Glikoproteinden zengin bir yapıdır. Virionun hücreye tutunmasını ve penetrasyonunu sağlar. 2) Tegümen:Virus tarafından kodlanan, hedef hücrede replikasyonda görev alan proteinleri içe-ren bir yapıdır. 3) Kapsid: Nükleik asit molekülünü çevreleyen ve nükleik asit molekülüyle az çok birleşik bir kabuktur. Bazı viruslarda bu birleşiklik nedeniyle nükleokapsid adını alır. Kapsomer adı verilen ve sayısı her virüs tipi için belirli olan polipeptidlerden oluşur. Virüsün antijenitesinden sorumludur. Zarfsız viruslarda tutunma ve penetrasyonu sağlar(1,2). 4) Viral genom: Herpes virusların genomu çift sarmallı DNA molekülüdür. 70-150 farklı viral protein sentezini sağlayacak RNA ekspresyonu yapabilir.
Mikrobiyoloji bülteni, 2007
Methicillin-resistant Staphylococcus aureus (MRSA) has emerged as an important pathogen in commun... more Methicillin-resistant Staphylococcus aureus (MRSA) has emerged as an important pathogen in community-acquired and nosocomial infections. The unique bactericidal action of mupirocin makes it one of the few antibiotics still effective against MRSA. The purpose of this study was to investigate the mupirocin resistance in MRSA strains isolated from wound infections of in- and out-patients of two distinct hospitals located in Ankara and Istanbul. A total of 143 MRSA strains were included in the study. Mupirocin resistance was investigated by Kirby-Bauer disk diffusion method and the results were confirmed by determination of the MIC values by E-test strips. Among 143 MRSA isolates, mupirocin resistance was detected by none of the methods, and overall mupirocin sensitivity was detected as 100 percent. The majority of mupirocin resistant MRSA is isolated from wound infections. The aetiology mostly depends on the increased topical use of the agent. The method used in the detection of mupiro...
International Journal of Antimicrobial Agents, 2007
2005 resistant to at least one antifungal. Conversely, C. glabrata showed low susceptibility to i... more 2005 resistant to at least one antifungal. Conversely, C. glabrata showed low susceptibility to itraconazole (18%), to fluconazole (59%), and, to a lower extent, to amphotericin B (88.3%) and to voriconazole (94%). Furthermore, the number of C. glabrata strains resistant to at least one antifungal steadily increased from 0 in 2003 to 10 strains in 2005.
Case Reports in Medicine, 2011
Brucellosis is a zoonotic infectious disease, which mainly present with lymphoreticular system in... more Brucellosis is a zoonotic infectious disease, which mainly present with lymphoreticular system invovement. However any organ system can be attacked by the microorganism. In this paper we present a 52-year-old female patient who was admitted to the Infectious Diseases Department with complaints of fatigue, arthralgias, fever, and weight loss. In the medical examination and radiological analysis bilateral pleural effusions and hepatosplenomegaly were detected. Serum transaminase levels were two times higher than the upper limits of normal. Abdominal ultrasound revealed sludge in the gallbladder and multiple hypodense splenic lesions (the largest was 1 cm in diameter). Brucella melitensis was isolated from the blood culture of the patient. Rifampicin (600 mg/day) and doxycycline (200 mg/day) therapy was started. Follow-up chest radiography and ultrasonography revealed the absence of pleural effusion. Splenic lesions and hepatosplenomegaly were totally regressed. The patient has been followed for 3 months after 6 week antibiotic regimen without recurrence. Brucellosis was expected to be the cause of all pathological signs.
Turkish Journal of Hematology, 2012
Objective: Patients with neutropenia due to cancer chemotherapy are prone to severe infections. C... more Objective: Patients with neutropenia due to cancer chemotherapy are prone to severe infections. Cancer patients can experience >1 infectious episode during the same period of neutropenia. This study aimed to determine the etiological and clinical characteristics of secondary infectious episodes in cancer patients with febrile neutropenia and to identify the factors associated with the risk of secondary infectious episodes.
Turkish Journal of Hematology, 2011
The clinical course of influenza A (H1N1) infection in allogeneic hematopoietic stem cell transpl... more The clinical course of influenza A (H1N1) infection in allogeneic hematopoietic stem cell transplantation (AHSCT)recipients is not clearly known. We report 3 AHSCT recipients that were infected with influenza A (H1N1). Each of thepatients had a different hematological disease and was at a different post-transplantation stages. All the patients weretreated with oseltamivir, and zanamivir was switched to oseltamivir in 1 patient. All the patients survived without anycomplications. The course of swine flu can vary and progress with bacterial or other viral infections in immunosuppressedpatients.
Transplantation Proceedings, 2005
We report a case of spontaneous bacterial peritonitis caused by Klebsiella pneumoniae in a 34-yea... more We report a case of spontaneous bacterial peritonitis caused by Klebsiella pneumoniae in a 34-year-old male recipient shortly after kidney transplantation. On posttransplant day 10, the patient started complaining of severe abdominal pain and nausea. Body temperature was 38.4°C. The abdomen was diffusely tender with rigidity and rebound. Laboratory data showed a normal erythrocyte sedimentation rate and serum creatinine level but a slightly elevated C-reactive protein concentration and leukocytosis of 36,200 cells/mm 3 with 88% neutrophils. Explorative laparotomy revealed diffuse purulent peritonitis without an intraabdominal source of infection, such as intestinal perforation. The peritoneal fluid revealed greater than 1000/mm 3 white blood cells and many gram-negative bacilli. Fluid cultures yielded growth of Klebsiella pneumoniae. The patient responded to antibiotic therapy; he was discharged in good condition. This case report draws attention to the impaired host defense that may predispose to spontaneous bacterial peritonitis in renal transplant recipients and alerts the clinician to the possibility of this rare disease.
Transplant International, 2003
Invasive fungal infections are life-threatening complications in solid-organ transplantation.
Journal of Infection, 2005
Aim. The limitations and opportunities of revised definition of fevers of unknown origin (FUO) in... more Aim. The limitations and opportunities of revised definition of fevers of unknown origin (FUO) in comparison to conventional definition were investigated, and prehospital characteristics of the patients were detailed.
International Journal of Antimicrobial Agents, 2007
International Journal of Antimicrobial Agents, 2007
International Journal of Antimicrobial Agents, 2007
medicine.ankara.edu.tr
Amaç: Bu çalışmada klinik örneklerden izole edilen ve enfeksiyon etkeni olarak kabul edilen 440 S... more Amaç: Bu çalışmada klinik örneklerden izole edilen ve enfeksiyon etkeni olarak kabul edilen 440 Staphylococcus aureus suşunun fusidik asite in-vitro duyarlılığı araştırılması amaçlandı. Gereç ve yöntem: "National Committee for Clinical Laboratory Standards" (NCCLS) önerileri doğrultusunda agar dilüsyon yöntemi ile minimal inhibitör konsantrasyon (MİK) değerleri belirlendi. MİK değeri ≥2 mg/L olan suşlar dirençli, ≤0.125mg/L olan suşlar duyarlı kabul edildi. Bulgular: Çalışmaya alınan 196 metisiline duyarlı S.aureus suşunda fusidik asite direnç saptanmazken, 244 metisiline dirençli S.aureus suşundan 2'si (%0.8) fusidik asite dirençli bulundu. Sonuç: Fusidik asit, metisiline dirençli ve duyarlı stafilokokların etken olduğu enfeksiyonlarda iyi bir tedavi seçeneği olarak karşımıza çıkmaktadır.
American Journal of Infection Control, 2005
blood and body fluids Ethiopia health care professionals occupational exposure a b s t r a c t Ba... more blood and body fluids Ethiopia health care professionals occupational exposure a b s t r a c t Background: Health care professionals (HCPs) are at high risk of contracting blood-borne infections due to their occupational exposure to blood and body fluids (BBFs). The incidence of these infections among HCPs are higher in low income countries such as Ethiopia. The aim of the study was to investigate the extent of occupational exposure to BBFs and its associated factors among HCPs in Bahir Dar town, Ethiopia. Methods: A cross-sectional study was used from October 1, 2012 to October 30, 2012. Three hundred and seventeen HCPs were included in the study using a simple random sampling technique. The data were collected using a structured questionnaire and analyzed using SPSS version 16. Bivariate and multivariate analyses were used to identify the factors related to exposure to BBFs. Results: Two hundred and nine (65.9%) HCPs were exposed to BBFs in the past year, of which 29.0% were needlestick injuries. Work experience [adjusted odds ratio (AOR) 4.13, 95% confidence interval (CI) 1.56e10.91], inconsistent use of gloves (AOR 1.98, 95% CI 1.04e3.43), and not complying with standard precautions (AOR 1.80, 95% CI 1.00e3.22) were the factors associated with occupational exposure to BBFs. Conclusion: A high proportion of HCPs was exposed to BBFs in this study. Occupational exposure to BBFs was determined by the use of gloves and not complying with standard precautions. Ensuring the availability of gloves, training about standard precautions, and motivation of HCPs to implement standard precautions should be emphasized to avoid such exposures.
Klimik Dergisi/Klimik Journal, 2011
The incidence of …, 2005
The incidence of Moraxella catarrhalis, Streptococcus pneumoniae, Haemoph ilusinfluenzae in acute... more The incidence of Moraxella catarrhalis, Streptococcus pneumoniae, Haemoph ilusinfluenzae in acute exacerbation of chronic obstructive pulmonary disease ... Kemal Osman Memikoğlu1, Alpay Azap1, Özlem Kurt2, Tuncay Hasip Sözen1, Mehmet Emin Tekeli1
Herpes virüs ailesinin bir üyesi olan Varisellazoster virusu (VZV), suçiçeği ve zona olmak üzere ... more Herpes virüs ailesinin bir üyesi olan Varisellazoster virusu (VZV), suçiçeği ve zona olmak üzere iki farklı klinik tabloya neden olur. Her iki tablo da immün sistemi sağlam olan kişilerde ve genç insanlarda ılımlı seyreden infeksiyonlardır. Fakat immün yetmezlikli hastalar ve yaşlılarda ağır seyidi infeksiyon ve kompikasyon gelişme riski fazladır. Organ nakli ve kortikosteroid kullanımı gibi immün baskılanmaya neden olan klinik uygulamaların artmasıyla birlikte VZV infeksiyonları daha önemli hale gelmiştir. Bu makalede VZV infeksiyonlarının klinik seyri, komplikasyonları, korunma ve tedavi yöntemleri derlenmiştir. Anahtar Kelimeler: Post herpetik Nevralji, Suçiçeği, Varisella-zoster Virüs, Zona zoster. SUMMARY Varicella-zoster Virüs Infections Varicella-zoster virüs (VZV) causes two distinct clinical entities: Varicella or chickenpox and herpes zoster or shingles. Both entities have a benign clinical course in immunocompetent and young individuals. But immunocompromised and elderly are at greater risk for severe infection and complications. As immunosuppressive clinical modalities such as organ transplantation and corticosteroid therapy have been vvidely used, the imponance of VZV infections has increased. Clinical course, complications, prevention and treatment of VZV infections have been reviewed in this article. Varicella-zoster virüs, Zona zoster. Varicella-Zoster virusu herpes virüs ailesinin bir üyesidir. Herpes virüs ailesinin genel özelliklerini taşır. Herpes virüs ailesinin genel özellikleri: Herpes virüs ailesi büyük (150-200nm), zarflı, DNA virüsleridir. 4 temel yapısal elemandan oluşurlar. 1) Zarf (envelop): Glikoproteinden zengin bir yapıdır. Virionun hücreye tutunmasını ve penetrasyonunu sağlar. 2) Tegümen:Virus tarafından kodlanan, hedef hücrede replikasyonda görev alan proteinleri içe-ren bir yapıdır. 3) Kapsid: Nükleik asit molekülünü çevreleyen ve nükleik asit molekülüyle az çok birleşik bir kabuktur. Bazı viruslarda bu birleşiklik nedeniyle nükleokapsid adını alır. Kapsomer adı verilen ve sayısı her virüs tipi için belirli olan polipeptidlerden oluşur. Virüsün antijenitesinden sorumludur. Zarfsız viruslarda tutunma ve penetrasyonu sağlar(1,2). 4) Viral genom: Herpes virusların genomu çift sarmallı DNA molekülüdür. 70-150 farklı viral protein sentezini sağlayacak RNA ekspresyonu yapabilir.
Mikrobiyoloji bülteni, 2007
Methicillin-resistant Staphylococcus aureus (MRSA) has emerged as an important pathogen in commun... more Methicillin-resistant Staphylococcus aureus (MRSA) has emerged as an important pathogen in community-acquired and nosocomial infections. The unique bactericidal action of mupirocin makes it one of the few antibiotics still effective against MRSA. The purpose of this study was to investigate the mupirocin resistance in MRSA strains isolated from wound infections of in- and out-patients of two distinct hospitals located in Ankara and Istanbul. A total of 143 MRSA strains were included in the study. Mupirocin resistance was investigated by Kirby-Bauer disk diffusion method and the results were confirmed by determination of the MIC values by E-test strips. Among 143 MRSA isolates, mupirocin resistance was detected by none of the methods, and overall mupirocin sensitivity was detected as 100 percent. The majority of mupirocin resistant MRSA is isolated from wound infections. The aetiology mostly depends on the increased topical use of the agent. The method used in the detection of mupiro...
International Journal of Antimicrobial Agents, 2007
2005 resistant to at least one antifungal. Conversely, C. glabrata showed low susceptibility to i... more 2005 resistant to at least one antifungal. Conversely, C. glabrata showed low susceptibility to itraconazole (18%), to fluconazole (59%), and, to a lower extent, to amphotericin B (88.3%) and to voriconazole (94%). Furthermore, the number of C. glabrata strains resistant to at least one antifungal steadily increased from 0 in 2003 to 10 strains in 2005.
Case Reports in Medicine, 2011
Brucellosis is a zoonotic infectious disease, which mainly present with lymphoreticular system in... more Brucellosis is a zoonotic infectious disease, which mainly present with lymphoreticular system invovement. However any organ system can be attacked by the microorganism. In this paper we present a 52-year-old female patient who was admitted to the Infectious Diseases Department with complaints of fatigue, arthralgias, fever, and weight loss. In the medical examination and radiological analysis bilateral pleural effusions and hepatosplenomegaly were detected. Serum transaminase levels were two times higher than the upper limits of normal. Abdominal ultrasound revealed sludge in the gallbladder and multiple hypodense splenic lesions (the largest was 1 cm in diameter). Brucella melitensis was isolated from the blood culture of the patient. Rifampicin (600 mg/day) and doxycycline (200 mg/day) therapy was started. Follow-up chest radiography and ultrasonography revealed the absence of pleural effusion. Splenic lesions and hepatosplenomegaly were totally regressed. The patient has been followed for 3 months after 6 week antibiotic regimen without recurrence. Brucellosis was expected to be the cause of all pathological signs.
Turkish Journal of Hematology, 2012
Objective: Patients with neutropenia due to cancer chemotherapy are prone to severe infections. C... more Objective: Patients with neutropenia due to cancer chemotherapy are prone to severe infections. Cancer patients can experience >1 infectious episode during the same period of neutropenia. This study aimed to determine the etiological and clinical characteristics of secondary infectious episodes in cancer patients with febrile neutropenia and to identify the factors associated with the risk of secondary infectious episodes.
Turkish Journal of Hematology, 2011
The clinical course of influenza A (H1N1) infection in allogeneic hematopoietic stem cell transpl... more The clinical course of influenza A (H1N1) infection in allogeneic hematopoietic stem cell transplantation (AHSCT)recipients is not clearly known. We report 3 AHSCT recipients that were infected with influenza A (H1N1). Each of thepatients had a different hematological disease and was at a different post-transplantation stages. All the patients weretreated with oseltamivir, and zanamivir was switched to oseltamivir in 1 patient. All the patients survived without anycomplications. The course of swine flu can vary and progress with bacterial or other viral infections in immunosuppressedpatients.
Transplantation Proceedings, 2005
We report a case of spontaneous bacterial peritonitis caused by Klebsiella pneumoniae in a 34-yea... more We report a case of spontaneous bacterial peritonitis caused by Klebsiella pneumoniae in a 34-year-old male recipient shortly after kidney transplantation. On posttransplant day 10, the patient started complaining of severe abdominal pain and nausea. Body temperature was 38.4°C. The abdomen was diffusely tender with rigidity and rebound. Laboratory data showed a normal erythrocyte sedimentation rate and serum creatinine level but a slightly elevated C-reactive protein concentration and leukocytosis of 36,200 cells/mm 3 with 88% neutrophils. Explorative laparotomy revealed diffuse purulent peritonitis without an intraabdominal source of infection, such as intestinal perforation. The peritoneal fluid revealed greater than 1000/mm 3 white blood cells and many gram-negative bacilli. Fluid cultures yielded growth of Klebsiella pneumoniae. The patient responded to antibiotic therapy; he was discharged in good condition. This case report draws attention to the impaired host defense that may predispose to spontaneous bacterial peritonitis in renal transplant recipients and alerts the clinician to the possibility of this rare disease.
Transplant International, 2003
Invasive fungal infections are life-threatening complications in solid-organ transplantation.
Journal of Infection, 2005
Aim. The limitations and opportunities of revised definition of fevers of unknown origin (FUO) in... more Aim. The limitations and opportunities of revised definition of fevers of unknown origin (FUO) in comparison to conventional definition were investigated, and prehospital characteristics of the patients were detailed.
International Journal of Antimicrobial Agents, 2007
International Journal of Antimicrobial Agents, 2007
International Journal of Antimicrobial Agents, 2007
medicine.ankara.edu.tr
Amaç: Bu çalışmada klinik örneklerden izole edilen ve enfeksiyon etkeni olarak kabul edilen 440 S... more Amaç: Bu çalışmada klinik örneklerden izole edilen ve enfeksiyon etkeni olarak kabul edilen 440 Staphylococcus aureus suşunun fusidik asite in-vitro duyarlılığı araştırılması amaçlandı. Gereç ve yöntem: "National Committee for Clinical Laboratory Standards" (NCCLS) önerileri doğrultusunda agar dilüsyon yöntemi ile minimal inhibitör konsantrasyon (MİK) değerleri belirlendi. MİK değeri ≥2 mg/L olan suşlar dirençli, ≤0.125mg/L olan suşlar duyarlı kabul edildi. Bulgular: Çalışmaya alınan 196 metisiline duyarlı S.aureus suşunda fusidik asite direnç saptanmazken, 244 metisiline dirençli S.aureus suşundan 2'si (%0.8) fusidik asite dirençli bulundu. Sonuç: Fusidik asit, metisiline dirençli ve duyarlı stafilokokların etken olduğu enfeksiyonlarda iyi bir tedavi seçeneği olarak karşımıza çıkmaktadır.
American Journal of Infection Control, 2005
blood and body fluids Ethiopia health care professionals occupational exposure a b s t r a c t Ba... more blood and body fluids Ethiopia health care professionals occupational exposure a b s t r a c t Background: Health care professionals (HCPs) are at high risk of contracting blood-borne infections due to their occupational exposure to blood and body fluids (BBFs). The incidence of these infections among HCPs are higher in low income countries such as Ethiopia. The aim of the study was to investigate the extent of occupational exposure to BBFs and its associated factors among HCPs in Bahir Dar town, Ethiopia. Methods: A cross-sectional study was used from October 1, 2012 to October 30, 2012. Three hundred and seventeen HCPs were included in the study using a simple random sampling technique. The data were collected using a structured questionnaire and analyzed using SPSS version 16. Bivariate and multivariate analyses were used to identify the factors related to exposure to BBFs. Results: Two hundred and nine (65.9%) HCPs were exposed to BBFs in the past year, of which 29.0% were needlestick injuries. Work experience [adjusted odds ratio (AOR) 4.13, 95% confidence interval (CI) 1.56e10.91], inconsistent use of gloves (AOR 1.98, 95% CI 1.04e3.43), and not complying with standard precautions (AOR 1.80, 95% CI 1.00e3.22) were the factors associated with occupational exposure to BBFs. Conclusion: A high proportion of HCPs was exposed to BBFs in this study. Occupational exposure to BBFs was determined by the use of gloves and not complying with standard precautions. Ensuring the availability of gloves, training about standard precautions, and motivation of HCPs to implement standard precautions should be emphasized to avoid such exposures.
Klimik Dergisi/Klimik Journal, 2011