Uner Kayabas | Niğde University (original) (raw)
Papers by Uner Kayabas
Flora, 2020
Introduction: Acinetobacter baumanii causes difficulties in the treatment of nosocomial infection... more Introduction: Acinetobacter baumanii causes difficulties in the treatment of nosocomial infections due to increasing resistance worldwide. With an increase in resistant infections, the use of colistin has come to the fore. We aimed to investigate the antimicrobial resistance profile of A. baumanii strains isolated from clinical specimens as hospital-acquired colonizations and infection agents and to evaluate the clinical and microbiologic responses and adverse effects of antibiotic regimens used in patients who were isolated because of having infectious agents. Materials and Methods: A retrospective descriptive study of 326 adult patients with nosocomial A. baumannii colonizations and infections was conducted between January 2012 and December 2017 in Niğde Education and Research Hospital. In addition, a total of 212 adult patients who received at least 72 hours of antimicrobial therapy were evaluated. Standard and automated methods were used to identify isolated strains and antibiot...
Journal of Medical Virology
The pathogenesis of COVID-19 is still not fully understood. Since SARS-COV-2 has a similar pathog... more The pathogenesis of COVID-19 is still not fully understood. Since SARS-COV-2 has a similar pathogenetic pathway to Mycobacterium tuberculosis, it has been reported that there may be a relationship between BCG vaccination rate and COVID-19 severity. This study investigated the relationship between tuberculin skin test (TST) induration diameter and the clinical course of COVID-19. Of 1963 adult patients who underwent TST, 76 patients with SARS-COV-2 infection confirmed by RT-PCR analysis of respiratory tract samples were included in the study. Relationships between COVID-19 clinical severity and TST positivity, induration size, and other clinical parameters were analyzed. Of the 76 patients, TST results were negative for 53 patients (69.7%) and positive for 23 patients (30.3%). COVID-19 severity was mild in 47 patients (61.8%), moderate in 22 patients (28.9%), and severe in 7 patients (9.3%). All TST-positive patients had mild disease. Patients with mild disease had significantly higher TST positivity rate (P<.001) and larger induration diameter (P<0.001). Area under the receiver operating characteristic (ROC) curve of TST induration size for the differentiation of mild with moderate and severe disease was 0.768 (P<.001). The maximum Youden J index value was 0.522 at an induration diameter of 6.5 mm, which had a sensitivity of 66.0% and specificity of 86.2%. COVID-19 patients with positive TST showed a significantly higher rate of mild disease than those with negative TST. TST positivity is favorably associated with the course of COVID-19. This article is protected by copyright. All rights reserved.
Transplantation Proceedings
INTRODUCTION Mucormycosis is a severe infection in renal transplant recipients. Here, we report a... more INTRODUCTION Mucormycosis is a severe infection in renal transplant recipients. Here, we report a case of maxillary sinus mucormycosis in a patient who presented with a facial pain complaint. CASE A 51-year-old female patient with renal transplantation due to autosomal dominant, polycystic kidney disease and diabetic nephropathy was admitted to our hospital with facial pain and minimal edema of the left half of her face on the 8th month of transplantation. On physical examination, there was only tenderness and slight edema on the left half of the face. On the paranasal computed tomography, extensive soft tissue densities involving septations, filling the left maxillary sinus, extending to the nasal cavity, and obliterating the left osteometeal unit were observed. Because facial pain was not relieved by antibiotics and several, potent analgesic drugs on the second day, mucormycosis infection with bone involvement was suspected. A left maxillary sinus excision was performed. Microscopic examination of the debridement specimen revealed necrotic bone interspersed with fungal hyphae, and culture isolated Rhizopus oryzae. Liposomal amphotericin B was started. The patient was on tacrolimus, prednisolone, and mycophenolate mofetil. Tacrolimus was switched to cyclosporine to regulate serum glucose levels. The left maxillary sinus was washed with liposomal amphoterin B daily and curetted with intervals. The patient started dialysis because of severe renal function loss. The patient was discharged on the 96th day of liposomal amphotericin B. CONCLUSION It should be kept in mind that mucormycosis may be present in the sinuses even if there is no evidence for nasal, oral, and dental examination in renal transplant patients with facial pain.
Klimik Dergisi/Klimik Journal
American Journal of Infection Control, 2016
Understanding the dynamics of aerial spread of Acinetobacter may provide useful information for p... more Understanding the dynamics of aerial spread of Acinetobacter may provide useful information for production of effective control measurements. We investigated genetic relationships between air and clinical isolates of Acinetobacter baumannii in an intensive care unit (ICU) setting. We conducted a prospective surveillance study in a tertiary care hospital for 8 months. A total of 186 air samples were taken from 2 ICUs. Clonal characteristics of air isolates were compared with the prospective clinical strains and the previously isolated strains of ICU patients over a 23-month period. Twenty-six (11.4%) air samples yielded A baumannii, of which 24 (92.3%) isolates were carbapenem-resistant. The Acinetobacter concentration was the highest in bedside sampling areas of infected patients (0.39 CFU/m(3)). Air isolates were clustered in 13 genotypes, and 7 genotypes (including 18 air strains) were clonally related to the clinical strains of 9 ICU patients. One clone continued to be cultured over 27 days in ICU air, and air isolates could be clonally related to 7-week retrospective and approximately 15-week prospective clinical strains. The results of this study suggest that infected patients could spread significant amounts of Acinetobacter to ICU air. These strains could survive in air for some weeks and could likely still infect new patients after some months. Special control measurements may be required against the airborne spread of Acinetobacter in ICUs.
Clinical and Developmental Immunology, Jan 4, 2014
Clinical Nephrology, 2013
Isolated case reports of peritonitis due to Brucella spp. during peritoneal dialysis (PD) continu... more Isolated case reports of peritonitis due to Brucella spp. during peritoneal dialysis (PD) continue to surface in the medical literature. However, the optimal treatment regimen for these patients, in particular with regards to the fate of PD catheter, is still largely unknown. We report a case of brucella peritonitis successfully treated with intraperitoneal administration of amikacin, along with oral rifampicin and doxycycline but without catheter removal. Furthermore, we have reviewed the literature up until present day.
Chemotherapy, 2012
Cutaneous anthrax (CA) is the most common clinical presentation in human anthrax, but the duratio... more Cutaneous anthrax (CA) is the most common clinical presentation in human anthrax, but the duration of antibiotic therapy in naturally occurring CA is controversial. The aim of this study was to compare the clinical outcomes of patients receiving antibiotic treatment for either 3-5 days (group 1) or 7-10 days (group 2) in uncomplicated CA. A total of 66 patients were enrolled; 29 (44%) in group 1 and 37 (56%) in group 2. Infections were classified as mild (n = 22, 33%) or severe (n = 44, 67%) CA. There were no significant differences between the groups in symptom resolution time, fever clearance time, healing of lesions, development and healing of eschars, requirement for surgical intervention or the development of complications. Both edema resolution time and duration of hospital stay were longer in group 2. There were no therapeutic failures, relapses or deaths in either group. Steroid therapy was used in 32% of patients with severe CA, but a beneficial effect on resolution of edem...
The new microbiologica, 2011
Human orf is a viral zoonotic infection caused by Parapoxvirus. The skin lesions of human orf can... more Human orf is a viral zoonotic infection caused by Parapoxvirus. The skin lesions of human orf can be misdiagnosed as cutaneous anthrax leading to overtreatment and also fear. This study was conducted to analyze an outbreak which led to deaths among kids and lambs in the same flock, and skin lesions in some persons who were living on the same farm that were initially diagnosed as cutaneous anthrax by a practitioner. Eight patients with skin lesions and eleven persons who had no skin lesion were considered as patients and control groups, respectively. The cultures obtained from the lesions of all patients were negative for Bacillus anthracis. The diagnosis of skin lesions was done by clinical findings, histopathological examination and PCR as human orf. To be under 20 years of age, direct contact with the animals, and contact with flayed skin of sick animals were the risk factors for human orf (Odds Ratio 7.5; 95% Confidence Interval 1.02-54.54, OR 12.25; 95% CI:1.3-100.9, OR 16.67; 9...
CEN Case Reports, 2015
ABSTRACT
Experimental and Clinical Transplantation Official Journal of the Middle East Society For Organ Transplantation, Dec 1, 2010
Infections in solid-organ transplant recipients are the most important causes of morbidity and mo... more Infections in solid-organ transplant recipients are the most important causes of morbidity and mortality. A primary goal in organ transplant is the prevention or effective treatment of infection, which is the most common life-threatening complication of long-term immunosuppressive therapy. A 21-year-old woman who underwent heart transplant 3 years previous owing to dilated cardiomyopathy was referred to our hospital with symptoms of high fever and cough. The patient's history revealed that she had received a trimethoprim-sulfamethoxazole double-strength tablet each day for prophylactic purposes. On chest radiograph, pneumonia was detected, and in broncho-alveolar lavage sample, Pneumocystis jiroveci cysts were found. After diagnosing P. jiroveci pneumonia, trimethoprim-sulfamethoxazole was initiated at 20 mg/kg/d including intravenous trimethoprim in divided dosages every 6 hours. On the sixth day of therapy, she died in intensive care unit. In solid-organ transplant recipients, although antipneumocystis prophylaxis is recommended within the first 6 to 12 months after transplant, lifelong prophylaxis is also used in several settings. In addition, the physician should keep in mind that P. jiroveci pneumonia may develop in solid organ recipients, despite trimethoprim-sulfamethoxazole prophylaxis.
Journal of immunology research, 2014
The liver is the largest solid organ in the body and commands a large blood supply that is rich i... more The liver is the largest solid organ in the body and commands a large blood supply that is rich in bacterial products, environment toxins, and food antigens, which are repeatedly scanned by cells within the liver. In addition, the regenerative capability of liver tissue makes it unique in comparison to other internal organs. In contrast to these unlike properties, the liver is one of the most common sites for metastatic diseases; it supports chronic viral infections caused by hepatitis B and C and can also promote tolerance against external antigens in animal models. Furthermore, liver transplantation often requires less immunosuppression compared to kidney and other solid organ transplantations. Despite these properties, the study of liver immunology remains in its infancy, and many questions remain unanswered. In that special issue, authors try to find answers in various subjects about immune response in liver under the approach of infection, malignancy, and transplantation.
The New Microbiologica Official Journal of the Italian Society For Medical Virology, May 1, 2007
Bacteriological and epidemiological studies were carried out on 90 isolates of methicillin-resist... more Bacteriological and epidemiological studies were carried out on 90 isolates of methicillin-resistant Staphylococcus aureus (MRSA) at Turgut Özal Medical Center of Inönü University, (Malatya/Turkey). MRSA isolates were obtained from patients with nosocomial infections. Staphylococcus aureus clinical isolates were collected between May 2004-May 2005. Isolates were tested for resistance to methicillin. Antimicrobial susceptibility testing and slime production evaluation was performed. Genotype studies were carried out by arbitrarily primed polymerase chain reaction (AP-PCR) and consequent cluster analysis. All of the isolates were mecA-positive in a PCR-based assay; all exhibited resistance to oxacillin, by agar dilution (MICs ≥4mg/L) and disc diffusion methods, and multiple antibiotics. Most MRSA isolates were collected in intensive care units. Of 90 samples, 53 were found to be unrelated to the others while the remaining 37 strains were either identical or closely related. Dendrogram analysis identified nine major clusters. These data support the opinion that MRSA are significant nosocomial pathogens in intensive care units and that resistant clones may be transmitted between patients. Molecular epidemiological tools are helpful for understanding transmission patterns and sources of infection, and are useful for measuring outcomes of intervention strategies implemented to reduce nosocomial MRSA.
Médecine et Maladies Infectieuses, 2002
The aim of this study was to evaluate the clinical, laboratory findings, and therapeutic features... more The aim of this study was to evaluate the clinical, laboratory findings, and therapeutic features of patients with brucellosis. The diagnosis was made by clinical findings, positive agglutination titer, and/or the isolation of Brucella species. Three hundred and twenty-two cases were acute, 121 sub-acute, 24 chronic, and 13 asymptomatic. Symptoms of patients were malaise in 432 (90%) patients, sweating in 405 (84.4%), arthralgia in 393 (81.9%), fever in 383 (79.8%), and back pain in 281 (58.5%). The most frequent findings were fever in 187 (39%) patients, hepatomegaly in 102 (21.3%), osteoarticular involvement in 91 (19%), splenomegaly in 68 (14.2%), nervous system involvement in 31 (6.5%) patients. Lymphocytosis was determined in 328 patients, anemia in 262 patients, thrombocytopenia in 35 patients, leukopenia in 37 patients, leukocytosis in 31 patients, and elevated erythrocyte sedimentation rate in 282 patients. Cultures were positive in 194 (45%) patients and all strains were identified as Brucella melitensis. Various treatment regimens were given to patients. No therapeutic failure was observed. The time to defervescence ranged from 2 to 15 days. Relapse occurred in 26 of the 480 patients (5.4%). There was no correlation between relapse and positive culture or complications. Brucellosis can present various clinical forms in endemic areas and mimics several diseases. © 2002 É ditions scientifiques et médicales Elsevier SAS. All rights reserved.
Transplantation proceedings, 2007
We describe the first case of isosporiasis in a liver transplant patient. Watery diarrhea due to ... more We describe the first case of isosporiasis in a liver transplant patient. Watery diarrhea due to Isospora belli was observed in a woman who had undergone liver transplantation 8 months prior. She was successfully treated with trimethoprim-sulfamethoxazole. This parasite should be taken into consideration as an opportunistic infection in transplant patients who need increased hygienic awareness.
Annals of clinical microbiology and antimicrobials, Jan 16, 2002
The emergence of Mycobacterium tuberculosis strains resistant to antituberculosis agents has rece... more The emergence of Mycobacterium tuberculosis strains resistant to antituberculosis agents has recently received increased attention owing largely to the dramatic outbreaks of multi drug resistance tuberculosis (MDR-TB). Patients residing in Zonguldak and Kayseri provinces of Turkey with, pulmonary tuberculosis diagnosed between 1972 and 1999 were retrospectively identified. Drug susceptibility tests had been performed for isoniazid (INH), rifampin (RIF), streptomycin (SM), ethambutol (EMB) and thiacetasone (TH) after isolation by using the resistance proportion method. Total 3718 patients were retrospectively studied. In 1972-1981, resistance rates for to SM and INH were found to be 14.8% and 9.8% respectively (n: 2172). In 1982-1991 period, resistance rates for INH, SM, RIF, EMB and TH were 14.2%, 14.4%, 10.5%, 2.7% and 2.9% (n: 683), while in 1992-1999 period 14.4%, 21.1%, 10.6%, 2.4% and 3.7% respectively (n: 863). Resistance rates were highest for SM and INH in three periods. MDR...
Giriş: Nozokomiyal infeksiyonlar, yoğun bakım ünitelerinin (YBÜ) önemli bir sorunu olmaya devam e... more Giriş: Nozokomiyal infeksiyonlar, yoğun bakım ünitelerinin (YBÜ) önemli bir sorunu olmaya devam etmektedir. Amaç: Yoğun bakım ünitelerinde gelişen nozokomiyal infeksiyonları değerlendirmek. Çalışma Şekli: Prospektif, sürveyans çalışması. Hastalar ve Yöntem: 1 Ocak 1997-1 Aralık 1997 tarihleri arasında YBÜ'de izlenen 1392 hasta çalışmaya alındı. Hastaların "Acute Physiology and Chronic Health Evaluation II (APACHE II)" skorları, altta yatan hastalıkları, ameliyat olup olmadıkları, YBÜ'de yatış süreleri ve gelişen nozokomiyal infeksiyonlar kaydedilip değerlendirildi. Sonuçlar: İzlenen 1392 hastanın 294 (%21.1)'ünde 359 nozokomiyal infeksiyon epizodu saptandı. Nozokomiyal infeksiyonlar cerrahi YBÜ'de %22.7 ve iç hastalıkları YBÜ'de %18.4 oranında bulundu. İnfeksiyon gelişen hastalarda yatıştaki APACHE II ´skoru ortalaması 12.5 ± 4.9, gelişmeyenlerde 10.9 ± 4.3 idi Conclusion: This prospective study highlighted that nosocomial infections are occuring very frequently in our ICU' s. New approaches to minimize them are needed.
The new microbiologica, 2011
Human orf is a viral zoonotic infection caused by Parapoxvirus. The skin lesions of human orf can... more Human orf is a viral zoonotic infection caused by Parapoxvirus. The skin lesions of human orf can be misdiagnosed as cutaneous anthrax leading to overtreatment and also fear. This study was conducted to analyze an outbreak which led to deaths among kids and lambs in the same flock, and skin lesions in some persons who were living on the same farm that were initially diagnosed as cutaneous anthrax by a practitioner. Eight patients with skin lesions and eleven persons who had no skin lesion were considered as patients and control groups, respectively. The cultures obtained from the lesions of all patients were negative for Bacillus anthracis. The diagnosis of skin lesions was done by clinical findings, histopathological examination and PCR as human orf. To be under 20 years of age, direct contact with the animals, and contact with flayed skin of sick animals were the risk factors for human orf (Odds Ratio 7.5; 95% Confidence Interval 1.02-54.54, OR 12.25; 95% CI:1.3-100.9, OR 16.67; 9...
Journal of Neurology, 2015
Predicting unfavorable outcome is of paramount importance in clinical decision making. Accordingl... more Predicting unfavorable outcome is of paramount importance in clinical decision making. Accordingly, we designed this multinational study, which provided the largest case series of tuberculous meningitis (TBM). 43 centers from 14 countries (Turkey) submitted data of microbiologically confirmed TBM patients hospitalized between 2000 and 2012. Unfavorable outcome was defined as survival with significant sequela or death. In developing our index, binary logistic regression models were constructed via 200 replicates of database by bootstrap resampling methodology. The final model was built according to the selection frequencies of variables. The severity scale included variables with arbitrary scores proportional to predictive powers of terms in the final model. The final model was internally validated by bootstrap resampling. A total of 507 patients' data were submitted among which 165 had unfavorable outcome. Eighty-six patients died while 119 had different neurological sequelae in 79 (16 %) patients. The full model included 13
Flora, 2020
Introduction: Acinetobacter baumanii causes difficulties in the treatment of nosocomial infection... more Introduction: Acinetobacter baumanii causes difficulties in the treatment of nosocomial infections due to increasing resistance worldwide. With an increase in resistant infections, the use of colistin has come to the fore. We aimed to investigate the antimicrobial resistance profile of A. baumanii strains isolated from clinical specimens as hospital-acquired colonizations and infection agents and to evaluate the clinical and microbiologic responses and adverse effects of antibiotic regimens used in patients who were isolated because of having infectious agents. Materials and Methods: A retrospective descriptive study of 326 adult patients with nosocomial A. baumannii colonizations and infections was conducted between January 2012 and December 2017 in Niğde Education and Research Hospital. In addition, a total of 212 adult patients who received at least 72 hours of antimicrobial therapy were evaluated. Standard and automated methods were used to identify isolated strains and antibiot...
Journal of Medical Virology
The pathogenesis of COVID-19 is still not fully understood. Since SARS-COV-2 has a similar pathog... more The pathogenesis of COVID-19 is still not fully understood. Since SARS-COV-2 has a similar pathogenetic pathway to Mycobacterium tuberculosis, it has been reported that there may be a relationship between BCG vaccination rate and COVID-19 severity. This study investigated the relationship between tuberculin skin test (TST) induration diameter and the clinical course of COVID-19. Of 1963 adult patients who underwent TST, 76 patients with SARS-COV-2 infection confirmed by RT-PCR analysis of respiratory tract samples were included in the study. Relationships between COVID-19 clinical severity and TST positivity, induration size, and other clinical parameters were analyzed. Of the 76 patients, TST results were negative for 53 patients (69.7%) and positive for 23 patients (30.3%). COVID-19 severity was mild in 47 patients (61.8%), moderate in 22 patients (28.9%), and severe in 7 patients (9.3%). All TST-positive patients had mild disease. Patients with mild disease had significantly higher TST positivity rate (P<.001) and larger induration diameter (P<0.001). Area under the receiver operating characteristic (ROC) curve of TST induration size for the differentiation of mild with moderate and severe disease was 0.768 (P<.001). The maximum Youden J index value was 0.522 at an induration diameter of 6.5 mm, which had a sensitivity of 66.0% and specificity of 86.2%. COVID-19 patients with positive TST showed a significantly higher rate of mild disease than those with negative TST. TST positivity is favorably associated with the course of COVID-19. This article is protected by copyright. All rights reserved.
Transplantation Proceedings
INTRODUCTION Mucormycosis is a severe infection in renal transplant recipients. Here, we report a... more INTRODUCTION Mucormycosis is a severe infection in renal transplant recipients. Here, we report a case of maxillary sinus mucormycosis in a patient who presented with a facial pain complaint. CASE A 51-year-old female patient with renal transplantation due to autosomal dominant, polycystic kidney disease and diabetic nephropathy was admitted to our hospital with facial pain and minimal edema of the left half of her face on the 8th month of transplantation. On physical examination, there was only tenderness and slight edema on the left half of the face. On the paranasal computed tomography, extensive soft tissue densities involving septations, filling the left maxillary sinus, extending to the nasal cavity, and obliterating the left osteometeal unit were observed. Because facial pain was not relieved by antibiotics and several, potent analgesic drugs on the second day, mucormycosis infection with bone involvement was suspected. A left maxillary sinus excision was performed. Microscopic examination of the debridement specimen revealed necrotic bone interspersed with fungal hyphae, and culture isolated Rhizopus oryzae. Liposomal amphotericin B was started. The patient was on tacrolimus, prednisolone, and mycophenolate mofetil. Tacrolimus was switched to cyclosporine to regulate serum glucose levels. The left maxillary sinus was washed with liposomal amphoterin B daily and curetted with intervals. The patient started dialysis because of severe renal function loss. The patient was discharged on the 96th day of liposomal amphotericin B. CONCLUSION It should be kept in mind that mucormycosis may be present in the sinuses even if there is no evidence for nasal, oral, and dental examination in renal transplant patients with facial pain.
Klimik Dergisi/Klimik Journal
American Journal of Infection Control, 2016
Understanding the dynamics of aerial spread of Acinetobacter may provide useful information for p... more Understanding the dynamics of aerial spread of Acinetobacter may provide useful information for production of effective control measurements. We investigated genetic relationships between air and clinical isolates of Acinetobacter baumannii in an intensive care unit (ICU) setting. We conducted a prospective surveillance study in a tertiary care hospital for 8 months. A total of 186 air samples were taken from 2 ICUs. Clonal characteristics of air isolates were compared with the prospective clinical strains and the previously isolated strains of ICU patients over a 23-month period. Twenty-six (11.4%) air samples yielded A baumannii, of which 24 (92.3%) isolates were carbapenem-resistant. The Acinetobacter concentration was the highest in bedside sampling areas of infected patients (0.39 CFU/m(3)). Air isolates were clustered in 13 genotypes, and 7 genotypes (including 18 air strains) were clonally related to the clinical strains of 9 ICU patients. One clone continued to be cultured over 27 days in ICU air, and air isolates could be clonally related to 7-week retrospective and approximately 15-week prospective clinical strains. The results of this study suggest that infected patients could spread significant amounts of Acinetobacter to ICU air. These strains could survive in air for some weeks and could likely still infect new patients after some months. Special control measurements may be required against the airborne spread of Acinetobacter in ICUs.
Clinical and Developmental Immunology, Jan 4, 2014
Clinical Nephrology, 2013
Isolated case reports of peritonitis due to Brucella spp. during peritoneal dialysis (PD) continu... more Isolated case reports of peritonitis due to Brucella spp. during peritoneal dialysis (PD) continue to surface in the medical literature. However, the optimal treatment regimen for these patients, in particular with regards to the fate of PD catheter, is still largely unknown. We report a case of brucella peritonitis successfully treated with intraperitoneal administration of amikacin, along with oral rifampicin and doxycycline but without catheter removal. Furthermore, we have reviewed the literature up until present day.
Chemotherapy, 2012
Cutaneous anthrax (CA) is the most common clinical presentation in human anthrax, but the duratio... more Cutaneous anthrax (CA) is the most common clinical presentation in human anthrax, but the duration of antibiotic therapy in naturally occurring CA is controversial. The aim of this study was to compare the clinical outcomes of patients receiving antibiotic treatment for either 3-5 days (group 1) or 7-10 days (group 2) in uncomplicated CA. A total of 66 patients were enrolled; 29 (44%) in group 1 and 37 (56%) in group 2. Infections were classified as mild (n = 22, 33%) or severe (n = 44, 67%) CA. There were no significant differences between the groups in symptom resolution time, fever clearance time, healing of lesions, development and healing of eschars, requirement for surgical intervention or the development of complications. Both edema resolution time and duration of hospital stay were longer in group 2. There were no therapeutic failures, relapses or deaths in either group. Steroid therapy was used in 32% of patients with severe CA, but a beneficial effect on resolution of edem...
The new microbiologica, 2011
Human orf is a viral zoonotic infection caused by Parapoxvirus. The skin lesions of human orf can... more Human orf is a viral zoonotic infection caused by Parapoxvirus. The skin lesions of human orf can be misdiagnosed as cutaneous anthrax leading to overtreatment and also fear. This study was conducted to analyze an outbreak which led to deaths among kids and lambs in the same flock, and skin lesions in some persons who were living on the same farm that were initially diagnosed as cutaneous anthrax by a practitioner. Eight patients with skin lesions and eleven persons who had no skin lesion were considered as patients and control groups, respectively. The cultures obtained from the lesions of all patients were negative for Bacillus anthracis. The diagnosis of skin lesions was done by clinical findings, histopathological examination and PCR as human orf. To be under 20 years of age, direct contact with the animals, and contact with flayed skin of sick animals were the risk factors for human orf (Odds Ratio 7.5; 95% Confidence Interval 1.02-54.54, OR 12.25; 95% CI:1.3-100.9, OR 16.67; 9...
CEN Case Reports, 2015
ABSTRACT
Experimental and Clinical Transplantation Official Journal of the Middle East Society For Organ Transplantation, Dec 1, 2010
Infections in solid-organ transplant recipients are the most important causes of morbidity and mo... more Infections in solid-organ transplant recipients are the most important causes of morbidity and mortality. A primary goal in organ transplant is the prevention or effective treatment of infection, which is the most common life-threatening complication of long-term immunosuppressive therapy. A 21-year-old woman who underwent heart transplant 3 years previous owing to dilated cardiomyopathy was referred to our hospital with symptoms of high fever and cough. The patient's history revealed that she had received a trimethoprim-sulfamethoxazole double-strength tablet each day for prophylactic purposes. On chest radiograph, pneumonia was detected, and in broncho-alveolar lavage sample, Pneumocystis jiroveci cysts were found. After diagnosing P. jiroveci pneumonia, trimethoprim-sulfamethoxazole was initiated at 20 mg/kg/d including intravenous trimethoprim in divided dosages every 6 hours. On the sixth day of therapy, she died in intensive care unit. In solid-organ transplant recipients, although antipneumocystis prophylaxis is recommended within the first 6 to 12 months after transplant, lifelong prophylaxis is also used in several settings. In addition, the physician should keep in mind that P. jiroveci pneumonia may develop in solid organ recipients, despite trimethoprim-sulfamethoxazole prophylaxis.
Journal of immunology research, 2014
The liver is the largest solid organ in the body and commands a large blood supply that is rich i... more The liver is the largest solid organ in the body and commands a large blood supply that is rich in bacterial products, environment toxins, and food antigens, which are repeatedly scanned by cells within the liver. In addition, the regenerative capability of liver tissue makes it unique in comparison to other internal organs. In contrast to these unlike properties, the liver is one of the most common sites for metastatic diseases; it supports chronic viral infections caused by hepatitis B and C and can also promote tolerance against external antigens in animal models. Furthermore, liver transplantation often requires less immunosuppression compared to kidney and other solid organ transplantations. Despite these properties, the study of liver immunology remains in its infancy, and many questions remain unanswered. In that special issue, authors try to find answers in various subjects about immune response in liver under the approach of infection, malignancy, and transplantation.
The New Microbiologica Official Journal of the Italian Society For Medical Virology, May 1, 2007
Bacteriological and epidemiological studies were carried out on 90 isolates of methicillin-resist... more Bacteriological and epidemiological studies were carried out on 90 isolates of methicillin-resistant Staphylococcus aureus (MRSA) at Turgut Özal Medical Center of Inönü University, (Malatya/Turkey). MRSA isolates were obtained from patients with nosocomial infections. Staphylococcus aureus clinical isolates were collected between May 2004-May 2005. Isolates were tested for resistance to methicillin. Antimicrobial susceptibility testing and slime production evaluation was performed. Genotype studies were carried out by arbitrarily primed polymerase chain reaction (AP-PCR) and consequent cluster analysis. All of the isolates were mecA-positive in a PCR-based assay; all exhibited resistance to oxacillin, by agar dilution (MICs ≥4mg/L) and disc diffusion methods, and multiple antibiotics. Most MRSA isolates were collected in intensive care units. Of 90 samples, 53 were found to be unrelated to the others while the remaining 37 strains were either identical or closely related. Dendrogram analysis identified nine major clusters. These data support the opinion that MRSA are significant nosocomial pathogens in intensive care units and that resistant clones may be transmitted between patients. Molecular epidemiological tools are helpful for understanding transmission patterns and sources of infection, and are useful for measuring outcomes of intervention strategies implemented to reduce nosocomial MRSA.
Médecine et Maladies Infectieuses, 2002
The aim of this study was to evaluate the clinical, laboratory findings, and therapeutic features... more The aim of this study was to evaluate the clinical, laboratory findings, and therapeutic features of patients with brucellosis. The diagnosis was made by clinical findings, positive agglutination titer, and/or the isolation of Brucella species. Three hundred and twenty-two cases were acute, 121 sub-acute, 24 chronic, and 13 asymptomatic. Symptoms of patients were malaise in 432 (90%) patients, sweating in 405 (84.4%), arthralgia in 393 (81.9%), fever in 383 (79.8%), and back pain in 281 (58.5%). The most frequent findings were fever in 187 (39%) patients, hepatomegaly in 102 (21.3%), osteoarticular involvement in 91 (19%), splenomegaly in 68 (14.2%), nervous system involvement in 31 (6.5%) patients. Lymphocytosis was determined in 328 patients, anemia in 262 patients, thrombocytopenia in 35 patients, leukopenia in 37 patients, leukocytosis in 31 patients, and elevated erythrocyte sedimentation rate in 282 patients. Cultures were positive in 194 (45%) patients and all strains were identified as Brucella melitensis. Various treatment regimens were given to patients. No therapeutic failure was observed. The time to defervescence ranged from 2 to 15 days. Relapse occurred in 26 of the 480 patients (5.4%). There was no correlation between relapse and positive culture or complications. Brucellosis can present various clinical forms in endemic areas and mimics several diseases. © 2002 É ditions scientifiques et médicales Elsevier SAS. All rights reserved.
Transplantation proceedings, 2007
We describe the first case of isosporiasis in a liver transplant patient. Watery diarrhea due to ... more We describe the first case of isosporiasis in a liver transplant patient. Watery diarrhea due to Isospora belli was observed in a woman who had undergone liver transplantation 8 months prior. She was successfully treated with trimethoprim-sulfamethoxazole. This parasite should be taken into consideration as an opportunistic infection in transplant patients who need increased hygienic awareness.
Annals of clinical microbiology and antimicrobials, Jan 16, 2002
The emergence of Mycobacterium tuberculosis strains resistant to antituberculosis agents has rece... more The emergence of Mycobacterium tuberculosis strains resistant to antituberculosis agents has recently received increased attention owing largely to the dramatic outbreaks of multi drug resistance tuberculosis (MDR-TB). Patients residing in Zonguldak and Kayseri provinces of Turkey with, pulmonary tuberculosis diagnosed between 1972 and 1999 were retrospectively identified. Drug susceptibility tests had been performed for isoniazid (INH), rifampin (RIF), streptomycin (SM), ethambutol (EMB) and thiacetasone (TH) after isolation by using the resistance proportion method. Total 3718 patients were retrospectively studied. In 1972-1981, resistance rates for to SM and INH were found to be 14.8% and 9.8% respectively (n: 2172). In 1982-1991 period, resistance rates for INH, SM, RIF, EMB and TH were 14.2%, 14.4%, 10.5%, 2.7% and 2.9% (n: 683), while in 1992-1999 period 14.4%, 21.1%, 10.6%, 2.4% and 3.7% respectively (n: 863). Resistance rates were highest for SM and INH in three periods. MDR...
Giriş: Nozokomiyal infeksiyonlar, yoğun bakım ünitelerinin (YBÜ) önemli bir sorunu olmaya devam e... more Giriş: Nozokomiyal infeksiyonlar, yoğun bakım ünitelerinin (YBÜ) önemli bir sorunu olmaya devam etmektedir. Amaç: Yoğun bakım ünitelerinde gelişen nozokomiyal infeksiyonları değerlendirmek. Çalışma Şekli: Prospektif, sürveyans çalışması. Hastalar ve Yöntem: 1 Ocak 1997-1 Aralık 1997 tarihleri arasında YBÜ'de izlenen 1392 hasta çalışmaya alındı. Hastaların "Acute Physiology and Chronic Health Evaluation II (APACHE II)" skorları, altta yatan hastalıkları, ameliyat olup olmadıkları, YBÜ'de yatış süreleri ve gelişen nozokomiyal infeksiyonlar kaydedilip değerlendirildi. Sonuçlar: İzlenen 1392 hastanın 294 (%21.1)'ünde 359 nozokomiyal infeksiyon epizodu saptandı. Nozokomiyal infeksiyonlar cerrahi YBÜ'de %22.7 ve iç hastalıkları YBÜ'de %18.4 oranında bulundu. İnfeksiyon gelişen hastalarda yatıştaki APACHE II ´skoru ortalaması 12.5 ± 4.9, gelişmeyenlerde 10.9 ± 4.3 idi Conclusion: This prospective study highlighted that nosocomial infections are occuring very frequently in our ICU' s. New approaches to minimize them are needed.
The new microbiologica, 2011
Human orf is a viral zoonotic infection caused by Parapoxvirus. The skin lesions of human orf can... more Human orf is a viral zoonotic infection caused by Parapoxvirus. The skin lesions of human orf can be misdiagnosed as cutaneous anthrax leading to overtreatment and also fear. This study was conducted to analyze an outbreak which led to deaths among kids and lambs in the same flock, and skin lesions in some persons who were living on the same farm that were initially diagnosed as cutaneous anthrax by a practitioner. Eight patients with skin lesions and eleven persons who had no skin lesion were considered as patients and control groups, respectively. The cultures obtained from the lesions of all patients were negative for Bacillus anthracis. The diagnosis of skin lesions was done by clinical findings, histopathological examination and PCR as human orf. To be under 20 years of age, direct contact with the animals, and contact with flayed skin of sick animals were the risk factors for human orf (Odds Ratio 7.5; 95% Confidence Interval 1.02-54.54, OR 12.25; 95% CI:1.3-100.9, OR 16.67; 9...
Journal of Neurology, 2015
Predicting unfavorable outcome is of paramount importance in clinical decision making. Accordingl... more Predicting unfavorable outcome is of paramount importance in clinical decision making. Accordingly, we designed this multinational study, which provided the largest case series of tuberculous meningitis (TBM). 43 centers from 14 countries (Turkey) submitted data of microbiologically confirmed TBM patients hospitalized between 2000 and 2012. Unfavorable outcome was defined as survival with significant sequela or death. In developing our index, binary logistic regression models were constructed via 200 replicates of database by bootstrap resampling methodology. The final model was built according to the selection frequencies of variables. The severity scale included variables with arbitrary scores proportional to predictive powers of terms in the final model. The final model was internally validated by bootstrap resampling. A total of 507 patients' data were submitted among which 165 had unfavorable outcome. Eighty-six patients died while 119 had different neurological sequelae in 79 (16 %) patients. The full model included 13