1
|
Derin O, Şahin M, Dumlu R, Başgönül S, Bayrak AD, Arduç Ş, Bayram S, Mikaliyova N, Kantürk A, Öncül A, Yıldız Sevgi D, Gençer S, Bayraktar B, Dökmetaş İ, Mert A. Registry-Based Retrospective Cohort Study of Mortality among Adults Admitted to Intensive Care Units in Istanbul with Hospital Acquired Pseudomonas aeruginosa Bloodstream-Infection between 2014-2021. Antibiotics (Basel) 2024; 13:90. [PMID: 38247649 PMCID: PMC10812563 DOI: 10.3390/antibiotics13010090] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2023] [Revised: 01/05/2024] [Accepted: 01/06/2024] [Indexed: 01/23/2024] Open
Abstract
BACKGROUND Managing Pseudomonas aeruginosa bloodstream infections (BSIs) is challenging due to increasing antimicrobial resistance, limited therapeutic options, and high mortality rates. In this study, we aimed to identify 30-day mortality risk factors and assess infectious diseases consultants' preferences for combination or monotherapy. METHODS The study was conducted in four hospitals in Istanbul, Turkey, involving 140 adult ICU beds and 336,780 ICU-bed-days between 1 January 2014, and 31 December 2021. A total of 157 patients were included in the study. Cox proportional hazard regression was performed to assess the factors on 30-day mortality. RESULTS The 30-day mortality rate was 44.6% (70/157). Higher Charlson Comorbidity Index (CCI) score, severe sepsis, primary bloodstream infection, being in COVID-19 pandemic period, and infection caused by MDR strain were associated with higher hazard of 30-day mortality. Combination therapy was more commonly used in patients with BSIs with MDR or DTR (difficult-to-treat) strains but did not significantly improve the hazard of 30-day mortality. CONCLUSIONS Targeted interventions and vigilant management strategies are crucial for patients with defined risk factors. While infectious disease consultants tended to favor combination therapy, particularly for drug-resistant strains, our analysis revealed no significant impact on 30-day mortality hazard. The increased incidence of P. aeruginosa BSIs during the pandemic emphasizes the need for infection control measures and appropriate antibiotic prescribing practices.
Collapse
Affiliation(s)
- Okan Derin
- Graduate School of Health Sciences, Epidemiology Doctorate Program, Istanbul Medipol University, 34815 Istanbul, Turkey
- Istanbul Şişli Hamidiye Etfal Training and Research Hospital Infectious Diseases and Clinical Microbiology, 34396 Istanbul, Turkey; (A.D.B.); (A.Ö.); (D.Y.S.); (İ.D.)
| | - Meyha Şahin
- Faculty of Medicine, Infectious Diseases and Clinical Microbiology, Istanbul Medipol University, 34214 Istanbul, Turkey; (M.Ş.); (N.M.)
| | - Rıdvan Dumlu
- Istanbul Prof. Dr. Cemil Taşçıoğlu Training and Research Hospital, Infectious Diseases and Clinical Microbiology, 34384 Istanbul, Turkey; (R.D.); (S.B.); (A.K.)
| | - Sedef Başgönül
- Department of Infectious Diseases and Clinical Microbiology, Acıbadem Mehmet Ali Aydınlar University, 34752 Istanbul, Turkey; (S.B.); (S.G.)
| | - Ahmet Doğukan Bayrak
- Istanbul Şişli Hamidiye Etfal Training and Research Hospital Infectious Diseases and Clinical Microbiology, 34396 Istanbul, Turkey; (A.D.B.); (A.Ö.); (D.Y.S.); (İ.D.)
- Hamidiye Faculty of Health Sciences, University of Health Sciences, 34668 Istanbul, Turkey; (Ş.A.); (B.B.)
| | - Şevval Arduç
- Hamidiye Faculty of Health Sciences, University of Health Sciences, 34668 Istanbul, Turkey; (Ş.A.); (B.B.)
- Istanbul Şişli Hamidiye Etfal Training and Research Hospital Microbiology and Clinical Microbiology, 34396 Istanbul, Turkey
| | - Sümeyye Bayram
- Istanbul Prof. Dr. Cemil Taşçıoğlu Training and Research Hospital, Infectious Diseases and Clinical Microbiology, 34384 Istanbul, Turkey; (R.D.); (S.B.); (A.K.)
- Hamidiye Faculty of Health Sciences, University of Health Sciences, 34668 Istanbul, Turkey; (Ş.A.); (B.B.)
| | - Nurlana Mikaliyova
- Faculty of Medicine, Infectious Diseases and Clinical Microbiology, Istanbul Medipol University, 34214 Istanbul, Turkey; (M.Ş.); (N.M.)
| | - Arzu Kantürk
- Istanbul Prof. Dr. Cemil Taşçıoğlu Training and Research Hospital, Infectious Diseases and Clinical Microbiology, 34384 Istanbul, Turkey; (R.D.); (S.B.); (A.K.)
| | - Ahsen Öncül
- Istanbul Şişli Hamidiye Etfal Training and Research Hospital Infectious Diseases and Clinical Microbiology, 34396 Istanbul, Turkey; (A.D.B.); (A.Ö.); (D.Y.S.); (İ.D.)
| | - Dilek Yıldız Sevgi
- Istanbul Şişli Hamidiye Etfal Training and Research Hospital Infectious Diseases and Clinical Microbiology, 34396 Istanbul, Turkey; (A.D.B.); (A.Ö.); (D.Y.S.); (İ.D.)
- Hamidiye Faculty of Health Sciences, University of Health Sciences, 34668 Istanbul, Turkey; (Ş.A.); (B.B.)
| | - Serap Gençer
- Department of Infectious Diseases and Clinical Microbiology, Acıbadem Mehmet Ali Aydınlar University, 34752 Istanbul, Turkey; (S.B.); (S.G.)
| | - Banu Bayraktar
- Hamidiye Faculty of Health Sciences, University of Health Sciences, 34668 Istanbul, Turkey; (Ş.A.); (B.B.)
- Istanbul Şişli Hamidiye Etfal Training and Research Hospital Microbiology and Clinical Microbiology, 34396 Istanbul, Turkey
| | - İlyas Dökmetaş
- Istanbul Şişli Hamidiye Etfal Training and Research Hospital Infectious Diseases and Clinical Microbiology, 34396 Istanbul, Turkey; (A.D.B.); (A.Ö.); (D.Y.S.); (İ.D.)
- Hamidiye Faculty of Health Sciences, University of Health Sciences, 34668 Istanbul, Turkey; (Ş.A.); (B.B.)
| | - Ali Mert
- Department of Internal Medicine, Istanbul Medipol University, 34815 Istanbul, Turkey
| |
Collapse
|
2
|
Derin O, Öztürk EN, Demirbaş ND, Sevgi DY, Dökmetaş İ. [A Patient Presented with Genital Eruptions: The Second Case of Monkeypox from Türkiye]. MIKROBIYOL BUL 2023; 57:134-140. [PMID: 36636852 DOI: 10.5578/mb.20239911] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
Abstract
Human monkeypox (MPX) disease is a re-emerging zoonotic infection caused by the monkeypox virus belonging to the same family as vaccinia and variola. The European Center for Disease Prevention and Control (ECDC) has documented an outbreak of MPX with atypical transmission paths throughout Europe. In this report, male-to-male sexual intercourse was first defined as a means of close humanto-human contact. The Ministry of Health of the Republic of Turkey announced via social media on June 30, 2022 that the first case confirmed by polymerase chain reaction (PCR) for the MPX virus in Turkey was admitted and isolated in a hospital. Four days after this statement, a 24-year-old Turkish man was hospitalized in our clinic with a bacterial infection of the penis and scrotum following local radiofrequency ablation therapy. A week ago, lesions resembling warts were noted in his medical history, for which a local radiofrequency ablation procedure was conducted at an external center. One day after his hospitalization, skin lesions of different stages (from macules, papules to umbilical papules) and several eruptions were detected on his face, nose tip, body, arms, and fingers, which gradually became more evident. After evaluating the risk factors, the patient was isolated with a preliminary diagnosis of MPX disease and samples were collected and sent for MPX virus detection to the reference laboratory according to the Ministry of Health guidelines. MPX virus nucleic acid was detected by PCR in samples taken from the lesion. The patient was discharged after 21 days of isolation and treatment for a secondary bacterial infection. In this case report the significance of differential diagnosis and screening tests for sexually transmitted infections (STI), a previously unreported case of MPX disease in Turkey, and a soft tissue infection that developed after local ablation treatment which was administered to a patient with MPX disease were presented. To be prepared for new and re-emerging infectious diseases, it was emphasized that well-structured continuing education based on current epidemiological data is required. Sexual contact has recently been identified as a new mode of transmission for MPX disease, and symptoms and signs may resemble those of other ulcerative sexually transmitted infections (STIs), such as "molluscum contagiousum" or syphilis. ORF disease is also in the differential diagnosis of MPX disease in Turkey. In addition, patients admitted with unreported STIs are permitted to receive health services without additional screenings. For this reason, easily accessible sexually transmitted disease centers with a high diagnostic efficiency can provide greater control over these diseases.
Collapse
Affiliation(s)
- Okan Derin
- Şişli Hamidiye Etfal Training and Research Hospital, Clinic of Infectious Diseases and Clinical Microbiology, İstanbul, Türkiye
| | - Esin Nagihan Öztürk
- Şişli Hamidiye Etfal Training and Research Hospital, Clinic of Infectious Diseases and Clinical Microbiology, İstanbul, Türkiye
| | - Nazife Duygu Demirbaş
- Şişli Hamidiye Etfal Training and Research Hospital, Clinic of Infectious Diseases and Clinical Microbiology, İstanbul, Türkiye
| | - Dilek Yıldız Sevgi
- Şişli Hamidiye Etfal Training and Research Hospital, Clinic of Infectious Diseases and Clinical Microbiology, İstanbul, Türkiye
| | - İlyas Dökmetaş
- Şişli Hamidiye Etfal Training and Research Hospital, Clinic of Infectious Diseases and Clinical Microbiology, İstanbul, Türkiye
| |
Collapse
|
3
|
Gül Ö, Gündüz A, Sevgi DY, Demirbaş ND, Uzun N, Dökmetaş İ. Cognitive Assessment of Young Adults Before and After Initiation of Combination Antiretroviral Therapy. Infect Dis Clin Microbiol 2022; 4:163-171. [PMID: 38633390 PMCID: PMC10986713 DOI: 10.36519/idcm.2022.154] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/14/2022] [Accepted: 06/16/2022] [Indexed: 04/19/2024]
Abstract
Objective In the determination and monitoring of neurocognitive disorders in human immunodeficiency virus (HIV)-positive individuals, there is a need for significantly more practical methods which provide results in a shorter time than the tests that require challenging and specialized expertise. This study aimed to evaluate cognitive functions and the factors affecting them in naïve HIV-positive patients using by Montreal Cognitive Assessment (MoCA) test before and after the initiation of combination antiretroviral therapy. Materials and Methods HIV-positive, treatment-naïve patients monitored between January-June 2017 were included in the study. The MoCA test was performed at the beginning and the sixth month of the treatment. Results Forty male patients were included in the study. The mean age was calculated as 29.1±4.0. When the factors affecting the MoCA score were examined, there was a significant relationship between the education level and the MoCA score. Smoking, using alcohol, and substance did not have a significant impact on baseline MoCA values. A significant correlation was found between cluster differentiation 4 (CD4) count and HIV RNA level and attention function. There was a significant increase in the total MoCA score and the MoCA subgroup scores at the end of the sixth month of the treatment. Conclusion MoCA test is one of the most practical tests that can be applied in a short time period, and it was found useful in evaluating the changes in the cognitive functions of HIV-positive patients during antiretroviral treatment.
Collapse
Affiliation(s)
- Özlem Gül
- Infectious Disease and Clinical Microbiology, Şişli Hamidiye Etfal Training and Research Hospital, İstanbul, Türkiye
| | - Alper Gündüz
- Infectious Disease and Clinical Microbiology, Şişli Hamidiye Etfal Training and Research Hospital, İstanbul, Türkiye
| | - Dilek Yıldız Sevgi
- Infectious Disease and Clinical Microbiology, Şişli Hamidiye Etfal Training and Research Hospital, İstanbul, Türkiye
| | - Nazife Duygu Demirbaş
- Infectious Disease and Clinical Microbiology, Şişli Hamidiye Etfal Training and Research Hospital, İstanbul, Türkiye
| | - Nuray Uzun
- Infectious Disease and Clinical Microbiology, Şişli Hamidiye Etfal Training and Research Hospital, İstanbul, Türkiye
| | - İlyas Dökmetaş
- Infectious Disease and Clinical Microbiology, Şişli Hamidiye Etfal Training and Research Hospital, İstanbul, Türkiye
| |
Collapse
|
4
|
Korkmaz P, Kurtaran B, Özdemir Armağan Ş, Turan Özden H, Kacar F, Ateş S, Durmuş G, Bayındır Bilman F, Uygun Kızmaz Y, Hamidi AA, Özdemir B, Yıkılgan AB, Fırat P, İnan A, Okay G, Işık ME, But A, Uğurlu K, Harman R, Ergüt Sezer B, Doyuk Kartal E, Kuşçu F, Şener A, Mıstanoğlu Özatağ D, Tükenmez Tigen E, Dağlı Ö, Koçak F, Kuşoğlu H, Ertürk Şengel B, Demirel A, Naz H, Agalar C, Öztürk Engin D, Dökmetaş İ, Gürsul NC, Yılmaz Karadağ F, Çayıröz MU, Kürekçi Y, Kadanalı A, Çakar ZŞ, Savaşçı Ü, Erdem İ, Çağan Aktaş S. The factors affecting inadequate empirical antimicrobial therapy and clinical course in upper urinary tract infections of the elderly patients. mjima 2020. [DOI: 10.4274/mjima.galenos.2020.2020.5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
|
5
|
Karaosmanoğlu HK, Mete B, Gündüz A, Aydin ÖA, Sargin F, Sevgi DY, Durdu B, Dökmetaş İ, Tabak F. Late presentation among patients with human immunodeficiency virus infection in Turkey. Cent Eur J Public Health 2019; 27:229-234. [PMID: 31580559 DOI: 10.21101/cejph.a5416] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2018] [Accepted: 06/30/2019] [Indexed: 11/15/2022]
Abstract
OBJECTIVE Late presentation of the patients with human immunodeficiency virus (HIV) infection is associated with less favourable treatment responses, more accelerated clinical progression, and a higher mortality risk. Although HIV prevalence is low in Turkey, it is steadily increasing and the information about late presentation among HIV-positives is limited. We aimed to analyze the status of late presentation among HIV-positive patients in Turkey. METHODS All newly diagnosed HIV/AIDS patients from 2003 to 2016 were enrolled in this study by five dedicated centres in Istanbul, Turkey. Demographic data, CD4+ counts, and HIV RNA were collected from medical records and were transferred to a HIV database system. Late pre- sentation was defined as presentation for care with a CD4 count < 350 cells/mm3 or presentation with an AIDS-defining event, regardless of the CD4 cell count. A medical literature search was done for the analysis of late presentation in Turkey. RESULTS The cohort included 1,673 patients (1,440 males, median age 35 years). Among them, 847 (50.6%) had an early diagnosis, with a CD count of more than 350 cells/mm3. The remaining 826 were late presenters. Among late presenters, 427 (25.5% of all, 51.7% of late presenters) presented with advanced HIV disease. Late presenters were more elderly and less educated. The gender seemed comparable between groups. Late presentation was more likely among married patients. Early presenters were more likely among homosexuals, those diagnosed in screening studies, and in lower HIV-RNA viral load category. There has been a decreasing trend among late presenters in 2011-2016 when compared to 2003-2011 period. CONCLUSION Current data suggest that half of HIV-infected patients present late in Turkey. In our cohort, those presented late were more elderly, less educated, married and had heterosexual intercourse. On admission, late presenters had more HIV-related diseases and were more likely in higher HIV-RNA category. In the cohort, men having sex with men were less likely late presenters. Efforts to reduce the proportion of late presentation are essential for almost every country. The countries should identify the risk factors of late presentation and should improve early diagnosis and presentation for HIV care.
Collapse
Affiliation(s)
- Hayat Kumbasar Karaosmanoğlu
- Department of Infectious Diseases and Clinical Microbiology, Bakirkoy Dr Sadi Konuk Training and Research Hospital, University of Health Sciences, Istanbul, Turkey
| | - Bilgül Mete
- Department of Infectious Diseases and Clinical Microbiology, Cerrahpasa Medical Faculty, Istanbul University, Istanbul, Turkey
| | - Alper Gündüz
- Department of Infectious Diseases and Clinical Microbiology, Sisli Hamidiye Training and Research Hospital, University of Health Sciences, Istanbul, Turkey
| | - Özlem Altuntaş Aydin
- Department of Infectious Diseases and Clinical Microbiology, Bakirkoy Dr Sadi Konuk Training and Research Hospital, University of Health Sciences, Istanbul, Turkey
| | - Fatma Sargin
- Department of Infectious Diseases and Clinical Microbiology, Goztepe Training and Research Hospital, Medeniyet University, Istanbul, Turkey
| | - Dilek Yildiz Sevgi
- Department of Infectious Diseases and Clinical Microbiology, Sisli Hamidiye Training and Research Hospital, University of Health Sciences, Istanbul, Turkey
| | - Bülent Durdu
- Department of Infectious Diseases and Clinical Microbiology, Medical Faculty, Bezmi Alem University, Istanbul, Turkey
| | - İlyas Dökmetaş
- Department of Infectious Diseases and Clinical Microbiology, Sisli Hamidiye Training and Research Hospital, University of Health Sciences, Istanbul, Turkey
| | - Fehmi Tabak
- Department of Infectious Diseases and Clinical Microbiology, Cerrahpasa Medical Faculty, Istanbul University, Istanbul, Turkey
| |
Collapse
|
6
|
Tabak F, Yurdaydın C, Kaymakoğlu S, Akarsu M, Akıncı EG, Akkız H, Alkım C, Çekin AH, Çuvalcı NÖ, Demir K, Değertekin B, Dökmetaş İ, Ersöz G, Hizel K, Kandemir FÖ, Önlen Y, Sonsuz A, Şenateş E, Tosun S, Tözün N, Idilman R, Guidelines Study Group VH. Diagnosis, management and treatment of hepatitis B virus infection: Turkey 2017 Clinical Practice Guidelines. Turk J Gastroenterol 2018; 28:73-83. [PMID: 29303103 DOI: 10.5152/tjg.2017.19] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Affiliation(s)
- Fehmi Tabak
- Turkish Association for the Study of the Liver, Istanbul, Turkey; Viral Hepatitis Society, Ankara, Turkey
| | - Cihan Yurdaydın
- Turkish Association for the Study of the Liver, Istanbul, Turkey; Viral Hepatitis Society, Ankara, Turkey
| | - Sabahattin Kaymakoğlu
- Turkish Association for the Study of the Liver, Istanbul, Turkey; Viral Hepatitis Society, Ankara, Turkey
| | - Mesut Akarsu
- Turkish Association for the Study of the Liver, Istanbul, Turkey; Viral Hepatitis Society, Ankara, Turkey
| | - Esra G Akıncı
- Turkish Association for the Study of the Liver, Istanbul, Turkey; Viral Hepatitis Society, Ankara, Turkey
| | - Hikmet Akkız
- Turkish Association for the Study of the Liver, Istanbul, Turkey; Viral Hepatitis Society, Ankara, Turkey
| | - Canan Alkım
- Turkish Association for the Study of the Liver, Istanbul, Turkey; Viral Hepatitis Society, Ankara, Turkey
| | - Ayhan H Çekin
- Turkish Association for the Study of the Liver, Istanbul, Turkey; Viral Hepatitis Society, Ankara, Turkey
| | - Nefise Ö Çuvalcı
- Turkish Association for the Study of the Liver, Istanbul, Turkey; Viral Hepatitis Society, Ankara, Turkey
| | - Kadir Demir
- Turkish Association for the Study of the Liver, Istanbul, Turkey; Viral Hepatitis Society, Ankara, Turkey
| | - Bülent Değertekin
- Turkish Association for the Study of the Liver, Istanbul, Turkey; Viral Hepatitis Society, Ankara, Turkey
| | - İlyas Dökmetaş
- Turkish Association for the Study of the Liver, Istanbul, Turkey; Viral Hepatitis Society, Ankara, Turkey
| | - Galip Ersöz
- Turkish Association for the Study of the Liver, Istanbul, Turkey; Viral Hepatitis Society, Ankara, Turkey
| | - Kenan Hizel
- Turkish Association for the Study of the Liver, Istanbul, Turkey; Viral Hepatitis Society, Ankara, Turkey
| | - Fatma Ö Kandemir
- Turkish Association for the Study of the Liver, Istanbul, Turkey; Viral Hepatitis Society, Ankara, Turkey
| | - Yusuf Önlen
- Turkish Association for the Study of the Liver, Istanbul, Turkey; Viral Hepatitis Society, Ankara, Turkey
| | - Abdullah Sonsuz
- Turkish Association for the Study of the Liver, Istanbul, Turkey; Viral Hepatitis Society, Ankara, Turkey
| | - Ebubekir Şenateş
- Turkish Association for the Study of the Liver, Istanbul, Turkey; Viral Hepatitis Society, Ankara, Turkey
| | - Selma Tosun
- Turkish Association for the Study of the Liver, Istanbul, Turkey; Viral Hepatitis Society, Ankara, Turkey
| | - Nurdan Tözün
- Turkish Association for the Study of the Liver, Istanbul, Turkey; Viral Hepatitis Society, Ankara, Turkey
| | - Ramazan Idilman
- Turkish Association for the Study of the Liver, Istanbul, Turkey; Viral Hepatitis Society, Ankara, Turkey
| | | |
Collapse
|
7
|
Ahmad Hamidi A, Gelmez Taş B, Gündüz A, Nur Çelebi S, Esen ES, Toprak D, Dökmetaş İ. Immunization rates of pneumococcal, influenza and tetanus vaccines and knowledge and attitudes of adult patients who receive inpatient treatment at hospital: Point prevalence study. Hum Vaccin Immunother 2018; 14:2649-2653. [PMID: 29913102 PMCID: PMC6314427 DOI: 10.1080/21645515.2018.1489187] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2018] [Accepted: 05/30/2018] [Indexed: 01/05/2023] Open
Abstract
The safety of vaccines, access to health care, the level of community's knowledge and the attention of physicians play a critical role in the rate of adult vaccination. This study aims to determine the immunization rate of pneumococcal, influenza and tetanus vaccines among the patients and their knowledge and attitudes in the hospital. The study is a cross-sectional point prevalence survey. The patients who agreed to participate in the study were interviewed using a questionnaire. Patients' gender, occupation, educational status, income level and risk factors (immunosuppressed and over 65 years old) were compared with the knowledge and attitudes about vaccinations. Of the 251 participants, 51.4% were female and 48.6% were male. The self-reported vaccination rate was 3.5% for pneumococcal, 8.6% for influenza and 26.6% for tetanus. Most of the patients have knowledge about influenza vaccination (90.3%). Patients with the high education level have significantly higher knowlege about tetanus vaccination and higher rate of tetanus vaccine compared to those with low education level (p = 0.04; p = 0.006). It was found that those with higher income levels had the more pneumococcal vaccination, more knowledge on tetanus vaccination, and more attitude that tetanus vaccine is necessary compared to those with lower income level (p < 0.05). Patients without risk factors have a higher rate of tetanus vaccination compared to those with risk factors (p < 0.001). It was inferred that the high level of education and income have a positive effect on the patients vaccination rates and their knowledge and attitude.
Collapse
Affiliation(s)
- Aziz Ahmad Hamidi
- Infectious Diseases and Clinical Microbiology Department, Şişli Hamidiye Etfal Training and Research Hospital, Health Sciences University, Istanbul, Turkey
| | - Beray Gelmez Taş
- Family Medicine Department, Şişli Hamidiye Etfal Training and Research Hospital, Health Sciences University, Istanbul, Turkey
| | - Alper Gündüz
- Infectious Diseases and Clinical Microbiology Department, Şişli Hamidiye Etfal Training and Research Hospital, Health Sciences University, Istanbul, Turkey
| | - Safiye Nur Çelebi
- Infectious Diseases and Clinical Microbiology Department, Şişli Hamidiye Etfal Training and Research Hospital, Health Sciences University, Istanbul, Turkey
| | - Elif Serap Esen
- Family Medicine Department, Şişli Hamidiye Etfal Training and Research Hospital, Health Sciences University, Istanbul, Turkey
| | - Dilek Toprak
- Family Medicine Department, Şişli Hamidiye Etfal Training and Research Hospital, Health Sciences University, Istanbul, Turkey
| | - İlyas Dökmetaş
- Infectious Diseases and Clinical Microbiology Department, Şişli Hamidiye Etfal Training and Research Hospital, Health Sciences University, Istanbul, Turkey
| |
Collapse
|
8
|
Yurdaydın C, Tabak F, Kaymakoğlu S, Akarsu M, Akıncı EG, Akkız H, Alkım C, Çekin AH, Çuvalcı NÖ, Demir K, Değertekin B, Dökmetaş İ, Ersöz G, Hizel K, Kandemir FÖ, Önlen Y, Sonsuz A, Şenateş E, Tosun S, Tözün N, Idilman R, Guidelines Study Group VH. Diagnosis, management and treatment of hepatitis delta virus infection: Turkey 2017 Clinical Practice Guidelines. Turk J Gastroenterol 2018; 28:84-89. [PMID: 29303104 DOI: 10.5152/tjg.2017.20] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Affiliation(s)
- Cihan Yurdaydın
- Turkish Association for the Study of the Liver, İstanbul, Turkey; Viral Hepatitis Society, Ankara, Turkey
| | - Fehmi Tabak
- Turkish Association for the Study of the Liver, İstanbul, Turkey; Viral Hepatitis Society, Ankara, Turkey
| | - Sabahattin Kaymakoğlu
- Turkish Association for the Study of the Liver, İstanbul, Turkey; Viral Hepatitis Society, Ankara, Turkey
| | - Mesut Akarsu
- Turkish Association for the Study of the Liver, İstanbul, Turkey; Viral Hepatitis Society, Ankara, Turkey
| | - Esra G Akıncı
- Turkish Association for the Study of the Liver, İstanbul, Turkey; Viral Hepatitis Society, Ankara, Turkey
| | - Hikmet Akkız
- Turkish Association for the Study of the Liver, İstanbul, Turkey; Viral Hepatitis Society, Ankara, Turkey
| | - Canan Alkım
- Turkish Association for the Study of the Liver, İstanbul, Turkey; Viral Hepatitis Society, Ankara, Turkey
| | - Ayhan H Çekin
- Turkish Association for the Study of the Liver, İstanbul, Turkey; Viral Hepatitis Society, Ankara, Turkey
| | - Nefise Ö Çuvalcı
- Turkish Association for the Study of the Liver, İstanbul, Turkey; Viral Hepatitis Society, Ankara, Turkey
| | - Kadir Demir
- Turkish Association for the Study of the Liver, İstanbul, Turkey; Viral Hepatitis Society, Ankara, Turkey
| | - Bülent Değertekin
- Turkish Association for the Study of the Liver, İstanbul, Turkey; Viral Hepatitis Society, Ankara, Turkey
| | - İlyas Dökmetaş
- Turkish Association for the Study of the Liver, İstanbul, Turkey; Viral Hepatitis Society, Ankara, Turkey
| | - Galip Ersöz
- Turkish Association for the Study of the Liver, İstanbul, Turkey; Viral Hepatitis Society, Ankara, Turkey
| | - Kenan Hizel
- Turkish Association for the Study of the Liver, İstanbul, Turkey; Viral Hepatitis Society, Ankara, Turkey
| | - Fatma Ö Kandemir
- Turkish Association for the Study of the Liver, İstanbul, Turkey; Viral Hepatitis Society, Ankara, Turkey
| | - Yusuf Önlen
- Turkish Association for the Study of the Liver, İstanbul, Turkey; Viral Hepatitis Society, Ankara, Turkey
| | - Abdullah Sonsuz
- Turkish Association for the Study of the Liver, İstanbul, Turkey; Viral Hepatitis Society, Ankara, Turkey
| | - Ebubekir Şenateş
- Turkish Association for the Study of the Liver, İstanbul, Turkey; Viral Hepatitis Society, Ankara, Turkey
| | - Selma Tosun
- Turkish Association for the Study of the Liver, İstanbul, Turkey; Viral Hepatitis Society, Ankara, Turkey
| | - Nurdan Tözün
- Turkish Association for the Study of the Liver, İstanbul, Turkey; Viral Hepatitis Society, Ankara, Turkey
| | - Ramazan Idilman
- Turkish Association for the Study of the Liver, İstanbul, Turkey; Viral Hepatitis Society, Ankara, Turkey
| | | |
Collapse
|
9
|
Dökmetaş İ, Hamidi AA, Bulut ME, Çetin S, Öncül A, Uzun N. Clinical effect of discordance in empirical treatment of cases with urinary tract infection accompanied by bacteremia. Turk J Urol 2017; 43:543-548. [PMID: 29201522 DOI: 10.5152/tud.2017.58538] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2017] [Accepted: 06/21/2017] [Indexed: 01/17/2023]
Abstract
Objective It has been shown in previous studies that inadequate empirical treatment is associated with mortality in a variety of infections caused by Gram-negative bacteria. In this study, the clinical effect of discordance in empirical treatment was investigated in patients with urinary tract infection (UTI) accompanied by bacteremia. Material and methods We retrospectively reviewed the files of adult (>18 years old) patients who were diagnosed with UTI in our clinic between January 2014 and December 2015. Cases in which the same causative microorganism grew in both blood and urine cultures were included in the study. Patients using ceftriaxone and carbapenem as empirical antibiotic therapy (EAT) were compared as two different groups. In cases that the ethiologic agents were extended- spectrum beta lactamase (ESBL)-producing Klebsiella pneumoniae and Escherichia coli isolates, if the microorganism was resistant to initial antibiotic treatment the situation was defined as EAT discordance, and if it was sensitive it was defined as EAT concordance. Results After the exclusion criteria were applied, 65 of the 266 cases examined were taken into the study. Clinical and laboratory features of cases of ceftriaxone and carbapenem groups were similar. There was no statistically significant difference between the two groups in terms of hospital stay and survival (p>0.05). Of 28 cases of ESBL-producing E. coli and K. pneumoniae, 18 were EAT discordant and 10 were EAT concordant. Clinical and laboratory features of EAT concordant and EAT discordant groups were similar. No statistically significant difference was found between the two groups in terms of hospital stay and survival (p>0.05). Conclusion It was considered that ceftriaxone can still be a viable option in the EAT of UTI, which is accompanied by bacteremia without severe sepsis and septic shock findings. It was concluded that EAT discordance may not have a negative effect on the duration of hospital stay and survival rates in neither total cases nor ESBL positive ones.
Collapse
Affiliation(s)
- İlyas Dökmetaş
- Department of Infectious Diseases and Clinical Microbiology, Health Sciences University, Şişli Hamidiye Etfal Training and Research Hospital, İstanbul, Turkey
| | - Aziz Ahmad Hamidi
- Department of Infectious Diseases and Clinical Microbiology, Health Sciences University, Şişli Hamidiye Etfal Training and Research Hospital, İstanbul, Turkey
| | - Mehmet Emin Bulut
- Department of Medical Microbiology, Health Sciences University, Şişli Hamidiye Etfal Training and Research Hospital, İstanbul, Turkey
| | - Sinan Çetin
- Department of Infectious Diseases and Clinical Microbiology, Health Sciences University, Şişli Hamidiye Etfal Training and Research Hospital, İstanbul, Turkey
| | - Ahsen Öncül
- Department of Infectious Diseases and Clinical Microbiology, Health Sciences University, Şişli Hamidiye Etfal Training and Research Hospital, İstanbul, Turkey
| | - Nuray Uzun
- Department of Infectious Diseases and Clinical Microbiology, Health Sciences University, Şişli Hamidiye Etfal Training and Research Hospital, İstanbul, Turkey
| |
Collapse
|
10
|
Sevgi DY, Bayraktar B, Gündüz A, Özgüven BY, Togay A, Bulut E, Uzun N, Dökmetaş İ. Serum soluble urokinase-type plasminogen activator receptor and interferon-γ-induced protein 10 levels correlate with significant fibrosis in chronic hepatitis B. Wien Klin Wochenschr 2015; 128:28-33. [PMID: 26546355 DOI: 10.1007/s00508-015-0886-4] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2015] [Accepted: 10/12/2015] [Indexed: 12/16/2022]
Abstract
BACKGROUND Hepatitis B virus (HBV) presents an important public health problem. Liver biopsy is currently the gold standard for assessing the degree of intrahepatic inflammation and for staging liver fibrosis. However, the value of liver biopsies is limited by sampling errors, understaging and interobserver variability in interpretation. There is, therefore, a need to identify novel, non-invasive serologic biomarkers for the development of new predictive models of fibrosis. METHODS We enrolled patients with chronic hepatitis B infection (CHB) and examined the relationships between serum soluble urokinase plasminogen activator receptor (suPAR) and interferon-induced protein-10 (IP-10), and the results of liver biopsies. Healthy volunteers with normal aminotransferase levels and negative serological results for HBV, hepatitis C virus and human immunodeficiency virus were recruited as controls. RESULTS Mean platelet volume, serum suPAR and IP-10 were significantly elevated in patients with CHB compared with controls. Median serum suPAR and IP-10 levels were significantly higher in patients with liver fibrosis compared with patients with mild fibrosis. There was no significant difference in mean platelet volume or aspartate aminotransferase-to-platelet ratio index scores between patients with mild and significant fibrosis. CONCLUSION suPAR and IP-10 were able to distinguish between significant and mild fibrosis with good sensitivity and specificity, and may thus represent useful biomarkers for identifying patients with significant fibrosis.
Collapse
Affiliation(s)
- Dilek Yıldız Sevgi
- Department of Infectious Diseases and Clinical Microbiology, Sisli Hamidiye Etfal Training and Research Hospital, Istanbul, Turkey.
| | - Banu Bayraktar
- Department of Clinical Microbiology, Sisli Hamidiye Etfal Training and Research Hospital, Istanbul, Turkey
| | - Alper Gündüz
- Department of Infectious Diseases and Clinical Microbiology, Sisli Hamidiye Etfal Training and Research Hospital, Istanbul, Turkey
| | - Banu Yılmaz Özgüven
- Department of Pathology, Sisli Hamidiye Etfal Training and Research Hospital, Istanbul, Turkey
| | - Alper Togay
- Department of Clinical Microbiology, Sisli Hamidiye Etfal Training and Research Hospital, Istanbul, Turkey
| | - Emin Bulut
- Department of Clinical Microbiology, Sisli Hamidiye Etfal Training and Research Hospital, Istanbul, Turkey
| | - Nuray Uzun
- Department of Infectious Diseases and Clinical Microbiology, Sisli Hamidiye Etfal Training and Research Hospital, Istanbul, Turkey
| | - İlyas Dökmetaş
- Department of Infectious Diseases and Clinical Microbiology, Sisli Hamidiye Etfal Training and Research Hospital, Istanbul, Turkey
| |
Collapse
|