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Gökcan MK, Kurtuluş DF, Aypak A, Köksal M, Ökten SR. Insights from 3D modeling and fluid dynamics in COVID-19 pneumonia. Med Biol Eng Comput 2024; 62:621-636. [PMID: 37980307 DOI: 10.1007/s11517-023-02958-0] [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] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2023] [Accepted: 10/25/2023] [Indexed: 11/20/2023]
Abstract
We address the lack of research regarding aerodynamic events behind respiratory distress at COVID-19. The use of chest CT enables quantification of pneumonia extent; however, there is a paucity of data regarding the impact of airflow changes. We reviewed 31 COVID-19 patients who were admitted in March 2020 with varying severity of pulmonary disease. Lung volumes were segmented and measured on CT images and patient-specific models of the lungs were created. Incompressible, laminar, and three-dimensional Navier-Stokes equations were used for the fluid dynamics (CFD) analyses of ten patients (five mild, five pneumonia). Of 31 patients, 17 were female, 18 had pneumonia, and 2 were deceased. Effective lung volume decreased in the general group, but the involvement of the right lung was prominent in dyspnea patients. CFD analyses revealed that the mass flow distribution was significantly distorted in pneumonia cases with diminished flow rate towards the right lung. In addition, the distribution of flow parameters showed mild group had less airway resistance with higher velocity (1.228 m/s vs 1.572 m/s) and higher static pressure values at airway branches (1.5112 Pa vs 1.3024 Pa). Therefore, we conclude that airway resistance and mass flow rate distribution are as important as the radiological involvement degree in defining the disease severity.
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Affiliation(s)
- M Kürşat Gökcan
- Otorhinolaryngology, Head and Neck Surgery Department, Ankara University Medical School, Ankara, Turkey.
- Ankara Üniversitesi KBB Hastalıkları Anabilim Dalı, İbni Sina Hastanesi Ek bina K-2, 06100, Sıhhiye, Ankara, Turkey.
| | - D Funda Kurtuluş
- Department of Aerospace Engineering, Faculty of Engineering, Middle East Technical University, Ankara, Turkey
| | - Adalet Aypak
- Department of Infectious Diseases and Clinical Microbiology, Ankara Bilkent City Hospital, Ankara, Turkey
| | - Murathan Köksal
- Department of Radiology, Ankara Bilkent City Hospital, Ankara, Turkey
| | - Sarper R Ökten
- Department of Radiology, Ankara Bilkent City Hospital, Ankara, Turkey
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Büyüktuna SA, Öksüz C, Tahmaz A, Sarıgül Yıldırım F, Türken M, Günal Ö, Topal Ş, Baran Aİ, Sarıkaya B, Çelik Ekinci S, Kaya S, Alkan Çeviker S, Aypak A, Yürük Atasoy P, İnan D, Köse A, Koç İnce N, Şenbayrak S, Kaya Ş, Özgüler M, Dindar Demiray EK, Köse Ş. [Distribution of the Prevalence of Human Leukocyte Antigen (HLA)-B*57:01 Positivity in HIV-1 Infected Individuals and Its Effects on Treatment: Türkiye Map-Buhasder Working Group]. MIKROBIYOL BUL 2024; 58:29-38. [PMID: 38263938 DOI: 10.5578/mb.20249903] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2024]
Abstract
Human immunodeficiency virus (HIV)/acquired immundeficiency syndrome (AIDS) is a critical global public health problem that significantly affects both life expectancy and the overall quality of life of individuals in all age groups. The landscape of HIV infection has changed significantly in recent years due to the introduction of effective combination antiretroviral therapies (ART). A key component of first-line ART regimens for HIV treatment is abacavir, a nucleoside HIV reverse transcriptase inhibitor. Although abacavir is effective in suppressing viral replication and managing disease, its clinical utility is overshadowed by the potential for life-threatening hypersensitivity reactions in HLA-B*57:01-positive patients. In our country, local data obtained from various centers regarding the prevalence of HLA-B*57:01 in HIV-1-infected patients are available. In this study, it was aimed to determine the prevalence of the HLA-B*57:01 genotype in HIV-infected patients who were followed up and treated in many regions of our country. This retrospective study consists of the data of the patients aged 18 years and over diagnosed with HIV-1 infection between 01.01.2019 and 31.07.2022. Age, gender, place of birth, mode of transmission of the disease, death status, CD4+ T cell count and HIV RNA levels at the first clinical presentation, HLA-B*57:01 positivity, and the method used, clinical stage of the disease, virological response time with the treatment they received were recorded from the patient files. Data were collected from 16 centers and each center used different methods to detect HLA-B*57:01. These methods were sequence-specific oligonucleotide probe hybridization (SSOP), DNA sequence-based typing (SBT), single-specific primer-polymerase chain reaction (SSP-PCR), allele-specific PCR (AS-PCR) and quantitative PCR (Q-PCR). A total of 608 HIV-infected individuals, 523 males (86%) and 85 females (14%), were included in the study. The mean age of the patients was 36.9 ± 11.9 (18-73) years. The prevalence of HLA-B*57:01 allele was found to be 3.6% (22 patients). The number of CD4+ T lymphocytes in HLA-B*57:01 allele-positive patients was > 500/ mm3 in 10 patients (45.5%), while the number of CD4+ T lymphocytes in HLA-B*57:01 negative patients was > 500/mm3 in 216 patients (36.9%) (p> 0.05). Viral load at the time of diagnosis was found to be lower in patients with positive HLA-B*57:01 allele but it was not statistically significant (p> 0.05). Although different treatment algorithms were used in the centers following the patients, it was observed that the duration of virological response was shorter in HLA-B*57:01 positive patients (p= 0.006). Although the presence of the HLA-B*57:01 allele has a negative impact due to its association with hypersensitivity, it is likely to continue to attract interest due to its association with slower progression of HIV infection and reduced risk of developing AIDS. In addition, although the answer to the question of whether it is cost-effective to screen patients for HLA-B*57:01 before starting an abacavir-containing ART regimen for the treatment of HIV infection is being sought, it seems that HIV treatment guidelines will continue to recommend screening to identify patients at risk in this regard.
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Affiliation(s)
- Seyit Ali Büyüktuna
- Sivas Cumhuriyet University Faculty of Medicine, Department of Infectious Diseases and Clinical Microbiology, Sivas, Türkiye
| | - Caner Öksüz
- Sivas State Hospital, Clinic of Infectious Diseases and Clinical Microbiology, Sivas, Türkiye
| | - Alper Tahmaz
- University of Health Sciences, Antalya Training and Research Hospital, Clinic of Infectious Diseases and Clinical Microbiology, Antalya, Türkiye
| | - Figen Sarıgül Yıldırım
- Antalya Life Hospital, Clinic of Infectious Diseases and Clinical Microbiology, Antalya, Türkiye
| | - Melda Türken
- University of Health Sciences İzmir Faculty of Medicine, İzmir City Hospital, Clinic of Infectious Disease and Clinical Microbiology, İzmir, Türkiye
| | - Özgür Günal
- Samsun University Faculty of Medicine, Department of Infectious Diseases and Clinical Microbiology, Samsun, Türkiye
| | - Şeyma Topal
- Samsun University Faculty of Medicine, Department of Infectious Diseases and Clinical Microbiology, Samsun, Türkiye
| | - Ali İrfan Baran
- Van Yüzüncü Yıl University Faculty of Medicine, Department of Infectious Diseases and Clinical Microbiology, Van, Türkiye
| | - Burak Sarıkaya
- University of Health Sciences, Sultan 2nd Abdulhamid Khan Training and Research Hospital, Clinic of Infectious Diseases and Clinical Microbiology, İstanbul, Türkiye
| | - Semiha Çelik Ekinci
- University of Health Sciences, Fatih Sultan Mehmet Training and Research Hospital, Clinic of Infectious Diseases and Clinical Microbiology, İstanbul, Türkiye
| | - Selçuk Kaya
- Çanakkale Onsekiz Mart University Faculty of Medicine, Department of Infectious Diseases and Clinical Microbiology, Çanakkale, Türkiye
| | - Sevil Alkan Çeviker
- Çanakkale Onsekiz Mart University Faculty of Medicine, Department of Infectious Diseases and Clinical Microbiology, Çanakkale, Türkiye
| | - Adalet Aypak
- University of Health Sciences, Ankara City Hospital, Clinic of Infectious Diseases and Clinical Microbiology, Ankara, Türkiye
| | - Pınar Yürük Atasoy
- University of Health Sciences, Ankara City Hospital, Clinic of Infectious Diseases and Clinical Microbiology, Ankara, Türkiye
| | - Dilara İnan
- Akdeniz University Faculty of Medicine, Department of Infectious Diseases and Clinical Microbiology, Antalya, Türkiye
| | - Adem Köse
- İnönü University Faculty of Medicine, Department of Infectious Diseases and Clinical Microbiology, Malatya, Türkiye
| | - Nevind Koç İnce
- Düzce University Faculty of Medicine, Department of Infectious Diseases and Clinical Microbiology, Düzce, Türkiye
| | - Seniha Şenbayrak
- University of Health Sciences, Haydarpasa Numune Training and Research Hospital, Clinic of Infectious Diseases and Clinical Microbiology, İstanbul, Türkiye
| | - Şafak Kaya
- University of Health Sciences, Gazi Yaşargil Training and Research Hospital, Clinic of Infectious Diseases and Clinical Microbiology, Diyarbakır, Türkiye
| | - Müge Özgüler
- University of Health Sciences Hamidiye Faculty of Medicine, Elazığ Fethi Sekin City Health Practice and Research Center, Clinic of Infectious Diseases and Clinical Microbiology, Elazığ, Türkiye
| | | | - Şükran Köse
- Dokuz Eylül University Faculty of Medicine, Department of Infectious Diseases and Clinical Microbiology, İzmir, Türkiye
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Turan Gökçe D, Arı D, Aypak A, Aydın O, Kaçar S, Bostancı EB, Akdoğan Kayhan M. Investigating Whether the Severity of SARS-CoV-2 Infection Is Higher in Liver Transplant Recipients: A Single-Center Experience. EXP CLIN TRANSPLANT 2023; 21:837-840. [PMID: 35297331 DOI: 10.6002/ect.2021.0494] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
OBJECTIVES Liver transplant recipients have been reported to be a high-risk population for severe disease from COVID-19 infection. In this crosssectional, single-center study, we investigated whether liver transplant increased the risk of death and severe disease in patients with SARS-CoV-2 infection. MATERIALS AND METHODS We collected data and serum anti-SARS-CoV-2 immunoglobulin M and immunoglobulin G results of 91 liver transplant recipients seen from September 2020 to March 2021. Liver transplant recipients were enrolled during presentation for scheduled routine follow-up visits. All patients who required serum anti-SARS-CoV-2 immunoglobulin M and immunoglobulin G tests completed a ques-tionnaire on clinical symptoms during the previous 6 months. RESULTS Among the 91 patients with SARS-CoV-2 immunoglobulin M and G results, 7 patients had a known history of symptomatic COVID-19 during the previous 6 months. Of the 84 participants who completed the questionnaire, 21 (25%) had positive anti-SARS-CoV-2 immunoglobulin M and G results. These 21 patients also received COVID-19 polymerase chain reaction tests, which were negative in all 21 patients. Overall, only 7 patients stated that they experienced flu-like upper respiratory tract infection symptoms or diarrhea. CONCLUSIONS We documented past SARS-CoV-2 infection in only 25% of our outpatient liver transplant recipients, and most were asymptomatic. We found no significant relationship between symptoms and seropositivity for SARS-CoV-2.
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Affiliation(s)
- Dilara Turan Gökçe
- From the Department of Gastroenterology,Ankara City Hospital, Ankara,Turkey
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Tanoglu A, Erdem H, Friedland JS, Ankaralı H, Garcia-Goez JF, Albayrak A, El-Kholy A, Ceviker SA, Amer F, Erol S, Darazam IA, Rabiei MM, Sarwar MZ, Zeb M, Nawaz H, Ceylan MR, Cernat R, Tasbakan M, Ayoade F, Ruch Y, Tigen ET, Angioni G, Rajani DP, Akhtar N, Surme S, Sengoz G, Karlıdag GE, Marino A, Ripon RK, Çağ Y, Aydın Ö, Akkoyunlu Y, Seyman D, Angamuthu K, Cascio A, Popescu CP, Sirmatel F, Eren E, Dar RE, Munu FU, Tanoglu EG, Echeverry E, Velez JD, Artuk C, Balin SO, Pandya N, Erdem A, Demiray EKD, Aypak A. Clinicopathological profile of peritoneal tuberculosis and a new scoring model for predicting mortality: an international ID-IRI study. Eur J Clin Microbiol Infect Dis 2023:10.1007/s10096-023-04630-9. [PMID: 37318601 DOI: 10.1007/s10096-023-04630-9] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2023] [Accepted: 06/03/2023] [Indexed: 06/16/2023]
Abstract
Existing literature about peritoneal tuberculosis (TBP) is relatively insufficient. The majority of reports are from a single center and do not assess predictive factors for mortality. In this international study, we investigated the clinicopathological characteristics of a large series of patients with TBP and determined the key features associated with mortality. TBP patients detected between 2010 and 2022 in 38 medical centers in 13 countries were included in this retrospective cohort. Participating physicians filled out an online questionnaire to report study data. In this study, 208 patients with TBP were included. Mean age of TBP cases was 41.4 ± 17.5 years. One hundred six patients (50.9%) were females. Nineteen patients (9.1%) had HIV infection, 45 (21.6%) had diabetes mellitus, 30 (14.4%) had chronic renal failure, 12 (5.7%) had cirrhosis, 7 (3.3%) had malignancy, and 21 (10.1%) had a history of immunosuppressive medication use. A total of 34 (16.3%) patients died and death was attributable to TBP in all cases. A pioneer mortality predicting model was established and HIV positivity, cirrhosis, abdominal pain, weakness, nausea and vomiting, ascites, isolation of Mycobacterium tuberculosis in peritoneal biopsy samples, TB relapse, advanced age, high serum creatinine and ALT levels, and decreased duration of isoniazid use were significantly related with mortality (p < 0.05). This is the first international study on TBP and is the largest case series to date. We suggest that using the mortality predicting model will allow early identification of high-risk patients likely to die of TBP.
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Affiliation(s)
- Alpaslan Tanoglu
- Department of Internal Medicine and Gastroenterology, Sancaktepe Sehit Prof Dr Ilhan Varank Training and Research Hospital, University of Health Sciences, 34785, Istanbul, Turkey.
| | - Hakan Erdem
- Department of Infectious Diseases & Clinical Microbiology, Gulhane School of Medicine, University of Health Sciences, Ankara, Turkey
- MKCC Cardiac Centre, Awali, Bahrain
| | | | - Handan Ankaralı
- Department of Biostatistics and Medical Informatics, Faculty of Medicine, Istanbul Medeniyet University, Istanbul, Turkey
| | - Jose Fernando Garcia-Goez
- Infectious Disease Service Hospital Universitario Fundacion Valle del Lili Colombia, Facultad de Medicina Universidad Icesi, Cali, Colombia
| | - Ayse Albayrak
- Department of Infectious Diseases and Clinical Microbiology, Faculty of Medicine, Ataturk University, Erzurum, Turkey
| | - Amani El-Kholy
- Department of Clinical Pathology, Faculty of Medicine, Cairo University, Cairo, Egypt
| | - Sevil Alkan Ceviker
- Department of Infectious Diseases, Faculty of Medicine, Canakkale Onsekiz Mart University, Canakkale, Turkey
| | - Fatma Amer
- Department of Medical Microbiology and Immunology, Zagazig Faculty of Medicine, Zagazig, Egypt
| | - Serpil Erol
- Department of Infectious Diseases, Haydarpasa Numune Training and Research Hospital, University of Health Sciences, Istanbul, Turkey
| | | | | | | | - Misbah Zeb
- Department of Infectious Diseases, Mayo Hospital, Lahore, Pakistan
| | - Hassan Nawaz
- Department of Infectious Diseases, Mayo Hospital, Lahore, Pakistan
| | | | - Roxana Cernat
- Department of Infectious Diseases, Clinical Hospital for Infectious Diseases, Constanta, Romania
| | - Meltem Tasbakan
- Department of Infectious Diseases, Ege University, Izmir, Turkey
| | - Folusakin Ayoade
- Department of Infectious Diseases, University of Miami, Miami, FL, USA
| | - Yvon Ruch
- Department of Infectious Diseases, Strasbourg University, Strasbourg, France
| | - Elif Tükenmez Tigen
- Department of Infectious Diseases, Pendik Training and Research Hospital, Marmara University, Istanbul, Turkey
| | - Goffredo Angioni
- Department of Infectious Diseases, Hospital SS Trinità, Borgomanero, Italy
| | - Dhanji P Rajani
- Microcare Laboratory & Tuberculosis Research Centre, Surat, Gujarat, India
| | - Nasim Akhtar
- Pakistan Institute of Medical Sciences, Islamabad, Pakistan
| | - Serkan Surme
- Department of Infectious Diseases, Haseki Training and Research Hospital, University of Health Sciences, Istanbul, Turkey
| | - Gonul Sengoz
- Department of Infectious Diseases, Haseki Training and Research Hospital, University of Health Sciences, Istanbul, Turkey
| | - Gulden Eser Karlıdag
- Department of Infectious Diseases, Elazig Fethi Sekin City Hospital, University of Health Sciences, Elazig, Turkey
| | - Andrea Marino
- Unit of Infectious Diseases, Department of Clinical and Experimental Medicine, ARNAS Garibaldi Hospital, University of Catania, Catania, Italy
| | - Rezaul Karim Ripon
- Department of Public Health and Informatics, Jahangirnagar University, Savar Union, Bangladesh
| | - Yasemin Çağ
- Department of Infectious Diseases and Clinical Microbiology, Istanbul Medeniyet University Goztepe Training and Research Hospital, Istanbul, Turkey
| | - Özlem Aydın
- Department of Infectious Diseases and Clinical Microbiology, Istanbul Medeniyet University Goztepe Training and Research Hospital, Istanbul, Turkey
| | - Yasemin Akkoyunlu
- Department of Infectious Diseases, Bezmialem Vakif University, Istanbul, Turkey
| | - Derya Seyman
- Department of Infectious Diseases, Antalya Education and Research Hospital, University of Health Sciences, Antalya, Turkey
| | - Kumar Angamuthu
- Department of Infectious Diseases, Almana General Hospitals, Dammam, Saudi Arabia
| | - Antonio Cascio
- Infectious Disease Unit, Policlinico "P. Giaccone", University of Palermo, Palermo, Italy
| | - Corneliu Petru Popescu
- Department of Infectious Diseases, Dr. Victor Babes Clinical Hospital of Infectious and Tropical Diseases, Bucharest, Romania
| | - Fatma Sirmatel
- Department of Infectious Diseases, Bolu Abant Izzet Baysal University Medical Faculty, Bolu, Turkey
| | - Esma Eren
- Department of Infectious Diseases, Kayseri City Hospital, Kayseri, Turkey
| | - Razi Even Dar
- Department of Infectious Diseases, Caemal, Haifa, Israel
| | - Foday Usman Munu
- Department of Infectious Diseases, Lakka Government Hospital, Freetown, Sierra Leone
| | - Esra Guzel Tanoglu
- Department of Molecular Biology and Genetics, University of Health Sciences, Istanbul, Turkey
| | - Esteban Echeverry
- Infectious Disease Service Hospital Universitario Fundacion Valle del Lili Colombia, Facultad de Medicina Universidad Icesi, Cali, Colombia
| | - Juan Diego Velez
- Infectious Disease Service Hospital Universitario Fundacion Valle del Lili Colombia, Facultad de Medicina Universidad Icesi, Cali, Colombia
| | - Cumhur Artuk
- Department of Infectious Diseases & Clinical Microbiology, Gulhane School of Medicine, University of Health Sciences, Ankara, Turkey
| | - Safak Ozer Balin
- Department of Infectious Diseases, Fırat University Medical Faculty, Elazig, Turkey
| | - Nirav Pandya
- Department of Infectious Diseases, Bhailal Amin General Hospital, Vadodara, India
| | - Aysegul Erdem
- Department of Pathology, Ataturk Sanatoryum Training and Research Hospital, Ankara, Turkey
| | | | - Adalet Aypak
- Department of Infectious Diseases and Clinical Microbiology, Ankara City Training and Research Hospital, Ankara, Turkey
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Ozbay BO, Aypak A, Bastug A, Aydos Ö, Mumcuoglu İ, Büyükberber SG, Karcıoğlu AM, Bodur H. An investigation of clinical characteristics and antimicrobial agent susceptibility patterns in clinical Comamonas testosteroni isolates: An increasingly prevalent nosocomial pathogen. Infect Dis Now 2023; 53:104622. [PMID: 36245130 DOI: 10.1016/j.idnow.2022.09.017] [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: 04/27/2022] [Revised: 09/07/2022] [Accepted: 09/14/2022] [Indexed: 10/14/2022]
Abstract
BACKGROUND Comamonas testosteroni is a gram-negative bacillus, known before 1987 as Pseudomonas testosteroni. Although considered as a rare pathogen, its frequency has been increasing. Data regarding its antibiotic susceptibility are insufficient. To date, forty-four cases have been reported in the literature. In this study, we identified the C. testosteroni infections observed in our hospital and evaluated their antimicrobial agent susceptibility patterns compared with cases reported in the literature. METHODS For the purposes of the present study, patients admitted to hospital between November 2019 and December 2020 were screened. Those with clinical and laboratory signs of infection with positive C. testosteroni growth in culture were enrolled. Clinical isolates obtained from the samples processed in accordance with standard microbiological examination procedures in our laboratory were defined by MALDI-TOF mass spectrometry with 99.9% probability as C. testosteroni. RESULTS C testosteroni infection was detected between November 2019 and December 2020 in eight patients in our hospital. Six of them had a bloodstream infection (BSI), one had pneumonia, and one had urinary tract infection due to C. testosteroni. Coexistence of COVID-19 was detected in four patients. Six out of the eight cases with BSI had hospital-acquired infection and all of the infections were healthcare-associated. When antimicrobial agent susceptibility results reported in the literature were evaluated in combination with the current results, ceftazidime and meropenem were found to be the most susceptible agents (96.1% and 80%, respectively). CONCLUSIONS The frequency of nosocomial C. testosteroni infections and resistance to antimicrobial agents are gradually increasing. While resistance to carbapenems is on the upswing, third-generation cephalosporins are still seen as suitable treatment options.
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Affiliation(s)
- Bahadır Orkun Ozbay
- Ministry of Health, Ankara City Hospital, Department of Infectious Diseases and Clinical Microbiology, Ankara, Turkey.
| | - Adalet Aypak
- Ministry of Health, Ankara City Hospital, Department of Infectious Diseases and Clinical Microbiology, Ankara, Turkey
| | - Aliye Bastug
- Health Science University Turkey, Ankara City Hospital, Department of Infectious Diseases and Clinical Microbiology, Ankara, Turkey
| | - Ömer Aydos
- Ministry of Health, Ankara City Hospital, Department of Infectious Diseases and Clinical Microbiology, Ankara, Turkey
| | - İpek Mumcuoglu
- Ministry of Health, Ankara City Hospital, Department of Medical Microbiology, Ankara, Turkey
| | | | - Ayşe Müge Karcıoğlu
- Ministry of Health, Ankara City Hospital, Department of Critical Care Medicine, Turkey
| | - Hurrem Bodur
- Health Science University Turkey, Ankara City Hospital, Department of Infectious Diseases and Clinical Microbiology, Ankara, Turkey
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Kilic H, Arguder E, Karalezli A, Unsal E, Guner R, Kayaslan B, Hasanoglu İ, Ates İ, Civak M, Akpınar E, Parlak E, Sadi F, Kocaman Y, Günay S, Metan E, Er M, Dalkıran A, Hezer H, Ergüden H, Hancıoğlu Z, Kalem A, Eser F, Aypak A, Akıncı E, Karahmetoğlu S, Gemcioglu E, Kalkan E, İnan O, Yilmaz A, Güler B, Çopuroğlu E, Turan İ, Gökmen D, Hayme S, Surel AA. Effect of chronic lung diseases on mortality of prevariant COVID-19 pneumonia patients. Front Med (Lausanne) 2022; 9:957598. [PMID: 36314036 PMCID: PMC9606396 DOI: 10.3389/fmed.2022.957598] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2022] [Accepted: 09/20/2022] [Indexed: 11/26/2022] Open
Abstract
Background The aim of the study is to assess the effect of chronic lung disease on mortality in patients hospitalized with the diagnosis of prevariant COVID-19 Pneumonia compared to patients without chronic lung disease. Research design and methods A cohort of 1,549 patients admitted to the pandemic clinic with a COVID-19 Pneumonia diagnosis was analyzed. Group 1 and Group 2 were compared in terms of the treatment they received, admission to intensive care, mortality and follow-up parameters. Results The patient group with COVID-19 and lung disease consisted of 231 participants (14.91%) (Group 1). The patient group with COVID-19 but without lung disease had 1,318 participants (85.19%). Group 1 cases were found to receive more oxygen therapy and mechanical ventilation than Group 2 cases (p ≤ 0.001), Following univariate and multiple logistic regression analyses, it was determined that patients with chronic lung disease had a 25.76% higher mortality risk [OR: 25.763, 95% CI (Lower-Upper) (2.445–271.465), p = 0.007]. Conclusion It was found that chronic lung disease contributed significantly to mortality in this study. Among chronic lung diseases, Chronic Obstructive Pulmonary Disease (COPD), lung cancer and interstitial lung diseases (ILDs) were shown to be more effective than other chronic lung diseases in patients with prevariant COVİD-19 population.
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Affiliation(s)
- Hatice Kilic
- Department of Pulmonary Medicine, Faculty of Medicine, Ankara Yildirim Beyazit University, Ankara, Turkey,*Correspondence: Hatice Kilic,
| | - Emine Arguder
- Department of Pulmonary Medicine, Faculty of Medicine, Ankara Yildirim Beyazit University, Ankara, Turkey
| | - Aysegul Karalezli
- Department of Pulmonary Medicine, Faculty of Medicine, Ankara Yildirim Beyazit University, Ankara, Turkey
| | - Ebru Unsal
- Department of Pulmonary Medicine, Faculty of Medicine, Ankara Yildirim Beyazit University, Ankara, Turkey
| | - Rahmet Guner
- Department of Infectious Disease, Faculty of Medicine, Ankara Yildirim Beyazit University, Ankara, Turkey
| | - Bircan Kayaslan
- Department of Infectious Disease, Faculty of Medicine, Ankara Yildirim Beyazit University, Ankara, Turkey
| | - İmran Hasanoglu
- Department of Infectious Disease, Faculty of Medicine, Ankara Yildirim Beyazit University, Ankara, Turkey
| | - İhsan Ates
- Department of Internal Medicine Disease, Faculty of Medicine, Ankara University of Health Science, Ankara City Hospital, Ankara, Turkey
| | - Musa Civak
- Department of Internal Medicine Diseases, Ankara City Hospital, Ankara, Turkey
| | - Esmehan Akpınar
- Department of Chest Diseases, Ankara City Hospital, Ankara, Turkey
| | - Ebru Parlak
- Department of Chest Diseases, Ankara City Hospital, Ankara, Turkey
| | - Filiz Sadi
- Department of Chest Diseases, Ankara City Hospital, Ankara, Turkey
| | - Yasin Kocaman
- Department of Chest Diseases, Ankara City Hospital, Ankara, Turkey
| | - Sibel Günay
- Department of Chest Diseases, Ankara City Hospital, Ankara, Turkey
| | - Esra Metan
- Department of Chest Diseases, Ankara City Hospital, Ankara, Turkey
| | - Mukremin Er
- Department of Chest Diseases, Ankara City Hospital, Ankara, Turkey
| | - Aynil Dalkıran
- Department of Chest Diseases, Ankara City Hospital, Ankara, Turkey
| | - Habibe Hezer
- Department of Chest Diseases, Ankara City Hospital, Ankara, Turkey
| | - Hülya Ergüden
- Department of Chest Diseases, Ankara City Hospital, Ankara, Turkey
| | - Zeynep Hancıoğlu
- Department of Chest Diseases, Ankara City Hospital, Ankara, Turkey
| | - Ayşe Kalem
- Department of Infectious Disease, Faculty of Medicine, Ankara Yildirim Beyazit University, Ankara, Turkey
| | - Fatma Eser
- Department of Infectious Disease, Faculty of Medicine, Ankara Yildirim Beyazit University, Ankara, Turkey
| | - Adalet Aypak
- Department of Infectious Disease, Faculty of Medicine, University of Health Science, Ankara, Turkey
| | - Esragül Akıncı
- Department of Infectious Disease, Faculty of Medicine, University of Health Science, Ankara, Turkey
| | - Selma Karahmetoğlu
- Department of Internal Medicine Diseases, Ankara City Hospital, Ankara, Turkey
| | - Emin Gemcioglu
- Department of Internal Medicine Diseases, Ankara City Hospital, Ankara, Turkey
| | - Emra Kalkan
- Department of Internal Medicine Diseases, Ankara City Hospital, Ankara, Turkey
| | - Osman İnan
- Department of Internal Medicine Diseases, Ankara City Hospital, Ankara, Turkey
| | - Abdulrezzak Yilmaz
- Department of Internal Medicine Diseases, Ankara City Hospital, Ankara, Turkey
| | - Bagdagul Güler
- Department of Internal Medicine Diseases, Ankara City Hospital, Ankara, Turkey
| | - Esra Çopuroğlu
- Department of Internal Medicine Diseases, Ankara City Hospital, Ankara, Turkey
| | - İşil Turan
- Department of Anesthesia, Ankara City Hospital, Ankara, Turkey
| | - Derya Gökmen
- Department of Biostatistics, School of Medicine, Ankara University, Ankara, Turkey
| | - Serhat Hayme
- Department of Biostatistics, School of Medicine, Ankara University, Ankara, Turkey
| | - Aziz Ahmet Surel
- Department of General Surgery, Ankara City Hospital, Ankara, Turkey
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Akbal Cufali S, Yagmur AR, Paksoy ZB, Cakmak MF, Ozcan KM, Aypak A. Tomographic Evaluation of Paranasal Sinus findings in COVID-19-Positive Patients. Eur J Rhinol Allergy 2022. [DOI: 10.5152/ejra.2022.22006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
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Mumcuoğlu İ, Çağlar H, Erdem D, Aypak A, Gün P, Kurşun Ş, Çakır EY, Aydoğan S, Kırca F, Dinç B. Secondary bacterial infections of the respiratory tract in COVID-19 patients. J Infect Dev Ctries 2022; 16:1131-1137. [PMID: 35905017 DOI: 10.3855/jidc.16724] [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: 04/19/2022] [Accepted: 04/29/2022] [Indexed: 10/31/2022] Open
Abstract
INTRODUCTION Secondary Bacterial Infections (SBIs) of the respiratory system are one of the biggest medical concerns in patients undergoing hospitalization with a diagnosis of COVID-19. This study aims to provide relevant data for the initiation of appropriate empirical treatment after examining the etiology and antimicrobial resistance of SBIs in COVID-19 patients under care in the Intensive Care Units (ICUs) in the largest pandemic hospital of our country. METHODOLOGY Between March 16, 2020 and December 31, 2021, 56,993 COVID patients were hospitalized, of which 7684 were admitted to ICUs. A total of 1513 patients diagnosed with SBIs have been included in this study. During the course of the study, demographic data, clinical course, etiology and antimicrobial resistance data of all patients were collected. RESULTS The most common causative agents of SBIs were inferred as Acinetobacter baumanii (35.1%), Staphylococcus aureus (15.2%), Klebsiella pneumoniae (12.3%) and Pseudomonas aeruginosa (10.4%). The isolation rates of carbapenem-resistant and colistin-resistant A. baumannii, K. pneumoniae and P. aeruginosa were 83.7%; 42.7%, 79.2%, and 5.6%, 42.7%, 1.7%, respectively. Acinetobacter pittii clustering was seen in one of the ICUs in the hospital. Multidrug resistant 92 (5.4%) Corynebacterium striatum isolates were also found as a causative agent with increasing frequency during the study period. CONCLUSIONS SBI of the respiratory system is one of the major complications in patients hospitalized with COVID-19. The antimicrobial resistance rates of the isolated bacteria are generally high, which indicates that more accurate use of antibacterial agents is necessary for SBIs in patients hospitalized with COVID-19 diagnosis.
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Affiliation(s)
- İpek Mumcuoğlu
- Department of Medical Microbiology, Dr. Abdurrahman Yurtaslan Ankara Oncology Training and Research Hospital, Ankara, Turkey.
| | - Hatice Çağlar
- Department of Medical Microbiology, Ankara City Hospital, Ankara, Turkey
| | - Deniz Erdem
- Department of Medical Microbiology, Ankara City Hospital, Ankara, Turkey
| | - Adalet Aypak
- Department of Infectious Diseases and Clinical Microbiology, Ankara City Hospital, Ankara, Turkey
| | - Pınar Gün
- Department of Medical Microbiology, Ankara City Hospital, Ankara, Turkey
| | - Şenol Kurşun
- Department of Medical Microbiology, Ankara City Hospital, Ankara, Turkey
| | - Esra Yakışık Çakır
- Department of Anaesthesiology and Reanimation Ankara, Ankara City Hospital, Ankara, Turkey
| | - Sibel Aydoğan
- Department of Medical Microbiology, Ankara City Hospital, Ankara, Turkey
| | - Fisun Kırca
- Department of Medical Microbiology, Ankara City Hospital, Ankara, Turkey
| | - Bedia Dinç
- Department of Medical Microbiology, Ankara City Hospital, Ankara, Turkey
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Cevher ŞK, Yenigün EC, Çankaya E, Aktürk S, Levent M, Aypak A, Dede F. Should We Weigh More on Home Dialysis Methods During Pandemic Periods: One Center Experience. Turk J Nephrol 2022. [DOI: 10.5152/turkjnephrol.2022.21073] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
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Guner R, Hasanoglu I, Kayaaslan B, Aypak A, Akinci E, Bodur H, Eser F, Kaya Kalem A, Kucuksahin O, Ates I, Bastug A, Tezer Tekce Y, Bilgic Z, Gursoy FM, Akca HN, Izdes S, Erdem D, Asfuroglu E, Hezer H, Kilic H, Civak M, Aydogan S, Buzgan T. Response to the letter to the editor. J Infect Public Health 2022; 15:65-67. [PMID: 34915424 PMCID: PMC8664607 DOI: 10.1016/j.jiph.2021.12.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2021] [Indexed: 11/19/2022] Open
Affiliation(s)
- Rahmet Guner
- Department of Infectious Disease and Clinical Microbiology, Ankara Yildirim Beyazit University, Ankara City Hospital, Ankara, Turkey.
| | - Imran Hasanoglu
- Department of Infectious Disease and Clinical Microbiology, Ankara Yildirim Beyazit University, Ankara City Hospital, Ankara, Turkey.
| | - Bircan Kayaaslan
- Department of Infectious Disease and Clinical Microbiology, Ankara Yildirim Beyazit University, Ankara City Hospital, Ankara, Turkey.
| | - Adalet Aypak
- Department of Infectious Disease and Clinical Microbiology, Ankara City Hospital, Ankara, Turkey.
| | - Esragul Akinci
- Department of Infectious Disease and Clinical Microbiology, University of Health Sciences, Ankara City Hospital, Ankara, Turkey.
| | - Hurrem Bodur
- Department of Infectious Disease and Clinical Microbiology, University of Health Sciences, Ankara City Hospital, Ankara, Turkey.
| | - Fatma Eser
- Department of Infectious Disease and Clinical Microbiology, Ankara Yildirim Beyazit University, Ankara City Hospital, Ankara, Turkey.
| | - Ayse Kaya Kalem
- Department of Infectious Disease and Clinical Microbiology, Ankara Yildirim Beyazit University, Ankara City Hospital, Ankara, Turkey.
| | - Orhan Kucuksahin
- Department of Rheumatology, Ankara Yildirim Beyazit University, Ankara City Hospital, Ankara, Turkey.
| | - Ihsan Ates
- Department of Internal Medicine, Ankara City Hospital, Ankara, Turkey.
| | - Aliye Bastug
- Department of Infectious Disease and Clinical Microbiology, University of Health Sciences, Ankara City Hospital, Ankara, Turkey.
| | - Yasemin Tezer Tekce
- Department of Infectious Disease and Clinical Microbiology, University of Health Sciences, Ankara City Hospital, Ankara, Turkey.
| | - Zeynep Bilgic
- Department of Infectious Disease and Clinical Microbiology, University of Health Sciences, Ankara City Hospital, Ankara, Turkey.
| | - Fahriye Melis Gursoy
- Department of Infectious Disease and Clinical Microbiology, University of Health Sciences, Ankara City Hospital, Ankara, Turkey.
| | - Hatice Nisa Akca
- Department of Infectious Disease and Clinical Microbiology, University of Health Sciences, Ankara City Hospital, Ankara, Turkey.
| | - Seval Izdes
- Department of Anaesthesiology and Reanimation Ankara, Yildirim Beyazit University, Ankara City Hospital, Ankara, Turkey.
| | - Deniz Erdem
- Department of Anaesthesiology and Reanimation Ankara, Ankara City Hospital, Ankara, Turkey.
| | - Emra Asfuroglu
- Department of Internal Medicine, Ankara City Hospital, Ankara, Turkey.
| | - Habibe Hezer
- Department of Pulmonary Diseases, Ankara City Hospital, Ankara, Turkey.
| | - Hatice Kilic
- Department of Pulmonary Diseases, Ankara Yildirim Beyazit University, Ankara City Hospital, Ankara, Turkey.
| | - Musa Civak
- Department of Internal Medicine Ankara City Hospital, Ankara, Turkey.
| | - Sibel Aydogan
- Department of Virology, Ankara City Hospital, Ankara, Turkey.
| | - Turan Buzgan
- Department of Infectious Disease and Clinical Microbiology, Ankara Yildirim Beyazit University, Ankara City Hospital, Ankara, Turkey.
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Guner R, Kayaaslan B, Hasanoglu I, Aypak A, Bodur H, Ates I, Akinci E, Erdem D, Eser F, Izdes S, Kalem AK, Bastug A, Karalezli A, Surel AA, Ayhan M, Karaahmetoglu S, Turan IO, Arguder E, Ozdemir B, Mutlu MN, Bilir YA, Sarıcaoglu EM, Gokcinar D, Gunay S, Dinc B, Gemcioglu E, Bilmez R, Aydos O, Asilturk D, Inan O, Buzgan T. Development and validation of nomogram to predict severe illness requiring intensive care follow up in hospitalized COVID-19 cases. BMC Infect Dis 2021; 21:1004. [PMID: 34563117 PMCID: PMC8467006 DOI: 10.1186/s12879-021-06656-w] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2020] [Accepted: 09/03/2021] [Indexed: 02/07/2023] Open
Abstract
BACKGROUND Early identification of severe COVID-19 patients who will need intensive care unit (ICU) follow-up and providing rapid, aggressive supportive care may reduce mortality and provide optimal use of medical resources. We aimed to develop and validate a nomogram to predict severe COVID-19 cases that would need ICU follow-up based on available and accessible patient values. METHODS Patients hospitalized with laboratory-confirmed COVID-19 between March 15, 2020, and June 15, 2020, were enrolled in this retrospective study with 35 variables obtained upon admission considered. Univariate and multivariable logistic regression models were constructed to select potential predictive parameters using 1000 bootstrap samples. Afterward, a nomogram was developed with 5 variables selected from multivariable analysis. The nomogram model was evaluated by Area Under the Curve (AUC) and bias-corrected Harrell's C-index with 95% confidence interval, Hosmer-Lemeshow Goodness-of-fit test, and calibration curve analysis. RESULTS Out of a total of 1022 patients, 686 cases without missing data were used to construct the nomogram. Of the 686, 104 needed ICU follow-up. The final model includes oxygen saturation, CRP, PCT, LDH, troponin as independent factors for the prediction of need for ICU admission. The model has good predictive power with an AUC of 0.93 (0.902-0.950) and a bias-corrected Harrell's C-index of 0.91 (0.899-0.947). Hosmer-Lemeshow test p-value was 0.826 and the model is well-calibrated (p = 0.1703). CONCLUSION We developed a simple, accessible, easy-to-use nomogram with good distinctive power for severe illness requiring ICU follow-up. Clinicians can easily predict the course of COVID-19 and decide the procedure and facility of further follow-up by using clinical and laboratory values of patients available upon admission.
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Affiliation(s)
- Rahmet Guner
- Department of Infectious Disease and Clinical Microbiology, Ankara Yildirim Beyazit University, Ankara City Hospital, Bilkent Street no:1, Ankara, 06800, Turkey
| | - Bircan Kayaaslan
- Department of Infectious Disease and Clinical Microbiology, Ankara Yildirim Beyazit University, Ankara City Hospital, Bilkent Street no:1, Ankara, 06800, Turkey.
| | - Imran Hasanoglu
- Department of Infectious Disease and Clinical Microbiology, Ankara Yildirim Beyazit University, Ankara City Hospital, Bilkent Street no:1, Ankara, 06800, Turkey
| | - Adalet Aypak
- Department of Infectious Disease and Clinical Microbiology, Ankara City Hospital, Ankara, Turkey
| | - Hurrem Bodur
- Department of Infectious Disease and Clinical Microbiology, University of Health Sciences, Ankara City Hospital, Ankara, Turkey
| | - Ihsan Ates
- Department of Internal Medicine, Ankara City Hospital, Ankara, Turkey
| | - Esragul Akinci
- Department of Infectious Disease and Clinical Microbiology, University of Health Sciences, Ankara City Hospital, Ankara, Turkey
| | - Deniz Erdem
- Department of Anesthesiology and Reanimation, Ankara City Hospital, Ankara, Turkey
| | - Fatma Eser
- Department of Infectious Disease and Clinical Microbiology, Ankara Yildirim Beyazit University, Ankara City Hospital, Bilkent Street no:1, Ankara, 06800, Turkey
| | - Seval Izdes
- Department of Anesthesiology and Reanimation and Intensive Care Unıt, Ankara Yildirim Beyazit University, Ankara City Hospital, Ankara, Turkey
| | - Ayse Kaya Kalem
- Department of Infectious Disease and Clinical Microbiology, Ankara Yildirim Beyazit University, Ankara City Hospital, Bilkent Street no:1, Ankara, 06800, Turkey
| | - Aliye Bastug
- Department of Infectious Disease and Clinical Microbiology, University of Health Sciences, Ankara City Hospital, Ankara, Turkey
| | - Aysegul Karalezli
- Department of Pulmonary Diseases, Ankara Yildirim Beyazit University, Ankara City Hospital, Ankara, Turkey
| | - Aziz Ahmet Surel
- Department of General Surgery, Ankara City Hospital, Ankara, Turkey
| | - Muge Ayhan
- Department of Infectious Disease and Clinical Microbiology, Ankara City Hospital, Ankara, Turkey
| | | | - Isıl Ozkocak Turan
- Department of Anesthesiology and Reanimation, University of Health Sciences, Ankara City Hospital, Ankara, Turkey
| | - Emine Arguder
- Department of Anesthesiology and Reanimation and Intensive Care Unıt, Ankara Yildirim Beyazit University, Ankara City Hospital, Ankara, Turkey
| | - Burcu Ozdemir
- Department of Infectious Disease and Clinical Microbiology, Ankara City Hospital, Ankara, Turkey
| | - Mehmet Nevzat Mutlu
- Department of Anesthesiology and Reanimation, Ankara City Hospital, Ankara, Turkey
| | - Yesim Aybar Bilir
- Department of Infectious Disease and Clinical Microbiology, Ankara City Hospital, Ankara, Turkey
| | - Elif Mukime Sarıcaoglu
- Department of Infectious Disease and Clinical Microbiology, Ankara City Hospital, Ankara, Turkey
| | - Derya Gokcinar
- Department of Anesthesiology and Reanimation, University of Health Sciences, Ankara City Hospital, Ankara, Turkey
| | - Sibel Gunay
- Department of Pulmonary Diseases, Ankara City Hospital, Ankara, Turkey
| | - Bedia Dinc
- Department of Microbiology, Ankara City Hospital, Ankara, Turkey
| | - Emin Gemcioglu
- Department of Internal Medicine, Ankara City Hospital, Ankara, Turkey
| | - Ruveyda Bilmez
- Department of Infectious Disease and Clinical Microbiology, Ankara City Hospital, Ankara, Turkey
| | - Omer Aydos
- Department of Infectious Disease and Clinical Microbiology, Ankara City Hospital, Ankara, Turkey
| | - Dilek Asilturk
- Department of Infectious Disease and Clinical Microbiology, Ankara City Hospital, Ankara, Turkey
| | - Osman Inan
- Department of Internal Medicine, Ankara City Hospital, Ankara, Turkey
| | - Turan Buzgan
- Department of Infectious Disease and Clinical Microbiology, Ankara Yildirim Beyazit University, Ankara City Hospital, Bilkent Street no:1, Ankara, 06800, Turkey
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12
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Yağmur AR, Akbal Çufalı Ş, Aypak A, Köksal M, Güneş YC, Özcan KM. Correlation of olfactory dysfunction with lung involvement and severity of COVID-19. Ir J Med Sci 2021; 191:1843-1848. [PMID: 34374938 PMCID: PMC8352757 DOI: 10.1007/s11845-021-02732-x] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2021] [Accepted: 07/29/2021] [Indexed: 12/14/2022]
Abstract
Background Olfactory dysfunction (OD) is a significant symptom of COVID-19 and may be the earliest symptom, or it may sometimes be the only manifestation of the disease. Aims To investigate whether OD is correlated with chest computed tomography (CT) findings, blood test parameters, and disease severity in COVID-19 patients. Methods The files of COVID-19 patients were retrospectively reviewed, and the ones who had information about smelling status and CT were taken into consideration. A total of 180 patients were divided into two groups: the OD group consisted of 89 patients with self-reported OD, and the No-OD group consisted of 91 subjects who did not complain of OD. The two groups were compared for the amount of lung consolidation on CT, intensive care unit (ICU) admission, and blood test parameters (complete blood count, alanine aminotransferase (ALT), aspartate aminotransferase (AST), creatine kinase (CK), lactate dehydrogenase (LDH), C-reactive protein (CRP), erythrocyte sedimentation rate (ESR), ferritin, D-dimer, interleukin-6 (IL-6)). Results The amount of lung consolidation and ICU admission were significantly higher in the No-OD group (p < 0.001 for both). White blood cell (p = 0.06), monocyte (p = 0.26), and platelet (p = 0.13) counts and hemoglobin (p = 0.63), ALT (p = 0.89), and D-dimer (p = 0.45) levels of the two groups were similar. Lymphocyte count (p = 0.01), neutrophil count (p = 0.01), and AST (p = 0.03), CK (p = 0.01), LDH (p < 0.001), CRP (p < 0.001), ESR (p < 0.001), ferritin (p < 0.001), and IL-6 (p < 0.001) levels were significantly higher in the No-OD group. Conclusions The patients presenting to the hospital with self-reported OD may have less lung involvement and a milder disease course compared to patients without OD on admission.
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Affiliation(s)
- Ali R. Yağmur
- Department of Otorhinolaryngology, Head and Neck Surgery, Ankara City Hospital, Ankara, Turkey
- Ankara, Turkey
| | - Şeyda Akbal Çufalı
- Department of Otorhinolaryngology, Head and Neck Surgery, Ankara City Hospital, Ankara, Turkey
| | - Adalet Aypak
- Department of Clinical Microbiology and Infectious Diseases, Ankara City Hospital, Ankara, Turkey
| | - Murathan Köksal
- Department of Radiology, Ankara City Hospital, Ankara, Turkey
| | - Yasin C. Güneş
- Department of Radiology, Ankara City Hospital, Ankara, Turkey
| | - Kürşat M. Özcan
- Department of Otorhinolaryngology, Head and Neck Surgery, Ankara City Hospital, Ankara, Turkey
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Gemcioglu E, Davutoglu M, Catalbas R, Karabuga B, Kaptan E, Aypak A, Kalem AK, Özdemir M, Yeşilova NY, Kalkan EA, Civak M, Kücüksahin O, Erden A, Ates I. Predictive values of biochemical markers as early indicators for severe COVID-19 cases in admission. Future Virol 2021. [PMCID: PMC8114836 DOI: 10.2217/fvl-2020-0319] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
Aim: COVID-19 is a pandemic that causes high morbidity and mortality, especially in severe patients. In this study, we aimed to search and explain the relationship between biochemical markers, which are more common, easily available and applicable to diagnose and to stage the disease. Materials & methods: In this study, 609 patients were evaluated retrospectively. 11 biochemical parameters were included in analysis to explain the relationship with severity of disease. Results: Nearly, all the parameters that have been evaluated in this study were statistically valuable as a predictive parameter for severe disease. Areas under the curve of blood urea nitrogen (BUN)/albumin ratio (BAR), CALL score and lymphocyte/C-reactive protein ratio were 0.795, 0.778 and 0.770. The BAR and neutrophil/albumin ratios provide important prognostic information for decision-making in severe patients with COVID-19. Conclusion: High BAR and neutrophil/albumin ratios may be a better predictor of severity COVID-19 than other routinely used parameters in admission.
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Affiliation(s)
- Emin Gemcioglu
- Ankara City Hospital, Department of Internal Medicine, Ankara 06800, Turkey
| | - Mehmet Davutoglu
- Yıldırım Beyazıt University School of Medicine, Department of Internal Medicine, Ankara 06800, Turkey
| | - Ramis Catalbas
- Yıldırım Beyazıt University School of Medicine, Department of Internal Medicine, Ankara 06800, Turkey
| | - Berkan Karabuga
- Yıldırım Beyazıt University School of Medicine, Department of Internal Medicine, Ankara 06800, Turkey
| | - Enes Kaptan
- Yıldırım Beyazıt University School of Medicine, Department of Internal Medicine, Ankara 06800, Turkey
| | - Adalet Aypak
- Ankara City Hospital, Department of Infectious Diseases & Clinical Microbiology, Ankara 06800, Turkey
| | - Ayse K Kalem
- Yıldırım Beyazıt University School of Medicine, Department of Infectious Diseases & Clinical Microbiology, Ankara 06800, Turkey
| | - Mustafa Özdemir
- Ankara City Hospital, Department of Internal Medicine, Ankara 06800, Turkey
| | - Necati Y Yeşilova
- Ankara City Hospital, Department of Internal Medicine, Ankara 06800, Turkey
| | - Emra A Kalkan
- Ankara City Hospital, Department of Internal Medicine, Ankara 06800, Turkey
| | - Musa Civak
- Ankara City Hospital, Department of Internal Medicine, Ankara 06800, Turkey
| | - Orhan Kücüksahin
- Yıldırım Beyazıt University School of Medicine, Department of Rheumatology, Ankara 06800, Turkey
| | - Abdulsamet Erden
- Ankara City Hospital, Department of Rheumatology, Ankara 06800, Turkey
| | - Ihsan Ates
- Ankara City Hospital, Department of Internal Medicine, Ankara 06800, Turkey
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14
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Eser F, Kayaaslan B, Güner R, Hasanoğlu I, Kaya Kalem A, Aypak A, Akinci E. The Effect of prolonged PCR Positivity on patient Outcomes and Determination of Isolation period in COVID-19 patients. Int J Clin Pract 2021; 75:e14025. [PMID: 33449410 PMCID: PMC7995230 DOI: 10.1111/ijcp.14025] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/13/2020] [Revised: 10/22/2020] [Accepted: 12/14/2020] [Indexed: 01/12/2023] Open
Abstract
AIMS The impact of ongoing PCR positivity on COVID-19 patients and the strategy and period of isolation were not fully understood. We aimed to investigate the factors that cause prolonged PCR positivity and its clinical impact on COVID-19 infection. In addition, we searched for an answer on what length of time would be best for isolation. METHODS Patients with confirmed COVID-19 infection were included in this retrospective study. Patients with PCR positivity (after symptom onset) longer than 14 days and PCR positivity less than 14 days were compared. The relationship between duration of symptoms and PCR negation time was examined. RESULTS A total of 339 patients were included in this study. Fifty (14%) patients had prolonged PCR positivity after 14 days. Demographic and clinical features, and clinical outcomes (disease severity and mortality) were similar among the two groups. Age (p 0.035) and symptom duration at admission (P < .001) were found as independent factors for prolonged PCR positivity. Median of total symptom duration was 7 days (IQR: 5-11). The duration of negative conversion of PCR test was median 9 days (IQR: 7-12) after symptom onset and PCR tests became negative 3 days (IQR: 2-5) after symptom improvement. CONCLUSIONS We found that ongoing PCR positivity has no detrimental effect on the course of the disease and clinical outcomes in COVID-19 patients. In addition, our results showed that isolation may be discontinued 10-14 days after symptom onset and/or after 2-5 days after resolution of symptoms. This results also support WHO and ECDC recommendations on this matter.
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Affiliation(s)
- Fatma Eser
- Ankara City Hospital, Faculty of Medicine, Infectious Disease and Clinical MicrobiologyAnkara Yildirim Beyazit UniversityAnkaraTurkey
| | - Bircan Kayaaslan
- Ankara City Hospital, Faculty of Medicine, Infectious Disease and Clinical MicrobiologyAnkara Yildirim Beyazit UniversityAnkaraTurkey
| | - Rahmet Güner
- Ankara City Hospital, Faculty of Medicine, Infectious Disease and Clinical MicrobiologyAnkara Yildirim Beyazit UniversityAnkaraTurkey
| | - Imran Hasanoğlu
- Ankara City Hospital, Faculty of Medicine, Infectious Disease and Clinical MicrobiologyAnkara Yildirim Beyazit UniversityAnkaraTurkey
| | - Ayse Kaya Kalem
- Ankara City Hospital, Faculty of Medicine, Infectious Disease and Clinical MicrobiologyAnkara Yildirim Beyazit UniversityAnkaraTurkey
| | - Adalet Aypak
- Ankara City Hospital, Infectious Disease and Clinical MicrobiologyUniversity of Health SciencesAnkaraTurkey
| | - Esragul Akinci
- Ankara City Hospital, Infectious Disease and Clinical MicrobiologyUniversity of Health SciencesAnkaraTurkey
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Kalem AK, Kayaaslan B, Neselioglu S, Eser F, Hasanoglu İ, Aypak A, Akinci E, Akca HN, Erel O, Guner R. A useful and sensitive marker in the prediction of COVID-19 and disease severity: Thiol. Free Radic Biol Med 2021; 166:11-17. [PMID: 33588050 PMCID: PMC7880846 DOI: 10.1016/j.freeradbiomed.2021.02.009] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/17/2020] [Revised: 02/01/2021] [Accepted: 02/04/2021] [Indexed: 12/11/2022]
Abstract
Thiol-disulphide homeostasis (TDH) is a new parameter indicating oxidative stress that plays a role in the pathogenesis of various clinical disorders. Our study planned to investigate TDH in COVID-19 patients. Age and gender-matched healthy subjects (n = 70) and COVID-19 patients (n = 144) were included in the study. In addition to the routine laboratory parameters of the groups, their native thiol (NT), total thiol (TT) and disulphide levels were measured. Primarily, we compared COVID-19 patients to the healthy control group for inflammatory parameters, NT, TT and disulphide levels. Then, COVID-19 patients were divided into two groups according to the severity of the disease as mild to moderate and severe COVID-19, and the three groups were compared with each other. Predictive value of thiol parameters in the diagnosis of COVID-19 and in the determining its severity, and its correlation with presence and duration of symptoms were investigated. Severe COVID-19 patients had lower NT and TT levels compared with healthy controls and mild to moderate patients (P < 0.001 for both). The results of ROC analysis show that the greatest AUC was IL-6 and NT (AUC = 0.97, AUC = 0.96, respectively) between control and COVID-19 patients, while it was CRP and NT (AUC = 0.85, AUC = 0.83) between mild to moderate and severe patients. A negative correlation was found between duration of symptoms of dyspnoea, cough, fever, and sore throat and NT (r = -0.45, P = 0.017, r = -0.418, P < 0.001, r = -0.131, P = 0.084, r = -0.452, P = 0.040, respectively). NT and TT levels have a strong predictive value in the diagnosis of COVID-19 and in determining disease severity. Our results support that changing TDH parameters appears to have an important role in disease pathogenesis and it can be used in clinical management of patients.
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Affiliation(s)
- Ayse Kaya Kalem
- Department of Infectious Diseases and Clinical Microbiology, Faculty of Medicine, Ankara Yildirim Beyazit University, Ankara City Hospital, Ankara, Turkey.
| | - Bircan Kayaaslan
- Department of Infectious Diseases and Clinical Microbiology, Faculty of Medicine, Ankara Yildirim Beyazit University, Ankara City Hospital, Ankara, Turkey
| | - Salim Neselioglu
- Department of Biochemistry, Faculty of Medicine, Ankara Yildirim Beyazit University, Ankara City Hospital, Ankara, Turkey
| | - Fatma Eser
- Department of Infectious Diseases and Clinical Microbiology, Faculty of Medicine, Ankara Yildirim Beyazit University, Ankara City Hospital, Ankara, Turkey
| | - İmran Hasanoglu
- Department of Infectious Diseases and Clinical Microbiology, Faculty of Medicine, Ankara Yildirim Beyazit University, Ankara City Hospital, Ankara, Turkey
| | - Adalet Aypak
- Department of Infectious Diseases and Clinical Microbiology, Ankara City Hospital, Ankara, Turkey
| | - Esragul Akinci
- Department of Infectious Diseases and Clinical Microbiology, Faculty of Medicine, University of Health Sciences, Ankara City Hospital, Ankara, Turkey
| | - H Nisa Akca
- Department of Infectious Diseases and Clinical Microbiology, Faculty of Medicine, Ankara Yildirim Beyazit University, Ankara City Hospital, Ankara, Turkey
| | - Ozcan Erel
- Department of Biochemistry, Faculty of Medicine, Ankara Yildirim Beyazit University, Ankara City Hospital, Ankara, Turkey
| | - Rahmet Guner
- Department of Infectious Diseases and Clinical Microbiology, Faculty of Medicine, Ankara Yildirim Beyazit University, Ankara City Hospital, Ankara, Turkey
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Guner R, Hasanoglu I, Kayaaslan B, Aypak A, Akinci E, Bodur H, Eser F, Kaya Kalem A, Kucuksahin O, Ates I, Bastug A, Tezer Tekce Y, Bilgic Z, Gursoy FM, Akca HN, Izdes S, Erdem D, Asfuroglu E, Hezer H, Kilic H, Cıvak M, Aydogan S, Buzgan T. Comparing ICU admission rates of mild/moderate COVID-19 patients treated with hydroxychloroquine, favipiravir, and hydroxychloroquine plus favipiravir. J Infect Public Health 2021; 14:365-370. [PMID: 33647553 PMCID: PMC7771901 DOI: 10.1016/j.jiph.2020.12.017] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2020] [Revised: 12/10/2020] [Accepted: 12/15/2020] [Indexed: 12/20/2022] Open
Abstract
BACKGROUND In this study, we aimed to compare the intensive care unit (ICU) admission rate of hospitalized mild/moderate COVID-19 patients treated with hydroxychloroquine (HCQ), favipiravir, and HCQ plus favipiravir. METHODS Single center retrospective designed observational study conducted in Ankara City Hospital. Patients who were hospitalized between March 15, 2020 and June 1, 2020 in COVID-19 inpatient clinics with laboratory confirmed diagnosis of COVID-19 were included in the study. An inverse probability of treatment weighting (IPTW) for multiple treatment groups approach was used to balance the differences in several variables on admission. RESULTS Among 2441 patients hospitalized with diagnosis of COVID-19 during the study period, 824 were eligible for the analysis. Median age of patients was 42 (18-93 years). Among all, 347 (43.2%) of the patients had mild disease, 470 (56.8%) had pneumonia. Propensity scores ranged from 0.1841 to 0.9381 in the HCQ group, from 0.03643 to 0.29885 in the favipiravir group, and from 0.03542 to 0.56184 in the HCQ plus favipiravir group. After IPTW for multiple treatment groups was applied, all the covariates in the planned propensity score had weighted standardized effect sizes below 10% which were ranged from 0.005 to 0.092. Multivariate analysis of treatment effect (adjusted effect of treatment) was indicated that there is no statistically significant difference between HCQ, favipiravir, and HCQ plus favipiravir treatment. After using combination of SMOTE and Bootstrap resampling approach, we found no statistically significant difference between HCQ and HCQ plus favipiravir groups in terms of ICU admission. However, compared with the HCQ group, ICU admission rate was statistically significantly higher in the favipiravir group. We obtained the similar results after the sensitivity analysis. CONCLUSIONS HCQ with or without favipiravir treatment is associated with reduced risk of ICU admission compared to favipiravir alone in mild to moderate COVID-19 adult patients.
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Affiliation(s)
- Rahmet Guner
- Department of Infectious Disease and Clinical Microbiology, Ankara Yildirim Beyazit University, Ankara City Hospital, Ankara, Turkey.
| | - Imran Hasanoglu
- Department of Infectious Disease and Clinical Microbiology, Ankara Yildirim Beyazit University, Ankara City Hospital, Ankara, Turkey.
| | - Bircan Kayaaslan
- Department of Infectious Disease and Clinical Microbiology, Ankara Yildirim Beyazit University, Ankara City Hospital, Ankara, Turkey.
| | - Adalet Aypak
- Department of Infectious Disease and Clinical Microbiology, Ankara City Hospital, Ankara, Turkey.
| | - Esragul Akinci
- Department of Infectious Disease and Clinical Microbiology, University of Health Sciences, Ankara City Hospital, Ankara, Turkey.
| | - Hurrem Bodur
- Department of Infectious Disease and Clinical Microbiology, University of Health Sciences, Ankara City Hospital, Ankara, Turkey.
| | - Fatma Eser
- Department of Infectious Disease and Clinical Microbiology, Ankara Yildirim Beyazit University, Ankara City Hospital, Ankara, Turkey.
| | - Ayse Kaya Kalem
- Department of Infectious Disease and Clinical Microbiology, Ankara Yildirim Beyazit University, Ankara City Hospital, Ankara, Turkey.
| | - Orhan Kucuksahin
- Department of Rheumatology, Ankara Yildirim Beyazit University, Ankara City Hospital, Ankara, Turkey.
| | - Ihsan Ates
- Department of Internal Medicine, Ankara City Hospital, Ankara, Turkey.
| | - Aliye Bastug
- Department of Infectious Disease and Clinical Microbiology, University of Health Sciences, Ankara City Hospital, Ankara, Turkey.
| | - Yasemin Tezer Tekce
- Department of Infectious Disease and Clinical Microbiology, Ankara City Hospital, Ankara, Turkey.
| | - Zeynep Bilgic
- Department of Infectious Disease and Clinical Microbiology, Ankara City Hospital, Ankara, Turkey.
| | - Fahriye Melis Gursoy
- Department of Infectious Disease and Clinical Microbiology, Ankara City Hospital, Ankara, Turkey.
| | - Hatice Nisa Akca
- Department of Infectious Disease and Clinical Microbiology, Ankara City Hospital, Ankara, Turkey.
| | - Seval Izdes
- Department of Anaesthesiology and Reanimation, Ankara Yildirim Beyazit University, Ankara City Hospital, Ankara, Turkey.
| | - Deniz Erdem
- Department of Anaesthesiology and Reanimation, Ankara City Hospital, Ankara, Turkey.
| | - Emra Asfuroglu
- Department of Internal Medicine, Ankara City Hospital, Ankara, Turkey.
| | - Habibe Hezer
- Department of Pulmonary Diseases, Ankara City Hospital, Ankara, Turkey.
| | - Hatice Kilic
- Department of Pulmonary Diseases, Ankara Yildirim Beyazit University, Ankara City Hospital, Ankara, Turkey.
| | - Musa Cıvak
- Department of Internal Medicine, Ankara City Hospital, Ankara, Turkey.
| | - Sibel Aydogan
- Department of Virology, Ankara City Hospital, Ankara, Turkey.
| | - Turan Buzgan
- Department of Infectious Disease and Clinical Microbiology, Ankara Yildirim Beyazit University, Ankara City Hospital, Ankara, Turkey.
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Erden A, Ozdemir B, Karakas O, Mutlu NM, Izdes S, Kalem AK, Bilir YA, Aypak A, Akinci E, Guner R, Kucuksahin O. Evaluation of 17 patients with COVID-19 pneumonia treated with anakinra according to HScore, SOFA, MuLBSTA, and Brescia-COVID respiratory severity scale (BCRSS) scoring systems. J Med Virol 2020; 93:1532-1537. [PMID: 32860431 DOI: 10.1002/jmv.26473] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [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: 08/03/2020] [Revised: 08/24/2020] [Accepted: 08/26/2020] [Indexed: 01/08/2023]
Abstract
COVID-19 pandemic has been affecting the whole world by increasing morbidity and mortality rates day by day. Treatment algorithms have been attempted as parallel to the increasing experience with COVID-19. In the pathogenesis of this virus pro-inflammatory cytokine storm has been called to have the main role. The right timing should be made for treatments. We proposed IL- 1 blocking by anakinra in seventeen COVID-19 patients at high risk of worsening. Patients were assessed according to HScore, SOFA (Sequential Organ Failure Assessment Score = SOFA), MuLBSTA Score (multilobular infiltration, hypo-lymphocytosis, bacterial coinfection, smoking history, hyper-tension, and age), Brescia-COVID respiratory severity scale (BCRSS). In our study, the mortality rate was 17.6%. Consequently, 1 (5.9%) patient was receiving low-flow oxygen supply, 3 (17.6%) patients needed no longer oxygen supply and 10 (58.8%) patients were discharged from the hospital. According to the results of our study in the manner of general evaluation; we found that SOFA, MuLBSTA, and BCRSS scores were one step ahead according to HScore being insufficient to determine early phases of the disease. In our opinion, the prominent factors that emphasize the use of anakinra could be listed as comorbidity, risk, or presence of secondary infection, ongoing malignant disease. However, the other factors that enhance the use of anakinra in the situation of viremia also could be sorted as no response to full dose antivirals, antiviral side effects, or no success to antiviral treatment.
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Affiliation(s)
- Abdulsamet Erden
- Division of Rheumatology, Department of Internal Medicine, Ankara City Hospital, Ankara, Turkey
| | - Bahar Ozdemir
- Division of Rheumatology, Department of Internal Medicine, Ankara City Hospital, Ankara, Turkey
| | - Ozlem Karakas
- Division of Rheumatology, Department of Internal Medicine, Ankara City Hospital, Ankara, Turkey
| | - Nevzat Mehmet Mutlu
- Department of Anesthesiology and Reanimation-Critical Care, Ankara City Hospital, Ankara, Turkey
| | - Seval Izdes
- Department of Anesthesiology and Reanimation-Critical Care, Ankara City Hospital, Yıldırım Beyazıt University, Ankara, Turkey
| | - Ayse Kaya Kalem
- Department of Infectious Diseases and Clinical Microbiology, Ankara City Hospital, Yıldırım Beyazıt University, Ankara, Turkey
| | - Yeşim Aybar Bilir
- Department of Infectious Diseases and Clinical Microbiology, Ankara City Hospital, Ankara, Turkey
| | - Adalet Aypak
- Department of Infectious Diseases and Clinical Microbiology, Ankara City Hospital, Ankara, Turkey
| | - Esragul Akinci
- Department of Infectious Diseases and Clinical Microbiology, Ankara City Hospital, University of Health Sciences, Ankara, Turkey
| | - Rahmet Guner
- Department of Infectious Diseases and Clinical Microbiology, Ankara City Hospital, Yıldırım Beyazıt University, Ankara, Turkey
| | - Orhan Kucuksahin
- Department of Internal Medicine, Division of Rheumatology, Ankara City Hospital, Yıldırım Beyazıt University, Ankara, Turkey
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Abstract
Measurements are one of the most important means of evaluating the quality of antibiotic consumption. This study has evaluated the antibiotic consumption using one-day point prevalence study data collected from different hospitals in Turkey. This research was planned as a multicenter point surveillance study which aimed demonstrating the use of antibiotics among inpatients in Turkey. On the day of surveillance, demographic data from 21,920 inpatients, names of antibiotics used by the inpatients, number of antibiotics approved by infectious disease specialist (IDS), and the length of antibiotic use were recorded. These results showed that 30.3% of patients were using antibiotics and 57.7% of those were IDS-approved. The rate of IDS-approved antibiotic consumption was higher for internal medicine wards and in intensive care units, whereas non-IDS-approved antibiotics were used among inpatients of surgical wards.
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Affiliation(s)
- Oguz Karabay
- Faculty of Medicine, Department of Infectious Diseases and Clinical Microbiology, Sakarya University Education and Research Hospital, Sakarya, Turkey
| | - Nevin Ince
- Faculty of Medicine, Department of Infectious Diseases and Clinical Microbiology, Düzce University School of Medicine, Düzce, Turkey
| | - Adalet Aypak
- Clinic of infectious Diseases and Clinical Microbiology, Ankara Numune Teaching and Research Hospital, Health Sciences University, Ankara, Turkey
| | - Ertugrul Guclu
- Faculty of Medicine, Department of Infectious Diseases and Clinical Microbiology, Sakarya University Education and Research Hospital, Sakarya, Turkey
| | - Hurrem Bodur
- Clinic of infectious Diseases and Clinical Microbiology, Ankara Numune Teaching and Research Hospital, Health Sciences University, Ankara, Turkey
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19
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But A, Yetkin MA, Kanyilmaz D, Aslaner H, Baştuğ A, Aypak A, Öngürü P, Akinci E, Mutlu NM, Bodur H. Analysis of epidemiology and risk factors for mortality in ventilator-associated pneumonia attacks in intensive care unit patients. Turk J Med Sci 2017; 47:812-816. [PMID: 28618727 DOI: 10.3906/sag-1601-38] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [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: 01/08/2016] [Accepted: 12/15/2016] [Indexed: 11/03/2022] Open
Abstract
BACKGROUND/AIM The aim of this study was to investigate the epidemiologic characteristics, the causative microorganisms and their antimicrobial susceptibility patterns, and the prognostic risk factors for mortality in critically ill patients with ventilator-associated pneumonia (VAP). MATERIALS AND METHODS In this retrospective observational study, all the critically ill patients with VAP hospitalized in a medical/surgical intensive care unit (ICU) between January 2010 and June 2015 were evaluated. Patients' demographic features and microbiological data were reviewed. RESULTS A total of 417 patients were clinically diagnosed with VAP; 51.1% of them were male and the average age was found as 69.9 ± 15.9 years. VAP was detected at approximately 25.0 ± 18.0 days of ICU stay and 17.9 ± 12.6 days after intubation. Acinetobacter baumannii (69.5%) was isolated as the most frequent VAP agent, and the most effective antibiotic was colistin. The crude mortality rate was detected as 39.8% among the patients. The presence of dyspnea at admission, coronary heart disease as a comorbidity, unconsciousness at admission, steroid usage, and prolonged hospital stay were observed as independent risk factors in multivariate analysis (P < 0.01). CONCLUSION According to the etiological microorganisms and antimicrobial susceptibility patterns, colistin was found to be the most reliable antibiotic for empirical antimicrobial therapy.
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Affiliation(s)
- Ayşe But
- Department of Infectious Diseases and Clinical Microbiology, Ankara Numune Education and Research Hospital, Ankara, Turkey
| | - Meltem Arzu Yetkin
- Department of Infectious Diseases and Clinical Microbiology, Ankara Numune Education and Research Hospital, Ankara, Turkey
| | - Dilek Kanyilmaz
- Infection Control Committee, Ankara Numune Education and Research Hospital, Ankara, Turkey
| | - Halide Aslaner
- Department of Infectious Diseases and Clinical Microbiology, Ankara Numune Education and Research Hospital, Ankara, Turkey
| | - Aliye Baştuğ
- Department of Infectious Diseases and Clinical Microbiology, Ankara Numune Education and Research Hospital, Ankara, Turkey
| | - Adalet Aypak
- Department of Infectious Diseases and Clinical Microbiology, Ankara Numune Education and Research Hospital, Ankara, Turkey
| | - Pınar Öngürü
- Department of Infectious Diseases and Clinical Microbiology, Ankara Numune Education and Research Hospital, Ankara, Turkey
| | - Esragül Akinci
- Department of Infectious Diseases and Clinical Microbiology, Ankara Numune Education and Research Hospital, Ankara, Turkey
| | - Nevzat Mehmet Mutlu
- Department of Anesthesiology and Reanimation, Ankara Numune Education and Research Hospital, Ankara, Turkey
| | - Hürrem Bodur
- Department of Infectious Diseases and Clinical Microbiology, Ankara Numune Education and Research Hospital, Ankara, Turkey
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20
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Hazirolan G, Aypak A, Aksu N. An unusual case of urinary tract infection caused by Saprochaete capitata under anidulafungin treatment. J Mycol Med 2017; 27:387-390. [PMID: 28478968 DOI: 10.1016/j.mycmed.2017.04.001] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [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: 01/05/2017] [Revised: 03/09/2017] [Accepted: 04/04/2017] [Indexed: 11/28/2022]
Abstract
Saprochaete capitata may cause uncommon severe infections, especially in immunocompromised patients. Here, we describe a rare case of urinary tract infection by S. capitata in a chronic kidney disease and diabetes mellitus patient, which occur during anidulafungin therapy. Mycological examinations of urine were positive to S. capitata identified by mass spectrometry and confirmed by ITS sequencing. Minimum inhibitory concentration (MIC) of the isolate for amphotericin B, fluconazole, itraconazole, voriconazole and, anidulafungin were 2, 16, 1, 1, and 8μg/mL, respectively. Presence of S. capitata infection was not known. Clinicians should be aware about these rare opportunistic fungal pathogens, particularly those with intrinsic or variable resistance to antifungals including echinocandins.
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Affiliation(s)
- G Hazirolan
- Medical microbiology, Ankara Numune training and research hospital, Ulku Mahallesi Talatpasa Bulvari No. 5 Altindag, 06100 Ankara, Turkey.
| | - A Aypak
- Clinical microbiology and infectious disease department, Ankara Numune training and research hospital, Ulku Mahallesi Talatpasa Bulvari, No. 5 Altindag, 06100 Ankara, Turkey
| | - N Aksu
- Medical microbiology, Ankara Numune training and research hospital, Ulku Mahallesi Talatpasa Bulvari No. 5 Altindag, 06100 Ankara, Turkey
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Abstract
BACKGROUND Brucellosis produces a variety of non-specific hematological abnormalities. The aim of the present study was to evaluate the hematological findings in childhood brucellosis. METHODS Medical records of children with brucellosis admitted to a tertiary hospital in a 1 year period, were analyzed retrospectively. RESULTS Sixty-nine patients (mean age, 14.5 ± 3.3 years) were diagnosed with brucellosis. The most common hematological finding was thrombocytopenia (n = 11, 15.9%). Thrombocytosis was detected in five patients (7.3%), leukopenia in four (5.8%), anemia in three (4.3%), and bicytopenia in three (4.3%). None of the patients had pancytopenia. Blood culture was positive for Brucella spp. in 41 patients (59.4%). Among those patients with positive blood culture, six (14.6%) had serum agglutination test titer ≤1/80. Platelet (PLT) count was significantly lower in the bacteremia-positive group. The OR (95%CI) of bacteremia for PLT cut-off 200,000/mm(3) was 0.148 (95%CI: 0.031-0.718) and relative risk was 1.718 (95%CI: 1.244-2.372; P = 0.010). CONCLUSIONS Brucellosis should be kept in mind in the differential diagnosis of isolated thrombocytopenia in pediatric patients from endemic areas.
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Affiliation(s)
- Adalet Aypak
- Department of Infectious Diseases and Clinical Microbiology
| | - Cenk Aypak
- Department of Family Medicine, Van Gevaş State Hospital
| | - Yasemin Bayram
- Microbiology Laboratory, Van Training and Research Hospital, Van, Turkey
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22
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Sunnetcioglu M, Baran AI, Sunnetcioglu A, Mentes O, Karadas S, Aypak A. Clinical and laboratory features of adult measles cases detected in Van, Turkey. J PAK MED ASSOC 2015; 65:273-276. [PMID: 25933560] [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] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
OBJECTIVE To evaluate adult measles patients with respect to their clinical and laboratory findings as well as complications. METHODS The retrospective study was conducted at YuzuncuYil University, Van, Turkey, between December 2012 and June 2013, and comprised cases diagnosed with measles. The diagnosis was based on clinical findings and all were serologically confirmed with the presence of Anti-measles Immunoglobulin M antibodies. RESULTS Of the 50 records studied, 41(84%) related to women. Overall mean age was 25.52±4.07 years. The most common symptoms were fever and rash 50(100%), malaise 49(98%), cough 48(96%), headache 44(88%) and sore throat 36(72%). The presence of Koplik spots, lymphadenopathy and hepatomegaly were observed in 3(6%), 6(12%) and 2(4%) patients respectively. Thrombocytopenia and elevated liver enzymes were detected in 26(52%) and 22(44%)patients. Pneumonia was the most common complication in 9(18%) patients. Other respiratory complications were bronchitis 5(10%) and laryngotracheitis 6(12%). Of the cases, 9(18%) exhibited otitis media. Premature delivery and spontaneous abortus occurred in 2(4%) and 3(6%) patients of the 15(30%) pregnant women. CONCLUSIONS Measles continues to be an important health problem in Turkey and needs an effective elimination programme.
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Affiliation(s)
- Mahmut Sunnetcioglu
- Department of Infectious Diseases, Faculty of Medicine, YuzuncuYil University, Van, Turkey
| | - Ali Irfan Baran
- Department of Infectious Diseases, Faculty of Medicine, YuzuncuYil University, Van, Turkey
| | - Aysel Sunnetcioglu
- Department of Pulmonary Diseases, Faculty of Medicine, YuzuncuYil University, Van, Turkey
| | - Osman Mentes
- Department of Infectious Diseases, Bingol State Hospital, Bingol, Turkey
| | - Sevdegul Karadas
- Department of Emergency Medicine, Faculty of Medicine, YuzuncuYil University, Van, Turkey
| | - Adalet Aypak
- Department of Infectious Diseases, Numune Training and Research Hospital, Ankara, Turkey
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23
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Azap A, Bozkurt GY, Yüksel MK, Kutlu H, Topçuoğlu P, Aypak A, Akan H. Secondary infections in cancer patients with febrile neutropenia. Turk J Haematol 2012; 29:254-8. [PMID: 24744669 PMCID: PMC3986750 DOI: 10.5152/tjh.2011.75] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2011] [Accepted: 05/17/2011] [Indexed: 11/22/2022] Open
Abstract
OBJECTIVE Patients with neutropenia due to cancer chemotherapy are prone to severe infections. Cancer patients canexperience >1 infectious episode during the same period of neutropenia. This study aimed to determine the etiologicaland clinical characteristics of secondary infectious episodes in cancer patients with febrile neutropenia and to identifythe factors associated with the risk of secondary infectious episodes. MATERIAL AND METHODS All cancer patients that received antineoplastic chemotherapy at Ankara University, School ofMedicine, Department of Hematology between May 2004 and May 2005 and developed neutropenia were included in thestudy. Data were collected using survey forms that were completed during routine infectious diseases consultation visits.Categorical data were analyzed using the chi-square test, whereas Student's t-test was used for continuous variables.Multivariate logistic regression analysis was performed to identify independent predictors of secondary infections (SIs). RESULTS SIs were observed during 138 (53%) of 259 febrile neutropenic episodes. Of the 138 episodes, 89 (64.5%)occurred in male patients with a mean age of 40.9 years (range: 17-76 years). In total, 80% of the SIs were clinically ormicrobiologically documented. Factors on d 4 of the initial febrile episode were analyzed via a logistic regression model. The presence of a central intravenous catheter (OR: 3.01; P<0.001), acute myeloid leukemia (AML) as the underlyingdisease (OR: 2.12; P=0.008), diarrhea (OR: 4.59; P=0.005), and invasive aspergillosis (IA) during the initial febrileepisode (OR: 3.96; P=0.009) were statistically significant risk factors for SIs. CONCLUSION Among the cancer patients with neutropenia in the present study, AML as the underlying disease, thepresence of a central venous catheter, diarrhea, and IA during the initial febrile episode were risk factors for thedevelopment of SIs.
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Affiliation(s)
- Alpay Azap
- Ankara University, School of Medicine, Department of Infectious Diseases and Clinical Microbiology, Ankara, Turkey
| | - Gülden Yılmaz Bozkurt
- Ankara University, School of Medicine, Department of Infectious Diseases and Clinical Microbiology, Ankara, Turkey
| | | | - Hakan Kutlu
- Ankara University, School of Medicine, Department of Infectious Diseases and Clinical Microbiology, Ankara, Turkey
| | - Pervin Topçuoğlu
- Ankara University, School of Medicine, Department of Hematology, Ankara, Turkey
| | - Adalet Aypak
- Ankara Numune Education and Research Hospital, Department of First Infectious Diseases and Clinical Microbiology, Ankara Turkey
| | - Hamdi Akan
- Ankara University, School of Medicine, Department of Hematology, Ankara, Turkey
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24
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Azap A, Yilmaz Bozkurt G, Kurt Yuksel M, Kutlu H, Topcuoglu P, Aypak A, Akan H. Secondary Infections in Cancer Patients with Febrile Neutropenia. Turk J Haematol 2012. [DOI: 10.5505/tjh.2012.24654] [Citation(s) in RCA: 4] [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: 11/04/2022] Open
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Abstract
Our aim was to compare the clinical, radiological and prognostic features of spontaneous spondylodiscitis secondary to tuberculosis (TS) and brucellosis (BS). This prospective study involved 41 patients diagnosed with spondylodiscitis. Of these, 18 (43.1%) had BS and 23 (56.1%) had TS. The mean age of TS patients was 52 ± 13.43 years and older than BS patients ( P < 0.001). A prolonged clinical course of the disease, constitutional symptoms, lymphocytosis, increased erythrocyte sedimentation rate (ESR), presence of posterior vertebrae lesions and psoas abscesses were significantly more frequent in the TS group. There are significant clinical, biological and radiological differences between TS and BS. These differences permit a presumptive aetiological diagnosis and orient the initial empirical medical treatment while awaiting a final microbiological diagnosis.
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Affiliation(s)
- Ali Kutta Çelik
- Department of Clinical Microbiology and Infectious Disease, Van Education and Research Hospital, 65100 Van
| | - Adalet Aypak
- Department of Clinical Microbiology and Infectious Disease, Van Education and Research Hospital, 65100 Van
| | - Cenk Aypak
- Department of Family Medicine, Gevas Hospital, 65110 Van, Turkey
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26
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Aypak A, Celik AK, Aypak C, Cikman O. Multidrug resistant typhoid fever outbreak in Ercek Village-Van, Eastern Anatolia, Turkey: clinical profile, sensitivity patterns and response to antimicrobials. Trop Doct 2010; 40:160-2. [PMID: 20478986 DOI: 10.1258/td.2010.090438] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
The present study discusses the clinical features and treatment outcomes during an outbreak caused by multidrug resistant (MDR) Salmonella typhi isolates from Van, Turkey. Of the 867 typhoid fever patients from the same village, 154 (17.8%) were hospitalised. A total of 42 (27.3%) cultures were positive. All S. typhi isolates were resistant to chloramphenicol, ampicillin and co-trimoxazole. Ceftriaxone was the most commonly used antibiotic (89%). It was found that the time-to-fever defervescence and the length of the hospital stay were greater for patients who were treated by ciprofloxacin than ceftriaxone (P < 0.001). Inappropriate antibiotic treatment should be discouraged in order to prevent the development of resistant strains of S. typhi.
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Affiliation(s)
- Adalet Aypak
- Department of Clinical Microbiology and Infectious Disease, Van Education and Research Hospital 65100, Van, Turkey.
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27
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Abstract
Hydatidosis is endemic in many Mediterranean countries, the Middle East, South America, Australia, New Zealand and Africa. It is caused by an infection from the Echinococcus granulosus larvae which can lead to the development of cysts. The most frequently affected organ is the liver. Splenic involvement alone is very rare. In this article, a case of an isolated giant splenic hydatid cyst is reported. The patient underwent splenectomy. The diagnosis of a hydatid cyst was confirmed by histopathology. This case suggests that hydatid disease should be considered as a differential diagnosis in every patient with a cystic mass of the spleen in endemic areas.
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Affiliation(s)
- Hatice Cabadak
- Department of Infectious Diseases and Clinical Microbiology, Türkiye Yüksek Ihtisas Education and Research Hospital, Ankara, Turkey
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