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İskender G, Mert D, Avşar Z, Kölgelier S, Ertek M. COVID-19 infection among healthcare workers in an oncology hospital. J Infect Dev Ctries 2023; 17:1246-1254. [PMID: 37824361 DOI: 10.3855/jidc.17404] [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: 09/20/2022] [Accepted: 03/27/2023] [Indexed: 10/14/2023] Open
Abstract
INTRODUCTION Healthcare workers are at high risk for acquiring COVID-19 and transmitting it to the patients especially to cancer patients in whom the risk of severe COVID-19 is high. We determined the rate of COVID-19 infection among healthcare workers in an oncology hospital and their epidemiological characteristics. METHODOLOGY Data of infected workers from March 11, 2020, to February 28, 2022 were obtained via Infection Control Committee COVID-19 Surveillance Records and evaluated retrospectively. RESULTS During this period 58.34% of 2,355 workers were vaccinated with > 3 doses of COVID-19 vaccines. A total of 1,294 COVID-19 attacks developed in 1,181 (50.14%) workers; mean age was 38.08 ± 9.52 years, 744 (63%) were female. Re-infection occurred in 112 (9.5%) workers. Source of infection in 858 attacks (66.31%) was unknown. Hospitalization was needed in 24 (2%) and intensive care unit admission in 1 (0.08%), no death occurred. In the first attacks, 587 (49.70%) were unvaccinated; in re-infections 66 (58.92%) were ≥ 3 doses vaccinated. Hospitalizations were predominantly in the pre-Delta period (16/24: 66.7%, p < 0.05). Re-infections occurred mostly in the Omicron variant period (p < 0.05). Relationship between hospitalization and male gender, age ≥ 50 years, "doctor" profession and presence of chronic diseases were significant (p < 0.05). CONCLUSIONS During the study period, half of the healthcare workers in our hospital developed COVID-19 infection of whom 9.5% re-infected, predominantly during the Omicron variant period. Our findings highlight the importance of taking preventive measures and administering booster vaccine doses even after initial vaccination/infection.
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Affiliation(s)
- Gülşen İskender
- University of Health Sciences Dr. Abdurrahman Yurtaslan Ankara Oncology Training and Research Hospital. Infectious Diseases and Clinical Microbiology Clinic, Ankara, Turkey
| | - Duygu Mert
- University of Health Sciences Dr. Abdurrahman Yurtaslan Ankara Oncology Training and Research Hospital. Infectious Diseases and Clinical Microbiology Clinic, Ankara, Turkey
| | - Zühal Avşar
- University of Health Sciences Dr. Abdurrahman Yurtaslan Ankara Oncology Training and Research Hospital. Infection Control Committee nursing staff. Ankara, Turkey
| | - Servet Kölgelier
- University of Health Sciences Dr. Abdurrahman Yurtaslan Ankara Oncology Training and Research Hospital. Infectious Diseases and Clinical Microbiology Clinic, Ankara, Turkey
| | - Mustafa Ertek
- University of Health Sciences Dr. Abdurrahman Yurtaslan Ankara Oncology Training and Research Hospital. Infectious Diseases and Clinical Microbiology Clinic, Ankara, Turkey
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Mert D, Iskender G, Kolgelier S, Ertek M. Evaluation of risk factors, causative pathogens, and treatment in recurrent percutaneous nephrostomy catheter-related urinary tract infections in cancer patients. Medicine (Baltimore) 2023; 102:e33002. [PMID: 37026920 PMCID: PMC10082244 DOI: 10.1097/md.0000000000033002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 04/08/2023] Open
Abstract
INTRODUCTION In cancer patients, percutaneous nephrostomy (PN) catheters can be used to relieve obstruction from chemotherapy, radiation therapy, or surgery, thereby improving kidney function and preventing further kidney damage. One of the complications of PN catheters is infections. Recurrent infections may delay chemotherapy, increase antimicrobial resistance with frequent antibiotic use, deteriorate the quality of life of patients, and increase costs. In this study, it was aimed to evaluate risk factors, causative pathogens, and treatment in recurrent PN catheter-related urinary tract infections in cancer patients. MATERIAL AND METHOD Cancer patients with PN catheter-associated urinary tract infection who were followed-up in the Infectious Diseases and Clinical Microbiology Clinic between January 1, 2012 and December 31, 2021 were included in the study. RESULTS The total catheterization time, and occurrence of preinfection catheter replacement, active chemotherapy, and kidney stones were significantly higher in patients with recurrent infection when compared to the other group (P = .000, P = .000, P = .007, and P = .018, respectively). ESBL-positive Escherichia coli and ESBL-positive Klebsiella pneumoniae were most commonly isolated from the PN catheter urine cultures of patients with recurrent infections. DISCUSSION Long-term use of the PN catheter increases the risk of urinary tract infection and sepsis. In this study, the total catheterization time, and occurrence of preinfection catheter replacement, active chemotherapy, and kidney stones were found to be risk factors for the development of recurrent PN catheter-related urinary tract infection in cancer patients. CONCLUSION It is important to know the risk factors in recurrent PN catheter-related urinary tract infections in cancer patients, take maximum protective measures, and follow-up. Knowing both the causative profile and the resistance rates will increase the chance of success in the treatment when empirical treatment is required. It should also be noted that these patients should be included in the group of patients who need prophylaxis for urinary tract infection.
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Affiliation(s)
- Duygu Mert
- Health Sciences University Dr. Abdurrahman Yurtaslan Ankara Oncology Training and Research Hospital, Department of Infectious Diseases and Clinical Microbiology, Ankara, Turkey
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Mert D, Ozer M, Merdin A, İskender G, Uncu Ulu B, Kizil Çakar M, Dal MS, Altuntaş F, Ertek M. Latent tuberculosis in adult hematopoietic stem cell transplantation recipients: Clinical experience from a previously endemic population. Medicine (Baltimore) 2022; 101:e31786. [PMID: 36401428 PMCID: PMC9678539 DOI: 10.1097/md.0000000000031786] [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] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/05/2022] Open
Abstract
Hematopoietic stem cell transplantation (HSCT) recipients may be at an elevated risk of developing active tuberculosis infection due to suppression in the cellular immune system. Herein, we aimed to evaluate the prevalence of latent tuberculosis and active tuberculosis in patients with allogeneic and autologous HSCT. In this cohort, data were obtained retrospectively from patients' records. The patients who were followed up in the bone marrow transplantation unit of the University of Health Sciences Dr Abdurrahman Yurtaslan Ankara Oncology Education and Research Hospital between January 2016 and December 2019 were screened for the study. And the HSCT recipients who had tuberculin skin test and/or QuantiFERON-TB gold (QFT-GIT) test results were included in the study. A total of 361 patients were included in the study, 227 patients had autologous HSCT, and 134 patients had allogeneic HSCT. QFT-GIT was performed in 10 patients with allogeneic HSCT, and it was found positive in only 1 patient. Tuberculin skin test ≥5 mm was accepted as positive and was accepted to have latent tuberculosis, and it was positive in 18.2% (41) of the patients with autologous HSCT and was positive in 21.6% (29) of the patients with allogeneic HSCT. There was no significant difference between the 2 groups (P = .429). Isoniazid (INH) prophylaxis was started in 16.7% of patients with autologous HSCT and 22.4% of patients with allogeneic HSCT. During follow-up, active tuberculosis did not develop in any patients in both groups. There was no statistically significant difference found between allogeneic and autologous HSCT recipients regarding the prevalence of latent tuberculosis. Active tuberculosis infection did not develop in any of the patients who started INH prophylaxis. INH prophylaxis seems to be very efficient in preventing the reactivation of latent tuberculosis in patients going through allogeneic HSCT and/or autologous HSCT.
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Affiliation(s)
- Duygu Mert
- University of Health Sciences Dr Abdurrahman Yurtaslan Ankara Oncology Education and Research Hospital, Department of Infectious Diseases and Clinical Microbiology, Ankara, Turkey
- *Correspondence: Duygu Mert, University of Health Sciences Dr Abdurrahman Yurtaslan Ankara Oncology Education and Research Hospital, Department of Infectious Diseases and Clinical Microbiology, Mehmet Akif Ersoy mah, Vatan cad., No: 91, Yenimahalle/Ankara 06200, Turkey (e-mail: )
| | - Muhammet Ozer
- Dana Farber Cancer Institute, Harvard Medical School, Boston, MA, USA
| | - Alparslan Merdin
- University of Health Sciences Ankara Gülhane Education and Research Hospital, Department of Hematology, Ankara, Turkey
| | - Gülşen İskender
- University of Health Sciences Dr Abdurrahman Yurtaslan Ankara Oncology Education and Research Hospital, Department of Infectious Diseases and Clinical Microbiology, Ankara, Turkey
| | - Bahar Uncu Ulu
- University of Health Sciences Abdurrahman Yurtaslan Ankara Oncology Education and Research Hospital, Department of Hematology & Bone Marrow Transplantation, Ankara, Turkey
| | - Merih Kizil Çakar
- University of Health Sciences Abdurrahman Yurtaslan Ankara Oncology Education and Research Hospital, Department of Hematology & Bone Marrow Transplantation, Ankara, Turkey
| | - Mehmet Sinan Dal
- University of Health Sciences Abdurrahman Yurtaslan Ankara Oncology Education and Research Hospital, Department of Hematology & Bone Marrow Transplantation, Ankara, Turkey
| | - Fevzi Altuntaş
- University of Health Sciences Abdurrahman Yurtaslan Ankara Oncology Education and Research Hospital, Department of Hematology & Bone Marrow Transplantation, Ankara, Turkey
| | - Mustafa Ertek
- University of Health Sciences Dr Abdurrahman Yurtaslan Ankara Oncology Education and Research Hospital, Department of Infectious Diseases and Clinical Microbiology, Ankara, Turkey
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Mert D, Merdin A. Evaluation of awareness about importance of high fever in leukemia and lymphoma patients receiving chemotherapy among healthcare professionals working in pharmacies other than hospital pharmacies: A survey from a Central Anatolian city. J Oncol Pharm Pract 2022; 29:543-546. [PMID: 35037782 DOI: 10.1177/10781552221074045] [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] [Indexed: 11/15/2022]
Abstract
INTRODUCTION Pharmacy staff are part of the healthcare delivery. In some cases, the patient goes to the pharmacy before the doctor and asks for a medicine suitable for his own complaint. The aim of this study is to evaluate the awareness about the importance of high fever in patients with leukemia and lymphoma receiving chemotherapy among healthcare professionals working in non-hospital pharmacies. MATERIAL AND METHOD The study is a survey study. 140 pharmacy employees working in non-hospital pharmacies in Ankara Province were included in the study. Volunteer participants were included in the study. Seven questions were asked to the participants. RESULTS About 47.1% of the participants stated that they would advise patients to go immediately to the nearest hospital's emergency department when they presented to the pharmacy and said that they had high fever. It was stated by 56.5% of the participating pharmacy employees that high fever did not pose the same risk for a leukemia or lymphoma patient receiving chemotherapy as it did for a leukemia or lymphoma patient not receiving chemotherapy. CONCLUSION In this study, it was found that awareness about importance of high fever in leukemia and lymphoma patients receiving chemotherapy among healthcare professionals working in pharmacies other than hospital pharmacies was not very high. Providing necessary information to the pharmacy personnels and increasing the awareness about importance of high fever in leukemia and lymphoma patients receiving chemotherapy among the non-hospital pharmacy staff might also contribute to the reduction of negativities associated with infections in such patients.
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Affiliation(s)
- Duygu Mert
- Universtiy of Health Sciences Ankara Dr. Abdurrahman Yurtaslan Oncology Training and Research Hospital, Infectious Diseases and Clinical Microbiology Clinic, Ankara, Turkey
| | - Alparslan Merdin
- Universtiy of Health Sciences Gülhane Education and Research Hospital, Hematology Clinic, Ankara, Turkey
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Mert D, Merdin A, Ceken S, Dal MS, Ertek M, Altuntas F. Evaluation of hepatitis B virus, hepatitis C virus, and human immunodeficiency virus seroprevalence in patients with diffuse large B cell lymphoma and Hodgkin's lymphoma. J Cancer Res Ther 2021; 17:951-955. [PMID: 34528547 DOI: 10.4103/jcrt.jcrt_465_19] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
Backgrounds Non-Hodgkin's lymphoma and Hodgkin's lymphomas (HL) are lymphoid neoplasms. Hepatitis B virus (HBV), hepatitis C virus (HCV), and human immunodeficiency virus (HIV) are viruses that could proliferate in lymphoid tissues. These viruses may cause lymphoproliferative diseases. The aim of this study was to evaluate the seroprevalence of HBV, HCV, and HIV in patients with diffuse large B-cell lymphoma (DLBCL) and HL, to compare the relationship between these two disease groups and to determine the relationship between the three viruses and their characteristics. Materials and Methods The study was a retrospective study. Patients who were followed up in hematology and hepatitis outpatient units between January 01, 2012, and May 01, 2019, were included in the study. Results A statistically significant relationship was observed between the disease groups in terms of hepatitis B surface antigen (HBsAg), hepatitis B core (HBc) IgG antibody, hepatitis B e antigen (HBeAg), and anti-HBe seropositivities (P = 0.004, P = 0.006, P = 0.041, and P = 0.014, respectively). There was also a statistically significant relationship between the disease groups in terms of anti-HCV seropositivity (P = 0.029). HBsAg, anti-HBc IgG, HBeAg, anti-Hbe, and HCV seropositivity rates were higher in patients with DLBCL than in patients with HL. Conclusion These findings suggest that there may be a relationship between hepatitis viruses and DLBCL. Evaluation of HBV and HCV infections in these patients before starting treatment is thought to be beneficial in initiating antiviral prophylaxis to prevent reactivation in seropositive cases. In addition, care should be taken for the development of lymphoma in the follow-up of HCV and HBV infections.
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Affiliation(s)
- Duygu Mert
- Department of Infectious Diseases and Clinical Microbiology, University of Health Sciences, Dr. Abdurrahman Yurtaslan Oncology Training and Research Hospital, Ankara, Turkey
| | - Alparslan Merdin
- University of Health Sciences, Dr. Abdurrahman Yurtaslan Oncology Training and Research Hospital, Hematology Clinic and Bone Marrow Transplantation Unit, Ankara, Turkey
| | - Sabahat Ceken
- Department of Infectious Diseases and Clinical Microbiology, University of Health Sciences, Dr. Abdurrahman Yurtaslan Oncology Training and Research Hospital, Ankara, Turkey
| | - Mehmet Sinan Dal
- University of Health Sciences, Dr. Abdurrahman Yurtaslan Oncology Training and Research Hospital, Hematology Clinic and Bone Marrow Transplantation Unit, Ankara, Turkey
| | - Mustafa Ertek
- Department of Infectious Diseases and Clinical Microbiology, University of Health Sciences, Dr. Abdurrahman Yurtaslan Oncology Training and Research Hospital, Ankara, Turkey
| | - Fevzi Altuntas
- University of Health Sciences, Dr. Abdurrahman Yurtaslan Oncology Training and Research Hospital, Hematology Clinic and Bone Marrow Transplantation Unit, Ankara, Turkey
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Ceken S, Gedik H, Iskender G, Demirelli M, Mert D, Yapar Toros G, Yigenoglu TN, Altuntas F, Oksuzoglu B, Ertek M. Evaluation of Risk Factors for Mortality in Febrile Neutropenia. J Infect Dev Ctries 2020; 14:886-892. [PMID: 32903233 DOI: 10.3855/jidc.12520] [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: 02/06/2020] [Accepted: 06/08/2020] [Indexed: 10/31/2022] Open
Abstract
INTRODUCTION We aimed to evaluate the epidemiology of infections and factors associated with mortality in patients with febrile neutropenia (FEN). METHODOLOGY The adult patients, who developed FEN after chemotherapy due to a hematologic malignancy or a solid tumor in a training and research hospital were evaluated, retrospectively. The demographic data of the patients, underlying malignancy, administered antimicrobial therapy, microbiological findings, and other risk factors associated with mortality were evaluated. RESULTS A total of 135 FEN episodes of 115 patients, who comprised of 72 (63%) patients with 89 FEN episodes due to hematologic malignancies (hemato-group) and 43 (37%) patients with 46 FEN episodes due to solid organ cancers (onco-group), were evaluated in the study. The median age was 47 years (range: 17-75 years) and 66 (57%) patients were male. A total of 12 patients (8.8%) died during 135 episodes of FEN including nine cases from hemato-group and three cases from onco-group. Those factors including a presence of pneumonia, advanced age, persistent fever despite an antimicrobial treatment, and need for mechanical ventilation in intensive care unit (ICU) with were determined as risk factors associated with mortality. CONCLUSIONS Morbidity and mortality are more common in patients with hematological malignancies compared to patients with solid organ cancers due to prolonged neutropenia. In case of persistent fever, an invasive fungal infection (IFI) should be kept in mind in patients with hematologic malignancies and then antifungal treatment should be initiated. Although a persistent fever is also common in patients with solid tumors, the necessity of antifungal therapy is rare due to the short duration of neutropenia.
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Affiliation(s)
- Sabahat Ceken
- Department of Infectious Diseases and Clinical Microbiology, Dr. Abdurrahman Yurtaslan Ankara Oncology Training and Research Hospital, Ankara, Turkey.
| | - Habip Gedik
- Department of Infectious Diseasesand Clinical Microbiology, Bakırkoy Sadi Konuk Training and Research Hospital, Istanbul, Turkey.
| | - Gulsen Iskender
- Department of Infectious Diseases and Clinical Microbiology, Dr. Abdurrahman Yurtaslan Ankara Oncology Training and Research Hospital, Ankara, Turkey.
| | - Meryem Demirelli
- Department of Infectious Diseases and Clinical Microbiology, Bafra State Hospital, Samsun, Turkey.
| | - Duygu Mert
- Department of Infectious Diseases and Clinical Microbiology, Dr. Abdurrahman Yurtaslan Ankara Oncology Training and Research Hospital, Ankara, Turkey.
| | - Goknur Yapar Toros
- Department of Infectious Diseases and Clinical Microbiology, Dr. Abdurrahman Yurtaslan Ankara Oncology Training and Research Hospital, Ankara, Turkey.
| | - Tugce Nur Yigenoglu
- Department of Hematology, Dr. Abdurrahman Yurtaslan Ankara Oncology Training and Research Hospital, Ankara, Turkey.
| | - Fevzi Altuntas
- Department of Hematology, Dr. Abdurrahman Yurtaslan Ankara Oncology Training and Research Hospital, Ankara, Turkey.
| | - Berna Oksuzoglu
- Department of Medical Oncology, Dr. Abdurrahman Yurtaslan Ankara Oncology Training and Research Hospital, Ankara, Turkey.
| | - Mustafa Ertek
- Department of Infectious Diseases and Clinical Microbiology, Dr. Abdurrahman Yurtaslan Ankara Oncology Training and Research Hospital, Ankara, Turkey.
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Mert D, Muslu S, Merdin A, Timuroğlu A, Dirim E, Ünver S, Ertek M. Five-year period evaluation of isolated agents and their resistance profiles in intensive care unit patients with malignancy. J Infect Dev Ctries 2020; 14:918-923. [PMID: 32903237 DOI: 10.3855/jidc.12219] [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: 11/16/2019] [Accepted: 03/04/2020] [Indexed: 10/31/2022] Open
Abstract
INTRODUCTION Patients treated in the intensive care unit (ICU) are usually patients who deteriorated health condition and could have longer hospital stay compared to other patients. Hospital infections are more common in ICU patients. The aim of this study was to evaluate the bacteria and treatment resistance profiles isolated from clinical specimens sent for hospital infections in ICU patients between January 1, 2014 and December 31, 2018. METHODOLOGY Bacteria isolated from various clinical samples sent for hospital infections in hospitalized patients in the Anesthesia and Reanimation Intensive Care Unit were retrospectively analyzed. RESULTS Culture positivity was detected in 547 of the sent clinical samples. Eighty Gram-positive bacteria, 389 Gram-negative bacteria and 78 fungi infection were identified in a total of 547 positive cultures. In Gram-positive bacteria, 4 MRSA, 6 VRE and 30 MRCoNS were identified as resistant strains. In Gram-negative bacteria, Acinetobacter spp. was the most culture positive strain with the number of 223. Carbapenem resistance was found in 258 of the Gram-negative bacteria and ESBL positivity was found in 44 of the Gram-negative bacteria strains. CONCLUSIONS Gram-negative bacteria were the most frequently isolated strain in samples. Recently, colistin resistance has been increasing in Acinetobacter spp. and the increase in carbapenemase enzyme in Escherichia coli, Pseudomonas and Klebsiella species has increased resistance to carbapenems. Knowing the microorganisms that grow in ICUs and their antibiotic resistance patterns may help to prevent contamination of resistant microorganisms by both appropriate empirical antibiotic treatment and more isolation as well as general hygiene standard precautions.
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Affiliation(s)
- Duygu Mert
- Infectious Diseases and Clinical Microbiology Clinic, University of Health Sciences Dr.Abdurrahman Yurtaslan Ankara Oncology Training and Research Hospital, Ankara, Turkey.
| | - Selda Muslu
- Anesthesia and Reanimation Intensive Care Unit, University of Health Sciences Dr. Abdurrahman Yurtaslan Ankara Oncology Training and Research Hospital, Ankara, Turkey.
| | - Alparslan Merdin
- Hematology Clinic and Bone Marrow Transplantation Unit, University of Health Sciences Dr. Abdurrahman Yurtaslan Ankara Oncology Training and Research Hospital, Ankara, Turkey.
| | - Arif Timuroğlu
- Anesthesia and Reanimation Intensive Care Unit, University of Health Sciences Dr. Abdurrahman Yurtaslan Ankara Oncology Training and Research Hospital, Ankara, Turkey.
| | - Ece Dirim
- Medical Microbiology Laboratory, University of Health Sciences Dr. Abdurrahman Yurtaslan Ankara Oncology Training and Research Hospital, Ankara, Turkey.
| | - Süheyla Ünver
- Anesthesia and Reanimation Intensive Care Unit, University of Health Sciences Dr. Abdurrahman Yurtaslan Ankara Oncology Training and Research Hospital, Ankara, Turkey.
| | - Mustafa Ertek
- Infectious Diseases and Clinical Microbiology Clinic, University of Health Sciences Dr.Abdurrahman Yurtaslan Ankara Oncology Training and Research Hospital, Ankara, Turkey.
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Mert D, Merdin A, Çakar MK, Dal MS, Altuntaş F. Evaluation of HBV, HCV, and HIV seroprevalence in patients with plasma cell disorders. Medicine (Baltimore) 2020; 99:e21799. [PMID: 32846815 PMCID: PMC7447389 DOI: 10.1097/md.0000000000021799] [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] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
Hepatitis B (HBV) and hepatitis C (HCV) viruses are hepatotropic and lymphotropic viruses that can proliferate either in lymphocytes and monocytes or hepatocytes.The aim of this study was to evaluate the seroprevalence of HBV, HCV, and human immunodeficiency virus (HIV) in patients with plasma cell disorders. We also aimed to compare patients with plasma cell disorders and chronic lymphocytic leukemia (CLL) in terms of HBV, HCV, and HIV seropositivity.This is a retrospective study. The patients who had patient file in the Multiple Myeloma Outpatient Unit of our hospital and were followed in our outpatient unit between January 1, 2012 and September 15, 2019, with diagnoses of either of the plasma cell disorders were included in the study. In addition, 272 CLL patients who were admitted to the Leukemia Outpatient Unit of our hospital were also enrolled in the study. The 2 disease groups were compared in terms of HBV, HCV, and HIV seropositivity.A statistically significant relationship was found between disease groups according to hepatitis B surface antigen (P < .05). Hepatitis B positivity were found to be more common in CLL patients. There was also a statistically significant relationship between the disease groups in terms of hepatitis B e antigen positivity (P = .001).We found that hepatitis B surface antigen positivity rate in CLL patients was higher than in patients with plasma cell disorders. Seroprevalence of HBV, HCV, and HIV was found to be very low in patients with plasma cell disorders.
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Affiliation(s)
- Duygu Mert
- Department of Infectious Diseases and Clinical Microbiology
| | - Alparslan Merdin
- University of Health Sciences Ankara Dr Abdurrahman Yurtaslan Oncology Training and Research Hospital, Hematology Clinic and Bone Marrow Transplantation Unit, Ankara, Turkey
| | - Merih Kizil Çakar
- University of Health Sciences Ankara Dr Abdurrahman Yurtaslan Oncology Training and Research Hospital, Hematology Clinic and Bone Marrow Transplantation Unit, Ankara, Turkey
| | - Mehmet Sinan Dal
- University of Health Sciences Ankara Dr Abdurrahman Yurtaslan Oncology Training and Research Hospital, Hematology Clinic and Bone Marrow Transplantation Unit, Ankara, Turkey
| | - Fevzi Altuntaş
- University of Health Sciences Ankara Dr Abdurrahman Yurtaslan Oncology Training and Research Hospital, Hematology Clinic and Bone Marrow Transplantation Unit, Ankara, Turkey
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İskender G, Mert D, Çeken S, Bahçecitapar M, Yenigün A, Ertek M. Hepatitis C screening and referral for further investigation and treatment in a tertiary care hospital. J Infect Dev Ctries 2020; 14:642-646. [PMID: 32683355 DOI: 10.3855/jidc.12584] [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] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2020] [Accepted: 05/22/2020] [Indexed: 10/31/2022] Open
Abstract
INTRODUCTION Hepatitis C virus infection is a major cause of cirrhosis and liver cancer worldwide. The knowledge of physicians about what should they do in case of any anti-HCV positivity in screening tests is of great importance. In this study the awareness and knowledge of physicians is evaluated by analyzing the rate of the referrals of anti-HCV positive patients to HCV RNA test and their treatment by different clinics. METHODOLOGY The patients tested for anti-HCV in internal medicine, surgery, gastroenterology and infectious disease clinics between 1 January and 31 December 2017 were evaluated retrospectively in a tertiary care hospital. RESULTS Anti-HCV testing was performed in 32,803 patients. Anti-HCV positivity was detected in 95 (0.28%) patients aged 88 years of age or younger (mean 60.89 ± 16.96 years), 57.89% of them were female. HCV RNA was tested in 50 (%52,63) of anti-HCV positive patients and it was found positive in 18 (36%) patients. In anti-HCV positive patients HCV RNA testing was requested most by infectious disease (100%) and gastroenterology (70.58%) clinics and least by surgery and other clinics (21% and 25% respectively). These differences were found to be statistically significant ( =33.65, p < 001). CONCLUSIONS Our study highlights the significant deficiencies existed in the referring patients with anti-HCV positivity for further examination and treatment by the attending physicians especially in surgical clinics. Performing HCV screening in the different steps of medical care and using electronic reminder systems directing physicians at appropriate diagnostic and treatment protocols can maximize the likelihood of the detection and treatment of HCV- infected patients.
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Affiliation(s)
- Gülşen İskender
- Infectious Diseases and Clinical Microbiology Clinic, Dr. Abdurrahman Yurtaslan Ankara Oncology Training and Research Hospital, Ankara, Turkey.
| | - Duygu Mert
- Infectious Diseases and Clinical Microbiology Clinic, Dr. Abdurrahman Yurtaslan Ankara Oncology Training and Research Hospital, Ankara, Turkey.
| | - Sabahat Çeken
- Infectious Diseases and Clinical Microbiology Clinic, Dr. Abdurrahman Yurtaslan Ankara Oncology Training and Research Hospital, Ankara, Turkey.
| | - Melike Bahçecitapar
- Department of Statistics, Hacettepe University Faculty of Science, Beytepe, Ankara,Turkey.
| | - Ayla Yenigün
- Microbiology Laboratory, Dr. Abdurrahman Yurtaslan Ankara Oncology Training and Research Hospital, Ankara, Turkey.
| | - Mustafa Ertek
- Infectious Diseases and Clinical Microbiology Clinic, Dr. Abdurrahman Yurtaslan Ankara Oncology Training and Research Hospital, Ankara, Turkey.
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Mert D, Merdin A. PREVALENCE OF THROMBOCYTOSIS, THROMBOCYTOPENIA, LYMPHOCYTOSIS AND LYMPHOCYTOPENIA IN PATIENTS WITH LOWER RESPIRATORY TRACT INFECTION AND PATIENTS WITH URINARY TRACT INFECTION. Acta Clin Croat 2020; 59:63-66. [PMID: 32724276 PMCID: PMC7382888 DOI: 10.20471/acc.2020.59.01.08] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
There are many reasons for abnormal lymphocyte and platelet counts. In this study, we aimed to assess the prevalence of thrombocytosis, thrombocytopenia, lymphocytosis and lymphocytopenia in patients with lower respiratory tract infection (LRTI) and patients with urinary tract infection (UTI). This retrospective study included 52 LRTI patients and 60 UTI patients. Control group consisted of 70 healthy individuals admitted to the infectiology outpatient unit. No statistically significant relationship was found between the groups of subjects and platelet count. Seven (11.7%) UTI patients and four (7.7%) LRTI patients had lymphocytopenia but there was no statistically significant relationship between the groups of subjects and lymphocyte count. Study results suggested a conclusion that lymphocyte and platelet counts could be within the normal ranges in patients with UTI, as well as in those with LRTI.
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Affiliation(s)
| | - Alparslan Merdin
- 1University of Health Sciences, Ankara Dr. Abdurrahman Yurtaslan Oncology Training and Research Hospital, Department of Infectious Diseases, Ankara, Turkey; 2University of Health Sciences, Ankara Dr. Abdurrahman Yurtaslan Oncology Training and Research Hospital, Hematology Clinic and Bone Marrow Transplantation Unit, Ankara, Turkey
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Merdin A, Çakar MK, Dal MS, Mert D, Yıldız J, Başçı S, Bakırtaş M, Darçın T, Şahin D, Ulu BU, Yiğenoğlu TN, Batgi H, Tetik A, İskender D, Altuntaş F. Evaluation of neutropenia-related outcomes in Hodgkin's lymphoma patients with moderate or severe neutropenia who received ABVD chemotherapy without using granulocyte-colony stimulating factor. J Oncol Pharm Pract 2019; 26:929-932. [PMID: 31822199 DOI: 10.1177/1078155219891663] [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] [Indexed: 11/15/2022]
Abstract
OBJECTIVE To evaluate the possible neutropenia-related effects of administering adriamycin [doxorubicin], bleomycin, vinblastin, dacarbazine (ABVD) chemotherapy in Hodgkin's lymphoma patients with moderate or severe neutropenia without granulocyte-colony stimulating factor supplementation. METHODS This study evaluated neutropenia-related outcomes and the need for granulocyte-colony stimulating factor use during the periods between chemotherapy rounds. Forty-three rounds of ABVD chemotherapy were evaluated in the study. The outcomes that could be related to neutropenia were analyzed. In addition, rounds of ABVD chemotherapy given in the presence of severe neutropenia were compared with ABVD chemotherapy rounds given in the presence of moderate neutropenia in terms of neutropenia-related outcomes and the need for granulocyte-colony stimulating factor use. The study only included patients with classical Hodgkin's disease (lymphoma). Patients with a final neutrophil count of <1 × 103 cells/µL (<1000 cells/µL) prior to chemotherapy round and those receiving ABVD chemotherapy for Hodgkin's lymphoma were included in the study. RESULTS We observed that none of the patients with moderate neutropenia before the start of chemotherapy round needed granulocyte-colony stimulating factor, and four patients with severe neutropenia prior to the start of chemotherapy round required granulocyte-colony stimulating factor. However, there was no statistically significant relationship between the severity of neutropenia (in terms of moderate and severe) before chemotherapy and granulocyte-colony stimulating factor requirement after chemotherapy (p> 0.05). Furthermore, none of the patients included in the study had bleomycin-related lung toxicity during the treatment periods included in the study. CONCLUSION Administering ABVD chemotherapy to patients with moderate neutropenia seems to be safe.
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Affiliation(s)
- Alparslan Merdin
- Hematology Clinic and Bone Marrow Transplantation Unit, University of Health Sciences, Ankara Dr. Abdurrahman Yurtaslan Oncology Education and Research Hospital, Ankara, Turkey
| | - Merih Kızıl Çakar
- Hematology Clinic and Bone Marrow Transplantation Unit, University of Health Sciences, Ankara Dr. Abdurrahman Yurtaslan Oncology Education and Research Hospital, Ankara, Turkey
| | - Mehmet Sinan Dal
- Hematology Clinic and Bone Marrow Transplantation Unit, University of Health Sciences, Ankara Dr. Abdurrahman Yurtaslan Oncology Education and Research Hospital, Ankara, Turkey
| | - Duygu Mert
- Infectious Diseases and Microbiology Clinic, University of Health Sciences Ankara, Dr. Abdurrahman Yurtaslan Oncology Education and Research Hospital, Ankara, Turkey
| | - Jale Yıldız
- Hematology Clinic and Bone Marrow Transplantation Unit, University of Health Sciences, Ankara Dr. Abdurrahman Yurtaslan Oncology Education and Research Hospital, Ankara, Turkey
| | - Semih Başçı
- Hematology Clinic and Bone Marrow Transplantation Unit, University of Health Sciences, Ankara Dr. Abdurrahman Yurtaslan Oncology Education and Research Hospital, Ankara, Turkey
| | - Mehmet Bakırtaş
- Hematology Clinic and Bone Marrow Transplantation Unit, University of Health Sciences, Ankara Dr. Abdurrahman Yurtaslan Oncology Education and Research Hospital, Ankara, Turkey
| | - Tahir Darçın
- Hematology Clinic and Bone Marrow Transplantation Unit, University of Health Sciences, Ankara Dr. Abdurrahman Yurtaslan Oncology Education and Research Hospital, Ankara, Turkey
| | - Derya Şahin
- Hematology Clinic and Bone Marrow Transplantation Unit, University of Health Sciences, Ankara Dr. Abdurrahman Yurtaslan Oncology Education and Research Hospital, Ankara, Turkey
| | - Bahar Uncu Ulu
- Hematology Clinic and Bone Marrow Transplantation Unit, University of Health Sciences, Ankara Dr. Abdurrahman Yurtaslan Oncology Education and Research Hospital, Ankara, Turkey
| | - Tuğçe Nur Yiğenoğlu
- Hematology Clinic and Bone Marrow Transplantation Unit, University of Health Sciences, Ankara Dr. Abdurrahman Yurtaslan Oncology Education and Research Hospital, Ankara, Turkey
| | - Hikmetullah Batgi
- Internal Medicine Clinic, University of Health Sciences, Ankara Education and Research Hospital, Ankara, Turkey
| | - Ayşegül Tetik
- Hematology Clinic and Bone Marrow Transplantation Unit, University of Health Sciences, Ankara Dr. Abdurrahman Yurtaslan Oncology Education and Research Hospital, Ankara, Turkey
| | - Dicle İskender
- Hematology Clinic and Bone Marrow Transplantation Unit, University of Health Sciences, Ankara Dr. Abdurrahman Yurtaslan Oncology Education and Research Hospital, Ankara, Turkey
| | - Fevzi Altuntaş
- Hematology Clinic and Bone Marrow Transplantation Unit, University of Health Sciences, Ankara Dr. Abdurrahman Yurtaslan Oncology Education and Research Hospital, Ankara, Turkey
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Mert D, Merdin A, Ceken S, Sinan Dal M, Ertek M, Altuntas F. Development of pneumonitis after rituximab treatment in a patient with lymphoma. J Oncol Pharm Pract 2019; 26:1009-1010. [PMID: 31653181 DOI: 10.1177/1078155219879496] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/23/2023]
Affiliation(s)
- Duygu Mert
- Department of Infectious Diseases and Clinical Microbiology, University of Health Sciences, Dr. Abdurrahman Yurtaslan Oncology Training and Research Hospital, Ankara, Turkey
| | - Alparslan Merdin
- Hematology Clinic and Bone Marrow Transplantation Unit, University of Health Sciences, Dr. Abdurrahman Yurtaslan Oncology Training and Research Hospital, Ankara, Turkey
| | - Sabahat Ceken
- Department of Infectious Diseases and Clinical Microbiology, University of Health Sciences, Dr. Abdurrahman Yurtaslan Oncology Training and Research Hospital, Ankara, Turkey
| | - Mehmet Sinan Dal
- Hematology Clinic and Bone Marrow Transplantation Unit, University of Health Sciences, Dr. Abdurrahman Yurtaslan Oncology Training and Research Hospital, Ankara, Turkey
| | - Mustafa Ertek
- Department of Infectious Diseases and Clinical Microbiology, University of Health Sciences, Dr. Abdurrahman Yurtaslan Oncology Training and Research Hospital, Ankara, Turkey
| | - Fevzi Altuntas
- Hematology Clinic and Bone Marrow Transplantation Unit, University of Health Sciences, Dr. Abdurrahman Yurtaslan Oncology Training and Research Hospital, Ankara, Turkey
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Mert D, Ceken S, Iskender G, Iskender D, Merdin A, Duygu F, Ertek M, Altuntas F. Epidemiology and mortality in bacterial bloodstream infections in patients with hematologic malignancies. J Infect Dev Ctries 2019; 13:727-735. [PMID: 32069257 DOI: 10.3855/jidc.11457] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [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: 03/17/2019] [Accepted: 06/30/2019] [Indexed: 10/31/2022] Open
Abstract
INTRODUCTION Patients with hematological malignancies, who are in the high risk group for infectious complications and bacterial bloodstream infections. The aim of the study evaluated epidemiology and mortality in bacterial bloodstream infections in patients with hematologic malignancies. In addition to determine the risk factors, changes in the distribution and frequency of isolated bacterias. METHODOLOGY In this retrospective study. There were investigated data from 266 patients with hematological malignancies and bacterial bloodstream infections who were hospitalized between the dates 01/01/2012 and 12/31/2017. RESULTS There were 305 blood and catheter cultures in febrile neutropenia attacks in total. In these total attacks, primary bloodstream infections were 166 and catheter-related bloodstream infections were 139. In blood cultures; Escherichia coli and Klebsiella pneumoniae bacteria were detected in 58,0% and 22,9% of the samples, respectively. 52,4% of the cultured Gram-negative bacterias were extended spectrum beta-lactamase (ESBL). Carbapenemase positive culture rate was 17,2% in Gram-negative bacteria cultures. Staphylococcus epidermidis was found in 38,4% of the Gram-positive bacteria cultures. In Gram-positive bacteria; methicillin resistance were detected in 82,2% of the samples. There was a statistically significant relationship between bloodstream infection and disease status. 60 patients with primary bloodstream infections were newly diagnosed. CONCLUSIONS In patients with hematological malignancies, certain factors in the bloodstream infections increase the mortality rate. With the correction of these factors, the mortality rate in these patients can be reduced. The classification of such risk factors may be an important strategy to improve clinical decision making in high-risk patients, such as patients with hematological malignancies.
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Affiliation(s)
- Duygu Mert
- University of Health Sciences Dr. Abdurrahman Yurtaslan Ankara Oncology Training and Research Hospital, Infectious Diseases and Clinic Microbiology Clinic, Ankara, Turkey.
| | - Sabahat Ceken
- University of Health Sciences Dr. Abdurrahman Yurtaslan Ankara Oncology Training and Research Hospital, Infectious Diseases and Clinic Microbiology Clinic, Ankara, Turkey.
| | - Gulsen Iskender
- University of Health Sciences Dr. Abdurrahman Yurtaslan Ankara Oncology Training and Research Hospital, Infectious Diseases and Clinic Microbiology Clinic, Ankara, Turkey.
| | - Dicle Iskender
- University of Health Sciences Dr. Abdurrahman Yurtaslan Ankara Oncology Training and Research Hospital, Hematology Clinic and Bone Marrow Transplantation Unit, Ankara, Turkey.
| | - Alparslan Merdin
- University of Health Sciences Dr. Abdurrahman Yurtaslan Ankara Oncology Training and Research Hospital, Hematology Clinic and Bone Marrow Transplantation Unit, Ankara, Turkey.
| | - Fazilet Duygu
- University of Health Sciences Dr. Abdurrahman Yurtaslan Ankara Oncology Training and Research Hospital, Infectious Diseases and Clinic Microbiology Clinic, Ankara, Turkey.
| | - Mustafa Ertek
- University of Health Sciences Dr. Abdurrahman Yurtaslan Ankara Oncology Training and Research Hospital, Infectious Diseases and Clinic Microbiology Clinic, Ankara, Turkey.
| | - Fevzi Altuntas
- University of Health Sciences Dr. Abdurrahman Yurtaslan Ankara Oncology Training and Research Hospital, Hematology Clinic and Bone Marrow Transplantation Unit, Ankara, Turkey.
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Ceken S, Iskender G, Gedik H, Duygu F, Mert D, Kaya AH, Altuntas F, Ertek M. Risk factors for bloodstream infections due to extended-spectrum β-lactamase producing Enterobacteriaceae in cancer patients. J Infect Dev Ctries 2018; 12:265-272. [PMID: 31851636 DOI: 10.3855/jidc.9720] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [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: 08/28/2017] [Accepted: 03/07/2018] [Indexed: 10/31/2022] Open
Abstract
INTRODUCTION Bloodstream infection (BSI) caused by Enterobacteriaceae is associated with mortality in cancer patients receiving chemotherapy. The aim of this study is to identify the risk factors and outcomes related to BSIs caused by extended-spectrum beta-lactamase (ESBL)-producing Enterobacteriaceae in cancer patients. METHODOLOGY Hematology/oncology patients, who were diagnosed with BSIs caused by Enterobacteriaceae by positive blood cultures were evaluated retrospectively. Patients were divided into two groups by ESBL-positive and ESBL-negative Enterobacteriaceae bacteremia. Patients' demographic features, underlying conditions, comorbidity, neutrophil count, duration of neutropenia, antibiotic use in the previous three months before infection, mechanical ventilation, steroid use, central venous catheter implementation, total parenteral nutrition (TPN), hospitalization in the past three months, stay in intensive care unit, quinolone prophylaxis, and history of infection with ESBL-producing Enterobactericeae were evaluated. Risk factors related to BSIs caused by ESBL-producing Enterobacteriaceae and mortality were assessed. RESULTS A total of 122 patients were evaluated retrospectively. Quinolone propyhlaxis, TPN, infection with Extended Spectrum Beta-Lactamase positive ESBL-P Enterobacteriaceae during the previous three months, treatment with piperasillin-tazobactam or carbapenems in the previous three months were found to be independent risk factors for ESBL-P BSIs. Longer duration of neutropenia before BSI and complication at the beginning of BSI were found to be independent risk factors for mortality related to infection. CONCLUSIONS ESBL-producing Enterobacteriacea should be treated with an appropriate antibiotic that is associated with better outcomes in hematology/oncology patients with BSIs. History of broad-spectrum antibiotic use and stay in hospital in the previous three months should be taken into consideration upon commencing antibiotic therapy.
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Affiliation(s)
- Sabahat Ceken
- Dr Abdurrahman Yurtaslan Oncology Research and Training Hospital, Ankara, Turkey.
| | - Gulsen Iskender
- Dr Abdurrahman Yurtaslan Oncology Research and Training Hospital, Ankara, Turkey.
| | - Habip Gedik
- Bakırkör Sadi Konuk Research and Training Hospital, Istanbul, Turkey.
| | - Fazilet Duygu
- Dr Abdurrahman Yurtaslan Oncology Research and Training Hospital, Ankara, Turkey.
| | - Duygu Mert
- Dr Abdurrahman Yurtaslan Oncology Research and Training Hospital, Ankara, Turkey.
| | - Ali Hakan Kaya
- Dr Abdurrahman Yurtaslan Oncology Research and Training Hospital, Ankara, Turkey.
| | - Fevzi Altuntas
- Dr Abdurrahman Yurtaslan Oncology Research and Training Hospital, Ankara, Turkey.
| | - Mustafa Ertek
- Dr Abdurrahman Yurtaslan Oncology Research and Training Hospital, Ankara, Turkey.
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Mert D, Batgi H, Merdin A, Çeken S, Dal MS, Tekgündüz E, Altuntaş F, Ertek M. BK Virus-associated Hemorrhagic Cystitis in Patients with Allogeneic Hematopoietic Cell Transplantation: Report of Three Cases. Hematol Rep 2017; 9:7205. [PMID: 28702160 PMCID: PMC5494446 DOI: 10.4081/hr.2017.7205] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2017] [Revised: 05/07/2017] [Accepted: 05/08/2017] [Indexed: 12/28/2022] Open
Abstract
BK viras is a human polyoma viras. It is acquired in early childhood and remains life-long latent in the genitourinary system. BK virus replication is more common in receiving immunosuppressive therapy receiving patients and transplant patients. BK virus could cause hemorrhagic cystitis in patients with allogeneic stem cell transplantation. Hemorrhagic cystitis is a serious complication of hematopoietic stem cell transplantation. Hemorrhagic cystitis could cause morbidity and long stay in the hospital. Diagnosis is more frequently determined by the presence of BK virus DNA detected with quantitative or real-time PCR testing in serum or plasma and less often in urine. The reduction of immunosuppression is effective in the treatment of BK virus infection. There are also several agents with anti-BK virus activity. Cidofovir is an active agent against a variety of DNA viruses including poliomyoma viruses and it is a cytosine nucleotide analogue. Intravenous immunoglobulin IgG (IVIG) also includes antibodies against BK and JC (John Cunningham) viruses. Hereby, we report three cases of hemorrhagic cystitis. Hemorrhagic cystitis developed in all these three cases of allogeneic stem cell transplantation due to acute myeloid leukemia (AML). BK virus were detected as the cause of hemorrhagic cystitis in these patients. Irrigation of the bladder was performed. Then levofloxacin 1 x750 mg intravenous and IVIG 0.5 gr/kg were started. But the hematuria did not decreased. In the first case, treatment with leflunomide was started, but patient died due to refractory AML and severe graft-versus-host disease after 4th day of leflunamide and levofloxacin treatments. Cidofovir treatment and the reduction of immunosuppressive treatment decreased the BK virus load and resulted symptomatic improvement in the second case. Initiation of cidofovir was planned in the third case. Administration of cidofovir together with the reduction of immunosuppression in the treatment of hemorrhagic cystitis associated with BK virus in allogeneic stem cell transplant recipients could be a good option.
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Affiliation(s)
- Duygu Mert
- Infectious Diseases and Clinical Microbiology Clinic, Dr. Abdurrahman Yurtaslan Ankara Oncology Training and Research Hospital, Ankara, Turkey
| | - Hikmetullah Batgi
- Hematology and Stem Cell Transplantation Clinic, Dr. Abdurrahman Yurtaslan Ankara Oncology Training and Research Hospital, Ankara, Turkey
| | - Alparslan Merdin
- Hematology and Stem Cell Transplantation Clinic, Dr. Abdurrahman Yurtaslan Ankara Oncology Training and Research Hospital, Ankara, Turkey
| | - Sabahat Çeken
- Infectious Diseases and Clinical Microbiology Clinic, Dr. Abdurrahman Yurtaslan Ankara Oncology Training and Research Hospital, Ankara, Turkey
| | - Mehmet Sinan Dal
- Hematology and Stem Cell Transplantation Clinic, Dr. Abdurrahman Yurtaslan Ankara Oncology Training and Research Hospital, Ankara, Turkey
| | - Emre Tekgündüz
- Hematology and Stem Cell Transplantation Clinic, Dr. Abdurrahman Yurtaslan Ankara Oncology Training and Research Hospital, Ankara, Turkey
| | - Fevzi Altuntaş
- Hematology and Stem Cell Transplantation Clinic, Dr. Abdurrahman Yurtaslan Ankara Oncology Training and Research Hospital, Ankara, Turkey
| | - Mustafa Ertek
- Infectious Diseases and Clinical Microbiology Clinic, Dr. Abdurrahman Yurtaslan Ankara Oncology Training and Research Hospital, Ankara, Turkey
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Mert D, Iskender G, Duygu F, Merdin A, Dal Mehmet S, Dogan M, Tekgündüz E, Ertek M, Altuntaş F. Invasive Aspergillosis with Disseminated Skin Involvement in a Patient with Acute Myeloid Leukemia: A Rare Case. Hematol Rep 2017. [PMID: 28626542 PMCID: PMC5472346 DOI: 10.4081/hr.2017.6997] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [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] [Indexed: 11/23/2022] Open
Abstract
Invasive pulmonary aspergillosis is most commonly seen in immunocompromised patients. Besides, skin lesions may also develop due to invasive aspergillosis in those patients. A 49-year-old male patient was diagnosed with acute myeloid leukemia. The patient developed bullous and zosteriform lesions on the skin after the 21st day of hospitalization. The skin biopsy showed hyphae. Disseminated skin aspergillosis was diagnosed to the patient. Voricanazole treatment was initiated. The patient was discharged once the lesions started to disappear.
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Affiliation(s)
- Duygu Mert
- Infectious Diseases and Clinical Microbiology, Ankara, Turkey
| | - Gülşen Iskender
- Infectious Diseases and Clinical Microbiology, Ankara, Turkey
| | - Fazilet Duygu
- Infectious Diseases and Clinical Microbiology, Ankara, Turkey
| | - Alparslan Merdin
- Hematology Clinic and Bone Marrow Transplantation Unit, Ankara, Turkey
| | | | - Mehmet Dogan
- Department of Pathology, Dr. Abdurrahman Yurtaslan Ankara Oncology Training and Research Hospital, Ankara, Turkey
| | - Emre Tekgündüz
- Hematology Clinic and Bone Marrow Transplantation Unit, Ankara, Turkey
| | - Mustafa Ertek
- Infectious Diseases and Clinical Microbiology, Ankara, Turkey
| | - Fevzi Altuntaş
- Hematology Clinic and Bone Marrow Transplantation Unit, Ankara, Turkey
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Ayaz C, Çelen MK, Dal T, Deveci Ö, Bayan K, Mert D, Oruç E, Özcan N, Kandemir I, Dal MS. Tenofovir disoproxil fumarate treatment in HbeAg-positive patients. Infez Med 2015; 23:31-35. [PMID: 25819048] [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] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
Tenofovir disoproxil fumarate (Tenofovir DF) is a nucleotide analogue. This multicentre study reports retrospectively the long-term efficacy and safety data with tenofovir DF treatment in nucleosid(t)e-naive, hepatitis B e antigen (HBeAg)-positive chronic hepatitis B patients. Thirty-one patients (11 females, 20 males) received 245 mg tenofovir DF per diem. All patients' initial serum hepatitis B virus (HBV) DNA levels were over 2,000 IU/ml. Serum alanine aminotransferase (ALT) levels, HBeAg, hepatitis B e antibodies (anti-HBe), hepatitis B surface antigen (HBsAg), hepatitis B surface antibodies (Anti-HBs), HBV DNA, creatinine and urea levels were evaluated at baseline, and at weeks 12, 24, 48 and 96 during therapy. Thirty-one patients completed 96 weeks of treatment. Mean age was 37.6 ± 9.4 years. The initial mean value of ALT was 79 ± 39.9 IU/L. At baseline, mean of fibrosis (Ishak) of liver biopsies was 2.3 ± 0.7. Two of the patients (5.9%) achieved HBV DNA less than 300 copies at week 12 of treatment and 97.1 % at week 96. HBeAg loss was observed in 6.7% of patients. At week 96, HBsAg loss was not observed in any of the patients. Mean ALT at week 48 was 32.7 U/L, at week 96 32.6 U/L. Renal safety was good. Creatinine remained stable. Tenofovir DF was well tolerated and produced potent, continuous viral suppression with increasing HBeAg loss.
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Affiliation(s)
- Celal Ayaz
- Tenofovir disoproxil fumarate (Tenofovir DF) is a nucleotide analogue. This multicentre study reports retrospectively the long-term efficacy and safety data with tenofovir DF treatment in nucleosid(t)e-naive, hepatitis B e antigen (HBeAg)-positive chronic hepatitis B patients. Thirty-one patients (11 females, 20 males) received 245 mg tenofovir DF per diem. All patients initial serum hepatitis B virus (HBV) DNA levels were over 2,000 IU/ml. Serum alanine aminotransferase (ALT) levels, HBeAg, hepatitis B e antibodies (anti-HBe), hepatitis B surface antigen (HBsAg), hepatitis B surface antibodies (Anti-HBs), HBV DNA, creatinine and urea levels were evaluated at baseline, and at weeks 12, 24, 48 and 96 during therapy. Thirty-one patients completed 96 weeks of treatment. Mean age was 37.6 years. The initial mean value of ALT was 79 IU/L. At baseline, mean of fibrosis (Ishak) of liver biopsies was 2.3 as average. Two of the patients (5.9%) achieved HBV DNA less than 300 copies at week 12 of treatment and 97.1 % at week 96. HBeAg loss was observed in 6.7% of patients. At week 96, HBsAg loss was not observed in any of the patients. Mean ALT at week 48 was 32.7 U/L, at week 96 32.6 U/L. Renal safety was good. Creatinine remained stable. Tenofovir DF was well tolerated and produced potent, continuous viral suppression with increasing HBeAg loss
| | - Mustafa Kemal Çelen
- Tenofovir disoproxil fumarate (Tenofovir DF) is a nucleotide analogue. This multicentre study reports retrospectively the long-term efficacy and safety data with tenofovir DF treatment in nucleosid(t)e-naive, hepatitis B e antigen (HBeAg)-positive chronic hepatitis B patients. Thirty-one patients (11 females, 20 males) received 245 mg tenofovir DF per diem. All patients initial serum hepatitis B virus (HBV) DNA levels were over 2,000 IU/ml. Serum alanine aminotransferase (ALT) levels, HBeAg, hepatitis B e antibodies (anti-HBe), hepatitis B surface antigen (HBsAg), hepatitis B surface antibodies (Anti-HBs), HBV DNA, creatinine and urea levels were evaluated at baseline, and at weeks 12, 24, 48 and 96 during therapy. Thirty-one patients completed 96 weeks of treatment. Mean age was 37.6 years. The initial mean value of ALT was 79 IU/L. At baseline, mean of fibrosis (Ishak) of liver biopsies was 2.3 as average. Two of the patients (5.9%) achieved HBV DNA less than 300 copies at week 12 of treatment and 97.1 % at week 96. HBeAg loss was observed in 6.7% of patients. At week 96, HBsAg loss was not observed in any of the patients. Mean ALT at week 48 was 32.7 U/L, at week 96 32.6 U/L. Renal safety was good. Creatinine remained stable. Tenofovir DF was well tolerated and produced potent, continuous viral suppression with increasing HBeAg loss
| | - Tuba Dal
- Tenofovir disoproxil fumarate (Tenofovir DF) is a nucleotide analogue. This multicentre study reports retrospectively the long-term efficacy and safety data with tenofovir DF treatment in nucleosid(t)e-naive, hepatitis B e antigen (HBeAg)-positive chronic hepatitis B patients. Thirty-one patients (11 females, 20 males) received 245 mg tenofovir DF per diem. All patients initial serum hepatitis B virus (HBV) DNA levels were over 2,000 IU/ml. Serum alanine aminotransferase (ALT) levels, HBeAg, hepatitis B e antibodies (anti-HBe), hepatitis B surface antigen (HBsAg), hepatitis B surface antibodies (Anti-HBs), HBV DNA, creatinine and urea levels were evaluated at baseline, and at weeks 12, 24, 48 and 96 during therapy. Thirty-one patients completed 96 weeks of treatment. Mean age was 37.6 years. The initial mean value of ALT was 79 IU/L. At baseline, mean of fibrosis (Ishak) of liver biopsies was 2.3 as average. Two of the patients (5.9%) achieved HBV DNA less than 300 copies at week 12 of treatment and 97.1 % at week 96. HBeAg loss was observed in 6.7% of patients. At week 96, HBsAg loss was not observed in any of the patients. Mean ALT at week 48 was 32.7 U/L, at week 96 32.6 U/L. Renal safety was good. Creatinine remained stable. Tenofovir DF was well tolerated and produced potent, continuous viral suppression with increasing HBeAg loss
| | - Özcan Deveci
- Tenofovir disoproxil fumarate (Tenofovir DF) is a nucleotide analogue. This multicentre study reports retrospectively the long-term efficacy and safety data with tenofovir DF treatment in nucleosid(t)e-naive, hepatitis B e antigen (HBeAg)-positive chronic hepatitis B patients. Thirty-one patients (11 females, 20 males) received 245 mg tenofovir DF per diem. All patients initial serum hepatitis B virus (HBV) DNA levels were over 2,000 IU/ml. Serum alanine aminotransferase (ALT) levels, HBeAg, hepatitis B e antibodies (anti-HBe), hepatitis B surface antigen (HBsAg), hepatitis B surface antibodies (Anti-HBs), HBV DNA, creatinine and urea levels were evaluated at baseline, and at weeks 12, 24, 48 and 96 during therapy. Thirty-one patients completed 96 weeks of treatment. Mean age was 37.6 years. The initial mean value of ALT was 79 IU/L. At baseline, mean of fibrosis (Ishak) of liver biopsies was 2.3 as average. Two of the patients (5.9%) achieved HBV DNA less than 300 copies at week 12 of treatment and 97.1 % at week 96. HBeAg loss was observed in 6.7% of patients. At week 96, HBsAg loss was not observed in any of the patients. Mean ALT at week 48 was 32.7 U/L, at week 96 32.6 U/L. Renal safety was good. Creatinine remained stable. Tenofovir DF was well tolerated and produced potent, continuous viral suppression with increasing HBeAg loss
| | - Kadim Bayan
- Tenofovir disoproxil fumarate (Tenofovir DF) is a nucleotide analogue. This multicentre study reports retrospectively the long-term efficacy and safety data with tenofovir DF treatment in nucleosid(t)e-naive, hepatitis B e antigen (HBeAg)-positive chronic hepatitis B patients. Thirty-one patients (11 females, 20 males) received 245 mg tenofovir DF per diem. All patients initial serum hepatitis B virus (HBV) DNA levels were over 2,000 IU/ml. Serum alanine aminotransferase (ALT) levels, HBeAg, hepatitis B e antibodies (anti-HBe), hepatitis B surface antigen (HBsAg), hepatitis B surface antibodies (Anti-HBs), HBV DNA, creatinine and urea levels were evaluated at baseline, and at weeks 12, 24, 48 and 96 during therapy. Thirty-one patients completed 96 weeks of treatment. Mean age was 37.6 years. The initial mean value of ALT was 79 IU/L. At baseline, mean of fibrosis (Ishak) of liver biopsies was 2.3 as average. Two of the patients (5.9%) achieved HBV DNA less than 300 copies at week 12 of treatment and 97.1 % at week 96. HBeAg loss was observed in 6.7% of patients. At week 96, HBsAg loss was not observed in any of the patients. Mean ALT at week 48 was 32.7 U/L, at week 96 32.6 U/L. Renal safety was good. Creatinine remained stable. Tenofovir DF was well tolerated and produced potent, continuous viral suppression with increasing HBeAg loss
| | - Duygu Mert
- Tenofovir disoproxil fumarate (Tenofovir DF) is a nucleotide analogue. This multicentre study reports retrospectively the long-term efficacy and safety data with tenofovir DF treatment in nucleosid(t)e-naive, hepatitis B e antigen (HBeAg)-positive chronic hepatitis B patients. Thirty-one patients (11 females, 20 males) received 245 mg tenofovir DF per diem. All patients initial serum hepatitis B virus (HBV) DNA levels were over 2,000 IU/ml. Serum alanine aminotransferase (ALT) levels, HBeAg, hepatitis B e antibodies (anti-HBe), hepatitis B surface antigen (HBsAg), hepatitis B surface antibodies (Anti-HBs), HBV DNA, creatinine and urea levels were evaluated at baseline, and at weeks 12, 24, 48 and 96 during therapy. Thirty-one patients completed 96 weeks of treatment. Mean age was 37.6 years. The initial mean value of ALT was 79 IU/L. At baseline, mean of fibrosis (Ishak) of liver biopsies was 2.3 as average. Two of the patients (5.9%) achieved HBV DNA less than 300 copies at week 12 of treatment and 97.1 % at week 96. HBeAg loss was observed in 6.7% of patients. At week 96, HBsAg loss was not observed in any of the patients. Mean ALT at week 48 was 32.7 U/L, at week 96 32.6 U/L. Renal safety was good. Creatinine remained stable. Tenofovir DF was well tolerated and produced potent, continuous viral suppression with increasing HBeAg loss
| | - Ebru Oruç
- Tenofovir disoproxil fumarate (Tenofovir DF) is a nucleotide analogue. This multicentre study reports retrospectively the long-term efficacy and safety data with tenofovir DF treatment in nucleosid(t)e-naive, hepatitis B e antigen (HBeAg)-positive chronic hepatitis B patients. Thirty-one patients (11 females, 20 males) received 245 mg tenofovir DF per diem. All patients initial serum hepatitis B virus (HBV) DNA levels were over 2,000 IU/ml. Serum alanine aminotransferase (ALT) levels, HBeAg, hepatitis B e antibodies (anti-HBe), hepatitis B surface antigen (HBsAg), hepatitis B surface antibodies (Anti-HBs), HBV DNA, creatinine and urea levels were evaluated at baseline, and at weeks 12, 24, 48 and 96 during therapy. Thirty-one patients completed 96 weeks of treatment. Mean age was 37.6 years. The initial mean value of ALT was 79 IU/L. At baseline, mean of fibrosis (Ishak) of liver biopsies was 2.3 as average. Two of the patients (5.9%) achieved HBV DNA less than 300 copies at week 12 of treatment and 97.1 % at week 96. HBeAg loss was observed in 6.7% of patients. At week 96, HBsAg loss was not observed in any of the patients. Mean ALT at week 48 was 32.7 U/L, at week 96 32.6 U/L. Renal safety was good. Creatinine remained stable. Tenofovir DF was well tolerated and produced potent, continuous viral suppression with increasing HBeAg loss
| | - Nida Özcan
- Tenofovir disoproxil fumarate (Tenofovir DF) is a nucleotide analogue. This multicentre study reports retrospectively the long-term efficacy and safety data with tenofovir DF treatment in nucleosid(t)e-naive, hepatitis B e antigen (HBeAg)-positive chronic hepatitis B patients. Thirty-one patients (11 females, 20 males) received 245 mg tenofovir DF per diem. All patients initial serum hepatitis B virus (HBV) DNA levels were over 2,000 IU/ml. Serum alanine aminotransferase (ALT) levels, HBeAg, hepatitis B e antibodies (anti-HBe), hepatitis B surface antigen (HBsAg), hepatitis B surface antibodies (Anti-HBs), HBV DNA, creatinine and urea levels were evaluated at baseline, and at weeks 12, 24, 48 and 96 during therapy. Thirty-one patients completed 96 weeks of treatment. Mean age was 37.6 years. The initial mean value of ALT was 79 IU/L. At baseline, mean of fibrosis (Ishak) of liver biopsies was 2.3 as average. Two of the patients (5.9%) achieved HBV DNA less than 300 copies at week 12 of treatment and 97.1 % at week 96. HBeAg loss was observed in 6.7% of patients. At week 96, HBsAg loss was not observed in any of the patients. Mean ALT at week 48 was 32.7 U/L, at week 96 32.6 U/L. Renal safety was good. Creatinine remained stable. Tenofovir DF was well tolerated and produced potent, continuous viral suppression with increasing HBeAg loss
| | - Idris Kandemir
- Tenofovir disoproxil fumarate (Tenofovir DF) is a nucleotide analogue. This multicentre study reports retrospectively the long-term efficacy and safety data with tenofovir DF treatment in nucleosid(t)e-naive, hepatitis B e antigen (HBeAg)-positive chronic hepatitis B patients. Thirty-one patients (11 females, 20 males) received 245 mg tenofovir DF per diem. All patients initial serum hepatitis B virus (HBV) DNA levels were over 2,000 IU/ml. Serum alanine aminotransferase (ALT) levels, HBeAg, hepatitis B e antibodies (anti-HBe), hepatitis B surface antigen (HBsAg), hepatitis B surface antibodies (Anti-HBs), HBV DNA, creatinine and urea levels were evaluated at baseline, and at weeks 12, 24, 48 and 96 during therapy. Thirty-one patients completed 96 weeks of treatment. Mean age was 37.6 years. The initial mean value of ALT was 79 IU/L. At baseline, mean of fibrosis (Ishak) of liver biopsies was 2.3 as average. Two of the patients (5.9%) achieved HBV DNA less than 300 copies at week 12 of treatment and 97.1 % at week 96. HBeAg loss was observed in 6.7% of patients. At week 96, HBsAg loss was not observed in any of the patients. Mean ALT at week 48 was 32.7 U/L, at week 96 32.6 U/L. Renal safety was good. Creatinine remained stable. Tenofovir DF was well tolerated and produced potent, continuous viral suppression with increasing HBeAg loss
| | - Mehmet Sinan Dal
- Tenofovir disoproxil fumarate (Tenofovir DF) is a nucleotide analogue. This multicentre study reports retrospectively the long-term efficacy and safety data with tenofovir DF treatment in nucleosid(t)e-naive, hepatitis B e antigen (HBeAg)-positive chronic hepatitis B patients. Thirty-one patients (11 females, 20 males) received 245 mg tenofovir DF per diem. All patients initial serum hepatitis B virus (HBV) DNA levels were over 2,000 IU/ml. Serum alanine aminotransferase (ALT) levels, HBeAg, hepatitis B e antibodies (anti-HBe), hepatitis B surface antigen (HBsAg), hepatitis B surface antibodies (Anti-HBs), HBV DNA, creatinine and urea levels were evaluated at baseline, and at weeks 12, 24, 48 and 96 during therapy. Thirty-one patients completed 96 weeks of treatment. Mean age was 37.6 years. The initial mean value of ALT was 79 IU/L. At baseline, mean of fibrosis (Ishak) of liver biopsies was 2.3 as average. Two of the patients (5.9%) achieved HBV DNA less than 300 copies at week 12 of treatment and 97.1 % at week 96. HBeAg loss was observed in 6.7% of patients. At week 96, HBsAg loss was not observed in any of the patients. Mean ALT at week 48 was 32.7 U/L, at week 96 32.6 U/L. Renal safety was good. Creatinine remained stable. Tenofovir DF was well tolerated and produced potent, continuous viral suppression with increasing HBeAg loss
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Demirpençe Ö, Sevim B, Yıldırım M, Ayan Nurlu N, Mert D, Evliyaoğlu O. Serum paraoxonase, TAS, TOS and ceruloplasmin in brucellosis. Int J Clin Exp Med 2014; 7:1592-1597. [PMID: 25035784 PMCID: PMC4100970] [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: 04/25/2014] [Accepted: 06/22/2014] [Indexed: 06/03/2023]
Abstract
UNLABELLED It is possible that brucellosis may be related to increase free radical production and antioxidant depletion. Thus, in the present study we aimed to evaluate the oxidative status in patient with brucellosis and healthy controls. METHODS This study includes the patients with brucellosis diagnosed by clinical findings and positive agglutination titer. The paraoxonase, ceruloplasmin, total antioxidant capacity and total oxidant status values were measured from the samples taken. The oxidative stress index value was calculated through the total antioxidant capacity and total oxidant status values. RESULTS A total number of 93 people, 40 women (43%) and 53 men (57%) were included to the study. The levels of ceruloplasmin were found higher in patients when compared to the control group (p < 0.001). The total antioxidant capacity level was found significantly higher in the patients group when compared to the control group (p < 0.001). The oxidative stress index value was significantly lower in the patients group when compared to the control group (p < 0.001). The paraoxonase-1 level was not different in control and patient groups (p = 0.077). CONCLUSIONS Brucellosis is an infection that is frequently seen in Mediterranean countries. This infection breaks the oxidant and antioxidant balance. In this disease, oxidant-antioxidant system indicators such as ceruloplasmin, total antioxidant capacity, total oxidant status and oxidative stress index can be used for showing the role of the brucella infection and for the monitoring of the treatment results.
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Affiliation(s)
- Özlem Demirpençe
- Department of Biochemistry, Dicle University Faculty of MedicineDiyarbakır, Turkey
| | - Bünyamin Sevim
- Department of Biochemistry, Dicle University Faculty of MedicineDiyarbakır, Turkey
| | - Mustafa Yıldırım
- Department of Medical Oncology, Ministry of Health Batman Regional Govermant HospitalBatman, Turkey
| | - Nilhan Ayan Nurlu
- Department of Biochemistry, Ministry of Health Gaziosmanpaşa Taksim Education and Research Hospital IstanbulTurkey
| | - Duygu Mert
- Department Enfection Disease and Clinical Microbiology, Ministry of Health Batman Regional Govermant HospitalBatman, Turkey
| | - Osman Evliyaoğlu
- Department of Biochemistry, Dicle University Faculty of MedicineDiyarbakır, Turkey
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Celen MK, Dal T, Ayaz C, Bayan K, Mert D, Devecil O, Oruc EK. Four-year study of entecavir efficacy and safety in nucleos(t)ide-naïve HBeAg positive chronic hepatitis B patients. Acta Clin Croat 2014; 53:31-36. [PMID: 24974664] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/03/2023] Open
Abstract
Entecavir is a guanosine analogue with activity against hepatitis B virus. The aim of this 4-year trial was to evaluate entecavir treatment in nucleos(t)ide-naïve HBeAg-positive chronic hepatitis B patients. Forty-nine patients received entecavir and nine of them withdrew from the trial at the end of week 96. The initial mean value of alanine aminotransferase was 79.4 +/- 41.5 IU/L, and at the end of the 4-year study period, 90% of patients had alanine aminotransferase values within the normal range. At week 96, 91.7% of patients had HBV DNA < 300 copies; at month 48, 90% of patients had HBV DNA < 50 IU/mL. HBeAg loss was recorded in 7.1% of patients at week 96 and in 12.5% at month 48. The rate of HBeAg seroconversion was 4.8% at week 96 and 7.5% at month 48. The rate of HBsAg seroconversion was 2.1% at week 96 and 2.5% at month 48. Entecavir as a potent and safe agent leading to continuous viral suppression proved to be safe and well tolerated therapy.
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Celen MK, Mert D, Ay M, Dal T, Kaya S, Yildirim N, Gulsun S, Barcin T, Kalkanli S, Dal MS, Ayaz C. Efficacy and safety of tenofovir disoproxil fumarate in pregnancy for the prevention of vertical transmission of HBV infection. World J Gastroenterol 2013; 19:9377-9382. [PMID: 24409065 PMCID: PMC3882411 DOI: 10.3748/wjg.v19.i48.9377] [Citation(s) in RCA: 66] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/24/2013] [Revised: 07/29/2013] [Accepted: 08/29/2013] [Indexed: 02/06/2023] Open
Abstract
AIM: To evaluate the effects of tenofovir disoproxil fumarate (TDF) use during late pregnancy to reduce hepatitis B virus (HBV) transmission in highly viremic mothers.
METHODS: This retrospective study included 45 pregnant patients with hepatitis B e antigen (+) chronic hepatitis B and HBV DNA levels > 107 copies/mL who received TDF 300 mg/d from week 18 to 27 of gestation (n = 21). Untreated pregnant patients served as controls (n = 24). All infants received 200 IU of hepatitis B immune globulin (HBIG) within 24 h postpartum and 20 μg of recombinant HBV vaccine at 4, 8, and 24 wk. Perinatal transmission rate was determined by hepatitis B surface antigen and HBV DNA results in infants at week 28.
RESULTS: At week 28, none of the infants of TDF-treated mothers had immunoprophylaxis failure, whereas 2 (8.3 %) of the infants of control mothers had immunoprophylaxis failure (P = 0.022). There were no differences between the groups in terms of adverse events in mothers or congenital deformities, gestational age, height, or weight in infants. At postpartum week 28, significantly more TDF-treated mothers had levels of HBV DNA < 250 copies/mL and normalized alanine aminotransferase compared with controls (62% vs none, P < 0.001; 82% vs 61%, P = 0.012, respectively).
CONCLUSION: TDF therapy during the second or third trimester reduced perinatal transmission rates of HBV and no adverse events were observed in mothers or infants.
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Tekin R, Karakoç ZÇ, Demirpençe Ö, Bozkurt F, Deveci Ö, Mert D. Retrospective analysis of 286 Brucellosis cases in the southeast of Turkey. J Clin Exp Invest 2012. [DOI: 10.5799/ahinjs.01.2012.03.0174] [Citation(s) in RCA: 3] [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: 11/23/2022] Open
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Ceran N, Yüksel Kocdogan F, Mert D, Erdem I, Dede B, Adaleti R, Ozyürek S, Karagül E, Göktaş P. Hepatitis A seroprevalence in children and young adults in Istanbul, Turkey: seroprevalence change and associated factors. J Viral Hepat 2012; 19:72-6. [PMID: 22187947 DOI: 10.1111/j.1365-2893.2011.01454.x] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/17/2023]
Abstract
Hepatitis A is a widespread infectious disease. The prevalence of the disease is closely related to socioeconomic status (SES) and environmental factors. Understanding its prevalence is essential for instituting appropriate precautions. The aim of this study was to determine the prevalence of hepatitis A and evaluate the associated demographic features in children and young adults in Istanbul. In total, 630 individuals between the ages of 5-24 were included in the study. They were classified into four age groups (5-9, 10-14, 15-19 and 20-24 years). The seropositivity of hepatitis A in the whole study population was 40%. Age-specific prevalence was 11.4% in children 5-9 years old, 29% in those 10-14 years old, 49.7% in those 15-19 years old and 69% in those 20-25 years old. Seropositivity was associated with increasing age, low SES, large family size, low maternal educational level, use of unsafe drinking water and living in regions with poor infrastructure and incomplete urbanization. When we compared our results with previous seroprevalence studies performed in Istanbul, we found an epidemiological shift towards increasing age. Factors associated with changes in prevalence were urbanization and associated infrastructure improvement, knowledge of the disease by the population, use of good hygiene and use of vaccination in those at high risk.
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Affiliation(s)
- N Ceran
- Haydarpaşa Numune Training and Research Hospital, Infectious Diseases and Clinical Microbiology Department, Istanbul, Turkey
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Ceran N, Mert D, Kocdogan FY, Erdem I, Adalati R, Ozyurek S, Goktas P. A randomized comparative study of single-dose fosfomycin and 5-day ciprofloxacin in female patients with uncomplicated lower urinary tract infections. J Infect Chemother 2010; 16:424-30. [PMID: 20585969 DOI: 10.1007/s10156-010-0079-z] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2009] [Accepted: 05/19/2010] [Indexed: 11/28/2022]
Abstract
Uncomplicated lower urinary tract infections (UTIs) are the most frequent infections in females. Increased resistance rates against commonly used antibiotics have led to the use of novel antimicrobials. The aim of the present study was to evaluate the bacteriological and clinical effects of single-dose fosfomycin trometamol (FMT) and 5-day ciprofloxacin in females with uncomplicated UTIs. In this randomized comparative study, 260 female patients between 18 and 65 years of age enrolled, of whom 142 completed the study. The most frequently isolated bacterial pathogen in the urine cultures of patients were Escherichia coli (82.3%) and Enterobacter spp. (8.4%). FMT sensitivity was 94% and ciprofloxacin sensitivity was 59% in Escherichia coli; in comparison, FMT sensitivity was 75% and ciprofloxacin sensitivity was 50% in Enterobacter spp. The MIC90 for FMT was 4 μg/ml. Of the 142 patients, 77 were treated with FMT and 65 were treated with ciprofloxacin. The clinical remission rate was 83% in the FMT group and 81% in the ciprofloxacin group; the bacterial eradication rate was 83% in the FMT group and 78% in the ciprofloxacin group, and there was no significant difference between the two study groups. In conclusion, a single dose of FMT (at 3 g) was as effective as ciprofloxacin, at 500 mg twice a day for 5 days, in the treatment of uncomplicated lower UTIs. It was concluded that the use of FMT as a first-line treatment in the empirical treatment of uncomplicated UTIs might have a positive impact on the problem of resistance to other antibiotics.
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Affiliation(s)
- Nurgul Ceran
- Infectious Diseases and Clinical Microbiology Clinics, Haydarpasa Numune Training and Research Hospital, Istanbul, Turkey.
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Erdem I, Cicekler N, Mert D, Yücesoy-Dede B, Ozyurek S, Goktas P. A case report of acute hepatitis due to brucellosis. Int J Infect Dis 2005; 9:349-50. [PMID: 16046270 DOI: 10.1016/j.ijid.2004.12.002] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2004] [Accepted: 12/21/2004] [Indexed: 11/20/2022] Open
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