1
|
Komut S, Çorakyer N, Kaplan G, Baykam N. An Evaluation of the Hitit Index in Differential Diagnosis of Crimean-Congo Hemorrhagic Fever in the Emergency Department. Medicina (Kaunas) 2023; 59:1796. [PMID: 37893514 PMCID: PMC10608086 DOI: 10.3390/medicina59101796] [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] [Subscribe] [Scholar Register] [Received: 08/01/2023] [Revised: 09/25/2023] [Accepted: 09/28/2023] [Indexed: 10/29/2023]
Abstract
Background and Objectives: Crimean-Congo Hemorrhagic Fever (CCHF) is a viral zoonotic infection, which is seen over a wide geographic area. The mortality rate is in inverse proportion to the ability of patients to access healthcare services. Therefore, early identification of patients is extremely important. The aim of this study was to test the sensitivity and specificity of the Hitit Index in the differentiation of CCHF cases at the time of presentation at the Emergency Department and to evaluate the agreement of this index with molecular (CCHFV RNA) and/or serological diagnostic tests (ELISA-CCHF IgM). Materials and Methods: The patients included were those who presented at the Emergency Department (ED) with the complaint of a tick bite or those identified as potential CCHF cases as a result of complaints and/or laboratory findings. For cases that met the study inclusion criteria, the Hitit Index score was calculated automatically from the parameters included in the index formula uploaded to the automation system in the ED at the time of presentation. Through comparisons of the agreement of the Hitit Index with the CCHFV-RNA and/or IgM results the power of the Hitit Index for differentiation of CCHF cases in ED was evaluated. Results: The data of 273 patients were analyzed. There was a history of tick bite in 236 (86%) cases. Of the evaluated cases, 110 (40.2%) were hospitalized; CCHF positivity was determined in 72 (26.4%). The Hitit Index values calculated in ED and at 24 h after hospitalization were determined to be significant in the prediction of the CCHF cases (p < 0.001, AUC = 0.919 (0.887-0.951); p < 0.001, AUC = 0.902 (0.841-0.962). For a cut-off point of 0 of the Hitit Index evaluated in ED, the classification success was found to have a sensitivity of 75% and specificity of 88% (PPV-NPV). For a cut-off point of 0 of the Hitit Index evaluated at 24 h after hospitalization, the classification success was found to have a sensitivity of 79.7% and specificity of 84% (PPV-NPV). Conclusions: The defined form of the Hitit Index can be used in the differentiation of CCHF cases in ED with high sensitivity and specificity levels. Just as evaluation with the Hitit Index prevents unnecessary hospitalization, it can also contribute to reducing mortality rates with the early identification of CCHF cases.
Collapse
Affiliation(s)
- Seval Komut
- Department of Emergency Medicine, Faculty of Medicine, Hitit University, 19040 Çorum, Turkey;
| | - Nurullah Çorakyer
- Department of Emergency Medicine, Faculty of Medicine, Hitit University, 19040 Çorum, Turkey;
| | - Gülcan Kaplan
- Department of Infectious Diseases and Clinical Microbiology, Faculty of Medicine, Hitit University, 19040 Çorum, Turkey; (G.K.); (N.B.)
| | - Nurcan Baykam
- Department of Infectious Diseases and Clinical Microbiology, Faculty of Medicine, Hitit University, 19040 Çorum, Turkey; (G.K.); (N.B.)
| |
Collapse
|
2
|
Gazi U, Baykam N, Karasartova D, Tosun O, Akdogan O, Yapar D, Sensoz S, Celikbas AK, Semra-Gureser A, Taylan-Ozkan A. Reduced phosphorylated Foxp3 levels in Crimean Congo haemorrhagic fever. Trop Biomed 2022; 39:587-591. [PMID: 36602220 DOI: 10.47665/tb.39.4.016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
Crimean-Congo haemorrhagic fever (CCHF) is a severe human infection which can lead to fatal consequences. Acute CCHF patients were previously shown to exhibit frequencies of regulatory T-cell (Treg) but lower Treg-mediated suppressive activities than the healthy counterparts. This study aims is to investigate the phosphorylation levels of Foxp3 protein (master regulator of Treg cells) in CCHF patients. Blood samples collected from 18 CCHF patients and nine healthy volunteers were used to isolate peripheral blood mononuclear cells (PBMCs). Total and phosphorylated Foxp3 expression levels in the isolated PBMC samples were monitored by western blot and quantified using ImageJ software. Total Foxp3 expression levels in CCHF patients displayed decreasing trend, but not significantly. In contrast, significantly lower expression levels of phosphorylated Foxp3 were reported in CCHF patients. Our results suggest a possible association between Foxp3 dephosphorylation and CCHF pathogenesis. Nevertheless, more studies are required to evaluate the effect of Foxp3 dephosphorylation on Treg function, which would not only help to enlighten the CCHF pathogenesis but also contribute to the development of effective treatment strategies.
Collapse
Affiliation(s)
- U Gazi
- Department of Medical Microbiology and Clinical Microbiology, Faculty of Medicine, Near East University, Nicosia, Cyprus
| | - N Baykam
- Department of Infectious Diseases and Clinical Microbiology, Hitit University Erol Olcok Corum Training and Research Hospital, Corum, Turkey
| | - D Karasartova
- Department of Medical Microbiology, Faculty of Medicine, Hitit University, Corum, Turkey
| | - O Tosun
- Department of Biostatistics, Faculty of Medicine, Near East University, Nicosia, Cyprus
| | - O Akdogan
- Department of Infectious Diseases and Clinical Microbiology, Hitit University Erol Olcok Corum Training and Research Hospital, Corum, Turkey
| | - D Yapar
- Department of Infectious Diseases and Clinical Microbiology, Hitit University Erol Olcok Corum Training and Research Hospital, Corum, Turkey
| | - S Sensoz
- Department of Nutrition and Dietetics, Faculty of Health Science, Hitit University, Corum, Turkey
| | - A K Celikbas
- Department of Infectious Diseases and Clinical Microbiology, Hitit University Erol Olcok Corum Training and Research Hospital, Corum, Turkey
| | - A Semra-Gureser
- Department of Medical Microbiology, Faculty of Medicine, Hitit University, Corum, Turkey
| | - A Taylan-Ozkan
- Department of Medical Microbiology, Faculty of Medicine, TOBB University of Economics and Technology; Ankara, Turkey
| |
Collapse
|
3
|
Akdoğan Ö, Yapar D, Uysal-Tan F, Tunçel-Öztürk P, Kaplan G, Kocagül-Çelikbaş A, Baykam N. A Rare Presentation of Leptospirosis: Dysarthria and Guillain-Barré Syndrome. Infect Dis Clin Microbiol 2022; 4:285-288. [PMID: 38633722 PMCID: PMC10985808 DOI: 10.36519/idcm.2022.155] [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] [Subscribe] [Scholar Register] [Received: 04/18/2022] [Accepted: 08/11/2022] [Indexed: 04/19/2024]
Abstract
Leptospirosis can present with severe cases such as polymyositis, peripheral neuropathy, and rarely, Guillain-Barré Syndrome (GBS). This paper reports a case who presented with dysarthria and GBS. A female patient presented with complaints of weakness, dizziness, diarrhea, and dysarthric. Her assessments included muscle strength globally 4/5 and deep tendon reflexes as hypoactive. An electromyographic examination was performed with the increase of weakness in the lower extremities, which indicated findings compatible with GBS. Antibodies against Leptospira biflexa serovar Patoc 1 at 1/400 titer were detected in the microscopic agglutination test (MAT). Neurological involvement in leptospirosis cases can range from meningoencephalitis to GBS.
Collapse
Affiliation(s)
- Özlem Akdoğan
- Department of Infectious Diseases and Clinical Microbiology,
Hitit University School of Medicine, Çorum, Turkey
| | - Derya Yapar
- Department of Infectious Diseases and Clinical Microbiology,
Hitit University School of Medicine, Çorum, Turkey
| | - Funda Uysal-Tan
- Department of Neurology, Hitit University School of Medicine,
Çorum, Turkey
| | - Pınar Tunçel-Öztürk
- Department of Infectious Diseases and Clinical Microbiology,
Hitit University School of Medicine, Çorum, Turkey
| | - Gülcan Kaplan
- Department of Infectious Diseases and Clinical Microbiology,
Hitit University School of Medicine, Çorum, Turkey
| | - Aysel Kocagül-Çelikbaş
- Department of Infectious Diseases and Clinical Microbiology,
Hitit University School of Medicine, Çorum, Turkey
| | - Nurcan Baykam
- Department of Infectious Diseases and Clinical Microbiology,
Hitit University School of Medicine, Çorum, Turkey
| |
Collapse
|
4
|
Sarıgül Yıldırım F, Üser Ü, Didem Sarı N, Kurtaran B, Önlen Y, Şenateş E, Gündüz A, Zerdali E, Karsen H, Batırel A, Karaali R, Güner R, Yamazhan T, Köse Ş, Erben N, İnce N, Köksal İ, Çuvalcı Öztoprak N, Yörük G, Kömür S, Bal T, Kaya S, Bozkurt İ, Günal Ö, Esen Yıldız İ, İnan D, Barut Ş, Namıduru M, Tosun S, Türker K, Şener A, Hızel K, Baykam N, Duygu F, Bodur H, Can G, Gül HC, Sağmak Tartar A, Çelebi G, Sünnetçioğlu M, Karabay O, Kumbasar Karaosmanoğlu H, Sırmatel F, Tabak F. In a Real-Life Setting, Direct-Acting Antivirals to People Who Inject Drugs with Chronic Hepatitis C in Turkey. Turk J Gastroenterol 2022; 33:971-978. [PMID: 36415900 PMCID: PMC9797763 DOI: 10.5152/tjg.2022.21834] [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] [Figures] [Subscribe] [Scholar Register] [Received: 10/09/2021] [Accepted: 01/12/2022] [Indexed: 11/23/2022]
Abstract
BACKGROUND People who inject drugs (PWID) should be treated in order to eliminate hepatitis C virus in the world. The aim of this study was to compare direct-acting antivirals treatment of hepatitis C virus for PWID and non-PWID in a real-life setting. METHODS We performed a prospective, non-randomized, observational multicenter cohort study in 37 centers. All patients treated with direct-acting antivirals between April 1, 2017, and February 28, 2019, were included. In total, 2713 patients were included in the study among which 250 were PWID and 2463 were non-PWID. Besides patient characteristics, treatment response, follow-up, and side effects of treatment were also analyzed. RESULTS Genotype 1a and 3 were more prevalent in PWID-infected patients (20.4% vs 9.9% and 46.8% vs 5.3%). The number of naïve patients was higher in PWID (90.7% vs 60.0%), while the number of patients with cirrhosis was higher in non-PWID (14.1% vs 3.7%). The loss of follow-up was higher in PWID (29.6% vs 13.6%). There was no difference in the sustained virologic response at 12 weeks after treatment (98.3% vs 98.4%), but the end of treatment response was lower in PWID (96.2% vs 99.0%). In addition, the rate of treatment completion was lower in PWID (74% vs 94.4%). CONCLUSION Direct-acting antivirals were safe and effective in PWID. Primary measures should be taken to prevent the loss of follow-up and poor adherence in PWID patients in order to achieve World Health Organization's objective of eliminating viral hepatitis.
Collapse
Affiliation(s)
- Figen Sarıgül Yıldırım
- Department of Infectious Diseases and Clinical Microbiology, Antalya Training and Research Hospital, Antalya, Turkey
| | - Ülkü Üser
- Department of Infectious Diseases and Clinical Microbiology, Antalya Training and Research Hospital, Antalya, Turkey
| | - Nagehan Didem Sarı
- Department of Infectious Diseases, İstanbul Education Research Hospital, İstanbul, Turkey
| | - Behice Kurtaran
- Department of Infectious Diseases and Clinical Microbiology, Çukurova University Faculty of Medicine, Adana, Turkey
| | - Yusuf Önlen
- Department of Infectious Diseases and Clinical Microbiology, Mustafa Kemal University Faculty of Medicine, Hatay, Turkey
| | - Ebubekir Şenateş
- Department of Gastroenterology, Medeniyet University Göztepe Training and Research Hospital, İstanbul, Turkey
| | - Alper Gündüz
- Department of Infectious Diseases, İstanbul Şişli Hamidiye Etfal Training and Research Hospital, İstanbul, Turkey
| | - Esra Zerdali
- Department of Infectious Diseases, Haseki Education Research Hospital, İstanbul, Turkey
| | - Hasan Karsen
- Department of Infectious Diseases and Clinical Microbiology, Harran University Faculty of Medicine, Şanlıurfa, Turkey
| | - Ayşe Batırel
- Department of Infectious Diseases, İstanbul Doctor Lütfi Kırdar Kartal Training and Research Hospital, İstanbul, Turkey
| | - Rıdvan Karaali
- Department of Infectious Diseases and Clinical Microbiology, Namık Kemal University Faculty of Medicine, Tekirdağ, Turkey
| | - Rahmet Güner
- Department of Infectious Diseases and Clinical Microbiology, Ankara Yıldırım Beyazıt University Faculty of Medicine, Ankara, Turkey
| | - Tansu Yamazhan
- Department of Infectious Diseases and Clinical Microbiology, Ege University Faculty of Medicine, İzmir, Turkey
| | - Şükran Köse
- Department of Infectious Diseases, İzmir Tepecik Training and Research Hospital, İzmir, Turkey
| | - Nurettin Erben
- Department of Infectious Diseases and Clinical Microbiology, Eskişehir Osmangazi University Faculty of Medicine, Eskişehir, Turkey
| | - Nevin İnce
- Department of Infectious Diseases and Clinical Microbiology, Düzce University Medical School, Düzce, Turkey
| | - İftihar Köksal
- Department of Infectious Diseases and Clinical Microbiology, Karadeniz Teknik University Faculty of Medicine, Trabzon, Turkey
| | - Nefise Çuvalcı Öztoprak
- Department of Infectious Diseases and Clinical Microbiology, Antalya Training and Research Hospital, Antalya, Turkey
| | - Gülşen Yörük
- Department of Infectious Diseases, İstanbul Education Research Hospital, İstanbul, Turkey
| | - Süheyla Kömür
- Department of Infectious Diseases and Clinical Microbiology, Mustafa Kemal University Faculty of Medicine, Hatay, Turkey
| | - Tayibe Bal
- Department of Gastroenterology, Medeniyet University Göztepe Training and Research Hospital, İstanbul, Turkey
| | - Sibel Kaya
- Department of Infectious Diseases and Clinical Microbiology, İstanbul University-Cerrahpaşa, Cerrahpaşa Faculty of Medicine, İstanbul, Turkey
| | - İlkay Bozkurt
- Department of Infectious Diseases and Clinical Microbiology, Ondokuz Mayıs University Faculty of Medicine, Samsun, Turkey
| | - Özgür Günal
- Department of Infectious Diseases, Samsun Education Research Hospital, Samsun, Turkey
| | - İlknur Esen Yıldız
- Department of Infectious Diseases and Clinical Microbiology, Recep Tayyip Erdoğan University Training and Research Hospital, Rize, Turkey
| | - Dilara İnan
- Department of Infectious Diseases and Clinical Microbiology, Akdeniz University Medical School, Antalya, Turkey
| | - Şener Barut
- Department of Infectious Diseases and Clinical Microbiology, Gaziosmanpaşa University Medical Faculty, Tokat, Turkey
| | - Mustafa Namıduru
- Department of Infectious Diseases and Clinical Microbiology, Gaziantep University Medical Faculty, Gaziantep, Turkey
| | - Selma Tosun
- Department of Infectious Diseases and Clinical Microbiology, Eskişehir Osmangazi University Faculty of Medicine, Eskişehir, Turkey
| | - Kamuran Türker
- Department of Infectious Diseases, İstanbul Bağcılar Training and Research Hospital, İstanbul, Turkey
| | - Alper Şener
- Department of Infectious Diseases and Clinical Microbiology, Çanakkale 18 Mart University Faculty of Medicine, Çanakkale, Turkey
| | - Kenan Hızel
- Department of Infectious Diseases and Clinical Microbiology, Gazi University Faculty of Medicine, Ankara, Turkey
| | - Nurcan Baykam
- Department of Infectious Diseases and Clinical Microbiology, Hitit University Faculty of Medicine, Çorum, Turkey
| | - Fazilet Duygu
- Department of Infectious Diseases, Ankara Dr. Abdurrahman Yurtaslan Ankara Oncology Training and Research Hospital, Ankara, Turkey
| | - Hürrem Bodur
- Department of Infectious Diseases, Ankara Numune Training and Research Hospital, Ankara, Turkey
| | - Güray Can
- Department of Gastroenterology, Bolu İzzet Baysal University Medical Faculty, Bolu, Turkey
| | - Hanefi Cem Gül
- Department of Infectious Diseases, Health Science University Gülhane Faculty of Medicine, Ankara, Turkey
| | - Ayşe Sağmak Tartar
- Department of Infectious Diseases and Clinical Microbiology, Fırat University School of Medicine, Elazığ, Turkey
| | - Güven Çelebi
- Department of Infectious Diseases and Clinical Microbiology, Zonguldak Bülent Ecevit University Training and Research Hospital, Zonguldak, Turkey
| | - Mahmut Sünnetçioğlu
- Department of Infectious Diseases and Clinical Microbiology, Yüzüncü Yıl University Faculty of Medicine, Van, Turkey
| | - Oğuz Karabay
- Department of Infectious Diseases and Clinical Microbiology, Sakarya University Training and Research Hospital, Sakarya, Turkey
| | - Hayat Kumbasar Karaosmanoğlu
- Department of Infectious Diseases, İstanbul Bakırköy Dr. Sadi Konuk Training and Research Hospital, İstanbul, Turkey
| | - Fatma Sırmatel
- Department of Infectious Diseases and Clinical Microbiology, Bolu İzzet Baysal University Medical Faculty, Bolu, Turkey
| | - Fehmi Tabak
- Department of Infectious Diseases and Clinical Microbiology, Gaziosmanpaşa University Medical Faculty, Tokat, Turkey
| |
Collapse
|
5
|
Önlen Y, Bal T, Çabalak M, Çuvalcı Öztoprak N, Didem Sarı N, Kurtaran B, Şenateş E, Gündüz A, Zerdali E, Karsen H, Batırel A, Karaali R, Güner R, Yamazhan T, Köse Ş, Erben N, İnce N, Köksal İ, Sarıgül Yıldırım F, Yörük G, Kömür S, Kaya S, Esen Ş, Günal Ö, Esen Yıldız İ, İnan D, Barut Ş, Namıduru M, Tosun S, Türker K, Şener A, Hızel K, Baykam N, Duygu F, Akıncı E, Can G, User Ü, Cem Gül H, Akbulut A, Çelebi G, Sünnetçioğlu M, Karabay O, Kumbasar Karaosmanoğlu H, Sırmatel F, Tabak F. Efficacy and Safety of Direct-Acting Antivirals in Elderly Patients with Chronic Hepatitis C: A Nationwide Real-Life, Observational, Multicenter Study from Turkey. Turk J Gastroenterol 2022; 33:862-873. [PMID: 35946896 PMCID: PMC9623221 DOI: 10.5152/tjg.2022.21271] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 04/28/2021] [Accepted: 01/30/2022] [Indexed: 06/15/2023]
Abstract
BACKGROUND The number and proportion of elderly patients living with chronic hepatitis C are expected to increase in the coming years. We aimed to compare the real-world efficacy and safety of direct-acting antiviral treatment in elderly and younger Turkish adults infected with chronic hepatitis C. METHODS In this multicenter prospective study, 2629 eligible chronic hepatitis C patients treated with direct-acting antivirals between April 2017 and December 2019 from 37 Turkish referral centers were divided into 2 age groups: elderly (≥65 years) and younger adults (<65 years) and their safety was compared between 2 groups in evaluable population. Then, by matching the 2 age groups for demographics and pretreatment risk factors for a non-sustained virological response, a total of 1516 patients (758 in each group) and 1244 patients (622 in each group) from the modified evaluable population and per-protocol population were included in the efficacy analysis and the efficacy was compared between age groups. RESULTS The sustained virological response in the chronic hepatitis C patients was not affected by the age and the presence of cirrhosis both in the modified evaluable population and per-protocol population (P = .879, P = .508 for modified evaluable population and P = .058, P = .788 for per-protocol population, respectively). The results of the per-protocol analysis revealed that male gender, patients who had a prior history of hepatocellular carcinoma, patients infected with non-genotype 1 hepatitis C virus, and patients treated with sofosbuvir+ribavirin had a significantly lower sustained virological response 12 rates (P < .001, P = .047, P = .013, and P = .025, respectively). CONCLUSION Direct-acting antivirals can be safely used to treat Turkish elderly chronic hepatitis C patients with similar favorable efficacy and safety as that in younger adults.
Collapse
Affiliation(s)
- Yusuf Önlen
- Mustafa Kemal University Faculty of Medicine, Antakya, Turkey
| | - Tayibe Bal
- Mustafa Kemal University Faculty of Medicine, Antakya, Turkey
| | - Mehmet Çabalak
- Mustafa Kemal University Faculty of Medicine, Antakya, Turkey
| | | | | | | | - Ebubekir Şenateş
- Department of Gastroenterology, Medeniyet University Faculty of Medicine, İstanbul, Turkey
| | - Alper Gündüz
- Department of Infectious Diseases, Şişli Hamidiye Etfal Training and Research Hospital, İstanbul, Turkey
| | - Esra Zerdali
- Department of Infectious Diseases, Haseki Training and Research Hospital, İstanbul, Turkey
| | - Hasan Karsen
- Department of Infectious Diseases and Clinical Microbiology, Harran University Faculty of Medicine, Urfa, Turkey
| | - Ayşe Batırel
- Department of Infectious Diseases, Kartal Training and Research Hospital, İstanbul, Turkey
| | - Rıdvan Karaali
- Department of Infectious Diseases and Clinical Microbiology, Tekirdağ Namık Kemal University Faculty of Medicine, Tekirdağ, Turkey
| | - Rahmet Güner
- Department of Infectious Diseases and Clinical Microbiology, Ankara City Hospital, Ankara, Turkey
| | - Tansu Yamazhan
- Department of Infectious Diseases and Clinical Microbiology, Ege University Faculty of Medicine, İzmir, Turkey
| | - Şükran Köse
- Department of Infectious Diseases, Tepecik Training and Research Hospital, İzmir, Turkey
| | - Nurettin Erben
- Department of Infectious Diseases and Clinical Microbiology, Eskişehir Osman Gazi University, Eskişehir, Turkey
| | - Nevin İnce
- Department of Infectious Diseases and Clinical Microbiology, Düzce University Faculty of Medicine, Düzce, Turkey
| | - İftihar Köksal
- Department of Infectious Diseases and Clinical Microbiology, Karadeniz Technical University Faculty of Medicine, Trabzon, Turkey
| | - Figen Sarıgül Yıldırım
- Department of Infectious Diseases, Antalya Training and Research Hospital, Antalya, Turkey
| | - Gülşen Yörük
- Department of Infectious Diseases, İstanbul Training and Research Hospital, İstanbul, Turkey
| | - Süheyla Kömür
- Department of Infectious Diseases and Clinical Microbiology, Çukurova University Faculty of Medicine, Adana, Turkey
| | - Sibel Kaya
- Department of Infectious Diseases and Clinical Microbiology, İstanbul University-Cerrahpaşa, Cerrahpaşa Faculty of Medicine, İstanbul, Turkey
| | - Şaban Esen
- Department of Infectious Diseases and Clinical Microbiology, Samsun 19 Mayıs University Faculty of Medicine, Samsun, Turkey
| | - Özgür Günal
- Department of Infectious Diseases, Samsun Training and Research Hospital, Samsun, Turkey
| | - İlknur Esen Yıldız
- Department of Infectious Diseases and Clinical Microbiology, RTE University Faculty of Medicine, Rize, Turkey
| | - Dilara İnan
- Department of Infectious Diseases and Clinical Microbiology, Akdeniz University Faculty of Medicine, Antalya, Turkey
| | - Şener Barut
- Department of Infectious Diseases and Clinical Microbiology, Gaziosmanpaşa University Faculty of Medicine, Tokat, Turkey
| | - Mustafa Namıduru
- Department of Infectious Diseases and Clinical Microbiology, Gaziantep University Faculty of Medicine, Gaziantep, Turkey
| | - Selma Tosun
- Department of Infectious Diseases, Bozyaka Training and Research Hospital, İzmir, Turkey
| | - Kamuran Türker
- Department of Infectious Diseases, Bağcılar Training and Research Hospital, İstanbul, Turkey
| | - Alper Şener
- Department of Infectious Diseases and Clinical Microbiology, Çanakkale 18 Mart University Faculty of Medicine, Çanakkale, Turkey
| | - Kenan Hızel
- Department of Infectious Diseases and Clinical Microbiology, Gazi University Faculty of Medicine, Ankara, Turkey
| | - Nurcan Baykam
- Department of Infectious Diseases and Clinical Microbiology, Hitit University Faculty of Medicine, Çorum, Turkey
| | - Fazilet Duygu
- Department of Infectious Diseases, Ankara Dr. Abdurrahman Yurtaslan Oncology Training and Research Hospital, Ankara, Turkey
| | - Esragül Akıncı
- Department of Infectious Diseases, Ankara Numune Training and Research Hospital, Ankara, Turkey
| | - Güray Can
- Department of Gastroenterology, Bolu İzzet Baysal University Faculty of Medicine, Bolu, Turkey
| | - Ülkü User
- Department of Infectious Diseases and Clinical Microbiology, Çukurova University Faculty of Medicine, Adana, Turkey
| | - Hanefi Cem Gül
- Department of Infectious Diseases, Gülhane Training and Research Hospital, Ankara, Turkey
| | - Ayhan Akbulut
- Department of Infectious Diseases and Clinical Microbiology, Fırat University Faculty of Medicine, Elazığ, Turkey
| | - Güven Çelebi
- Department of Infectious Diseases and Clinical Microbiology, Bülent Ecevit University Faculty of Medicine, Zonguldak, Turkey
| | - Mahmut Sünnetçioğlu
- Department of Infectious Diseases and Clinical Microbiology, Yüzüncü Yıl University Faculty of Medicine, Van, Turkey
| | - Oğuz Karabay
- Department of Infectious Diseases and Clinical Microbiology, Sakarya University Faculty of Medicine, Hatay, Turkey
| | | | - Fatma Sırmatel
- Department of Infectious Diseases and Clinical Microbiology, Bolu İzzet Baysal University Faculty of Medicine, Bolu, Turkey
| | - Fehmi Tabak
- İstanbul University-Cerrahpaşa, Cerrahpaşa Medical Faculty of Medicine, İstanbul, Turkey
| |
Collapse
|
6
|
Akarca US, Baykam N, Güner R, Günşar F, İdilman R, Kaymakoğlu S, Köksal İ, Tabak F, Yamazhan T. Eliminating Viral Hepatitis in Turkey: Achievements and Challenges. Egypt J Immunol 2022. [DOI: 10.4274/vhd.galenos.2022.2022-9-1] [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: 12/01/2022]
|
7
|
Yapar D, Akdoğan Ö, Boyacı H, Yılmaz YA, Topçu H, Arslan S, Yılmaz B, Kodalak G, Çebi K, Kayadibi H, Çelikbaş AK, Gülhan M, Baykam N. COVID-19 and Crimean-Congo Hemorrhagic Fever: Is there any Similarity in Chest Radiology? Infect Dis Clin Microbiol 2022; 4:1-6. [PMID: 38633543 PMCID: PMC10986582 DOI: 10.36519/idcm.2022.81] [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] [Subscribe] [Scholar Register] [Received: 08/21/2021] [Accepted: 12/04/2021] [Indexed: 04/19/2024]
Abstract
Objective While the coronavirus disease 2019 (COVID-19) pandemic was continuing at full speed, patients with Crimean-Congo hemorrhagic fever (CCHF), which is endemic in our region, apply to the emergency department simultaneously. The presence of computed tomography (CT) lesions suggesting COVID-19 in some CCHF patients has brought to our mind the question of whether there is CCHF lung involvement even though respiratory symptoms are not at the forefront. Methods In this study, the findings of chest CT, demographic data and clinical symptoms of cases who had thorax tomography scan with suspicion of COVID-19 in the emergency department in the spring and summer of 2020 and were diagnosed with CCHF as a result of the evaluation and followed up in our clinic were compared with the findings of COVID-19 cases that were hospitalized and treated in the same period. Results Seventy-seven COVID-19 and 25 CCHF cases were included in the study. Myalgia, headache, diarrhea, nausea and vomiting were significantly higher in CCHF patients ( p<0.05). Cough was significantly more common in COVID-19 patients ( p=0.034). Ground-glass opacity (GGO) was the most common tomography finding in CCHF, and cases without lung involvement were significantly higher (p=0.001). GGO, consolidation, vascularization, atelectasis band, reverse halo, air-bubble, nodule were significantly high in COVID-19 patients. Conclusion During the epidemic period, no pathological finding was found in thoracic CT in most of the CCHF cases, and the presence of involvement in the lung tomography in cases with similar clinical and laboratory findings should primarily suggest the diagnosis of COVID-19.
Collapse
Affiliation(s)
- Derya Yapar
- Department of Infectious Diseases and Clinical Microbiology, Hitit University School of Medicine, Çorum, Turkey
| | - Özlem Akdoğan
- Department of Infectious Diseases and Clinical Microbiology, Hitit University School of Medicine, Çorum, Turkey
| | - Hilal Boyacı
- Department of Chest Diseases, Hitit University School of Medicine, Çorum, Turkey
| | - Yasemin Arı Yılmaz
- Department of Chest Diseases, Hitit University School of Medicine, Çorum, Turkey
| | - Hülya Topçu
- Department of Anesthesiology, Hitit University School of Medicine, Çorum, Turkey
| | - Sertaç Arslan
- Department of Chest Diseases, Hitit University School of Medicine, Çorum, Turkey
| | - Burak Yılmaz
- Department of Chest Diseases, Hitit University School of Medicine, Çorum, Turkey
| | - Gamze Kodalak
- Department of Internal Medicine, Hitit University School of Medicine, Çorum, Turkey
| | - Kazım Çebi
- Department of Infectious Diseases and Clinical Microbiology, Hitit University Çorum Erol Olçok Education and Training Hospital, Çorum, Turkey
| | - Hüseyin Kayadibi
- Department of Medical Biochemistry, Hitit University School of Medicine, Çorum, Turkey
- Department of Medical Biochemistry, Eskişehir Osmangazi University, School of Medicine, Eskişehir, Turkey
| | - Aysel Kocagül Çelikbaş
- Department of Infectious Diseases and Clinical Microbiology, Hitit University School of Medicine, Çorum, Turkey
| | - Meral Gülhan
- Department of Chest Diseases, Hitit University School of Medicine, Çorum, Turkey
| | - Nurcan Baykam
- Department of Infectious Diseases and Clinical Microbiology, Hitit University School of Medicine, Çorum, Turkey
| |
Collapse
|
8
|
Şenol E, Çilli A, Günen H, Şener A, Dumlu R, Ödemiş A, Topçu AF, Yıldız Y, Güner R, Özhasenekler A, Mutlu B, Köktürk N, Sevimli N, Baykam N, Yapar D, Ekin S, Polatlı M, Gök ŞE, Kılınç O, Sayıner A, Karaşahin Ö, Çuhadaroğlu Ç, Sesin Kocagöz A, Togan T, Arpağ H, Katı H, Köksal İ, Aksoy F, Hasanoğlu C. The Role of Pneumococcal Pneumonia among Community-Acquired Pneumonia in Adult Turkish Population: TurkCAP Study. Turk Thorac J 2022; 22:339-345. [PMID: 35110252 DOI: 10.5152/turkthoracj.2021.20223] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
OBJECTIVE To evaluate the rate of pneumococcal pneumonia (PP) among patients with community-acquired pneumonia (CAP) in Turkey and to investigate and compare features of PP and non-PP CAP patients. MATERIAL AND METHODS This multicenter, non-interventional, prospective, observational study included adult CAP patients (age ≥ 18 years). Diagnosis of PP was based on the presence of at least 1 positive laboratory test result for Streptococcus pneumoniae (blood culture or sputum culture or urinary antigen test [UAT]) in patients with radiographic findings of pneumonia. RESULTS Four hundred sixty-five patients were diagnosed with CAP, of whom 59 (12.7%) had PP. The most common comorbidity was chronic obstructive pulmonary disease (30.1%). The mean age, smoking history, presence of chronic neurological disease, and CURB-65 score were significantly higher in PP patients, when compared to non-PP patients. In PP patients, 84.8% were diagnosed based ony on the UAT. The overall rate of PP patients among CAP was calculated as 22.8% considering the UAT sensitivity ratio of 63% (95% confidence interval: 45-81). The rate of intensive care treatment was higher in PP patients (P = .007). While no PP patients were vaccinated for pneumococcus, 3.8% of the non-PP patients were vaccinated (P = .235). Antibiotic use in the preceding 48 hours was higher in the non-PP group than in the PP group (31.8% vs. 11.1%, P = .002). The CURB-65 score and the rate of patients requiring inpatient treatment according to this score were higher in the PP group. CONCLUSION The facts that PP patients were older and required intensive care treatment more frequently as compared to non-PP patients underline the burden of PP.
Collapse
Affiliation(s)
- Esin Şenol
- Department of Infectious Diseases, Gazi University, Faculty of Medicine, Ankara, Turkey
| | - Aykut Çilli
- Department of Pulmonary Diseases, Akdeniz University, Faculty of Medicine, Antalya, Turkey
| | - Hakan Günen
- Department of Pulmonary Diseases, Süreyyapaşa Chest Diseases and Thoracic Surgery Training and Research Hospital, Istanbul, Turkey
| | - Alper Şener
- Department of Infectious Diseases and Clinical Microbiology, 18 Mart University, Faculty of Medicine, Çanakkale, Turkey
| | - Rıdvan Dumlu
- Department of Infectious Diseases and Clinical Microbiology, 18 Mart University, Faculty of Medicine, Çanakkale, Turkey
| | - Ayşe Ödemiş
- Department of Pulmonary Diseases, Akdeniz University, Faculty of Medicine, Antalya, Turkey
| | - Ayşe Füsun Topçu
- Department of Pulmonary Diseases, Dicle University, Faculty of Medicine, Diyarbakır, Turkey
| | - Yeşim Yıldız
- Department of Infectious Diseases and Clinical Microbiology, Mardin State Hospital, Mardin, Turkey
| | - Rahmet Güner
- Department of Infectious Diseases and Clinical Microbiology, Ankara Atatürk Training and Research Hospital, Ankara, Turkey
| | - Ayhan Özhasenekler
- Department of Emergency Medicine, Ankara Atatürk Training and Research Hospital, Ankara, Turkey
| | - Birsen Mutlu
- Department of Infectious Diseases, Kocaeli University, Faculty of Medicine, Kocaeli, Turkey
| | - Nurdan Köktürk
- Department of Pulmonary Diseases, Gazi University, Faculty of Medicine, Ankara, Turkey
| | - Nurgül Sevimli
- Department of Pulmonary Diseases, Gazi University, Faculty of Medicine, Ankara, Turkey
| | - Nurcan Baykam
- Department of Infectious Diseases and Clinical Microbiology, Hitit University, Faculty of Medicine, Çorum, Turkey
| | - Derya Yapar
- Department of Infectious Diseases and Clinical Microbiology, Hitit University, Faculty of Medicine, Çorum, Turkey
| | - Selami Ekin
- Department of Pulmonary Diseases, Yüzüncü Yıl University, Faculty of Medicine, Van, Turkey
| | - Mehmet Polatlı
- Department of Pulmonary Diseases, Adnan Menderes University, Faculty of Medicine, Aydın, Turkey
| | - Şebnem Eren Gök
- Department of Infectious Diseases and Clinical Microbiology, Bozok University, Faculty of Medicine, Yozgat, Turkey
| | - Oğuz Kılınç
- Department of Pulmonary Diseases, Dokuz Eylül University, Faculty of Medicine, Izmir, Turkey
| | - Abdullah Sayıner
- Department of Pulmonary Diseases, Ege University, Faculty of Medicine, Izmir, Turkey
| | - Ömer Karaşahin
- Department of Infectious Diseases and Clinical Microbiology, Erzurum Regional Training and Research Hospital, Erzurum, Turkey
| | - Çağlar Çuhadaroğlu
- Department of Pulmonary Diseases and Sleep Disorder, Acıbadem Health Group Maslak Hospital, Istanbul, Turkey
| | - Ayşe Sesin Kocagöz
- Department of Infectious Diseases and Clinical Microbiology, Acıbadem Health Group Maslak Hospital, Istanbul, Turkey
| | - Turhan Togan
- Department of Infectious Diseases and Clinical Microbiology, Başkent University Konya Hospital, Konya, Turkey
| | - Hüseyin Arpağ
- Department of Pulmonary Diseases, Sutcu Imam University, Faculty of Medicine, Kahramanmaraş, Turkey
| | - Hakan Katı
- Department of Infectious Diseases, Gazi University, Faculty of Medicine, Ankara, Turkey
| | - İftihar Köksal
- Department of Infectious Diseases, Karadeniz Technical University, Faculty of Medicine, Trabzon, Turkey
| | - Firdevs Aksoy
- Department of Infectious Diseases, Karadeniz Technical University, Faculty of Medicine, Trabzon, Turkey
| | - Canan Hasanoğlu
- Department of Pulmonary Diseases, Ankara Atatürk Training and Research Hospital, Ankara, Turkey
| |
Collapse
|
9
|
Akdogan O, Yapar D, Topcu H, Arslan S, Boyaci H, Yilmaz Y, Celikbas A, Baykam N. Traumatic lung pathologies confused with COVID-19. Med-Science 2022. [DOI: 10.5455/medscience.2021.10.350] [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: 11/03/2022] Open
|
10
|
Bakir M, Öksüz C, Karakeçili F, Baykam N, Barut Ş, Büyüktuna SA, Özkurt Z, Öz M, Barkay O, Akdoğan Ö, Elaldi N, Hasbek M, Engin A. Which scoring system is effective in predicting mortality in patients with Crimean Congo hemorrhagic fever? A validation study. Pathog Glob Health 2021; 116:193-200. [PMID: 34866547 DOI: 10.1080/20477724.2021.2012921] [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: 10/19/2022] Open
Abstract
We aimed to decide which scoring system is the best for the evaluation of the course of Crimean-Congo Hemorrhagic Fever (CCHF) by comparing scoring systems such as qSOFA (quick Sequential Organ Failure Assessment), SOFA (Sequential Organ Failure Assessment), APACHE II (Acute Physiology and Chronic Health Evaluation II) and SGS (Severity Grading System) in centers where patients with CCHF were monitored. The study was conducted with patients diagnosed with CCHF in five different centers where the disease was encountered most commonly. Patients having proven PCR and/or IgM positivity for CCHF were included in the study. The scores of the scoring systems on admission, at the 72nd hour and at the 120th hour were calculated and evaluated. The data of 388 patients were obtained from five centers and evaluated. SGS, SOFA and APACHE II were the best scoring systems in predicting mortality on admission. All scoring systems were significant in predicting mortality at the 72nd and 120th hours. On admission, there was a correlation between the qSOFA, SOFA and APACHE II scores and the SGS scores in the group of survivors. All scoring systems had a positive correlation in the same direction. The correlation coefficients were strong for qSOFA and SOFA, but poor for APACHE II. A one-unit rise in SGS increased the probability of death by 12.818 times. qSOFA did not provide significant results in predicting mortality on admission. SGS, SOFA and APACHE II performed best at admission and at the 72nd and 120th hours.
Collapse
Affiliation(s)
- Mehmet Bakir
- Faculty of Medicine, Department of Infectious Diseases and Clinical Microbiology, Sivas Cumhuriyet University, Sivas, Turkey
| | - Caner Öksüz
- Faculty of Medicine, Department of Infectious Diseases and Clinical Microbiology, Sivas Cumhuriyet University, Sivas, Turkey
| | - Faruk Karakeçili
- Department of Infectious Diseases and Clinical Microbiology, Erzincan Binali Yıldırım University, Mengücek Gazi Training and Research Hospital, Erzincan, Turkey
| | - Nurcan Baykam
- Faculty of Medicine, Department of Infectious Diseases and Clinical Microbiology, Çorum Hitit University, Çorum, Turkey
| | - Şener Barut
- Faculty of Medicine, Department of Infectious Diseases and Clinical Microbiology, Tokat Gaziosmanpaşa University, Tokat, Turkey
| | - Seyit Ali Büyüktuna
- Faculty of Medicine, Department of Infectious Diseases and Clinical Microbiology, Sivas Cumhuriyet University, Sivas, Turkey
| | - Zülal Özkurt
- Faculty of Medicine, Department of Infectious Diseases and Clinical Microbiology, Ataturk University, Erzurum, Turkey
| | - Murteza Öz
- Faculty of Medicine, Department of Infectious Diseases and Clinical Microbiology, Sivas Cumhuriyet University, Sivas, Turkey
| | - Orçun Barkay
- Department of Infectious Diseases and Clinical Microbiology, Erzincan Binali Yıldırım University, Mengücek Gazi Training and Research Hospital, Erzincan, Turkey
| | - Özlem Akdoğan
- Faculty of Medicine, Department of Infectious Diseases and Clinical Microbiology, Çorum Hitit University, Çorum, Turkey
| | - Nazif Elaldi
- Faculty of Medicine, Department of Infectious Diseases and Clinical Microbiology, Sivas Cumhuriyet University, Sivas, Turkey
| | - Murşit Hasbek
- Faculty of Medicine, Department of Medical Microbiology, Sivas Cumhuriyet University, Sivas, Turkey
| | - Aynur Engin
- Faculty of Medicine, Department of Infectious Diseases and Clinical Microbiology, Sivas Cumhuriyet University, Sivas, Turkey
| |
Collapse
|
11
|
Yagci-Caglayik D, Kayaaslan B, Yapar D, Kocagul-Celikbas A, Ozkaya-Parlakay A, Emek M, Baykam N, Tezer H, Korukluoglu G, Ozkul A. Monitoring Crimean-Congo haemorrhagic fever virus RNA shedding in body secretions and serological status in hospitalised patients, Turkey, 2015. ACTA ACUST UNITED AC 2020; 25. [PMID: 32183931 PMCID: PMC7078823 DOI: 10.2807/1560-7917.es.2020.25.10.1900284] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [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: 11/20/2022]
Abstract
IntroductionCrimean-Congo haemorrhagic fever (CCHF) is a tick-borne disease in Africa, Asia, the Balkan peninsula, the south-east of Europe and the Middle East, with mortality rates of 3-30%. Transmission can also occur through contact with infected animals or humans.AimThis observational, prospective case series aimed to investigate detectable viral genomic RNA in whole-body fluids and antibody dynamics in consecutive daily samples of patients diagnosed with CCHF until discharge from hospital.MethodsWe tested 18 patients and 824 swabs and sera with RT-PCR and 125 serum samples serologically.ResultsThe longest duration until clearance of viral RNA was 18 days from serum collection and 18, 15, 13, 19 and 17 days, respectively, from nasal, oral, genital (urethral or vaginal) and faecal swab, and urine. In seven patients, viral load decreased in serum at the same time as it increased in urine or persisted at the same logarithmic values. Despite clearance in serum, viral RNA was detected in faeces and genital swabs in two and three patients, respectively. Viral clearance from body fluids occurred earlier than from serum in eight patients on ribavirin treatment. The shortest seroconversion time was 3 days after symptom onset for IgM and IgG. Seroconversion of IgG occurred until Day 14 of symptoms.ConclusionWe report persistence of viral RNA in urine, faeces and genital swabs despite serum clearance. This may indicate a need for extending isolation precautions, re-evaluating discharge criteria and transmission risk after discharge, and considering oral swabs as a less invasive diagnostic alternative.
Collapse
Affiliation(s)
- Dilek Yagci-Caglayik
- Ankara University Faculty of Veterinary Medicine, Department of Virology, Ankara, Turkey.,Public Health General Directorate of Turkey, Virology Laboratory, Ankara, Turkey.,Marmara University Pendik Training and Research Hospital, Department of Infectious Diseases and Clinical Microbiology, Istanbul, Turkey
| | - Bircan Kayaaslan
- Yıldırım Beyazıt University Faculty of Medicine, Department of Infectious Diseases and Clinical Microbiology, Ankara, Turkey
| | - Derya Yapar
- Hitit University Faculty of Medicine, Department of Infectious Diseases and Clinical Microbiology, Corum, Turkey
| | - Aysel Kocagul-Celikbas
- Hitit University Faculty of Medicine, Department of Infectious Diseases and Clinical Microbiology, Corum, Turkey
| | - Aslinur Ozkaya-Parlakay
- Health Sciences University, Ankara Children's Hematology Oncology Training and Research Hospital, Department of Pediatric Infectious Diseases, Ankara, Turkey
| | - Mestan Emek
- Akdeniz University Faculty of Medicine, Department of Public Health, Antalya, Turkey
| | - Nurcan Baykam
- Hitit University Faculty of Medicine, Department of Infectious Diseases and Clinical Microbiology, Corum, Turkey
| | - Hasan Tezer
- Gazi University Faculty of Medicine, Department of Pediatric Infectious Diseases, Ankara, Turkey
| | - Gulay Korukluoglu
- Public Health General Directorate of Turkey, Virology Laboratory, Ankara, Turkey
| | - Aykut Ozkul
- Ankara University, Biotechnology Institute, Ankara, Turkey.,Ankara University Faculty of Veterinary Medicine, Department of Virology, Ankara, Turkey
| |
Collapse
|
12
|
Kayadibi H, Yapar D, Akdogan O, Ulusu NN, Baykam N. Hitit Index to distinguish patients with and without Crimean-Congo hemorrhagic fever. Ticks Tick Borne Dis 2019; 10:1035-1040. [PMID: 31160263 DOI: 10.1016/j.ttbdis.2019.05.010] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [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: 12/14/2018] [Revised: 04/20/2019] [Accepted: 05/25/2019] [Indexed: 02/07/2023]
Abstract
Crimean-Congo hemorrhagic fever (CCHF) is fatal. Therefore, it is very important to use an inexpensive, easily accessible, quick and accurate screening index based on clinical signs and laboratory parameters to identify patients suspected of having CCHF. Laboratory test results on the day of hospitalization for 268 inpatients suspected of having CCHF were used to calculate the laboratory section of the Hitit Index, while 65 of these were also monitored daily during their hospital stay to develop the clinical section of the Hitit Index. Two-hundred CCHF-negative outpatients were also evaluated. One-hundred and forty-nine inpatients were CCHF-positive and 119 inpatients were CCHF-negative. The Hitit Index is 5.6 - (5.3*lymphocyte) - (0.02*fibrinogen) - (12*direct bilirubin) + (0.04*AST) + (0.32*hematocrit) - (0.5*neutrophil) - (0.07*CKD-EPI) - (0.001*CK) ± conjunctival hyperemia (+1.5 in conjunctival hyperemia presence and -1.5 in conjunctival hyperemia absence). In 65 inpatients monitored daily, Hitit Index results for CCHF-positive and negative inpatients were 6.10(1.90-12.30) and -5.35(-8.83- -1.95), while CCHF-negative outpatients were -10.99(-15.64- -6.95) (P < 0.001), respectively. On hospitalization day, just one inpatient was false-negative in 27 CCHF-positive inpatients, while four were false-positive among 38 CCHF-negative inpatients using the Hitit Index. After 24 h, just one inpatient was diagnosed falsely among 27 CCHF-positive and 38 CCHF-negative inpatients, and there was no change after 48 h. Management of patients living in endemic regions suspected of having CCHF could be achieved within minutes using the Hitit Index. Patients with Hitit Index less than zero can be monitored as outpatients, while patients with Hitit Index results above zero must be hospitalized in infectious diseases wards. This study was not registered since it was retrospective.
Collapse
Affiliation(s)
- Huseyin Kayadibi
- Hitit University School of Medicine, Department of Medical Biochemistry, Corum, Turkey.
| | - Derya Yapar
- Hitit University School of Medicine, Department of Infectious Diseases and Clinical Microbiology, Corum, Turkey
| | - Ozlem Akdogan
- Hitit University School of Medicine, Department of Infectious Diseases and Clinical Microbiology, Corum, Turkey
| | - Nuray N Ulusu
- Koc University School of Medicine, Department of Medical Biochemistry, Istanbul, Turkey
| | - Nurcan Baykam
- Hitit University School of Medicine, Department of Infectious Diseases and Clinical Microbiology, Corum, Turkey
| |
Collapse
|
13
|
Erçen Diken Ö, Arslan S, Akdoğan Ö, Yapar D, Ünal Ö, Demir E, Baykam N. Clinical, radiological and prognostic features of influenza cases in the influenza epidemic during years 2016-2017. Tuberk Toraks 2018; 66:144-149. [PMID: 30246658 DOI: 10.5578/tt.66122] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Introduction Influenza subtypes vary by clinical, radiological, and prognostic courses and may go along with viral pneumonia. We aimed to identify clinical, radiological, and prognostic aspects of influenza epidemic during years 2016-2017. Materials and Methods Influenza cases reported to the Public Health Directorate in our city was assessed retrospectively. Clinical, radiological, and prognostic parameters were compared based on influenza subtypes. Result We analyzed samples from 197 cases with suspected influenza. Mean age of the subjects was 51.17 ± 26.74. We found influenza A/H1N1, influenza A/H3N2, and influenza B in 59 (30.0%), 29 (14.7%), and 3 (1.5%) cases, respectively. Comorbidity was present in 48 (24.4%) cases. Most common radiological finding was interstitial pattern. Seventy-one and 79 per cent of H1N1 and H3N2 cases were influenza pneumonia, respectively. The prevalence of overall mortality was 5.5% with a predominance in H1N1 over H3N2. Influenza vaccination had been performed in 6.8% and 3.4% of H1N1 and H3N2 cases, respectively. We detected no mortality in any vaccinated patient. We identified 6 pregnant women, 2 of which ended up with preterm birth, and another one with abortion. Conclusions Often manifested as lower respiratory tract infection, influenza may cause epidemics with increased mortality rate. Influenza should be suspected when interstitial pattern was seen on radiological images. H1N1 cases course worse. Since the prognosis is better in vaccinated patients, seasonal influenza vaccination among the community needs to be elevated. In addition, protective measures like vaccination should be taken in pregnancy to avoid preterm delivery or abortion.
Collapse
Affiliation(s)
- Özlem Erçen Diken
- Department of Chest Diseases, Faculty of Medicine, Hitit University, Corum, Turkey
| | - Sertaç Arslan
- Department of Chest Diseases, Faculty of Medicine, Hitit University, Corum, Turkey
| | - Özlem Akdoğan
- Department of Infectious Diseases and Clinical Microbiology, Faculty of Medicine, Hitit University, Corum, Turkey
| | - Derya Yapar
- Department of Infectious Diseases and Clinical Microbiology, Faculty of Medicine, Hitit University, Corum, Turkey
| | - Özgür Ünal
- Department of Infectious Diseases and Clinical Microbiology, Faculty of Medicine, Hitit University, Corum, Turkey
| | - Emre Demir
- Department of Biostatistics, Faculty of Medicine, Hitit University, Corum, Turkey
| | - Nurcan Baykam
- Department of Infectious Diseases and Clinical Microbiology, Faculty of Medicine, Hitit University, Corum, Turkey
| |
Collapse
|
14
|
Idilman R, Baykam N, Kaymakoğlu S, Tabak F, Bahçecioğlu HI, Bektaş A, Bulut C, Günşar F, İnan D, Karaosmanoğlu HK, Karasu Z, Kuşçu F, Mete B, Özbakır Ö, Özdoğan OC, Parlak M, Sırmatel F, Topalak Ö, Ünsal B, Guidelines Study Group VH. Turkey 2017 Clinical Practice Guidelines on recommendations for screening diagnosing and managing hepatitis C virus. Turk J Gastroenterol 2018; 28:90-93. [PMID: 29303105 DOI: 10.5152/tjg.2017.21] [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] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
The present guideline updates the Turkish recommendations for the screening, diagnosis and management of Hepatitis
C virus (HCV) infection prepared by the Turkish Association for the Study of the Liver (TASL) and Viral Hepatitis
Society (VHS). The aim of this guidance was to provide updates recommendations to physicians, who are interested
in HCV care on the optimal screening, diagnosis and pre-treatment management for patients with HCV infection
in Turkey. These recommendations, produced by panel experts, were aimed to addresses the management issues
ranging from diagnosis and linkage to care, to the optimal treatment regimen in patients with HCV infection. Recommendations
are based on evidence and opinions of more than 70% of the panelists. This guidance is supported by
the memberships of two societies and not by pharmaceutical companies. This guidance will be updated frequently
as new data become available.
Collapse
Affiliation(s)
- Ramazan Idilman
- Turkish Association for the Study of the Liver, İstanbul, Turkey; Viral Hepatitis Society, Ankara, Turkey
| | - Nurcan Baykam
- Turkish Association for the Study of the Liver, İstanbul, Turkey; Viral Hepatitis Society, Ankara, Turkey
| | - Sabahattin Kaymakoğlu
- Turkish Association for the Study of the Liver, İstanbul, Turkey; Viral Hepatitis Society, Ankara, Turkey
| | - Fehmi Tabak
- Turkish Association for the Study of the Liver, İstanbul, Turkey; Viral Hepatitis Society, Ankara, Turkey
| | - Halil I Bahçecioğlu
- Turkish Association for the Study of the Liver, İstanbul, Turkey; Viral Hepatitis Society, Ankara, Turkey
| | - Ahmet Bektaş
- Turkish Association for the Study of the Liver, İstanbul, Turkey; Viral Hepatitis Society, Ankara, Turkey
| | - Cemal Bulut
- Turkish Association for the Study of the Liver, İstanbul, Turkey; Viral Hepatitis Society, Ankara, Turkey
| | - Fulya Günşar
- Turkish Association for the Study of the Liver, İstanbul, Turkey; Viral Hepatitis Society, Ankara, Turkey
| | - Dilara İnan
- Turkish Association for the Study of the Liver, İstanbul, Turkey; Viral Hepatitis Society, Ankara, Turkey
| | - Hayat K Karaosmanoğlu
- Turkish Association for the Study of the Liver, İstanbul, Turkey; Viral Hepatitis Society, Ankara, Turkey
| | - Zeki Karasu
- Turkish Association for the Study of the Liver, İstanbul, Turkey; Viral Hepatitis Society, Ankara, Turkey
| | - Ferit Kuşçu
- Turkish Association for the Study of the Liver, İstanbul, Turkey; Viral Hepatitis Society, Ankara, Turkey
| | - Birgül Mete
- Turkish Association for the Study of the Liver, İstanbul, Turkey; Viral Hepatitis Society, Ankara, Turkey
| | - Ömer Özbakır
- Turkish Association for the Study of the Liver, İstanbul, Turkey; Viral Hepatitis Society, Ankara, Turkey
| | - Osman C Özdoğan
- Turkish Association for the Study of the Liver, İstanbul, Turkey; Viral Hepatitis Society, Ankara, Turkey
| | - Mehmet Parlak
- Turkish Association for the Study of the Liver, İstanbul, Turkey; Viral Hepatitis Society, Ankara, Turkey
| | - Fatma Sırmatel
- Turkish Association for the Study of the Liver, İstanbul, Turkey; Viral Hepatitis Society, Ankara, Turkey
| | - Ömer Topalak
- Turkish Association for the Study of the Liver, İstanbul, Turkey; Viral Hepatitis Society, Ankara, Turkey
| | - Belkis Ünsal
- Turkish Association for the Study of the Liver, İstanbul, Turkey; Viral Hepatitis Society, Ankara, Turkey
| | | |
Collapse
|
15
|
Gazi U, Yapar D, Karasartova D, Gureser AS, Akdogan O, Unal O, Baykam N, Taylan Ozkan A. The role of T reg population in pathogenesis of Crimean Congo hemorrhagic fever. Virus Res 2018; 250:1-6. [PMID: 29625147 DOI: 10.1016/j.virusres.2018.04.003] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2018] [Revised: 04/02/2018] [Accepted: 04/02/2018] [Indexed: 01/26/2023]
Abstract
Crimean-Congo hemorrhagic fever (CCHF) is a severe human infection caused by CCHF virus (CCHFV). Today, although the literature on CCHF pathogenesis is still limited, it is thought to be associated with immunosuppression in the early phase of infection followed by pro-inflammatory immune response that may lead to fatal outcomes. The aim of this study is to investigate the role of regulatory T-cells (Treg cells) in the pathogenesis of CCHFV. Peripheral blood mononuclear cell samples collected from 14 acute CCHF patients with mild disease course and 13 healthy subjects were included in this study. Treg expression and functional levels were analyzed by flow cytometry. Treg cells were identified as CD4+CD25 + CD127dim cells, and their functional levels were compared by measuring their ability to suppress CD69 and CD154 expression by activated T-cells. The flow cytometry analysis revealed that total T-cell and helper T-cell levels did not vary between the two groups. In contrast, CCHF patients displayed higher Treg cell levels but lower Treg suppressive activities when compared with control subjects. This is the first study on the involvement of Treg cells in CCHF pathogenesis. Our results indicate that even though Treg cell levels are elevated during acute phase of CCHF infection, not all generated Treg cells has immunosuppressive capacity, and therefore may not represent 'true' Treg cell population. Future studies on the intrinsic mechanisms responsible for the reduced Treg inhibitory activities are required for further enlightening the CCHF pathogenesis, especially in the acute phase of the disease.
Collapse
Affiliation(s)
- Umut Gazi
- Department of Medical and Clinical Microbiology, Faculty of Medicine, Near East University, Nicosia, Cyprus
| | - Derya Yapar
- Department of Infectious Diseases and Clinical Microbiology, Hitit University, Corum, Turkey
| | | | | | - Ozlem Akdogan
- Department of Infectious Diseases and Clinical Microbiology, Hitit University, Corum, Turkey
| | - Ozgur Unal
- Infectious Diseases and Clinical Microbiology, Hitit University Erol Olcok Corum Training and Research Hospital, Corum, Turkey
| | - Nurcan Baykam
- Department of Infectious Diseases and Clinical Microbiology, Hitit University, Corum, Turkey.
| | - Aysegul Taylan Ozkan
- Department of Medical and Clinical Microbiology, Faculty of Medicine, Near East University, Nicosia, Cyprus; Department of Medical Microbiology, Hitit University, Corum, Turkey
| |
Collapse
|
16
|
Ergönül Ö, Şeref C, Eren Ş, Çelikbaş A, Baykam N, Dokuzoğuz B, Gönen M, Can F. Cytokine response in crimean-congo hemorrhagic fever virus infection. J Med Virol 2017; 89:1707-1713. [PMID: 28547808 DOI: 10.1002/jmv.24864] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.7] [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: 11/09/2016] [Accepted: 05/16/2017] [Indexed: 01/22/2023]
Abstract
We described the predictive role of cytokines in fatality of Crimean Congo Hemorrhagic Fever Virus (CCHFV) infection by using daily clinical sera samples. Consequent serum samples of the selected patients in different severity groups and healthy controls were examined by using human cytokine 17-plex assay. We included 12 (23%) mild, 30 (58%) moderate, 10 (19%) severe patients, and 10 healthy volunteers. The mean age of the patients was 52 (sd 15), 52% were female. Forty-six patients (88%) received ribavirin. During disease course, the median levels of IL-6, IL-8, IL-10, IL-10/12, IFN-γ, MCP-1, and MIP-1b were found to be significantly higher among CCHF patients than the healthy controls. Within the first 5 days after onset of disease, among the fatal cases, the median levels of IL-6 and IL-8 were found to be significantly higher than the survived ones (Fig. 3), and MCP-1 was elevated among fatal cases, but statistical significance was not detected. In receiver operating characteristic (ROC) analysis, IL-8 (92%), IL-6 (92%), MCP-1 (79%) were found to be the most significant cytokines in predicting the fatality rates in the early period of the disease (5 days). IL-6 and IL-8 can predict the poor outcome, within the first 5 days of disease course. Elevated IL-6 and IL-8 levels within first 5 days could be used as prognostic markers.
Collapse
Affiliation(s)
- Önder Ergönül
- Department of Infectious Diseases, School of Medicine, Koç University, Istanbul, Turkey
| | - Ceren Şeref
- School of Medicine, Koç University, Istanbul, Turkey
| | - Şebnem Eren
- Ankara Numune Training and Research Hospital, Ankara, Turkey
| | - Aysel Çelikbaş
- Ankara Numune Training and Research Hospital, Ankara, Turkey
| | - Nurcan Baykam
- Department of Infectious Diseases and Clinical Microbiology, School of Medicine, Hitit University, Çorum, Turkey
| | - Başak Dokuzoğuz
- Ankara Numune Training and Research Hospital, Ankara, Turkey
| | - Mehmet Gönen
- School of Medicine, Koç University, Istanbul, Turkey.,Department of Industrial Engineering, College of Engineering, Koç University, Istanbul, Turkey
| | - Füsun Can
- Department of Medical Microbiology, School of Medicine, Koç University, Istanbul, Turkey
| |
Collapse
|
17
|
Deniz S, Baykam N, Celikbas A, Yilmaz SM, Guzel TC, Dokuzoguz B, Ergonul O. Screening Household Members of Acute Brucellosis Cases in Endemic Areas and Risk Factors for Brucellosis. Vector Borne Zoonotic Dis 2016; 15:468-72. [PMID: 26273807 DOI: 10.1089/vbz.2014.1723] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Early diagnosis and treatment of acute brucellosis cases were targeted by screening the household members of the index cases. We also aimed to describe the causal relations of brucellosis in an endemic region. A cross-sectional study was performed among household members (29 index cases, 113 household members). Brucellosis was diagnosed on the basis of clinical findings, serum agglutinin titer of ≥1/160 in standard tube agglutination test (STA), or a positive blood culture. Index cases were defined as patients who had been admitted to the clinic on suspicion of brucellosis and then confirmed as brucellosis cases. The people who lived in the same house as the index cases were defined as household members. The risk factors for seropositivity were studied by multivariate analysis. Independent variables of gender, consuming fresh cheese, blood groups, dealing with husbandry, and contact with the placenta of infected animals were included to the model. Backward and forward selections were performed. Nineteen out of 113 (17%) screened individuals had agglutination titers ≥1/160. The mean ages of index cases and household members were 43 years (standard deviation [SD] 18) and 29 years (SD 19), respectively. In multivariate analysis, consuming fresh cheese (odds ratio [OR]=3.1, confidence interval [CI] 1.07-9.68, p=0.049), blood group A (OR=2.6, CI 1.18-5.96, p=0.018), contact with the placenta of the infected animals (OR=3.7, CI 1.42-9.68, p=0.007), and age >30 years (OR=2.8, CI 1.25-6.51, p=0.13) were found to be associated with brucellosis. In univariate analysis, the individuals with blood group B were protected from brucella infection (p=0.013). In conclusion, screening of the people in brucellosis-endemic areas should be considered for early diagnosis and treatment. To our knowledge, blood groups were studied for the first time by this study. Higher prevalence of brucellosis among the individuals with blood group A and less prevalence among the individuals with blood group B should be considered for further studies on pathogenesis.
Collapse
Affiliation(s)
- Secil Deniz
- 1 Haydarpasa Numune Training and Research Hospital , Department of Infectious Diseases and Clinical Microbiology, Istanbul, Turkey
| | - Nurcan Baykam
- 2 Ankara Numune Training and Research Hospital , Department of Infectious Diseases and Clinical Microbiology, Ankara, Turkey
| | - Aysel Celikbas
- 2 Ankara Numune Training and Research Hospital , Department of Infectious Diseases and Clinical Microbiology, Ankara, Turkey
| | - Sirin Menekse Yilmaz
- 3 Kartal Dr. Lutfi Kirdar Training and Research Hospital , Department of Infectious Diseases and Clinical Microbiology, Istanbul, Turkey
| | - Tugba Cirkin Guzel
- 2 Ankara Numune Training and Research Hospital , Department of Infectious Diseases and Clinical Microbiology, Ankara, Turkey
| | - Basak Dokuzoguz
- 2 Ankara Numune Training and Research Hospital , Department of Infectious Diseases and Clinical Microbiology, Ankara, Turkey
| | - Onder Ergonul
- 4 Koc University , School of Medicine, Department of Infectious Diseases Istanbul, Turkey
| |
Collapse
|
18
|
Avkan-Oğuz V, Baykam N, Sökmen S, Güner R, Agalar F, Alp E, Doğrul A, Turhan Ö, Ağalar C, Kurtaran B, Geçim İE, Özaras R, Yılmaz G, Akbulut A, Koksal İ. Recommendations for intra-abdominal infections consensus report. Ulus Cerrahi Derg 2016; 32:306-321. [PMID: 28149134 DOI: 10.5152/ucd.2016.3688] [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] [Subscribe] [Scholar Register] [Received: 08/12/2016] [Accepted: 09/26/2016] [Indexed: 12/12/2022]
Abstract
Guidelines include the recommendations of experts from various specialties within a topic in consideration of data specific to each country. However, to date there has not been a guideline standardizing the nomenclature and offering recommendations for intra-abdominal infections (IAIs) in Turkey. This is mainly due to the paucity of laboratory studies regarding the clinical diagnosis and treatment of IAIs or the sensitivity of microorganisms isolated from patients with IAIs. However, due to the diversification of host characteristics and advancements in technological treatment methods, it has become imperative to 'speak a common language'. For this purpose May 2015, a group of 15 experts in intra-abdominal infections, under the leadership of the Infectious Diseases and Clinical Microbiology Specialty Society of Turkey (EKMUD) and with representatives from the Turkish Surgical Association, Turkish Society of Colon and Rectal Surgery, Hernia Society, Turkish Society of Hepato-pancreato-biliary Surgery, and the Turkish Society of Hospital Infections and Control, was formed to analyze relevant studies in the literature. Ultimately, the suggestions for adults found in this consensus report were developed using available data from Turkey, referring predominantly to the 2010 guidelines for diagnosing and managing complicated IAIs in adults and children by the Infectious Diseases Society of America (IDSA) and the Surgical Infection Society. The recommendations are presented in two sections, from the initial diagnostic evaluation of patients to the treatment approach for IAI. This Consensus Report was presented at the EKMUD 2016 Congress in Antalya and was subsequently opened for suggestions on the official websites of the Infectious Diseases and Clinical Microbiology Specialty Society of Turkey and Turkish Surgical Association for one month. The manuscript was revised according to the feedback received.
Collapse
Affiliation(s)
- Vildan Avkan-Oğuz
- Department of Infectious Diseases and Clinical Microbiology, Dokuz Eylül University School of Medicine, İzmir, Turkey
| | - Nurcan Baykam
- Department of Infectious Diseases and Clinical Microbiology, Hitit University Çorum Training and Research Hospital, Çorum, Turkey
| | - Selman Sökmen
- Department of General Surgery, Dokuz Eylül University School of Medicine, İzmir, Turkey
| | - Rahmet Güner
- Department of Infectious Diseases and Clinical Microbiology, Yıldırım Beyazıt University School of Medicine, Ankara, Turkey
| | - Fatih Agalar
- Department of General Surgery, Anadolu Medical Center, Kocaeli, Turkey
| | - Emine Alp
- Department of Infectious Diseases and Clinical Microbiology, Erciyes University School of Medicine, Kayseri, Turkey
| | - Ahmet Doğrul
- Departments of General Surgery, Hacettepe University School of Medicine, Ankara, Turkey
| | - Özge Turhan
- Department of Infectious Diseases and Clinical Microbiology, Akdeniz University School of Medicine, Antalya, Turkey
| | - Canan Ağalar
- Department of Infectious Diseases and Clinical Microbiology, Fatih Sultan Mehmet Training and Research Hospital, İstanbul, Turkey
| | - Behice Kurtaran
- Department of Infectious Diseases and Clinical Microbiology, Çukurova University School of Medicine, Adana, Turkey
| | - İbrahim Ethem Geçim
- Department of General Surgery, Ankara University School of Medicine, Ankara, Turkey
| | - Reşat Özaras
- Department of Infectious Diseases and Clinical Microbiology, İstanbul University Cerrahpasa School of Medicine, İstanbul, Turkey
| | - Gürdal Yılmaz
- Department of Infectious Diseases and Clinical Microbiology, Karadeniz Technical University School of Medicine, Trabzon, Turkey
| | - Ayhan Akbulut
- Department of Infectious Diseases and Clinical Microbiology, Fırat University School of Medicine, Elazığ, Turkey
| | - İftihar Koksal
- Department of Infectious Diseases and Clinical Microbiology, Karadeniz Technical University School of Medicine, Trabzon, Turkey; The president of EKMUD
| |
Collapse
|
19
|
Yilmaz G, Sunbul M, Yapar D, Baykam N, Hasanoglu I, Guner R, Barut S, Tutuncu EE, Gunes F, Aksoy F, Kaya S, Bozkurt I, Sencan I, Khorgami P, Fatollahzadeh N, Keshtkar-Jahromi M, Koksal I. Ribavirin in Treatment of Crimean-Congo Hemorrhagic Fever (CCHF): An International Multicenter Retrospective Analysis. Open Forum Infect Dis 2016. [DOI: 10.1093/ofid/ofw172.531] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- Gürdal Yilmaz
- Department of Infectious Diseases and Clinical Microbiology, Karadeniz Technical University Medical Faculty, Trabzon, Turkey
| | - Mustafa Sunbul
- Department of Infectious Diseases and Clinical Microbiology, Ondokuz Mayis University Medical School, Samsun, Turkey
| | - Derya Yapar
- Department of Infectious Diseases and Clinical Microbiology, Hitit University Medical School, Corum, Turkey
| | - Nurcan Baykam
- Department of Infectious Diseases and Clinical Microbiology, Hitit University Medical School, Corum, Turkey
| | - Imran Hasanoglu
- Infectious Diseases and Clinical Microbiology, Yildirim Beyazit University School of Medicine, Ankara, Turkey
| | - Rahmet Guner
- Infectious Diseases and Clinical Microbiology, Yildirim Beyazit University School of Medicine, Ankara, Turkey
| | - Sener Barut
- Department of Infectious Diseases and Clinical Microbiology, Gaziosmanpasa University Medical School, Tokat, Turkey
| | - Emin Ediz Tutuncu
- Department of Infectious Diseases and Clinical Microbiology, Diskapi Yildirim Beyazit Training and Research Hospital, Ankara, Turkey
| | - Ferdi Gunes
- Department of Infectious Diseases and Clinical Microbiology, Gaziosmanpasa University Medical School, Tokat, Turkey
| | - Firdevs Aksoy
- Department of Infectious Diseases and Clinical Microbiology, Karadeniz Technical University Medical Faculty, Trabzon, Turkey
| | - Selcuk Kaya
- Department of Infectious Diseases and Clinical Microbiology, Karadeniz Technical University Medical Faculty, Trabzon, Turkey
| | - Ilkay Bozkurt
- Department of Infectious Diseases and Clinical Microbiology, Ondokuz Mayis University Medical School, Samsun, Turkey
| | - Irfan Sencan
- Department of Infectious Diseases and Clinical Microbiology, Diskapi Yildirim Beyazit Training and Research Hospital, Ankara, Turkey
| | - Parisa Khorgami
- Infectious Diseases and Tropical Medicine Research Center, Zahedan University of Medical Sciences, Zahedan, Islamic Republic of Iran
| | - Naeimeh Fatollahzadeh
- Infectious Diseases and Tropical Medicine Research Center, Zahedan University of Medical Sciences, Zahedan, Islamic Republic of Iran
| | - Maryam Keshtkar-Jahromi
- Medicine/Infectious Diseases, Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Iftihar Koksal
- Department of Infectious Diseases and Clinical Microbiology, Karadeniz Technical University Medical Faculty, Trabzon, Turkey
| |
Collapse
|
20
|
Yapar D, Erenler AK, Terzi Ö, Akdoğan Ö, Ece Y, Baykam N. Predicting tularemia with clinical, laboratory and demographical findings in the ED. Am J Emerg Med 2015; 34:218-21. [PMID: 26577431 DOI: 10.1016/j.ajem.2015.10.034] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2015] [Revised: 10/15/2015] [Accepted: 10/17/2015] [Indexed: 11/19/2022] Open
Abstract
INTRODUCTION We aimed to determine clinical, laboratory and demographical characteristics of tularemia on admission to Emergency Department (ED). MATERIAL AND METHODS Medical data of 317 patients admitted to ED and subsequently hospitalized with suspected tularemia between January 1, 2011, and May 31, 2015, were collected. Patients were divided into 2 groups according to microagglutination test results, as tularemia (+) and tularemia (-). RESULTS Of the 317 patients involved, 49 were found to be tularemia (+) and 268 were tularemia (-). Mean age of the tularemia (+) patients was found to be higher than that of tularemia (-) patients. When compared to tularemia (-) patients, a significant portion of patients in tularemia (+) patients were elderly, living in rural areas and had contact with rodents. When clinical and laboratory findings of the 2 groups were compared, any statistical significance could not be determined. CONCLUSION Tularemia is a disease of elderly people living in rural areas. Contact with rodents also increases risk of tularemia in suspected patients.
Collapse
Affiliation(s)
- Derya Yapar
- Infectious Diseases, Hitit University Çorum Education and Research Hospital, Department of Infectious Diseases, Çorum, Turkey.
| | - Ali Kemal Erenler
- Emergency Medicine, Hitit University Çorum Education and Research Hospital, Department of Emergency Medicine, Bahçelievler Mah. 19200, Çorum, Turkey.
| | - Özlem Terzi
- Public Health, Ondokuzmayis University, Department of Public Health, Samsun, Turkey.
| | - Özlem Akdoğan
- Infectious Diseases, Hitit University Çorum Education and Research Hospital, Department of Infectious Diseases, Çorum, Turkey.
| | - Yasemin Ece
- Hitit University Çorum Education and Research Hospital, Department of Emergency Medicine, Çorum, Turkey.
| | - Nurcan Baykam
- Infectious Diseases, Hitit University Çorum Education and Research Hospital, Department of Infectious Diseases, Çorum, Turkey.
| |
Collapse
|
21
|
Güner R, Tufan ZK, Bulut C, Ersöz G, Batırel A, Kaçmaz B, Kayaaslan B, Baykam N, Arı A, Öğütlü A, Alpat SN, Durdu Y, Günal Ö, Gürbüz Y, Aydın E, Tosun S, Tabak F. Waiting for Interferon-free Regimens for Chronic Hepatitis C Patients: A Multicenter Observational Study. Egypt J Immunol 2014. [DOI: 10.4274/vhd.98698] [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: 12/01/2022]
|
22
|
Eren Gok S, Kocagul Celikbas A, Baykam N, Atay Buyukdemirci A, Eroglu MN, Evren Kemer O, Dokuzoguz B. Evaluation of tularemia cases focusing on the oculoglandular form. J Infect Dev Ctries 2014; 8:1277-84. [PMID: 25313604 DOI: 10.3855/jidc.3996] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2013] [Revised: 04/06/2014] [Accepted: 04/14/2014] [Indexed: 10/31/2022] Open
Abstract
INTRODUCTION Tularemia is a zoonotic disease caused by Francisella tularensis. The oculoglandular form is one of the rarest forms. In this study, evaluated tularemia patients, focusing on the ocular form and the efficacy of early antibiotic therapy. METHODOLOGY During a tularemia outbreak, the epidemiological and clinical findings, laboratory assays, and drugs used for the treatment of 48 patients were recorded prospectively. The diagnosis of tularemia was confirmed with microagglutination test (MAT) as well as clinical findings. RESULTS The mean age of the subject was 48.6 years; 23 (47.9%) of them were female. Thirty-six (81.25%) patients had clinical presentation compatible with oropharyngeal tularemia, seven (14.58%) with oculoglandular tularemia, and two (4.1%) with ulceroglandular tularemia. The most common symptoms were fever (91.6%) and sore throat (81.2%), and the most common findings were lymphadenopathy (91.6%) and tonsillopharyngitis (81.2%). In the oculoglandular form, fever, lymphadenopathy, periorbital edema, conjunctival injection, and chemosis were found. The most distinctive ophthalmic feature was follicular conjunctivitis and conjunctival epithelial defects. Forty-five cases had positive serological results with MAT. All the patients were treated with antibiotics considered effective against F. tularensis, and topical antimicrobial treatment was given to the patients with oculoglandular tularemia. Twenty-six (54.16%) patients, who were admitted within three weeks of the onset of symptoms, recovered without sequel. CONCLUSIONS During tularemia outbreaks, ocular involvement should be considered carefully. The early administration of appropriate treatment will be more effective in resolving the infection and preventing complications. Along with systemic antibiotic therapy, topical treatment will help recovery.
Collapse
Affiliation(s)
- Sebnem Eren Gok
- Ankara Numune Training and Research Hospital, Ankara, Turkey.
| | | | | | | | | | | | | |
Collapse
|
23
|
GÖk ŞE, Kaptanoĝlu E, Çelikbaş A, ErgÖnül Ö, Baykam N, Eroĝlu M, Dokuzoĝuz B. Vertebral osteomyelitis: clinical features and diagnosis. Clin Microbiol Infect 2014; 20:1055-60. [DOI: 10.1111/1469-0691.12653] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2013] [Revised: 04/11/2014] [Accepted: 04/23/2014] [Indexed: 11/29/2022]
|
24
|
Ergonul O, Guven T, Ugurlu K, Celikbas AK, Gok SE, Comoglu S, Baykam N, Dokuzoguz B. Reply to Kesav et al. Clin Infect Dis 2013; 57:1057-8. [DOI: 10.1093/cid/cit399] [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: 11/13/2022] Open
|
25
|
Dokuzoguz B, Celikbas AK, Gök ŞE, Baykam N, Eroglu MN, Ergönül Ö. Severity scoring index for Crimean-Congo hemorrhagic fever and the impact of ribavirin and corticosteroids on fatality. Clin Infect Dis 2013; 57:1270-4. [PMID: 23946218 DOI: 10.1093/cid/cit527] [Citation(s) in RCA: 70] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Patients infected with Crimean-Congo hemorrhagic fever (CCHF) virus present with a wide clinical spectrum. In observational studies, the effects of therapeutic agents are confounded by severity. We describe use of a clinical severity scoring index (SSI) for CCHF patients and assess the effect of ribavirin and corticosteroid therapy on the case-fatality rate, stratified by SSI. METHODS The study group included hospitalized patients who received a diagnosis of CCHF at the Infectious Diseases and Clinical Microbiology Clinic of Ankara Numune Education and Research Hospital between 2004 and 2011. The SSI included platelet count, bleeding, fibrinogen level, activated partial thromboplastin time, and somnolence. The effects of ribavirin and corticosteroid on the case-fatality rate were studied by univariate and multivariate analysis, stratified by SSI. RESULTS Two hundred eighty-one confirmed cases of CCHF were included in the study. Of 281 patients, 23 (8%) died. The mean age (±SD) of the patients was 47 ± 16 years. Forty-nine percent were female. The mean duration of stay at our clinic after onset of symptoms was 4.4 days, with a range of 1-14 days. In multivariate analysis of factors for the prediction of death, the SSI (odds ratio [OR], 3.27; 95% confidence interval [CI], 2.09-5.13) and ribavirin use (OR, 0.04; 95% CI, .004-.48) were found to be statistically significant factors. CONCLUSION The SSI is an accurate predictor of death and will therefore be a useful tool for case management and for drug-assessment studies. After stratification of cases by SSI, ribavirin was found to be effective in reducing the case-fatality rate, especially among moderately ill patients, whereas steroids were found to be beneficial particularly among patients with severe disease.
Collapse
Affiliation(s)
- Basak Dokuzoguz
- Clinical Microbiology and Infectious Diseases Clinic, Ankara Numune Education and Research Hospital, Ankara
| | | | | | | | | | | |
Collapse
|
26
|
Guven T, Ugurlu K, Ergonul O, Celikbas AK, Gok SE, Comoglu S, Baykam N, Dokuzoguz B. Neurobrucellosis: clinical and diagnostic features. Clin Infect Dis 2013; 56:1407-12. [PMID: 23446629 DOI: 10.1093/cid/cit072] [Citation(s) in RCA: 111] [Impact Index Per Article: 10.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND We describe the neurological involvement in brucellosis and revisited diagnostic criteria for neurobrucellosis. METHODS Patients with laboratory-confirmed brucellosis who were consequently hospitalized were observed prospectively in a brucellosis-endemic region. The neurobrucellosis was diagnosed by any one of the following criteria: (1) symptoms and signs consistent with neurobrucellosis; (2) isolation of Brucella species from cerebrospinal fluid (CSF) and/or presence of anti-Brucella antibodies in CSF; (3) the presence of lymphocytosis, increased protein, and decreased glucose levels in CSF; or (4) diagnostic findings in cranial magnetic resonance imaging or CT. RESULTS Lumbar puncture was performed in 128 laboratory-confirmed brucellosis cases who had neurological symptoms and signs, and 48 (37.5%) were diagnosed as neurobrucellosis. The sensitivity of tube agglutination (TA) in CSF was 0.94, specificity 0.96, positive predictive value 0.94, and negative predictive value 0.96. Brucella bacteria were isolated from CSF in 7 of 48 patients (15%). The mean age of 48 neurobrucellosis patients was 42 years (SD, 19 years), and 16 (33%) were female. The most common neurological findings were agitation (25%), behavioral disorders (25%), muscle weakness (23%), disorientation (21%), and neck rigidity (17%). Cranial nerves were involved in 9 of 48 patients (19%). One patient was left with a sequela of peripheral facial paralysis and 2 patients with sensorineural hearing loss. CONCLUSIONS Patients with severe and persistent headache and other neurologic symptoms and signs should be considered for neurobrucellosis in endemic regions and to possibly receive longer therapy than 6 weeks. Brucella TA with Coombs test in CSF is sensitive and specific by using a cutoff of ≥1:8.
Collapse
Affiliation(s)
- Tumer Guven
- Infectious Diseases and Clinical Microbiology Clinic, Ataturk Training and Research Hospital, Ankara, Turkey
| | | | | | | | | | | | | | | |
Collapse
|
27
|
Ergönül Ö, Çelikbaş A, Dokuzoğuz B, Eren Ş, Baykam N, Esener H. Ribavirin in Crimean‐Congo Hemorrhagic Fever: Primum Non Nocere. Clin Infect Dis 2009; 49:1621-2. [DOI: 10.1086/644778] [Citation(s) in RCA: 5] [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: 11/03/2022] Open
|
28
|
Baykam N, Ergonul O, Ulu A, Eren S, Celıkbas A, Eroglu M, Dokuzoguz B. Characterıstıcs of cutaneous anthrax ın Turkey. J Infect Dev Ctries 2009. [DOI: 10.3855/jidc.551] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022] Open
Abstract
BACKGROUND: Incidence of anthrax is diminishing in developed countries; however, it remains a public health problem in developing countries, especially those whose main source of income is farming.
METHODOLOGY: Charts of patients hospitalized between 1992 and 2008 in the Infectious Diseases and Clinical Microbiology Department of Ankara Numune Education and Research Hospital were reviewed.
RESULTS: Fifty-eight cases with cutaneous anthrax were reviewed. The mean age was 49.8, and 36.2% were female. The most common professions were farmers (62%), butchers (19%), and housewives (15%). The mean incubation period was eight days. Most cases (62%) were exposed to bacteria when butchering sick animals. Eighteen patients used an antibiotic before admission to hospital (31%). The predominantly affected sites were hands (39%) and fingers (29%), followed by forearms (12%), eyelids (7%) and necks (3%). All cases initially had painless ulcers with vesicles; dissemination of the lesion was seen in 27.5% of patients. Gram stain was positive in 11 cases; culture was positive in 7 cases for Bacillus anthracis. All patients except one were discharged and treated with penicillin and/or ciprofloxacin or imipenem. One patient with a disseminated lesion on the neck died even though a steroid was used with the antibiotic.
CONCLUSIONS: Cutaneous anthrax should be considered as a possible diagnosis in cases with a painless ulcer with vesicles, edema, and a history of exposure to animals or animal products. Despite previous antibiotic use, taking smears and cultures should be encouraged. Treatment with penicillin G or penicillin procain alone is effective for cases with cutaneous anthrax without severe edema and superinfection.
Collapse
|
29
|
Baykam N, Ergonul O, Ulu A, Eren S, Celikbas A, Eroglu M, Dokuzoguz B. Characteristics of cutaneous anthrax in Turkey. J Infect Dev Ctries 2009; 3:599-603. [PMID: 19801802] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2009] [Indexed: 05/28/2023] Open
Abstract
BACKGROUND Incidence of anthrax is diminishing in developed countries; however, it remains a public health problem in developing countries, especially those whose main source of income is farming. METHODOLOGY Charts of patients hospitalized between 1992 and 2008 in the Infectious Diseases and Clinical Microbiology Department of Ankara Numune Education and Research Hospital were reviewed. RESULTS Fifty-eight cases with cutaneous anthrax were reviewed. The mean age was 49.8, and 36.2% were female. The most common professions were farmers (62%), butchers (19%), and housewives (15%). The mean incubation period was eight days. Most cases (62%) were exposed to bacteria when butchering sick animals. Eighteen patients used an antibiotic before admission to hospital (31%). The predominantly affected sites were hands (39%) and fingers (29%), followed by forearms (12%), eyelids (7%) and necks (3%). All cases initially had painless ulcers with vesicles; dissemination of the lesion was seen in 27.5% of patients. Gram stain was positive in 11 cases; culture was positive in 7 cases for Bacillus anthracis. All patients except one were discharged and treated with penicillin and/or ciprofloxacin or imipenem. One patient with a disseminated lesion on the neck died even though a steroid was used with the antibiotic. CONCLUSIONS Cutaneous anthrax should be considered as a possible diagnosis in cases with a painless ulcer with vesicles, edema, and a history of exposure to animals or animal products. Despite previous antibiotic use, taking smears and cultures should be encouraged. Treatment with penicillin G or penicillin procain alone is effective for cases with cutaneous anthrax without severe edema and superinfection.
Collapse
Affiliation(s)
- Nurcan Baykam
- Infectious Diseases and Clinical Microbiology Department, Ankara Numune Education and Research Hospital, Ankara, Turkey.
| | | | | | | | | | | | | |
Collapse
|
30
|
Baykam N, Esener H, Ergonul O, Kosker PZ, Cirkin T, Celikbas A, Eren S, Dokuzoguz B. Methicillin-resistant Staphylococcus aureus on hospital admission in Turkey. Am J Infect Control 2009; 37:247-9. [PMID: 18945517 DOI: 10.1016/j.ajic.2008.05.014] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2008] [Revised: 05/20/2008] [Accepted: 05/27/2008] [Indexed: 11/27/2022]
Abstract
A total of 900 patients were screened for methicillin-resistant Staphylococcus aureus (MRSA) on hospital admission, and 11 MRSA strains (1.2%) were detected. All 11 MRSA strains were positive for the mecA and PVL genes. Eight of the 11 MRSA-positive patients (72%) had a history of hospitalization within the previous 12 months.
Collapse
Affiliation(s)
- Nurcan Baykam
- Department of Infectious Diseases and Clinical Microbiology, Ankara Numune Education and Research Hospital, Ankara, Turkey.
| | | | | | | | | | | | | | | |
Collapse
|
31
|
Alp MN, Baykam N, Kural G. Immune recovery uveitis associated with highly active antiretroviral therapy in a patient with CMV retinitis and AIDS despite a low CD4+ T cell count: case report and a review of the literature. Int Ophthalmol 2009; 30:183-9. [PMID: 19198761 DOI: 10.1007/s10792-009-9303-1] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2008] [Accepted: 01/20/2009] [Indexed: 11/26/2022]
Abstract
An unusual case of CMV retinitis and AIDS who developed immune recovery uveitis (IRU) despite a low CD4+ T cell count achieved during HAART is reported. A 36-year-old female complained of blurred vision in both eyes six months after initiation of anti-CMV retinitis therapy and HAART. Ocular examination revealed a substantial intraocular inflammation causing a dense vitreous haze and frosted branch angiitis. Consecutive CD4+ T cell counts were 20 cells/mm(3) or less and plasma HIV mRNA was undetectable. The laboratory test for Cytomegalovirus was positive whereas those for infections known to cause uveitis were negative. The inflammatory reaction resolved with treatment, but she developed retinal detachment just before she died of pulmonary complications. A review of the literature led us to propose that our patient developed an intraocular inflammation which may probably be a form of IRU and it might be appropriate to employ additional criteria in the definition and the diagnosis of IRU.
Collapse
Affiliation(s)
- Mehmet Numan Alp
- Department of Ophthalmology, Numune Training and Research Hospital, Dr Mediha Eldem Sokak 69/10, 06640, Ankara, Turkey.
| | | | | |
Collapse
|
32
|
Celikbas A, Ergonul O, Baykam N, Eren S, Esener H, Eroğlu M, Dokuzoguz B. Epidemiologic and clinical characteristics of HIV/AIDS patients in Turkey, where the prevalence is the lowest in the region. ACTA ACUST UNITED AC 2007; 7:42-5. [PMID: 17989428 DOI: 10.1177/1545109707306575] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
The authors describe the epidemiologic and clinical characteristics of 97 human immunodeficiency virus (HIV)-infected patients, who were followed between 1993 and 2006. Seventy-two percent of the patients were male, and median age at diagnosis was 36 years (range, 13-71 years). The mean years of survival was 3, and maximum length of life after diagnosis was 9 years. The most common professions were truck drivers, workers, and housewives. Forty-six percent of the males had a history of working abroad. Heterosexual intercourse was the most common (84%) route of transmission. Seventy-four percent of the women acquired infection from their husbands. In Turkey, less educated or uneducated and poor men are the primary target of the HIV infection usually by sexual contact with foreign women. Considering the low education status of the patients, appropriate education programs should be developed to prevent the dissemination of HIV infection. Because a significant number of patients were diagnosed at very late stages, the physicians and other health care workers should be educated on the clinical pictures of HIV/AIDS.
Collapse
Affiliation(s)
- Aysel Celikbas
- Ankara Numune Education and Research Hospital, The First Infectious Diseases and Clinical Microbiology Clinic, Ankara, Turkey
| | | | | | | | | | | | | |
Collapse
|
33
|
Celikbas A, Ergonul O, Aksaray S, Tuygun N, Esener H, Tanir G, Eren S, Baykam N, Guvener E, Dokuzoguz B. Measles, rubella, mumps, and varicella seroprevalence among health care workers in Turkey: is prevaccination screening cost-effective? Am J Infect Control 2006; 34:583-7. [PMID: 17097453 DOI: 10.1016/j.ajic.2006.04.213] [Citation(s) in RCA: 49] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2006] [Revised: 04/24/2006] [Accepted: 04/24/2006] [Indexed: 11/29/2022]
Abstract
BACKGROUND To investigate the immune status of health care workers (HCWs) against measles, rubella, mumps, and varicella zoster (MMRV) in Turkey and to define an appropriate vaccination program among HCWs. METHODS Voluntary HCWs from a children's hospital and a general hospital were included in the study between March and May 2005. The specific IgG antibodies against MMRV viruses were screened by ELISA. RESULTS Three hundred sixty-three HCWs participated in the study; 186 (51%) were physicians, 118 (33%) were nurses, 36 (10%) were housekeeping staff, and 23 (6%) were medical technicians. The proportion of HCWs who had antibodies against measles was 98.6%; rubella, 98.3%; mumps, 92.2%; and varicella, 98%. No association was found between the susceptibility to at least 1 of MMRV virus infections and gender, age, duration of work, profession, and department of work in analysis either among the whole study group, or each hospital. The positive predictive value for the history of varicella was 100%, whereas it was 92% for MMR. The cost of vaccination for varicella was significantly expensive without screening before vaccination. However, there was not much difference for MMR infections. CONCLUSION A policy based on obtaining the history of varicella infection from the staff and then screening the ones with negative history and vaccination of only seronegative HCWs was found to be appropriate.
Collapse
Affiliation(s)
- Aysel Celikbas
- Ankara Numune Education and Research Hospital, The First Infectious Diseases and Clinical Microbiology Clinic, Turkey
| | | | | | | | | | | | | | | | | | | |
Collapse
|
34
|
Eren S, Bayam G, Ergönül O, Celikbaş A, Pazvantoğlu O, Baykam N, Dokuzoğuz B, Dilbaz N. Cognitive and emotional changes in neurobrucellosis. J Infect 2006; 53:184-9. [PMID: 16647757 DOI: 10.1016/j.jinf.2005.10.029] [Citation(s) in RCA: 32] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2005] [Revised: 10/29/2005] [Accepted: 10/31/2005] [Indexed: 11/19/2022]
Abstract
OBJECTIVE To determine cognitive and emotional changes among neurobrucellosis patients. METHODS The patients with neurobrucellosis and controls with brucellosis without neurologic involvement were included in the study. Neurobrucellosis was diagnosed by the following criteria: (i) symptoms or clinical findings compatible with neurobrucellosis, including headache, confusion, mental and emotional changes; (ii) isolation of Brucella spp. from CSF and/or demonstration of antibodies to Brucella > or = 1/4 in the CSF; (iii) the presence of lymphocytosis, increased protein and decreased glucose levels in the CSF; and (iv) clinical improvement with appropriate treatment. Two psychiatrists interviewed the patients, and performed the Hamilton Depression Rating Scale (HDRS) tests and Mini-Mental State Examination (MMSE) tests. RESULTS Thirty-four neurobrucellosis cases and 30 patients with brucellosis without neurological involvement were studied. The mean age was 41 years, 12 (41%) patients were female, 13 (46%) patients were farmers, and 7 (25%) patients were housewives. Among the neurobrucellosis cases, before the antibiotic therapy, the mean MMSE test score was 21.6, one week after the therapy 22.7, and two weeks after the therapy 24.3 (p=0.024, and p<0.001, respectively). At the day of admission before therapy, the mean of HDRS test was 9.9, one week after therapy it was 7.8, and two weeks after therapy it was 5 (p=0.014, and p<0.001, respectively). CONCLUSION The cognitive and emotional disturbances among neurobrucellosis patients were documented by MMSE and HDRS tests. These disorders improve by antibiotic therapy, without any anti-depressive or anti-psychotic therapy.
Collapse
Affiliation(s)
- Sebnem Eren
- The First Infectious Diseases and Clinical Microbiology Clinic, Ankara Numune Education and Research Hospital, Talatpasa bulvari, Sihhiye, 06230, Ankara, Turkey.
| | | | | | | | | | | | | | | |
Collapse
|
35
|
Celikbaş AK, Ergönül O, Baykam N, Eren S, Güven T, Dokuzoğuz B. [Malaria in Turkey and 14 years of clinical experience]. MIKROBIYOL BUL 2006; 40:237-43. [PMID: 17001853] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/12/2023]
Abstract
In this retrospective study, the epidemiologic and clinical characteristics of 105 adult malaria patients, who had been hospitalized between the period of 1992 and 2006 were evaluated. Nineteen percent of the patients were female, and the mean age was 28 +/- 10 years. Fifty percent of the patients acquired the infection in Southeastern Anatolia, while they were on military duty. The most common complaints were rigor (93%), fever (90%), sweating (90%), headache (76%), nausea (45%), and fatigue (38%). The most common physical examination findings were splenomegaly (86%) and hepatomegaly (62%). Anemia was detected in 23%, leukopenia in 47%, thrombocytopenia in 73%, two fold increase in ALT or AST enzyme levels in 32% of the patients. Plasmodium vivax was detected in 101 (96%) patients, whereas P. falciparum was detected in 4 patients (4%). Although the number of malaria cases in Turkey is declining in recent years, the febrile patients with a history of travel to the endemic regions should raise the suspicion of malaria.
Collapse
Affiliation(s)
- Aysel Kocagül Celikbaş
- Ankara Numune Eğitim ve Araştirma Hastanesi, 1. Enfeksiyon Hastaliklari ve Klinik Mikrobiyoloji Kliniği, Ankara
| | | | | | | | | | | |
Collapse
|
36
|
Ergonul O, Celikbas A, Baykam N, Eren S, Dokuzoguz B. Analysis of risk-factors among patients with Crimean-Congo haemorrhagic fever virus infection: severity criteria revisited. Clin Microbiol Infect 2006; 12:551-4. [PMID: 16700704 DOI: 10.1111/j.1469-0691.2006.01445.x] [Citation(s) in RCA: 139] [Impact Index Per Article: 7.7] [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: 11/29/2022]
Abstract
The aim of this study was to determine the predictors of mortality among patients infected with Crimean-Congo haemorrhagic fever (CCHF) virus. Among patients with acute febrile syndrome, characterised by malaise, bleeding, leukopenia and thrombocytopenia, who were admitted to hospital during the spring and summer of 2002-2004, 54 had positive IgM and/or PCR results for CCHF virus in blood or tissue. The overall case fatality rate was 7.4%. Among the fatalities, haematemesis (p 0.009), melaena (p 0.001) and somnolence (p 0.022) were more common, the median platelet count was significantly lower (10,600/mL vs. 20,000/mL; p 0.038), the mean prothrombin time (27 s vs. 16 s; p 0.002) and mean activated partial thromboplastin time (73 s vs. 44 s; p < 0.001) were longer, and the mean alanine transferase (ALT) level (1,125 vs. 331; p < 0.001), the mean aspartate transferase (AST) level (3,118 vs. 913; p 0.004) and the mean fibrinogen level (119 vs. 340; p 0.012) were higher. Serum IgM and IgG against CCHF virus was detected in 25% and 0%, respectively, of fatal cases, compared with 94% and 62%, respectively, of cases with favourable outcomes. Oral ribavirin was prescribed to 22 (41%) patients. Of the four fatal cases, it was the intention to prescribe ribavirin to three patients, but this was not possible because of haematemesis and melaena. Higher levels of AST (>or= 700 U/L) and ALT (>or= 900 U/L) are suggested for use as severity criteria. Oral ribavirin was not effective for patients with haematemesis, and intravenous ribavirin is necessary for treatment of CCHF.
Collapse
Affiliation(s)
- O Ergonul
- Infectious Diseases and Clinical Microbiology Department, Ankara Numune Education and Research Hospital, Ankara, Turkey.
| | | | | | | | | |
Collapse
|
37
|
Ergonul O, Tuncbilek S, Baykam N, Celikbas A, Dokuzoguz B. Evaluation of serum levels of interleukin (IL)-6, IL-10, and tumor necrosis factor-alpha in patients with Crimean-Congo hemorrhagic fever. J Infect Dis 2006; 193:941-4. [PMID: 16518755 DOI: 10.1086/500836] [Citation(s) in RCA: 151] [Impact Index Per Article: 8.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2005] [Accepted: 10/25/2005] [Indexed: 11/03/2022] Open
Abstract
We investigated the role played by cytokines in the mortality of patients with Crimean-Congo hemorrhagic fever (CCHF). Serum levels of several cytokines were measured in 3 patients with fatal CCHF and in 27 patients with nonfatal CCHF. Levels of interleukin (IL)-6 (P< or = .001) and tumor necrosis factor (TNF)-alpha (P = .004) were significantly higher in patients with fatal CCHF than in patients with nonfatal CCHF, whereas levels of IL-10 were not significantly different between the 2 groups (P = .937). Disseminated intravascular coagulation (DIC) scores were also higher in the patients with fatal CCHF (P = .023). Levels of IL-6 and TNF-alpha were positively correlated with DIC scores, whereas levels of IL-10 were negatively correlated with DIC scores. In conclusion, these findings demonstrate that proinflammatory cytokines play a major role in the mortality of patients with CCHF.
Collapse
Affiliation(s)
- Onder Ergonul
- Infectious Diseases and Clinical Microbiology Clinic, Ankara Numune Education and Research Hospital, Ankara, Turkey.
| | | | | | | | | |
Collapse
|
38
|
Celikbaş A, Ergönül O, Dokuzoğuz B, Eren S, Baykam N, Polat-Düzgün A. Crimean Congo hemorrhagic fever infection simulating acute appendicitis. J Infect 2005; 50:363-5. [PMID: 15845439 DOI: 10.1016/j.jinf.2004.05.020] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/29/2004] [Indexed: 11/30/2022]
Abstract
An unusual cause of acute abdominal pain simulating acute appendicitis is presented. The patient was admitted with complaints of fever, malaise, headache, nausea, vomiting, diarrhoea, and severe bleeding. Based on the clinical and epidemiological findings, a diagnosis of Crimean Congo hemorrhagic fever virus infection was suspected, and ribavirin therapy was started. While her clinical condition was improving, she experienced a sudden pain at her right lower quadrant of the abdomen. Explorative laparotomy revealed haemorrhage within the abdominal muscles. Her CCHF IgM was found to be positive.
Collapse
Affiliation(s)
- Aysel Celikbaş
- First Infectious Diseases and Clinical Microbiology Clinic, Ankara Numune Education and Research Hospital, Ankara, Turkey
| | | | | | | | | | | |
Collapse
|
39
|
Keskiner R, Ergönül O, Demiroglu Z, Eren S, Baykam N, Dokuzoguz B. Risk of tuberculous infection among healthcare workers in a tertiary-care hospital in Ankara, Turkey. Infect Control Hosp Epidemiol 2005; 25:1067-71. [PMID: 15636294 DOI: 10.1086/502345] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.0] [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: 11/04/2022]
Abstract
OBJECTIVE To determine risk factors for tuberculin skin test (TST) positivity among healthcare workers (HCWs). DESIGN Two-step TST was performed in 2002. SETTING Tertiary-care hospital in Ankara, Turkey. PARTICIPANTS A sample of 491 hospital HCWs were included. Information related to demographics, profession, work duration, department, and individual and family history of tuberculosis (TB) was obtained by a structured questionnaire. RESULTS Four hundred eight (83%) had two-step TST positivity. On multivariate analysis, male physicians (relative risk [RR], 1.5; 95% confidence interval [CI95], 1.23-1.69; P = .001), nurses (RR, 1.5; CI95, 1.29-1.66; P = .005), radiology technicians (RR, 1.7; CI95, 1.35-1.73; P = .002), laboratory technicians (RR, 1.6; CI95, 1.3-1.74; P = .007), and male housekeepers (RR, 1.6; (HCWs). CI95, 1.38-1.7; P < .001) had a higher risk than did female physicians. Among laboratory technicians, radiology technicians had the highest TST positivity (85%). HCWs working for less than 1 year (RR, 0.8; CI95, 0.72-0.98; P = .027) had a lower risk of infection. The HCWs having bacille Calmette-Guerin vaccination (RR, 1.12; CI95, 1.08-1.45) had higher TST positivity. CONCLUSION Male physicians, nurses, and laboratory technicians had increased risk of Mycobacterium tuberculosis infection in this setting, but community exposure likely accounted for most infections.
Collapse
Affiliation(s)
- Ramazan Keskiner
- Infectious Disease Department, Ankara Numume Education and Research Hospital, Ankara, Turkey
| | | | | | | | | | | |
Collapse
|
40
|
Dokuzoğuz B, Ergönül O, Baykam N, Esener H, Kiliç S, Celikbaş A, Eren S, Esen B. Characteristics of B. melitensis versus B. abortus bacteraemias. J Infect 2005; 50:41-5. [PMID: 15603839 DOI: 10.1016/j.jinf.2004.02.005] [Citation(s) in RCA: 31] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/21/2004] [Indexed: 11/17/2022]
Abstract
OBJECTIVE To determine the epidemiological and the clinical characteristics of bacteremic brucellosis. METHODS A prospective study, performed in the First Infectious Diseases Clinic of Ankara Numune Education and Research Hospital. All the patients had positive culture result for Brucella spp. RESULTS Fifty-four acute bacteremic brucellosis cases were included. The majority of patients (76%) were from rural Anatolia. Brucella melitensis serotypes were more common than Brucella abortus (83% versus 17%). Fever and arthralgia were the most common symptoms. The number of patients with back pain and arthralgia was higher in B. abortus infected group (p = 0.014 and p = 0.009). CONCLUSIONS B. melitensis is the most common subtype of Brucella infection in Turkey. The infections with B. abortus spp. are not less severe than the infections with B. melitensis.
Collapse
Affiliation(s)
- Başak Dokuzoğuz
- The First Infectious Diseases and Clinical Microbiology Clinic, Ankara Numune Education and Research Hospital, Ankara, Turkey
| | | | | | | | | | | | | | | |
Collapse
|
41
|
Celikbaş AK, Ulu A, Ergönül O, Eren S, Baykam N, Dokuzoguz B. [Case report: cutaneous tuberculosis and tuberculous osteomyelitis]. MIKROBIYOL BUL 2005; 39:95-9. [PMID: 15900843] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/02/2023]
Abstract
In this report, a 27 years old male patient diagnosed to have skin and bone tuberculosis (TB) has been presented. The patient admitted to the hospital with the complaints of fever, weight loss and night sweats. Patient's history revealed that following a trauma a skin lesion in the right ankle was developed and this was followed by the development of many lesions in different parts of the body. The lesions persisted despite the use of various antibiotics since a year. It has been recorded that his father has already been receiving anti-tuberculosis treatment. Osteomyelitis was detected in the distal part of right tibia by computerized tomography, and Mycobacterium tuberculosis was isolated from the specimens of skin lesion. The patient was immunocompetent, and there was no pulmonary involvement. Isoniazid (INAH), rifampin (RIF), ethambutol and morphozinamid therapy has been started and completed to 12 months with INAH and RIF. In the post-treatment follow-up of patient for one year, no relapse was detected. As a result, tuberculosis should be considered in patients with persistent skin lesions especially in endemic countries.
Collapse
Affiliation(s)
- Aysel Kocagul Celikbaş
- Ankara Numune Egitim ve Araştirma Hastanesi Birinci infeksiyon Hastaliklari ve Klinik Mikrobiyoloji Klinigi, Ankara
| | | | | | | | | | | |
Collapse
|
42
|
Ergönül O, Kocagül Celikbaş A, Altin N, Eren S, Baykam N, Dokuzoğuz B. [A case report: Kikuchi-Fujimoto disease]. MIKROBIYOL BUL 2004; 38:455-9. [PMID: 15700674] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/01/2023]
Abstract
Kikuchi-Fujimoto disease (histiocytic necrotizing lymphadenitis) which presents with fever and lymphadenopathy, should be considered in differential diagnosis of fever with unknown origin. We presented a 19 years old male patient with complaints of fever and lymphadenopathy. The case was diagnosed as Kikuchi-Fujimoto disease by histopathological evaluation.
Collapse
Affiliation(s)
- Onder Ergönül
- Ankara Numune Eğitim ve Araştirma Hastanesi, 1. infeksiyon Hastaliklan ve Klinik Mikrobiyoloji Kliniği, Ankara
| | | | | | | | | | | |
Collapse
|
43
|
Ergönül O, Celikbaş A, Dokuzoguz B, Eren S, Baykam N, Esener H. Characteristics of Patients with Crimean-Congo Hemorrhagic Fever in a Recent Outbreak in Turkey and Impact of Oral Ribavirin Therapy. Clin Infect Dis 2004; 39:284-7. [PMID: 15307042 DOI: 10.1086/422000] [Citation(s) in RCA: 182] [Impact Index Per Article: 9.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2003] [Accepted: 02/26/2004] [Indexed: 11/03/2022] Open
Abstract
We describe the epidemiological, clinical, and laboratory findings and the role of ribavirin therapy for 35 patients who received a diagnosis of Crimean-Congo hemorrhagic fever (CCHF). All patients had immunoglobulin M antibodies and/or PCR results positive for CCHF virus in blood or tissue specimens. Eighty-six percent of the patients were considered to have severe cases of CCHF. The overall case-fatality rate was 2.8%. Eight patients were given ribavirin, and all 8 survived. We suggest using ribavirin to treat patients with CCHF, particularly those with severe cases.
Collapse
Affiliation(s)
- Onder Ergönül
- Infectious Diseases and Clinical Microbiology Department, Ankara Numune Education and Research Hospital, Ankara, Turkey.
| | | | | | | | | | | |
Collapse
|
44
|
Baykam N, Esener H, Ergönül O, Eren S, Celikbas AK, Dokuzoguz B. In vitro antimicrobial susceptibility of Brucella species. Int J Antimicrob Agents 2004; 23:405-7. [PMID: 15081093 DOI: 10.1016/j.ijantimicag.2003.09.024] [Citation(s) in RCA: 46] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2003] [Accepted: 09/22/2003] [Indexed: 10/26/2022]
Abstract
MIC50 and MIC90 values of doxycycline, rifampicin, ciprofloxacin, trimethoprim-sulphamethoxazole and ceftriaxone for 42 blood isolates of Brucella species were determined using the Etest. Thirty-seven isolates were identified as B. melitensis and five as B. abortus. Doxycycline had the lowest and rifampicin the highest MIC50 values. Four strains were non-susceptible to rifampicin, and one strain was resistant to trimethoprim-sulphamethoxazole. There is no significantly important resistance problem for antibiotics targeted against Brucella species in Turkey. However, since rifampicin is commonly used for prevalent diseases such as tuberculosis, the regional susceptibility pattern of rifampicin should be assessed periodically.
Collapse
Affiliation(s)
- Nurcan Baykam
- Ankara Numune Research and Education Hospital, First Infectious Diseases and Clinical Microbiology Department, Ankara, Turkey.
| | | | | | | | | | | |
Collapse
|