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Turhan AB, Icten S, Ayazoglu TA, Cag Y, Ankarali H, Turhan AH. ABO-Rh Blood Types and Clinical Consequences of COVID-19 Infection. Niger J Clin Pract 2022; 25:1660-1665. [PMID: 36308236 DOI: 10.4103/njcp.njcp_2042_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/16/2023]
Abstract
AIM AND BACKGROUND Because of there is no sufficient evidence showing a relationship between blood types and severity of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection, this study was planned to investigate the effects of ABO blood group on the clinical outcomes of SARS-CoV-2 infection. PATIENTS AND METHODS The data of the patients were examined retrospectively. The patients who were hospitalized in wards or intensive care unit, constituted the study group. The patients who presented to the hospital because of other causes and whose blood type examinations were performed, were included in the control group. RESULTS The study group consisted of 406 six patients were diagnosed with SARS-CoV-2 infection. Control group consisted of 38079 patients whose blood group was determined for any reason in the same period. The rate of Rh negativity was significantly higher in the patient group (p = 0,01). Hospitalization duration in intensive care was significantly longer in the blood type A and AB groups compared to the blood type O group (p = 0,03). CONCLUSION Our results are in agreement with other studies suggesting that blood group O individuals are somewhat more resistant to clinically overt infection with SARS-CoV-2 than other blood groups. In addition, Rh negativity may also be an individual risk factor for SARS-CoV-2 infection.
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Affiliation(s)
- A B Turhan
- Pediatric Hematology Oncology Clinic, Transfusion Center, Göztepe Prof. Dr. Süleyman Yalçin City Hospital,, Turkey
| | - S Icten
- Chest Diseases Clinic, Göztepe Prof. Dr. Süleyman Yalçin City Hospital, Istanbul, Turkey
| | - T A Ayazoglu
- Anesthesiology and Reanimation Clinic, Göztepe Prof. Dr. Süleyman Yalçin City Hospital, Istanbul, Turkey
| | - Y Cag
- Department of Infectious Diseases and Clinical Microbiology, Göztepe Prof. Dr. Süleyman Yalçin City Hospital, Istanbul, Turkey
| | - H Ankarali
- Department of Biostatistics and Medical Informatics, Istanbul Medeniyet University Göztepe Education and Research Hospital, Istanbul, Turkey
| | - A H Turhan
- Department of Pediatrics, Division of Neonatology, Bahçeşehir University, Istanbul, Turkey
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Cag Y, Al Madadha ME, Ankarali H, Cag Y, Demir Onder K, Seremet-Keskin A, Kizilates F, Čivljak R, Shehata G, Alay H, Alkan-Ceviker S, Yilmaz-Karadag F, Cagla-Sonmezer M, Ezzelarab Ramadan M, Magdelena DI, Radic LB, Arapovic J, Kesmez-Can F, El-Sayed NM, Campbell OB, Eser-Karlidag G, Khedr R, Isik ME, Petrov MM, Cernat R, Erturk U, Uygun-Kizmaz Y, Huljev E, Amer F, Ceylan MR, Marino A, Kul G, Damar-Cakirca T, Khalaf YM, Isik AC, Ariyo OE, Hakyemez IN, Ripon RK, Afkhamzadeh A, Dindar-Demiray EK, Gideon OO, Belitova M, Altindis M, El-Sokkary R, Tekin R, Garout MA, Zajkowska J, Fazal F, Bekcibasi M, Hukic M, Nizamuddin S, Surme S, Fernandez R, El-Kholy A, Akhtar N, Ijaz S, Cortegiani A, Meric-Koc M, Hasman H, Maduka AV, ElKholy JA, Sari S, Khan MA, Akin Y, Kose S, Erdem H. Vaccine hesitancy and refusal among parents: An international ID-IRI survey. J Infect Dev Ctries 2022; 16:1081-1088. [PMID: 35797304 DOI: 10.3855/jidc.16085] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2021] [Accepted: 02/22/2022] [Indexed: 10/31/2022] Open
Abstract
INTRODUCTION Although vaccines are the safest and most effective means to prevent and control infectious diseases, the increasing rate of vaccine hesitancy and refusal (VHR) has become a worldwide concern. We aimed to find opinions of parents on vaccinating their children and contribute to available literature in order to support the fight against vaccine refusal by investigating the reasons for VHR on a global scale. METHODOLOGY In this international cross-sectional multicenter study conducted by the Infectious Diseases International Research Initiative (ID-IRI), a questionnaire consisting of 20 questions was used to determine parents' attitudes towards vaccination of their children. RESULTS Four thousand and twenty-nine (4,029) parents were included in the study and 2,863 (78.1%) were females. The overall VHR rate of the parents was found to be 13.7%. Nineteen-point three percent (19.3%) of the parents did not fully comply with the vaccination programs. The VHR rate was higher in high-income (HI) countries. Our study has shown that parents with disabled children and immunocompromised children, with low education levels, and those who use social media networks as sources of information for childhood immunizations had higher VHR rates (p < 0.05 for all). CONCLUSIONS Seemingly all factors leading to VHR are related to training of the community and the sources of training. Thus, it is necessary to develop strategies at a global level and provide reliable knowledge to combat VHR.
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Affiliation(s)
- Yakup Cag
- Department of Pediatrics, University of Health Sciences Kartal Dr. Lutfi Kirdar City Hospital, Istanbul, Turkey.
| | - Mohammad Emad Al Madadha
- Department of Microbiology and Immunology, Institute of Marine and Environmental Technology, University of Maryland School of Medicine, Baltimore, Maryland, United States
| | - Handan Ankarali
- Department of Biostatistics and Medical Informatics, Istanbul Medeniyet University Faculty of Medicine, Istanbul, Turkey
| | - Yasemin Cag
- Department of Infectious Diseases and Clinical Microbiology, Istanbul Medeniyet University Faculty of Medicine, Istanbul, Turkey
| | - Kubra Demir Onder
- Department of Infectious Diseases and Clinical Microbiology, University of Health Sciences Antalya Training and Research Hospital, Antalya, Turkey
| | - Aysegul Seremet-Keskin
- Department of Infectious Diseases and Clinical Microbiology, University of Health Sciences Antalya Training and Research Hospital, Antalya, Turkey
| | - Filiz Kizilates
- Department of Infectious Diseases and Clinical Microbiology, University of Health Sciences Antalya Training and Research Hospital, Antalya, Turkey
| | - Rok Čivljak
- Department for Respiratory Tract Infections, Dr. Fran Mihaljević University Hospital for infectious Diseases, University of Zagreb School of Medicine, Zagreb, Croatia
| | - Ghaydaa Shehata
- Department of Neurology, Assiut University Faculty of Medicine, Assiut, Egypt
| | - Handan Alay
- Department of Infectious Diseases and Clinical Microbiology, Ataturk University Faculty of Medicine, Erzurum, Turkey
| | - Sevil Alkan-Ceviker
- Department of Infectious Diseases and Clinical Microbiology, Onsekiz Mart University Faculty of Medicine, Canakkale, Turkey
| | - Fatma Yilmaz-Karadag
- Department of Infectious Diseases and Clinical Microbiology, University of Health Sciences Sancaktepe Şehit Prof. Dr Ilhank Varank Training and Research Hospital. İstanbul, Turkey
| | - Meliha Cagla-Sonmezer
- Department of Infectious Diseases and Clinical Microbiology, Hacettepe University Faculty of Medicine, Ankara, Turkey
| | | | - Dumitru Irina Magdelena
- Department of Infectious Diseases, Clinical Infectious Diseases Hospital Constanta, Ovidius University of Constanta, Constanta, Romania
| | | | - Jurica Arapovic
- Department of Infectious Diseases, University Clinical Hospital Mostar, Mostar, Bosnia and Herzegovina
| | - Fatma Kesmez-Can
- Department of Infectious Diseases and Clinical Microbiology, Ataturk University Faculty of Medicine, Erzurum, Turkey
| | | | | | - Gulden Eser-Karlidag
- Department of Infectious Diseases and Clinical Microbiology, University of Health Sciences Fethi Sekin City Hospital, Elazig, Turkey
| | - Reham Khedr
- Department of Pediatric Oncology, National Cancer Institute - Cairo University / Children Cancer Hospital Egypt, Cairo, Egypt
| | - Mehmet Emirhan Isik
- Department of Infectious Diseases and Clinical Microbiology, University of Health Sciences Kosuyolu Training and Research Hospital, Istanbul, Turkey
| | - Michael Mihailov Petrov
- Department of Microbiology and Immunology, Medical University of Plovdiv Faculty of Pharmacy, Plovdiv, Bulgaria
| | - Roxana Cernat
- Department of Infectious Diseases, Clinical Infectious Diseases Hospital Constanta, Ovidius University of Constanta, Constanta, Romania
| | - Umran Erturk
- Department of Infectious Diseases, Bahrain Oncology Center, Bahrain
| | - Yesim Uygun-Kizmaz
- Department of Infectious Diseases and Clinical Microbiology, University of Health Sciences Kosuyolu Training and Research Hospital, Istanbul, Turkey
| | - Eva Huljev
- Department for Respiratory Tract Infections, Dr. Fran Mihaljević University Hospital for Infectious Diseases, Zagreb, Croatia
| | - Fatma Amer
- Department of Medical Microbiology and Immunology, Faculty of Medicine, Zagazig University, Zagazig, Egypt
| | - Mehmet Resat Ceylan
- Department of Infectious Diseases and Clinical Microbiology, MD. University of Harran Faculty of Medicine, Şanliurfa, Turkey
| | - Andrea Marino
- Department of Clinical and Experimental Medicine, ARNAS Garibaldi Unit of Infectious diseases, University of Catania, Catania, Italy
| | - Gulnur Kul
- Department of Infectious Diseases and Clinical Microbiology, Kirikhan state Hospital, Hatay, Turkey
| | - Tuba Damar-Cakirca
- Department of Infectious Diseases and Clinical Microbiology, Şanliurfa training and research hospital, Sanliurfa, Turkey
| | - Yara Mohsen Khalaf
- Department of epidemiology High institute of public health,Alexandria University Infectious Disease Clinical pharmacist, Antimicrobial stewardship department, International Medical Center Hospital, Alexandria, Egypt
| | - Arzu Cennet Isik
- Department of Internal Medicine, University of Health Sciences Kartal Dr. Lutfi Kirdar City Hospital, Istanbul, Turkey
| | - Olumuyiwa Elijah Ariyo
- Department of Infectious Diseases and Tropical Medicine, Federal Teaching Hospital Ido-Ekiti, Ekiti, Nigeria
| | - Ismail Necati Hakyemez
- Department of Infectious Diseases and Clinical Microbiology, Balikesir University Faculty of Medicine, Balikesir, Turkey
| | - Rezaul Karim Ripon
- Department of Public Health and Informatics, Jahangirnagar University, Savar, Bangladesh
| | - Abdorrahim Afkhamzadeh
- Department of Community Medicine, Kurdistan University of Medical Sciences, Sanandaj, Iran
| | | | | | - Maya Belitova
- Department of Anesthesiology and Intensive Care, University Hospital "Queen Giovanna"-ISUL, EAD, Sofia, Bulgaria
| | - Mustafa Altindis
- Department of Microbiology, Sakarya University Faculty of Medicine, Sakarya, Turkey
| | - Rehab El-Sokkary
- Department of Medical Microbiology and Immunology, Faculty of Medicine, Zagazig University, Zagazig, Egypt
| | - Recep Tekin
- Department of Infectious Diseases and Clinical Microbiology, Dicle University Faculty of Medicine, Diyarbakir, Turkey
| | - Mohammed Ahmed Garout
- Department of Community Medicine and Health Care for Pilgrims, Umm Al-Qura University Faculty of Medicine, Makkah, Saudi Arabia
| | - Joanna Zajkowska
- Department of Infectious Diseases and Neuroinfections, Medical University in Białystok, Bialystok, Poland
| | - Farhan Fazal
- Department of Medicine, Kasturba Medical College Mangalore, Mangalore, India
| | - Muhammed Bekcibasi
- Department of Infectious Diseases and Clinical Microbiology, Bismil State Hospital, Diyarbakir, Turkey
| | - Mirsada Hukic
- Department of Clinical Microbiology, Institute for Biomedical Diagnostic and Research NALAZ, Sarajevo, Bosnia and Herzegovina
| | - Summiya Nizamuddin
- Section of Microbiology, Department of Pathology, Shaukat Khanum Memorial Cancer Hospital and Research Centre, Lahore, Pakistan
| | - Serkan Surme
- Department of Infectious Diseases and Clinical Microbiology, University of Health Sciences Haseki Training and Research Hospital, Istanbul, Turkey
| | - Ricardo Fernandez
- Department of Pulmonary and Critical Care, San Juan City Hospital, San Juan, Puerto Rico
| | - Amani El-Kholy
- Department of Clinical Pathology, Cairo University Hospital, Cairo, Egypt
| | - Nasim Akhtar
- Department of Infectious Diseases, Pakistan Institute of Medical Sciences, Islamabad, Pakistan
| | - Saadia Ijaz
- Department of Pathology, Shalamar institute of health sciences, Lahore, Pakistan
| | - Andrea Cortegiani
- Department of Surgical, Oncological and Oral Science (Di.Chir.On.S.), University of Palermo, Palermo, Italy
| | - Meliha Meric-Koc
- Department of Infectious Diseases and Clinical Microbiology, Bezmialem Vakif University Faculty of Medicine, Istanbul, Turkey
| | - Hakan Hasman
- Department of Emergency, Ankara Medicalpark Private Hospital, Ankara, Turkey
| | - Agah Victor Maduka
- Department of microbiology, Ebonyi State University Teaching Hospital Abakaliki, Ebonyi State, Nigeria
| | - Jehan Ali ElKholy
- Department of Anesthesia, Pain Management, Cairo University Hospital, Cairo, Egypt
| | - Sema Sari
- Department of Intensive Care, Nigde Training and Research Hospital, Nigde, Turkey
| | - Mumtaz Ali Khan
- Department of Epidemiology and Disease Surveillance, National institute of health Islamabad, Islamabad, Pakistan
| | - Yasemin Akin
- Department of Pediatrics, University of Health Sciences Kartal Dr. Lutfi Kirdar City Hospital, Istanbul, Turkey
| | - Sukran Kose
- Department of Infectious Diseases and Clinical Microbiology, Tepecik Training and Research Hospital, Izmir, Turkey
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Sager G, Cetin BS, Cag Y, Pinar ZV, Akin Y. Auditory phoneme discrimination, articulation, and language disorders in patients with genetic epilepsy with febrile seizures plus: A case-control study. Epilepsy Behav 2022; 129:108626. [PMID: 35231857 DOI: 10.1016/j.yebeh.2022.108626] [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] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/31/2021] [Revised: 02/08/2022] [Accepted: 02/11/2022] [Indexed: 11/26/2022]
Abstract
INTRODUCTION Genetic epilepsy with febrile seizures plus (GEFS+) is an epilepsy syndrome with clinical heterogeneity that was first described in 1997. Central auditory processing (CAP) is defined as the neurophysiological process in decoding sound waves from the outer ear to the auditory cortex. The present study aimed to analyze CAP and phonological disorders in preschool-age children with GEFS+. MATERIAL AND METHOD This is a prospective case-control study. Twenty-seven patients diagnosed with GEFS+ aged between 4 years and 6 years and 6 months and 31 healthy controls in the same age range were included in the study. Phonological sensitivity test (SAT) and auditory discrimination test (İAT) were applied to both groups, and the results of both groups were statistically compared. RESULTS The SAT and İAT raw and Z scores of the subjects in the study group were found to be significantly higher than those of the control group (p = 0.001; p < 0.01). Electroencephalography (EEG) status of the patients or the duration of antiseizure medication use did not have a statistically significant effect on the outcome. CONCLUSION Patients with GEFS+ have a significantly high impairment in both articulation and auditory discrimination of phonemes compared with the healthy population. Early diagnosis and early treatment of this condition can prevent potential literacy problems and the development of dyslexia in the future.
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Affiliation(s)
- Gunes Sager
- Department of Pediatric Neurology, Kartal Dr. LutfiKirdar City Hospital, Istanbul, Turkey.
| | - Beyza Sungur Cetin
- Department of Language and Speech Therapy, Kartal Dr. LutfiKirdar City Hospital, Istanbul, Turkey
| | - Yakup Cag
- Department of Pediatrics, Kartal Dr. LutfiKirdar City Hospital, Istanbul, Turkey
| | - Zeynep Vatansever Pinar
- Department of Child and Adolescent Psychiatry, Dr. LutfiKirdar City Hospital, Istanbul, Turkey
| | - Yasemin Akin
- Department of Pediatrics, Kartal Dr. LutfiKirdar City Hospital, Istanbul, Turkey
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Sager S, Cag Y, Akin Y. Determination of the factors that cause valproic acid resistance in the pediatric juvenile myoclonic epilepsy cohort. Med-Science 2022. [DOI: 10.5455/medscience.2021.08.244] [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
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Sager S, Kole M, Batu U, Cag Y, Akin Y. Evaluation of clinical characteristics between febrile seizures and generalized epilepsy febrile seizure plus. Med-Science 2022. [DOI: 10.5455/medscience.2022.05.113] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Abstract
In the present study, we aimed to compare the characteristics of febrile seizure (FS) and generalized epilepsy with febrile seizure plus (GEFS+) in terms of their clinical prognosis and treatment. Among the 95 patients between 5-18 years of age included in this single-center retrospective cross-sectional hospital-based study, 55 and 40 patients were diagnosed with FS and GEFS+, respectively. Clinical characteristics, family history, and treatment responses of both groups were statistically compared. The FS and GEFS+ groups were not significantly different in terms of the median and mean ages for the onset of FS. Prolonged FS was seen as significantly higher in the FS group than in the GEFS+ group (p=0.014). The mean age of afebrile seizure was 3.5 years in the GEFS+ group. The prevalence of febrile/afebrile seizures in the family was significantly higher in the GEFS+ group than in the FS group. Febrile seizure recurrence risk was significantly higher in GEFS + group. The rate of seizure recurrence was low in both groups, particularly in patients receiving anti-epileptic treatment. Levetiracetam was found to be effective in preventing seizures in both groups. It is important to investigate the risk factors for the development of GEFs in patients presenting with FS.
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Yilmaz S, Uzunoglu I, Inandiklioglu N, Cag Y, Karaaslan A, Cetin C, Akin Y. The evaluation of complete blood count ratios in children with 2019 novel coronavirus (2019 and #8208;ncov) infection. Med-Science 2022. [DOI: 10.5455/medscience.2021.08.246] [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
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Cag Y, Haciseyitoglu D, Ozdemir AA, Cag Y. Antibiotic Resistance and Bacteria in Urinary Tract Infections in Pediatric Patients. Medeni Med J 2021; 36:217-224. [PMID: 34915679 PMCID: PMC8565589 DOI: 10.5222/mmj.2021.78535] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2021] [Accepted: 08/21/2021] [Indexed: 11/05/2022] Open
Abstract
Objective Antibiotic resistance against bacterial pathogens associated with urinary tract infections (UTI) is rapidly increasing worldwide. In this study, we aimed at determining the causative microorganisms in children under 17 years of age diagnosed with UTI in our hospital and the antibiotic resistance rates of these causes. Methods We isolated and retrospectively analyzed 4801 urine samples of children under 17 years old who presented with bacterial growth in their urine cultures. The isolated bacteria and their antibiotic resistance profiles were statistically analyzed. Results Most (2001/77.2%) of 2592 patients included in the study were female and the mean age and median interquartile range (IQR) was 55 (12-98) months. Except for the neonatal period, the female gender was predominant in all age groups (p<0.0001). The most frequently isolated bacteria included Escherichia coli (67.7%), Klebsiella spp. (10.7%), and Enterococcus spp. (8.8%). The most and least resistant antibiotics were ampicillin (66.6%) and meropenem (0.3%) for E. coli, respectively. Although resistance of E. faecalis to ampicillin and ciprofloxacin is at a low level, E. faecium is much more resistant to these antibiotics (p<0.0001). Conclusion It is important that each center determines its own resistant antibiotics so as to guide empirical treatment. Re-evaluating each antibiotic that is started to be used empirically according to the results of culture and sensitivity in addition to switching to a suitable antibiotic would be very effective in reducing resistance rates.
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Affiliation(s)
- Yakup Cag
- University of Health Sciences, Kartal Dr. Lütfi Kırdar City Hospital, Department of Pediatrics, Istanbul, Turkey
| | - Demet Haciseyitoglu
- Zonguldak Karaelmas University Faculty of Medicine, Department of Medical Microbiology, Zonguldak, Turkey
| | | | - Yasemin Cag
- Faculty of Medicine, Department of Infectious Diseases and Clinical Microbiology, Istanbul, Turkey
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Cag Y, Erdem H, Gormez A, Ankarali H, Hargreaves S, Ferreira-Coimbra J, Rubulotta F, Belliato M, Berger-Estilita J, Pelosi P, Blot S, Lefrant JY, Mardani M, Darazam IA, Cag Y, Rello J. Anxiety among front-line health-care workers supporting patients with COVID-19: A global survey. Gen Hosp Psychiatry 2021; 68:90-96. [PMID: 33418193 PMCID: PMC7749993 DOI: 10.1016/j.genhosppsych.2020.12.010] [Citation(s) in RCA: 59] [Impact Index Per Article: 19.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/27/2020] [Revised: 12/10/2020] [Accepted: 12/17/2020] [Indexed: 02/07/2023]
Abstract
OBJECTIVE We aimed to explore anxiety status across a broad range of HCWs supporting patients with COVID-19 in different global regions. METHOD This was an international online survey in which participation was on voluntary basis and data were submitted via Google Drive, across a two-week period starting from March 18, 2020. The Beck Anxiety Inventory was used to quantify the level of anxiety. RESULTS 1416 HCWs (70.8% medical doctors, 26.2% nurses) responded to the survey from 75 countries. The distribution of anxiety levels was: normal/minimal (n = 503, 35.5%), low (n = 390, 27.5%); moderate (n = 287, 20.3%), and severe (n = 236, 16.7%). According to multiple generalized linear model, female gender (p = 0.001), occupation (ie, being a nurse dealing directly with patients with COVID-19 [p = 0.017]), being younger (p = 0.001), reporting inadequate knowledge on COVID-19 (p = 0.005), having insufficient personal protective equipment (p = 0.001) and poor access to hand sanitizers or liquid soaps (p = 0.008), coexisting chronic disorders (p = 0.001) and existing mental health problems (p = 0.001), and higher income of countries where HCWs lived (p = 0.048) were significantly associated with increased anxiety. CONCLUSIONS Front-line HCWs, regardless of the levels of COVID-19 transmission in their country, are anxious when they do not feel protected. Our findings suggest that anxiety could be mitigated ensuring sufficient levels of protective personal equipment alongside greater education and information.
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Affiliation(s)
- Yasemin Cag
- Department of Infectious Diseases and Clinical Microbiology, Istanbul Medeniyet University Faculty of Medicine, Istanbul, Turkey.
| | | | - Aynur Gormez
- Department of Psychiatry, Istanbul Medeniyet University Faculty of Medicine, Istanbul, Turkey
| | - Handan Ankarali
- Department of Biostatistics and Medical Informatics, Istanbul Medeniyet University Faculty of Medicine, Istanbul, Turkey
| | - Sally Hargreaves
- Institute for Infection and Immunity, St George's University of London, London, United Kingdom
| | | | - Francesca Rubulotta
- Department of Intensive Care Medicine Charing Cross Hospital Imperial College NHS Trust London, United Kingdom
| | - Mirko Belliato
- UOC Anestesia e Rianimazone 1, IRCCS Fondazione Policlinico San Matteo, Pavia, Italy
| | - Joana Berger-Estilita
- Department of Anaesthesiology and Pain Medicine, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | - Paolo Pelosi
- Department of Surgical Sciences and Integrated Diagnostics, University of Genoa, Genoa, Italy,San Martino Policlinico Hospital, IRCCS for Oncology and Neurosciences, Genoa, Italy
| | - Stijn Blot
- Department of Internal Medicine & Pediatrics, Faculty of Medicine & Health Science Ghent University, Ghent, Belgium
| | - Jean Yves Lefrant
- Department of Anaesthesia Critical Care Emergency and Pain Medicine, University Hospital of Nimes, Montpellier University, Nimes, France
| | - Masoud Mardani
- Department of Infectious Diseases, Loghman Hakim Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Ilad Alavi Darazam
- Department of Infectious Diseases, Loghman Hakim Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Yakup Cag
- University of Health Sciences, Department of Pediatrics, Dr. Lutfi Kirdar Kartal Training and Research Hospital, Istanbul, Turkey
| | - Jordi Rello
- Department of Anaesthesia Critical Care Emergency and Pain Medicine, University Hospital of Nimes, Montpellier University, Nimes, France,Clinical Research and Epidemiology in Pneumonia and Sepsis, Vall d'Hebron Institute of Research (VHIR), Barcelona, Spain,Centro de Investigacion Biomedica en Red de Enfermedades Respiratorias (CIBERES), Madrid, Spain
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Cag Y, Pacal Y, Gunduz M, Isik S, Kertmen BA, Toprak N, Ozaydin SE, Ozcetin M, Kut A. The effect of peripheral blood eosinophilia on inflammatory markers in asthmatic patients with lower respiratory tract infections. J Int Med Res 2019; 47:2452-2460. [PMID: 31006357 PMCID: PMC6567716 DOI: 10.1177/0300060519844859] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Background To investigate the behaviour of the inflammatory marker neutrophil-to-lymphocyte ratio (NLR) in the presence of peripheral blood eosinophilia (PBE) in paediatric asthma patients with lower respiratory tract (LRT) infections. Methods This retrospective study enrolled consecutive patients aged ≥5 years who were diagnosed with asthma and whose haemogram values were available. The patients were further subdivided based on the presence or absence of LRT infections and allergies. NLR and C-reactive protein (CRP) were evaluated in relation to the presence or absence of PBE (≥4% eosinophils). Results A total of 991 patients were enrolled in the study. Patients with LRT infections had significantly higher leucocyte and neutrophil counts, a greater NLR and a higher level of CRP compared with patients without LRT infections. Overall, patients with PBE had significantly lower NLRs and CRP regardless of the presence or absence of an LRT infection. The PBE percentage showed moderate inverse correlations with NLR (r = −0.34) and CRP (r = −0.20). Conclusion The presence of PBE was significantly associated with lower NLR and CRP regardless of the presence or absence of an infectious condition.
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Affiliation(s)
- Yakup Cag
- 1 Department of Paediatrics, University of Health Sciences Kartal Dr. Lutfi Kirdar Training and Research Hospital, Istanbul, Turkey
| | - Yakup Pacal
- 2 Department of Paediatric Pulmonology, Health Sciences Sureyyapasa Chest Disease and Thoracic Surgery Training and Research Hospital, Istanbul, Turkey
| | - Mehmet Gunduz
- 2 Department of Paediatric Pulmonology, Health Sciences Sureyyapasa Chest Disease and Thoracic Surgery Training and Research Hospital, Istanbul, Turkey
| | - Sakine Isik
- 2 Department of Paediatric Pulmonology, Health Sciences Sureyyapasa Chest Disease and Thoracic Surgery Training and Research Hospital, Istanbul, Turkey
| | - Birgul Altinsoy Kertmen
- 2 Department of Paediatric Pulmonology, Health Sciences Sureyyapasa Chest Disease and Thoracic Surgery Training and Research Hospital, Istanbul, Turkey
| | - Necmettin Toprak
- 2 Department of Paediatric Pulmonology, Health Sciences Sureyyapasa Chest Disease and Thoracic Surgery Training and Research Hospital, Istanbul, Turkey
| | - Sadik Erhan Ozaydin
- 2 Department of Paediatric Pulmonology, Health Sciences Sureyyapasa Chest Disease and Thoracic Surgery Training and Research Hospital, Istanbul, Turkey
| | - Mustafa Ozcetin
- 3 Department of Paediatrics, Istanbul Faculty of Medicine, Istanbul University, Istanbul, Turkey
| | - Arif Kut
- 4 Department of Paediatric Pulmonology, Medical Faculty, Maltepe University, Istanbul, Turkey
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Inan A, Erdem H, Elaldi N, Gulsun S, Karahocagil MK, Pekok AU, Ulug M, Tekin R, Bosilkovski M, Kaya S, Haykir-Solay A, Demirdal T, Kaya S, Sunnetcioglu M, Sener A, Tosun S, Aydin E, Ural S, Yamazhan T, Muhcu M, Ayaslioglu E, Bilgic-Atli S, Erbay A, Ergen P, Kadanali A, Sahin S, Sahin-Horasan E, Avci A, Cag Y, Beeching NJ. Brucellosis in pregnancy: results of multicenter ID-IRI study. Eur J Clin Microbiol Infect Dis 2019; 38:1261-1268. [PMID: 30989418 DOI: 10.1007/s10096-019-03540-z] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2019] [Accepted: 03/13/2019] [Indexed: 12/31/2022]
Abstract
Brucellosis in pregnant women is reported to be associated with obstetric complications (OCs), and adequate data for human brucellosis during pregnancy are largely lacking. We performed this multicenter retrospective cross-sectional study to evaluate the epidemiology, clinical course, treatment responses, and outcomes of brucellosis among pregnant women. The study period comprised a 14-year period from January 2002 to December 2015. All consecutive pregnant women diagnosed with brucellosis in 23 participating hospitals were included. Epidemiological, clinical, laboratory, therapeutic, and outcome data along with the assessment data of the neonate were collected using a standardized questionnaire. Data of 242 patients were analyzed. The OC rate was 14.0% (34/242) in the cohort. Of the 242 women, 219 (90.5%) delivered at term, 3 (1.2%) had preterm delivery, 15 (6.2%) aborted, and 5 (2.1%) had intrauterine fetal demise. Seventeen (7.0%) of the newborns were considered as low birth weight. Spontaneous abortion (6.1%) was the commonest complication. There were no maternal or neonatal deaths and pertinent sequelae or complications were not detected in the newborns. Splenomegaly (p = 0.019), nausea and/or vomiting (p < 0.001), vaginal bleeding (p < 0.001), anemia (blood hemoglobin < 11 g/dL; p < 0.001), high level of serum aspartate aminotransferase (> 41 IU/L; p = 0.025), oligohydramnios on ultrasonography (p = 0.0002), history of taking medication other than Brucella treatment during pregnancy (p = 0.027), and Brucella bacteremia (p = 0.029) were the significant factors associated with OCs. We recommend that pregnant women with OC or with fever should be investigated for brucellosis if they live in or have traveled to an endemic area.
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Affiliation(s)
- Asuman Inan
- Department of Infectious Diseases and Clinical Microbiology, Haydarpasa Numune Training and Research Hospital, Istanbul, Turkey
| | - Hakan Erdem
- Department of Infectious Diseases and Clinical Microbiology, Gulhane Training and Research Hospital, Ankara, Turkey.
| | - Nazif Elaldi
- Department of Infectious Diseases and Clinical Microbiology, School of Medicine, Cumhuriyet University, Sivas, Turkey
| | - Serda Gulsun
- Department of Infectious Diseases and Clinical Microbiology, Diyarbakir Training and Research Hospital, Diyarbakir, Turkey
| | - Mustafa K Karahocagil
- Department of Infectious Diseases and Clinical Microbiology, Yuzuncuyil University School of Medicine, Van, Turkey
| | - Abdullah U Pekok
- Department of Infectious Diseases and Clinical Microbiology, Pendik Medical Park Hospital, Istanbul, Turkey
| | - Mehmet Ulug
- Department of Infectious Diseases and Clinical Microbiology, Private Umut Hospital, Eskisehir, Turkey
| | - Recep Tekin
- Department of Infectious Diseases and Clinical Microbiology, Dicle University School of Medicine, Sivas, Turkey
| | - Mile Bosilkovski
- Department of Infectious Diseases and Febrile Conditions, Skopje Medical Faculty, Skopje, Republic of Macedonia
| | - Safak Kaya
- Department of Infectious Diseases and Clinical Microbiology, Diyarbakir Training and Research Hospital, Diyarbakir, Turkey
| | - Asli Haykir-Solay
- Department of Infectious Diseases and Clinical Microbiology, Dışkapı Yıldırım Beyazıt Training and Research Hospital, Ankara, Turkey
| | - Tuna Demirdal
- Department of Infectious Diseases and Clinical Microbiology, Katip Celebi University School of Medicine, Izmir, Turkey
| | - Selcuk Kaya
- Department of Infectious Diseases and Clinical Microbiology, Karadeniz Technical University School of Medicine, Trabzon, Turkey
| | - Mahmut Sunnetcioglu
- Department of Infectious Diseases and Clinical Microbiology, Yuzuncuyil University School of Medicine, Van, Turkey
| | - Alper Sener
- Department of Infectious Diseases and Clinical Microbiology, Onsekiz Mart University School of Medicine, Canakkale, Turkey
| | - Selma Tosun
- Department of Infectious diseases and Clinical Microbiology, Izmir Bozyaka Training and Research Hospital, Izmir, Turkey
| | - Emsal Aydin
- Department of Infectious Diseases and Clinical Microbiology, Kafkas University School of Medicine, Kars, Turkey
| | - Serap Ural
- Department of Infectious Diseases and Clinical Microbiology, Katip Celebi University School of Medicine, Izmir, Turkey
| | - Tansu Yamazhan
- Department of Infectious Diseases and Clinical Microbiology, Ege University School of Medicine, Izmir, Turkey
| | - Murat Muhcu
- Department of Obstetrics and Gynecology, GATA Haydarpasa Training Hospital, Istanbul, Turkey
| | - Ergin Ayaslioglu
- Department of Infectious Diseases and Clinical Microbiology, Kirikkale University School of Medicine, Kırıkkale, Turkey
| | - Seval Bilgic-Atli
- Department of Infectious Diseases and Clinical Microbiology, Diyarbakir Training and Research Hospital, Diyarbakir, Turkey
| | - Ayse Erbay
- Department of Infectious Diseases and Clinical Microbiology, Bozok University School of Medicine, Yozgat, Turkey
| | - Pinar Ergen
- Department of Infectious Diseases and Clinical Microbiology, Medeniyet University, Goztepe Training and Research Hospital, Istanbul, Turkey
| | - Ayten Kadanali
- Department of Radiology, Umraniye Training and Research Hospital, Istanbul, Turkey
| | - Suzan Sahin
- Department of Infectious Diseases and Clinical Microbiology, Dr. Lutfi Kirdar Training and Research Hospital, Istanbul, Turkey
| | - Elif Sahin-Horasan
- Department of Infectious Diseases and Clinical Microbiology, Mersin University School of Medicine, Mersin, Turkey
| | - Ali Avci
- Department of Urology, Katip Celebi University, Ataturk Training and Research Hospital, Izmir, Turkey
| | - Yakup Cag
- Department of Infectious Diseases and Clinical Microbiology, Turkish Health Sciences University, Dr. Lutfi Kirdar Training and Research Hospital, Istanbul, Turkey
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11
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Abstract
Objective: To evaluate the maternal and neonatal 25-hydroxyvitamin D [25(OH)D] levels and the effect of 25(OH)D levels on the development of neonatal sepsis. Methods: This prospective study was performed in the neonatal intensive care unit of Medicine Hospital/Biruni University between November 2017 and September 2018. Fifty one term infants with sepsis group and 56 term infants with control group were included in this study. Blood samples for whole blood count, CRP, Ca, P, ALP, 25(OH)D and culture were obtained from all neonates. Results: Mean vitamin D levels for the neonates and their mothers were found to be 12.4±8.5 ng/ml and 13±8.7 ng/ml, respectively. There was a significant correlation between maternal and newborn 25(OH)D levels (r=0.72, p<0.01). The number of the newborns with vitamin D deficiency was significantly higher in the sepsis group (n=31, 60.8%) than in the control group (n=30, 53.6%; p=0.00), corresponding to significantly lower levels of vitamin D in the sepsis group (11±5.5 ng/ml vs. 13.8±10.6 ng/ml; p=0.012). Similarly, maternal vitamin D levels was significantly lower in the sepsis group than in the control group (10.8±5.6 ng/ml vs. 14.9±10 ng/ml; p=0.001). Conclusion: Our findings suggest that there may be an association between vitamin D deficiency and neonatal sepsis
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Affiliation(s)
- Abdurrahman Avar Ozdemir
- Abdurrahman Avar Ozdemir Department of Pediatrics, Medicine Hospital, Biruni University, Istanbul, Turkey
| | - Yakup Cag
- Yakup Cag Department of Pediatrics, Dr. Lutfi Kirdar Training and Research Hospital, Medical Sciences University, Istanbul, Turkey
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12
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Cag Y, Özdemir AA, Yükselmiş U, Akdeniz E, Özçetin M. Association Between Rapid Antigen Testing and Antibiotic Use and Accuracy of Peripheral Blood Parameters in Detecting Group A Streptococcus in Children With Tonsillopharyngitis. Front Pediatr 2019; 7:322. [PMID: 31428594 PMCID: PMC6688128 DOI: 10.3389/fped.2019.00322] [Citation(s) in RCA: 4] [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] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/09/2019] [Accepted: 07/18/2019] [Indexed: 11/13/2022] Open
Abstract
Objectives: To investigate the effect of rapid antigen testing (RAT) on the practice of antibiotic prescription as well as the accuracy of peripheral blood neutrophil-to-lymphocyte ratio (NLR) and C-reactive protein (CRP) values in detecting group A beta-hemolytic Streptococcus (GABHS) in children with tonsillopharyngitis. Methods: In a multicenter study performed in Turkey, we retrospectively analyzed data from 668 consecutive pediatric patients under 17 years of age, who presented with signs and symptoms of tonsillopharyngitis and underwent RAT. The rates of positive and negative RAT results were determined and patients' antibiotic prescriptions were examined in relation to RAT results. In addition, the accuracy of peripheral blood NLR and CRP values was examined for 212 patients whose laboratory data were available, with RAT as the reference standard. Results: Positive RAT results were observed in 190 of 668 (28.4%) patients. Antibiotics were prescribed to all 190 patients with positive RAT results and to 8 of 478 patients with negative RAT results. Overall, the rate of antibiotic prescription was 29.6%. Patients with positive and negative RAT results did not differ significantly with regard to NLR and CRP values. In ROC analysis, the area under the ROC curve (AUC) of NLR and CRP were 0.54 (95% confidence interval [CI] 0.45-0.64), and 0.55 (95% CI 0.45-0.65), respectively. Conclusion: RAT results proved highly associated with antibiotic prescribing, suggesting that RATs could be of great value in preventing unnecessary antibiotic use. Our findings also suggest that NLR and CRP are poorly accurate to identify GABHS in children with tonsillopharyngitis.
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Affiliation(s)
- Yakup Cag
- Department of Pediatrics, Kartal Dr. Lutfi Kırdar Training and Research Hospital, University of Health Sciences, Istanbul, Turkey
| | | | - Ufuk Yükselmiş
- Department of Pediatrics, Kartal Dr. Lutfi Kırdar Training and Research Hospital, University of Health Sciences, Istanbul, Turkey
| | - Ezgi Akdeniz
- Department of Pharmacy, Süreyyapaşa Chest Diseases and Thoracic Surgery Training and Research Hospital, University of Health Sciences, Istanbul, Turkey
| | - Mustafa Özçetin
- Department of Pediatrics, Faculty of Medicine, Istanbul University, Istanbul, Turkey
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13
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Ozcetin M, Kilic A, Cag Y, Bilgili F, Aksoy B. A case of hypomelanosis of Ito accompanied by unilateral abnormal limb overgrowth and delayed speech. North Clin Istanb 2018; 7:71-73. [PMID: 32232208 PMCID: PMC7103738 DOI: 10.14744/nci.2018.86648] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2017] [Accepted: 10/10/2018] [Indexed: 11/20/2022] Open
Abstract
Hypomelanosis of Ito (HI) is characterized by unilateral or bilateral hypopigmented skin lesions and usually presents as a multisystemic disorder. Skin lesions may develop in different textures, such as linear, whorled, or patchy, and are often accompanied by abnormalities of the central nervous system, skeletal system, eyes, and teeth. HI is associated with sporadic gene mutations but not gender. Presentation of the current case may be of use in reminding practitioners of the common extracutaneous findings of HI, along with some rare manifestations, such as delayed speech and asymmetric limb growth.
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Affiliation(s)
- Mustafa Ozcetin
- Department of Pediatrics, Istanbul University Istanbul Faculty of Medicine, Istanbul, Turkey
| | - Ayse Kilic
- Department of Pediatrics, Istanbul University Istanbul Faculty of Medicine, Istanbul, Turkey
| | - Yakup Cag
- Department of Pediatrics, Dr. Lutfi Kirdar Kartal Training and Research Hospital, Istanbul, Turkey
| | - Fuat Bilgili
- Department of Orthopedics and Traumatology, Istanbul University Istanbul Faculty of Medicine, Istanbul, Turkey
| | - Busra Aksoy
- Department of Pediatrics, Istanbul University Istanbul Faculty of Medicine, Istanbul, Turkey
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14
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Hakyemez IN, Erdem H, Beraud G, Lurdes M, Silva-Pinto A, Alexandru C, Bishop B, Mangani F, Argemi X, Poinot M, Hasbun R, Sunbul M, Akcaer M, Alp S, Demirdal T, Angamuthu K, Amer F, Ragab E, Shehata GA, Ozturk-Engin D, Ozgunes N, Larsen L, Zimmerli S, Sipahi OR, Tukenmez Tigen E, Celebi G, Oztoprak N, Yardimci AC, Cag Y. Correction to: Prediction of unfavorable outcomes in cryptococcal meningitis: results of the multicenter infectious Diseases International Research Initiative (ID-IRI) cryptococcal meningitis study. Eur J Clin Microbiol Infect Dis 2018; 37:1241-1242. [PMID: 29855841 DOI: 10.1007/s10096-018-3281-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
In the original version of this article, Mustafa Sunbul was not included in the list of authors for this article. The name has been added accordingly.
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Affiliation(s)
- I N Hakyemez
- Department of Infectious Diseases and Clinical Microbiology, Faculty of Medicine, Bezmialem Vakif University, Istanbul, Turkey
| | - H Erdem
- Infectious Diseases International Research Initiative (ID-IRI), Ankara, Turkey. .,Department of Infectious Diseases and Clinical Microbiology, Gulhane Medical Academy, Ankara, Turkey.
| | - G Beraud
- Department of Infectious Diseases, Poitiers University Hospital, Poitiers, France
| | - M Lurdes
- Department of Infectious Diseases, Centro Hospitalar S. João and Faculty of Medicine of University of Porto, Porto, Portugal
| | - A Silva-Pinto
- Department of Infectious Diseases, Centro Hospitalar S. João and Faculty of Medicine of University of Porto, Porto, Portugal
| | - C Alexandru
- Department of Infectious Diseases, Victor Babes University of Medicine and Pharmacy, Timisoara, Romania
| | - B Bishop
- Department of Internal Medicine B, Rambam Medical Center, Haifa, Israel
| | - F Mangani
- Department of Infectious and Tropical Diseases, "G. B. Rossi" University Hospital, Verona, Italy
| | - X Argemi
- Department of Infectious Diseases, Nouvel Hôpital Civil, Strasbourg, France
| | - M Poinot
- Department of Infectious and Tropical Diseases, University Hospital of Pontchaillou, Rennes, France
| | - R Hasbun
- Department of Infectious Diseases, The University of Texas Health Science Center at Houston, Medical School, Houston, TX, USA
| | - M Sunbul
- Department of Infectious Diseases and Clinical Microbiology, Ondokuz Mayis University School of Medicine, Samsun, Turkey
| | - M Akcaer
- Department of Infectious Diseases and Clinical Microbiology, Gulhane Medical Academy, Ankara, Turkey
| | - S Alp
- Department of Infectious Diseases and Clinical Microbiology, Faculty of Medicine, Hacettepe University, Ankara, Turkey
| | - T Demirdal
- Department of Infectious Diseases and Clinical Microbiology, Faculty of Medicine, Izmir Katip Celebi University, Izmir, Turkey
| | - K Angamuthu
- Department of Clinical Microbiology, Almana General Hospital, Dammam, Saudi Arabia
| | - F Amer
- Department of Medical Microbiology and Immunology, Faculty of Medicine, Zagazig University, Zagazig, Egypt
| | - E Ragab
- Diagnostic Microbiology Lab of Alexandria University Hospital, Alexandria, Egypt
| | - G A Shehata
- Department of Neurology, Faculty of Medicine, Assiut University, Assiut, Egypt
| | - D Ozturk-Engin
- Department of Infectious Diseases and Clinical Microbiology, Haydarpasa Numune Training and Research Hospital, Istanbul, Turkey
| | - N Ozgunes
- Department of Infectious Diseases and Clinical Microbiology, Faculty of Medicine, Okan University, Istanbul, Turkey
| | - L Larsen
- Department of Infectious Diseases, Odense University Hospital, Odense, Denmark
| | - S Zimmerli
- Department of Infectious Diseases, Bern University Hospital and Institute for Infectious Diseases, University of Bern, Bern, Switzerland
| | - O R Sipahi
- Department of Infectious Diseases and Clinical Microbiology, Faculty of Medicine, Ege University, Izmir, Turkey
| | - E Tukenmez Tigen
- Department of Infectious Disease and Clinical Microbiology, Faculty of Medicine, Marmara University, Istanbul, Turkey
| | - G Celebi
- Department of Infectious Diseases and Clinical Microbiology, Faculty of Medicine, Bulent Ecevit University, Zonguldak, Turkey
| | - N Oztoprak
- Department of Infectious Diseases and Clinical Microbiology, Antalya Training and Research Hospital, Antalya, Turkey
| | - A C Yardimci
- Department of Infectious Diseases and Clinical Microbiology, Istanbul Training and Research Hospital, Istanbul, Turkey
| | - Y Cag
- Department of Infectious Diseases and Clinical Microbiology, Faculty of Medicine, Istanbul Medeniyet University, Istanbul, Turkey
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15
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Erol B, Culpan M, Caskurlu H, Sari U, Cag Y, Vahaboglu H, Özumut SH, Karaman MI, Caskurlu T. Changes in antimicrobial resistance and demographics of UTIs in pediatric patients in a single institution over a 6-year period. J Pediatr Urol 2018; 14:176.e1-176.e5. [PMID: 29428362 DOI: 10.1016/j.jpurol.2017.12.002] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/12/2017] [Accepted: 12/03/2017] [Indexed: 10/18/2022]
Abstract
PURPOSE To determine changes in antimicrobial resistance and demographics of UTIs in pediatric patients in a single institution over a 6-year period. MATERIALS AND METHODS The current study examined outpatient urinary isolates from patients aged <18 years. A retrospective cross-sectional analysis of bacteria isolated from children with UTI was performed between 2009 and 2014. The most common bacterial pathogens were determined in the following four age groups: <2 years; 2-5 years; 6-12 years; and 13-17 years. The study analyzed the prevalence and antibiotic resistance patterns for the six most common uropathogens: Escherichia coli, Proteus, Klebsiella, Enterobacter, Pseudomonas and Enterococcus (Summary table). The antibiotic resistance pattern for UTI during 2009-2014 was also examined. RESULTS A total of 6515 urinary cultures was examined. The majority of these isolates were from female patients (66.8%). E. coli was the most common uropathogen overall, but the prevalence of E. coli was higher among females (79.5%) than males (54.9%). The biggest percentage of isolates in males was from children aged <2 years (46.1%). Conversely, the majority of isolates in females were from children aged >6 years (46.8%). Results of antimicrobial resistance for E. coli were the highest for ampicillin (70%) and lowest for meropenem (0.19%). Comparing the hospital network data from 2009 to 2014, E. coli resistance increased for ampicillin (from 47.1% to 89%), trimethoprim-sulfamethoxazole (TMP-SMX) (from 44.8% to 56%) and nitrofurantoin (from 5.3% to 15.1%). In contrast, cephalosporins have maintained low antibiotic resistance. CONCLUSION UTI in females was nearly twice as common than in males. E. coli remained the most common pediatric uropathogen. Although widely used in other tract infections, ampicillin was a poor empiric choice for pediatric UTIs. Cephalosporins were appropriate alternatives given their low resistance rates. A successful empirical treatment protocol should be based on local epidemiology and susceptibility rates.
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Affiliation(s)
- B Erol
- Istanbul Medeniyet University Faculty of Medicine, Department of Urology, Istanbul, Turkey.
| | - M Culpan
- Istanbul Medeniyet University Faculty of Medicine, Department of Urology, Istanbul, Turkey
| | - H Caskurlu
- Istanbul Medeniyet University Faculty of Medicine, Department of Infectious Diseases and Clinical Microbiology, Istanbul, Turkey
| | - U Sari
- Istanbul Medeniyet University Faculty of Medicine, Department of Urology, Istanbul, Turkey
| | - Y Cag
- Istanbul Medeniyet University Faculty of Medicine, Department of Infectious Diseases and Clinical Microbiology, Istanbul, Turkey
| | - H Vahaboglu
- Istanbul Medeniyet University Faculty of Medicine, Department of Infectious Diseases and Clinical Microbiology, Istanbul, Turkey
| | - S H Özumut
- Istanbul Medeniyet University Faculty of Medicine, Department of Pediatrics, Istanbul, Turkey
| | - M I Karaman
- Istanbul Medeniyet University Faculty of Medicine, Department of Urology, Istanbul, Turkey
| | - T Caskurlu
- Istanbul Medeniyet University Faculty of Medicine, Department of Urology, Istanbul, Turkey
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16
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Erdem H, Inan A, Guven E, Hargreaves S, Larsen L, Shehata G, Pernicova E, Khan E, Bastakova L, Namani S, Harxhi A, Roganovic T, Lakatos B, Uysal S, Sipahi OR, Crisan A, Miftode E, Stebel R, Jegorovic B, Fehér Z, Jekkel C, Pandak N, Moravveji A, Yilmaz H, Khalifa A, Musabak U, Yilmaz S, Jouhar A, Oztoprak N, Argemi X, Baldeyrou M, Bellaud G, Moroti RV, Hasbun R, Salazar L, Tekin R, Canestri A, Čalkić L, Praticò L, Yilmaz-Karadag F, Santos L, Pinto A, Kaptan F, Bossi P, Aron J, Duissenova A, Shopayeva G, Utaganov B, Grgic S, Ersoz G, Wu AKL, Lung KC, Bruzsa A, Radic LB, Kahraman H, Momen-Heravi M, Kulzhanova S, Rigo F, Konkayeva M, Smagulova Z, Tang T, Chan P, Ahmetagic S, Porobic-Jahic H, Moradi F, Kaya S, Cag Y, Bohr A, Artuk C, Celik I, Amsilli M, Gul HC, Cascio A, Lanzafame M, Nassar M. The burden and epidemiology of community-acquired central nervous system infections: a multinational study. Eur J Clin Microbiol Infect Dis 2017; 36:1595-1611. [PMID: 28397100 DOI: 10.1007/s10096-017-2973-0] [Citation(s) in RCA: 37] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2017] [Accepted: 03/22/2017] [Indexed: 12/11/2022]
Abstract
Risk assessment of central nervous system (CNS) infection patients is of key importance in predicting likely pathogens. However, data are lacking on the epidemiology globally. We performed a multicenter study to understand the burden of community-acquired CNS (CA-CNS) infections between 2012 and 2014. A total of 2583 patients with CA-CNS infections were included from 37 referral centers in 20 countries. Of these, 477 (18.5%) patients survived with sequelae and 227 (8.8%) died, and 1879 (72.7%) patients were discharged with complete cure. The most frequent infecting pathogens in this study were Streptococcus pneumoniae (n = 206, 8%) and Mycobacterium tuberculosis (n = 152, 5.9%). Varicella zoster virus and Listeria were other common pathogens in the elderly. Although staphylococci and Listeria resulted in frequent infections in immunocompromised patients, cryptococci were leading pathogens in human immunodeficiency virus (HIV)-positive individuals. Among the patients with any proven etiology, 96 (8.9%) patients presented with clinical features of a chronic CNS disease. Neurosyphilis, neurobrucellosis, neuroborreliosis, and CNS tuberculosis had a predilection to present chronic courses. Listeria monocytogenes, Staphylococcus aureus, M. tuberculosis, and S. pneumoniae were the most fatal forms, while sequelae were significantly higher for herpes simplex virus type 1 (p < 0.05 for all). Tackling the high burden of CNS infections globally can only be achieved with effective pneumococcal immunization and strategies to eliminate tuberculosis, and more must be done to improve diagnostic capacity.
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Affiliation(s)
- H Erdem
- Principal Coordinator of ID-IRI, Ankara, Turkey.
- Department of Infectious Diseases and Clinical Microbiology, Gulhane Medical Academy, 06010, Etlik, Ankara, Turkey.
| | - A Inan
- Department of Infectious Diseases and Clinical Microbiology, Haydarpasa Numune Training and Research Hospital, Istanbul, Turkey
| | - E Guven
- Beytepe Murat Erdi Eker State Hospital, Ankara, Turkey
| | - S Hargreaves
- International Health Unit, Section of Infectious Diseases and Immunity, Commonwealth Building, Hammersmith Campus, Imperial College London, London, UK
| | - L Larsen
- Department of Infectious Diseases Q, Odense University Hospital, Odense, Denmark
| | - G Shehata
- Department of Neurology and Psychiatry, Assiut University Hospital, Assiut, Egypt
| | - E Pernicova
- Avenier, Centres for Vaccination and Travel Medicine, Prague, Czech Republic
- Faculty Hospital Brno, Department of Infectious Diseases, Brno, Czech Republic
| | - E Khan
- Shifa International Hospital, Islamabad, Pakistan
| | - L Bastakova
- Faculty Hospital Brno, Department of Infectious Diseases and Masaryk University Faculty of Medicine, Brno, Czech Republic
| | - S Namani
- Infectious Diseases Clinic, University Clinical Center of Kosovo, Prishtina, Kosovo
| | - A Harxhi
- Service of Infectious Disease, University Hospital Center of Tirana, Tirana, Albania
| | - T Roganovic
- Infectious Diseases Clinic, University Hospital Clinical Center Banja Luka, Banja Luka, Bosnia and Herzegovina
| | - B Lakatos
- Department of Infectious Diseases, Saint Laszlo Hospital, Budapest, Hungary
| | - S Uysal
- Department of Infectious Diseases and Clinical Microbiology, Seyfi Demirsoy State Hospital, Buca, İzmir, Turkey
| | - O R Sipahi
- Department of Infectious Diseases and Clinical Microbiology, Ege University School of Medicine, Izmir, Turkey
| | - A Crisan
- Department of Infectious Diseases, Victor Babes University of Medicine and Pharmacy, Timisoara, Romania
| | - E Miftode
- Hospital of Infectious Diseases, Gr. T. Popa University of Medicine and Pharmacy, Iasi, Romania
| | - R Stebel
- Faculty Hospital Brno, Department of Infectious Diseases and Masaryk University Faculty of Medicine, Brno, Czech Republic
| | - B Jegorovic
- Clinic for Infectious and Tropical Diseases, Clinical Centre of Serbia, Faculty of Medicine, University of Belgrade, Belgrade, Serbia
| | - Z Fehér
- Department of Infectious Diseases, Markusovszky University Teaching Hospital, Szombathely, Hungary
| | - C Jekkel
- Department of Infectious Diseases, Saint Laszlo Hospital, Budapest, Hungary
| | - N Pandak
- General Hospital Slavonski Brod, Department for Infectious Diseases, School of Medicine, University of Split, Split, Croatia
| | - A Moravveji
- Social Determinants of Health Research Center, Department of Community Medicine, Kashan University of Medical Sciences, Kashan, Iran
| | - H Yilmaz
- Department of Infectious Diseases and Clinical Microbiology, Ondokuz Mayis University School of Medicine, Samsun, Turkey
| | - A Khalifa
- Department of Neurology, Damascus Hospital, Damascus, Syria
| | - U Musabak
- Department of Immunology and Allergy, Losante Hospital, Ankara, Turkey
| | - S Yilmaz
- Gulhane Medical Academy, Blood Bank, Clinical Microbiology Division, Ankara, Turkey
| | - A Jouhar
- Department of Neurology, Damascus Hospital, Damascus, Syria
| | - N Oztoprak
- Antalya Education and Research Hospital, Antalya, Turkey
| | - X Argemi
- Infectious Diseases Department, Nouvel Hôpital Civil, Strasbourg, France
| | - M Baldeyrou
- Infectious Diseases Department, Nouvel Hôpital Civil, Strasbourg, France
| | - G Bellaud
- Department of Infectious Diseases, Tenon University Hospital, Paris, France
| | - R V Moroti
- Carol Davila University of Medicine and Pharmacy and Matei Bals National Institute for Infectious Diseases, Bucharest, Romania
| | - R Hasbun
- Medical School, Department of Infectious Diseases, The University of Texas Health Science Center at Houston, Houston, TX, USA
| | - L Salazar
- Medical School, Department of Infectious Diseases, The University of Texas Health Science Center at Houston, Houston, TX, USA
| | - R Tekin
- Department of Infectious Diseases and Clinical Microbiology, Dicle University School of Medicine, Diyarbakir, Turkey
| | - A Canestri
- Department of Infectious Diseases, Tenon University Hospital, Paris, France
| | - L Čalkić
- Department of Infectious Diseases, Zenica Cantonal Hospital, Zenica, Bosnia and Herzegovina
| | - L Praticò
- University Division of Infectious and Tropical Diseases, Piazza Spedali Civili, 25123, Brescia, Italy
| | - F Yilmaz-Karadag
- Goztepe Training and Research Hospital, Department of Infectious Diseases and Clinical Microbiology, Medeniyet University, Istanbul, Turkey
| | - L Santos
- Infectious Diseases Service, Centro Hospitalar São João and Faculty of Medicine, University of Porto, Porto, Portugal
| | - A Pinto
- Infectious Diseases Service, Centro Hospitalar São João and Faculty of Medicine, University of Porto, Porto, Portugal
| | - F Kaptan
- Department of Infectious Diseases and Clinical Microbiology, Katip Celebi University School of Medicine, Izmir, Turkey
| | - P Bossi
- Department Maladies Infectieuses, Institut Pasteur de Paris-HPA, Paris, France
| | - J Aron
- Department Maladies Infectieuses, Institut Pasteur de Paris-HPA, Paris, France
| | - A Duissenova
- Department of Infectious and Tropical Diseases, Asfendiyarov Kazakh National Medical University, Almaty, Kazakhstan
| | - G Shopayeva
- Department of Infectious and Tropical Diseases, Asfendiyarov Kazakh National Medical University, Almaty, Kazakhstan
| | - B Utaganov
- Department of Infectious and Tropical Diseases, Asfendiyarov Kazakh National Medical University, Almaty, Kazakhstan
| | - S Grgic
- Clinic for Infectious Diseases, University Hospital of Mostar, Mostar, Bosnia and Herzegovina
| | - G Ersoz
- Department of Infectious Diseases and Clinical Microbiology, Mersin University School of Medicine, Mersin, Turkey
| | - A K L Wu
- Department of Clinical Pathology, Pamela Youde Nethersole Eastern Hospital, Hong Kong SAR, China
| | - K C Lung
- Department of Clinical Pathology, Pamela Youde Nethersole Eastern Hospital, Hong Kong SAR, China
| | - A Bruzsa
- Department of Infectious Diseases, Saint Laszlo Hospital, Budapest, Hungary
| | - L B Radic
- Department of Infectious Diseases, General Hospital Dubrovnik, Dubrovnik, Croatia
| | - H Kahraman
- Department of Infectious Diseases and Clinical Microbiology, Ege University School of Medicine, Izmir, Turkey
| | - M Momen-Heravi
- Department of Infectious Diseases, Social Determinants of Health Research Center, Kashan University of Medical Sciences, Kashan, Iran
| | - S Kulzhanova
- Department of Infectious Diseases, Astana Medical University, Astana, Kazakhstan
| | - F Rigo
- Unit of Infectious Diseases, Azienda Ospedaliera Universitaria Integrata, Verona, Italy
| | - M Konkayeva
- Department of Infectious Diseases, Astana Medical University, Astana, Kazakhstan
| | - Z Smagulova
- Department of Infectious Diseases, Astana Medical University, Astana, Kazakhstan
| | - T Tang
- Infectious Diseases Team, Department of Medicine, Queen Elizabeth Hospital, Hong Kong, China
| | - P Chan
- Neurology Team, Department of Medicine, Queen Elizabeth Hospital, Hong Kong, China
| | - S Ahmetagic
- University Clinical Center Tuzla, Tuzla, Bosnia and Herzegovina
| | - H Porobic-Jahic
- University Clinical Center Tuzla, Tuzla, Bosnia and Herzegovina
| | - F Moradi
- Infectious and Tropical Diseases Research Center, Hormozgan University of Medical Sciences, Bandar Abbas, Iran
| | - S Kaya
- Department of Infectious Diseases and Clinical Microbiology, Karadeniz Technical University School of Medicine, Trabzon, Turkey
| | - Y Cag
- School of Medicine, Department of Infectious Diseases and Clinical Microbiology, Medeniyet University, Istanbul, Turkey
| | - A Bohr
- Institute of Inflammation Research, Department of Infectious Diseases and Rheumatology, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark
| | - C Artuk
- Department of Infectious Diseases and Clinical Microbiology, Gulhane Training and Research Hospital, Ankara, Turkey
| | - I Celik
- Department of Infectious Diseases and Clinical Microbiology, Kayseri Training and Research Hospital, Kayseri, Turkey
| | - M Amsilli
- Infectious Diseases Unit, CHU Bicètre, Paris, France
| | - H C Gul
- Department of Infectious Diseases and Clinical Microbiology, Gulhane Training and Research Hospital, Ankara, Turkey
| | - A Cascio
- Department of Health Promotion Sciences and Mother and Child Care "G. D'Alessandro", University of Palermo, Palermo, Italy
| | - M Lanzafame
- Unit of Infectious Diseases, Azienda Ospedaliera Universitaria Integrata, Verona, Italy
| | - M Nassar
- Infection Control Department, Saudi German Hospital Group, Jeddah, Saudi Arabia
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Tosun S, Batirel A, Oluk AI, Aksoy F, Puca E, Bénézit F, Ural S, Nayman-Alpat S, Yamazhan T, Koksaldi-Motor V, Tekin R, Parlak E, Tattevin P, Kart-Yasar K, Guner R, Bastug A, Meric-Koc M, Oncu S, Sagmak-Tartar A, Denk A, Pehlivanoglu F, Sengoz G, Sørensen SM, Celebi G, Baštáková L, Gedik H, Dirgen-Caylak S, Esmaoglu A, Erol S, Cag Y, Karagoz E, Inan A, Erdem H. Tetanus in adults: results of the multicenter ID-IRI study. Eur J Clin Microbiol Infect Dis 2017; 36:1455-1462. [PMID: 28353183 DOI: 10.1007/s10096-017-2954-3] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2017] [Accepted: 02/28/2017] [Indexed: 02/08/2023]
Abstract
Tetanus is an acute, severe infection caused by a neurotoxin secreting bacterium. Various prognostic factors affecting mortality in tetanus patients have been described in the literature. In this study, we aimed to analyze the factors affecting mortality in hospitalized tetanus patients in a large case series. This retrospective multicenter study pooled data of tetanus patients from 25 medical centers. The hospitals participating in this study were the collaborating centers of the Infectious Diseases International Research Initiative (ID-IRI). Only adult patients over the age of 15 years with tetanus were included. The diagnosis of tetanus was made by the clinicians at the participant centers. Izmir Bozyaka Education and Research Hospital's Review Board approved the study. Prognostic factors were analyzed by using the multivariate regression analysis method. In this study, 117 adult patients with tetanus were included. Of these, 79 (67.5%) patients survived and 38 (32.5%) patients died. Most of the deaths were observed in patients >60 years of age (60.5%). Generalized type of tetanus, presence of pain at the wound area, presence of generalized spasms, leukocytosis, high alanine aminotransferase (ALT) and C-reactive protein (CRP) values on admission, and the use of equine immunoglobulins in the treatment were found to be statistically associated with mortality (p < 0.05 for all). Here, we describe the prognostic factors for mortality in tetanus. Immunization seems to be the most critical point, considering the advanced age of our patients. A combination of laboratory and clinical parameters indicates mortality. Moreover, human immunoglobulins should be preferred over equine sera to increase survival.
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Affiliation(s)
- S Tosun
- Department of Infectious Diseases and Clinical Microbiology, Izmir Bozyaka Training and Research Hospital, Izmir, Turkey
| | - A Batirel
- Department of Infectious Diseases and Clinical Microbiology, Dr. Lutfi Kirdar Training and Research Hospital, Istanbul, Turkey
| | - A I Oluk
- Department of Infectious Diseases and Clinical Microbiology, Izmir Bozyaka Training and Research Hospital, Izmir, Turkey
| | - F Aksoy
- Department of Infectious Diseases and Clinical Microbiology, Karadeniz Technical University School of Medicine, Trabzon, Turkey
| | - E Puca
- Department of Infectious Diseases, University Hospital Center "Mother Teresa", Tirana, Albania
| | - F Bénézit
- Infectious Diseases and Intensive Care Unit, University Hospital of Pontchaillou, Rennes, France
| | - S Ural
- Ataturk Training and Research Hospital, Department of Infectious Diseases and Clinical Microbiology, Katip Celebi University, Izmir, Turkey
| | - S Nayman-Alpat
- Department of Infectious Diseases and Clinical Microbiology, Osmangazi University School of Medicine, Eskisehir, Turkey
| | - T Yamazhan
- Department of Infectious Diseases and Clinical Microbiology, Ege University School of Medicine, Izmir, Turkey
| | - V Koksaldi-Motor
- Tayfur Ata Sokmen School of Medicine, Department of Infectious Diseases and Clinical Microbiology, Mustafa Kemal University, Hatay, Turkey
| | - R Tekin
- Department of Infectious Diseases and Clinical Microbiology, Dicle University School of Medicine, Diyarbakir, Turkey
| | - E Parlak
- Department of Infectious Diseases and Clinical Microbiology, Ataturk University School of Medicine, Erzurum, Turkey
| | - P Tattevin
- Infectious Diseases and Intensive Care Unit, University Hospital of Pontchaillou, Rennes, France
| | - K Kart-Yasar
- Department of Infectious Diseases and Clinical Microbiology, Bakırköy Dr. Sadi Konuk Training and Research Hospital, Istanbul, Turkey
| | - R Guner
- Ataturk Training and Research Hospital, Department of Infectious Diseases and Clinical Microbiology, Yildirim Beyazit University, Ankara, Turkey
| | - A Bastug
- Department of Infectious Diseases and Clinical Microbiology, Numune Training and Research Hospital, Ankara, Turkey
| | - M Meric-Koc
- Department of Infectious Diseases and Clinical Microbiology, Kocaeli University School of Medicine, Izmit, Turkey
| | - S Oncu
- Department of Infectious Diseases and Clinical Microbiology, Adnan Menderes University School of Medicine, Aydin, Turkey
| | - A Sagmak-Tartar
- Department of Infectious Diseases and Clinical Microbiology, Firat University School of Medicine, Elazig, Turkey
| | - A Denk
- Department of Infectious Diseases and Clinical Microbiology, Firat University School of Medicine, Elazig, Turkey
| | - F Pehlivanoglu
- Department of Infectious Diseases and Clinical Microbiology, Haseki Training and Research Hospital, Istanbul, Turkey
| | - G Sengoz
- Department of Infectious Diseases and Clinical Microbiology, Haseki Training and Research Hospital, Istanbul, Turkey
| | - S M Sørensen
- Department of Infectious Diseases, Aalborg University Hospital, Aalborg, Denmark
| | - G Celebi
- School of Medicine, Department of Infectious Diseases and Clinical Microbiology, Bulent Ecevit University, Zonguldak, Turkey
| | - L Baštáková
- Faculty Hospital Brno, Department of Infectious Diseases and Faculty of Medicine, Masaryk University, Brno, Czech Republic
| | - H Gedik
- Department of Infectious Diseases and Clinical Microbiology, Bakırköy Dr. Sadi Konuk Training and Research Hospital, Istanbul, Turkey
| | - S Dirgen-Caylak
- Department of Infectious Diseases and Clinical Microbiology, Mugla Sitki Kocman University School of Medicine, Mugla, Turkey
| | - A Esmaoglu
- Faculty of Medicine, Department of Anesthesiology Intensive Care Unit, Erciyes University, Kayseri, Turkey
| | - S Erol
- Department of Infectious Diseases and Clinical Microbiology, Haydarpasa Numune Training and Research Hospital, Istanbul, Turkey
| | - Y Cag
- School of Medicine, Department of Infectious Diseases and Clinical Microbiology, Medeniyet University, Istanbul, Turkey
| | - E Karagoz
- Department of Infectious Diseases and Clinical Microbiology, Fatih Sultan Mehmet Training and Research Hospital, Istanbul, Turkey
| | - A Inan
- Department of Infectious Diseases and Clinical Microbiology, Haydarpasa Numune Training and Research Hospital, Istanbul, Turkey
| | - H Erdem
- Principal Coordinator of ID-IRI, Ankara, Turkey.
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18
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Erdem H, Cag Y. Managing atypical and typical herpetic central nervous system infections: results of a multinational study - Authors' reply. Clin Microbiol Infect 2017; 23:421-422. [PMID: 28143783 DOI: 10.1016/j.cmi.2017.01.016] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2016] [Revised: 12/26/2016] [Accepted: 01/22/2017] [Indexed: 11/28/2022]
Affiliation(s)
- H Erdem
- Infectious Diseases International Research Initiative (ID-IRI), Ankara, Turkey
| | - Y Cag
- Department of Infectious Diseases and Clinical Microbiology, Istanbul Medeniyet University, Goztepe Training and Research Hospital, Istanbul, Turkey
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19
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Cag Y, Erdem H, Leib S, Defres S, Kaya S, Larsen L, Poljak M, Ozturk-Engin D, Barsic B, Argemi X, Sørensen SM, Bohr AL, Tattevin P, Gunst JD, Baštáková L, Jereb M, Johansen IS, Karabay O, Pekok AU, Sipahi OR, Chehri M, Beraud G, Shehata G, Fontana R, Maresca M, Karsen H, Sengoz G, Sunbul M, Yilmaz G, Yilmaz H, Sharif-Yakan A, Kanj S, Parlak E, Pehlivanoglu F, Korkmaz F, Komur S, Kose S, Ulug M, Bolukcu S, Coskuner SA, Stahl JP, Ince N, Akkoyunlu Y, Halac G, Sahin-Horasan E, Tireli H, Kilicoglu G, Al-Mahdawi A, Nemli SA, Inan A, Senbayrak S, Vahaboglu H, Elaldi N. Managing atypical and typical herpetic central nervous system infections: results of a multinational study. Clin Microbiol Infect 2016; 22:568.e9-568.e17. [PMID: 27085724 DOI: 10.1016/j.cmi.2016.03.027] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2015] [Revised: 03/20/2016] [Accepted: 03/26/2016] [Indexed: 11/19/2022]
Abstract
There have been many studies pertaining to the management of herpetic meningoencephalitis (HME), but the majority of them have focussed on virologically unconfirmed cases or included only small sample sizes. We have conducted a multicentre study aimed at providing management strategies for HME. Overall, 501 adult patients with PCR-proven HME were included retrospectively from 35 referral centres in 10 countries; 496 patients were found to be eligible for the analysis. Cerebrospinal fluid (CSF) analysis using a PCR assay yielded herpes simplex virus (HSV)-1 DNA in 351 patients (70.8%), HSV-2 DNA in 83 patients (16.7%) and undefined HSV DNA type in 62 patients (12.5%). A total of 379 patients (76.4%) had at least one of the specified characteristics of encephalitis, and we placed these patients into the encephalitis presentation group. The remaining 117 patients (23.6%) had none of these findings, and these patients were placed in the nonencephalitis presentation group. Abnormalities suggestive of encephalitis were detected in magnetic resonance imaging (MRI) in 83.9% of the patients and in electroencephalography (EEG) in 91.0% of patients in the encephalitis presentation group. In the nonencephalitis presentation group, MRI and EEG data were suggestive of encephalitis in 33.3 and 61.9% of patients, respectively. However, the concomitant use of MRI and EEG indicated encephalitis in 96.3 and 87.5% of the cases with and without encephalitic clinical presentation, respectively. Considering the subtle nature of HME, CSF HSV PCR, EEG and MRI data should be collected for all patients with a central nervous system infection.
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Affiliation(s)
- Y Cag
- Dr Lütfi Kirdar Training and Research Hospital, Department of Infectious Diseases and Clinical Microbiology, Istanbul, Turkey
| | - H Erdem
- Gulhane Medical Academy, Department of Infectious Diseases and Clinical Microbiology, Ankara, Turkey.
| | - S Leib
- Institute for Infectious Diseases, University of Bern, Switzerland
| | - S Defres
- Institute of Infection and Global Health, University of Liverpool, United Kingdom; Tropical Infections Diseases Unit In Royal Liverpool and Broadgreen University Hospitals NHS Trust, United Kingdom
| | - S Kaya
- Karadeniz Technical University School of Medicine, Department of Infectious Diseases and Clinical Microbiology, Trabzon, Turkey
| | - L Larsen
- Odense University Hospital, Department of Infectious Diseases Q, Odense, Denmark
| | - M Poljak
- Institute of Microbiology and Immunology, Faculty of Medicine, University of Ljubljana, Ljubljana, Slovenia
| | - D Ozturk-Engin
- Haydarpasa Numune Training and Research Hospital, Department of Infectious Diseases and Clinical Microbiology, Istanbul, Turkey
| | - B Barsic
- Dr. Fran Mihaljevic University Hospital for Infectious Diseases, Department of Infectious Diseases, University of Zagreb School of Medicine, Zagreb, Croatia
| | - X Argemi
- Nouvel Hôpital Civil, Department of Infectious Diseases, Strasbourg, France
| | - S M Sørensen
- Aalborg University Hospital, Department of Infectious Diseases, Denmark
| | - A L Bohr
- Copenhagen University Hospital, Institute of Inflammation Research, Department of Infectious Diseases and Rheumatology, Rigshospitalet, Denmark
| | - P Tattevin
- University Hospital of Pontchaillou, Department of Infectious and Tropical Diseases, Rennes, France
| | - J D Gunst
- Aarhus University Hospital, Department of Infectious Diseases, Aarhus, Denmark
| | - L Baštáková
- Faculty Hospital Brno, Department of Infectious Diseases, Masaryk University, Faculty of Medicine, Brno, Czech Republic
| | - M Jereb
- University Medical Centre, Department of Infectious Diseases, Ljubljana, Slovenia
| | - I S Johansen
- Odense University Hospital, Department of Infectious Diseases Q, Odense, Denmark
| | - O Karabay
- Sakarya University School of Medicine, Department of Infectious Diseases and Clinical Microbiology, Sakarya, Turkey
| | - A U Pekok
- Private Erzurum Sifa Hospital, Department of Infectious Diseases and Clinical Microbiology, Erzurum, Turkey
| | - O R Sipahi
- Ege University School of Medicine, Department of Infectious Diseases and Clinical Microbiology, Izmir, Turkey
| | - M Chehri
- Hvidovre Hospital, Department of Infectious Diseases, Copenhagen, Denmark
| | - G Beraud
- Poitiers University Hospital, Department of Infectious Diseases, France
| | - G Shehata
- Assiut University Hospital, Department of Neurology and Psychiatry, Assiut, Egypt
| | - R Fontana
- University of Catania, Section of Infectious Diseases, Department of Clinical and Molecular Biomedicine, Catania, Italy
| | - M Maresca
- University of Catania, Section of Infectious Diseases, Department of Clinical and Molecular Biomedicine, Catania, Italy
| | - H Karsen
- Harran University, School of Medicine, Department of Infectious Diseases and Clinical Microbiology, Sanliurfa, Turkey
| | - G Sengoz
- Haseki Training and Research Hospital, Department of Infectious Diseases and Clinical Microbiology, Istanbul, Turkey
| | - M Sunbul
- Ondokuz Mayis University School of Medicine, Department of Infectious Diseases and Clinical Microbiology, Samsun, Turkey
| | - G Yilmaz
- Ankara University School of Medicine, Department of Infectious Diseases and Clinical Microbiology, Ankara, Turkey
| | - H Yilmaz
- Ondokuz Mayis University School of Medicine, Department of Infectious Diseases and Clinical Microbiology, Samsun, Turkey
| | - A Sharif-Yakan
- American University of Beirut Medical Center, Beirut, Lebanon
| | - S Kanj
- American University of Beirut Medical Center, Beirut, Lebanon
| | - E Parlak
- Ataturk University School of Medicine, Department of Infectious Diseases and Clinical Microbiology, Erzurum, Turkey
| | - F Pehlivanoglu
- Haseki Training and Research Hospital, Department of Infectious Diseases and Clinical Microbiology, Istanbul, Turkey
| | - F Korkmaz
- Konya Training and Research Hospital, Department of Infectious Diseases and Clinical Microbiology, Konya, Turkey
| | - S Komur
- Cukurova University School of Medicine, Department of Infectious Diseases and Clinical Microbiology, Adana, Turkey
| | - S Kose
- Tepecik Training and Research Hospital, Department of Infectious Diseases and Clinical Microbiology, Izmir, Turkey
| | - M Ulug
- Private Umit Hospital, Department of Infectious Diseases and Clinical Microbiology, Eskisehir, Turkey
| | - S Bolukcu
- Haydarpasa Numune Training and Research Hospital, Department of Infectious Diseases and Clinical Microbiology, Istanbul, Turkey
| | - S A Coskuner
- Izmir Bozyaka Training and Research Hospital, Department of Infectious Diseases and Clinical Microbiology, Izmir, Turkey
| | - J P Stahl
- Joseph Fourier University and University Hospital of Grenoble, Department of Infectious Diseases, Grenoble, France
| | - N Ince
- Duzce University School of Medicine, Department of Infectious Diseases and Clinical Microbiology, Konuralp, Duzce, Turkey
| | - Y Akkoyunlu
- Bezmi Alem Vakif University, School of Medicine, Department of Infectious Diseases and Clinical Microbiology, Istanbul, Turkey
| | - G Halac
- Bezmi Alem Vakif University, School of Medicine, Department of Neurology, Istanbul, Turkey
| | - E Sahin-Horasan
- Mersin University School of Medicine, Department of Infectious Diseases and Clinical Microbiology, Mersin, Turkey
| | - H Tireli
- Haydarpasa Numune Training and Research Hospital, Department of Neurology, Turkey
| | - G Kilicoglu
- Haydarpasa Numune Training and Research Hospital, Department of Radiology, Turkey
| | - A Al-Mahdawi
- Department of Neurology, Baghdad Teaching Hospital, Iraq
| | - S A Nemli
- Katip Celebi University School of Medicine, Department of Infectious Diseases and Clinical Microbiology, Izmir, Turkey
| | - A Inan
- Haydarpasa Numune Training and Research Hospital, Department of Infectious Diseases and Clinical Microbiology, Istanbul, Turkey
| | - S Senbayrak
- Haydarpasa Numune Training and Research Hospital, Department of Infectious Diseases and Clinical Microbiology, Istanbul, Turkey
| | - H Vahaboglu
- Medeniyet University, Goztepe Training and Research Hospital, Department of Infectious Diseases and Clinical Microbiology, Istanbul, Turkey
| | - N Elaldi
- Cumhuriyet University School of Medicine, Department of Infectious Diseases and Clinical Microbiology, Sivas, Turkey
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20
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Erdem H, Ak O, Elaldi N, Demirdal T, Hargreaves S, Nemli SA, Cag Y, Ulug M, Naz H, Gunal O, Sirmatel F, Sipahi OR, Alpat SN, Ertem-Tuncer G, Sozen H, Evlice O, Meric-Koc M, Dogru A, Koksaldi-Motor V, Tekin R, Ozdemir D, Ozturk-Engin D, Savasci U, Karagoz E, Cekli Y, Inan A. Infections in travellers returning to Turkey from the Arabian peninsula: a retrospective cross-sectional multicenter study. Eur J Clin Microbiol Infect Dis 2016; 35:903-10. [PMID: 26964538 PMCID: PMC7087946 DOI: 10.1007/s10096-016-2614-z] [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] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2016] [Accepted: 02/17/2016] [Indexed: 11/17/2022]
Abstract
Mass gatherings pooling people from different parts of the world—the largest of which is to Mecca, Saudi Arabia, for Hajj—may impose risks for acquisition and dissemination of infectious diseases. A substantial number of pilgrims to Hajj and Umrah are Turkish citizens (456,000 in 2014) but data are lacking on scale of the problem. We did a retrospective cross-sectional multicenter study in Turkey to explore the range of infections among inpatients who had recently returned from the Arabian Peninsula. Our inclusion criteria were patients who had acquired an infection during their trip to an Arabian Peninsula country, or who became symptomatic within 1 week of their return. The data were collected retrospectively for January 1, 2013 and March 1, 2015. 185 Turkish patients were recruited to the study across 15 referral centers with travel associated infectious diseases after returning from Arabian Peninsula countries (predominantly Saudi Arabia 163 [88.1 %] for religious purposes 162 [87.5 %]). Seventy four (40.0 %) of them were ≥ 65 years old with numerous comorbidities including diabetes (24.3 %) and COPD (14.1 %). The most common clinical diagnosis was respiratory tract infections (169 [91.5 %]), followed by diarrheal diseases (13 [7 %]), and there was one case of MERS-CoV. Patients spent a median of 5 (3–7) days as hospital inpatients and overall mortality was 1.1 %. Returning travellers from the Arabian Peninsula present as inpatients with a broad range of infectious diseases similar to common community acquired infections frequently seen in daily medical practices in Turkey.
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Affiliation(s)
- H Erdem
- Department of Infectious Diseases and Clinical Microbiology, Gulhane Medical Academy, Ankara, Turkey.
| | - O Ak
- Department of Infectious Diseases and Clinical Microbiology, Dr. Lutfi Kirdar Training and Research Hospital, Istanbul, Turkey
| | - N Elaldi
- Department of Infectious Diseases and Clinical Microbiology, Cumhuriyet University School of Medicine, Sivas, Turkey
| | - T Demirdal
- Department of Infectious Diseases and Clinical Microbiology, Katip Celebi University School of Medicine, Izmir, Turkey
| | - S Hargreaves
- International Health Unit, Section of Infectious Diseases and Immunity, Imperial College London, Commonwealth Building, Hammersmith Campus, London, UK
| | - S A Nemli
- Department of Infectious Diseases and Clinical Microbiology, Katip Celebi University School of Medicine, Izmir, Turkey
| | - Y Cag
- Goztepe Training and Research Hospital, Department of Infectious Diseases and Clinical Microbiology, Medeniyet University, Istanbul, Turkey
| | - M Ulug
- Department of Infectious Diseases and Clinical Microbiology, Private Umit Hospital, Eskisehir, Turkey
| | - H Naz
- Department of Infectious Diseases and Clinical Microbiology, Kocaeli State Hospital, Kocaeli, Turkey
| | - O Gunal
- Department of Infectious Diseases and Clinical Microbiology, Samsun Training and Research Hospital, Samsun, Turkey
| | - F Sirmatel
- School of Medicine, Department of Infectious Diseases and Clinical Microbiology, Abant Izzet Baysal University, Bolu, Turkey
| | - O R Sipahi
- Department of Infectious Diseases and Clinical Microbiology, Ege University School of Medicine, Izmir, Turkey
| | - S N Alpat
- Department of Infectious Diseases and Clinical Microbiology, Osmangazi University School of Medicine, Eskisehir, Turkey
| | - G Ertem-Tuncer
- Department of Infectious Diseases and Clinical Microbiology, Ankara Training and Research Hospital, Ankara, Turkey
| | - H Sozen
- Department of Infectious Diseases and Clinical Microbiology, Mugla Sitki Kocman University School of Medicine, Mugla, Turkey
| | - O Evlice
- Department of Infectious Diseases and Clinical Microbiology, Dr. Lutfi Kirdar Training and Research Hospital, Istanbul, Turkey
| | - M Meric-Koc
- Department of Infectious Diseases and Clinical Microbiology, Kocaeli University School of Medicine, Izmit, Turkey
| | - A Dogru
- Goztepe Training and Research Hospital, Department of Infectious Diseases and Clinical Microbiology, Medeniyet University, Istanbul, Turkey
| | - V Koksaldi-Motor
- Tayfur Ata Sokmen School of Medicine, Department of Infectious Diseases and Clinical Microbiology, Mustafa Kemal University, Hatay, Turkey
| | - R Tekin
- Department of Infectious Diseases and Clinical Microbiology, Dicle University School of Medicine, Diyarbakir, Turkey
| | - D Ozdemir
- Department of Infectious Diseases and Clinical Microbiology, Duzce University School of Medicine, Konuralp, Duzce, Turkey
| | - D Ozturk-Engin
- Department of Infectious Diseases and Clinical Microbiology, Haydarpasa Numune Training and Research Hospital, Istanbul, Turkey
| | - U Savasci
- Department of Infectious Diseases and Clinical Microbiology, Gulhane Medical Academy, Ankara, Turkey
| | - E Karagoz
- Department of Infectious Diseases and Clinical Microbiology, Military Hospital, Van, Turkey
| | - Y Cekli
- Department of Infectious Diseases and Clinical Microbiology, Gulhane Medical Academy, Ankara, Turkey
| | - A Inan
- Department of Infectious Diseases and Clinical Microbiology, Haydarpasa Numune Training and Research Hospital, Istanbul, Turkey
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Erdem H, Elaldi N, Ak O, Gulsun S, Tekin R, Ulug M, Duygu F, Sunnetcioglu M, Tulek N, Guler S, Cag Y, Kaya S, Turker N, Parlak E, Demirdal T, Ataman Hatipoglu C, Avci A, Bulut C, Avci M, Pekok A, Savasci U, Kaya S, Sozen H, Tasbakan M, Guven T, Bolukcu S, Cesur S, Sahin-Horasan E, Kazak E, Denk A, Gonen I, Karagoz G, Haykir Solay A, Alici O, Kader C, Senturk G, Tosun S, Turan H, Baran A, Ozturk-Engin D, Bozkurt F, Deveci O, Inan A, Kadanali A, Sayar M, Cetin B, Yemisen M, Naz H, Gorenek L, Agalar C. Genitourinary brucellosis: results of a multicentric study. Clin Microbiol Infect 2014; 20:O847-53. [DOI: 10.1111/1469-0691.12680] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2013] [Revised: 05/12/2014] [Accepted: 05/12/2014] [Indexed: 01/15/2023]
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Erdem H, Ozturk-Engin D, Yesilyurt M, Karabay O, Elaldi N, Celebi G, Korkmaz N, Guven T, Sumer S, Tulek N, Ural O, Yilmaz G, Erdinc S, Nayman-Alpat S, Sehmen E, Kader C, Sari N, Engin A, Cicek-Senturk G, Ertem-Tuncer G, Gulen G, Duygu F, Ogutlu A, Ayaslioglu E, Karadenizli A, Meric M, Ulug M, Ataman-Hatipoglu C, Sirmatel F, Cesur S, Comoglu S, Kadanali A, Karakas A, Asan A, Gonen I, Kurtoglu-Gul Y, Altin N, Ozkanli S, Yilmaz-Karadag F, Cabalak M, Gencer S, Umut Pekok A, Yildirim D, Seyman D, Teker B, Yilmaz H, Yasar K, Inanc Balkan I, Turan H, Uguz M, Kilic S, Akkoyunlu Y, Kaya S, Erdem A, Inan A, Cag Y, Bolukcu S, Ulu-Kilic A, Ozgunes N, Gorenek L, Batirel A, Agalar C. Evaluation of tularaemia courses: a multicentre study from Turkey. Clin Microbiol Infect 2014; 20:O1042-51. [PMID: 24975504 DOI: 10.1111/1469-0691.12741] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2014] [Revised: 06/25/2014] [Accepted: 06/26/2014] [Indexed: 11/30/2022]
Abstract
In this multicentre study, which is the largest case series ever reported, we aimed to describe the features of tularaemia to provide detailed information. We retrospectively included 1034 patients from 41 medical centres. Before the definite diagnosis of tularaemia, tonsillitis (n = 653, 63%) and/or pharyngitis (n = 146, 14%) were the most frequent preliminary diagnoses. The most frequent clinical presentations were oropharyngeal (n = 832, 85.3%), glandular (n = 136, 13.1%) and oculoglandular (n = 105, 10.1%) forms. In 987 patients (95.5%), the lymph nodes were reported to be enlarged, most frequently at the cervical chain jugular (n = 599, 58%), submandibular (n = 401, 39%), and periauricular (n = 55, 5%). Ultrasound imaging showed hyperechoic and hypoechoic patterns (59% and 25%, respectively). Granulomatous inflammation was the most frequent histological finding (56%). The patients were previously given antibiotics for 1176 episodes, mostly with β-lactam/β-lactamase inhibitors (n = 793, 76%). Antituberculosis medications were provided in seven (2%) cases. The patients were given rational antibiotics for tularaemia after the start of symptoms, with a mean of 26.8 ± 37.5 days. Treatment failure was considered to have occurred in 495 patients (48%). The most frequent reasons for failure were the production of suppuration in the lymph nodes after the start of treatment (n = 426, 86.1%), the formation of new lymphadenomegalies under treatment (n = 146, 29.5%), and persisting complaints despite 2 weeks of treatment (n = 77, 15.6%). Fine-needle aspiration was performed in 521 patients (50%) as the most frequent drainage method. In conclusion, tularaemia is a long-lasting but curable disease in this part of the world. However, the treatment strategy still needs optimization.
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Affiliation(s)
- H Erdem
- Department of Infectious Diseases and Clinical Microbiology, GATA Haydarpasa Training Hospital, Istanbul, Turkey
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23
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Ozturk-Engin D, Erdem H, Gencer S, Kaya S, Baran AI, Batirel A, Tekin R, Celen MK, Denk A, Guler S, Ulug M, Turan H, Pekok AU, Mermut G, Kaya S, Tasbakan M, Tulek N, Cag Y, Inan A, Yalci A, Ataman-Hatipoglu C, Gonen I, Dogan-Celik A, Bozkurt F, Gulsun S, Sunnetcioglu M, Guven T, Duygu F, Parlak E, Sozen H, Tosun S, Demirdal T, Guclu E, Karabay O, Uzun N, Gunal O, Diktas H, Haykir-Solay A, Erbay A, Kader C, Aydin O, Erdem A, Elaldi N, Kadanali A, Yulugkural Z, Gorenek L, Altındis M, Bolukcu S, Agalar C, Ormeci N. Liver involvement in patients with brucellosis: results of the Marmara study. Eur J Clin Microbiol Infect Dis 2014; 33:1253-62. [PMID: 24557334 DOI: 10.1007/s10096-014-2064-4] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2013] [Accepted: 01/20/2014] [Indexed: 12/27/2022]
Abstract
Brucellosis is a zoonotic disease that primarily affects the reticuloendothelial system. But, the extent of liver damage in due course of the disease is unclear. This study included 325 brucellosis patients with significant hepatobiliary involvement identified with microbiological analyses from 30 centers between 2000 and 2013. The patients with ≥5 times of the upper limit of normal for aminotransferases, total bilirubin level ≥2 mg/dl or local liver lesions were enrolled. Clinical hepatitis was detected in 284 patients (87.3 %) and cholestasis was detected in 215 (66.1 %) patients. Fatigue (91 %), fever (86 %), sweating (83 %), arthralgia (79 %), and lack of appetite (79 %) were the major symptoms. Laboratory tests showed anemia in 169 (52 %), thrombocytopenia in 117 (36 %), leukopenia in 81 (25 %), pancytopenia in 42 (13 %), and leukocytosis in 20 (6 %) patients. The most commonly used antibiotic combinations were doxycycline plus an aminoglycoside (n = 73), doxycycline plus rifampicin (n = 71), doxycycline plus rifampicin and an aminoglycoside (n = 27). The duration of ALT normalization differed significantly in three treatment groups (p < 0.001). The use of doxycycline and an aminoglycoside in clinical hepatitis showed better results compared to doxycycline and rifampicin or rifampicin, aminoglycoside, doxycycline regimens (p < 0.05). However, the length of hospital stay did not differ significantly between these three combinations (p > 0.05). During the follow-up, treatment failure occurred in four patients (1 %) and relapse was seen in three patients (0.9 %). Mortality was not observed. Hepatobiliary involvement in brucellosis has a benign course with suitable antibiotics and the use of doxycycline and an aminoglycoside regimen seems a better strategy in select patients.
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Affiliation(s)
- D Ozturk-Engin
- Department of Infectious Diseases and Clinical Microbiology, Haydarpasa Numune Training and Research Hospital, Istanbul, Turkey
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Abstract
PURPOSE Evaluation of a patient with necrotizing fasciitis of the eyelid spreading from parotid gland. METHODS Interventional case report. The patient admitted with rapidly progressive swelling, redness, and pain of four eyelids, and whole face. Pathogenic microorganism was searched, laboratory tests were evaluated. Intensive medical treatment and necrotic wound debridement was performed. RESULTS The patient had been receiving oral cephalosporin at the time she was referred to our hospital, but her infection had spread rapidly under this treatment. In addition to her eyelid necrosis, septic shock developed within 24 hours. No pathogenic microorganism was detected in cultures. The patient responded to intravenous sulbactam ampicillin, surgical debridement of necrotic wound and supportive medical care. Moderate ptosis was the only complication observed in this patient. Reconstructive surgery was not needed. CONCLUSIONS With prompt antibiotic treatment and surgical debridement, cosmetic and functional success may be obtained in necrotizing fasciitis cases rarely seen with parotid gland origin.
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Affiliation(s)
- E K Akcay
- Department of Ophthalmology, Ankara Ataturk Education and Research Hospital, Ankara, Turkey.
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Abstract
To establish the prevalence of positive penicillin skin tests among outpatients without any drug reaction history. Skin testing was performed in 147 children (aged 6-13 years) who had had received a penicillin preparation at least three times in the last 12 months without any allergic reaction. Before testing, detailed pediatric and allergy history were learned and then all children were tested with benzyl penicilloyl polylysin (PPL) and mixture of minor antigenic determinants. The test procedures were made epidermally and intradermally subsequently in every subject. The overall frequency of positive skin reactions to penicillin antigens was 10.2%. A mild systemic reaction was observed in one of the children during testing with PPL. We concluded that frequent use of penicillin and other beta-lactam antibiotics leads to sensitization of children in our study population despite these children seem to be asymptomatic during testing time.
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Affiliation(s)
- Feyzullah Cetinkaya
- Department of Pediatrics, Sisli Etfal Education and Research Hospital, Istanbul, Turkey.
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