AIM: This study aims to compare point prevalence results which were done with one year interval i... more AIM: This study aims to compare point prevalence results which were done with one year interval in a university hospital with a 1,200-bed capacity. METHODS: The study assessed antibiotic usage among all hospitalised patients in the hospital on April 20, 2012 and April 19, 2013, using the point prevalence method. The assessment was carried out by an infectious disease specialist relying on the basic principles of antibiotic usage and current antimicrobial treatment guides. The causes of antibiotic usage were classified under three groups, namely, empirical, infection diagnosis and prophylactic. Data were transferred to computer and analysed using SPSS 15.0. We used the chi square method for comparisons of categorical variables. P values
ÖZET Bu çalışmada, özellikle yoğun bakım ünitelerinde ventilatörle ilişkili pnömoni (VİP)'ye... more ÖZET Bu çalışmada, özellikle yoğun bakım ünitelerinde ventilatörle ilişkili pnömoni (VİP)'ye neden olan olası etkeni hızlı ve doğru tanımlamak için kullanılan endotrakeal aspirat (ETA) ve mini-bronkoalveoler lavaj (BAL) yöntemleriyle alınan kültür sonuçlarının kıyaslanması amaçlanmıştır. Hastanemiz yoğun bakım ünitesinde Haziran 2010-Haziran 2011 tarihleri arasında mekanik ventilatörde takip edilen 92 hastadan VİP gelişen 30 (% 32.2) hasta çalışmaya dahil edilmiştir. VİP tanısı klinik ve radyolojik olarak konulmuş; hastalar klinik ...
To describe the true coagulase-negative staphylococci (CoNS) bacteremia rate compared with contam... more To describe the true coagulase-negative staphylococci (CoNS) bacteremia rate compared with contaminants, and to determine the SCCmec types in methicillin-resistant staphylococci and evaluate the diversity between methicillin-resistant CoNS (MRCoNS) and methicillin-resistant Staphylococcus aureus (MRSA) isolates during a 10-month study period. Materials and methods: Th e true CoNS bacteremia or bloodstream infection episode was defi ned on the basis of previous studies on CoNS bacteremia and the defi nitions of the Centers for Disease Control and Prevention. SCCmec types were determined by using the real-time PCR method. A total of 357 staphylococci isolates, including 313 CoNS and 44 S. aureus, were obtained from 462 positive blood culture samples. Results: A total of 249 CoNS bacteremia episodes in 231 patients were evaluated. Of these episodes, 45 (18.1%) in 41 patients were considered to be true CoNS bacteremia, whereas 204 in 190 patients were found to be contaminant. In the present study, all of the MRSA isolates harbored only SCCmec type III, but MRCoNS strains harbored diff erent SCCmec types and SCCmec type IV was the most prevalent. Conclusion: Th e true CoNS bacteremia rate was consistently within the range reported in the literature. We also concluded that MRCoNS isolates carrying mostly SCCmec type IV elements may not be related to the presence of MRSA isolates carrying only SCCmec type III element in our institution.
We read with great interest the paper by Koru et al. (1), in which in vitro efficacy of hyperbari... more We read with great interest the paper by Koru et al. (1), in which in vitro efficacy of hyperbaric oxygen (HBO) therapy against Leishmania tropica promastigotes and amastigotes was investigated. We applaud their efforts to seek new treatments for leishmaniasis, which is an important health problem in Turkey. However, we have some concerns regarding the clinical usability of HBO therapy in the treatment of leishmaniasis.
To assess the effi ciency of hyperbaric oxygen (HBO) therapy on L. tropica, which is the major ca... more To assess the effi ciency of hyperbaric oxygen (HBO) therapy on L. tropica, which is the major causative agent of cutaneous leishmaniasis in Turkey. Materials and methods: Th e eff ects of HBO on Leishmania tropica promastigote and amastigote forms were studied at a pressure of 2.5 atmosphere absolute (ata). We examined the cytotoxic eff ect of HBO on promastigotes using the trypan blue exclusion test and the 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide (MTT) dye-reduction assay. To investigate the eff ects of HBO treatment on the growth of the promastigotes, HBO-treated and non-HBO-treated cell culture fl asks were incubated at 26 °C for 3 days, while the eff ects of HBO on L. tropica amastigotes were detected using the acridine orange staining method. Results: We observed that the cytotoxic eff ect emerged aft er 2 h and reached a maximum at 6 h with both methods. Th e number of live promastigotes was monitored for 24 h aft er treatment and there was a slight elevation at 2 h of treatment, but signifi cant suppression was seen aft er 4 and 6 h of treatment (P < 0.001). We detected that the eff ect of HBO on L. tropica amastigote forms increased by 3.3%, 17.2%, and 38.5% at 2, 4, and 6 h, respectively. Conclusion: Th e results presented here indicate that HBO treatment could be used as supportive therapy in association with chemotherapeutic agents against L. tropica infection.
Journal of infection in developing countries, Jan 28, 2017
This study aimed to identify a follow-up modality that can be used to evaluate therapeutic respon... more This study aimed to identify a follow-up modality that can be used to evaluate therapeutic responses in patients receiving treatment for brucellar sacroillitis and to determine whether antibiotherapy can be stopped. A total of 32 patients with sacroiliac joint involvement demonstrated via magnetic resonance imaging or bone scintigraphy were followed up and treated. Patients received 200 mg/day of doxycycline and 600-900 mg/day of rifampicin for 3-21 months, and 1 g/day of streptomycin for 21 days. The mean age of the 32 patients involved was 21.81±4.09. In total, 10/32 patients did not complete therapy, and the remaining 22 patients received combination antibiotic treatment for a mean of 8.95±4.34 months. Of the 22 patients, 15 underwent MRI, and 7 of them did not consent to MRI. Similarly, 17 patients were followed up by bone scintigraphy, and 5 patients did not have scintigraphy results. In 9/17 patients followed up with bone scintigraphy, sacroiliitis findings were found to reduc...
There is no report on the factors affecting the resolution of symptoms related to meningitis duri... more There is no report on the factors affecting the resolution of symptoms related to meningitis during treatment of tuberculous meningitis (TBM). Thus, we examined the factors associated with early therapeutic responses. This multicenter study included 507 patients with microbiologically confirmed TBM. However, 94 patients eligible for the analysis were included in this study from 24 centers. Six out of 94 patients died and the statistical analysis was performed with 88 survivors. Early and late responder groups were compared in the statistical analysis. P &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt; 0.05 were considered to show a significant difference. In the multivariate analysis, the presence of vasculitis (P = 0.029, OR = 10.491 [95% CI, 1.27-86.83]) was found to be significantly associated with a delayed fever response whereas hydrocephalus was associated with altered mental status for &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;gt;9 days duration (P = 0.005, OR = 5.740 [95% CI, 1.68-19.57]). According to linear regression analysis, fever was significantly persisting (&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;gt;7 days) in the presence of vasculitis (17.5 vs. 7, P&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt; 0.001) and hydrocephalus (11 vs. 7, P = 0.029). Hydrocephalus was significantly associated with persisting headache (21 vs. 12, P = 0.025), delayed recovery of consciousness (19.5 vs. 7, P = 0.001), and a delay in complete recovery (21 vs. 14, P = 0.007) in the linear regression analysis. Following institution of treatment, the complaints seemed to disappear in up to 2 weeks among TBM survivors. In the absence of hydrocephalus or vasculitis, one week of anti-tuberculosis treatment seems to be adequate for the resolution of TBM symptoms. Hydrocephalus and vasculitis delay the resolution of TBM symptoms in response to antimycobacterial treatment.
The aim of this study is to investigate the epidemiology and recent incidence of HIV infection am... more The aim of this study is to investigate the epidemiology and recent incidence of HIV infection among young male candidates scheduled for military recruitment and whole young population in Turkey, a country previously known as markedly low prevalence of HIV infection. Materials and Methods: In the present study, the medical records from respective health institutions between the years 2007 and 2013 of male candidates scheduled for recruitment from recruitment offices serving under the National Defence Ministry of Turkish Republic, diagnosed with HIV infection and as such judged as unfit for service were requested. Results: While the total number of new HIV/AIDs cases in 2000 was 157, a fourfold increase (589) was recorded in the year 2010, and reaching 1,068 by the year 2012. Considering, data from the national statistics, in the year 2013 (including the month of November), a total of 7050 HIV positive cases were reported and of all the cases 4,931 (72%) consisted of males. At the same time, an important part of this group falls into the 18-45 year group category. Conclusion: As a conclusion, the prevalence of HIV infection in Turkey remains still low as compared to that of current global figures but the case numbers of HIV positive candidates of recruits and young people in the whole population are increasing alarmingly in significant manner due to every new coming year. So, programs targeted at identifying high risk groups and increasing the testing rates and preventive measures about HIV infection should be improved and developed
Abstract: Percutaneous liver biopsy is a common practice in the differential diagnosis of chronic... more Abstract: Percutaneous liver biopsy is a common practice in the differential diagnosis of chronic liver diseases. Mortality and morbidity rates from percutaneous liver biopsy are low but not without risk. The major complication and mortality rates are about 2-4% and 0.01-0.33%, respectively. Injury of the gallbladder is rare. Rapid diagnosis and careful management of injuries to the biliary system are necessary because of potential morbidity associated with bile peritonitis. In the present case ,we report a 30 year old man who had acute abdomen caused by bile peritonitis after percutaneous liver biopsy. The patient was successfully managed conservatively with intravenous fluids, antibiotic therapy, and intensive care unit monitoring without requiring any surgical intervention. Key Words: Liver biopsy, gallbladder, bile peritonitis
Numerous viral and bacterial pathogens have been reported causing acute respiratory tract infecti... more Numerous viral and bacterial pathogens have been reported causing acute respiratory tract infection (ARTI). Nasopharyngeal swab (NPS) specimens from 351 patients (278 children, 73 adults) with suspected upper and lower ARTI were submitted during the study period from Jan. 2005 to Dec. 2006. Organism-specific nucleic acids were detected using TemPlex technology (ResPlex I and II, Genaco Biomedical Products, Huntsville, AL). Amplified products were identified using a suspension array for multiplex detection performed on a Luminex 100 instrument (Luminex, Austin, TX). A total of 221 viral and bacterial respiratory agents were detected in 148 patients (135 [48.5%] of the 278 children and 13 [17.8%] of the 73 adults) with suspected ARTI. A single respiratory pathogen was detected in 89 patients [25.35%], whereas mixed infection with two or three pathogens was found in 59 [16.8%] of 351 suspected patients. S. pneumonia was the most frequently isolated strain (54 [15.3%] of 351 patients), followed by H. influenzae (37 [10.5%]), rhinoviruses (35 [9.9%]), influenza A virus (23 [6.5%]), enteroviruses (19 [5.4%]), hMPV (14 [3.9%]), PIV-1 (12 [3.4%]), PIV-3 (11 [3.1%]), RSV (10 [2.8%]), and influenza B virus (6 [1.7%]). Mixed infections were more frequent in children (56 [20.1%] of 278) than adult patients (3 [4.1%] of 73 patients). The detection rate of the bacteria peaked in the spring season (37 [40.6%] of 91 bacteria), followed by winter (24 infections), autumn (18 infections) and summer (12 infections). The prevalence of co-infection is ~40%, finding a much higher incidence of co-infection with more than one agent than that reported previously.
The objective of this study was to compare the results of cultures obtained by mini-bronchoalveol... more The objective of this study was to compare the results of cultures obtained by mini-bronchoalveolar lavage (BAL) and endotracheal aspiration (ETA) techniques, used for rapid and accurate determination of pathogens causing ventilator-associated pneumonia (VAP) in intensive care units. Of the 92 patients on mechanical ventilation followed at the emergency intensive care unit of our hospital between June 2010 and June 2011, 30 (32.2%) patients were diagnosed as VAP and they were included in this study. VAP diagnosis were based on the clinical and radiological findings. Clinical pulmonary infection score (CPIS) of > 6 was accepted as the clinical criteria of VAP. Initially ETA samples were collected from the patients followed by mini-BAL sampling 15 minutes later, together with urine and two blood cultures. Microbiological evaluation and identification were performed by conventional methods and Phoenix 100 (BD Diagnostic Systems, ABD) automated system. In quantitative culture analysi...
Hydatid cyst, caused by Echinococcus granulosus is a worldwide occurring infectious disease . Alt... more Hydatid cyst, caused by Echinococcus granulosus is a worldwide occurring infectious disease . Although diffuse internal localization of hydatid cysts is common, intramuscular localization has rarely been reported. In this text, we present two cases. In case 1, ultrasonography (US) of a 22 years old male revealed a cystic mass in the paraspinal muscles. After the magnetic resonance imaging, percutaneous drainage was implemented under US guidance to the patient. The cavity was drained and rinsed with alcohol (95%). The cysts, examined after 7 days, displayed a progressive shrinkage and solidification. In case 2, the hydatid cysts were localized in the lateral abdominal wall region. The patient was operated and treated with albendazole. The cystic lesions with rare anatomic localizations require differential diagnosis, especially particularly in the endemic regions of hydatid disease. Following a positive diagnosis, a less invasive method can be applied. Percutaneous drainage treatment was efficient for both diagnosis and treatment in case 1.
Suçiçeği çocukluk çağının oldukça bulaşıcı viral bir hastalığıdır. Kuluçka süresi 10-21 gün arası... more Suçiçeği çocukluk çağının oldukça bulaşıcı viral bir hastalığıdır. Kuluçka süresi 10-21 gün arasında değişir. Tipik cilt döküntüleri vezikülo-püstüler tarzadadır ve tüm vücutta görülebilir. Primer suçiçeği enfeksiyonu çocukluk çağında geçirildiğinde hafif seyirli iken, erişkinlerde veya immün sistemi baskılanmış kişilerde ciddi komplikasyonlarla seyredebilir. Pnömoni, yetişkinlerde suçiçeğine bağlı mortalite ve morbiditenin önemli bir nedenidir. Bu nedenle, suçiçeği geçirmekte olan hastalarda ciddi komplikasyonların gelişebileceği akılda tutulmalıdır. Bu olgu, suçiçeğinin ciddi bir komplikasyonu olan pnömoniye dikkat çekmek amacıyla sunulmuştur.
Turkish Bulletin of Hygiene and Experimental Biology, 2012
Brucellosis is a zoonotic disease caused by Brucella species that is a gram negative coccobacilli... more Brucellosis is a zoonotic disease caused by Brucella species that is a gram negative coccobacilli and can cause symptoms such as fever, diaphoresis, arthalgia and myalgia. Although humans become infected by Geliş Tarihi /
International Journal of Infectious Diseases, 2014
Background: Acute hepatitis A virus infection, is a common infection, seen especially in childhoo... more Background: Acute hepatitis A virus infection, is a common infection, seen especially in childhood, in developing countries and is usually asymptomatic however rarely it can present with extrahepatic manifestations.A 22-year old male presented to a primary care center with fever, nausea and vomiting and received a diagnosis of an upper respiratory tract infection. Four days after the onset of complaints, the patient's urine color darkened (tea color), and jaundice in the sclera was noticed. Methods & Materials: In his abdominal examination, his liver crossed over the midclavicular line about 3 cm. There was significant pain and tenderness in the upper right quadrant. In laboratory evaluation the following findings were present; WBC count 11000/mm 3 , AST 559U/L, ALT 1830U/L, ALP 357U/L, GGT 327U/L, direct bilirubin 8,71 mg/dL, total bilirubin 16,09 mg/dL, albumin 3.85 mg/dL, prothrombin time(PT) 17.4 seconds, INR 1.26, bilirubin and urobilinogen in the urine (++++). Results: An abdominal ultrasonography was performed which revealed that the liver was 174 mm, with a grade 1 diffusely increased parenchyme echo. Also, free fluid was present in the pelvic and perihepatic areas. The wall of the GB was measured as 14.6 mm(N:3 mm)(Image 1). There was intramural air present in the wall of the GB. Also in the pericholecystic area, a reticular heterogenous hypoechoic structure, 15 mm in diameter was observed. In the light of these findings, a diagnosis of emphysematous cholecystitis was established, and parenteral ampicilin-sulbactam was initiated empirically. In serological evaluations that were conducted to find out the etiology of the acute hepatitis presentation, HBsAg, anti-HBc IgM, anti-HBc IgG, anti-HCV tests were negative. However anti-HAV IgM and anti-HAVIgG was positive. Within 48 hours of the patient's admission, as there was no improvement in the patient's clinical status, and an increase in the abdominal pain, a laparascopic cholecystectomy was performed. Twenty days after the operation the patients laboratory findings, abdominal USG and liver tests were normal. Conclusion: To sum up, HAV infection can be seen in all age groups, in developing countries, such as our country. It must be kept in mind that, although very rarely, HAV infections may exhibit extrahepatic complications.
Bu çalışmada, Kayseri ilinde hizmet veren bir hastanenin çocuk sağlığı ve hastalıkları ile enfeks... more Bu çalışmada, Kayseri ilinde hizmet veren bir hastanenin çocuk sağlığı ve hastalıkları ile enfeksiyon hastalıkları polikliniğine başvuran 16-24 yaş grubundaki olgularda hepatit A virüsü (HAV) için seropozitifliği değerlendirmeyi amaçladık. Gereç ve yöntem: Bu retrospektif çalışma, Kayseri' de bir kamu hastanesinde yapıldı. Çalışmada, 01 Ocak 2006-01 Nisan 2010 tarihleri arasında hastaneye başvuran 16-24 yaş arasındaki 1032 hastanın anti-HAV IgG sonuçları değerlendirildi ve bu sonuçların hastaların yaş ve cinsiyet ile ilişkisi incelendi. Hepatit A'ya karşı aşılama hikayesi pozitif olan olgular çalışmaya dahil edilmedi. Verilerin analizinde 15.0 SPSS istatistik programı kullanıldı. Bulgular: Çalışmaya dahil olan 1032 olgunun 769' u erkek (74.6%) ve 263' ü kız (% 25.4) idi. Çalışmaya katılan kızların yaş ortalaması 22.3± 2 yıl iken erkeklerin 20.6±4 yıl idi. Toplam anti HAV IgG seropozitifliği %61.8 (638/1032) idi. Kız olguların 150/263'si (%57.0) anti HAV IgG pozitif iken erkeklerin 488/769' i (%63.4) anti HAV IgG pozitif saptandı. Çalışmaya dahil edilen olguları yaş ve cinsiyet gruplarına göre incelediğimizde aralarında seropozitiflik açısından istatistiksel olarak anlamlı bir fark yoktu (p>0,05). Sonuç: Çalışmamızda, genç erişkinlerde HAV seroprevalansının düşük olduğu görüldü. Erişkin yaşlarda daha ağır seyreden Hepatit A virüs enfeksiyonundan korunmak için, aşılama gibi etkin tedbirlerin alınması gerekli gözükmektedir.
The Journal of Infection in Developing Countries, 2014
Introduction: This study aimed to review the possible sources of infection of 16 oropharyngeal tu... more Introduction: This study aimed to review the possible sources of infection of 16 oropharyngeal tularemia hospital cases, and to document their epidemiological and demographical characteristics, laboratory findings, treatment methods, and treatment results. Methodology: Sixteen cases from a Turkish military hospital between January 2011 and December 2012 were retrospectively evaluated. The age, sex, occupation, place of residence, symptoms, duration of symptoms, laboratory results, treatment and duration, and treatment results were recorded. Tularemia was diagnosed through tularemia-specific tests once the other conditions that may have caused lymphadenopathy were excluded. Results: Twelve of the patients included in this study were males. The average age of the patients was 32.1±17.2 years. Sore throat, fatigue, and fever were the most frequent symptoms. The mean duration of symptoms was 21.6±6.9 days. All the patients had been treated for tonsillopharyngitis in primary healthcare i...
AIM: This study aims to compare point prevalence results which were done with one year interval i... more AIM: This study aims to compare point prevalence results which were done with one year interval in a university hospital with a 1,200-bed capacity. METHODS: The study assessed antibiotic usage among all hospitalised patients in the hospital on April 20, 2012 and April 19, 2013, using the point prevalence method. The assessment was carried out by an infectious disease specialist relying on the basic principles of antibiotic usage and current antimicrobial treatment guides. The causes of antibiotic usage were classified under three groups, namely, empirical, infection diagnosis and prophylactic. Data were transferred to computer and analysed using SPSS 15.0. We used the chi square method for comparisons of categorical variables. P values
ÖZET Bu çalışmada, özellikle yoğun bakım ünitelerinde ventilatörle ilişkili pnömoni (VİP)'ye... more ÖZET Bu çalışmada, özellikle yoğun bakım ünitelerinde ventilatörle ilişkili pnömoni (VİP)'ye neden olan olası etkeni hızlı ve doğru tanımlamak için kullanılan endotrakeal aspirat (ETA) ve mini-bronkoalveoler lavaj (BAL) yöntemleriyle alınan kültür sonuçlarının kıyaslanması amaçlanmıştır. Hastanemiz yoğun bakım ünitesinde Haziran 2010-Haziran 2011 tarihleri arasında mekanik ventilatörde takip edilen 92 hastadan VİP gelişen 30 (% 32.2) hasta çalışmaya dahil edilmiştir. VİP tanısı klinik ve radyolojik olarak konulmuş; hastalar klinik ...
To describe the true coagulase-negative staphylococci (CoNS) bacteremia rate compared with contam... more To describe the true coagulase-negative staphylococci (CoNS) bacteremia rate compared with contaminants, and to determine the SCCmec types in methicillin-resistant staphylococci and evaluate the diversity between methicillin-resistant CoNS (MRCoNS) and methicillin-resistant Staphylococcus aureus (MRSA) isolates during a 10-month study period. Materials and methods: Th e true CoNS bacteremia or bloodstream infection episode was defi ned on the basis of previous studies on CoNS bacteremia and the defi nitions of the Centers for Disease Control and Prevention. SCCmec types were determined by using the real-time PCR method. A total of 357 staphylococci isolates, including 313 CoNS and 44 S. aureus, were obtained from 462 positive blood culture samples. Results: A total of 249 CoNS bacteremia episodes in 231 patients were evaluated. Of these episodes, 45 (18.1%) in 41 patients were considered to be true CoNS bacteremia, whereas 204 in 190 patients were found to be contaminant. In the present study, all of the MRSA isolates harbored only SCCmec type III, but MRCoNS strains harbored diff erent SCCmec types and SCCmec type IV was the most prevalent. Conclusion: Th e true CoNS bacteremia rate was consistently within the range reported in the literature. We also concluded that MRCoNS isolates carrying mostly SCCmec type IV elements may not be related to the presence of MRSA isolates carrying only SCCmec type III element in our institution.
We read with great interest the paper by Koru et al. (1), in which in vitro efficacy of hyperbari... more We read with great interest the paper by Koru et al. (1), in which in vitro efficacy of hyperbaric oxygen (HBO) therapy against Leishmania tropica promastigotes and amastigotes was investigated. We applaud their efforts to seek new treatments for leishmaniasis, which is an important health problem in Turkey. However, we have some concerns regarding the clinical usability of HBO therapy in the treatment of leishmaniasis.
To assess the effi ciency of hyperbaric oxygen (HBO) therapy on L. tropica, which is the major ca... more To assess the effi ciency of hyperbaric oxygen (HBO) therapy on L. tropica, which is the major causative agent of cutaneous leishmaniasis in Turkey. Materials and methods: Th e eff ects of HBO on Leishmania tropica promastigote and amastigote forms were studied at a pressure of 2.5 atmosphere absolute (ata). We examined the cytotoxic eff ect of HBO on promastigotes using the trypan blue exclusion test and the 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide (MTT) dye-reduction assay. To investigate the eff ects of HBO treatment on the growth of the promastigotes, HBO-treated and non-HBO-treated cell culture fl asks were incubated at 26 °C for 3 days, while the eff ects of HBO on L. tropica amastigotes were detected using the acridine orange staining method. Results: We observed that the cytotoxic eff ect emerged aft er 2 h and reached a maximum at 6 h with both methods. Th e number of live promastigotes was monitored for 24 h aft er treatment and there was a slight elevation at 2 h of treatment, but signifi cant suppression was seen aft er 4 and 6 h of treatment (P < 0.001). We detected that the eff ect of HBO on L. tropica amastigote forms increased by 3.3%, 17.2%, and 38.5% at 2, 4, and 6 h, respectively. Conclusion: Th e results presented here indicate that HBO treatment could be used as supportive therapy in association with chemotherapeutic agents against L. tropica infection.
Journal of infection in developing countries, Jan 28, 2017
This study aimed to identify a follow-up modality that can be used to evaluate therapeutic respon... more This study aimed to identify a follow-up modality that can be used to evaluate therapeutic responses in patients receiving treatment for brucellar sacroillitis and to determine whether antibiotherapy can be stopped. A total of 32 patients with sacroiliac joint involvement demonstrated via magnetic resonance imaging or bone scintigraphy were followed up and treated. Patients received 200 mg/day of doxycycline and 600-900 mg/day of rifampicin for 3-21 months, and 1 g/day of streptomycin for 21 days. The mean age of the 32 patients involved was 21.81±4.09. In total, 10/32 patients did not complete therapy, and the remaining 22 patients received combination antibiotic treatment for a mean of 8.95±4.34 months. Of the 22 patients, 15 underwent MRI, and 7 of them did not consent to MRI. Similarly, 17 patients were followed up by bone scintigraphy, and 5 patients did not have scintigraphy results. In 9/17 patients followed up with bone scintigraphy, sacroiliitis findings were found to reduc...
There is no report on the factors affecting the resolution of symptoms related to meningitis duri... more There is no report on the factors affecting the resolution of symptoms related to meningitis during treatment of tuberculous meningitis (TBM). Thus, we examined the factors associated with early therapeutic responses. This multicenter study included 507 patients with microbiologically confirmed TBM. However, 94 patients eligible for the analysis were included in this study from 24 centers. Six out of 94 patients died and the statistical analysis was performed with 88 survivors. Early and late responder groups were compared in the statistical analysis. P &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt; 0.05 were considered to show a significant difference. In the multivariate analysis, the presence of vasculitis (P = 0.029, OR = 10.491 [95% CI, 1.27-86.83]) was found to be significantly associated with a delayed fever response whereas hydrocephalus was associated with altered mental status for &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;gt;9 days duration (P = 0.005, OR = 5.740 [95% CI, 1.68-19.57]). According to linear regression analysis, fever was significantly persisting (&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;gt;7 days) in the presence of vasculitis (17.5 vs. 7, P&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt; 0.001) and hydrocephalus (11 vs. 7, P = 0.029). Hydrocephalus was significantly associated with persisting headache (21 vs. 12, P = 0.025), delayed recovery of consciousness (19.5 vs. 7, P = 0.001), and a delay in complete recovery (21 vs. 14, P = 0.007) in the linear regression analysis. Following institution of treatment, the complaints seemed to disappear in up to 2 weeks among TBM survivors. In the absence of hydrocephalus or vasculitis, one week of anti-tuberculosis treatment seems to be adequate for the resolution of TBM symptoms. Hydrocephalus and vasculitis delay the resolution of TBM symptoms in response to antimycobacterial treatment.
The aim of this study is to investigate the epidemiology and recent incidence of HIV infection am... more The aim of this study is to investigate the epidemiology and recent incidence of HIV infection among young male candidates scheduled for military recruitment and whole young population in Turkey, a country previously known as markedly low prevalence of HIV infection. Materials and Methods: In the present study, the medical records from respective health institutions between the years 2007 and 2013 of male candidates scheduled for recruitment from recruitment offices serving under the National Defence Ministry of Turkish Republic, diagnosed with HIV infection and as such judged as unfit for service were requested. Results: While the total number of new HIV/AIDs cases in 2000 was 157, a fourfold increase (589) was recorded in the year 2010, and reaching 1,068 by the year 2012. Considering, data from the national statistics, in the year 2013 (including the month of November), a total of 7050 HIV positive cases were reported and of all the cases 4,931 (72%) consisted of males. At the same time, an important part of this group falls into the 18-45 year group category. Conclusion: As a conclusion, the prevalence of HIV infection in Turkey remains still low as compared to that of current global figures but the case numbers of HIV positive candidates of recruits and young people in the whole population are increasing alarmingly in significant manner due to every new coming year. So, programs targeted at identifying high risk groups and increasing the testing rates and preventive measures about HIV infection should be improved and developed
Abstract: Percutaneous liver biopsy is a common practice in the differential diagnosis of chronic... more Abstract: Percutaneous liver biopsy is a common practice in the differential diagnosis of chronic liver diseases. Mortality and morbidity rates from percutaneous liver biopsy are low but not without risk. The major complication and mortality rates are about 2-4% and 0.01-0.33%, respectively. Injury of the gallbladder is rare. Rapid diagnosis and careful management of injuries to the biliary system are necessary because of potential morbidity associated with bile peritonitis. In the present case ,we report a 30 year old man who had acute abdomen caused by bile peritonitis after percutaneous liver biopsy. The patient was successfully managed conservatively with intravenous fluids, antibiotic therapy, and intensive care unit monitoring without requiring any surgical intervention. Key Words: Liver biopsy, gallbladder, bile peritonitis
Numerous viral and bacterial pathogens have been reported causing acute respiratory tract infecti... more Numerous viral and bacterial pathogens have been reported causing acute respiratory tract infection (ARTI). Nasopharyngeal swab (NPS) specimens from 351 patients (278 children, 73 adults) with suspected upper and lower ARTI were submitted during the study period from Jan. 2005 to Dec. 2006. Organism-specific nucleic acids were detected using TemPlex technology (ResPlex I and II, Genaco Biomedical Products, Huntsville, AL). Amplified products were identified using a suspension array for multiplex detection performed on a Luminex 100 instrument (Luminex, Austin, TX). A total of 221 viral and bacterial respiratory agents were detected in 148 patients (135 [48.5%] of the 278 children and 13 [17.8%] of the 73 adults) with suspected ARTI. A single respiratory pathogen was detected in 89 patients [25.35%], whereas mixed infection with two or three pathogens was found in 59 [16.8%] of 351 suspected patients. S. pneumonia was the most frequently isolated strain (54 [15.3%] of 351 patients), followed by H. influenzae (37 [10.5%]), rhinoviruses (35 [9.9%]), influenza A virus (23 [6.5%]), enteroviruses (19 [5.4%]), hMPV (14 [3.9%]), PIV-1 (12 [3.4%]), PIV-3 (11 [3.1%]), RSV (10 [2.8%]), and influenza B virus (6 [1.7%]). Mixed infections were more frequent in children (56 [20.1%] of 278) than adult patients (3 [4.1%] of 73 patients). The detection rate of the bacteria peaked in the spring season (37 [40.6%] of 91 bacteria), followed by winter (24 infections), autumn (18 infections) and summer (12 infections). The prevalence of co-infection is ~40%, finding a much higher incidence of co-infection with more than one agent than that reported previously.
The objective of this study was to compare the results of cultures obtained by mini-bronchoalveol... more The objective of this study was to compare the results of cultures obtained by mini-bronchoalveolar lavage (BAL) and endotracheal aspiration (ETA) techniques, used for rapid and accurate determination of pathogens causing ventilator-associated pneumonia (VAP) in intensive care units. Of the 92 patients on mechanical ventilation followed at the emergency intensive care unit of our hospital between June 2010 and June 2011, 30 (32.2%) patients were diagnosed as VAP and they were included in this study. VAP diagnosis were based on the clinical and radiological findings. Clinical pulmonary infection score (CPIS) of > 6 was accepted as the clinical criteria of VAP. Initially ETA samples were collected from the patients followed by mini-BAL sampling 15 minutes later, together with urine and two blood cultures. Microbiological evaluation and identification were performed by conventional methods and Phoenix 100 (BD Diagnostic Systems, ABD) automated system. In quantitative culture analysi...
Hydatid cyst, caused by Echinococcus granulosus is a worldwide occurring infectious disease . Alt... more Hydatid cyst, caused by Echinococcus granulosus is a worldwide occurring infectious disease . Although diffuse internal localization of hydatid cysts is common, intramuscular localization has rarely been reported. In this text, we present two cases. In case 1, ultrasonography (US) of a 22 years old male revealed a cystic mass in the paraspinal muscles. After the magnetic resonance imaging, percutaneous drainage was implemented under US guidance to the patient. The cavity was drained and rinsed with alcohol (95%). The cysts, examined after 7 days, displayed a progressive shrinkage and solidification. In case 2, the hydatid cysts were localized in the lateral abdominal wall region. The patient was operated and treated with albendazole. The cystic lesions with rare anatomic localizations require differential diagnosis, especially particularly in the endemic regions of hydatid disease. Following a positive diagnosis, a less invasive method can be applied. Percutaneous drainage treatment was efficient for both diagnosis and treatment in case 1.
Suçiçeği çocukluk çağının oldukça bulaşıcı viral bir hastalığıdır. Kuluçka süresi 10-21 gün arası... more Suçiçeği çocukluk çağının oldukça bulaşıcı viral bir hastalığıdır. Kuluçka süresi 10-21 gün arasında değişir. Tipik cilt döküntüleri vezikülo-püstüler tarzadadır ve tüm vücutta görülebilir. Primer suçiçeği enfeksiyonu çocukluk çağında geçirildiğinde hafif seyirli iken, erişkinlerde veya immün sistemi baskılanmış kişilerde ciddi komplikasyonlarla seyredebilir. Pnömoni, yetişkinlerde suçiçeğine bağlı mortalite ve morbiditenin önemli bir nedenidir. Bu nedenle, suçiçeği geçirmekte olan hastalarda ciddi komplikasyonların gelişebileceği akılda tutulmalıdır. Bu olgu, suçiçeğinin ciddi bir komplikasyonu olan pnömoniye dikkat çekmek amacıyla sunulmuştur.
Turkish Bulletin of Hygiene and Experimental Biology, 2012
Brucellosis is a zoonotic disease caused by Brucella species that is a gram negative coccobacilli... more Brucellosis is a zoonotic disease caused by Brucella species that is a gram negative coccobacilli and can cause symptoms such as fever, diaphoresis, arthalgia and myalgia. Although humans become infected by Geliş Tarihi /
International Journal of Infectious Diseases, 2014
Background: Acute hepatitis A virus infection, is a common infection, seen especially in childhoo... more Background: Acute hepatitis A virus infection, is a common infection, seen especially in childhood, in developing countries and is usually asymptomatic however rarely it can present with extrahepatic manifestations.A 22-year old male presented to a primary care center with fever, nausea and vomiting and received a diagnosis of an upper respiratory tract infection. Four days after the onset of complaints, the patient's urine color darkened (tea color), and jaundice in the sclera was noticed. Methods & Materials: In his abdominal examination, his liver crossed over the midclavicular line about 3 cm. There was significant pain and tenderness in the upper right quadrant. In laboratory evaluation the following findings were present; WBC count 11000/mm 3 , AST 559U/L, ALT 1830U/L, ALP 357U/L, GGT 327U/L, direct bilirubin 8,71 mg/dL, total bilirubin 16,09 mg/dL, albumin 3.85 mg/dL, prothrombin time(PT) 17.4 seconds, INR 1.26, bilirubin and urobilinogen in the urine (++++). Results: An abdominal ultrasonography was performed which revealed that the liver was 174 mm, with a grade 1 diffusely increased parenchyme echo. Also, free fluid was present in the pelvic and perihepatic areas. The wall of the GB was measured as 14.6 mm(N:3 mm)(Image 1). There was intramural air present in the wall of the GB. Also in the pericholecystic area, a reticular heterogenous hypoechoic structure, 15 mm in diameter was observed. In the light of these findings, a diagnosis of emphysematous cholecystitis was established, and parenteral ampicilin-sulbactam was initiated empirically. In serological evaluations that were conducted to find out the etiology of the acute hepatitis presentation, HBsAg, anti-HBc IgM, anti-HBc IgG, anti-HCV tests were negative. However anti-HAV IgM and anti-HAVIgG was positive. Within 48 hours of the patient's admission, as there was no improvement in the patient's clinical status, and an increase in the abdominal pain, a laparascopic cholecystectomy was performed. Twenty days after the operation the patients laboratory findings, abdominal USG and liver tests were normal. Conclusion: To sum up, HAV infection can be seen in all age groups, in developing countries, such as our country. It must be kept in mind that, although very rarely, HAV infections may exhibit extrahepatic complications.
Bu çalışmada, Kayseri ilinde hizmet veren bir hastanenin çocuk sağlığı ve hastalıkları ile enfeks... more Bu çalışmada, Kayseri ilinde hizmet veren bir hastanenin çocuk sağlığı ve hastalıkları ile enfeksiyon hastalıkları polikliniğine başvuran 16-24 yaş grubundaki olgularda hepatit A virüsü (HAV) için seropozitifliği değerlendirmeyi amaçladık. Gereç ve yöntem: Bu retrospektif çalışma, Kayseri' de bir kamu hastanesinde yapıldı. Çalışmada, 01 Ocak 2006-01 Nisan 2010 tarihleri arasında hastaneye başvuran 16-24 yaş arasındaki 1032 hastanın anti-HAV IgG sonuçları değerlendirildi ve bu sonuçların hastaların yaş ve cinsiyet ile ilişkisi incelendi. Hepatit A'ya karşı aşılama hikayesi pozitif olan olgular çalışmaya dahil edilmedi. Verilerin analizinde 15.0 SPSS istatistik programı kullanıldı. Bulgular: Çalışmaya dahil olan 1032 olgunun 769' u erkek (74.6%) ve 263' ü kız (% 25.4) idi. Çalışmaya katılan kızların yaş ortalaması 22.3± 2 yıl iken erkeklerin 20.6±4 yıl idi. Toplam anti HAV IgG seropozitifliği %61.8 (638/1032) idi. Kız olguların 150/263'si (%57.0) anti HAV IgG pozitif iken erkeklerin 488/769' i (%63.4) anti HAV IgG pozitif saptandı. Çalışmaya dahil edilen olguları yaş ve cinsiyet gruplarına göre incelediğimizde aralarında seropozitiflik açısından istatistiksel olarak anlamlı bir fark yoktu (p>0,05). Sonuç: Çalışmamızda, genç erişkinlerde HAV seroprevalansının düşük olduğu görüldü. Erişkin yaşlarda daha ağır seyreden Hepatit A virüs enfeksiyonundan korunmak için, aşılama gibi etkin tedbirlerin alınması gerekli gözükmektedir.
The Journal of Infection in Developing Countries, 2014
Introduction: This study aimed to review the possible sources of infection of 16 oropharyngeal tu... more Introduction: This study aimed to review the possible sources of infection of 16 oropharyngeal tularemia hospital cases, and to document their epidemiological and demographical characteristics, laboratory findings, treatment methods, and treatment results. Methodology: Sixteen cases from a Turkish military hospital between January 2011 and December 2012 were retrospectively evaluated. The age, sex, occupation, place of residence, symptoms, duration of symptoms, laboratory results, treatment and duration, and treatment results were recorded. Tularemia was diagnosed through tularemia-specific tests once the other conditions that may have caused lymphadenopathy were excluded. Results: Twelve of the patients included in this study were males. The average age of the patients was 32.1±17.2 years. Sore throat, fatigue, and fever were the most frequent symptoms. The mean duration of symptoms was 21.6±6.9 days. All the patients had been treated for tonsillopharyngitis in primary healthcare i...
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