Yazar "Bayindir, Yasar" seçeneğine göre listele

Listeleniyor 1 - 20 / 49
  • Küçük Resim
    Öğe
    Antimicrobial susceptibility pattern of Escherichia coli and Klebsiella pneumoniae isolated from patients with urinary tract infections in a tertiary care hospital
    (2021) Dogan, Ahmet; Kose, Adem; Gezer, Yakup; Bayindir, Yasar; Ersoy, Yasemin; Ozden, Mehmet; Memisoglu, Funda; Altunisik Toplu, Sibel
    Aim: To determine etiological microorganisms from urine samples in patients diagnosed with UTI and to detect the antimicrobial susceptibility pattern of Escherichia coli and Klebsiella pneumoniae in a Tertiary Care Hospital. Materials and Methods: A cross-sectional study was conducted using urine culture samples and sensitivity reports collected retrospectively from our laboratory records over a period from Jan 2013 to Dec 2017. Results: A total of 729 urine culture isolates from 660 patients were included. Two-hundred eighty-four (41.8%) of the patients were male and 384 (58.2%) were female. The most common microorganisms were 46.4% E. coli, 18.2% K. pneumoniae and 12.1% Enterococcus spp., respectively. A total of 284 urine culture isolates produced extended spectrum beta-lactamases (ESBL), of which 186 (65.5%) were E. coli and 98 (34.5%) were K. pneumoniae. The most susceptible antimicrobials are meropenem, imipenem, amikacin, and fosfomycin, respectively. We determined that the antimicrobial drugs with the lowest susceptibility rates for both E. coli and K. pneumoniae were amoxicillin-clavulanate (24.5%), trimethoprim-sulfamethoxazole (30.7%) and ceftriaxone (43.2%). Additionally, their susceptibilities have gradually decreased. Ertapenem susceptibility has decreased more in K. pneumoniae isolates than E. coli. Conclusion: Antimicrobial resistance and ESBL-producing for both E. coli and K. pneumoniae have been increasing over the years. Our findings may contribute to choosing the proper antibiotic for the empirical treatment of UTI and preventing treatment failure.
  • Küçük Resim
    Öğe
    Antimicrobial susceptibility pattern of Escherichia coli andKlebsiella pneumoniae isolated from patients with urinarytract infections in a tertiary care hospital
    (2021) Doğan, Ahmet; Köse, Adem; Gezer, Yakup; Ersoy, Yasemin; Bayindir, Yasar; Özden, Mehmet; Memisoglu, Funda; Altunisik Toplu, Sibel
    Aim: To determine etiological microorganisms from urine samples in patients diagnosed with UTI and to detect the antimicrobial susceptibility pattern of Escherichia coli and Klebsiella pneumoniae in a Tertiary Care Hospital.Materials and Methods: A cross-sectional study was conducted using urine culture samples and sensitivity reports collected retrospectively from our laboratory records over a period from Jan 2013 to Dec 2017.Results: A total of 729 urine culture isolates from 660 patients were included. Two-hundred eighty-four (41.8%) of the patients were male and 384 (58.2%) were female. The most common microorganisms were 46.4% E. coli, 18.2% K. pneumoniae and 12.1% Enterococcus spp., respectively. A total of 284 urine culture isolates produced extended spectrum beta-lactamases (ESBL), of which 186 (65.5%) were E. coli and 98 (34.5%) were K. pneumoniae. The most susceptible antimicrobials are meropenem, imipenem, amikacin, and fosfomycin, respectively. We determined that the antimicrobial drugs with the lowest susceptibility rates for both E. coli and K. pneumoniae were amoxicillin-clavulanate (24.5%), trimethoprim-sulfamethoxazole (30.7%) and ceftriaxone (43.2%). Additionally, their susceptibilities have gradually decreased. Ertapenem susceptibility has decreased more in K. pneumoniae isolates than E. coli.Conclusion: Antimicrobial resistance and ESBL-producing for both E. coli and K. pneumoniae have been increasing over the years. Our findings may contribute to choosing the proper antibiotic for the empirical treatment of UTI and preventing treatment failure.
  • Küçük Resim Yok
    Öğe
    Artificial vascular graft migration into hollow viscus organs in patients who underwent right lobe living donor liver transplantation
    (Taylor & Francis Ltd, 2020) Koc, Cemalettin; Akbulut, Sami; Bilgic, Yilmaz; Otan, Emrah; Sarici, Baris; Isik, Burak; Bayindir, Yasar
    Background:To share our experience with hollow viscus migration of artificial vascular grafts (AVG) used for venous reconstruction of the right anterior sector in living donor liver transplantations (LDLT). Methods:Clinical, radiological, and endoscopic data of 13 right lobe LDLT patients (range: 26-67 years) with a diagnosis of postoperative AVG migration into adjacent hollow viscus were analyzed. Results:Biliary complications were detected in 12 patients. A median of four times endoscopic retrograde cholangiopancreatography (ERCP) procedures were performed in 11 patients prior to AVG migration diagnosis. A median of 2.5 times various percutaneous radiological interventional procedures were performed in eight patients prior to AVG migration diagnosis. The site of migration was the duodenum in eight patients, gastric antrum in four, and Roux limb in the remaining one patient. The migrated AVS were made of polytetrafluoroethylene (PTFE) in 10 patients and polyethylene terephthalate (Dacron) in three. The migrated AVGs were endoscopically removed in seven patients and surgically removed in six. Only one patient died due to sepsis unrelated to AVG migration. Conclusion:AVG migration into the adjacent hollow viscus following right lobe LDLT is a rare and serious complication. Repetitive ERCP, interventional radiological procedures, infection related to biliary leakage, and thrombosis of AVGs are among the possible risk factors.
  • Küçük Resim Yok
    Öğe
    Association Between Helicobacter pylori and Pharyngolaryngeal Carcinomas: Role in Development and Prognostic Significance
    (Galenos Yayincilik, 2019) Bayindir, Tuba; Bayindir, Yasar; Firat Koca, Cigdem; Demir, Ismail; Otlu, Baris
    Helicobacter pylori is a worldwide common bacteria that infects humans. This Gram-negative microorganism is microaerophilic, spiral or curved shaped, and urease, catalase and oxidase-positive. It has the ability to live in the acidic environment of the gastric mucosa. It has been shown that H. pylori plays a role in the development of gastric ulcers and malignant lesions. Furthermore, it was reported that H. pylori may be a cause of several systemic illnesses such as cardiovascular, dermatologic, immunologic, neurologic, hematologic, ophthalmologic, gynecologic, endocrine, and hepatobiliary diseases. In addition, positive or negative correlations between H. pylori infection and rhinitis, sinusitis, adenoiditis or adenoid hyperplasia, otitis media, tonsillitis, or tonsil hypertrophy have been demonstrated in various studies in the literature. However, H. pylori's role in the pathogenesis or association with these diseases remains controversial. Some studies reported that systemic immune and inflammatory responses against H. pylori might cause some systemic diseases as well as different types of malignancies. Although there are studies about the role of H. pylori in benign and malignant diseases of the upper and lower respiratory tract, further studies are needed to reveal the pathophysiological relationship between H. pylori infection and respiratory diseases. The aim of this review was to summarize the studies that reported either a positive or negative relationship between H. pylori and benign and malignant diseases of the respiratory tract.
  • Küçük Resim Yok
    Öğe
    Attenuation of Antibody Response and Elevation of CD4+CD25+Foxp3+ Treg cell Frequency During Chronic Liver Fibrosis
    (Wiley, 2017) Canpolat, Esra; Karaca, Mete; Kayhan, Basak; Kayhan, Burcak; Bayindir, Yasar; Yilmaz, Sezai
    [Abstract Not Available]
  • Küçük Resim Yok
    Öğe
    A Case of Infective Endocarditis Due to Abiotrophia defectiva, and Treatment with Ertapenem
    (Galenos Publ House, 2021) Duman, Yucel; Altunisik Toplu, Sibel; Tanriverdi, Elif Seren; Bayindir, Yasar
    The most frequently reported infections due to Abiotrophia defectiva worldwide are bacteraemia and endocarditis. It is estimated that A. defectiva causes approximately 5-6% of microbiologically proven endocarditis and plays a role in the etiology of culture negative endocarditis. In this article we reported a patient with infective endocarditis (IE) due to penicillin resistant A defectiva, which caused vegetation in the mitral valve, embolism in the spleen and successfully treated with ertapenem. A 70-year-old female patient was admitted to the emergency service with fever and abdominal pain. The patient had a pronounced widespread abdominal tenderness in the left quadrant. The body temperature was 38.9 degrees C, C-reactive protein (CRP) level was 12.7 mg/dl and white blood cell count was 13.3x10(3) mm(3). The patient was hospitalized to investigate fever's reason. It was learned in the anamnesis that she used warfarin. Considering the pre-diagnosis of urinary tract infection, empirical treatment with ceftriaxone 2x1 g/day was started. However, due to the increase in International Normalized Ratio value on the second day of ceftriaxone treatment, ertapenem 1x1 g/day was started by considering drug interaction between warfarin and ceftriaxone. Transesophageal echocardiography of the patient revealed a 1.2x1.2 cm vegetation on the posterior leaflet surface of the mitral valve, and ischemia due to embolism in the spleen was detected on abdominal computer tomography. Penicillin resistant A defectiva grew in the blood culture. The patient was diagnosed as having IE on the seventh day of her admission. Ertapenem treatment was completed in six weeks due to the patient's absence of fever, decreased CRP level, and the absence of A. defectiva in the seventh day control blood culture. After treatment, vegetation was not observed in the transthoracic echocardiography of the patient and no signs of ischemia was detected in the spleen. Detection of A. defectiva shaped the follow-up process of our patient by bringing the diagnosis of IE to mind. In treatment of A defectiva-related IE, guidelines suggest long-term combination of aminoglycosides with beta-lactams or vancomycin. However, in our patient, treatment was provided by using ertapenem alone for six weeks. In addition, we believed that early diagnosis and treatment in our patient prevented serious complications.
  • Küçük Resim Yok
    Öğe
    A Case of Tubo-ovarian Abscess due to Salmonella enterica Following an In Vitro Fertilization Attempt
    (Galenos Yayincilik, 2019) Yakupogullari, Yusuf; Isik, Burak; Gursoy, Nafia Canan; Bayindir, Yasar; Otlu, Baris
    [Abstract Not Available]
  • Küçük Resim Yok
    Öğe
    Cerebrospinal Fluid Viscosity: A Novel Diagnostic Measure for Acute Meningitis
    (Lippincott Williams & Wilkins, 2010) Yetkin, Funda; Kayabas, Uner; Ersoy, Yasemin; Bayindir, Yasar; Toplu, Sibel Altunisik; Tek, Ibrahim
    Introduction: Early diagnosis of acute meningitis has paramount importance in clinical practice because of mortality and morbidity of the disease. Examination of cerebrospinal fluid (CSF) has critical value for the diagnosis of acute meningitis and discrimination of bacterial and aseptic meningitis. It has been previously reported that plasma viscosity can be used as an inflammatory marker. In this study we aimed to evaluate the role of CSF viscosity as a complementary measure for diagnosis of meningitis in suspected patients. Methods: Forty-one consecutive patients who underwent lumbar puncture to rule out meningitis were studied prospectively. Twenty-seven patients were diagnosed with meningitis, of whom 13 patients had aseptic meningitis and 14 patients had bacterial meningitis. Meningitis was ruled out in 14 patients. Results: CSF protein and CSF viscosity were significantly higher in patients with meningitis compared to nonmeningitis. Receiver operator characteristic (ROC) analysis revealed that CSF viscosity was highly sensitive (100%) and specific (93%); measures for the diagnosis of meningitis in the study population was comparable to those of CSF protein. Additionally, patients with meningitis were also divided into two groups as having bacterial and aseptic meningitis. CSF viscosity also significantly differed between bacterial and aseptic meningitis. Conclusion: The CSF viscosity is a simple and easy method and can be used as an adjunctive measure for the diagnosis of meningitis. With the support of further and larger clinical studies, CSF viscosity may have a role in the discrimination of bacterial versus aseptic meningitis.
  • Küçük Resim Yok
    Öğe
    Ciprofloxacin-induced urticaria and tenosynovitis: A case report
    (Karger, 2008) Kayabas, Uner; Yetkin, Funda; Firat, Ahmet K.; Ozcan, Hamdi; Bayindir, Yasar
    Background: Tendon disorders are rare events associated with fluoroquinolone congestion. Skin reactions are more frequent than tendon disorders. We reported this case as the combination of ciprofloxacin-induced urticaria and tenosynovitis has been unreported in young women. Case: A 28-year-old woman without underlying disease developed urticarias and tendinopathy 4 days after the initiation of ciprofloxacin treatment for urinary infection. MRI of the left foot revealed increased synovial fluid surrounding the tendon of the flexor hallucis longus muscle representing tenosynovitis. Ciprofloxacin was ceased due to the possibility of ciprofloxacin-induced tendinopathy and urticaria. Complete resolution of her symptoms and findings occurred 3 days after discontinuation of ciprofloxacin without any additional treatment. Conclusion: Early discontinuation of fluoroquinolone therapy when tendinopathy is suspected is the basis of therapy. So, it should be kept in mind that fluoroquinolone-induced tendinopathy may occur in an otherwise healthy young patient with no risk factors and in a site other than the Achilles tendon. Copyright (C) 2008 S. Karger AG, Basel.
  • Küçük Resim Yok
    Öğe
    Coronavirus Precautions: Experience of High Volume Liver Transplant Institute
    (Aves, 2022) Baskiran, Adil; Akbulut, Sami; Sahin, Tevfik Tolga; Tuncer, Adem; Kaplan, Kuntay; Bayindir, Yasar; Yilmaz, Sezai
    Background: To present the struggle of a high volume liver transplant center against coronavirus infectious disease-2019 pandemic. Methods: Between March 2020 and December 2020, the demographic and clinical data of staff and liver transplant candidates diagnosed with coronavirus infectious disease-2019 in our Liver Transplant Institute were prospectively analyzed. Results: First, 32 healthcare staff were diagnosed with coronavirus infectious disease-2019, and 6 of them were surgeons. Six staff were asymptomatic, while 24 staff had mild or moderate and 2 staff had severe coronavirus infectious disease-2019. All the staff recovered from the disease without any permanent sequela and returned to duty after 2 consecutive negative polymerase chain reaction results within 24-hour intervals. Second, during the preoperative investigation, 6 living liver donor candidates and 13 recipients were tested positive for coronavirus infectious disease-2019 (son = 6, unrelated = 3, cousin = 3, daughter = 2, cadaveric = 1). Eleven patients received favipiravir and 8 did not receive any treatment because they were asymptomatic. Only one recipient who had severe coronavirus infectious disease-2019 died due to multiple organ failure syndrome. One recipient died in the early postoperative period. The median duration from the initial diagnosis of the patients till the transplant procedure was 21-days (min-max: 14-105 days). During the time of operation, the polymerase chain reaction tests of the donors and the recipients were negative, and the thorax tomography images showed no signs of viral pneumonia. Conclusion: Meticulous precautions, multidisciplinary approach, team effort, and organization of facilities can increase the quality of care of these patients in the coronavirus infectious disease-2019 era. Healthcare workers have shown tremendous effort and are the true heroes of this era.
  • Küçük Resim Yok
    Öğe
    Cytomegalovirus associated severe pneumonia in three liver transplant recipients
    (J Infection Developing Countries, 2020) Kose, Adem; Yalcinsoy, Murat; Samdanci, Emine Turkmen; Barut, Bora; Otlu, Baris; Yilmaz, Sezai; Bayindir, Yasar
    Introduction: Cytomegalovirus (CMV), is the most common opportunistic infection, remains a cause of life-threatening disease and allograft rejection in liver transplant (LT) recipients. The purpose of this case series is to state that CMV may lead to severe pneumonia along with other bacteria. Methodology: CMV pneumonia was diagnosed with the thoracic computed tomography (CT) scan findings, bronchoscopic biopsy, real time quantitative Polymerase Chain Reaction (qPCR) and clinical symptoms. For extraction of CMV DNA from the clinical sample, EZ1 Virus Mini Kit v2.0 (Qiagen, Germany) was used, and aplification was performed with CMV QS-RGQ Kit (Qiagen, Germany) on Rotor Gene Q 5 Plex HMR (Qiagen, Germany) device. Results: All recipients had severe pneumonia, leukopenia, thrombocytopenia and at least two-fold increase in transaminases on seventh, twenty-eighth and twenty-second days after surgery, respectively. Thoracic CT scan revealed as diffuse interstitial infiltration in the lung parenchyma. Bronchoscopy, Gram-staining and culture from bronchoalveolar lavage (BAL) fluid were performed in all of them. During bronchoscopy, a bronchial biopsy was administered to two recipients. One recipient could not be performed procedure because of deep thrombocytopenia. PCR results were positive from serum and BAL fluid. Bronchial biopsy was compatible with CMV pneumonia. However, Pseudomonas aeruginosae was found in two cases and Klebsiella pneumoniae in one case BAL fluid cultures. Conclusions: CMV pneumonia can be seen simultaneously with bacterial agents due to the indirect effects of the CMV. It should be kept in mind that CMV pneumonia may cause severe clinical courses and can be mortal.
  • Küçük Resim Yok
    Öğe
    Diagnosis of tularemia in a university hospital in Türkiye - 11-year evaluation
    (2023) Gezer, Yakup; Toplu, Sibel; Celık, Dondu; Ersoy, Yasemin; Bayindir, Yasar; Özden, Mehmet; Memişoğlu, Funda
    Aim: Francisella tularensis is a Gram-negative coccobacillus and is the causative agent of tularemia, which is endemic in our country. The most common clinical form in Turkey is the oropharyngeal form. Sensitive lymphadenopathy is the most important finding, and fever, fatigue, and muscle and joint pain may occur in all clinical forms. Rodents such as rabbits, mice, and squirrels are the main reservoirs for humans, and the transmission is through contact with infected animal secretions and organs, contaminated water, and food. This study aimed to examine the socio-demographic, epidemiological, and clinical features of cases diagnosed with tularemia. Materials and Methods: Among the 583 patients whose serum samples were sent with a preliminary diagnosis of tularemia between 2011 and 2021, tularemia microagglutination test result (MAT) ?1/160 titer, 18 years and older cases were included in the study. Results: A total of 24 tularemia cases were detected, with a mean age of 43.3±17 years, 10 (41.7%) were male, and 14 (58.3%) were female. The most common symptoms and findings among the cases were lymphadenopathy (LAP) (95.8%), fatigue (66.7%), sore throat, and high fever (58.3%), and the most common epidemiological history was living in a rural area (91.7%) and dealing with animal husbandry (66.7%), and 18 (75%) cases were referred to as oropharyngeal tularemia. More than half of the cases were detected between October and March. Conclusion: Tularemia is one of the endemic diseases in our country, and the epidemio- logical history should be taken carefully and kept in mind in the differential diagnosis of lymphadenopathy. Since it is the first tularemia study conducted in Malatya, it shows the epidemiological characteristics of the region.
  • Küçük Resim Yok
    Öğe
    Diagnostic and treatment outcomes of patients with pulmonary tuberculosis in the first year of COVID-19 pandemic
    (Who Eastern Mediterranean Regional Office, 2022) Yakupogullari, Yusuf; Ermis, Hilal; Kazgan, Zeynep; Otlu, Baris; Bayindir, Yasar; Gulbas, Gazi; Tanriverdi, Elif
    Background: The COVID-19 pandemic has put a significant strain on human life and health care systems, however, little is known about its impact on tuberculosis (TB) patients. Aims: To assess the impact of COVID-19 pandemic on pulmonary tuberculosis (PTB) diagnosis, treatment and patient outcomes, using the WHO definitions. Methods: A cross-sectional study was conducted in Malatya region, Turkey (population 800 000). Data on regional PTB test numbers, case notification rates and PTB patients' clinical characteristics and treatment outcomes were collected. Data from the first pandemic year (2020) were compared to data from the previous 3 years (2017-2019). The attitudes and experiences of patients were analysed. Results: Despite a non-significant 22% decrease in annual PTB case notifications (P = 0.317), the number of TB tests performed (P = 0.001) and PTB patients evaluated (P = 0.001) decreased significantly during the pandemic year compared with the previous 3 years. The proportion of patients with high (3/4+) sputum acid-fast bacilli grades (P = 0.001), TB relapse (P = 0.022) and treatment failure (P = 0.018) increased significantly. The median 64.5-day treatment delay detected in 2017-2019 increased significantly to 113.5 days in 2020 (P = 0.001), due primarily to patients' reluctance to visit a health care facility. Conclusion: In addition to the problems with case detection, this study shows notable deterioration in several indicators related to the severity, contagiousness and poor outcomes of TB, which had already been suppressed for decades.
  • Küçük Resim Yok
    Öğe
    Differential diagnosis of the granulomatous appendicitis: Retrospective analysis of 16 cases
    (Turkish Assoc Trauma Emergency Surgery, 2021) Akbulut, Sami; Koc, Cemalettin; Sarici, Kemal Baris; Samdanci, Emine; Yakupogullari, Yusuf; Bayindir, Yasar
    BACKGROUND: This study aims to present the usability of real-time polymerase chain reaction (PCR) and interferon-gamma release assay (IGRA) in the differential diagnosis of granulomatous appendicitis (GAp), especially in areas where tuberculosis (TB) is endemic. METHODS: Sixteen patients underwent appendectomy with presumed diagnosis of acute appendicitis were retrospectively analyzed for histopathological diagnosis of GAp. Real-time PCR method was used to show the whether presence of DNA of the tubercle bacilli in paraffin-embedded tissue blocks. IGRA test was used to investigate whether tubercle bacilli-specific interferon gamma was present in peripheral blood. RESULTS: Sixteen patients (male: 10 female: 6) aged between 21 and 82 years were included in this study. All patients had acute appendicitis and three of them also had appendiceal perforation. Histopathologically, necrotizing granulomatous inflammation was detected in all appendectomy specimens. Acid-fast bacilli were not detected in any of the pathology slides stained with Ehrlich-Ziehl-Neelsen. Real-time PCR was studied in paraffin-embedded tissue blocks of all patients with GAp, but the TB bacilli DNA was amplified in only three patients. IGRA test was studied in peripheral blood samples of 12 patients with GAp and results were as follows: negative (n=9), positive (n=2) and indeterminate (n=1). CONCLUSION: We believe that the use of anamnesis, histopathological findings, tissue PCR, blood IGRA and clinical findings together are important for differential diagnosis of GAp, especially where TB is endemic. We also suggest that all appendectomy specimens should be sent to the laboratory for histopathological evaluation even if specimens appear macroscopically normal.
  • Küçük Resim Yok
    Öğe
    Evaluation of 23 cutaneous anthrax patients in eastern Anatolia, Turkey: diagnosis and risk factors
    (Wiley, 2008) Ozcan, Hamdi; Kayabas, Uner; Bayindir, Yasar; Bayraktar, Mehmet R.; Ay, Selma
    Background Anthrax is a potentially fatal zoonotic disease. The diagnosis of cutaneous anthrax (CA) may be very difficult, particularly in atypical presentations and nonendemic regions. Aim To evaluate the clinical features and diagnostic difficulties of 23 anthrax cases seen between May 2004 and September 2006. Methods Twenty-three patients with CA were included in this study. The diagnosis of CA was based on clinical findings and/or microbiologic procedures. Results All patients with a diagnosis of CA were followed up. One patient experienced toxemic shock. Twenty-two patients had a history of animal contact. Only one patient did not recall any history of suspicious contact. The clinical presentation of CA was typical in 20 patients (87%). Two patients were initially misdiagnosed with insect bites and one patient with angioedema. Cultures from the lesions were positive for Bacillus anthracis in seven cases (30.4%). Gram stain from the lesions revealed Gram-positive rods in eight cases (34.8%). Fifteen patients (65.2%) were diagnosed by clinical presentation and a history of contact with sick animals and/or contaminated animal products. Conclusions CA is a very contagious and important infectious disease worldwide. Early and accurate diagnosis dramatically affects the prognosis of the disease. The diagnosis of CA may be difficult, especially in atypical presentations and nonendemic areas. Thus, CA should be kept in mind, especially in these situations.
  • Küçük Resim Yok
    Öğe
    Evaluation of CD4/CD8 ratio in treatment follow-up of patients with HIV diagnois in an infection clinic
    (2022) Gezer, Yakup; Toplu, Sibel; Yüksel, Mustafa; Köse, Adem; Memişoğlu, Funda; Ozden, Mehmet; Bayindir, Yasar
    Abstract Aim: Antiretroviral therapy (ART) regimens used in the treatment of HIV are assumed to suppress the virus in plasma indefinitely and restore CD4 lymphocyte count. There is increasing evidence that a reversed CD4/CD8 ratio is associated with immune dysfunction, even in patients who have achieved virological suppression with ART and have elevated CD4 lymphocytes. The CD4/CD8 ratio has emerged as a guiding marker as an indicator of immunoactivation in HIV-infected patients. It was aimed to evaluate the CD4/CD8 ratio of HIV-diagnosed patients at baseline and at follow-up after ART regimen. Materials and Methods: A total of 150 patients were included in the study by retrospectively scanning the CD4/CD8 ratio at the initial and 24th week of follow-up in patients who were diagnosed with HIV and started treatment in the Infectious Diseases and Clinical Microbiology Clinic of the Hospital of the Medical Faculty between 2011-2021. ART treatment regimens were divided into three groups as nucleoside reverse transcriptase inhibitor (NRTI)+protease inhibitor (PI), NRTI+non-nucleoside reverse transcriptase inhibitor (NNRTI) or NRTI+ integrase strand transfer inhibitor (INSTI). Results: A total of 150 patients were included in the study. While the initial CD4/CD8 ratio of the patients was 0.36, it increased to 0.61 at the 24th week of treatment. Among the 144 patients whose baseline values were CD4/CD8<1, the rate of the ones who achieved CD4/CD8?1 value at week 24 after ART regimens was found as 13.2% (19/144). It was observed that the CD4/CD8 ratio in the group receiving INSTI was higher (15.1%) than those of the other groups. The undetectable HIV RNA level after treatment was significantly mostly observed in the group, receiving the integrase-based regimen, with 77.1%. With effective ART, CD4/CD8 normalization is higher in individuals with high CD4 T cell counts before treatment. There was a significant increase in the CD4/CD8 ratio in all three ART regimen groups. However, most of the patients who achieved a CD4/CD8 ratio ?1 were in the INSTI-based ART group. Conclusion: The CD4/CD8 ratio may contribute to clinical evaluation in long-term follow-up as a marker of immunological response in individuals treated with a diagnosis of HIV.
  • Küçük Resim Yok
    Öğe
    Evaluation of Culture-confirmed Extrapulmonary Tuberculosis Cases in a University Hospital
    (Galenos Yayincilik, 2019) Toplu, Sibel Altunisik; Kayabas, Uner; Otlu, Baris; Bayindir, Yasar; Ersoy, Yasemin; Memisoglu, Funda
    Introduction: Tuberculosis (TB) is caused by Mycobacterium tuberculosis and can involve any organ, especially the lungs. In recent years, especially in developed countries, the incidence of TB has increased due to the growing number of people with acquired immunodeficiency. This has led to an increase in the incidence of extrapulmonary TB (EPTB). This study examined patients with EPTB confirmed by positive M. tuberculosis culture in Inonu University Faculty of Medicine, Department of Microbiology and Clinical Microbiology, Molecular Microbiology Laboratory. Materials and Methods: Patients with positive M. tuberculosis culture in the molecular microbiology laboratory of our hospital between January 1, 2004 and December 31, 2014 were retrospectively evaluated according to culture-confirmed site of involvement, acid-fast bacillus (AFB), polymerase chain reaction (PCR) positivity, drug resistance, and mortality. Results: The study included 132 patients; 41 (31.1%) were male and 91 (68.9%) were female. The mean age was 46.4 +/- 18.5 (17-86) years. Extrapulmonary TB types were TB lymphadenitis in 48 patients (36.4%), musculoskeletal TB in 23 (17.4%), disseminated TB in 17 (12.9%), urinary TB in 11 (8.3%), abdominal TB in 11 (8.3%), TB meningitis in eight (6.1%), pleural TB in six (4.5%), genital TB in five (3.8%), and cutaneous TB in three patients (2.3%). Acid-fast bacillus positivity rates were 21.7% in musculoskeletal samples, 16.6% in pleural samples, 12.5% in cerebrospinal fluid, 9% in urinary tract samples, and 6.2% in lymph nodes. Polymerase chain reaction positivity was not detected in cerebrospinal fluid or skin samples. The rate of resistance to at least one anti-tuberculous drug was 20%. Mortality was 16.1% (n=9) in the 56 patients (42.4%) with available data. Conclusion: Lymphatic TB was the most common form in our patients. According to national data, pleural TB is among the common forms of EPTB in Turkey. However, the rate of pleural TB was low in our study due to the lack of pleural biopsy in our hospital during the study period. In TB-endemic regions such as Turkey, it is important to consider EPTB in the differential diagnosis of patients with relevant clinical findings and to confirm the diagnosis with TB culture primarily, as well as methods such as AFB staining and PCR.
  • Küçük Resim Yok
    Öğe
    Evaluation of Cytomegalovirus Infections in Liver Transplant Recipients Under Universal Prophylaxis: A Single Centre Experience
    (Kowsar Publ, 2021) Toplu, Sibel Altunisik; Kose, Adem; Karakas, Serdar; Bayindir, Yasar; Otlu, Baris; Yilmaz, Sezai
    Background: Cytomegalovirus (CMV) is one of the leading viral agents that can pave the way for serious complications and organ damage in solid organ transplant (SOT) recipients after transplantation. Strategies have been developed to protect at-risk patients from CMV infection following transplantation. Since more than 90% of adults in Turkey were positive for CMV IgG, universal CMV prophylaxis was applied, and the results were evaluated. Objectives: This study aimed to evaluate the results of universal CMV prophylaxis after liver transplantation in the long term. Methods: A total of 1,090 liver transplant patients were evaluated in terms of CMV infection in the Organ Transplantation Institute of Inonu University, Malatya, Turkey, from October 2014 to December 2019. In order to identify the CMV infections, quantitative nucleic acid amplification (QNAT) was used to detect potential CMV DNA. The cut-off value of CMV DNA was determined to be 1000 copies/mL after transplantation. Results: According to the clinical and laboratory assessments, 33 (3%) patients were diagnosed with CMV infection, and 25 (2.3%) patients were evaluated as possibly having CMV syndrome. Also, eight of the 33 patients were assessed as having end-organ CMV disease and 25 as probable CMV syndrome. In the late period following prophylaxis, CMV infection was observed in 10 (0.9%) cases. The infection rate after prophylaxis (0.9%) was lower than the infection rate (2.1%) seen during prophylaxis. Conclusions: Close clinical follow-up with CMV prophylaxis and strict monitoring of CMV DNA by determining a specific cut-off point are important in the follow-up of liver transplant patients.
  • Küçük Resim
    Öğe
    Evaluation of HLA-B*57:01 and its effect on antiretroviral therapy in patients with human immunodeficiency virus infection: Experience of a University Hospital
    (2020) Altunisik Toplu, Sibel; Ersoy, Yasemin; Bayindir, Yasar; Memisoglu, Funda; Kose, Adem; Otlu, Gonca
    Aim: Before the decision to start abacavir (ABC), which is a member of the antiretroviral therapy (ART) combinations, the presence of the HLA-B*57:01 allele gene should be investigated in case of hypersensitivity to the drug. In recent years, many clinics tend to conduct “treat now” policy for HIV therapy. We aimed to evaluate HLA-B*57:01 test results and its effect on the initiation time of ART, combination and changing of ART.Materials and Methods: HLA-B*57:01 screening test was evaluated retrospectively in the HIV-infected patients admitted to Inonu University Faculty of Medicine Department of Infectious Diseases and Clinical Microbiology between January 2019 and December 2019.Moreover, the time frame of HLA-B*57:01 tests were evaluated along with the HIV confirmation test completion time. It was evaluated whether there was any effect on the start of treatment and treatment change.Results: Of the 47 HIV-positive patients 44 (93.6%) were male and 3 (6.4%) were female whose HLA-B*57:01 allele was screened. The mean age ± SD of these 47 patients was 37.7 ± 13.5 years. HLA-B*57:01 gene positivity was not detected in any of our cases. After HLA-B*57:01 test detection, ten (21%) of these patients were treated with ABC sulfate plus dolutegravir sodium plus lamivudine. Five of the patients were naive patients, while the other five patients were treatment experienced. HLA-B*57: 01 allele test completion time of the patients (mean ± SD) was 4.02 ± 2.35 days. HLA-B*57:01 completion time did not differ statistically in patients with and without treatment change (p=0.243). Conclusion: HIV infected individuals should be started to treat with ART soon after their diagnosis. To detect the HLA-B*57:01 allele in genomic DNA is important in this period. The fact that this procedure can be performed in centers following HIV-infected patients will positively affect the process of starting treatment.
  • Küçük Resim Yok
    Öğe
    Evaluation of Nosocomial Infections after ABO-Compatible and Incompatible Liver Transplantations
    (Galenos Yayincilik, 2018) Bayar, Filiz Surucu; Bayindir, Yasar; Isik, Burak; Ozgor, Dincer; Kayabas, Uner; Kuzucu, Cigdem; Yilmaz, Sezai
    Introduction: Liver transplantation is currently the only treatment option in acute hepatic failure and end-stage liver disease. In spite of their complications, ABO-incompatible liver transplantations are performed due to the shortage of suitable donors and the urgent need for organs. Despite developments in surgical techniques and improvements in antimicrobial prophylaxis strategies, infection is still an important complication and continues to be a major cause of death. In this study, ABO-compatible and ABO-incompatible liver transplant recipients were compared retrospectively in terms of infections and survival. Materials and Methods: Sixteen ABO-incompatible liver transplant recipients whose transplant surgeries were performed by the Liver Transplant Team between March 2002 and January 2011 were included in the study. ABO-compatible liver transplant recipients whose surgeries were undergone before and after the ABO-incompatible transplantation were selected as control group (total 32 patients). Patients' postoperative one year data were obtained from hospital records in both groups. Results: In the first postoperative year after liver transplantation, 12 (75%) of the ABO-incompatible recipients and 21 (65.6%) of the ABO-compatible recipients experienced at least one infection attack (p=0.509). The infection attack rate was 175% in the ABO-incompatible group and 113% in the ABO-compatible group (p=0.262). Eight (50%) of the 16 ABO-incompatible recipients and nine (28.1%) of the 32 ABO-compatible recipients died within one year of transplantation (p=0.135). There were no statistically significant differences between the groups in terms of mortality or infection rates. Pseudomonas aeruginosa was the most common isolate in both ABO-compatible and incompatible recipients. Conclusion: The findings of the study showed that ABO-incompatible transplants were comparable to ABO-compatible transplants in terms of infection rates and survival. It should be kept in mind that ABO-incompatible liver transplantation may be an option, especially in emergencies and in selected cases, despite differences in complications between centers and patient groups and concerns about greater complications in ABO-incompatible patients. However, further studies are needed on this topic.