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Öğe Candidemia in adult intensive care units: Analysis of a 4 year process in a tertiary hospital in Turkey(2020) Erdoğan, Esra; Erdoğan, Mehmet Mustafa; Delen, Leman AcunAim: Candidemia are one of the most important causes of mortality and morbidity in inpatients, and their importance is increasingwith the increasing number of immunosuppressive patients and the widespread use of invasive procedures and broad spectrumantibiotics in recent years. In our study, we aimed to identify Candida species isolated from blood cultures and to determine theantifungal susceptibility rates of adult patients who were hospitalized in Malatya Education and Research Hospital Intensive CareUnits between July 2015 and July 2019, and had Candida growth in at least one of their blood cultures.Materials and Methods: The blood cultures isolated from adult intensive care units patients and sent to the Microbiology Laboratoryof our hospital over the four years, were examined retrospectively. Species distribution and antifungal susceptibility were determinedusing VITEK 2 Compact System (BioMerieux, France).Results: Of the 123 clinical samples, 59 (48%) were C. albicans, 21 (17.1%) were C. parapsilosis, 18 (14.6%) were C. tropicalis, 12(9.8%) were C. glabrata, 5 (4.1%) were C. kefyr, 2 (1.6%) were C. krusei, 2 (1.6%) were C. lipoliytica, 2 (1.6%) were C. lusitaniae, 1 (0.8%)was C. dubliniensis and 1 (0.8%) was C. pelliculosa. 96.5% of C. glabrata strains were found to be susceptible to amphotericin-B,93.1% to fluconazole, 98.3% to voriconazole, 93.5% to caspofungin, 91.4% to micafungin and 96.7% to flucytosine. 98.1% of nonalbicansCandida (NAC) strains were found to be susceptible to amphotericin-B, 74.6% to fluconazole, 90.7% to voriconazole, 78.4%to caspofungin, 80% to micafungin and 100% to flucytosine.Conclusion: The highest resistance to antifungals was found in C. glabrata and the highest susceptibility was observed in C. tropicalis.In order to develop effective and accurate infection control strategies and reduce mortality and morbidity, it is important to know thedistribution and susceptibility of infectious agents, especially in critical patients in intensive care units.Öğe Karaciğer prezervasyon solüsyonunun etkinliğinin arttırılması üzerine melatonin etkisi: Histolojik ve biyokimyasal çalışma(İnönü Üniversitesi, 2018) Erdoğan, Mehmet Mustafa; Vardı, Nı?garKaraciğer nakillerinde başarı oranını en çok etkileyen faktörlerin başında, alınan dokudaki hücrelerin normal histolojik ve biyokimyasal özelliklerinin korunması gelmektedir. Bu amaçla organın alınması ve nakli esnasında çeşitli doku prezervasyon solüsyonları kullanılmaktadır. Bu solüsyonların koruyucu özelliğini arttıran etkenlerden birisi antioksidan kullanımıdır. Çalışmamızda, nakil öncesi intraperitoneal melatonin uygulamasının karaciğer prezervasyon hasarı üzerine etkilerinin araştırılması amaçlanmıştır. Çalışmamızda Serum Fizyolojik (SF) grubu, University of Wisconsin (UW) grubu ile hepatektomiden 45 dk öncesinde melatonin uygulanan University of Wisconsin + Melatonin (UW+Mel) grubu sıçanlarına ait karaciğer dokularının histolojik ve biyokimyasal özellikleri karşılaştırıldı. Hematoksilen&eozin boyamalarda, hidropik dejenerasyon, sinüzoidal dilatasyon, hepatosit nekrozu açısından, 0. saat (p=0.129) ve 12. saat (p=0.150) total skor değerlendirilmesinde gruplar arasında anlamlı derecede fark saptanmadı. Yapılan Caspase 3 immünohistokimyasal boyamada 12. saat UW grubunda UW+Mel grubuna kıyasla anlamlı derecede Caspase 3 immünreaktivite pozitifliğinde artış gözlendi (p=0.005). PAS boyanma yoğunluğu açısından 0. ve 12. saatlerde gruplar arasında fark bulunmadı. Biyokimyasal analizler sonucunda 0. ve 12. saatlerde UW grubuna kıyasla UW+Mel grubunda MDA ve TOS düzeyinin anlamlı derecede arttığı gözlendi. GSH aktivitesi ve TAS düzeyi karşılaştırıldığında ise ise 0. saatte UW ve UW+Mel grupları arasında anlamlı derecede fark gözlenmezken, 12. saatte UW grubuna kıyasla UW+Mel grubunda anlamlı derecede azalma saptandı. Ayrıca UW 12. saat grubuna kıyasla UW+Mel 12. saat grubunda karaciğer enzimlerinden AST, ALT ve ALP düzeylerinin anlamlı derecede azaldığı tespit edildi. Elde edilen bulgular değerlendirildiğinde, sitoprotektif bir antioksidan olan melatoninin intraperitoneal uygulamasının, UW solüsyonu içerisinde karaciğerin doku bütünlüğünün ve hepatositlerin histolojik ve biyokimyasal özelliklerinin korunmasında etkin bir rol oynadığı tespit edilmiştir. Bu nedenle, karaciğer nakli öncesi donöre melatonin uygulamasının, prezervasyon ortamında karaciğer dokusunun histolojik ve biyokimyasal açıdan korunmasında önemli katkıları olduğu düşünülmektedir. Anahtar Kelimeler: Karaciğer, Prezervasyon, UW solüsyonu, melatonin.Öğe Seroprevalence of toxoplasmosis in women admitted to an education and research hospital in eastern anatolia after the syrian crisis(2020) Erdoğan, Esra; Erdoğan, Mehmet Mustafa; Altındağ, Mehmet MuratAbstract: Aim: Toxoplasmosis caused by Toxoplasma gondii, is a zoonotic disease which is generally asymptomatic. However, it causes serious symptoms in pregnant women and immunocompromised individuals. About one third of the people worldwide are seropositive. Due to the civil war in Syria, Turkey has been home to more than 4 million refugees. This unexpected increase in the Syrian population in particular increases the risk of infectious diseases. The aim of this study was to evaluate the prevalence of Toxoplasma gondii, antitoxoplasma IgG and IgM antibodies in local and Syrian women, who were admitted to Obstetrics and Gynecology Clinic of Malatya Education and Research Hospital, which is a tertiary care hospital in eastern part of Turkey, between January 2015 and July 2019. Material and Methods: The anti-toxoplasma IgG and anti-toxoplasma IgM antibody values of women who were admitted to our hospital and evaluated in terms of toxoplasma, determined by using “Chemiluminescence Immunoassay (CLIA)” method, were investigated retrospectively. Results: According to the results analyzed in a total of 11.025 women, including 743 Syrian refugees, the seropositivity of antitoxoplasma IgG and IgM were found to be 25.8% (2.819/10.932) and 1.6% (180/11.025), respectively. Among these patients, the seropositivity of anti-toxoplasma IgG was found to be 25.3% (190/750) and the seropositivity of anti-toxoplasma IgM was found to be 2.5% (20/797) in pregnant women. Anti-toxoplasma IgG and IgM seropositivity were found to be 27.9% and 0.5%, respectively, in Syrian women. In Malatya, a city located in eastern Turkey, Toxoplasma gondii seropositivity was found to be common to the extent that it could not be neglected in both local women and Syrian refugees. No statistically significant difference could be found in Syrian female refugees living in Malatya in terms of carrying toxoplasma antibodies when compared with the local women. More than 70% of pregnant women were observed to be seronegative and they were at serious risk for toxoplasmosis. In particular, it was concluded that women at childbearing age, who constitute the risk group, should be made aware of the disease and serological tests should be performed routinely for toxoplasma.Öğe YOĞUN BAKIM ÜNİTELERİNDEN İZOLE EDİLEN PSEUDOMONAS AERUGİNOSA SUŞLARININ ANTİBİYOTİKLERE DUYARLILIKLARI(2021) Erdoğan, Mehmet Mustafa; Delen, Leman Acun; Erdoğan, EsraÖz: Pseudomonas aeruginosastrains are frequently isolated, especially from inpatient samples in intensive care units. These strains lead to infections that are difficult to treat due to antibiotic resistance, thus increasing morbidity and mortality. The aim of this study is to determine the resistance of P. aeruginosaisolates, isolated from intensive care patients of Malatya Training and Research Hospital, to various antibiotics. P. aeruginosastrains isolated from various clinical samples of patients who were followed up in intensive care units of Malatya Training and Research Hospital between July 2016 and July 2019, were included in the study. Identification and in vitro antibiotic susceptibility of the strains were determined using Vitek 2 automated system (bioMérieux, France). Of the 468 P. aeruginosastrains included in the study, 51.7% were isolated from respiratory tract samples, followed by urine samples with 31.2% and, abscess and wound samples with 9%. Colistin and norfloxacin were determined to be the most effective antibiotics for P. aeruginosastrains, while the lowest susceptibility was determined for aztreonam among the studied antibiotics. Susceptibility rates were determined to be; 76.5% for amikacin, 8.1% for aztreonam, 74.4% for gentamicin, 62.2% for imipenem, 97.1% for colistin, 57.5% for levofloxacin, 61.4% for meropenem, 57.4% for netilmisin, 89.9% for norfloxacin, 48.7% for piperacillin/tazobactam, 35.7% for piperacillin, 57.7% for cefepime, 62.7% for ceftazidime, 66% for ciprofloxacin, and 80.9% for tobramycin. In order to develop effective and accurate infection control strategies and reduce morbidity and mortality, it is important to know the distribution and susceptibility of infectious agents, especially in critical patients in intensive care units.
