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    Candidemia in adult intensive care units: Analysis of a 4 year process in a tertiary hospital in Turkey
    (2020) Erdogan, Esra; Erdogan, Mehmet Mustafa; Acun Delen, Leman
    Aim: Candidemia are one of the most important causes of mortality and morbidity in inpatients, and their importance is increasing with the increasing number of immunosuppressive patients and the widespread use of invasive procedures and broad spectrum antibiotics in recent years. In our study, we aimed to identify Candida species isolated from blood cultures and to determine the antifungal susceptibility rates of adult patients who were hospitalized in Malatya Education and Research Hospital Intensive Care Units 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 Laboratory of our hospital over the four years, were examined retrospectively. Species distribution and antifungal susceptibility were determined using 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 nonalbicans Candida (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 the distribution and susceptibility of infectious agents, especially in critical patients in intensive care units.
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    The Risk Factors Affecting Length of Stay and Mortality in Covid 19 Patients: Laboratory Parameters, Comorbidities, and Demographic Characteristics
    (Duzce Univ, Fac Medicine, 2021) Delen, Leman Acun; Erdogan, Esra; Yasar, Seyma
    Objective: Covid 19 can cause fatal pneumonia and serious complications. In the course of the disease the levels of different biochemical parameters increased and these parameters provide important information about the prognosis of the disease. The aim of this study was to investigate the relationship between biochemical parameters and length of stay and mortality in Covid 19 patients. Methods: In this retrospective study, a total of 767 Covid 19 patients hospitalized in our hospital were included. The demographic characteristics, length of stay, comorbid diseases and biochemical parameters of the patients were scanned from the hospital's database and patient files and recorded. Patients were grouped according to the length of stay; 1st Group: 7 days and less, 2nd Group: 8-10 days, 3rd Group: 11-13 days, and 4th Group: 14 days and more. Results: The mean CRP level was significantly higher in group 4 compared to group 1 (p = 0.002). The mean levels of LDH, PRO_BNP, and procalcitonin were significantly higher in group 4 compared to group 1 and group 2 (p <0.001, p = 0.026, p = 0.007, respectively). The mean level of fibrinogen was significantly higher in group 4 compared to group 2 (p = 0.011). Presence of DM and HT as comorbidities (p = 0.022, p = 0.006) and high levels of LDH and ferritin (p <0.001, p = 0.041) significantly increased the risk of death. Conclusions: The results of our study show that positive correlation between the levels of CRP, LDH, PCT, PROBNP, and fibrinogen the prolongation of hospitalization in Covid 19 patients and these parameters can be associated with the severity disease. These results show that increased levels of LDH and ferritin, age, prolongation of hospitalization, and the presence of HT and DM increase mortality rate and can be specific parameters in terms of prognosis.
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    Seroprevalence of toxoplasmosis in women admitted to an education and research hospital in eastern anatolia after the syrian crisis
    (2020) Erdogan, Esra; Erdogan, Mehmet Mustafa; Altindag, Mehmet Murat
    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.