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Aile içinde hepatit b virüsünün geçişi
(İnönü Üniversitesi Tıp Fakültesi Dergisi, 1997) Ersoy, Yasemin; Sönmez, Emine; Çetin, Cumali; Durmaz, Rıza
Aile içinde hepatit B virımı geçişini araştırmak amacıyla kliniğimize başvuran kronik HBsAg taşıyıcı ve kronik hepatitli 82 olgu ’mm aile bireyleri hepatit B göstergeleri yönünden araştırıldı. 184 aile bireyinin serumları ELISA yöntemi ile tarandı. Kontrol grubu olarak herhangi bir şikayeti olmayan ve risk grubunda bulunmayan 75 kişi alındı ve aynı yöntemle hepatit B göstergelerine bakıldı. Aile bireylerinde HBsAg pozitifliği %16.5, anti HBsAg pozitifliği %17.6 ve toplam seropozitivite %34.1 bulunurken kontrol grubunda HBsAg %5.3, antiHBsAg %6.6 ve toplam serpozitivite %11.9 olarak bulundu. İki grup arasındaki fark istatistiksel olarak anlamlı idi (p<0.05). Aile bireylerinde seropozitivitenin yüksekliği ve kardeşler arasında da geçişin yüksek olması perinatal geçiş yanında horizontal geçişin düşünülmesi gerektiğini desteklemiştir. Sonuç olarak aile bireyleri risk grubundadır ve HBsAg taşıyıcıların aile bireyleri taranmalı ve hepatit B virusu yönünde proflaksi uygulanmalıdır.
Ankilozan spondilitli hastalarda etanercept tedavisinin etkinliği ve güvenilirliği
(2010) Kalı, Gökhan; Ersoy, Yüksel; Durmuş, Bekir; Altay, Zuhal; Baysal, Özlem; Ersoy, Yasemin
Amaç: Bu çalışmanın amacı; ankilozan spondilit (AS)’li hastalarda etanercept tedavisinin etkinliğini ve güvenilirliğini araştırmaktır. Gereç ve Yöntem: 21 AS’li hasta tedavi öncesi ve 6 aylık tedaviden sonra klinik ve laboratuvar parametrelerle değerlendirildi. Tedavinin etkinliği ayrıca Uluslararası AS Çalışma Grubu (ASAS)’nun AS’te tedaviye yanıt kriterleri olan ASAS-20, ASAS-40, ASAS-5/6, ASAS parsiyel remisyon ve BASDAI-50 yanıtı ile belirlendi. Bulgular: 6 aylık etanercept tedavisinden sonra klinik ve laboratuvar değerlendirme parametrelerinin tümünde istatistiksel olarak anlamlı iyileşme görüldü. Ayrıca 18 hastada ASAS-20, 16 hastada ASAS-40, 14 hastada ASAS-5/6, 10 hastada ASAS parsiyel remisyon ve 16 hastada BASDAI-50 yanıtları elde edildi. Ciddi yan etki nedeni ile tedaviyi bırakmak zorunda kalan hasta olmadı. 4 hastada enjeksiyon yeri reaksiyonu, 1 hastada eritem, 1 hastada bulantı-kusma şikayeti tespit edildi. Sonuç: Bulgularımız, etanercept tedavisinin AS’li hastalarda etkili olduğunu ve güvenle kullanılabileceğini göstermektedir.
Ankilozan Spondilitli Hastalarda Etanercept Tedavisinin Etkinliği ve Güvenilirliği+
(İnönü Üniversitesi Tıp Fakültesi Dergisi, 2010) Kalı, Gökhan; Ersoy, Yüksel; Durmuş, Bekir; Altay, Zühal; Baysal, Özlem; Ersoy, Yasemin
Bu çalışmanın amacı; ankilozan spondilit (AS)’li hastalarda etanercept tedavisinin etkinliğini ve güvenilirliğini araştırmaktır. Gereç ve Yöntem: 21 AS’li hasta tedavi öncesi ve 6 aylık tedaviden sonra klinik ve laboratuvar parametrelerle değerlendirildi. Tedavinin etkinliği ayrıca Uluslararası AS Çalışma Grubu (ASAS)’nun AS’te tedaviye yanıt kriterleri olan ASAS-20, ASAS-40, ASAS-5/6, ASAS parsiyel remisyon ve BASDAI-50 yanıtı ile belirlendi. Bulgular: 6 aylık etanercept tedavisinden sonra klinik ve laboratuvar değerlendirme parametrelerinin tümünde istatistiksel olarak anlamlı iyileşme görüldü. Ayrıca 18 hastada ASAS-20, 16 hastada ASAS-40, 14 hastada ASAS-5/6, 10 hastada ASAS parsiyel remisyon ve 16 hastada BASDAI-50 yanıtları elde edildi. Ciddi yan etki nedeni ile tedaviyi bırakmak zorunda kalan hasta olmadı. 4 hastada enjeksiyon yeri reaksiyonu, 1 hastada eritem, 1 hastada bulantı-kusma şikayeti tespit edildi. Sonuç: Bulgularımız, etanercept tedavisinin AS’li hastalarda etkili olduğunu ve güvenle kullanılabileceğini göstermektedir.
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.
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.
Assessment of the effectiveness of a ventilator associated pneumonia prevention bundle that contains endotracheal tube with subglottic drainage and cuff pressure monitorization
(Elsevier Brazil, 2017) Akdogan, Ozlem; Ersoy, Yasemin; Kuzucu, Cigdem; Gedik, Ender; Togal, Turkan; Yetkin, Funda
The effectiveness of prevention bundles on the occurrence and mortality of ventilator associated pneumonia (VAP) was evaluated in many studies. However, the effectiveness of endotracheal tube with subglottic secretion drainage (ETT-SD) and cuff pressure monitorization in VAP bundles have not been adequately assessed. In this study, we aimed to evaluate the effectiveness of VAP bundle containing ETT-SD and cuff pressure monitorization. This was a prospective, controlled study that was carried out between March 2011 and April 2012 including intubated patients. The study was conducted at the Anesthesiology Intensive Care Unit 1 and 2 (10 beds each) in a 898-bed university hospital. Occurrence of VAP and compliance with the parameters of the VAP prevention bundles were assessed daily. Patients intubated with the standard endotracheal tube were recruited as controls, mainly in the first six months of the study as ETT-SD and cuff pressure monometer had not yet been implemented. In the second term, patients intubated with ETT-SD were included as cases. Occurrence of VAP, mortality, and compliance with VAP prevention bundles were monitored. A total of 133 patients, 37 cases and 96 controls were recruited. VAP incidence declined from 40.82 to 22.16 per 1000 ventilator days among controls and cases, respectively (p < 005). On average, VAP occurred 17.33 +/- 21.09 days in the case group and 10.43 +/- 7.83 days in the control group (p = 0.04). However, mortality of cases and controls at the 14th and 30th days was not different. VAP prevention bundles including the utilization of ETT-SD, monitoring cuff pressure, and oral care with chlorhexidine were efficient in reducing the rate of VAP. (C) 2017 Sociedade Brasileira de Infectologia. Published by Elsevier Editora Ltda.
Assessment of the effectiveness of a ventilator associated pneumonia prevention bundle thatcontains endotracheal tube with subglottic drainage and cuff pressure monitorization
(Elsevıer brazıl, r sete setembro, 111-16, rıo de janeıro, rj 20050-006, brazıl, 2017) Akdogan, Ozlem; Ersoy, Yasemin; Kuzucu, Cigdem; Gedik, Ender; Togal, Turkan; Yetkin, Funda
The effectiveness of prevention bundles on the occurrence and mortality of ventilator associated pneumonia (VAP) was evaluated in many studies. However, the effectiveness of endotracheal tube with subglottic secretion drainage (ETT-SD) and cuff pressure monitorization in VAP bundles have not been adequately assessed. In this study, we aimed to evaluate the effectiveness of VAP bundle containing ETT-SD and cuff pressure monitorization. This was a prospective, controlled study that was carried out between March 2011 and April 2012 including intubated patients. The study was conducted at the Anesthesiology Intensive Care Unit 1 and 2 (10 beds each) in a 898-bed university hospital. Occurrence of VAP and compliance with the parameters of the VAP prevention bundles were assessed daily. Patients intubated with the standard endotracheal tube were recruited as controls, mainly in the first six months of the study as ETT-SD and cuff pressure monometer had not yet been implemented. In the second term, patients intubated with ETT-SD were included as cases. Occurrence of VAP, mortality, and compliance with VAP prevention bundles were monitored. A total of 133 patients, 37 cases and 96 controls were recruited. VAP incidence declined from 40.82 to 22.16 per 1000 ventilator days among controls and cases, respectively (p < 005). On average, VAP occurred 17.33 +/- 21.09 days in the case group and 10.43 +/- 7.83 days in the control group (p = 0.04). However, mortality of cases and controls at the 14th and 30th days was not different. VAP prevention bundles including the utilization of ETT-SD, monitoring cuff pressure, and oral care with chlorhexidine were efficient in reducing the rate of VAP. (C) 2017 Sociedade Brasileira de Infectologia. Published by Elsevier Editora Ltda.
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.
Co-Production of OXA-48 and NDM-1 Carbapenemases in Providencia rettgeri: the First Report
(ANKARA MICROBIOLOGY SOC, HACETLEPE UNIV FACULTY MEDICINE DEPT MICROBIOLOGY, 06100 ANKARA, TURKEY, 2018) Otlu, Barış; Yakupoğulları, Yusuf; Gürsoy, Nafile Canan; Duman, Yücel; Bayındır, Yaşar; Tekerekoğlu, Mehmet Sait; Ersoy, Yasemin
Our country is the epicenter of the OXA-48-like carbapenemase-producing Klebsiella and Escherichia coli; and in the recent years, the concern has been increasing due to both spreading of this resistance to other members of Enterobacteriaceae family and acquiring other carbapenemases by the OXA-48-producing strains. In this study, OXA-48 and NDM-1 co-production was presented in Providencia rettgeri. Two P.rettgeri strains that were resistant to all antimicrobials except colistin and tigecyclin, were isolated from two patients in the burn unit of our hospital, including one from the urine sample of a 68 years female in April 2017, and the other from a burn wound swab of a 35 years old male, in November 2017. Minimal inhibitory concentrations (MICs) of the isolates for imipenem and meropenem were measured as >= 32 mu g/ml; and for colistin and tigecyclin were 1 ve 0.5 mu g/ml, respectively. Multiplex PCR analysis showed that both strains were carrying bla(oxA-48 )and bla(NDM-1 )carbapenemases, and bla(TEM) extended spectrum beta-lactamase genes. By using DNA sequence analysis, the TEM gene was typed as bla(TEM-1). The Pulsed Field Gel Electrophoresis (PFGE) analysis indicated that these two strains which were consecutively isolated from two different patients in a single unit within about seven months were genetically indistinguishable. No significant data that could explain the spread of these isolates was obtained from our retrospective analysis of the medical records including the results of environmental surveillance cultures, and patients' history. Nevertheless, hospital infection control committee enforced the infection control measures in that unit, and no further isolation was observed within three months period following the last isolation, neither from environmental nor from clinical samples. With this study, it was emphasized that the co-production of OXA-48 and NDM-1 carbapenemases which was reported from only three Enterobacteriaceae species up to date was ongoing for spreading to other species by using horizontal route, and also showing a potential to be a growing problem in the hospitals, by clonal expansion (vertical route). Effectively using of the molecular epidemiological methods will provide useful data to better understand the transmission dynamics of such rare, but problematic species in hospitals.
Çocuklarda Enterokokkal Enfeksiyonlar: Sekiz Yıllık Çalışma Sonuçları
(İnönü Üniversitesi, Tıp Fakültesi, Enfeksiyon Hastalıkları ve Klinik Mikrobiyoloji Anabilim Dalı, Malatya, Türkiye, 2011) Ersoy, Yasemin
[Abstract Not Acailable]
Çoğul Direnç veya Ekstrem İlaç Direnci Olan 30 Acinetobacter Suşunda in Vitro Tigesiklin Duyarlılığının Disk Difüzyon, E-test ve Buyyon Mikrodilüsyon Yöntemleri ile Değerlendirilmesi
(İnönü Üniversitesi Tıp Fakültesi Dergisi, 2011) Mansur, Ahmet; Kuzucu, Çiğdem; Ersoy, Yasemin; Yetkin, Funda
Acinetobacter spp. are primarily associated with nosocomial infections and these isolates resistant to most antimicrobial agents. The present study was conducted to evaluate the in vitro susceptibility of tigecyline in multi-drug-resistant (MDR) and extreme-drug resistance (XDR) Acinetobacter strains by three different methods. MDR Acinetobacter isolates described in the study were resistant to at least three of the following antibiotics: imipenem, meropenem, ceftazidime, cefepime, aztreonam, piperacillin tazobactam, ciprofloxacin, tetracycline, ampicillin-sulbactam, trimethoprim-sulfamethoxazole, amikacin, gentamicin and tobramycin. XDR was defined as resistance to all above antibiotics excluding colistin and tigecyline. Identification of Acinetobacter spp. were made conventional methods. Antibiotic susceptibility tests were performed according to the criteria of Clinical and Laboratory Standards Institute (CLSI). All of the isolates were found resistant to carbapenem. Disk diffusion, E-test and broth microdilution methods were used to evaluate the in vitro susceptibility of tigecyline. No tigecycline interpretative criteria universally accepted for Acinetobacter spp, therefore the Food and Drug Administration approved breakpoints for members of the family Enterobacteriaceae have been used. A total of 30 (five strains were MDR and 25 strains were XDR) Acinetobacter strains were isolated from various clinical specimens (8 paracentesis fluid, 8 blood, 7 tracheal aspirates, 5 wound, 2 urine, 2 catheter, 1 sputum) of hospitalized patients in Turgut Ozal Medical Center in 2008 year. All of the MDR and XDR strains were susceptible to tigecyline by broth microdilution method. Against Acinetobacter spp, an MIC range between 0.03 and 0.5 ?g/ml was observed by broth microdilution and MIC50 and MIC90 values were determined as 0.12 ?g/ml and 0.25 ?g/ml, respectively. Twenty five strains (83%) were found susceptible to tigecyline when the disk diffusion brekpoints were considered as ?16mm susceptible and ?12mm resistant. Against Acinetobacter spp, an MIC range between 1 and 8 ?g/ml was observed by E test. MICs of tigecycline determined by E test were 8 to 64 times higher and 30% (9/30) of the isolates were resistant to tigecycline by E test (MIC breakpoint 2 ?g/ml ). Broth microdilution method must to use in the resistant Acinetobacter spp, by E test and disk diffusion method.
Device-associated nosocomial infection surveillance in the neurosurgery intensive care unit of the Inonu University Turgut Ozal Medical Center
(Doc Design Informatics Co Ltd, 2008) Yetkin, Funda; Ersoy, Yasemin; Karaman, Perihan; Kayabas, Uner; Bayindir, Yaflar; Kocak, Ayhan
Patients in the intensive care units (ICUs) have a high risk of infection due to the severity of illness of the patients treated and the high number of medical devices used. For patients requiring neurosurgical intensive care there are certain risk factors (e.g. altered consciousness, impaired protective reflexes, head injury) of acquiring nosocomial infections (NIs). In this study, we prospectively investigated NIs, device utilization ratios and device-associated infection rates, isolated agents and their antimicrobial susceptibilities in the neurosurgery intensive care unit of the Inonu University Turgut Ozal Medical Center between May 2006-April 2007. 613 patients with a total of 3561 patient days were enrolled. The overall incidence of NIs was 13.9% per 100 patients and the incidence density 23.8 per 1,000 patient days. Pneumonia (65.8%), bloodstream infections (16.5%), and urinary tract infections (15.3%) were the most frequent NIs recorded. The rate of ventilator-associated pneumonia was 67.2 infections per 1,000 ventilator-days, the rate of catheter-associated bloodstream infection was 8.1 per 1,000 central line-days, and the rate of catheter-associated urinary tract infection was 3.9 infections per 1,000 urinary catheter-days. Of the bacteria determined 56.8% were Gram-negative. In this group Pseudomonas aeruginosa was the most frequently isolated (25%). Staphylococcus aureus (20.4%) was the most frequently found Gram-positive bacteria (38.6%). We aim to investigate the causes of ventilator-associated pneumonia and catheter-associated bloodstream infections and to determine necessary preventive measures in an observative and multidisciplinary studies.
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.
THE EFFECT OF SODIUM DICHLOROISOCYANURATE DIHYDRATE TO PREVENT THE ENVIRONMENTAL TRANSMISSION OF MULTIDRUG-RESISTANT ACINETOBACTER BAUMANNII IN HOSPITAL SETTINGS
(Parlar Scientific Publications (P S P), 2020) Duman, Yucel; Kuzucu, Cigdem; Ersoy, Yasemin; Otlu, Baris
Nosocomial infections are a substantial concern as the major cause of morbidity and mortality of hospitalized patients' in the world. Disinfection of inanimate environment, equipment and hospital setting is important to prevent nosocomial infections. Sodium dichloroisocyanurate dihydrate (NaDCC) can he used for disinfection of environment and medical devices. The aims of this study were to determine the efficacy of NaDCC at various concentrations and times against multi-drug resistant Acinetobacter strains. In the first phase of the study, the bactericidal activity of NaDCC to A. baumannii was investigated by quantitative suspension test, In the second phase, the surface activity of NaDCC was tested by surface disinfection application test. In the third phase, before the cleaning of randomly selected patient's room A. baumannii contamination on the inanimate environment objects and equipment was investigated. After the cleaning of the room the effect of NaDCC was tested. As a result of the quantitative suspension test; NaDCC was inhibited the all A. baumannii and ATCC strains. In the surface disinfection application test, it was determined that at the concentration of 1000 ppm and 500 ppm, the activity of NaDCC; at 5th, 30th and 60th minutes was effective to micro-organisms at 5 log level, respectively. But at 100 ppm concentration it was effective to at 5th minutes three. at 30th and 60th minutes seven A. baumannii strains at 5 log levels, while it was effective at log 1 level to other A. baumannii strains and S. aureus, E. colt and P. aeruginosa ATCC. As a result of investigation the A. baumannii contamination in patient's room; before the cleaning, we determined A. baumannii contamination on the inanimate objects of room (such as bed surface, bed edges, control device, nightstand, chair) and on equipment (such as stethoscope, steam appliance, blood pressure device, aspirator heads, ventilator surfaces). After the cleaning it was determined that at 1000 ppm concentration at 5th, 30th and 60th minutes NaDCC was effective to A. baumannii at 5 log levels, However, at 500 ppm concentration at 5th minute it was effective at log 5 level except control device. At 30th and 60th minutes of 500 ppm concentration of NaDCC was effective at log 5 level to A. baumannii, At 100 ppm concentration at 5th, 30th and 60th minutes it was effective to A. baumannii strains at log 1 level on inanimate objects and equipment. In low concentration, NaDCC efficacy was reduced against A. baumannii. The application concentration and time of the disinfectant to clean up the equipment and the environment is very important for preventing nosocomial infections and the spread of A. baumannii. Thus, it is necessary to check and follow up the staff and to create clean and disinfection training programs for educating staff.
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.
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.
An Evaluation of Percutaneous Injuries of Healthcare Personnel: An Eigth-Year Data Analysis
(2015) Aydın, Fatma; Cantürk Kaplan, Elif; Kuzucu, Çiğdem; Parmaksız, Nalan; Çelik, Tülay; Yetkin, Funda; Ersoy, Yasemin
Öz: Amaç: Kesici delici alet yaralanmaları sağlık çalışanları için önemli bir problemdir. Bu çalışmada hastanemizde sekiz yıl içinde oluşan perkütan yaralanmaların retrospektif yıllara göre dağılımının irdelenmesi amaçlanmıştır. Gereç ve Yöntemler: Hastanemizde 2006-2013 yılları arasında oluşan perkütan yaralanma olayları retrospektif incelenmiştir. Bulgular: Sekiz yıllık dönemde 144 personelde perkütanöz yaralanma kaydedilmiştir. Bunların %44\\\'ü (63 kişi) temizlik çalışanı, %17\\\'si (25) hemşire, %12\\\'si (17) tıp öğrencisi, %12\\\'si (17) hasta bakıcı, %6\\\'sı (9) öğrenci hemşire, %5\\\'i (7) teknisyen ve %4\\\'ü (6) doktordur. Perkütan yaralanmaların 126\\\'sı (%87) iğne batması, 11\\\'i (%8) bistürü kesisi, 7\\\'si (%5) mukozal temas (göze sıçrama) şeklinde gerçekleşmiştir. Yıllar içerisinde toplam yaralanma olaylarında ve temizlik çalışanı, hasta bakıcı ve hemşire yaralanmalarında anlamlı düşüş olduğu görülmüştür (p<0.001). Sonuç: Sekiz yıl içerisinde sağlık çalışanlarında perkütan yaralanma olaylarının anlamlı olarak azaldığı saptanmıştır. Hastanemizde Sağlık çalışanlarına eğitimlerin düzenli verilmesi ve geri bildirimlerin takip edilmesi planlanmıştır
Evaluation of the patient with lymphadenopathy: Is it always easy to reach the correct diagnosis?
(2021) Köse, Adem; Doğan, Ahmet; Bayindir, Yasar; Ersoy, Yasemin; Özden, Mehmet; Memişoğlu, Funda; Toplu, Sibel
Lymphadenopathy (LAP) is a common clinical problem in adult patients and should be thoroughly evaluated in a tertiary hospital to investigate its reasons. In this study,we aimed to present the demographic characteristics, etiology, diagnosis and follow-up results of the patients who applied with LAP symptoms and findings. This studywas designed to include adult patients with neck, armpit, or groin swelling accompanied by symptoms, such as fever, night sweats, weight loss, cough and sputum betweenJanuary 2010 and August 2017, retrospectively. Patients’ data were collected from electronic files. Patients were diagnosed using radiological, histopathological,bacteriological, serological and other microbiological methods. Two hundred-thirty patients were included in this study. The mean age was 43.12±17.06 SD in males and45.74±16.64 in females. On admission, the most common symptoms were night sweats (31%), fever (23%), weight loss (17%) and cough and/or sputum (13%) in orderof frequency. However, 16% of the patients were asymptomatic. In this study, 157 (68.26%) patients were diagnosed. Tuberculosis (n=76; 33%), malignancies (n=28,12.1%) and tularemia (N=14; 6.1%) were the most common diseases causing LAP that was most commonly located in the bilateral cervical chain. Lymphadenopathyshould be evaluated comprehensively concerning diagnosing or ruling out many diseases that must be treated necessarily. Knowledge and awareness of the diseases as acause of LAP may contribute to the early and correct diagnosis. Therefore, undiagnosed patients should be followed, and the institutions should develop policies for thispurpose, such as telemedicine applications.
Follow-up and treatment of primary HIV infection in Pregnancy
(2022) Sağlam Kandemir, Esra; Altunisik Toplu, Sibel; Ersoy, Yasemin
The pregnant population infected with "human immunodeficiency virus" (HIV), an important member of the retrovirus family, are encountered with increasing frequency in our clinical experience today. Early and effective suppression of HIV viremia will reduce the risk of mother-to-child transmission of HIV. In the light of the case we aimed to review the antiretroviral treatment (ART) options that can be used in HIV-positive pregnant women and to share an our clinical experience.
Fusarium Fungemia After Electric Burn: A Case Report
(2023) Ersoy, Yasemin; Doğan, Ahmet; Duman, Yücel; Fırat, Cemal
Fusarium bloodstream infections, which are mostly seen in immunosuppressive patients, are serious life-threatening infec- tions. Here, we present a 35-year-old male patient who was being followed up for electric shock due to Fusarium fungemia, which developed while receiving antibacterial therapy. It was thought that the patient’s central venous catheter, use of broad-spec- trum antibiotics, and severe burn could be the most important risk factors. The patient was successfully treated by withdraw- ing the catheter and administering Liposomal Amphotericin-B 3 mg/kg daily for 3 weeks. Blood culture is critical in burn patients, and Fusarium infections should also be considered.

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