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Öğe Antibiotic Resistance and Molecular Epidemiology of Vancomycin-Resistant Enterococci in a Tertiary Care Hospital in Turkey(Dove Medical Press Ltd, 2020) Asgin, Nergis; Otlu, BarisPurpose: Vancomycin-resistant enterococci (VRE) have become a global health threat in the last two decades. In this study, we aimed to determine antibiotic resistance using phenotypic and genotypic methods in VRE strains obtained from inpatients and to investigate clonal relatedness among strains. Methods: Identification and antibiotic susceptibility of 47 VRE strains obtained from inpatients at Karabuk University Hospital from 2014 to 2015 were determined using the BD PhoenixTM automated microbiology system. Vancomycin resistance genes (Van A and B) were detected by polymerase chain reaction. Clonal relatedness among the strains was evaluated by pulsed-field gel electrophoresis (PFGE). Results: All 47 VRE strains obtained from rectal (n=35), blood (n=7), and urine (n=5) samples were confirmed as Enterococcus faecium; they were resistant to ampicillin, gentamicin, vancomycin, and teicoplanin. One E. faecium isolate was intermediately resistant to linezolid. No strain was resistant to quinupristin-dalfopristin or daptomycin. Only vanA was detected among strains. According to the PFGE results, 31 of 47 strains were clonally related with a clustering rate of 66%. No common clone was detected. Conclusion: VRE infections are associated with high mortality, morbidity, and healthcare expenditures. Increasing resistance to last-line drugs, such as linezolid and daptomycin, among VRE strains is a great concern. Therefore, comprehensive measures should be performed to reduce VRE colonization. Although there was no common clone VRE outbreak, polyclonal spread was observed in our hospital. The high clustering rate indicated cross-contamination. Thus, a more effective infection control program should be implemented.Öğe An antibody of TNF-alpha did not prevent thioacetamide-induced hepatotoxicity in rats(Sage Publications Ltd, 2011) Demirel, Ulvi; Harputluoglu, Murat M. M.; Seckin, Yuksel; Ciralik, Harun; Temel, Ismail; Ozyalin, Fatma; Otlu, BarisTumor necrosis factor (TNF)-alpha antibodies have been shown to reduce liver damage in different models. We investigated the effects of infliximab (a TNF-alpha antibody) on liver damage in thioacetamide (TAA)-induced hepatotoxicity in rats. Group 1 (n = 8) was the control group. In group 2 (n = 8), the TAA group, the rats received 300 mg/kg intraperitoneal (ip) TAA daily for 2 days. In group 3 (n = 8), the TAA + Infliximab (INF) group, infliximab (5 mg/kg ip daily) was administered 48 hours before the first dose of TAA daily for 2 days and was maintained for 4 consecutive days. In group 4 (n = 8), the INF group, the rats received only ip infliximab (5 mg/kg) daily. Livers were excised for histopathological and biochemical tests (thiobarbituric-acid-reactive substances [TBARS], and myeloperoxidase [MPO]). Serum ammonia, aspartate transaminase (AST), alanine transaminase (ALT), TNF-alpha, liver TBARS and MPO levels, and liver necrosis and inflammation scores in the TAA group were significantly higher than in the control and INF groups (all p < 0.01). All parameters except AST were not significantly different between TAA and TAA + INF. In conclusion, our results suggest that oxidative stress plays an important role in TAA-induced hepatotoxicity, and infliximab does not improve oxidative liver damage.Öğe Antimicrobial Resistance and Molecular Epidemiology of Corynebacterium striatum Isolated in a Tertiary Hospital in Turkey(Mdpi, 2020) Asgin, Nergis; Otlu, BarisAlthough Corynebacterium striatum is part of the human flora, it has recently drawn attention both for its multidrug resistance and its role as an invasive infection/outbreak agent. This cross-sectional study aimed to determine the antimicrobial resistance and clonal relationships among C. striatum strains. In total, 81 C. striatum strains were identified using Phoenix-100(TM) (BD, Sparks, MD, USA). The antimicrobial resistance of the strains was determined using the Kirby-Bauer disk diffusion method. Clonal relatedness among the strains was performed via arbitrarily primed polymerase chain reaction (AP-PCR). All 81 C. striatum strains were resistant to penicillin, cefotaxime, ciprofloxacin, and tetracycline, but susceptible to vancomycin and linezolid. The resistance rates to gentamicin, erythromycin, and clindamycin were 34.6%, 79%, and 87.7% respectively. AP-PCR results showed no predominant clone among the C. striatum strains. Corynebacterium striatum is reportedly the cause of an increasing number of invasive infections/outbreaks. Moreover, treatment options are limited. The study showed that vancomycin, linezolid, and gentamicin can be selected for the empirical treatment of C. striatum infections. Although no single-clone outbreak was observed in our hospital, small clonal circulations were observed within some units, indicating cross-contamination. Therefore, a comprehensive infection control program is warranted in future.Öğe Antimicrobial susceptibility profile of ceftolozane/tazobactam, ceftazidime/avibactam and cefiderocol against carbapenem-resistant Pseudomonas aeruginosa clinical isolates from Türkiye(Springer, 2024) Buyukyanbolu, Ecem; Genc, Leyla; Cyr, Elizabeth A.; Karakus, Mehmet; Comert, Fusun; Otlu, Baris; Aktas, ElifPurpose Carbapenem resistant Pseudomonas aeruginosa (CR-PA) is escalating worldwide and leaves clinicians few therapeutic options in recent years, beta-lactam/beta-lactamase inhibitor combinations (ceftolozane-tazobactam, ceftazidime-avibactam) and a new siderophore cephalosporin (cefiderocol) have been approved for the treatment of P. aeruginosa infection and have shown potent activity against isolates defined as carbapenem resistant. The aim of this study was to determine the phenotypic profile of these agents against CR-PA in the emerging setting of carbapenemases. Methods CR-PA clinical isolates were collected from three teaching hospitals in different geographical regions between January 2017-December 2021. All isolates were subjected to phenotypic carbapenemase testing using modified carbapenem inactivation method. MICs were determined by reference broth microdilution and evaluated according to EUCAST standards, while genotypic profiling was determined using PCR methods. Results 244 CR-PA sourced most frequently from the respiratory tract (32.2%), blood (20.4%) and urine (17.5%) were evaluated. Of all isolates, 32 (13.1%) were phenotypically and 38 (15.6%) were genotypically defined as carbapenemase-positive. The most common carbapenemase was GES (63.1%), followed by VIM (15.8%). The MIC50/90(S%) of ceftazidime/avibactam, ceftolozane/tazobactam and cefiderocol in all CR-PA isolates were 4 and 32 (80%), 1 and > 64 (69%) and 0.25 and 1 mg/L (96%), respectively. Cefiderocol was also the most active agent in carbapenemase-positive isolates (90%). Conslusion While ceftolozane/tazobactam and ceftazidime/avibactam remained highly active against CR-PA devoid of carbapenemases, cefiderocol provided potent in vitro activity irrespective of carbapenemase production. When considering the potential clinical utility of newer agents against CR-PA, regional variations in carbapenemase prevalence must be considered.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, BarisHelicobacter 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.Öğe Association of Helicobacter pylori infection with systemic inflammation in preeclampsia(Taylor & Francis Ltd, 2010) Ustun, Yusuf; Engin-Ustun, Yaprak; Ozkaplan, Esra; Otlu, Baris; Tekerekoglu, Mehmet SaitMethods. Forty patients with preeclampsia and 40 normotensive pregnant women of similar age and body mass index at the third trimester of gestation were selected for the study. Chlamydia pneumonia IgM and IgGs, Helicobacter pylori IgAs and concentrations of CRP and TNF-alpha were measured. Results. Concentrations of CRP and TNF-alpha were significantly higher in patients with preeclampsia than in control subjects. In the preeclamptic group, positivity rate for Helicobacter pylori IgA was significantly higher as compared to controls (p = 0.034). CRP and TNF-alpha levels were higher in Helicobacter pylori seropositive subjects. Conclusion. We demonstrated high levels of serum CRP and TNF-alpha in preeclamptic women who were seropositive to Helicobacter pylori in comparison with those in seronegative subjects.Öğe Beijing/w and major spoligotype families of Mycobacterium tuberculosis strains isolated from tuberculosis patients in Eastern Turkey(Edizioni Int Srl, 2009) Otlu, Baris; Durmaz, Riza; Gunal, Selami; Sola, Christophe; Zozio, Thierry; Rastogi, NalinThe aim of this study was to determine the Beijing/W family and major phylogenetic clades of Mycobacterium tuberculosis strains Of tuberculosis patients in a city with a tuberculosis incidence higher than the country average. A total of 220 M. tuberculosis strains isolated over a period of more than four years were typed by spoligotyping. Spoligotyping resulted in 64 different patterns, 38 (17.3%) of which were unique, and 26 were clusters including 182 (82.7%) strains. The major shared types were ST 53 (n=55, 25%), ST 41 (LAM7-TUR; n=19, 8.6%), and ST 284 (n=15, 6.8%). The major clades observed ranked in the following order: ill-defined T superfamily (n=112, 50.9%); Latino-American-Mediterranean (LAM; n=33, 15%); Haarlem (n=24, 10.9%); and the S family (n=9, 4.1%). Three strains were in the Beijing family. A high number of strains (33 strains) showed patterns that did not fall within any of the major clades described. M. tuberculosis strains in Malatya have both STs showing a widespread distribution over the world and those restricted to this city, confirming the highly diverse nature of tuberculosis. Our results Suggest that the Beijing clade, which is more prevalent among the strains with MDR and isoniazid resistance, is currently not a problem in Eastern Turkey.Öğe BK virus-induced acute motor-axonal polyneuropathy in a renal transplant patient(Springer Japan Kk, 2016) Taskapan, Hulya; Kayabas, Uner; Otlu, Baris; Kamisli, Ozden; Yaprak, Cisel Yilmaz; Sahin, Fatma TerziogluNeurological complications are not uncommon in patients with renal transplantation, mostly affecting the central nervous system, and less frequently the peripheral nerves. BK virus infection is relatively common in transplant recipients and in some cases may lead to neurological complications. In this report, we present an interesting case of a patient who developed acute axonal motor polyneuropathy in the course of BK virus infection 3 months after kidney transplantation. After BK virus clearence in blood, a significant improvement was noted in her polyneuropathy. In patients with acute axonal motor polyneuropathy after transplantation BK virus-induced polyneuropathy should be excluded.Öğe Brain abscess and bronchopneumonia caused by Acinetobacter baumannii in a 2-year-old female sheep(Taylor & Francis Ltd, 2018) Eroksuz, Yesari; Otlu, Baris; Eroksuz, Hatice; Gursoy, Nafia Canan; Yerlikaya, Zeynep; Incili, Canan Akdeniz; Karabulut, Burak[Abstract Not Available]Öğe Brain abscess and bronchopneumonia caused by acinetobacter baumannii in a 2-year-old femalesheep(Taylor & francıs ltd, 2-4 park square, mılton park, abıngdon or14 4rn, oxon, england, 2018) Eroksuz, Yesari; Otlu, Baris; Eroksuz, Hatice; Gursoy, Nafia Canan; Yerlikaya, Zeynep; Incili, Canan Akdeniz; Karabulut, Burak; Timurkaan, Necati; Timurkan, Mehmet OzkanÖğe Carbapenem-resistant Klebsiella pneumoniae outbreak with monoclonal spread: Evaluation of resistance genes and ceftazidime-avibactam susceptibility(Elsevier, 2023) Arici, Neslihan; Tanriverdi, Elif Seren; Calik, Seyma; Kansak, Nilgun; Adaleti, Riza; Otlu, Baris; Aksaray, SebahatPurpose: The aim of this study was to investigate ceftazidime-avibactam (CAZ-AVI) susceptibility, carbapenemase genes, and clonal relationship in carbapenem-resistant Klebsiella pneumoniae (CrKp) isolates.Methods: A total of 28 non-repetitive CrKp isolates with positive carbapenemase production determined by the modified carbapenem inactivation method (mCIM), were included in the study. Identification of the isolates was performed with MALDI-TOF MS (VITEK-MS, bioMerieux, France). The automated system (VITEK-2, bioMerieux) and gradient diffusion test (Etest, bioMerieux) were used to determine antibiotic susceptibility. The mCIM was performed according to CLSI (2021) recommendations. CAZ-AVI susceptibility was carried out using the standard disc diffusion method. Results were evaluated according to EUCAST 2022 criteria. The blaOXA-48, blaNDM, blaKPC, blaIMP and blaVIM genes were investigated by multiplex PCR. The clonal relationship between isolates was determined by both AP-PCR and PFGE methods.Results: Of the total 28 isolates, 89.3% were susceptible to CAZ-AVI. blaOXA-48 gene was found in 85.7% of the isolates, blaOXA-48 thorn blaNDM gene in 10.7%, and blaNDM gene in 3.6%. blaKPC, blaIMP and blaVIM genes were not detected. Three clusters with three different genotypes were determined by the PFGE method. The largest cluster was Genotype A (n:24), followed by Genotype B (n:3), and Genotype C (n:1). AP-PCR was highly compatible with PFGE. The isolates of Genotype A, mostly from the intensive care unit (ICU), were evaluated as outbreak strains with monoclonal dissemination. Conclusions: OXA-48 remains the most frequently detected enzyme in CrKp strains in our country. The ceftazidime-avibactam susceptibility rate of 89.3% indicates that this antibiotic is still effective against CrKp isolates. The unnoticed outbreak detected in our study revealed the severity of intra-hospital cross-contamination affecting different wards, including the ICU. Therefore, in order to limit the spread of CrKp isolates, it is of great importance to implement strict infection control measures, and molecular surveillance programs, especially in the ICU.Öğe A Case of Intra-abdominal Tuberculosis Due to Mycobacterium bovis Mimicking Ovarian Cancer: Importance of Microbiological Diagnosis(Ankara Microbiology Soc, 2022) Dalgic, Bahise Cagla Taskin; Yenisehirli, Gulgun; Tanriverdi, Elif Seren; Akkan, Murat; Otlu, Baris; Sezer, Oznur; Koseoglu, Handan inonuMycobacterium bovis causes gastrointestinal tuberculosis by being transmitted through consumption of infected milk and dairy products, mostly in developing countries, and can spread to the other neighbourhood intra-abdominal tissues and organs. In addition to the symptoms such as weight loss, weakness, abdominal pain, and chronic diarrhea in female patients with abdominal tuberculosis, findings such as pelvic mass, ascites and CA-125 elevation may be encountered. Patients with these symptoms usually preliminary diagnosed as having ovarian cancer. It is very important to distinguish between these two diseases quickly, which have different treatment protocols. In this case report, a case of intra-abdominal tuberculosis caused by M.bovis, whose diagnosis was confirmed by microbiological methods with the findings mimicking ovarian cancer such as weight loss, ascites, pelvic mass and increased CA-125 was presented. Tuberculosis was considered in the differential diagnosis of a 23-year old female patient with abdominal pain, weight loss, ascites, pelvic mass, and elevated CA-125 (643.9 U/ml) findings and a mass in the left tubaovarian region on abdominal CT. The ileum biopsy sample taken during colonoscopy and ascitic fluid sample taken with paracentesis were sent to our laboratory for acid-fast bacilli (AFB) staining and tuberculosis culture. In our laboratory, samples were incubated in both liquid culture system [BACTEC MGIT 320 Mycobacteria Culture System (Becton Dickinson,USA)] and solid culture medium [Lowenstein-Jensen Medium (Becton Dickinson,USA)] and AFB smears were performed. While AFB smears were negative, ileum biopsy material showed growth on day 14 and ascitic fluid sample on day 11 in liquid culture medium. AFB smear was prepared from broth and red bacilli were seen on a blue background that formed cord factor. The bacillus was identified as Mycobacterium tuberculosis complex by the immunochromatographic rapid test [BD MGIT TBc Identification Test (BD,USA)]. The anti-tuberculosis drug treatment was initiated with the diagnosis of intra-abdominal tuberculosis. The isolated bacillus was found to be sensitive to isoniazid, rifampicin, ethambutol and resistant to streptomycin, according the drug susceptibility test results. Subspecies identification of M.tuberculosis complex was investigated by matrix-assisted laser desorption ionization-time of flight mass spectrometry (MALDI-TOF MS) but could not be determined by this method. Genotyping was performed with the GenoType MTBC VER 1.X (Hain Lifescience, HardwiesenstraBe, Germany) kit. The isolate was identified as M.bovis. In the follow-up of the patient three months later, it was determined that tumor markers, ascitic fluid and intra-abdominal lymph nodes regressed significantly and the mass in the left ovary completely disappeared. In this report, we presented a case with intra-abdominal tuberculosis whose clinical, radiological and laboratory findings mimic ovarian cancer to imply the importance of microbiological diagnosis.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]Öğe Case report: systemic tuberculosis caused by Mycobacterium bovis in a cat(Bmc, 2019) Eroksuz, Yesari; Baydar, Ersoy; Otlu, Baris; Dabak, Murat; Eroksuz, Hatice; Karabulut, Burak; Incili, Canan AkdenizBackgroundThe diagnosis of previous cases of feline tuberculosis in Turkey has been made based solely on pathological changes without isolation of the causative agent. This case report details the first case of feline tuberculosis in Turkey for which the causative agent (Mycobacterium bovis) was confirmed with microbiological isolation, morphological evaluation, molecular (PCR) characterization and antibiotic sensitivity.Case presentationSystemic tuberculosis was diagnosed via postmortem examination of a 5-year-old stray male cat. Mycobacterium bovis was isolated from the lungs, bronchial and gastrointestinal lymph nodes, kidney and liver. The isolate was defined as M. bovis using the Genotype MTBC assay (Hain Lifescience, Germany), which allows differentiation of species within the Mycobacterium tuberculosis complex with an easy-to-perform reverse hybridization assay.Pathological changes were characterized by multifocal to coalescing granulomatous inflammation in the lungs, liver, lymph nodes and kidneys. Further pathological changes included severe, diffuse, hepatocytic atrophy, periportal fibrosis with lymphohistiocytic infiltration, multifocal lymphohistiocytic interstitial nephritis, mild focal pulmonary anthracosis and mild renal and hepatic amyloidosis. Infection by immunosuppressive viral pathogens including feline herpes virus-1, feline immunodeficiency virus and feline parvovirus virus were ruled out by polymerase chain reaction assay (PCR). The isolated mycobacteria were susceptible to isoniazid, ethambutol, rifampicin or streptomycin.ConclusionDisseminated M. bovis is a rare infection in cats. Involvement of submandibular lymph nodes suggested that primary transmission might have been the oral route in the present case.Öğe The characteristics of nasopharyngeal Streptococcus pneumoniae in children attending a daycare unit(Edizioni Int Srl, 2008) Abut, Latife Iseri; Apan, Teoman; Otlu, Baris; Caliskan, Ahmet; Durmaz, RizaS. pneumoniae is a component of normal nasopharyngeal flora in children. Nasopharyngeal colonization in children attending daycare units has an important effect on the spread of S. pneumoniae. In this study, we aimed to investigate colonization status, antimicrobial susceptibility, and clonal relatedness of the S. pneumoniae strains in children attending a daycare unit. One hundred and six nasopharyngeal swabs were collected from 25 children attending a daycare unit in an 8-month period. S. pneumoniae was identified by a conventional method. Antibacterial sensitivities of the strains were tested by disc diffusion method. Pulsed field gel electrophoresis (PFGE) was used to analyze the clonal relationship of the strains. A total of 25 (23.5 %) S. pneumoniae strains were identified from 106 nasopharyngeal swaps. S. pneumoniae growth was detected in at least one culture of the 19 children (colonization rate; 76%). Seven of the 25 strains (28%) showed resistance to penicillin, 5 (20%) were resistant to trimethoprim-sulfomethoxsazole. The other tested antibiotics were almost effective. The clonal relationship among strains was found as 54.5%. The highest rate of strain entry was in the winter months with strains of opaque colonies, which are known to be more pathogenic. However, the spreading rate among the children was the highest in the summer months and the strains detected in these months had transparent colonies with more transmitting characteristics. Therefore, to prevent S. pneumoniae infection in closed crowded areas, the summer months should not be overlooked.Öğe Chemical composition, antimicrobial activities, and molecular docking studies of Turkish propolis ethanol extract(Czech Academy Agricultural Sciences, 2023) Ozbey, Gokben; Muz, Mustafa Necati; Tanriverdi, Elif Seren; Erkan, Sultan; Bulut, Niyazi; Otlu, Baris; Zigo, FrantisekThe purpose of the present study was to investigate the antimicrobial effect of propolis ethanol extract col-lected from the Tarsus district of Mersin province, Kilis province, Yayladagi district of Hatay province in southern Turkiye and Sarkoy district of Tekirdag province of northwestern Turkiye against Escherichia coli (ATCC 25922), Helicobacter pylori (ATCC 43504), Pseudomonas aeruginosa (ATCC 27853), and Staphylococcus aureus (ATCC 29213). Their chemical constituents were detected via liquid chromatography-mass spectrometry/mass spectrometry (LC-MS/MS). They were used in a molecular docking approach to search the interactions between the propolis compounds. A total of 24 phenolic compounds were detected in all samples. 3-4 dimethoxycinnamic acid, caffeic acid and genistein were indicated to be the predominant phenolic compounds in propolis extracts by LC-MS/MS, while rutin was found in the lowest concentra-tion. Phenolic compounds were detected in a high concentration of the propolis samples collected from the Tarsus dis-trict of Mersin province. The broth microdilution method determined minimum inhibition concentration (MIC) values. MIC values ranged from 0.02 to 14 mg center dot mL-1. E. coli and S. aureus examined were as susceptible to the propolis extracts ex-cept for Mersin and Tekirdag propolis samples. The propolis sample collected from the Tarsus district of Mersin province presented the highest antibacterial activity on P aeruginosa with MIC values of 1 mg center dot mL-1. Active substances in propolis were docked to the relevant target proteins (5LMM, 4NX9, 5YHG, and 5FXT) representing E. coli (ATCC 25922), H. py-lori (ATCC 43504), P aeruginosa (ATCC 27853), and S. aureus (ATCC 29213), and with the help of molecular simulation. With this study, we indicated that the ethanol extract of propolis had a stronger antibacterial activity on S. aureus isolates than that of E. coli, H. pylori, and P aeruginosa. Although each component of propolis contributed to the antibacterial activity, the contribution of the vitexin component to the antibacterial activity was found to be quite significant.Öğe Clinical Characteristics and Outcomes of Liver Transplantation Recipients With COVID-19 Pneumonia(Elsevier Science Inc, 2021) Kose, Adem; Toplu, Sibel Altunisik; Yalcinsoy, Murat; Yakupogullari, Yusuf; Otlu, Baris; Otan, Emrah; Aydin, CemalettinBackground. We aimed to evaluate the clinical characteristics and outcomes of mild-severe COVID-19 pneumonia cases in liver transplant (LT) recipients. Methods. Ten LT recipients diagnosed as having COVID-19 pneumonia in a 6-month period in our transplantation center were included. Demographic and medical data of the recipients were retrospectively collected; clinical courses, treatment responses, and outcomes were evaluated. Results. Ten LT recipients were male, had a median age of 57 years (min-max, 36-69 years; interquartile range [IQR], 13 years), and had right lobe from living donor LT performed in a median of 11 months (min-max, 1-72 months; IQR, 12 months). Five patients had severe pneumonia, and the remaining patients had mild/moderate pneumonia. The most frequent symptoms were fever (90%) and cough (70%). Favipiravir, enoxaparin sodium, and corticosteroid were initiated at the time of the diagnosis; immunosuppressive drug doses were reduced or discontinued in 3 cases. Lymphopenia median: 510/mL (min-max, 90-1400 mL; IQR, 610 mL), increased levels of C-reactive protein median: 4.72 (min-max, 0.31-23.4; IQR, 8.5), and ferritin median: 641 (min-max, 40 to >= 1650; IQR, 1108) were frequent. Four patients required antibacterial treatments because of emerging bacterial pneumonia and/or sepsis. All patients were hospitalized for a median of 10 days. One patient with sepsis died on the 26th day after intensive care unit admission, and the remaining 9 survived. No further complication was recorded for 1-month follow-up. Conclusions. Commencing favipiravir, enoxaparin sodium, and corticosteroid treatments; close follow-up of the developing complications; the temporary reduction or cessation of immunosuppression; a multidisciplinary approach; early awareness of the bacterial infections; and the initiation appropriate antibiotic treatments can contribute to success.Öğe Clinical Properties of COVID-19 Developed in the Patients with Tuberculosis(Ankara Microbiology Soc, 2022) Otlu, Baris; Yakupogullari, Yusuf; Tanriverdi, Elif Seren; Bentli, RecepThere are limited publications about the Coronavirus disease 19 (COVID-19) clinic developing in the patients with active tuberculosis (TB). In this study, it was aimed to determine some clinical features of patients diagnosed with TB who also had COVID-19. In this retrospective cross-sectional study, 71 pa- tients with COVID-19 were evaluated out of a total of 595 patients diagnosed with TB in our province between 2015 and 2021. After contracting COVID-19, a total of nine (12.6%) TB patients were hospital- ized, five (7%) patients were admitted to the intensive care unit, three (4.2%) were intubated, and one (1.4%) died due to severe COVID-19. The frequency of such health problems was found to be higher than the normal population living in the same province. None of these complications were observed in a total of 40 female TB patients, and the hospital and intensive care unit admission rates for men were significantly higher than for women. The results of this study showed that men with active TB had more health problems due to COVID-19 than the normal population. Comprehensive studies are needed to detail the resilience of female TB patients against COVID-19.Öğe Clinical, microbiologic, and epidemiologic characteristics of Pseudomonas aeruginosa infections in a University Hospital, Malatya, Turkey(Mosby-Elsevier, 2006) Yetkin, Gulay; Otlu, Baris; Cicek, Aysegul; Kuzucu, Cigdem; Durmaz, RizaBackground: Pseudomonas aeruginosa strains are generally resistant to many antibiotics, and nosocomial infections because of this species are one of the major problems in many hospitals. Molecular typing provides very useful information about origin and transmission of the strains. The aims of the present study were to investigate clinical and microbiologic characteristics of the nosocomial infections caused by P aeruginosa strains in a medical center and to bring up the cross-transmission level of this opportunistic pathogen in a university hospital by analyzing the clonal relationship among the isolates. Methods: A total of 105 P aeruginosa strains had been identified among the 80 inpatients in a 1-year period from August 2003 to August 2004. Demographic, clinical, and epidemiologic data of the patients were prospectively recorded. The standardized disk-diffusion method was used to determine resistance of the strains to imipenem, ceftazidime, aztreonam, amikacin, gentamicin, mezlocillin, cefepime, tobramycin, meropenem, ceftriaxone, and ciprofloxacin. Clonal relatedness of the strains was investigated by pulsed-field gel electrophoresis (PFGE). Results: Of the 105 P aeruginosa strains identified, 45 (43%) were isolated from the patients hospitalized in intensive care units. Thirteen patients had repeated pseudomonas infection (total 38 infections/13 patients); 26 of these repeated infections in 9 patients showed the same localization. Half of the patients had at least 1 underlying disease such as burn (48%), chronic illness (32%), and malignancy (20%). Fifty-seven patients (71%) had urinary and/or other catheterization. Urinary tract infection (35 %) was the most frequent infection encountered, followed by respiratory tract infection (34%) and sepsis (13%). Resistance to the antibiotics tested was in the 12% to 88% range; amikacin was the most effective and ceftriaxone was the least effective antibiotic, The PFGE typing method showed that 28 of the 80 patients' isolates were clonally related, including 23 indistinguishable or closely related strains (29%), and 5 possibly related strains (6%). Epidemiologic data of the 16 patients (20% of the patients) confirmed a clonal relationship among the strains. Of the 26 isolates of the 9 patients having repeated infection in the same location, 18 (69%) were in the clonally related groups, whereas 11 of the 12 strains isolated from repeated infections on different body sites were clonally different. Conclusion: Our results indicated that P aeruginosa infections in our hospital mainly affected the patients hospitalized in intensive care units and those having catheterization, burn, and/or chronic illness. Amikacin was the best antibiotic as far as bacterial resistance was considered. Although lack of major PFGE type confirmed no P aeruginosa outbreak, typing results showed that cross transmission and treatment failure are the 2 main problems, which should be consider together to prevent this bacterial infection in medical centers.Öğe Comparative humoral response of mRNA and inactivated vaccines against COVID-19 in healthy adults aged 60 years and older(J Infection Developing Countries, 2023) Guvenir, Meryem; Yuruker, Ozel; Yetkin, Osman; Suer, Kaya; Otlu, BarisIntroduction: A vaccine against coronavirus disease 2019 (COVID-19) is critically needed for older adults because of the increased morbidity and mortality rates.Methodology: In this prospective study, we analysed the titre magnitude of the IgG antibodies directed against the SARS-CoV-2 Spike Protein S1 (S1-RBD) antigen in both CoronaVac and Pfizer-BioNTech groups. The samples were tested to detect antibodies that bind to the receptor -binding domain of the spike protein of SARS-CoV-2 using the Enzyme-Linked Immunosorbent Assay (ELISA) technique with SARS-CoV-2 IgG II Quant. The cut-off value was > 50 AU/mL. GraphPad Prism software was used. Statistical significance was defined atp < 0.05.Results: The CoronaVac group (12 females, 13 males) had a mean age of 69.64 +/- 1.38 years. The Pfizer-BioNTech group (13 males, 12 females) had a mean age of 72.36 +/- 1.44 years. The anti-S1-RBD titre decrease rate from the 1st to the 3rd month for CoronaVac and Pfizer-BioNTech groups was 74.31% and 86.48%, respectively. There was no statistically significant difference in the antibody titre between the 1st month and 3rd month for the CoronaVac group. However, there was a significant difference between the 1st and 3rd month in the Pfizer-BioNTech group. In addition, there was no statistically significant difference in the genders between the 1st and 3rd month of the antibody titres for both the CoronaVac Pfizer-BioNTech group.Conclusions: The levels of anti-S1-RBD, the preliminary outcome data of our study, represents one piece of the puzzle of humoral response and duration of vaccination protection.
