Browsing by Author "Kinikli, Sami"
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Article Citation Count: 8The Effects of Antimicrobial Resistance and the Compatibility of Initial Antibiotic Treatment on Clinical Outcomes in Patients With Diabetic Foot Infection(Sage Publications inc, 2023) Saltoglu, Nese; Surme, Serkan; Ezirmik, Elif; Kadanali, Ayten; Kurt, Ahmet Furkan; Sahin Ozdemir, Meryem; Kinikli, SamiWe aimed to determine pathogen microorganisms, their antimicrobial resistance patterns, and the effect of initial treatment on clinical outcomes in patients with diabetic foot infection (DFI). Patients with DFI from 5 centers were included in this multicenter observational prospective study between June 2018 and June 2019. Multivariate analysis was performed for the predictors of reinfection/death and major amputation. A total of 284 patients were recorded. Of whom, 193 (68%) were male and the median age was 59.9 +/- 11.3 years. One hundred nineteen (41.9%) patients had amputations, as the minor (n = 83, 29.2%) or major (n = 36, 12.7%). The mortality rate was 1.7% with 4 deaths. A total of 247 microorganisms were isolated from 200 patients. The most common microorganisms were Staphylococcus aureus (n = 36, 14.6%) and Escherichia coli (n = 32, 13.0%). Methicillin resistance rates were 19.4% and 69.6% in S aureus and coagulase-negative Staphylococcus spp., respectively. Multidrug-resistant Pseudomonas aeruginosa was detected in 4 of 22 (18.2%) isolates. Extended-spectrum beta-lactamase-producing Gram-negative bacteria were detected in 20 (38.5%) isolates of E coli (14 of 32) and Klebsiella spp. (6 of 20). When the initial treatment was inappropriate, Klebsiella spp. related reinfection within 1 to 3 months was observed more frequently. Polymicrobial infection (p = .043) and vancomycin treatment (p = .007) were independent predictors of reinfection/death. Multivariate analysis revealed vascular insufficiency (p = .004), hospital readmission (p = .009), C-reactive protein > 130 mg/dL (p = .007), and receiving carbapenems (p = .005) as independent predictors of major amputation. Our results justify the importance of using appropriate narrow-spectrum empirical antimicrobials because higher rates of reinfection and major amputation were found even in the use of broad-spectrum antimicrobials.Conference Object Citation Count: 0Evaluation of Infectious Diseases in Pregnant Women(Aves, 2020) Tülek, Necla; Tulek, Necla; Kinikli, Sami; Erdinc, Fatma Sebnem; Ataman-Hatipoglu, Cigdem; Tuncer-Ertem, Gunay; Cesur, Salih; Basic SciencesObjective: In this study, we aimed to investigate the infections and their clinical outcomes in pregnant women who were hospitalized with a diagnosis of any infectious disease. Methods: Distribution of bacterial and viral infections in 60 pregnant women who were hospitalized due to any infectious disease between years 2015 and 2018 during a three-year period were evaluated retrospectively. Results: Urinary tract infections (65%) and gastroenteritis (8.3%) were the most common bacterial infections, and human immunodefficiency virus (HIV) infection and chickenpox were most common viral infections. All patients were followed at the inpatient clinic except two patients who had hospitalized in intensive care unit due to influenza and Listeria meningitis. An HIV-positive pregnant woman received zidovudin intrapartum and was followed up later. All the other infections recovered without complications. Conclusions: Urinary tract infection was the most common infectious disease among pregnant women. The necessity of hospitalization due to community-acquired but avoidable and vaccine-preventable diseases verified that informing pregnant women about the prevention of infections and screening them before pregnancy against vaccine-preventable diseases.Article Citation Count: 0Investigation of SARS-CoV-2 antibody levels after COVID-19 vaccine in chronic hepatitis B patients(Aepress Sro, 2024) Dursun, Ali Doğan; Afsar, Fatma Elcin; Afşar, Fatma Elçin; Aksoy, Altan; Karahan, Gizem; Cesur, Salih; Urtimur, Ufuk; Basic SciencesAIM: The aim was to compare SARS-CoV-2 IgG antibody levels in chronic hepatitis B patients and healthcare personnel selected as the control group and to determine factors such as age, gender, vaccine type, and number of vaccines that may affect the antibody levels. MATERIALS AND METHODS: 87 chronic hepatitis B (CHB) patients followed in Ankara Training and Research Hospital Infectious Diseases Clinic and Mamak State Hospital Infectious Diseases outpatient clinic and 89 healthcare personnel selected as the control group were included in the study. SARS-CoV-2 IgG antibody levels in the serum samples of patients and healthcare personnel who received the COVID-19 vaccine were studied with the ELISA method in the Microbiology Laboratory of Ankara Training and Research Hospital, using a commercial ELISA kit (Abbott, USA) in line with the recommendations of the manufacturer. In the study, SARS-CoV-2 IgG levels were compared in CHB patients and healthcare personnel. In addition, the relationship between SARS-CoV-2 antibody level, gender, average age, natural history of the disease, number of vaccinations, vaccine type (Coronavac TM vaccine alone, BNT162b2 vaccine alone or Coronavac TM and BNT162b2 vaccine (heterologous vaccination)), treatment duration of CHB was investigated. Statistical analyses were made in the SPSS program. A value of p <= 0.05 was considered statistically significant. FINDINGS: A total of 167 people, including 87 CKD patients and 80 healthcare personnel as the control group, were included in the study. SARS-CoV-2 IgG antibody levels were detected above the cut-off level in the entire study group, regardless of the vaccine type. No difference was detected in SARS-CoV-2 IgG titers after COVID-19 vaccination between CHB patients and healthcare personnel. There was a statistically significant difference in SARS-CoV-2 IgG antibody levels among individuals participating in the study according to vaccine types. Compared to those who received Coronavac TM vaccine alone, the average SARS-CoV-2 IgG level was found to be statistically significantly higher in those who received BNT162b2 vaccine alone or heterologous vaccination with Coronavac TM + BNT162b2 vaccine. There was no difference between the groups in terms of age, gender, number of vaccinations, natural transmission of the disease, and duration of antiviral therapy in the CHD patient group. CONCLUSION: As a result, SARS-CoV-2 IgG antibody levels above the cut-off value were achieved with Coronavac TM and BNT162b2 vaccines in both CHD patients and healthy control groups. however, both CHD patients and healthcare personnel had higher antibody levels than those who received BNT162b2 alone or those who received heterologous vaccination had higher antibody levels than those with Coronavac TM alone. Therefore, if there are no contraindications, BNT162b2 vaccine may be preferred in CHB and health personnel (Tab. 2, Ref. 14) .Article Citation Count: 0Retrospective Evaluation of Potential Rabies Exposure Cases Over Nine Years: Single-Center Experience(Bilimsel Tip Yayinevi, 2024) Tülek, Necla; Kilic, Esra Kaya; Tulek, Necla; Kinikli, Sami; Bulut, Cemal; Basic SciencesIntroduction: T & uuml;rkiye is the only European country where suspected rabies exposure from animal contact is a significant public health concern. In this study, we evaluate cases investigated in our vaccination center, where individuals with suspected rabies exposure have been seeking consultation for many years. The evaluation encompasses demographic characteristics, distribution by years and seasons, the type of animal involved in the contact, the prevalence of stray animals, and the rabies vaccination status of owned animals. Materials and Methods: The study involves cases reported to the Public Health Center from those who sought consultation at our center between January 1, 2011, and December 31, 2019. Demographic characteristics, distribution by years and seasons, the type of animal involved in the contact, the prevalence of stray animals, and the rabies vaccination status of owned animals were retrospectively evaluated. Results: Over the nine years, there were a total of 39.731 cases, resulting in an average of 4414 cases per year. Of these cases, 61% were male, and 68.83% were between the ages of 15 and 64. The most cases occurred in summer and autumn. Of the suspected rabies contacts, 69% involved dogs, and 83.4% of these dogs were unowned. Forty-one point eight percent of the owned dogs were vaccinated. Eighty-nine point six percent of the cats were unowned, and the rate of vaccination among the owned cats was 28.2%. Over the years, there has been a decrease in the use of the 10 -day observation approach, while an increase in the administration of rabies vaccine and/or immunoglobulin has been observed. Conclusion: Seventy percent of all risky rabies contacts involve dogs, with a high rate of 84% of these dogs being unowned. To mitigate contact involving the risk of rabies, addressing the uncontrolled reproduction of stray animals, particularly dogs, and ensuring control and vaccination of the existing animal population appear to be primary measures. Improving the vaccination rate of owned animals, currently at only 30-40%, can prevent people from encountering risky rabies contacts, thereby potentially reducing the need for rabies prophylaxis significantly.Article Citation Count: 17Risk factors for linezolid-associated thrombocytopenia and negative effect of carbapenem combination(J infection developing Countries, 2019) Kilic, Esra Kaya; Bulut, Cemal; Sonmezer, Meliha Cagla; Ozel, Ozlem; Hatipoglu, Cigdem Ataman; Ertem, Gunay Tuncer; Kinikli, SamiIntroduction: Linezolid is a synthetic antimicrobial agent with a broad spectrum of activity against virtually all Gram-positive bacteria. Although linezolid is generally well tolerated, the prolonged use of linezolid can lead to myelosuppression, including neutropenia, thrombocytopenia, and anemia. The aim of this study was investigating the risk factors for thrombocytopenia in patients who received linezolid therapy. Methodology: This retrospective study was performed on patients who received linezolid therapy between July 2007 and December 2017. Thrombocytopenia was defined as either a platelets count of < 100x10(9)/L or a 25% reduction from the baseline platelet count. Results: A total of 371 patients, (198 (53%) male and 173(47%) female were included into the study. Mean duration of therapy was 12.81 +/- 5.19 days. Linezolid-induced thrombocytopenia was detected in a total of 111 patients. Using the univariate analysis advanced sex, serum urea concentration, baseline platelet level and low eGFR value were found to be risk factors for linezolid associated thrombocytopenia (p < 0.05). According to a multivariate analysis, patients undergoing carbapenem treatment combination therapy (p = 0.003) and with a baseline platelet level of < 200x10(9)/L (p = 0.00) were found to have a high risk of developing thrombocytopenia. Conclusions: Several factors may influence of linezolid associated thrombocytopenia. Platelet count should be monitored during therapy and thrombocytopenia should be kept in mind in patients with baseline platelet level of < 200x10(9)/L, low eGFR, linezolid-carbapenem combination therapy.