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Article Investigation of Tetanus Seropositivity Levels in Adult Patients with Rabies Risk Exposure Admitted To a Hospital in Ankara(J Infection Developing Countries, 2025) Gurkaynak, Pinar; Demircan, Serife A.; Tulek, Necla; Kinikli, Sami; Erdinc, Fatma S.; Tuncer, GunayIntroduction: This study aimed to assess tetanus seropositivity levels among adult patients admitted to a tertiary care hospital following rabies risk exposure, and to explore potential factors influencing their immunological status. Methodology: This cross-sectional descriptive epidemiological study included 182 adult individuals (68 females and 114 males) who presented to the hospital following rabies risk exposure. The demographic data was collected during a face-to-face interview, and the tetanus antibody concentrations were assessed using a micro-enzyme-linked immunosorbent assay (ELISA) kit. Serum antibody levels of >= 0.1 IU/mL were defined as "seropositive", while values below this threshold were considered "seronegative". Results: Seropositivity was identified in 81.9% of the patients. There was a significant decline in antibody levels with age (p < 0.001). The Spearman correlation analysis showed a moderately significant negative correlation between age and antibody titers (r = - 0.404, p < 0.001). In addition, there were significantly higher tetanus antibody levels in patients from urban areas, those vaccinated during pregnancy, and those vaccinated within the past 10 years (p = 0.025, 0.036, and 0.013, respectively). Conclusions: Overall, the results highlight a reduction in tetanus antibody levels with age, emphasizing the importance of receiving a booster dose every 10 years. In addition, rabies risk exposure, particularly in older adults, presents a valuable opportunity to administer tetanus vaccination.Article Citation - WoS: 29Citation - Scopus: 33Risk 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, Sami; Tuncer Ertem, Günay; Ataman Hatipoğlu, Çiğdem; Kaya Kılıç, EsraIntroduction: 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.Article Investigation of Sars-Cov Antibody Levels After Covid-19 Vaccine in Chronic Hepatitis B Patients(Aepress Sro, 2024) Kinikli, Sami; Afsar, Fatma Elcin; Dursun, Ali Dogan; Aksoy, Altan; Karahan, Gizem; Cesur, Salih; Urtimur, UfukAIM: 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 - WoS: 21Citation - Scopus: 21The 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.
