Browsing by Author "KAZAK, ESRA"
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Publication Antibody response to hepatitis B vaccination in isolated anti-Hbc IgG positive cases(Galenos Yayıncılık, 2012-08-01) Kazak, Esra; Yılmaz, Emel; Mıstık, Reşit; Akalın, Halis; Akgöz, Semra; Göral, Güher; KAZAK, ESRA; YILMAZ, EMEL; Mıstık, Reşit; AKALIN, EMİN HALİS; Göral, Güher; Uludağ Üniversitesi/Tıp Fakültesi/Enfeksiyon Hastalıkları ve Klinik Mikrobiyoloji Anabilim Dalı.; Uludağ Üniversitesi/Tıp Fakültesi/Tıbbi Mikrobiyoloji Anabilim Dalı.; 0000-0001-7530-1279; AAU-8952-2020; AAG-8459-2021; HTL-9425-2023; DFY-3761-2022; JGX-8396-2023Objective: We aimed to investigate the antibody response secondary to 1 dose of hepatitis B vaccine and factors affecting this response in isolated cases of anti-HBc IgG positive cases.Materials and Methods: Fortyone people who were positive for isolated anti-HBc and negative for other markers of hepatitis B were recruited in the study. The level of anti-HBs was measured at the 10th and 30th day after the administration of hepatitis B vaccine to these 41 people. HBV-DNA was searched with PCR in people who did not developed a secondary antibody response to one dose of vaccination at Day 10 and 30.Results: Anti-HBs was found to be at protective levels (>= 10 IU/mL) in 27 (65.8 %) out of 41 people included in the study. The antibody response developed in 27 people with one dose of vaccination was thought to be a secondary response, and the 14 people who did not form anti-HBs and were found to be negative for HBVDNA by PCR were thought to have false anti-HBc positivity and be inactive HBs Ag carriers (HBs Ag falling below the measurable level in time and presence of antiHBe or preS, S, precor, cor mutant strain infection). There was a highly significant correlation between antibody levels at Day 10 and Day 30 (p< 0.001). In addition, when the antibody levels of people who developed secondary response at Day 10 were investigated, antibody levels of non-smokers were found to be (0-1000 IU/mL; 194.3 +/- 327.2 IU/mL) significantly higher compared to smokers (0-70 IU/mL; 12 +/- 21.8 IU/mL) (p= 0.015). No statistically significant difference was determined between the antibody responses at Day 10 and Day 30 of people with a history of diabetes mellitus (DM), malignity, chronic diseases, alcohol consumption, previous HBsAg positivity and HBV-DNA positivity, anti-HCV positivity, and hepatitis B carriers in the family (p> 0.05).Conclusion: An anamnestic response is suggested in people who give anti-HBs response to one dose of hepatitis B vaccine. However, a false anti-HBc IgG positivity or undetectable levels of HBs Ag should be considered in people who do not give antibody response. According to our results smoking affects the level of antibody response negatively. But we need further studies involving more people.Publication Aspergillus infections in intensive care units: Before and after the COVID-19 pandemic(Bilimsel Tıp Yayınevi, 2022-01-01) Tüzemen, Nazmiye Ülkü; Önal, Uğur; Akalın, Emin Halis; Kazak, Esra; Heper, Yasemin; İşçimen, Remzi; Kelebek Girgin, Nermin; Yılmaz, Emel; Özakın, Cüneyt; Şöhret Kahveci, Ferda; Ener, Beyza; TÜZEMEN, NAZMİYE ÜLKÜ; ÖNAL, UĞUR; AKALIN, EMİN HALİS; KAZAK, ESRA; HEPER, YASEMİN; İŞÇİMEN, REMZİ; KELEBEK GİRGİN, NERMİN; YILMAZ, EMEL; ÖZAKIN, CÜNEYT; KAHVECİ, FERDA ŞÖHRET; ENER, BEYZA; Bursa Uludağ Üniversitesi/Tıp Fakültesi/Tıbbi Mikrobiyoloji Anabilim Dalı.; Bursa Uludağ Üniversitesi/Tıp Fakültesi/İnfeksiyon Hastalıkları ve Klinik Mikrobiyoloji Anabilim Dalı.; Bursa Uludağ Üniversitesi/Tıp Fakültesi/Anestezi ve Reanimasyon Anabilim Dalı.; 0000-0003-3544-3509; 0000-0001-6194-3254; 0000-0001-7530-1279; 0000-0002-5882-1632; 0000-0002-3894-1231; ACQ-7832-2022; AAU-8952-2020; JCO-3678-2023; A-4290-2018; CTY-9474-2022; DWL-9897-2022; GBC-7197-2022; HJZ-6992-2023; JKC-3728-2023; IMY-6211-2023; CNK-0895-2022Introduction: Aspergillus species have begun to cause invasive pulmonary aspergillosis (IPA) with increasing frequency in patients with known risk factors in intensive care units (ICU). An international multicenter cohort study (AspICU) established criteria for diagnosis of invasive pulmonary aspergillosis (IPA) in intensive care units. In our study, patients with Aspergillus spp. growth in deep tracheal aspirate (DTA) samples in ICU were evaluated according to AspICU criteria.Materials and Methods: This study is a retrospective study. DTA samples were collected from the Pandemic and Reanimation ICU and performed in the Medical Microbiology Laboratory by separated two periods; pre-pandemic (1 March 2019-31 December 2019) and post-pandemic (1 March 2020-31 December 2020). Cases with Aspergillus spp. growth in the DTA samples in the Pandemic ICU were evaluated as COVID 19 associated pulmonary aspergillosis (CAPA) according to AspICU criteria.Results: While Aspergillus spp. was grown in the DTA of three patients in 2019 and five patients in 2020 in the Reanimation ICU, and 11 patients in the Pandemic ICU. Growths belonging to one patient from both Reanimation (2019) and Pandemic ICUs were considered as colonization. Other growths were interpreted as IPA according to AspICU criteria. When the incidence rates according to 10000 patient days were compared, the incidence rate increased significantly in 2020 (19.1) (p< 0.001) compared to 2019 (3.4); In 2020, it was determined that it increased significantly in the Pandemic ICU (40.4) (p< 0.001) compared to Reanimation ICU (9.2).Conclusion: It should not be forgotten that intensive care patients are also at risk for IPA, especially after viral infections (such as COVID-19, Influenza). Although the incidence of IPA was not very high, it was observed that it tended to increase according to our study. The diagnosis of IPA is problematic, therefore it is necessary to increase awareness and sample diversity and to use biomarkers more widely other than hematology patients.Publication Evaluation of using empiric glycopeptides in accordance with the idsa guidelines in hematologic malignancy patients with febrile neutropenia(Mattioli 1885, 2022-05-01) Yalçın, Cumali; Özkalemkaş, Fahir; Özkocaman, Vildan; Ersal, Tuba; Pınar, İbrahim Ethem; Orhan, Bedrettin; Candar, Ömer; Çubukcu, Sinem; Koca, Tuba Güllü; Akyol, Merve Nur; Ada, Nevriye Gül; Özakın, Cüneyt; Kazak, Esra; Akalın, Halis; Ali, Rıdvan; YALÇIN, CUMALİ; ÖZKALEMKAŞ, FAHİR; ÖZKOCAMAN, VİLDAN; ERSAL, TUBA; PINAR, İBRAHİM ETHEM; ORHAN, BEDRETTİN; CANDAR, ÖMER; ÇUBUKÇU, SİNEM; GÜLLÜ KOCA, TÛBA; AKYOL, MERVE NUR; ADA, NEVRİYE GÜL; ÖZAKIN, CÜNEYT; KAZAK, ESRA; AKALIN, EMİN HALİS; ALİ, RIDVAN; Bursa Uludağ Üniversitesi/Tıp Fakültesi/İç Hastalıkları Anabilim Dalı/Hematoloji Bilim Dalı.; Bursa Uludağ Üniversitesi/Tıp Fakültesi/İç Hastalıkları Anabilim Dalı.; Bursa Uludağ Üniversitesi/Tıp Fakültesi/Mikrobiyoloji Anabilim Dalı.; Bursa Uludağ Üniversitesi/Tıp Fakültesi/Mikrobiyoloji ve Enfeksiyon Hastalıkları Anabilim Dalı.; 0000-0001-9907-1498; 0000-0003-4168-2821; 0000-0001-7530-1279; 0000-0003-3970-2344; 0000-0001-5428-3630; KIE-5102-2024; JIW-1248-2023; FQG-8981-2022; AAJ-4354-2021; JGM-6601-2023; ACW-2157-2022; EOZ-1609-2022; JJB-0254-2023; GWQ-5007-2022; JYC-2094-2024; GNJ-2469-2022; AAG-8392-2021; AAG-8459-2021; AAU-8952-2020; GXD-8209-2022Background: This study aimed to evaluate the effects of the appropriate use of empiric glycopeptide therapy in hematologic malignancy patients with febrile neutropenia (FN).Materials and Methods: Patients with FN who were hospitalized in our clinic and started empiric glycopeptide therapy were retrospectively analyzed. Empiric glycopeptide treatment initial indications were determined according to 7 specific criteria in the IDSA guidelines. In addition, the duration of glycopeptide use according to initial indications, causative pathogens in culture positivity, frequency of VRE infection, and the mortality rate was identified.Results: 87 patients were included. Of these, 102 episodes of FN were analyzed. Appropriate use of glycopeptides was observed in 98% of patients. The most common initial indication for glycopeptide was skin or soft-tissue infection, with 52% (n = 53). The mean duration of glycopeptide use was 11 (2-22) days. The time of glycopeptide use was longer in patients with catheter-related infections than in those with severe mucositis and hemodynamic instability (p = 0,041/p = 0,016). The duration of glycopeptide use was shorter in patients with consolidation therapy than in those without consolidation therapy. The mortality rate in culture-positive patients was significantly higher than in culture-negative patients (p = 0.041). At 72 h, glycopeptide therapy was discontinued in 8 of 79 FN episodes within culture-negative patients.Conclusion: This study showed that the mortality rate was higher in culture-positive patients. Additionally, glycopeptides should be discontinued early with no evidence of gram-positive infection.Publication Healthcare-associated stenotrophomonas maltophilia bacteraemia: Retrospective evaluation of treatment and outcome(Springernature, 2021-10-20) Tuncel, Tekin; Akalın, Halis; Payaslıoğlu, Melda; Yılmaz, Emel; Kazak, Esra; Heper, Yasemin; Özakın, Cüneyt; Tuncel, Tekin; AKALIN, EMİN HALİS; PAYASLIOĞLU, AYŞE MELDA; YILMAZ, EMEL; KAZAK, ESRA; HEPER, YASEMİN; ÖZAKIN, CÜNEYT; Bursa Uludağ Üniversitesi/Tıp Fakültesi/Enfeksiyon Hastalıkları ve Klinik Mikrobiyoloji Anabilim Dalı.; 0000-0001-7530-1279; 0000-0003-1785-3539; AAU-8952-2020; EBR-5383-2022; FQO-1207-2022; GDP-0005-2022; AAG-8459-2021; CTY-9474-2022; JNH-9929-2023IntroductionStenotrophomonas maltophilia (SM) is one of the common gram-negative pathogens that cause nosocomial infections. The aim of the present study is to evaluate the treatment and outcome of SM bacteraemia.Materials and MethodsWe retrospectively evaluated antimicrobial treatment in adult patients with nosocomial SM bacteraemia, with the 14th and 30th-day mortality as the outcome.ResultsIn total, 140 adult patients with SM bacteraemia who were diagnosed between January 1, 2002, and December 31, 2016 were enrolled in the present study. Seventy-one (50.7%) patients were in the intensive care unit (ICU). The 14th and the 30th-day mortality rates were 32.9% (n=46) and 45.7% (n=64), respectively. Female sex (OR, 7.47; 95% CI 1.61-34.47, p<0.01), steroid use within the last month (OR, 10.2; 95% CI 1.27-82.27, p=0.029), Pittsburgh bacteraemia score (PBS) >= 4 (OR, 39.9; 95% CI 4.96-321.32, p<0.001) and solid organ malignancy (OR, 9.6; 95% CI 1.73-53.72, p<0.01) were independent risk factors for 14th day mortality. Removal of the catheter was an independent protective factor for both 14th (OR, 0.05; 95% CI 0.22-0.010, p<0.001) and 30th day (OR, 0.039;95% CI 0.164-0.009, p<0.001) mortality. We did not detect any difference between treatment regimens including trimethoprim-sulfamethoxazole (TMP/SMX) or levofloxacin in terms of mortality. We found that TMP/SMX and levofloxacin combination did not significantly improve patient prognosis.ConclusionDue to the high mortality rates associated with nosocomial SM bacteraemia, adequate antibiotic therapy should be initiated immediately in the suspicion of infection, and prompt removal of any indwelling central venous catheter is important.Publication Impact of posaconazole prophylaxis and antifungal treatment on BAL GM performance in hematology malignancy patients with febrile neutropenia: A real life experience(Springer, 2023-10-16) Acet-Öztürk, Nilüfer Aylin; Ömer-Topcu, Dilara; Vurat Acar, Kübra; Aydın-Güçlü, Özge; Pınar, İbrahim Ethem; Demirdoğen, Ezgi; Görek-Dilektasli, Aslı; Kazak, Esra; Özkocaman, Vildan; Ursavaş, Ahmet; Özkalemkaş, Fahir; Ener, Beyza; Ali, Rıdvan; Akalın, Halis; ACET ÖZTÜRK, NİLÜFER AYLİN; ÖMER TOPÇU, DİLARA; VURAT ACAR, KÜBRA; AYDIN GÜÇLÜ, ÖZGE; PINAR, İBRAHİM ETHEM; DEMİRDÖĞEN, EZGİ; GÖREK DİLEKTAŞLI, ASLI; KAZAK, ESRA; ÖZKOCAMAN, VİLDAN; URSAVAŞ, AHMET; ÖZKALEMKAŞ, FAHİR; ENER, BEYZA; ALİ, RIDVAN; AKALIN, EMİN HALİS; Bursa Uludağ Üniversitesi/Tıp Fakültesi/Göğüs Hastalıkları Anabilim Dalı.; Bursa Uludağ Üniversitesi/Tıp Fakültesi/İç Hastalıkları Anabilim Dalı.; Bursa Uludağ Üniversitesi/Tıp Fakültesi/Hematoloji Anabilim Dalı.; Bursa Uludağ Üniversitesi/Tıp Fakültesi/Enfeksiyon Hastalıkları ve Klinik Mikrobiyoloji Anabilim Dalı.; Bursa Uludağ Üniversitesi/Tıp Fakültesi/Mikrobiyoloji Anabilim Dalı.; 0000-0002-6375-1472; 0000-0002-7400-9089; 0000-0001-7530-1279; AAI-3169-2021; JGM-6601-2023; Z-1424-2019; AAH-9812-2021; AAU-8952-2020; AAG-8459-2021; FRE-8778-2022; JQQ-5505-2023; GXD-8045-2022; JHW-9355-2023; FQG-8981-2022; JIW-1248-2023; CNK-0895-2022; GXD-8209-2022BackgroundDiagnostic accuracy of galactomannan measurements is highly variable depending on the study population, diagnostic procedures, and treatment procedures. We aimed to evaluate the effect of posaconazole prophylaxis and empiric antifungal treatment upon diagnostic accuracy of GM measurements in bronchoalveolar lavage (BAL), bronchial lavage (BL), and serum in hematological malignancy population.MethodsPatients hospitalized in a single tertiary care center with hematologic malignancies undergoing fiberoptic bronchoscopy (FOB) with a preliminary diagnosis of IPA were retrospectively included.ResultsIn all the study population (n = 327), AUC for BAL, BL, and serum GM were as follows: 0.731 [0.666-0.790], 0.869 [0.816-0.912], and 0.610 [0.540-0.676] with BL samples having the best diagnostic value. GM measurements in patients under posaconazole prophylaxis (n = 114) showed similar diagnostic performance. While specificity was similar between patients with and without posaconazole prophylaxis, sensitivity of GM measurements was lower in patients with prophylaxis. Analyses with patient classified according to antifungal treatment at the time of FOB procedure (n = 166) showed a decreased diagnostic accuracy in serum GM and BAL GM measurements related with the duration of treatment. However, BAL, BL, and serum GM measurements presented similar sensitivity and specificity in higher cut-off values in longer durations of antifungal treatment.ConclusionOur study shows that posaconazole prophylaxis and active short-term (3 days) antifungal treatment do not significantly affect overall diagnostic performance of GM measurements in bronchoalveolar lavage and bronchial lavage samples. However, using different cut-off values for patients receiving active treatment might be suggested to increase sensitivity.Publication Impact of revised EORTC/MSGERC 2020 criteria on diagnosis and prognosis of invasive pulmonary aspergillosis in patients with hematological malignancies undergoing bronchoscopy(Masson Editeur, 2022-06-14) Acet-Öztürk, N. A.; Ömer-Topcu, D.; Vurat-Acar, K.; Aydın-Güçlü, O.; Pınar, I. E.; Demirdoğen, E.; Görek-Dilektaşli, A.; Kazak, E.; Özkocaman, V; Ursavaş, A.; Akalın, H.; Özkalemkas, F.; Ener, B.; Ali, R.; ACET ÖZTÜRK, NİLÜFER AYLİN; ÖMER TOPÇU, DİLARA; VURAT ACAR, KÜBRA; AYDIN GÜÇLÜ, ÖZGE; PINAR, İBRAHİM ETHEM; DEMİRDÖĞEN, EZGİ; GÖREK DİLEKTAŞLI, ASLI; KAZAK, ESRA; ÖZKOCAMAN, VİLDAN; URSAVAŞ, AHMET; AKALIN, EMİN HALİS; ÖZKALEMKAŞ, FAHİR; ENER, BEYZA; ALİ, RIDVAN; Uludağ Üniversitesi/Tıp Fakültesi/Göğüs Hastalıkları Anabilim Dalı.; Uludağ Üniversitesi/Tıp Fakültesi/İç Hastalıkları Anabilim Dalı.; Uludağ Üniversitesi/Tıp Fakültesi/Hematoloji Anabilim Dalı.; Uludağ Üniversitesi/Tıp Fakültesi/Enfeksiyon Hastalıkları ve Klinik Mikrobiyoloji Anabilim Dalı.; Uludağ Üniversitesi/Tıp Fakültesi/Mikrobiyoloji Anabilim Dalı.; 0000-0001-9907-1498; 0000-0002-7380-2501; JII-3270-2023; FRE-8778-2022; GXC-7806-2022; GXD-8045-2022; JGM-6601-2023; JIA-5197-2023; CRM-4095-2022; CZK-6380-2022; JIR-6730-2023; AAI-3169-2021; EJJ-6847-2022; JIW-1248-2023; CNK-0895-2022; GXD-8209-2022Introduction: The first consensus definitions for invasive fungal diseases (IFD) were published in 2002. Advan-ces in diagnostic tests and a clear need for improvement in certain areas led to a revision of these definitions in 2008. However, growing data on Aspergillus galactomannan (GM) thresholds and the introduction of new polymerase chain reaction-based diagnostic tests resulted in a further update by EORTC and Mycoses Study Group Education and Research Consortium (MSGERC) in 2020. Compared to the 2008 version, the 2020 EORTC/MSGERC criteria have stricter definitions, especially regarding GM levels, which should lead to improved specificity. Thus, our study aimed to evaluate diagnostic changes, based on GM levels, resulting from these new definitions and ascertain the impact of the new classification on mortality rates. Method: Patients hospitalized in a single tertiary care center with hematologic malignancies and undergoing bronchoscopy for suspected IPA between April 2004 and December 2019 were included in this retrospective study. Results: The study population consisted of 327 patients with 31 patients (nine patients with proven IPA and 22 patients with no IPA) excluded from the study. 194 patients were classified as probable IPA cases according to 2008 EORTC/MSG criteria. However, 53 (27.3%) of these patients were re-classified as possible IPA according to 2020 EORTC/MSGERC criteria, due to novel galactomannan cut-off levels. Compared to re-classified possible IPA patients, those remaining in the probable IPA category experienced a higher incidence of septic shock (34.0% vs 16.9%, p=0.02), and required more non-invasive (12.0% vs 0.0%, p=0.004) and invasive (44.6 vs 24.5%, p=0.01) mechanical ventilation. There was a higher in-hospital mortality rate in probable IPA patients than in the re-clas-sified possible IPA group (42.5% vs 22.6%, p=0.01). Patients reassigned to possible IPA had similar underlying dis-eases, radiological features and prognosis to patients already classified as possible IPA. Independent risk factors for mortality were classification as probable IPA according to 2020 EORTC/MSGERC criteria, lack of remission from hematologic malignancy, and number of nodules in Thorax CT. Conclusion: The use of 2020 EORTC/MSGERC criteria resulted in a 27.3% significant reduction in probable IPA diagnoses and created a more homogeneous category of patients with respect to treatment response, prog-nosis and mortality. Therefore, 2020 EORTC/MSGERC criteria afford more reliable mortality prediction than 2008 EORTC/MSG criteria.(c) 2022 SFMM. Published by Elsevier Masson SAS. All rights reserved.Publication Impact of the revised EORTC/MSGERC 2020 criteria upon prognosis in patients with hematologic malignancies undergoing bronchoscopy(European Respiratory Soc Journals, 2021-09-05) Topcu, Dilara Omer; Acer, Kubra Vurat; Guclu, Ozge Aydin; Pinar, Ibrahim Ethem; Demirdogen, Ezgi; Dilektasli, Asli Gorek; Kazak, Esra; Ozkocaman, Vildan; Ursavas, Ahmet; Akalin, Halis; Ozkalemtas, Fahir; Ener, Beyza; Ali, Ridvan; Ozturk, Nilufer Aylin Acet; ACET ÖZTÜRK, NİLÜFER AYLİN; ÖMER TOPÇU, DİLARA; VURAT ACAR, KÜBRA; AYDIN GÜÇLÜ, ÖZGE; PINAR, İBRAHİM ETHEM; DEMİRDÖĞEN, EZGİ; GÖREK DİLEKTAŞLI, ASLI; KAZAK, ESRA; ÖZKOCAMAN, VİLDAN; URSAVAŞ, AHMET; AKALIN, EMİN HALİS; Ozkalemtas, Fahir; ENER, BEYZA; ALİ, RIDVAN; Bursa Uludağ Üniversitesi/Tıp Fakültesi/Göğüs Hastalıkları Anabilim Dalı.; Bursa Uludağ Üniversitesi/Tıp Fakültesi/İç Hastalıkları Anabilim Dalı.; Bursa Uludağ Üniversitesi/Tıp Fakültesi/Hematoloji Anabilim Dalı.; Bursa Uludağ Üniversitesi/Tıp Fakültesi/Enfeksiyon Hastalıkları ve Klinik Mikrobiyoloji Anabilim Dalı.; Bursa Uludağ Üniversitesi/Tıp Fakültesi/Tıbbi Mikrobiyoloji Anabilim Dalı.; 0000-0002-6375-1472; 0000-0003-1005-3205; 0000-0002-7400-9089; 0000-0001-7530-1279; 0000-0002-6375-1472; 0000-0003-1005-3205; 0000-0002-4803-8206; JGM-6601-2023; KHE-5423-2024; AAU-8952-2020; JPK-7012-2023; JWP-2738-2024; AAI-3169-2021; Z-1424-2019; JIF-7772-2023; CBS-8892-2022; AAG-9930-2019; CNP-1063-2022; AAG-8459-2021; FQG-8981-2022; FQJ-3657-2022; AAG-8523-2021; GXD-8209-2022Publication Invasive fungal infections in renal transplant recipients: Epidemiology and risk factors(Oxford Univ Press, 2015-05-01) Şahin, Sezin Zorlu; Akalın, Halis; YILDIZ, ABDULMECİT; KAZAK, ESRA; AKALIN, EMİN HALİS; Ersoy, Alparslan; ERSOY, ALPARSLAN; OCAKOĞLU, GÖKHAN; Ocakoğlu, Gökhan; Dizdar, Oğuzhan; Kazak, Esra; ENER, BEYZA; Ener, Beyza; Bursa Uludağ Üniversitesi/Tıp Fakültesi/Mikrobiyoloji Anabilim Dalı.; Bursa Uludağ Üniversitesi/Tıp Fakültesi/Nefroloji Anabilim Dalı.; Bursa Uludağ Üniversitesi/Tıp Fakültesi/Biyoistatistik Anabilim Dalı.; 0000-0001-7530-1279; 0000-0002-1114-6051; HLG-6346-2023; AAH-5180-2021; AAG-8459-2021; AAU-8952-2020; AAH-5054-2021; AAG-8523-2021; D-6213-2013Publication Propensity score and desirability of outcome ranking analysis of ertapenem for treatment of nonsevere bacteremic urinary tract infections due to extended-spectrum-beta-lactamase-producing enterobacterales in kidney transplant recipients(Amer Soc Microbiology, 2021-08-05) Gutierrez-Gutierrez, Belen; Perez-Nadales, Elena; Perez-Galera, Salvador; Fernandez-Ruiz, Mario; Carratala, Jordi; Oriol, Isabel; Cordero, Elisa; Antonio Lepe, Jose; Tan, Ban Hock; Corbella, Laura; Paul, Mical; Natera, Alejandra M.; David, Miruna D.; Montejo, Miguel; Iyer, Ranganathan N.; Pierrotti, Ligia Camera; Merino, Esperanza; Steinke, Seema Mehta; Rana, Meenakshi M.; Munoz, Patricia; Mularoni, Alessandra; van Delden, Christian; Grossi, Paolo Antonio; Seminari, Elena Maria; Günseren, Filiz; Lease, Erika D.; Roilides, Emmanuel; Fortun, Jesus; Arslan, Hande; Coussement, Julien; Tufan, Zeliha Kocak; Pilmis, Benoit; Rizzi, Marco; Loeches, Belen; Eriksson, Britt Marie; Abdala, Edson; Soldani, Fabio; Lowman, Warren; Clemente, Wanessa Trindade; Bodro, Marta; Carmen Farinas, Maria; Kazak, Esra; Martinez-Martinez, Luis; Maria Aguado, Jose; Torre-Cisneros, Julian; Pascual, Alvaro; Rodriguez-Bano, Jesus; KAZAK, ESRA; Bursa Uludağ Üniversitesi/Tıp Fakültesi/Enfeksiyon Hastalıkları ve Klinik Mikrobiyoloji Anabilim Dalı.; AAG-8459-2021There are scarce data on the efficacy of ertapenem in the treatment of bacteremia due to extended-spectrum-beta-lactamase (ESBL)-producing Enterobacterales (ESBL-E) in kidney transplant (KT) recipients. We evaluated the association between treatment with ertapenem or meropenem and clinical cure in KT recipients with nonsevere bacteremic urinary tract infections (B-UTI) caused by ESBL-E. We performed a registered, retrospective, international (29 centers in 14 countries) cohort study (INCREMENT-SOT, NCT02852902). The association between targeted therapy with ertapenem versus meropenem and clinical cure at day 14 (the principal outcome) was studied by logistic regression. Propensity score matching and desirability of outcome ranking (DOOR) analyses were also performed. A total of 201 patients were included; only 1 patient (treated with meropenem) in the cohort died. Clinical cure at day 14 was reached in 45/100 (45%) and 51/101 (50.5%) of patients treated with ertapenem and meropenem, respectively (adjusted OR 1.29; 95% CI 0.51 to 3.22; P = 0.76); the propensity score-matched cohort included 55 pairs (adjusted OR for clinical cure at day 14, 1.18; 95% CI 0.43 to 3.29; P = 0.74). In this cohort, the proportion of cases treated with ertapenem with better DOOR than with meropenem was 49.7% (95% CI, 40.4 to 59.1%) when hospital stay was considered. It ranged from 59 to 67% in different scenarios of a modified (weights-based) DOOR sensitivity analysis when potential ecological advantage or cost was considered in addition to outcome. In conclusion, targeted therapy with ertapenem appears as effective as meropenem to treat nonsevere B-UTI due to ESBL-E in KT recipients and may have some advantages.Publication Risk factors for occupational brucellosis among veterinary personnel in turkey(Elsevier Science Bv, 2014-11-01) Kutlu, Murat; Ergonul, Onder; Sayin-Kutlu, Selda; Guven, Tumer; Ustun, Cemal; Alp-Cavuş, Sema; Öztürk, Şerife Baron; Acicbe, Özlem; Akalın, Şerife; Tekin, Recep; Tekin-Koruk, Suda; Demiroğlu, Yusuf Ziya; Keskiner, Ramazan; Gönen, Ibak; Sapmaz-Karabağ, Sevil; Boşnak, Vuslat; Kazak, Esra; KAZAK, ESRA; Bursa Uludağ Üniversitesi/Tıp Fakültesi; AAG-8459-2021Veterinarians and veterinary technicians are at risk for occupational brucellosis. We described the risk factors of occupational brucellosis among veterinary personnel in Turkey. A multicenter retrospective survey was performed among veterinary personnel who were actively working in the field. Of 712 veterinary personnel, 84(11.8%) had occupational brucellosis. The median number of years since graduation was 7 (interquartile ranges [IQR], 4-11) years in the occupational brucellosis group, whereas this number was 9 (IQR, 4-16) years in the non-brucellosis group (p < 0.001). In multivariable analysis, working in the private sector (odds ratio [OR], 2.8; 95% confidence interval [95% CI], 1.55-5.28, p = 0.001), being male (OR, 4.5; 95% CI, 1.05-18.84, p = 0.041), number of performed deliveries (OR, 1.01; 95% CI, 1.002-1.02, p = 0.014), and injury during Brucella vaccine administration (OR, 5.4; 95% CI, 3.16-9.3, p < 0.001) were found to be risk factors for occupational brucellosis. We suggest that all veterinary personnel should be trained on brucellosis and the importance of using personal protective equipment in order to avoid this infection. (C) 2014 Elsevier B.V. All rights reserved.Publication The distribution of mature and/or immature myeloid cells and their role in effective anti-viral immune responses in COVID-19 positive patients(Wiley, 2021-08-01) Ermiş, Diğdem Yöyen; Dömbaz, Fatma; Karaçay, Mehmet; Etgü, Onur; Kızmaz, Muhammed Ali; Şimşek, Abdurrahman; Çağan, Eren; Aşan, Ali; Yılmaz, Emel; Kazak, Esra; Pınar, İbrahim Ethem; Bal, Salih Haldun; Arslan, Gözde; Karaca, Mert; Özkocaman, Vildan; Özkalemtaş, Fahir; Akalın, Emin Halis; Budak, Ferah; Oral, Haluk Barbaros; YÖYEN ERMİŞ, DİĞDEM; Dombaz, Fatma; Karaçay, Mehmet; Etgü, Onur; Kızmaz, Muhammed Ali; ŞİMŞEK, ABDURRAHMAN; YILMAZ, EMEL; KAZAK, ESRA; PINAR, İBRAHİM ETHEM; BAL, SALİH HALDUN; Arslan, Gözde; KARACA, MERT; ÖZKOCAMAN, VİLDAN; Özkalemtaş, Fahir; AKALIN, EMİN HALİS; BUDAK, FERAH; ORAL, HALUK BARBAROS; Bursa Uludağ Üniversitesi/Tıp Fakültesi/İmmünoloji Ana Bilim Dalı.; Bursa Uludağ Üniversitesi/Sağlık Bilimleri Enstitüsü.; Bursa Uludağ Üniversitesi/Tıp Fakültesi/Rasit Durusoy Kan Bankası.; Bursa Uludağ Üniversitesi/Tıp Fakültesi/Hemotoloji Anabilim Dalı.; Bursa Uludağ Üniversitesi/Tıp Fakültesi/Enfeksiyon Hastalıkları ve Klinik Mikrobiyoloji Anabilim Dalı.; 0000-0001-7288-3250; 0000-0001-5334-7911; 0000-0001-8850-0269; 0000-0002-8856-7356; 0000-0003-1785-3539; 0000-0001-7530-1279; 0000-0001-7625-9148; 0000-0003-0463-6818; KHE-5423-2024; AAU-8952-2020; HKN-2347-2023; JGM-6601-2023; JFS-2013-2023; AAG-7381-2021; K-7285-2012; IZP-9398-2023; F-4657-2014; JWP-2738-2024; GYL-2038-2022; DWR-5356-2022; CXY-4200-2022; CPT-2053-2022; GDP-0005-2022; AAG-8459-2021; FQJ-3657-2022; FQG-8981-2022Publication Two cases of zika virus disease diagnosed after traveling to cuba(Doc Design Informatics Co Ltd, 2019-04-01) Mistik, Resit; Menemenlioğlu, Dilek; Şimsek, Sümeyra; Kazak, Esra; KAZAK, ESRA; Bursa Uludağ Üniversitesi/Tıp Fakültesi/Enfeksiyon Hastalıkları anabilim Dalı.Zika virus, is an arbovirus belonging to the Flavivirus genus first isolated from a Rhesus monkey in 1947 in Uganda. It is mainly transmitted by mosquitoes of Aedes genus. Most common signs and symptoms are fever, fatigue, headache, and rash. In this report, we report two cases of Zika virus disease with diffuse artralgias, maculopapular rash, and fatigue symptoms developing after traveling to Cuba. In the literature there were no cases of Zika virus disease reported from our country, and these are considered the first cases in Turkey.Publication Update on treatment options for spinal brucellosis(Wiley-blackwell, 2014-02-01) Ulu-Kılıç, A.; Karakas, A.; Erdem, H.; Türker, T.; İnal, A. S.; Ak, O.; Turan, H.; İnan, A.; Duygu, F.; Demiraslan, H.; Kader, C.; Sener, A.; Dayan, S.; Deveci, O.; Tekin, R.; Saltoğlu, N.; Aydın, M.; Horasan, E. S.; Gül, H. C.; Ceylan, B.; Kadanalı, A.; Karabay, O.; Karagoz, G.; Kayabaş, U.; Turhan, V.; Engin, D.; Gülsün, S.; Elaldı, N.; Alabay, S.; Kazak, E.; KAZAK, ESRA; Bursa Uludağ Üniversitesi/Tıp Fakültesi; AAG-8459-2021We evaluated the efficacy and tolerability of antibiotic regimens and optimal duration of therapy in complicated and uncomplicated forms of spinal brucellosis. This is a multicentre, retrospective and comparative study involving a total of 293 patients with spinal brucellosis from 19 health institutions. Comparison of complicated and uncomplicated spinal brucellosis was statistically analysed. Complicated spinal brucellosis was diagnosed in 78 (26.6%) of our patients. Clinical presentation was found to be significantly more acute, with fever and weight loss, in patients in the complicated group. They had significantly higher leukocyte and platelet counts, erythrocyte sedimentation rates and C-reactive protein levels, and lower haemoglobulin levels. The involvement of the thoracic spine was significantly more frequent in complicated cases. Spondylodiscitis was complicated, with paravertebral abscess in 38 (13.0%), prevertebral abscess in 13 (4.4%), epidural abscess in 30 (10.2%), psoas abscess in 10 (3.4%) and radiculitis in 8 (2.7%) patients. The five major combination regimens were: doxycycline 200mg/day, rifampicin 600mg/day and streptomycin 1g/day; doxycycline 200mg/day, rifampicin 600mg/day and gentamicin 5mg/kg; doxycycline 200mg/day and rifampicin 600mg/day; doxycycline 200mg/day and streptomycin 1g/day; and doxycycline 200mg/day, rifampicin 600mg/day and ciprofloxacin 1g/day. There were no significant therapeutic differences between these antibiotic groups; the results were similar regarding the complicated and uncomplicated groups. Patients were mostly treated with doxycycline and rifampicin with or without an aminoglycoside. In the former subgroup, complicated cases received antibiotics for a longer duration than uncomplicated cases. Early recognition of complicated cases is critical in preventing devastating complications. Antimicrobial treatment should be prolonged in complicated spinal brucellosis in particular.