Person: TÜZEMEN, NAZMİYE ÜLKÜ
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TÜZEMEN
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NAZMİYE ÜLKÜ
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Publication Evaluation of serum indirect haemagglutination test results of suspected cystic echinococcosis cases from 2009-2017(Pakistan Medical Assoc, 2022-06-01) Tuzemen, Nazmiye Ulku; Alver, Oktay; Ozakin, Cuneyt; Ener, Beyza; Tuzemen, Nazmiye Ulku; TÜZEMEN, NAZMİYE ÜLKÜ; Alver, Oktay; ALVER, OKTAY; Ozakin, Cuneyt; ÖZAKIN, CÜNEYT; Ener, Beyza; ENER, BEYZA; Tıp Fakültesi; Mikrobiyoloji Ana Bilim Dalı; A-4290-2018Objective: This study aims to evaluate the serological, radiological and epidemiological analysis of suspected cystic echinococcosis patients, and to assess the positivity rate in the region. Method: The retrospective study was conducted at Bursa Uludag University Hospital, Turkey and comprised data from January 2009 to December 2017 related to patients of either gender with suspected cystic echinococcosis who underwent indirect haemagglutination testing. Demographic and clinical data of patients who tested positive were analysed. Statistical analysis was done using SPSS 23. Results: Of the 3910 patients with a mean age of 41.6 +/- 19.35 years (range: 0-93 years) who underwent indirect haemagglutination testing, 692(17.7%) tested positive; 390(56.4%) females, and 302(43.6%) males. The highest seropositivity rate 107(15.5%) was observed in 2011, followed by 104(15%) in 2016. Seropositive cases were predominantly seen in those aged 40-49 years 131 (18.9%), followed by those aged 50-59 years 124 (17.9%). Conclusion: Cystic echinococcosis was found to be a public health problem in South Marmara region of Turkey.Publication Investigation of parasitic infection rate in stool samples submitted to uludag university parasitology laboratory between 2011-2015(Bilimsel Tip Yayinevi, 2017-01-01) Tüzemen, Nazmiye Ülkü; TÜZEMEN, NAZMİYE ÜLKÜ; Alver, Oktay; Ener, Beyza; ENER, BEYZA; ALVER, OKTAY; Tıp Fakültesi; Tıbbi Mikrobiyoloji Ana Bilim Dalı; 0000-0003-3544-3509; AAA-5241-2021; A-4290-2018; AAG-8523-2021Introduction: Intestinal parasitic infections are among the most significant causes of morbidity and mortality in undeveloped countries, particularly in children. These infections may cause loss in physical and mental progress of children in particular, and loss of work and labour force in adults.Materials and Methods: In this study, patients who applied with various gastrointestinal complaints to the clinics of the Uludag University Medical Faculty, were thoroughly investigated for the presence of intestinal parasites. A total of 8981 stool and 854 cellophane tape samples were parasitologically evaluated. All stool samples were prepared using formal-ethyl acetate concentration method for helminth ova and protozoan cysts, and examined in lugol preparations microscopically with 10x and 40x magnifications. Preparations were examined by using oil-immersion objectives (100x) following trichrome and modified Erlich-Ziehl-Nielsen staining for the diagnosis of intestinal and coccidian protozoa, respectively. For the detection of Entamoeba histolytica adezin antigen in stools, commercial ELISA kit (Wampole (R) E. histolytica II Test Kit; TechLab, USA) was used.Results: In this study, one or more parasites were found in 327 (3.6%) of the 8981 stool samples (including nonpathogenic protozoa). Enterobius vermicularis eggs were detected in 29 (3.4%) out of 854 samples by using the cellophane tape method. Of the parasite detected cases, 165 (50.5%) were female and 162 (49.5%) were male. Giardia intestinalis (0.9%) and E. vermicularis (3.4%) were the most frequently detected protozoon and helmint parasites, respectively. The parasites were detected mostly in summer months (26.3%).Conclusion: Although the prevalence rates of intestinal parasites were lower than those in the previous studies carried out in the city, it is seen that the presence of intestinal parasites is still a serious public health problem in our region.Publication Evaluation of the combination treatments with intravenous fosfomycin for carbapenem-resistant Klebsiella pneumoniae(Assoc Medica Brasileira, 2023-01-01) ÖNAL, UĞUR; Tüzemen, Nazmiye Ülkü; TÜZEMEN, NAZMİYE ÜLKÜ; Kaya, Pınar Küçükdemirci; KELEBEK GİRGİN, NERMİN; KÜÇÜKDEMİRCİ KAYA, PINAR; İŞÇİMEN, REMZİ; ÖZAKIN, CÜNEYT; Özakın, Cüneyt; Kahveci, Ferda Şöhret; KAHVECİ, FERDA ŞÖHRET; Akalın, Halis; AKALIN, EMİN HALİS; Tıp Fakültesi; Mikrobiyoloji Ana Bilim Dalı; 0000-0003-3544-3509; 0000-0002-8428-8245; 0000-0002-5882-1632; 0000-0001-7530-1279; JCO-3678-2023; AAU-8952-2020; A-4290-2018OBJECTIVE: The aim of this study was to evaluate the combination treatments with intravenous fosfomycin for carbapenem-resistant Klebsiella pneumoniae infections in a tertiary-care center.METHODS: Between December 24, 2018 and November 21, 2022, adult patients diagnosed with bloodstream infection or ventilator-associated pneumonia due to culture-confirmed carbapenem-resistant Klebsiella pneumoniae in the anesthesiology and reanimation intensive care units were investigated retrospectively.RESULTS: There were a total of 62 patients fulfilling the study inclusion criteria. No significant difference was recorded in 14-and 30-day mortality among different types of combination regimens such as fosfomycin plus one or two antibiotic combinations. Hypokalemia (OR:5.651, 95%CI 1.019- 31.330, p=0.048) was found to be a significant risk factor for 14-day mortality, whereas SOFA score at the time of diagnosis (OR:1.497, 95%CI 1.103- 2.032, p=0.010) and CVVHF treatment (OR:6.409, 95%CI 1.395-29.433, p=0.017) were associated with 30-day mortality in multivariate analysis.CONCLUSION: In our study, high mortality rates were found in patients with bloodstream infection or ventilator-associated pneumonia due to carbapenem-resistant Klebsiella pneumoniae, and no significant difference was recorded in 14-and 30-day mortality among different types of combination regimens such as fosfomycin plus one or two antibiotic combinations.Publication Retrospective evaluation of colistin-resistant isolates in automated system by gradient diffusion method and broth microdilution method(Doc Design Informatics, 2019-04-01) Efe, Kadir; Tüzemen, Nazmiye Ülkü; TÜZEMEN, NAZMİYE ÜLKÜ; Akalın, Halis; AKALIN, EMİN HALİS; Özakın, Cüneyt; ÖZAKIN, CÜNEYT; Tıp Fakültesi; Tıbbi Mikrobiyoloji Ana Bilim Dalı; 0000-0003-3544-3509; 0000-0001-7530-1279; A-4290-2018; AAU-8952-2020; AAG-8392-2021Objective: Optimizing colistin susceptibility testing has difficulties because of its high molecular weight and high binding capacity to polystyrene which is frequently used in antibiotic susceptibility testing. We aimed to compare the results of isolates, which were detected as colistin-resistant in the automated system, obtained by using broth microdilution (BMD) method which is the gold standard, with gradient diffusion method (GDM).Methods: We investigated 36 Klebsiella pneumoniae, 9 Acinetobacter baumannii and 5 Pseudomonas aeruginosa isolates, identified by the Phoenix (TM) 100 (Becton Dickinson, Sparks, MD, USA) automated system, isolated from various clinical specimens sent to the Central Microbiology Laboratory between August 2016 and April 2017. The susceptibility of the isolates was also tested by GDM and BMD method.Results: When the colistin resistance rates obtained from the gold standard BMD method were compared with the automated method, the categorical agreement (CA) rate of the automated system was 92% for all isolates, 100% for K. pneumoniae, 77.8% for A. baumannii, and 60% for P. aeruginosa. The very major error (VME) rate was 0%, and the major error (ME) rate was 8% for all isolates. When GDM was used for all isolates, CA was found to be 20% for all isolates, 16.7% for K. pneumoniae, 22.2% for P. aeruginosa and 40% for A. baumannii. VME was found to be 80%, and ME was %0 for all isolates.Conclusions: CA, VME and ME rates of Phoenix (TM) 100 for detecting colistin resistance is within acceptable limits according to ISO 20776 standard, but the rates of GDM is not suitable for this purpose.Publication Mycoplasma hominis and ureaplasma urealyticum: Their role in urogenital system infections and retrospective evaluation of antibiotic resistance rates(Aves, 2019-04-01) Tuüzemen, Nazmiye Ülkü; Efe, Kadir; Özakın, Cüneyt; TÜZEMEN, NAZMİYE ÜLKÜ; ÖZAKIN, CÜNEYT; Tıp Fakültesi; Tıbbi Mikrobiyoloji Ana Bilim Dalı; 0000-0003-3544-3509; A-4290-2018; AAG-8392-2021Objective: Mycoplasma hominis and Ureaplasma urealyticum are opportunistic pathogens which can frequently be isolated from genitourinary tracts of humans. The aim of this study was to evaluate the presence, epidemiologic features and antibiotic susceptibility of M. hominis and U. urealyticum agents in urine specimens which were sent from various clinics of Uludag University, Hospital of Health Application and Research Center for diagnosis of genitourinary system infection.Methods: Urinary specimen results of M. hominis and U. urealyticum were retrospectively reviewed between January 2015 and December 2016 in our hospital. Urinary specimens were examined using Mycoplasma IES (Autobio Diagnostics, Zhengzhou, People's Republic of China) in 2015 and Biosynex (R) Mycoplasmatest (Biosynex, Illkirch-Graffenstaden, France) in 2016 for the identification of M. hominis and U. urealyticum. Simultaneous urine culture and complete urinalysis results were compared with results of M. hominis and U. urealyticum.Results: In our study, we evaluated 5852 samples of 2926 patients comprising 67.43% females and 32.57% males for detection of M. hominis and U. urealyticum in urine. While U. urealyticum, and M. hominis were detected in 22.25% (651/2926) and 1.23% (36/2926) of the samples, respectively; coinfection was detected in 3.79% (111/2926). M. hominis and/or U. urealyticum positivity (n=798/2926) were found to be 32.12% in women and 11.02% in men. Resistance rates of M. hominis according to sex were found to be higher in women for ciprofloxacin and a statistically significant difference was found (chi(2)=4.336, p=0.037).Conclusions: As there was no growth in routine urine cultures of about half of the M. hominis and/or U. urealyticum-positive patients, it is recommended to consider the presence of urogenital M. hominis and U. urealyticum infections for treatment and to use laboratory tests for the diagnosis of these agents especially in the presence of risky conditions such as pregnancy.Publication An outbreak of Ralstonia insidiosa bloodstream infections caused by contaminated heparinized syringes(Elsevier, 2022-08-05) Tüzemen, Nazmiye Ulkü; Önal, Uğur; Kazak, Esra; Tezgeç, Nergiz; Eren, Hale; Şimşek, Hüsniye; Bakkaloğlu, Zekiye; Ünaldı, Özlem; Çelebi, Solmaz; Yılmaz, Emel; Hacımustafaoğlu, Mustafa; Akalın, Emin Halis; Özakın, Cüneyt; TÜZEMEN, NAZMİYE ÜLKÜ; ÖNAL, UĞUR; KAZAK, ESRA; Tezgeç, Nergiz; Eren, Hale; ÇELEBİ, SOLMAZ; HACIMUSTAFAOĞLU, MUSTAFA KEMAL; YILMAZ, EMEL; AKALIN, EMİN HALİS; ÖZAKIN, CÜNEYT; Tıp Fakültesi; Tıbbi Mikrobiyoloji Ana Bilim Dalı; 0000-0001-6953-8499 ; A-4290-2018; ACQ-7832-2022; AAG-8459-2021; GQV-3906-2022; GQT-6881-2022; ENK-4130-2022; HJZ-6992-2023; CTG-5805-2022; AAU-8952-2020; DXX-3499-2022Introduction: Ralstonia insidiosa , a gram-negative waterborne bacteria able to survive and grow in any type of water source, can cause nosocomial infections, and are considered emerging pathogens of infectious diseases in hospital settings. In this study, we report an outbreak of R. insidiosa at our center related to contaminated heparinized syringes.Material and methods: The present study was conducted in a tertiary care university hospital in Turkey. An outbreak analysis was performed between September 2021 and December 2021. Microbiological samples were obtained from environmental sources and from patient blood cultures. Species identification was performed using matrix-assisted laser desorption ionization time-of-flight mass spectrometry (MALDI-TOF MS). To inves-tigate the clonality of strains, all confirmed isolates were sent to the National Reference Laboratory and pulsed -field gel electrophoresis (PFGE) was used to perform molecular typing.Results: Seventeen R. insidiosa isolates were identified from the blood cultures of 13 patients from various wards and intensive care units. Isolates from seven patient blood cultures and two heparinized blood gas syringes were characterized by PFGE. All isolates were found to belong to the same clone of R. insidiosa.Conclusion: R. insidiosa was identified as the cause of a nosocomial infection outbreak in our hospital, which was then rapidly controlled by the infection-control team. When rare waterborne microorganisms grow in blood or other body fluid cultures, clinicians and the infection-control team should be made aware of a possible outbreak.Publication Association of SARS-CoV-2 cycle threshold (Ct) values with clinical course and serum biomarkers in COVID-19 patients(J Infection Developing Countries, 2022-03-01) Sağlık, İmran; Ener, Beyza; Akalın, Halis; Özdemir, Buşra; Ocakoğlu, Gökhan; Yalçın, Barış; Onal, Uğur; Güçlü, Özge Aydın; Öztürk, Nilüfer Aylin Acet; Tüzemen, Ülku; Demirdoğen, Ezgi; Dilektaşlı, Asli Görek; Ağca, Harun; Kazak, Esra; Coşkun, Funda; Heper, Yasemin; Payaslıoğlu, Melda; Ediger, Dane; Ursavaş, Ahmet; Yılmaz, Emel; Özakin, Cüneyt; Uzaslan, Esra; Karadağ, Mehmet; SAĞLIK, İMRAN; ENER, BEYZA; AKALIN, EMİN HALİS; OCAKOĞLU, GÖKHAN; ÖNAL, UĞUR; AYDIN GÜÇLÜ, ÖZGE; ACET ÖZTÜRK, NİLÜFER AYLİN; TÜZEMEN, NAZMİYE ÜLKÜ; DEMİRDÖĞEN, EZGİ; GÖREK DİLEKTAŞLI, ASLI; AĞCA, HARUN; KAZAK, ESRA; COŞKUN, NECMİYE FUNDA; HEPER, YASEMİN; PAYASLIOĞLU, AYŞE MELDA; EDİGER, DANE; URSAVAŞ, AHMET; YILMAZ, EMEL; ÖZAKIN, CÜNEYT; KARADAĞ, MEHMET; Tıp Fakültesi; Göğüs Hastalıkları Ana Bilim Dalı; 0000-0003-0864-4989; 0000-0001-7530-1279; 0000-0002-1114-6051; 0000-0001-6194-3254; 0000-0003-1005-3205; 0000-0002-6375-1472; 0000-0002-7400-9089; 0000-0001-7099-9647; 0000-0002-2651-2034; 0000-0003-3604-8826; 0000-0002-2954-4293; 0000-0002-3894-1231; 0000-0001-5428-3630; 0000-0002-9027-1132; AAD-1271-2019; ISU-9626-2023; ACQ-7832-2022; JCO-3678-2023; AAI-3169-2021; AAU-8952-2020; AAH-5180-2021; AAG-8744-2021; JPK-7012-2023; A-4970-2019Introduction: Our knowledge has gaps regarding severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) replication levels and its association to severity of Coronavirus disease 2019 (COVID-19). The aim of this study was to investigate the association of SARS-CoV-2 viral load with disease severity and serum biomarkers in COVID-19 patients. Methodology: Viral load was determined via cycle threshold (Ct) values of SARS-CoV-2 real-time reverse transcriptase-polymerase chain reaction (RT-PCR) in 214 adult patients. Ct values were compared with clinical severity, biochemical and hematological biomarkers. Results: Clinical course of the disease was mild (49.1%), moderate (40.2%), and severe (10.7%). Median Ct value was 28.2 (IQR: 22.2-33.8) during the first week of the disease. Ct values were lower within five days after symptom onset [lowest Ct value on the third day (median: 24, IQR: 20.6-32.3)], but they increased significantly during the second and third weeks. No association was detected between admission Ct values and disease severity. Gender, age, co-morbidity, and mortality did not differ significantly in patients with low (<= 25) and high (> 25) Ct values. White blood cell, neutrophil, platelet, and especially lymphocyte counts, were significantly lower in patients with low Ct values. Conclusions: No definitive/clear correlation between SARS-CoV-2 viral load and severity and mortality was found in the studied COVID-19 patients. However, neutrophil, platelet, and especially lymphocyte count were significantly lower in patients with a high viral load.Publication Retrospective evaluation of colistin-resistant isolates in automated system by gradient diffusion method and broth microdilution method (vol 32, pg 57, 2019)(Aves, 2019-08-01) Tüzemen, Nazmiye Ülkü; Efe, Kadir; Akalın, Halis; Özakın, Cüneyt; TÜZEMEN, NAZMİYE ÜLKÜ; AKALIN, EMİN HALİS; ÖZAKIN, CÜNEYT; Tıp Fakültesi; Tıbbi Mikrobiyoloji Ana Bilim Dalı; 0000-0003-3544-3509; 0000-0001-7530-1279; AAG-8392-2021; AAU-8952-2020; A-4290-2018Publication Trends of bloodstream infections in a university hospital during 12 years(Polskie Towarzystwo Mikrobiologow-polish Society Of Microbiologists, 2022-09-24) Tuzemen, Nazmiye Ulku; Payaslioglu, Melda; Özakin, Cuneyt; Ener, Beyza; Akalin, Halis; Tuzemen, Nazmiye Ulku; TÜZEMEN, NAZMİYE ÜLKÜ; Payaslioglu, Melda; PAYASLIOĞLU, AYŞE MELDA; Ozakin, Cuneyt; ÖZAKIN, CÜNEYT; Ener, Beyza; ENER, BEYZA; Akalin, Halis; AKALIN, EMİN HALİS; Tıp Fakültesi; Enfeksiyon Hastalıkları ve Klinik Mikrobiyoloji Ana Bilim Dalı; 0000-0001-7530-1279; A-4290-2018; AAU-8952-2020This study aims to investigate trends in bloodstream infections and their antimicrobial susceptibility profiles over 12 years in our hospital. This retrospective study was carried out in the Bursa Uludag University Hospital, Turkey, during 2008-2019. Blood cultures from patients were performed using BACTEC System. Isolates were identified with Phoenix System until 2018 and "matrix-assisted laser desorption ionization time-of-flight mass spectrometry" (MALDI-TOF MS) in 2019. Antibiotic susceptibility testing was performed with Phoenix System. Patient data came from the BD EpiCenter (TM) data management system. Escherichia coli was found to be the most common Gram-negative (11.6%), and coagulase-negative staphylococci were the most common Gram-positive (10.1%) monomicrobial growth. Overall, there was a significant increase in rates of extended-spectrum beta-lactamase positive E. coli (p = 0.014) and Klebsiella pneumonia (p < 0.001), carbapenem-resistant E. coli (p < 0.001), and K. pneumoniae (p < 0.001) and colistin-resistant K. pneumoniae (p < 0.001) and Acinetobacter baumannii (p < 0.001) over 12 years. Carbapenem and colistin resistance has increased dramatically in recent years. We believe that regular monitoring of the distribution of pathogens and antibiotic susceptibility profiles, especially in intensive care units, can contribute to evidence for the increase in resistant microorganisms and help prevent their spread with antimicrobial stewardship and infection control policies.Publication Oxa-48 dominance meets ceftazidime-avibactam: A battle against life-threatening carbapenem-resistant klebsiella pneumoniae infections in the intensive care unit(Springernature, 2023-10-10) Önal, Uğur; Tüzemen, Ülkü; Kaya, Pınar K.; İşçimen, Remzi; Girgin, Nermin Küçükdemirci; Özakın, Cüneyt; Kahveci, Ferda; Akalın, Halis; ÖNAL, UĞUR; TÜZEMEN, NAZMİYE ÜLKÜ; KÜÇÜKDEMİRCİ KAYA, PINAR; ÖZAKIN, CÜNEYT; KAHVECİ, FERDA ŞÖHRET; İŞÇİMEN, REMZİ; Girgin, Nermin Küçükdemirci; AKALIN, EMİN HALİS; Tıp Fakültesi; Mikrobiyoloji Bölümü; 0000-0001-6194-3254; 0000-0002-8428-8245; JCO-3678-2023; JCO-2264-2023; JNY-9122-2023; JMU-3479-2023; DTU-3148-2022; JNH-9929-2023; CYR-2043-2022; CYR-2043-2022; AAU-8952-2020ObjectiveIn this study, we aimed to describe the outcomes in ICU patients with bloodstream infection (BSI) or ventilatory-associated pneumonia (VAP) due to carbapenem-resistant Klebsiella pneumoniae (CRKP) who received ceftazidime-avibactam treatment at a tertiary care university hospital.MethodsPatients aged 18 years or older who were admitted to the Anesthesiology and Reanimation ICU at Bursa Uludag University Faculty of Medicine Hospital between June 13, 2021, and July 16, 2023, and diagnosed with BSI or VAP due to CRKP were included in this study.ResultsA total of 42 patients treated with ceftazidimeavibactam were included. Total crude mortality rates were 33.3% on day 14 and 54.8% on day 30. Mortality rates on the 14th and 30th days were 37.5% and 62.5% in patients with BSI and 27.8% and 44.4% in patients with VAP, respectively. There was no statistically significant difference between monotherapy and combination therapy in terms of mortality rates on days 14 and 30, respectively (3/11 vs. 11/31, p=0.620; 5/11 vs. 18/31, p=0.470). Immunosuppression (10/11 vs. 13/31, p=0.005), the Sequential Organ Failure Assessment (SOFA) score >= 8 (at the initiation of treatment; 19/25 vs. 4/17, p<0.001), INCREMENT-CPE score >= 10 (12/16 vs. 3/10, p=0.024) and longer duration (in days) from culture collection to treatment initiation (5.0 +/- 0.61 vs. 3.11 +/- 0.48, p=0.024) were found to have a statistically significant effect on 30-day mortality. In multivariate analysis, a SOFA score >= 8 at the initiation of treatment (p=0.037, OR: 17.442, 95% CI: 1.187-256.280) was found to be a significant risk factor affecting mortality (30-day).ConclusionThe mortality rates of patients with CRKP infection who were followed up in the ICU were found to be high, and it was observed that whether ceftazidime-avibactam treatment was given as a combination or monotherapy did not affect mortality. Further multicentre studies with a larger number of patients are needed to gain a comprehensive understanding of the topic, given that this treatment is typically reserved for documented infections.