Person: KAZAK, ESRA
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KAZAK
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ESRA
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Publication A case of arthropod-borne ulceroglandular tularemia(Aves, 2013-12-01) Kazak, Esra; Akın, Hicran; Helvacı, Safiye; KAZAK, ESRA; Akın, Hicran; Helvacı, Safiye; Tıp Fakültesi; İnfeksiyon Hastalıkları ve Klinik Mikrobiyoloji Ana Bilim Dalı; AAG-8459-2021; CBT-0656-2022; EXQ-2687-2022In Turkey, most of tularemia cases are in oropharyngeal form because the main routes of transmission are waterborne and contaminated food ingestion. On the other hand, ulceroglandular form is generally observed as a result of contact with infected animals and animal products. Arthropod-borne tularemia is very rare in Turkey. In this study, we present an arthropod-borne ulceroglandular tularemia case in Bursa province.Publication Remdesivir treatment for patients with moderate to severe COVİD-19(Tübitak Bilimsel ve Teknolojik Araştırma Kurumu, 2022-01-01) Hasanoğlu, İmran; Güner, Rahmet; Çelik, İlhami; Kanat, Fikret; Batirel, Ayşe; Dizman, Gülçin Telli; Eren, Esma; Sevgi, Dilek Yıldız; Bozkurt, İlkay; Yaşar, Kadriye Kart; Şenoğlu, Sevtap; Kazak, Esra; Karaali, Rıdvan; Çelikbaş, Aysel; Pullukçu, Hüsnü; Çağatay, Arif Atahan; Ünal, Serhat; Erdinç, Şebnem; Tabak, Fehmi; Gül, Ahmet; Alp, Emine; KAZAK, ESRA; Tıp Fakültesi; Enfeksiyon Hastalıkları ve Klinik Mikrobiyoloji Ana Bilim Dalı; 0000-0002-7380-2501; AAG-8459-2021Background/aim: Remdesivir, which was first developed for the treatment of Ebola disease but failed to meet expectations, has become hope in the fight against the COVID-19 pandemic. This study aimed to evaluate risk factors for mortality and prognosis of adult moderate/severe COVID-19 patients treated with remdesivir, and safety and tolerability of 5 days of remdesivir treatment.Materials and methods: This multicenter prospective observational study was conducted in 14 centers in Turkey. Pregnancy or breastfeeding, multiorgan failure, or usage of vasopressors for septic shock, ALT>5 x the upper limit of the normal range, or eGRF<30 mL/min or dialysis and receiving favipiravir were the exclusion criteria of the study.Results: Among 500 patients, 494 patients were included in the study. On admission, 392 (79.3%) patients had moderate and 102 (20.6%) patients had severe COVID-19. The 28-day mortality was 10.1%. The median of the scores of the seven-category ordinal scale assessed on days 0, 3, 5, 7 were 4 and 3 on day 14. When the survival status of the patients was evaluated according to the time between the remdesivir start date and the end date of the symptoms, no statistically significant difference was found between the medians of the groups (p = 0.404). In multivariable analysis, age (OR, 1.05; 95%CI, 1.02-1.08; p = 0.003), SpO(2) level on admission (OR, 3.03; 95%CI, 1.35-6.81; p = 0.007), heart rate (OR, 2.48; 95%CI, 1.01-6.07; p = 0.047), follow-up site at the hospital (clinic/ICU) (OR, 26.4; 95%CI, 11.6-60.17; p<0.001) were independently associated with increased mortality. Grade 3 adverse event (AE) was observed in 4 (0.8%) patients. None of the patients experienced grade 4 or 5 AEs.Conclusion: Remdesivir is a safe and well-tolerated drug and older age, low SpO(2) l evel on admission, tachycardia, and ICU admission are independently associated with increased mortality among patients with moderate/severe COVID-19 receiving remdesivir treatment.Publication Tocilizumab treatment in covid-19: A prognostic study using propensity score matching(Wroclaw Medical Univ, 2022-08-11) Güçlü, Özge Aydın; Önal, Uğur; Akalın, Halis; Öztürk, Nilüfer Aylin Acet; Belik, Hazel Öztürk; Demirdoğen, Ezgi; Dilektaşlı, Aslı Görek; Kazak, Esra; Ocakoğlu, Gökhan; Sağlık, İmran; Coşkun, Funda; Ediger, Dane; Heper, Yasemin; Ursavaş, Ahmet; Yılmaz, Emel; Uzaslan, Esra; Karadağ, Mehmet; AYDIN GÜÇLÜ, ÖZGE; ÖNAL, UĞUR; AKALIN, EMİN HALİS; ACET ÖZTÜRK, NİLÜFER AYLİN; ÖZTÜRK BELİK, HAZEL; DEMİRDÖĞEN, EZGİ; GÖREK DİLEKTAŞLI, ASLI; KAZAK, ESRA; OCAKOĞLU, GÖKHAN; SAĞLIK, İMRAN; COŞKUN, NECMİYE FUNDA; EDİGER, DANE; HEPER, YASEMİN; URSAVAŞ, AHMET; YILMAZ, EMEL; UZASLAN, AYŞE ESRA; KARADAĞ, MEHMET; Tıp Fakültesi; 0000-0003-1005-3205; 0000-0001-6194-3254; 0000-0001-7530-1279; 0000-0002-6375-1472; 0000-0002-7400-9089; 0000-0001-7099-9647; 0000-0002-1114-6051; 0000-0003-0864-4989; 0000-0003-3604-8826; 0000-0002-2954-4293; 0000-0003-1785-3539; 0000-0002-9027-1132; AAG-8744-2021; AAD-1271-2019; JCO-3678-2023; AAH-5180-2021; JPK-7012-2023; ACQ-7832-2022; AAU-8952-2020; AAI-3169-2021; AAG-9930-2019; Z-1424-2019; GQC-6764-2022; DTT-7416-2022Background. The potential role of interleukin-6 (IL-6) in coronavirus disease 2019 (COVID-19) pneumonia provides the rationale for investigating IL-6 signaling inhibitors.Objectives. To evaluate and report treatment responses to tocilizumab (TCZ) in COVID-19 patients and compare mortality outcomes with those of standard care.Materials and methods. Patients hospitalized with a severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection, diagnosed with reverse transcription polymerase chain reaction (RT-PCR) between March 2020 and April 2021, were enrolled in this single-center retrospective cohort study. Propensity score matching was performed in order to reduce confounding effects secondary to imbalances in receiving TCZ treatment.Results. A total of 364 patients were included in this study. Two hundred thirty-six patients received standard care, while 128 patients were treated with TCZ in addition to standard care (26 (20.3%) patients received a dose of 400 mg intravenously once, while 102 (79.7%) patients received a total dose of 800 mg intravenously). In the propensity score-matched population, less noninvasive mechanical ventilation (p = 0.041) and mechanical ventilation support (p = 0.015), and fewer deaths (p = 0.008) were observed among the TCZ-treated patients. The multivariate adjusted Cox regression model showed a significantly higher survival rate among TCZ patients compared to controls (hazard ratio (HR): 0.157, 95% confidence interval (95% CI): 0.026-0.951; p = 0.044). The hazard ratio for mortality in the TCZ group was 0.098 (95% CI: 0.030-0.318; p = 0.0001 using log-rank test).Conclusions. This study determined that TCZ treatment in COVID-19 patients was associated with better survival, reduced need for mechanical ventilation and reduced hospital-associated mortality.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; 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 Peripheral CD39-expressing regulatory T cell subsets play an age-dependent role in the severity of COVID-19(Wiley, 2021-08-01) Çağan, Eren; Şimşek, Abdurrahman; Kızmaz, Muhammed Ali; Dombaz, Fatma; Tezcan, Gülçin; Asan, Ali; Demir, H. İbrahim; Bal, S. Haldun; Ermiş, Diğdem Yöyen; Dilektaşlı, Aslı Görek; Kazak, Esra; Akalın, E. Halis; Oral, Halük Barbaros; Budak, Ferah; ŞİMŞEK, ABDURRAHMAN; Kızmaz, Muhammed Ali; Dombaz, Fatma; TEZCAN, GÜLÇİN; Demir, H. İbrahim; BAL, SALİH HALDUN; YÖYEN ERMİŞ, DİĞDEM; GÖREK DİLEKTAŞLI, ASLI; KAZAK, ESRA; AKALIN, EMİN HALİS; ORAL, HALUK BARBAROS; BUDAK, FERAH; Diş Hekimliği Fakültesi; Temel Bilimler Bölümü; 0000-0001-7625-9148 ; 0000-0002-5956-8755 ; 0000-0001-5334-7911 ; 0000-0001-8850-0269 ; AAG-7381-2021; HKN-2347-2023; DWR-5356-2022; AAH-3843-2020; GPN-1473-2022; KBR-5535-2024; GYL-2038-2022; DTT-7416-2022; AAG-8459-2021; AAU-8952-2020; K-7285-2012; IZP-9398-2023European Federat Immunol SocPublication Distribution of hepatitis c virus genotypes in the south Marmara Region(Derman Medical Publ, 2015-03-01) Ağca, Harun; AĞCA, HARUN; Mistik, Reşit; Kazak, Esra; KAZAK, ESRA; Tıp Fakültesi; Enfeksiyon Hastalıkları ve Klinik Mikrobiyoloji Ana Bilim Dalı; 0000-0002-2651-2034; ISU-9626-2023; AAG-8459-2021; AAH-4027-2021Aim: Hepatitis C virus (HCV) is an important caustive agent of hepatitis, cirrhosis and hepatocellular carcinoma both in our country and the world. Prognosis and response to treatment is related with the genotype of HCV which has six genotypes and over a hundred quasispecies. Knowing the HCV genotype is also important for epidemiological data. In this study we aimed to investigate the HCV genotypes of samples sent to Uludag University Hospital Microbiology Laboratory which is the reference centre in the South Marmara Region. Material and Method: This study was done retrospectively to analyse the HCV patients' sera sent to our laboratory between July 2010 and December 2012 for HCV genotyping. Artus HCV QS-RGQ PCR kit (Qiagene, Hilden, Germany) was used in Rotor-Gene Q (Qiagene, Hilden Germany) for detection of HCV RNA. HCV RNA positive samples of patients' sera were were used for genotyping by the Linear Array HCV genotyping test (Roche, NJ, USA). Results: 214 (92.6 %) of total 231 patients included in the study were genotype 1, one (0.4 %) was genotype 2, nine (3.9 %) were genotype 3 and, seven (3.4 %) were found genotype 4. Three of genotype 3 patients were of foreign nationality, two were born abroad and one of the genotype 4 patients were born abroad. Discussion: Concordant with our country data the most frequent genotype was 1, genotype 2 was seen in patients especially related with foreign countries and genotype 4 was seen rare. The importance of genotype 1, which is seen more frequent in our country and region is; resistance to antiviral treatment and prolonged treatment duration in chronic hepatitis C patients.Publication Candida infections in intensive care unit: how to treat ?(Aves, 2019-08-01) Kazak, Esra; KAZAK, ESRA; Tıp Fakültesi; İnfeksiyon Hastalıkları ve Klinik Mikrobiyoloji Ana Bilim Dalı; AAG-8459-2021The number of fungal infections observed in hospitalized patients has been gradually increasing in recent years. Bloodstream infections due to Candida spp. constitute the majority of hospital-acquired fungal infections. Two-thirds of all candidemias occur in patients in the intensive care units. Early initiation of appropriate treatment decreases high mortality in these cases. On the other hand, difficulty in diagnosis, economic cost of drug treatments, development of resistance, and effect of unnecessary drug use on ecology are major obstacles to the initiation of treatment. The recommendations on which conditions, in which patients, and when and which antifungal therapy should be initiated are discussed in this review.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 Prognostic factors for COVID-19 patients(J Infection Developing Countries, 2022-03-01) Önal, Uğur; Güçlü, Özge Aydın; Akalın, Halis; Öztürk, Nilüfer Aylin Acet; Semet, Cihan; Demirdoğen, Ezgi; Dilektaşlı, Aslı Görek; Sağlık, İmran; Kazak, Esra; Özkaya, Güven; Coşkun, Funda; Ediger, Dane; Heper, Yasemin; Ursavaş, Ahmet; Yılmaz, Emel; Uzaslan, Esra; Karadağ, Mehmet; ÖNAL, UĞUR; AYDIN GÜÇLÜ, ÖZGE; AKALIN, EMİN HALİS; ACET ÖZTÜRK, NİLÜFER AYLİN; SEMET, CİHAN; DEMİRDÖĞEN, EZGİ; GÖREK DİLEKTAŞLI, ASLI; SAĞLIK, İMRAN; KAZAK, ESRA; ÖZKAYA, GÜVEN; COŞKUN, NECMİYE FUNDA; EDİGER, DANE; HEPER, YASEMİN; URSAVAŞ, AHMET; YILMAZ, EMEL; UZASLAN, AYŞE ESRA; KARADAĞ, MEHMET; Tıp Fakültesi; Mikrobiyoloji Ana Bilim Dalı; 0000-0001-6194-3254; 0000-0003-1005-3205; 0000-0001-7530-1279; 0000-0002-6375-1472; 0000-0002-7400-9089; 0000-0001-7099-9647; 0000-0003-0864-4989; 0000-0003-0297-846X; 0000-0003-3604-8826; 0000-0002-2954-4293; 0000-0002-3894-1231; 0000-0002-9027-1132; A-4421-2016; AAG-8459-2021; GCM-3391-2022; DTT-7416-2022; AAH-9812-2021; AEA-4817-2022; Z-1424-2019; AAU-8952-2020; AAG-9930-2019; ACQ-7832-2022; AAD-1271-2019; AAE-9142-2019; CTY-9474-2022; AAI-3169-2021; HJZ-6992-2023; CDI-1977-2022; AAG-8744-2021Introduction: Determining prognostic factors in patients with coronavirus disease (COVID-19) can have great impact on treatment planning and follow-up strategies. Herein, we aimed to evaluate prognostic factors and clinical scores for confirmed COVID-19 patients in a tertiary care hospital in the Bursa region of Turkey. Methodology: Patients who had been diagnosed with COVID-19 microbiologically and/or radiologically between March and October 2020 in a tertiary-care university hospital were enrolled retrospectively. Adult patients (>= 18 years) with a clinical spectrum of moderate, severe, or critical illness were included. The dependent variable was 30-day mortality and logistic regression analysis was used to evaluate any variables with a significant p value (< 0.05) in univariate analysis. Results: A total of 257 patients were included in the study. The mortality rate (30-day) was 14.4%. In logistic regression analysis, higher scores on sequential organ failure assessment (SOFA) (p < 0.001, odds ratio (OR) = 1.86, 95% CI = 1.42-2.45) and CURB-65 pneumonia severity criteria (p = 0.001, OR = 2.60, 95% CI = 1.47-4.57) were found to be significant in predicting mortality at admission. In deceased patients, there were also significant differences between the baseline, day-3, day-7, and day-14 results of D-dimer (p = 0.01), ferritin (p = 0.042), leukocyte (p = 0.019), and neutrophil (p = 0.007) counts. Conclusions: In our study of COVID-19 patients, we found that high SOFA and CURB-65 scores on admission were associated with increased mortality. In addition, D-dimer, ferritin, leukocyte and neutrophil counts significantly increased after admission in patients who died.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; 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.
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