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    COMPARISON OF CLINICAL, LABORATORY FINDINGS AND COMPLICATIONS IN BACTERIEMIC AND NONBACTERIEMIC BRUCELLOSIS: A SINGLE CENTER EXPERIENCE
    (2023) Bektaş, Özlen; Aksoy, Firdevs; Aydın, Nurten Nur; Üstündağ, Medine Gözde; Kaya, Selçuk; Yılmaz, Gürdal; Köksal, İftihar
    Objective: Brucellosis is a systemic zoonosis that affects various organs or body systems and can mimic many diseases. Symptoms can range from acute febrile illness to chronic clinical manifestations with severe complications. In our study, we investigated the relationship between bacteremia and clinical and laboratory findings, and complications in patients with brucellosis. Material and Methods: Two hundred and twenty-three patients diagnosed with brucellosis between 2005 and 2020 in the department of infectious diseases and clinical microbiology of a tertiary care university hospital were included in the study. Rose Bengal test, Brucella standard tube agglutination test and culture (blood and/or bone marrow culture) were used for the diagnosis of brucellosis. The patients were divided into two groups according to their bacteremia status. Patients with positive culture were identified as bacteremia, and patients with negative culture were identified as non-bacteriemic. Results: A total of 223 patients were included in the study, of which 142 (63.7%) were male. While weight loss, fever and hematological complications were higher in bacteremia cases (p=0.001, p
  • Küçük Resim
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    Comparison of Immunological and Virological Recovery with Rapid, Early, and Late Start of Antiretroviral Treatment in Naive Plwh: Real-World Data
    (Dove Medical Press Ltd, 2023) Sarıgül Yıldırım, Figen; Candevir, Aslıhan; Akhan, Sıla; Kaya, Selçuk; Çabalak, Mehmet; Alkan, Sevil
    Background: Rapid initiation of antiretroviral therapy (ART) reduces the transmission of HIV infection in the community. This study aimed to determine whether rapid ART initiation is effective compared to standard ART treatment in our country. Methods: Patients were grouped based on time to treatment initiation. HIV RNA levels, CD+4 T cell count, CD4/CD8 ratio, and ART regimens were recorded at baseline and follow-up visits for 12 months. Results: There were 368-ART naive adults (treatment initiated at the time of HIV diagnosis; 143 on the first day, 48 on the secondseventh day, and 177 after the seventh day). Although virological suppression rates at 12th months were higher in all groups, over 90% on average, there were no statistically significant differences in HIV-1 RNA suppression rates, CD+4 T cell count, and CD4/CD8 ratio normalization in the studied months but in multivariate logistic regression analysis; showed a significant correlation between both virological and immunological response and those with CD4+ T <350 cells/mL at 12th month in total patients. Conclusion: Our findings support the broader application of recommendations for rapid ART initiation in HIV patients.
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    Evaluation of the risk of hospitalization in health care workers ınfected with COVID-19 university hospital experience
    (Çanakkale Onsekiz Mart Üniversitesi, 2023) Alıravcı, Işıl Deniz; Kaya, Selçuk
    Objectives: In this study, it was aimed to determine the rates of hospitalized COVID-19 infected healthcare workers(HCW’s) at Canakkale Onsekiz Mart University Hospital, to examine clinical, laboratory, breakthrough infection rate and vaccination data, and to reveal hospital and intensive care risk parameters by comparing them with the literature. Methods: In this retrospective study, COVID-19 infected HCW’s, whose diagnosis confirmed by real-time polymerase chain reaction and hospitalized at Canakkale Onsekiz Mart University Hospital between April 6, year 2020, and January 1, year 2023, were included. Demographic and clinical data were retrospectively scanned from the hospital information management system and vaccination data were obtained from the surveillance records. Results: During the study period, 10 (1.3%) of the 760 HCW’s diagnosed with COVID-19 infection were followed up in the ward and two (0.2%) in the intensive care unit. The mean age of all patients was 39.1, hospitalized patients in the ward was 40.6±8.9; hospitalized in the intensive care unit(ICU) was 36.0±2.8 years. Eight of the hospitalized patients (66.6%) did not have any additional disease. Obesity, hypertension, diabetes, and asthma were among the comorbid diseases seen in the patients. 5 (41.6%) of the twelve patient’s blood group was B Rh+. Eight of 12 hospitalized patients were not vaccinated (66.6%). Conclusion: In our study, a lower rate of hospitalization in the service and ICU (1.3%, 0.2%) was observed in HCW’s, and mortality did not occured. Lymphopenia, LDH, ferritin, and high white blood cell count were determined as weight criteria in the intensive care unit. Considering the distribution of the ratio of inpatients to outpatients by years, it was seen that vaccination reduced hospitalizations
  • Küçük Resim
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    HIV-1 enfekte bireylerde insan lökosit antijeni (HLA)-B*57:01 pozitifliği prevalansının dağılımı ve tedavi üzerine etkileri: Türkiye Haritası-BUHASDER Çalışma Grubu
    (Ankara Mikrobiyoloji Derneği, 2024) Büyüktuna, Seyit Ali; Öksüz, Caner; Tahmaz, Alper; Sarıgül Yıldırım, Figen; Kaya, Selçuk; Çelik Ekinci, Semiha
    İnsan immün yetmezlik virüsü [human immunodeficiency virus (HIV)]/kazanılmış immün yetmezlik sendromu [acquired immune deficiency syndrome (AIDS)], tüm yaş gruplarındaki bireylerin hem beklenen yaşam süresini hem de genel yaşam kalitesini önemli ölçüde etkileyen kritik bir küresel halk sağlığı sorunudur. HIV enfeksiyonunun manzarası, etkin kombine antiretroviral tedavilerin (ART) kullanılmaya başlanması nedeniyle son yıllarda önemli ölçüde değişmiştir. HIV tedavisi için birinci basamak ART rejimlerinin temel bileşenlerinden biri, bir nükleozid HIV ters transkriptaz inhibitörü olan abakavirdir. Abakavir viral replikasyonu baskılamada ve hastalığı yönetmede etkili olsa da HLA-B*57:01 pozitif hastalarda yaşamı tehdit eden aşırı duyarlılık reaksiyonunun ortaya çıkma potansiyeli nedeniyle klinik faydası gölgelenmektedir. Ülkemizde HIV-1 ile enfekte hastalarda HLA-B*57:01 prevalansı ile ilgili çeşitli merkezlerden elde edilen lokal veriler mevcuttur. Bu çalışmada, ülkemizin birçok bölgesinde takip ve tedavisi yapılan HIV ile enfekte hastalarda HLA-B*57:01 genotipinin prevalansını belirlemek amaçlanmıştır. Bu çalışma, 01.01.2019-31.07.2022 tarihleri arasında HIV-1 ile enfekte tanısı alan 18 yaş ve üzerindeki hastaların verilerinden oluşan retrospektif bir çalışmadır. Katılımcıların yaş, cinsiyet, doğum yeri, hastalığın bulaş şekli, ölüm durumları, ilk klinik başvurudaki CD4+ T hücre sayısı ve HIV RNA düzeyleri, HLA-B*57:01 pozitifliği ve kullanılan yöntem, hastalığın klinik evresi, almış oldukları tedavi ile oluşan virolojik yanıt süresi hasta dosyalarından kaydedilmiştir. Toplam 16 merkezden veri toplanmış olup her merkez HLA-B*57:01’i tespit etmek için farklı yöntemler kullanmıştır. Bunlar; diziye özgül oligonükleotit prob hibridizasyon (SSOP), DNA dizi tabanlı tiplendirme (SBT), tekli özgül primer-polimeraz zincir reaksiyonu [single-specific primerpolymerase chain reaction (SSP-PCR)], alele özgül PCR [allele specific-PCR (AS-PCR)] ve kantitatif PCR [quantitative-PCR (Q-PCR)] yöntemleridir. Çalışmaya HIV ile enfekte 523 erkek (%86), 85 (%14) kadın olmak üzere toplam 608 kişi dahil edilmiştir. Hastaların yaş ortalaması 36.9 ± 11.9 (18-73) yıl olarak saptanmıştır. HLA-B*57:01 aleli prevalansı %3.6 (22 hasta) olarak bulunmuştur. HLA-B*57:01 aleli pozitif bulunan hastaların CD4+ T lenfosit sayısı 10 hastada (%45.5) > 500/mm3 olarak saptanırken, HLA-B*57:01 negatif hastalarda ise CD4+ T lenfosit sayısı 216 hastada (%36.9) > 500/mm3 olarak bulunmuştur (p> 0.05). HLA-B*57:01 aleli pozitif bulunan hastalarda tanı anında viral yük daha düşük olarak gözlenmiş ancak istatistiksel olarak anlamlı saptanmamıştır (p> 0.05). Hastaları takip eden merkezlerde farklı tedavi algoritmaları kullanılmakla birlikte HLA-B*57:01 pozitif olan olgularda virolojik yanıt süresinin daha kısa olduğu tespit edilmiştir (p= 0.006). HLA-B*57:01 aleli varlığının her ne kadar aşırı duyarlılıkla olan ilişkisi nedeniyle olumsuz bir etkisi olsa da HIV enfeksiyonunun daha yavaş ilerlemesi ve AIDS gelişme riskinin azalmasıyla olan ilişkisi nedeniyle de ilgi çekmeye devam edecek gibi durmaktadır. Ayrıca “HIV enfeksiyonu tedavisi için abakavir içeren ART rejimi başlamadan önce, hastaların HLA-B*57:01 açısından taranması maliyet etkin midir?” sorusunun cevabı aransa da HIV tedavi rehberleri bu konuda risk altındaki hastaların belirlenmesi için taramayı önermeye devam edecek gibi gözükmektedir.
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    Öğe
    Syphilis coinfection in individuals living with HIV: tertiary university hospital data
    (Pamukkale University, 2025) Alıravcı, Işıl Deniz; Yenice Aktaş, Sevinç; Kaya, Selçuk
    Purpose: This study aimed to examine the coinfection of syphilis in HIV-positive individuals and the epidemiological and clinical characteristics of these patients. Material and methods: Our study was conducted in Çanakkale Onsekiz Mart University, between 13.02.2018 and 13.02.2024, in 26 patients with clinically and laboratory-confirmed syphilis co-infection among 142 HIV/AIDS patients who were followed up and confirmed in the infectious diseases and clinical microbiology outpatient clinic. Results: A total of 142 HIV positive and 26 (18.3%) syphilis coinfected patients between the ages of 17-77 were included in the study. The mean ages of the infected and syphilis coinfected patients were 39.1 and 41.07, respectively. Six (23%) of the coinfected patients were married, the remaining 14 (53.8%) were single or divorced, five had multiple partners; 20 (77%) were heterosexual, four (15%) were men who have sex with men (MSM), and two (8%) were bisexual. Simultaneous HIV/syphilis positivity was detected in 14 (54%) of the coinfected patients at the time of diagnosis, while 7 (27%) were detected during the HIV treatment follow-up period, and 5 (19%) were detected before HIV diagnosis. Of the patients with coinfection, five (19.2%) had primary syphilis, 10 (38.5%) had latent syphilis, and 11 (42.3%) had secondary syphilis at the time of diagnosis. Twenty-two (85%) of the patients had been diagnosed and treated for syphilis only once, while the remaining (15%) had received two or more treatments. Conclusions: The prevalence of syphilis coinfection and reinfection in patients was 18.3% and 15%, respectively. In cases of coinfection, male gender, alcohol and drug consumption, being MSM, irregular lifestyles, and sexual habits were found to be effective. It is important to conduct screening for syphilis and other sexually transmitted diseases (STDs) in HIV-infected patients. Providing psychiatric support to these patients in organizing their life plans is also very important for preventing HIV transmission and syphilis coinfection. © 2025, Pamukkale University. All rights reserved.