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Öğe A Case of Brucellosis Presenting with Infarction in the Spleen(Doc Design Informatics Co Ltd, 2022) Alkan, Sevil; Guclu-Kayta, Safiye Bilge; Vurucu, Servan; Akca, Anil; Yuksel, Cihan; Onder, Taylan; Sener, AlperBrucellosis may present with different clinical pictures due to its ability to involve various organs. Although splenomeg-aly can be seen as a result of spleen involvement in brucellosis, splenic infarction is rare. However, left upper quadrant pain may be observed when splenic infarct occurs. This case report presents a case of brucellosis with splenic infarct.Öğe An Insidious Clinical Picture: Optic Nerve Involvement in Patients with COVID-19(Galenos Publ House, 2022) Ocak, Ozgul; Şahin, Erkan Melih; Sener, Alper; Ocak, BarisObjective: Many neurological symptoms due to central nervous system, peripheral nervous system and musculoskeletal system damage have been reported in more than a third of patients with coronavirus disease-2019 (COVID-19). Although optic neuritis has been reported in patients with COVID-19, they are extremely rare. The aim of this study was screening optic nerve involvement in COVID-19 with visual evoked potential (VEP) in asymptomatic patients without a history of visual impairment. Materials and Methods: Pattern reversal VEP measurements were made in 101 adult patients with COVID-19 without a history of visual impairment after they completed COVID-19 treatments and the quarantine period. VEPs were recorded with the 4-channel electromyography-evoked device in a dark room. P100 latencies and amplitudes were analyzed by the same neurologist. Results: A total of 34 (33.7%) patients had P100 latency prolongation. There was no significant difference in terms of gender, age or outpatient/inpatient treatment status. There was no significant correlation between the time of polymerase chain reaction diagnosis and VEP values. Conclusion: Contrary to previous studies, asymptomatic optic nerve involvement after COVID-19 was detected by VEP measurements. Prolongation of P100 latency shows the probable linkage between COVID-19 virus and angiotensin converting enzyme 2 receptors in human eyes.Öğe Antimicrobial activity of the leaves of Verbascum sinuatum L. on microorganisms isolated from urinary tract infection(Academic Journals, 2009) Sener, Alper; Dulger, BasaranThe ethanolic extracts obtained from the leaves of Verbascum sinuatum L. (Scrophulariaceae) were investigated for their antimicrobial activities against the pathogens causing complicated urine tract infection (Enterococcus faecalis, Escherichia coli, Klebsiella pnemonlae, Pseudomonas aeruginosa, Proteus mirabilis and Candida albicans) disk diffusion method and microdilution method. Some antibacterial and antifungal antibiotics were used as a positive reference standard to determine the sensitivity of the strains. The extracts showed strong antimicrobial activity against Enterococcus faecalis, Proteus mirabilis and Candida albicans with inhibition zones of 20.0, 18.0 and 20.0 mm, with MIC's and MBC's of 4.0 (8.0), 8.0 (16.0) and 8.0 (16.0) mu g/mL, respectively. Also, the extracts exhibited moderate activity against the other test microorganisms. The results demonstrate that the ethanol extract of the aerial parts of Verbascum sinuatum L. has significant activity and suggest that it may be useful in the treatment of infections.Öğe CMV reactivation in immunocompetent critically ill intensive care unit patients: a retrospective study(Journal of Infection in Developing Countries, 2024) Onder, Taylan; Alkan, Sevil; Dogan, Ebru; Sener, AlperIntroduction: Cytomegalovirus (CMV) reactivation is observed in immunosuppressive patients and causes adverse clinical outcomes. CMV reactivation in immunocompetent patients is less known. We aimed to retrospectively investigate CMV reactivation in immunocompetent critically ill patients with bacterial growth in lower respiratory tract; and investigate the relationship between reactivation and outcomes such as length of stay (LOS), mechanical ventilation duration, and mortality. Methodology: Intensive care unit (ICU) patients that were CMV IgG-positive, CMV IgM-negative immunocompetent, mechanically ventilated for over 48 hours, and were diagnosed with respiratory tract colonization with Acinetobacter baumannii or ventilator-associated pneumonia (VAP) were included. Reverse transcriptase polymerase chain reaction (RT-PCR) was performed on serum and endotracheal aspirate samples. The patients were divided into groups of those with and without VAP and sepsis. Reactivation rates and CMV DNA levels were compared between the groups. Results: CMV reactivation was seen in 27 of 34 patients (79.4%). CMV DNA level was 5.8 times higher in patients with VAP and sepsis than patients without, but the difference was not statistically significant (p = 0.717). LOS and mechanical ventilation duration were higher in patients with reactivation (p = 0.047 and 0.036). No relationship was found between reactivation and mortality (p = 0.774). Conclusions: The rate of CMV reactivation was 79.4%. This was the second-highest reactivation rate reported in the literature. The reactivation was associated with prolonged hospitalization and mechanical ventilation. Copyright © 2024 Onder et al.Öğe COVID-19 or not?(Doc Design Informatics Co Ltd, 2022) Gonlugur, Ugur; Resorlu, Mustafa; Sener, Alper; Gonlugur, TanseliBilateral multilobar ground-glass opacities are characteristic features of COVID-19 pneumonia. However, the dif-ferential diagnosis of ground-glass opacities is challenging. The aim of this paper was to share our experiences with other colleagues. The first patient presented with anosmia and loss of taste. Legionella antigen in urine was positive. The second patient had bilateral ground-glass opacities, which predominantly involved the upper lung zones and lym-phopenia. Radiological findings were the same with the radiological control of 8 months ago, and she had a diagnosis of sarcoidosis. The third patient complained of dyspnoea. The inspection of national health system records showed a histological diagnosis of nonspecific interstitial/organizing pneumonia. The fourth patient had findings suggestive of congestive heart failure such as bilateral pleural effusion, peribronchial cuffing, and interlobular septa thickening. The co-existence of multiple ill-defined centrilobular ground-glass opacities suggested a concomitant disease but lesions disappeared with furosemid infusion within 5 days. The fifth patient presented with only right upper lobe consolida-tion. The opacities did not exceed the horizontal fissure. The intact fissure suggested a bacterial aetiology, but PCR tests of the nasopharyngeal samples were positive for COVID-19. This finding suggested that pulmonary infiltrate of COVID-19 was inflammatory rather than infective in nature. In conclusion, old imaging studies were more useful in the differential diagnosis.Öğe Epidemiological Evaluation of a Rapidly-Prevented Tularemia Outbreak in Canakkale Province, Turkey(Ankara Microbiology Soc, 2011) Otkun, Muserref Tatman; Alper Akçalı; Karadenizli, Aynur; Ozbey, Nilgun; Gazel, Deniz; Sener, Alper; Guclu, OguzTularemia is a disease caused by Francisella tularensis and widely seen at northern hemisphere of the world. In Turkey, oropharyngeal infections caused by a less virulent serotype F.tularensis subsp. holarctica are more prevalent. The aim of this study was to present the results of an epidemiological research performed after the detection of tularemia cases from Biga county of Canakkale province, Turkey, in December 2009. Following the report of two tularemia suspected cases from two villages (Baliklicesme and Sinekci) of Biga, an epidemiological investigation was undertaken to inspect the situation in this area. Water samples, clinical samples as throat swabs, wound swabs and serum samples were collected. Samples were cultured on heart agar supplemented with sheep blood, cysteine and antibiotics. Cultures were incubated at 37 degrees C in 5% CO(2) and followed for 10 days. Suspected colonies were identified by slide agglutination test using F.tularensis antisera. F.tularensis antibodies were investigated by standard tube agglutination method. Positive results obtained with agglutination test were also checked for a probable cross-reaction with Brucella antibodies by Rose-Bengal test. Water and wound samples were investigated using real-time polymerase chain reaction (RT Taqman PCR; Quantica, Techne Inc, UK) with probe and primers specific for ISFtu2 gene. All of the cultures yielded negative results, however eight of 16 water samples, one lymph node aspirate and one throat sample were found positive in F.tularensis TaqMan RT-PCR test. In tube agglutination test positive antibody titers between 1:20-1:1280 were detected in 36 of 115 serum samples. Two cases with antibody titers of 1:1280 and accompanying acute clinical findings, were diagnosed as tularemia and treated accordingly. Lymphatic drainage fluid samples obtained from one of these patients yielded positive result in PCR, however clinical sample could not be obtained from the other patient. The only epidemiological linkage between these acute cases (n= 2) and the other seropositive subjects (n= 34) was the use of local water supply system. It was learned that water obtained through reverse osmosis system had been used as drinking water at Baliklicesme village. Pre- and post-reverse osmosis system water samples from Baliklicesme village and samples from water supply of Sinekci village revealed positive results for F.tularensis by PCR. Since the only epidemiological relation between these two villages was using local water supply, tularemia cases encountered in this area were attributed to a water-borne epidemic and an automatic chlorination system was set up at each water reservoir in these villages. The establishment of these preventive measures curbed the growth of the epidemic. The cases presenting with throat sore, fever, lymphadenopathy (more than 2 cm), non-responsive to beta-lactam antibiotics, should be further investigated for tularemia. This work emphasizes that systematic setup and control of water disinfection systems are crucial to prevent tularemia outbreaks. Community and related authorities should be educated about the importance of water sanitation and chlorination.Öğe Epidural Abscess Due to a Mycobacterium tuberculosis Strain with Primary Resistance to Isoniazid and Ethambutol(Ankara Microbiology Soc, 2012) Sener, Alper; Alper Akçalı; Karatag, Ozan; Kosar, Sule; Degirmenci, Yildiz; Akman, TarikTuberculosis is primarily characterized by pulmonary involvement, however, one third of the cases exhibit extrapulmonary tuberculosis. In this report, a case of epidural abscess due to Mycobacterium tuberculosis with primary resistance to isoniazid and ethambutol was presented. A 57-year-old male patient was admitted to emergency service with ten days history of weakness in legs, disability of walking and fever. Neurological examination revealed paraplegia of lower extremities, numbness distal to T2 disc level and hyperactivity of deep tendon reflexes indicating transverse myelitis. Laboratory findings were as follows; ESR: 74 mm/hour, CRP: 22 g/L, ALT: 42 IU/L, AST: 45 IU/L and white blood cell count 23.000/mm(3) (45% polymorphonuclear leukocyte, 45% lymphocyte, 10% monocyte). Spinal magnetic resonance imaging showed a fusiform abscess localized at anterior epidural space and extending along levels of C5-6 and C6-7. The longitudinal dimension of the abscess was 3 cm. The lesion was hypoin-tense on T1 and hyperintense on T2 weighted MRI images with prominent rim shaped contrast enhancement on contrast-enhanced T1-weighted images. At fourth day of hospitalization the patient underwent neurosurgical management. M.tuberculosis was isolated from the cultures of operation material by Mycobacteria Growth Incubator Tube system (MGIT, BBL; BD, USA) on the 12th day. The isolate was found susceptible to streptomycin and rifampisin, but resistant to isoniazid and ethambutol. The treatment was initiated with rifampicin 600 mg/day, pyrazinamid 2 g/day, ethambutol 1.5 g/day and levofloxacin 500 mg/day. At the end of second month levofloxacin 500 mg/day and rifampisin 600 mg/day combination was sustained and total treatment period was planned as nine months. As far as the national literature was considered, this was the first case of extrapulmonary tuberculosis with primary resistance to isoniazid and ethambutol.Öğe Evaluation of antimicrobial activity of Ballota acetabulosa(Academic Journals, 2010) Dulger, Basaran; Sener, AlperThe ethanol extracts obtained from Ballota acetabulosa (L.) Benth (Lamiaceae) were investigated for their antimicrobial activity against Bacillus cereus ATCC 7064, Bacillus subtilis ATCC 6633, Stapylococcus aureus ATCC 6538P, Escherichia coli ATCC 10538, Proteus vulgaris ATCC 6899, Salmonella typhimurium CCM 5445, Psuedomonas aeruginosa ATCC 27853, Debaryomyces hansenii DSM 70238, Kluyveromyces fragilis ATCC 8608 and Rhodotorula rubra DSM 70403 by disc diffusion method and micro dilution method. The extracts showed strong antibacterial activity against E. coli, with inhibition zones of 18.6 mm and with minimum inhibitory concentrations (MICs) and minimum bactericidal concentrations (MBCs) of 16 (32) mu g/mL, respectively. K. fragilis is among the most susceptible in the yeast cultures, with inhibition zone of 18.2 mm and with MICs and minimum fungicidal concentrations (MFCs) of 16 (32) mu g/mL, respectively. Also, the extracts exhibited moderate activity in the other test of micro-organisms. The results demonstrate that the ethanol extract of the aerial parts of B. acetabulosa has significant activity and suggest that it may be useful in the treatment of infections.Öğe Evaluation of the Hospitalized Coronavirus Disease 2019 Patients in First 3 Months of the Pandemic(Aves, 2022) Alkan, Sevil; Akca, Anil; Sener, Alper; Dogan, Ebru; Gonlugur, Ugur; Simsek, Tuncer; Ozer, SuleOBJECTIVE: Data about Turkish coronavirus disease 2019 patients are limited. We evaluated hospitalized coronavirus disease 2019 patients who were followed up in the first 3 months of the pandemic. MATERIAL AND METHODS: This retrospective, single-center, observational study included 415 confirmed hospitalized coronavirus disease 2019 patients. The patients were divided into groups, namely, mild, moderate, and critically ill patients. Symptoms at the time of admission, clinical, laboratory, and imaging findings were examined. RESULTS: In our study, 6.74% of coronavirus disease 2019 patients had severe disease, 59.5% were male, and the mortality rate was 11.3%. Diabetes mellitus and chronic obstructive pulmonary disease were more frequently seen in critically ill patient groups and hyper- tension in moderate patient groups. Anemia and aspartate aminotransferase levels were higher in non-survivors among mild coronavirus disease 2019 patients. In the moderate patients' group, aspartate aminotransferase, lactate dehydrogenase, international normalized ratio, ferritin, and D-dimer levels were higher and lymphocyte, hemoglobin levels were lower; in the critically ill patients' group, platelets were lower and uric acid levels were higher in non-survivor patients. CONCLUSION: In mild patients, anemia, lymphopenia, and increased aspartate aminotransferase levels; in moderate patients, leukopenia, anemia, and increased aspartate aminotransferase, lactate dehydrogenase, international normalized ratio, ferritin, and D-dimer levels; in the critically ill patient group, lower platelet and increased uric acid levels should he followed closely as they are mortality predictors.Öğe Glenohumeral joint tuberculosis with multiple cold abscesses: An uncommon cause of shoulder pain(2013) Kizildag, Betul; Sener, Alper; Komurcu, Erkam; Karatag, Ozan; Kosar, SuleThe musculoskeletal system involvement of tuberculosis (TB) other than spinal TB is a rare and less-known entity. Furthermore symptoms of musculoskeletal involvement of TB infection are non-spesific, relatively slow and indolent. The diagnosis of TB is less considered by clinicians among other common causes of shoulder pain including traumatic and degenerative conditions. We reported a 72-year-old patient suffering shoulder pain for the last 2 years who was diagnosed with glenohumeral joint TB arthrithis associated with multiple cold abscesses in adjacent soft tissues; emphasising significant clinical and imaging findings.Öğe Hepatitis B Seroprevalance Among Health care Workers in a Tertiary Hospital(Galenos Yayincilik, 2013) Alper Akçalı; Sener, Alper; Otkun, Muserref Tatman; Akgoz, Semra; Otkun, Ali MetinObjective: In this study it is aimed, to determine the seroprevalence of HBV in health care workers in our hospital and to determine the factors that affect the epidemiology of transmission. Materials and Methods: Serum samples were taken from those of the hospital employees between June 2009-June 2010 and a questionnaire was held. Samples were tested for HBsAg, antiHBs and antiHBc total with MEIA method with an autoanalyser. Results: The mean age of the study group was 30.9 (+/- 6.9) and 100 men, 156 women participated on a voluntary basis. Professions were grouped as, 95 doctors, 60 nurses, midwives, 26 technicians, 16 laboratory technicians, biologists, 13 nurses, 19 cleaners, 27 administrative and technical staff. 188 people under 10 years, and 68 people over ten years worked in the field of health care. In this study, 22 people found contacted with HBV (8.6%), 234 persons (91.4%) were not contacted with HBV, 166 of them (64.8%) were vaccinated. One person (0.4%) were positive for HBsAg. None of the nursing aides was vaccianted, 26.3% of cleaning workers were found to be vaccinated. According to the results of laboratory tests, among needle injured person in the last year, being vaccinated (25 persons, 89.3%) and to have prior infection (27 people, 96.4%) rates were significantly higher (p = 0.003). By multivariate multinomial logistic regression analysis to determine the factors that affect transmission of hepatitis B, none of the variables was observed as a significant factor (p> 0.05). Conclusion: HBsAg seroprevalence is very low compared to other studies in our hospital. Vaccination rate is high. However, nurses and cleaning personnel vaccination rate found particularly low. Considering that these services are carried out in health care settings by frequently changing personnel, training and vaccination of these individuals should be planned before starting the work. While needlestick and sharp injuries were seen mostly by people those previously infected or vaccinated, this suggest that these people must be trained and informed again about bloodborne infectious agents like HBV and others.Öğe In vitro comparison of epidural bacteria filters permeability and screening scanning electron microscopy(Elsevier Science Inc, 2015) Sener, Aysin; Erkin, Yuksel; Sener, Alper; Tasdogen, Aydin; Dokumaci, Esra; Elar, ZahideBackground and objectives: Epidural catheter bacteria filters are barriers in the patient-controlled analgesia/anaesthesia for preventing contamination at the epidural insertion site. The efficiency of these filters varies according to pore sizes and materials. Method: The bacterial adhesion capability of the two filters was measured in vitro experiment. Adhesion capacities for standard Staphylococcus aureus (ATCC 25923) and Pseudomonas aeruginosa (ATCC 27853) strains of the two different filters (Portex and Rusch) which have the same pore size were examined. Bacterial suspension of 0.5 Mc Farland was placed in the patient-controlled analgesia pump, was filtered at a speed of 5 mL/h. in continuous infusion for 48 h and accumulated in bottle. The two filters were compared with colony counts of bacteria in the filters and bottles. At the same time, the filters and adhered bacteria were monitored by scanning electron microscope. Results: Electron microscopic examination of filters showed that the Portex filter had a granular and the Rusch filter fibrillary structure. Colony counting from the catheter and bottle showed that both of the filters have significant bacterial adhesion capability (p <0.001). After the bacteria suspension infusion, colony countings showed that the Portex filter was more efficient (p <0.001). There was not any difference between S. aureus and P aeruginosa bacteria adhesion. In the SEM monitoring after the infusion, it was physically shown that the bacteria were adhered efficiently by both of the filters. Conclusion: The granular structured filter was found statistically and significantly more successful than the fibrial. Although the pore sizes of the filters were same - of which structural differences shown by SEM were the same - it would not be right to attribute the changes in the efficiencies to only structural differences. Using microbiological and physical proofs with regard to efficiency at the same time has been another important aspect of this experiment. (C) 2013 Sociedade Brasileira de Anestesiologia. Published by Elsevier Editora Ltda. All rights reserved.Öğe Lipoprotein(a): A New Intensive Care Unit Admission Predictor in Coronavirus Disease 2019 Patients(Aves, 2023) Kucuk, Ugur; Kirilmaz, Bahadir; Sener, Alper; Alkan, Sevil; Vurucu, Servan; Aksit, ErcanOBJECTIVE: Endothelium-related events in patients with coronavirus disease 2019 are linked to a poor prognosis. Lipoprotein(a) plays a role in vascular endothelial cell dysfunction. This research aims to investigate whether baseline serum lipoprotein(a) levels could be a predictor for intensive care unit admission and related clinical parameters in coronavirus disease 2019 patients. MATERIAL AND METHODS: The research covers 126 patients who were hospitalized in intensive care unit or the non-intensive care unit in our hospital. This prospective cohort study was conducted from January 2021 to June 2021. The patients who were positive for severe acute respiratory syndrome coronavirus 2 according to real-time polymerase chain reaction test results were included in the study. Two groups were created according to the status of intensive care unit admission. Lipoprotein(a) was studied from blood samples taken at the time of hospital admission. RESULTS: According to the results of the first clinical evaluation, 46 patients were admitted to the intensive care unit and 80 patients were admitted to non-intensive care unit in the hospital. Patients with intensive care unit admission had significantly higher serum lipoprotein(a) levels than patients without intensive care unit admission (40.9 ng/mL and 17.4 ng/mL, P < .001, respectively). The regres-sion analysis revealed that serum lipoprotein(a) levels were independently related to intensive care unit admission (odds ratio 1.242, 95% CI 1.109-1.391, P < .001). In receiver operating characteristic curve analysis, lipoprotein(a) level & GE;31.42 ng/mL had 82.6% sensitivity and 72.5% specificity in predicting intensive care unit admission. The risk of intensive care unit admission was seen to be 12.522-fold higher in cases with lipoprotein(a) level & GE;31.42. CONCLUSION: Lipoprotein(a) could be used as a useful biomarker for the triage of coronavirus disease 2019 patients. Baseline serum lipoprotein(a) levels may serve as a useful prognostic biomarker in patients hospitalized for coronavirus disease 2019.Öğe MICROBIOLOGICAL EXAMINATION OF BLACK MUSSELS (MYTILUS GALLOPROVINCIALIS) CAUGHT IN DARDANELLES(Nobel Ilac, 2013) Sener, Alper; Demir, Neslihan; Cakici, Nesrin; Cakici, Hasan; Kaya, Hasan; Bakar, CoskunObjective: Among seafoods mussels are the most common ones that are mostly raw consumed raw Bacterial contamination in foods that cause food poisoning are is known to be due to mainly storage and processing conditions. Due to mussels' dietary specifications, them filter water and take in its toxic substances and microbial contaminants. Mussel bacterial load prior to consumption is important to demonstrate pollution levels of the hunting regions. Material and Method: In this study, black mussels (Mytilus galloprovincialis) hunted from seven different stations on two coasts of Dardanelles two coast (Asia: Cardak, Yapildak, Saricay; Europe: Kilitbahir, Eceabat, Camburnu, Gelibolu) were analyzed microbiologically in the months of February and June. Mussel samples were examined for total aerobic mesophilic bacteria (TAMB), coliform group bacteria, Escherichia coli, Staphylococcus aureus and Salmonella spp. Results: The mean colony count from all stations was; 5.4x10(5)+/- 1.6x10(6) cfu/g TAMB, 1.0x10(5)+/- 2.6x10(5) cfu/g coliform group bacteria, 2.6x10(5)+/- 1.4x10(6) cfu/g E. coli, 2.2x10(5)+/- 1.3x10(5) cfu/g S. aureus respectively. Salmonella spp. were not detected in any mussel samples examined. Black mussels hunted in June had significantly higher microbiological contamination for all bacteria than mussels hunted in February (p<0.0001). When we investigated two coasts as Anatolia (Cardak, Yapildak, Saricay) and Europe (Kilitbahir, Eceabat, Camburnu, Gelibolu) in two different periods; contamination on Europe coast was significantly higher for TAMB at february (p=0.01), at the same time S. aureus contamination was significantly higher at Anatolia coast (p=0.02). TAMB (p=0.004) and E.coli (p=0.005) count in samples on Anatolian coast were found to be significantly higher. Conclusion: Mussels bacterial load may vary depending on region and the hunting season. Mussels' bacterial load of mussels is more higher especially if hunted during the summer months. In our region, when we compared the Anatolian and European coasts, the bacterial load of hunted mussels on Anatolian coast was higher Food processing and storage conditions are important especially in food poisoning of raw consumed foods. In addition it should be kept in mind that region and the season for seafood hunting is also an important factor In order to prevent the health risks associated with mussels, heat treatment has to be applied prior to consumption.Öğe Oxybutynin effects on Staphylococcus epidermidis biofilm production(Lippincott Williams & Wilkins, 2008) Gedik, Abdullah; Ersay, Ahmet; Atmaca, Selahattin; Sener, AlperBackground: Oxybutynin is a tertiary amine and has chemical similarities like prolamine sulfate. Protamine sulfate's effect on bacterial viability has been shown in some studies; however, there is scanty data regarding the effect of oxybutynin on bacterial viability. Accordingly, the aim of the present study was to investigate the effect of oxybutynin on bacterial viability. Methods: Twenty of Staphylococcus epidermidis (S. epidermidis) strains were isolated from patients who had catheter-associated urinary tract infection. These strains were exposed to 5 different concentrations of oxybutynin in tryptic soy broth (TSB) media (max: 5 mg/mL, min: 0.05 mg/mL). Quantitative growth patterns were measured by spectrophotometer. Under the same media conditions, biofilm production of individual strains was measured by Deighton's micromethod at the end of the 6-hour incubation period. Results: After the incubation period, weak and strong slime-producing bacteria groups were obtained and both groups' slime productions were extensively low at 5 mg/mL concentration of oxybutynin. Slime production of S. epidermidis was inversely correlated with oxybutynin concentrations. Conclusion: Although there was a dose-dependent reduction of biofilm production, there seemed to be no bactericidal effect of oxybutynin on S. epidermidis.Öğe Seroprevalence of Hepatitis E in Hospital Employees and Investigation of Risk Factors(Aves, 2020) Cakmak-Topfedaisi, Ozlem; Sener, AlperObjective: There are few epidemiologic case-control studies in Turkey about hepatitis E virus (HEV). Seroprevalence and risk factor studies will guide vaccination recommendations in our country. It was aimed to detect HEV antibodies and to investigate the risk factors for hepatitis E in the cleaning staff of Canakkale Onsekiz Mart University Hospital for Medical Research and Practice. Methods: 90 cleaning staff working at the canakkale Onsekiz Mart University Hospital and 90 administrative staff were included in the study group. The presence of HEV IgG and IgM antibodies were investigated by micro-ELISA. HEV-RNA was investigated in IgG-positive patients. Known and predicted risk factors for fecal -orally transmitted infections were included in questionnaires. Correlation analysis between groups was made in terms of age, gender, education, number of rooms in their house, number of residents in their house, source of drinking and domestic water, history of jaundice, surgery, blood transfusion and chronic disease (including drug use), and use of common items. Open-ended questions were used for investigation of possible risk factors. Results: Anti-HEV IgG was positive in 13 (7.2%) subjects. None of them showed anti-HEV IgM positivity. REV RNA positivity was not detected. The relationship between seropositivity and being over 45 years old, having more than five siblings, and having less than two rooms in the house were statistically significant (p<0.005). Seropositivity was found as high as 18% in the group with poor socioeconomic status. There was no significant relationship between seropositivity and gender, socioeconomic status, education level, number of rooms, history of jaundice and source of drinking water, There was no difference between each groups in the answers to the open-ended questions. Conclusions: Being over 45 years old, living in crowded and small homes increase the risk of HEV infection.Öğe Surgical site infection rates in 16 cities in Turkey: findings of the International Nosocomial Infection Control Consortium (INICC)(Mosby-Elsevier, 2015) Leblebicioglu, Hakan; Erben, Nurettin; Rosenthal, Victor D.; Sener, Alper; Uzun, Cengiz; Senol, Gunes; Ersoz, GuldenBackground: Surgical site infections (SSIs) are a threat to patient safety; however, there were no available data on SSI rates stratified by surgical procedure (SP) in Turkey. Methods: Between January 2005 and December 2011, a cohort prospective surveillance study on SSIs was conducted by the International Nosocomial Infection Control Consortium (INICC) in 20 hospitals in 16 Turkish cities. Data from hospitalized patients were registered using the Centers for Disease Control and Prevention (CDC) National Healthcare Safety Network (NHSN) methods and definitions for SSIs. Surgical procedures (SPs) were classified into 22 types according to International Classification of Diseases, Ninth Revision criteria. Results: We recorded 1879 SSIs, associated with 41,563 SPs (4.3%; 95% confidence interval, 4.3-4.7). Among the results, the SSI rate per type of SP compared with rates reported by the INICC and CDC NHSN were 11.9% for ventricular shunt (vs 12.9% vs 5.6%); 5.3% for craniotomy (vs 4.4% vs 2.6%); 4.9% for coronary bypass with chest and donor incision (vs 4.5 vs 2.9); 3.5% for hip prosthesis (vs 2.6% vs 1.3%), and 3.0% for cesarean section (vs 0.7% vs 1.8%). Conclusions: In most of the 22 types of SP analyzed, our SSI rates were higher than the CDC NHSN rates and similar to the INICC rates. This study advances the knowledge of SSI epidemiology in Turkey, allowing the implementation of targeted interventions. Copyright (C) 2015 by the Association for Professionals in Infection Control and Epidemiology, Inc. Published by Elsevier Inc. All rights reserved.Öğe The clinical features, treatment and prognosis of neutropenic fever and Coronavirus disease 2019 results of the multicentre teos study(Nature Portfolio, 2024) Elik, Dilsah Baskol; Kaya, Safak; Alkan, Sevil; Demirdal, Tuna; Sener, Alper; Kaya, Selcuk; Tunccan, Ozlem GuzelThis multicentre (22 centres in Turkey) retrospective cohort study aimed to assess the clinical outcomes of patients with neutropenic fever and SARS-CoV-2 positivity. Study period was 15 March 2020-15 August 2021. A total of 170 cases (58 female, aged 59 +/- 15.5 years) that fulfilled the inclusion criteria were included in the study. One-month mortality rate (OMM) was 44.8%. The logistic regression analysis showed the following significant variables for the mentioned dependent variables: (i) achieving PCR negativity: receiving a maximum of 5 days of favipiravir (p = 0.005, OR 5.166, 95% CI 1.639-16.280); (ii) need for ICU: receiving glycopeptide therapy at any time during the COVID-19/FEN episode (p = 0.001, OR 6.566, 95% CI 2.137-20.172), the need for mechanical ventilation (p < 0.001, OR 62.042, 95% CI 9.528-404.011); (iii) need for mechanical ventilation: failure to recover from neutropenia (p < 0.001, OR 17.869, 95% CI 3.592-88.907), receiving tocilizumab therapy (p = 0.028, OR 32.227, 95% CI 1.469-707.053), septic shock (p = 0.001, OR 15.4 96% CI 3.164-75.897), and the need for ICU (p < 0.001, OR 91.818, 95% CI 15.360-548.873), (iv) OMM: [mechanical ventilation (p = 0.001, OR 19.041, 95% CI 3.229-112.286) and septic shock (p = 0.010, OR 5.589,95% CI 1.509-20.700)]. Although it includes a relatively limited number of patients, our findings suggest that COVID-19 and FEN are associated with significant mortality and morbidity.Öğe The evaluation of exposure to hepatitis A virus in HBsAg-positive persons: A multicentre study from Turkey(Journal of Pure and Applied Microbiology, 2014) Celen, Mustafa Kemal; Turker, Kamuran; Oztoprak, Nefise; Sener, Alper; Tuna, Nazan; Ince, Nevin; Erdem, IlknurChronic hepatitis B is a major public health problem in our country. Hepatitis A vaccination in HBV carriers who did not encounter with Hepatitis A virus is also significant. We aimed to evaluate the rate of exposure to HAV in HBsAg-positive persons, and the distribution of seronegative individuals according to age groups. Medical records of 4793 patients from 14 centers who were positive for hepatitis B surface antigen (HBsAg). A total 3514 cases (73.3%) were male and 1279 (26.7) were female. The HBsAg positive patients who were previously tested for HAV IgG at the time of firstly admitted to a center. HBsAg positive patients who were previously not tested for HAV IgG were tested and these . patients were confirmed serologically for HAV. The distribution of cases according to age were determined. In this study, 4793 HBsAg-positive patients were evaluated. The ratio of testing of anti-HAV IgG was very low during the first visit (54.2%). Seronegativity was highest in the age group under 19 years of age (26.2%) followed by 20-25 age group (15.5%) and 26-29 age group (12.5%). Testing of HAV serology should not be ignored in especially HBsAg-positive young adults and seronegative young adults should be vaccinated.Öğe Which is More Important and Insidious in Dialysis Patients? Occult Hepatitis B or Occult Hepatitis C?(Galenos Yayincilik, 2020) Gazel, Ozlem Zanapalioglu; Sener, AlperObjectives: The aim of this study was to investigate the presence of occult hepatitis B infection (OBI) and Occult hepatitis C infection (OCI) in hemodialysis patients and to determine whether there is an activation in the follow-up or not. Materials and Methods: Demographic data, causes of renal failure, access to hemodialysis, duration of hemodialysis, alanine aminotransferase (ALT) levels, hepatitis indicators of 100 HD patients with normal ALT levels were recorded in this study. Serum anti-hepatitis B core antibody (anti-HBc) immunoglobulin G (IgG) was tested with ELISA (Architecht, Abbott). Serum hepatitis B virus (HBV)-DNA, HCV-RNA [in peripheral blood mononuclear cells (PBMNC)] were studied with real-time polymerase chain reaction method. Results: Anti-HBc IgG positivity was detected in 27% of patients, but with no isolated anti-HBc IgG positivity. In 4% of the patients, HBV-DNA positivity and OBI infection were detected. None of the patients showed HCV-RNA positivity in serum and in PBMNC, therefore OCI was not detected. None of the patients developed OBI or OCI activation in five-years follow-up. Renal transplantation was performed in one of the OBI patients and lifelong prophylaxis was planned with oral antiviral medication. Conclusion: Presence of OCI is lower than OBI in hemodialysis patients.
