Browsing by Author "AKALIN, EMİN HALİS"

Now showing 1 - 20 of 55

A novel β-lactam-aminoglycoside combination in veterinary medicine: The couse of ceftiofur and gentamicin to combat resistant Escherichia coli
(Hellenic Veterinary Medical Society, 2020-04-01) Cengiz, M.; Şahintürk, P.; Hepbostancı, G.; Akalın, H.; Sonal, S.; CENGİZ, MURAT; ŞAHİNTÜRK, SERDAR; AKALIN, EMİN HALİS; SONAL, SONGÜL; HEPBOSTANCI, G.; Bursa Uludağ Üniversitesi/Veteriner Fakültesi.; Bursa Uludağ Üniversitesi/Tıp Fakültesi.; Bursa Uludağ Üniversitesi/Sağlık Bilimleri Enstitüsü.; 0000-0001-7530-1279; AAU-8952-2020; ABE-5935-2020
The focus of this study was to evaluate the efficacy of ceftiofur+gentamicin combination to increase the success of antimicrobial inhibition against resistant Escherichia coli (E.coli) strains isolated from animals. Interaction between drugs was determined using checkerboard method and the fractional inhibitory concentration index was interpreted as synergism, antagonism and indifference. The combination was defined as bactericidal or bacteriostatic based on the minimum bactericidal test results. Mutant prevention concentration test was used to evaluate the resistance tendency suppression potential of the combination. The synergistic effect was detected for all E. coli strains by the checkerboard method; even the strains that were resistant to the individual compounds in the combination. Based on the results of minimum bactericidal concentration test, the combination exhibited bactericidal effect against all E. coli strains. In addition, the individual mutant prevention concentrations of ceftiofur and gentamicin decreased up to 125-fold by using the combination for the inhibition of resistant E. coli strains. The results indicated that killing potential of co-use of the compounds is much stronger than their individual use. The combination achieved to decrease the mutant prevention concentrations and this can reduce the risk of emergence of single mutations during treatment done with suggested doses.
A rare presentation of cat-scratch disease: A case report with neuroretinitis and review of cases reported from Turkey
(Doc Design Informatics Co Ltd, 2022-09-01) Çınar, Tuğba; ÖNAL, UĞUR; ÇINAR, TUĞBA; YALÇINBAYIR, ÖZGÜR; Yalçınbayır, Özgür; Akalın, Halis; AKALIN, EMİN HALİS; Bursa Uludağ Üniversitesi/Tıp Fakültesi/Tıbbi Mikrobiyoloji Anabilim Dalı.; Bursa Uludağ Üniversitesi/Tıp Fakültesi/Göz Hastalıkları Anabilim Dalı.; 0000-0001-6194-3254; 0000-0002-7311-5277; 0000-0001-7530-1279; ACQ-7832-2022; JCO-3678-2023; AAU-8952-2020; IYJ-9408-2023
Neuroretinitis is a rare presentation of cat-scratch disease caused by Bartonella henselae. In this case report, we aimed to describe a 46-year-old male patient who presented with acute visual loss and was diagnosed as neuroretinitis. Fundus examination showed evidence of optic disc edema, macular star, and peripapillary hemorrhagia. The serological tests were positive for Bartonella with both IgM and IgG titers as 1/320. He was successfully treated with doxycycline for eight weeks. Both clinical and serological improvements were observed during the follow-up.
A retrospective evaluation of critically ill patients infected with H1N1 influenza A virus in Bursa, Turkey, during the 2009-2010 pandemic
(Makerere Univ, 2015-01-01) Nermin, Kelebek Girgin; Remzi, İşçimen; Zeynep, Akoğul; İlker, Çimen; Meltem, Öner Torlar; Güven, Özkaya; Ferda, Kahveci; Halis, Akalın; KELEBEK GİRGİN, NERMİN; İŞÇİMEN, REMZİ; Akoğul, Zeynep; Çimen, İlker; Torlar, Meltem Öner; ÖZKAYA, GÜVEN; KAHVECİ, FERDA ŞÖHRET; AKALIN, EMİN HALİS; Uludağ Üniversitesi/Tıp Fakültesi/Anesteziyoloji ve Reanimasyon Anabilim Dalı.; Uludağ Üniversitesi/Tıp Fakültesi/Mikrobiyoloji ve Enfeksiyon Hastalıkları Anabilim Dalı.; Uludağ Üniversitesi/Tıp Fakültesi/Biyoistatistik Anabilim Dalı.; AAH-7250-2019; FTV-1495-2022; EIE-4319-2022; JOR-4047-2023; FMO-2967-2022; EZV-3846-2022; CPT-2668-2022; EZJ-5901-2022
Background: H1N1 influenza A virus infections were first reported in April 2009 and spread rapidly, resulting in mortality worldwide. The aim of this study was to evaluate patients with H1N1 infection treated in the intensive care unit (ICU) in Bursa, Turkey.Methods: Demographic characteristics, clinical features, and outcome relating to H1N1 infection were retrospectively analysed in patients treated in the ICU.Results: Twenty-three cases of H1N1 infection were treated in the ICU. The mean age of patients was 37 years range: (1782). Fifteen patients were female (65.2%). The mean Acute Physiology and Chronic Health Evaluation (APACHE) II score was 19 range: (5-39). The most common symptoms were dyspnea (73.9%), fever (69.6%), and cough (60.9%). Mechanical ventilation was required for all patients. Oseltamivir and antibiotics were administered to all patients. Six (26.1%) patients died. APACHE II scores were higher in the deceased 28.5 range: [16-39] vs. 14 range: [5-28] in survivors; p = 0.013).Conclusion: When compared to the literature, the demographic, epidemiological, and clinical characteristics were similar in the cases we encountered. The mortality rate was high despite the use of appropriate treatment. We believe that the high mortality is related to higher APACHE II scores. The H1N1 virus should be considered in community acquired pneumonia, especially in younger patients presenting with severe pneumonia.
Analysis of risk factors associated with urinary tract infection in renal transplant recipients
(Oxford University Press, 2015-05-01) Ersoy, Alparslan; Aktaş, Nimet; Oruç, Ayşegül; Gül, Bülent; Yıldız, Abdülmecit; Sayılar, Emel Işıktaş; Ayar, Yavuz; Akalın, Halis; ERSOY, ALPARSLAN; ORUÇ, AYŞEGÜL; GÜL, CUMA BÜLENT; YILDIZ, ABDULMECİT; AKALIN, EMİN HALİS; AKTAŞ, NİMET; SAYILAR, EMEL IŞIKTAŞ; AYAR, YAVUZ; 0000-0002-0342-9692; 0000-0003-4607-9220; 0000-0001-7530-1279; AAH-5054-2021; AAH-4002-2021; W-2575-2017; AAU-8952-2020; GSE-0029-2022; O-9948-2015; AGF-0767-2022
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-8396-2023
Objective: 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.
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-0895-2022
Introduction: 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.
Association of cytotoxic T lymphocyte subsets with disease severity in Covid-19
(Wiley, 2021-08-01) Kızmaz, Muhammed Ali; Çağan, Eren; Şimşek, Abdurrahman; Dombaz, Fatma; Tezcan, Gülçin; Aşan, Ali; Demir, H. İbrahim; Bal, S. Haldun; Ermiş, Diğdem Yöyen; Coşkun, Necmiye Funda; Akalın, E. Halis; Oral, Haluk Barbaros; Budak, Ferah; Kızmaz, Muhammed Ali; ŞİMŞEK, ABDURRAHMAN; Dombaz, Fatma; TEZCAN, GÜLÇİN; Demir, H. İbrahim; BAL, SALİH HALDUN; YÖYEN ERMİŞ, DİĞDEM; COŞKUN, NECMİYE FUNDA; AKALIN, EMİN HALİS; ORAL, HALUK BARBAROS; BUDAK, FERAH; Bursa Uludağ Üniversitesi/Tıp Fakültesi/İmmünoloji Anabilim Dalı.; Bursa Uludağ Üniversitesi/Diş Hekimliği Fakültesi/Temel Bilimler Bölümü.; Bursa Uludağ Üniversitesi/Tıp Fakültesi/Göğüs Hastalıkları Anabilim Dalı.; Bursa Uludağ Üniversitesi/Tıp Fakültesi/Klinik Mikrobiyoloji ve Enfeksiyon Hastalıkları Anabilim Dalı.; 0000-0001-5334-7911; 0000-0001-8850-0269; 0000-0001-7288-3250; 0000-0002-5956-8755; 0000-0002-8856-7356; 0000-0001-7585-7971; 0000-0003-3604-8826; 0000-0001-7530-1279; 0000-0003-0463-6818; 0000-0001-7625-9148; 0000-0003-3604-8826; HKN-2347-2023; IZP-9398-2023; AAH-3843-2020; F-4657-2014; AAG-7381-2021; K-7285-2012; AAU-8952-2020; DWR-5356-2022; GPN-1473-2022; KBR-5535-2024; GYL-2038-2022; AAD-1271-2019
Cerebral toxoplasmosis as the presenting manifestation of HIV/AIDS
(Doc Design Informatics Co Ltd, 2011-04-01) Oğuz-Ayarcı, Ayşe; Mıstık, Reşit; Akın, Hicran; Hakyemez, Bahattin; Helvacı, Safiye; Akalın, Halis; Oral, Barbaros; Oğuz-Ayarcı, Ayşe; Mıstık, Reşit; Akın, Hicran; HAKYEMEZ, BAHATTİN; Helvacı, Safiye; AKALIN, EMİN HALİS; ORAL, HALUK BARBAROS; Uludağ Üniversitesi/Tıp Fakültesi/Enfeksiyon Hastalıkları ve Klinik Mikrobiyoloji Anabilim Dalı.; Uludağ Üniversitesi/Tıp Fakültesi/Radyoloji Anabilim Dalı.; 0000-0001-7530-1279; 0000-0003-0463-6818; AAI-2318-2021; K-7285-2012; AAU-8952-2020; FOZ-1105-2022; DFY-3761-2022; CBT-0656-2022; EXQ-2687-2022
During the course of HIV infection, opportunistic infections are common. Toxoplasmosis is an opportunistic infection that can cause encephalitis and intracerebral mass lesions in HIV/AIDS patients. We report a previously healthy 41-year-old man with balance disorder due to cerebral toxoplasmosis as the presenting manifestation of HIV/AIDS.
Chronic granulomatous disease diagnosed in adulthood
(Turkish Soc Immunology, 2015-12-01) Karakeçili, Faruk; Akın, Hicran; Pekgöz, Murat; Mistik, Reşit; Oral, Haluk Barboros; ORAL, HALUK BARBAROS; Akalın, Halis; AKALIN, EMİN HALİS; Bursa Uludağ Üniversitesi/Tıp Fakültesi/ Enfeksiyon Hastalıkları ve Klinik Mikrobiyoloji Anabilim Dalı.; Bursa Uludağ Üniversitesi/Tıp Fakültesi/Tıbbi Mikrobiyoloji Anabilim Dalı.; Bursa Uludağ Üniversitesi/Tıp Fakültesi/İç Hastalıkları Anabilim Dalı.; 0000-0002-7368-7187; 0000-0003-0463-6818; 0000-0001-7530-1279; AAU-8952-2020; K-7285-2012
Chronic granulomatous disease (CGD) is a rare, genetically heterogeneous disease characterized by severe infections that can be life threatening. The disease develops due to defects in nicotinamide adenine dinucleotide phosphate (NADPH) oxidase system. It is characterized by granuloma formation depending on recurrent infections and increased inflammatory response. Lung, skin, lymph nodes, and liver are the most involved organs. Nitroblue tetrazolium test (NBT) is the most frequently used test in screening. In this article, a chronic granulomatous disease case diagnosed in adulthood and having recurrent liver and lung abscesses is reported in light of the literature. A 22-year-old male patient was admitted to our polyclinic with high fever for two weeks. Patient's family history was received in terms of CGD and NBT was carried out. Patient's NBT result was negative (0%) twice. The patient was administered empiric ceftriaxone and metronidazole treatment. Abscess drainage was planned for the patient diagnosed as CGD as a result of the analyses. The patient who developed fever response and whose laboratory values improved was discharged proposing polyclinic control with trimethoprim/ sulfamethoxazole and itraconazole prophylaxis. This case indicates that, although rarely, CGD might be diagnosed in adulthood in our country where consanguineous marriage and hereditary diseases are common.
Clinical manifestations of adult-onset still's disease
(Doc Design Informatics Co Ltd, 2020-08-01) Semet, Cihan; Şişman, Ayşe Sena; Çınar, Tuğba; Anaç, İsmail; Pehlivan, Yavuz; Akalın, Halis; SEMET, CİHAN; ŞİŞMAN, AYŞE SENA; ÇINAR, TUĞBA; ANAÇ, İSMAİL; PEHLİVAN, YAVUZ; AKALIN, EMİN HALİS; Bursa Uludağ Üniversitesi/Tıp Fakültesi/Enfeksiyon Hastalıkları ve Klinik Mikrobiyoloji Anabilim Dalı.; Bursa Uludağ Üniversitesi/Tıp Fakültesi/İç Hastalıkları Anabilim Dalı.; Bursa Uludağ Üniversitesi/Tıp Fakültesi/Romatoloji Anabilim Dalı.; 0000-0001-7530-1279; 0000-0003-2210-820X; AEA-4817-2022; GOI-2416-2022; IQX-9185-2023; CBL-8711-2022; IRX-3951-2023; AAU-8952-2020
Comparison of clinical, laboratory, and radiological characteristics between COVID-19, influenza, and adenovirus pneumonia: A narrative review
(Galenos Yayıncılık, 2021-01-01) Önal, Uğur; Ursavaş, Ahmet; Akalın, Halis; ÖNAL, UĞUR; URSAVAŞ, AHMET; AKALIN, EMİN HALİS; Bursa Uludağ Üniversitesi/Tıp Fakültesi/Enfeksiyon Hastalıkları ve Klinik Mikrobiyoloji Anabilim Dalı; Bursa Uludağ Üniversitesi/Tıp Fakültesi/Göğüs Hastalıkları Anabilim Dalı; 0000-0001-6194-3254; 0000-0001-7530-1279; 0000-0001-6953-8499; ACQ-7832-2022; AAI-3169-2021; AAU-8952-2020; JCO-3678-2023
The Coronavirus disease-2019 (COVID-2019) pandemic is a major global healthcare problem nowadays, and because of the high numbers of infected patients, it is vitally important to distinguish this from other types of viral pneumonia caused by influenza or adenovirus, which may have similar signs and symptoms. We conducted a narrative literature review and performed a PubMed and Scopus search for studies published up to November 18, 2020, using the following medical subject headings terms: ["comparison," "comparisons" AND "severe acute respiratory syndrome coronavirus 2," "ncov," "2019 ncov," "covid 19," "sars coy 2," "coronavirus," "coy" AND ("influenzas," "influenza," "influenzae," "human influenza" OR "adenoviridae," "adenovirus," "adenoviridae infections")]. This narrative review aims to compare pneumonia caused by severe acute respiratory syndrome coronavirus-2, influenza, and adenovirus in terms of clinical, laboratory, and radiological characteristics. In conclusion, although these viral pneumonia clinics share the similar patterns of symptoms and laboratory findings; we believe that there have some distrinctions especially in radiological findings.
Conventional amphotericin b associated nephrotoxicity in patients with hematologic malignancies
(Cureus, 2021-07-17) Gürsoy, Vildan; Özkalemkaş, Fahir; Özkocaman, Vildan; Yeğen, Zafer Serenli; Pınar, İbrahim Ethem; Ener, Beyza; Akalın, Halis; Kazak, Esra; Ali, Rıdvan; Ersoy, Alparslan; ÖZKALEMKAŞ, FAHİR; ÖZKOCAMAN, VİLDAN; PINAR, İBRAHİM ETHEM; ENER, BEYZA; AKALIN, EMİN HALİS; ALİ, RIDVAN; ERSOY, ALPARSLAN; Bursa Uludağ Üniversitesi/Tıp Fakültesi/İç Hastalıkları Anabilim Dalı/Hematoloji Bilim Dalı.; Bursa Uludağ Üniversitesi/Tıp Fakültesi/Mikrobiyoloji Anabilim Dalı.; Bursa Uludağ Üniversitesi/Tıp Fakültesi/Enfeksiyon Hastalıkları ve Klinik Mikrobiyoloji Anabilim Dalı.; Bursa Uludağ Üniversitesi/Tıp Fakültesi/İç Hastalıkları Anabilim Dalı/Nefroloji Bilim Dalı.; 0000-0001-9907-1498 ; 0000-0002-4803-8206; DLR-8474-2022 ; JIR-6730-2023 ; JGM-6601-2023 ; AAG-8523-2021 ; AAU-8952-2020; AAG-8459-2021; GXD-8209-2022; CPX-5894-2022
Introduction: Amphotericin B (AmB-d) is one of the most effective therapeutic options against frequently life-threatening systemic fungal infections in patients with hematologic malignancies. However, significant adverse effects including nephrotoxicity associated with its use limit its more widespread use. The objectives of our study were to determine the incidence of AmB-d associated nephrotoxicity, to evaluate clinical and epidemiological characteristics of patients, and to support the notion that conventional amphotericin B remains a valid therapeutic option among hematologic patients with proper patient selection.Materials and methods: A total of 110 patients with hematologic malignancies were admitted to our Hematology Unit between January 2014 and November 2017 who required anti-fungal therapy during intensive systemic chemotherapy. The incidence of AmB-d associated nephrotoxicity, side effect profile, time to nephrotoxicity, and clinical and epidemiological characteristics associated with treatment success were assessed retrospectively.Results: Of the 110 patients receiving AmB-d, 70 (63.6%) were male and 40 (36.4%) were female. The mean age of participants was 44 years. The most common diagnosis was acute myeloid leukemia (n=53, 48.2%), and the most common chemotherapy protocol was 7 + 3 remission-induction (cytarabine 100 mg/m(2) days 1-7, Idarubicin 12 mg/m(2) days 1-3; n=24, 21.8%). In 56.4% of the patients, antifungal therapy was given empirically. In 40 patients (36.4%), nephrotoxicity was observed following antifungal treatment, and only four patients had stage 3 renal failure. The mean duration of time to nephrotoxicity from initiation of amphotericin B was four days (min: 2, max: 31). All patients were found to receive at least one additional potential nephrotoxic treatment during the antifungal treatment process.Conclusion: AmB-d is associated with a significant risk of nephrotoxicity. In most hematological patients, antifungal treatment is initiated empirically, and patients received prolonged courses of treatment. Therefore, it is plausible to initiate such treatment with AmB-d, when one considers the already high treatment costs in this patient group as well as the fact that AmB-d offers similar efficacy to antifungal agents at a lower cost. AmB-d may be recommended as a first-line agent in this patient group with the introduction of newer and more costly antifungal agents when needed, on the basis of the fact that these patients can be closely monitored in a hospital setting, reversible nature of nephrotoxicity upon discontinuation, and rare occurrence of severe renal failure requiring dialysis.
Conventional culture and molecular screening methods for detection of vancomycin-resistant enterococci activity
(Carbone Editore, 2016-01-01) Karakecili, Faruk; Cilo, Burcu Dalyan; Akın, Hicran; Ağca, Harun; Sınırtaş, Melda; Özakın, Cüneyt; Yılmaz, Emel; Akalın, Halis; Cilo, Burcu Dalyan; Akın, Hicran; AĞCA, HARUN; Sınırtaş, Melda; ÖZAKIN, CÜNEYT; YILMAZ, EMEL; AKALIN, EMİN HALİS; Uludağ Üniversitesi/Tıp Fakültesi/Microbiooji Bölümü; 0000-0002-7368-7187; 0000-0002-2651-2034; 0000-0002-3894-1231; 0000-0001-7530-1279; IVV-5845-2023; AAH-4027-2021; AAU-8952-2020; AAG-8392-2021; ISU-9626-2023
Introduction: Early identification of vancomycin-resistant enterococci (VRE) colonization by screening patients is necessary in tends of preventing spread and development of infection. The purpose of this study was to investigate the presence of VRE using and real time polymerase chain reaction (RT-PCR) and to compare the results and costs.Materials and methods: Patients in the risk group attending our hospital and planned for treatment with hospitalization were included. Two rectal swab specimens were taken. One swab specimen was inoculated into enterococci broth for CCSM. Resistant gene investigation was performed with the other specimen by using RT-PCR. The costs of the two methods were then compared.Results: VRE were detected in 75 (6.63%) of the 1130 patients screened using the two methods. Resistance gene was determined in 69 (6.1%) patients using RT-PCR and 32 (2.8%) with CCSM. RT-PCR results were negative in 6 patients with VRE growth determined using CCSM. VRE was detected with CCSM in all 26 patients in whom vanA genotype VRE were determined using RT-PCR, but no growth was determined with CCSM in any of the 43 patients in whom vanB genotype VRE were detected. Results obtained in 3 days using CCSM and within 4 hours using RT-PCR. Costs were 58 $ with CCSM and 46 $ with RT-PCR.Conclusion: VRE colonization being detected faster with RT-PCR than CCSM. When the costs in isolation of patients until VRE screening test results emerged were compared, VRE screening with RT-PCR was cost-effective. RT-PCR was markedly superior to CCSM in determining VanB type resistance. Due to the late results from CCSM and its failure to detect VanB type resistance, we think that RT-PCR can be an alternative to CCSM or that the two techniques can usefully be combined depending on the hospital conditions.
Coronavirus disease 2019 and antibiotic stewardship-antibiotic usage in adult patients: Is it necessary? When should it be concerned?
(Galenos Publ House, 2021-01-30) Önal, Uğur; Akalın, Halis; ÖNAL, UĞUR; AKALIN, EMİN HALİS; Bursa Uludağ Üniversitesi/Tıp Fakültesi/Enfeksiyon Hastalıkları ve Klinik Mikrobiyoloji Anabilim Dalı.; 0000-0001-6194-3254; 0000-0001-7530-1279; JCO-3678-2023; AAU-8952-2020; ACQ-7832-2022
Antibiotic consumption rates were quite high in number, although the bacterial coinfection rates were low in coronavirus disease 2019 pneumonia. Generally, empirical antibiotic treatment is not recommended for uncomplicated coronavirus disease 2019 mild to moderate pneumonia cases. On the other hand, antibiotic treatment and de-escalation are recommended for intubated intensive care unit patients or critical patients with sepsis, septic shock, or acute respiratory distress syndrome. The presentation of patients with severe coronavirus disease 2019 pneumonia can direct the clinicians to use antibiotics. We believe that wait and watch strategy can be preferred in such cases without sepsis, secondary bacterial infection findings, or procalcitonin < 0.5 ng/mL. We think that a new wave of resistance will occur inevitably if we cannot perform the antibiotic stewardship properly.
Crimean-congo haemorrhagic fever in south Marmara region, Turkey
(Doc Design Informatics Co Ltd, 2009-12-01) Bölük, Gülçin; Özvatan-Şener, Tülay; Yılmaz, Emel; Akalın, Halis; Mıstık, Reşit; Helvacı, Safiye; Bölük, Gülçin; Özvatan-Şener, Tülay; YILMAZ, EMEL; AKALIN, EMİN HALİS; Mıstık, Reşit; Helvacı, Safiye; Uludağ Üniversitesi/Tıp Fakültesi/Enfeksiyon Hastalıkları ve Klinik Mikrobiyoloji Anabilim Dalı.; 0000-0001-7530-1279; KFT-0453-2024; AAU-8952-2020; HTL-9425-2023; FQE-4671-2022; DFY-3761-2022; EXQ-2687-2022
Crimean-Congo haemorrhagic fever (CCHF) is an infectious disease caused by Nairovirus. The causative agent of the disease is transmitted by ticks of Hyalomma genus, and ticks play a role in transmission of the virus between wild animals, livestock and humans. We report two cases with CCHF who were followed in our clinic.
Diagnostic efficacy of aspergillus galactomannan lateral flow assay in patients with hematological malignancies: A prospective multicenter study
(Springer, 2023-06-05) Alhan, Özlem; Saba, Rabin; Akalın, Emin Halis; Ener, Beyza; Yüce, Zeynep Türe; Deveci, Burak; Güncü, Mehmet Mucahit; Kahveci, Hüseyin Nadir; Yılmaz, Asu Fergün; Odabaşı, Zekaver; AKALIN, EMİN HALİS; ENER, BEYZA; Uludağ Üniversitesi/Tıp Fakültesi/Enfeksiyon Hastalıkları ve Klinik Anabilim Dalı Mikrobiyoloji; Uludağ Üniversitesi/Tıp Fakültesi/Tıbbi Mikrobiyoloji Anabilim Dalı; AAU-8952-2020; CNK-0895-2022
BackgroundA rapid and reliable diagnostic test is needed to reduce mortality through early diagnosis of invasive aspergillosis (IA) in patients with hematological malignancies.ObjectiveTo evaluate the efficacy of serum and bronchoalveolar lavage (BAL) Aspergillus galactomannan lateral flow assay (GM-LFA) in IA diagnosis and determine the correlation of GM-LFA with GM enzyme immunoassay (GM-EIA) in patients with hematological malignancies.MethodsIn this prospective multicenter study, we used serum and BAL fluid samples from patients with hematological malignancies and suspected IA and performed GM-LFA and GM-EIA. According to the EORTC/MSGERC criteria, patients were grouped as proven (n = 6), probable (n = 22), possible IA (n = 55), or no IA (n = 88). The performance of serum GM-LFA at 0.5 optical density index (ODI) and area under the curve (AUC) were calculated. Spearman's correlation analysis and kappa statistics were performed to determine the agreement between the tests.ResultsGM-LFA showed an AUC of 0.832 in proven/probable IA (sensitivity [SEN], specificity [SPE], negative predictive value [NPV], and diagnostic accuracy were 75%, 100%, 92.6%, and 93.9%, respectively, at a 0.5 ODI) versus that in no IA. A moderate positive correlation was noted between the GM-LFA and GM-EIA scores (p = 0.01). The observed agreement between the tests at 0.5 ODI was almost perfect (p < 0.001). After excluding patients who received mold-active antifungal prophylaxis or treatment, the SEN, SPE, NPV, and diagnostic accuracy for proven/probable IA were 76.2%, 100%, 93.3%, and 94.5%, respectively.ConclusionsSerum GM-LFA demonstrated high discriminatory power and good diagnostic performance for IA in patients with hematological malignancies.
Epidemiology and clinical and radiographic characteristics of pneumonia in kidney transplant recipients; 24-year experience
(Turk Nefroloji Diyaliz Transplantasyon Dergisi, 2017-01-01) Dizdar, Oğuzhan Sıtkı; ERSOY, ALPARSLAN; AKALIN, EMİN HALİS; Bursa Uludağ Üniversitesi/Tıp Fakültesi/Nefroloji Anabilim Dalı.; Bursa Uludağ Üniversitesi/Tıp Fakültesi/Mikrobiyoloji Anabilim Dalı.; 0000-0001-7530-1279; D-6213-2013; AAU-8952-2020; AAH-5054-2021
OBJECTIVE: Pneumonia increases morbidity and mortality in kidney transplant (KT) recipients. This study aimed to investigate characteristics of pneumonias in KT recipients by focusing on clinical and radiographic findings and diagnostic methods over a long study period.MATERIAL and METHODS: The medical records of kidney transplant recipients who had a diagnosis of pneumonia from 1988 to 2011 were reviewed retrospectively.RESULTS: Among 406 consecutive KT recipients, 20% had pneumonia during the study period and total 111 episodes of pneumonia developed in these patients. Fifty-six percent of the pneumonias were community acquired and 44% nosocomial. Bacterial infections were the most common cause (20%) and 13 (12%) of the episodes were polymicrobial. Antibiotic usage in the last three months was significantly more common in fungal pneumonia episodes than others. Bronchoscopy had the highest final overall diagnostic yield.CONCLUSION: Community-acquired pneumonia was more common, but it showed a more benign clinical course. Bacterial pneumonia was the most common cause, but polymicrobial infection was present in a significant number of KT recipients. Fungi can invade KT recipients, in particular, patients in the interval of 1-6 month after transplantation and patients who have used antibiotics in the last three months.
Epidemiology and clinical characteristics of lower respiratory tract infections among kidney transplant recipients
(Oxford Univ Press, 2013-05-01) Akalın, Halis; Dizdar, Oğuzhan; Ersoy, Alparslan; AKALIN, EMİN HALİS; ERSOY, ALPARSLAN; Uludağ Üniversitesi/Tıp Fakültesi.; 0000-0002-0710-0923; AAH-5054-2021; AAU-8952-2020
Evaluation of indoleamine 2, 3 dioxygenase (IDO) gene polymorphisms in COVID-19
(Wiley, 2021-08-01) Karaca, Mert; Arslan, Gözde; Ermiş, Diğdem Yöyen; Bal, Salih Haldun; Uzaslan, Esra Kunt; Özkalemkaş, Fahir; Macunluoğlu, Aslı Ceren; Budak, Ferah; Akalın, Halis; Oral, Haluk Barbaros; KARACA, MERT; Arslan, Gözde; YÖYEN ERMİŞ, DİĞDEM; BAL, SALİH HALDUN; Uzaslan, Esra Kunt; ÖZKALEMKAŞ, FAHİR; Macunluoğlu, Aslı Ceren; BUDAK, FERAH; AKALIN, EMİN HALİS; ORAL, HALUK BARBAROS; Bursa Uludağ Üniversitesi/Tıp Fakültesi/İmmunoloji Anabilim Dalı.; Bursa Uludağ Üniversitesi/Tıp Fakültesi/Göğüs Hastalıkları Anabilim Dalı.; Bursa Uludağ Üniversitesi/Tıp Fakültesi/İç Hastalıkları Anabilim Dalı.; Bursa Uludağ Üniversitesi/Tıp Fakültesi/Biostatik Anabilim Dalı.; Bursa Uludağ Üniversitesi/Tıp Fakültesi/Enfeksiyon Hastalıkları ve Klinik Mikrobiyoloji Anabilim Dalı.; 0000-0002-6802-5998; 0000-0001-7625-9148; 0000-0001-7530-1279; 0000-0003-0463-6818; 0000-0002-6802-5998; 0000-0001-6711-676X; IZP-9398-2023; AAU-8952-2020; K-7285-2012; F-4657-2014; JFS-2013-2023; AAG-7406-2021; GYL-2038-2022; KBR-5535-2024; AAI-1004-2021; JLE-5241-2023; GBP-6589-2022
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; Bursa Uludağ Üniversitesi/Tıp Fakültesi/Tıbbi Mikrobiyoloji Anabilim Dalı.; Bursa Uludağ Üniversitesi/Tıp Fakültesi/Mikrobiyoloji Anabilim Dalı.; Bursa Uludağ Üniversitesi/Tıp Fakültesi/Anestezi ve Reanimasyon Anabilim Dalı.; 0000-0003-3544-3509; 0000-0002-8428-8245; 0000-0002-5882-1632; 0000-0001-7530-1279; JCO-3678-2023; AAU-8952-2020; A-4290-2018
OBJECTIVE: 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.