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Öğe Bacterial adhesion to braided surgical sutures: an in vitro study(Springer, 2016) Boybeyi, Ozlem; Kacmaz, Birgul; Gunal, Yasemin Dere; Gul, Serdar; Yorubulut, Serap; Aslan, Mustafa KemalBackground Surgical suture materials are accepted to be associated with a substantial proportion of surgical site infections. These infections are related with biofilm formation similar to that of other synthetic and implantable medical devices. Methods We conducted an in vitro study to investigate the bacterial adherence to different types of braided surgical sutures. The included sutures were polyglactin (Vicryl (R)) group (VG), rapidly absorbable polyglactin (Rapide-Vicryl (R)) group (RVG), nitrofurazone-coated polyglactin (Vicryl (R)) group (FVG), polyethylene terephthalate (Etibond (R)) group (EG), and natural silk (Silk (R)) group (SG). All sutures were cut in 1 cm length, embedded into tryptic soy broth, and then 10(6)-CFU/ml Escherichia coli and Staphylococcus aureus were added. After the 24th and 96th hour of incubation, bacterial colonies were counted, and results were expressed as CFU/cm. Results E. coli adhesion was significantly lower in VG and significantly higher in SG compared to FVG, RVG, and EG at the 24th and 96th hour of cultivation (p< 0.05). The S. aureus adhesion results at 24th hour showed that VG had the least bacterial adhesion, and FVG had the most bacterial adhesion compared to other sutures (p< 0.05). The S. aureus adhesion results at the 96th hour of cultivation showed that bacterial adhesion on sutures was not significantly different between groups (p> 0.05). Conclusion Of all braided surgical sutures, bacterial adhesion is significantly lower in polyglactin and significantly higher in silk sutures. Nitrofurazone coverage of suture worsens S. aureus contamination of the suture.Öğe Clinical Patterns and Seasonal Distribution of Urinary Tract Infection Caused by Extended-spectrum Beta-lactamase-producing Bacteria in Children(Bilimsel Tip Yayinevi, 2021) Tursun, Serkan; Arslan, Zeynep; Alpcan, Aysegul; Gul, Serdar; Kandur, YasarIntroduction: Extended-spectrum beta-lactamase-producing Escherichia coli or Klebsiella pneumoniae infections in the pediatric age group are mostly nosocomial infections. This study aimed to investigate the clinical pattern of extended-spectrum beta-lactamase positive urinary tract infection and its seasonal distribution. Materials and Methods: We retrospectively reviewed the medical records of pediatric patients with extended-spectrum beta-lactamases-positive UTI, who were followed-up in our clinic between lune 2015 and lune 2020. Results: One hundred-and-ten patients with ESBL-positive UTI and 231 with non-ESBL UTI were enrolled in this study. The rate of male sex in the ESBL group was significantly lower than that in the non-ESBL group (10.9% vs 27.2%, p= 0.001). The patients with ESBL were older than those in the non-ESBL group (81.3 +/- 49.0 months vs 56.0 +/- 47.2 months, p= 0.001). E. coli was the most iso- lated bacteria in both groups (68% and 70.5%, respectively). The rate of Klebsiella isolation in urine culture was significantly greater in the ESBL group than in the non-ESBL group (p= 0.04). The seasonal distribution of ESBL-positive patients was as follows: spring (18/16.4%), summer (25/22.7%), autumn (25/22.7%), and winter (42/38.2%). Conclusion: There is a substantially high rate of antibiotic resistance among patients with urinary tract infection in developing countries like Turkey. Moreover, we should be aware of the risk of ESBL-positive UTIs, especially in winter.Öğe A comparison of the recoverable proportion of methicillin-resistant Staphylococcus aureus from two different types of papers(German Medical Science-Gms, 2016) Kacmaz, Birgul; Gul, SerdarAim: Paper is used for various purposes in hospitals. Generally, there are two different types of paper, which are commonly used in our facility: wood-free paper, and paper containing wood. We compared the recoverable proportion of methicillin-resistant Staphylococcus aureus (MRSA; ATCC 43300) from the surface of such papers. Method: The papers were divided into two groups: Group 1: wood-free paper; Group 2: paper containing wood. The papers were contaminated in a standardized procedure with 0.1 mL of a 5x10(7) CFU MRSA/mL stock solution. Results: The recoverable proportion of MRSA was higher in the wood-containing papers than in the papers without wood (P=0.043). Conclusion: This study indicates that if paper is purchased for healthcare facilities it should not contain wood, but rather wood-free paper types should be considered.Öğe Investigation of immunity against Bordetella pertussis in pregnant women and an overview of the vaccination schedule in Turkey(Turkish J Pediatrics, 2021) Gul, Serdar; Sonmez, Cemile; Ayvaz, Gokce; Kilic, SelcukBackground. Pertussis caused by Bordetella pertussis, is a disease leading to significant morbidity and mortality in neonates and infants. Direct protection of the infant may be achieved by maternal and neonatal vaccination. Despite primary vaccination, infants under six months pose the greatest risk of infection with pertussis. Maternal immunization provides a high level of infant protection from birth until immunity is achieved by active vaccination. There is no routine Tdap vaccination recommendation for pregnant women in Turkey. This study was carried out to determine pertussis antibody levels in pregnant women and provide data for improving vaccine planning. Methods. The study was carried out with 133 pregnant women in Turkey. Antibody titers to pertussis toxin (anti-PT) and filamentous hemagglutinin (anti-FHA) were measured by the commercially available ELISA. Results. Among 133 participants, 93 (69.9%) were found to be immune according to anti-PT IgG antibody levels. According to anti-FHA IgG antibody levels, 123 (92.5%) participants were considered to be immune. A positive correlation was observed between PT and FHA and the findings were statistically significant (P <0.001, r = 0.343). In the study group, the ages of the participants varied between 17 and 44 years. The mean age of those who were immune was 27.3 +/- 5.6, the mean age of non-immune patients was 29.1 +/- 6.2 and the difference was not statistically significant (P= 0.14). Conclusions. Our results reveal that approximately one-third of pregnant women were not immune to pertussis, reflecting many young infants to be vulnerable to pertussis infection until the onset of primary vaccinations, although childhood pertussis vaccination coverage has been high for a long time. We conclude that Tdap vaccine recommendation for pregnant women regardless of previous immunization history may be beneficial for the protection of infants in their first six months.Öğe Potential Drug-Drug Interactions with Antimicrobials in Hospitalized Patients: A Multicenter Point-Prevalence Study(Int Scientific Information, Inc, 2018) Kuscu, Ferit; Ulu, Astihan; Inal, Ayse S.; Suntur, Bedia M.; Aydemir, Hande; Gul, Serdar; Tasova, YesimBackground: Improper use of antimicrobials can cause adverse drug events and high costs. The purpose of this study was to investigate the frequency and potential drug-drug interactions associated with antimicrobials among hospitalized patients. Material/Methods: This study was conducted on the same day in 5 different hospitals in Turkey. We included patients aged (3) 18 years who received at least 1 antimicrobial drug and at least 1 of any other drug. The Micromedex (R) online drug reference system was used to control and describe the interactions. Drug interactions were classified as contraindicated, major, moderate, and minor. Results: Potential drug-drug interactions with antimicrobials were 26.4% of all interactions. Five (42%) of 12 contraindicated interactions and 61 (38%) of 159 major interactions were with antimicrobials. Quinolones, triazoles, metronidazole, linezolid, and clarithromycin accounted for 173 (25.7%) of 673 prescribed antimicrobials, but were responsible for 141 (92.1%) of 153 interactions. In multivariate analysis, number of prescribed antimicrobials (odds ratio: 2.3001, 95% CI: 1.6237-3.2582), number of prescribed drugs (odds ratio: 1.2008, 95% CI: 1.0943-1.3177), and hospitalization in the university hospital (odds ratio: 1.7798, 95% CI: 1.0035-3.1564) were independent risk factors for developing drug interactions. Conclusions: Due to risk of drug interactions, physicians should be more cautious when prescribing antimicrobials, particularly when prescribing quinolones, linezolid, azoles, metronidazole, and macrolides.Öğe Reliability of VITEK (R) 2 System for Identification of Yeasts: An Isolate of Candida parapsilosis Incorrectly Identified as Cryptococcus neoformans(Aves, 2017) Kacmaz, Birgul; Gul, Serdar; Karabicak, Nilgun; Ayaslioglu, Ergin; Bulut, Cemal; Caliskan, Okan…Öğe Risk Factors for Colistin-Associated Acute Kidney Injury: A Multicenter Study from Turkey(Natl Inst Infectious Diseases, 2016) Gul, Serdar; Kuscu, Ferit; Aydemir, Hande; Ozturk, Dogan Baris; Deveci, Ozcan; Duygu, Fazilet; Aslan, EmelThe aim of this study was to investigate the incidence of acute kidney injury (AKI) and risk factors due to colistin use in patients infected with multidrug-resistant pathogens. This multicenter, retrospective, observational study was conducted in Turkey, at 5 different research and university hospitals. Cox regression analyses were performed, to determine independent predictors of AKI. From April 2012 to July 2014, a total of 216 patients aged between 18-94 years, treated with colistimethate sodium (CMS) were included in the study. The mean age of the patients was 60.3 +/- 20.1 years. The overall incidence of AKI was 34.3% (74/216) at any time during treatment. Concomitant use of loop diuretics, baseline creatinine level, and CMS dosage were independently associated with AKI. According to our results, patients with higher baseline creatinine levels, or patients who had to use concomitant loop diuretics may need to be monitored more closely, and dose adjustment should be done promptly. More comprehensive studies are, however, still needed to evaluate the efficacy of low-dose colistin since higher doses tend to increase the risk of AKI.Öğe Seroprevalence of Brucellosis among Children in the Middle Anatolia Region of Turkey(Icddr B, 2014) Gul, Serdar; Satilmis, Ozgun Kiris; Ozturk, Baris; Gokce, Mehmet Ilker; Kuscu, FeritBrucellosis is an important public-health problem in Turkey. Children may constitute 20 to 30% of all brucellosis cases in the world, especially in the endemic regions. Data on the seroprevalence of brucellosis in childhood are very limited. In this study, we aimed to evaluate the seroprevalence of brucellosis among a child population. One thousand one hundred and ten subjects were included in the study. Blood samples were collected and tested with Rose Bengal (RB) and standard tube agglutination test (SAT). RB test results were positive for 6 patients, and SAT was negative for all patients. Our findings suggest that seroprevalence of brucellosis is decreasing in Middle Anatolia due to a new cattle vaccination and eradication programme which was initiated in 2009.Öğe Sustained Virologic Response with Triple Therapy in a Hemodialysis Patient with Chronic HCV Infection(Galenos Yayincilik, 2014) Kaygusuz, Sedat; Gul, Serdar; Gulhan, MuhammetChronic hepatitis C virus (HCV) infection is more prevalent and has been proven to be an independent risk factor over mortality among hemodialysis patients than normal population. Since sustained virologic response (SVR) is so beneficial and may be maintained in 90-100% of post-transplant cases, treatment of chronic HCV infection is strongly suggested for all patients undergoing renal transplantation. A 45-year-old male patient had been offered to have renal transplantation due to chronic renal failure, and referred to our clinic because of chronic HCV infection (HCV-RNA positive). He had received hemodialysis three times a week since 2007. The patient was diagnosed with chronic HCV infection fifteen years ago and was given a 48-week lasting IFN therapy in 2000 and a subsequent therapy of PEG-IFN-alpha 2a for 48 weeks in 2004. Although both therapies had yielded end of treatment responses, subsequent relapses occurred. The patient was given a combination treatment involving PEG-IFN-alpha 2a (135 mu g/wk) for 24 weeks and ribavirin (200 mg/day) for 24 weeks and telaprevir (3 x 750 mg) for the first 12 weeks, and a weekly control visit in our clinic. The therapy was generally well tolerated and SVR was achieved. Triple therapy might be used as a treatment option in hemodialysis patients with genotype 1 chronic HCV infections.Öğe Transmission dynamics of Covid-19 in Italy, Germany and Turkey considering social distancing, testing and quarantine(J INFECTION DEVELOPING COUNTRIES, 2020) Gul, Serdar; Tuncay, Kagan; Binici, Baris; Aydin, Beyazit BestamiIntroduction: There are significant differences in the active cases and fatality rates of Covid-19 for different European countries. Methodology: The present study employs Monte Carlo based transmission growth simulations for Italy, Germany and Turkey. The probabilities of transmission at home, work and social networks and the number of initial cases have been calibrated to match the basic reproduction number and the reported fatality curves. Parametric studies were conducted to observe the effect of social distancing, work closure, testing and quarantine of the family and colleagues of positively tested individuals. Results: It is observed that estimates of the number of initial cases in Italy compared to Turkey and Germany are higher. Turkey will probably experience about 30% less number of fatalities than Germany due its smaller elderly population. If social distancing and work contacts are limited to 25% of daily routines, Germany and Turkey may limit the number of fatalities to a few thousands as the reproduction number decreases to about 1.3 from 2.8. Random testing may reduce the number of fatalities by 10% upon testing least 5/1000 of the population. Quarantining of family and workmates of positively tested individuals may reduce the total number of fatalities by about 50%. Conclusions: The fatality rate of Covid-19 is estimated to be about 1.5% based on the simulation results. This may further be reduced by limiting the number of non-family contacts to two, conducting tests more than 0.5% of the population and immediate quarantine of the contacts for positively tested individuals.
