Browsing by Author "Çetin Ç.B."

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    Investigation of nasal carriage of community-acquired methicillin resistant staphylococcus aureus in primary and high school students; [Ilköǧretim ve lise öǧrencilerinde toplum kökenli metisiline dirençli Staphylococcus aureus burun taşιyιcιlιǧιnιn araştιrιlmasι]
    (2008) Özgüven A.; Tünger Ö.; Çetin Ç.B.; Dinç G.
    The aim of this study was to evaluate the carriage rate and risk factors of community-acquired methicillin-resistant Staphylococcus aureus (CA-MRSA) among the students in Manisa, Turkey. A total of 2015 students (1012 from the last phase of high schools and 1003 from the first phase of primary schools) were included in the study. None of the students had nasal MRSA carriage. Methicillin-sensitive S.aureus (MSSA) colonization rate was 14.7% (296/2015). Nasal carriage of MSSA was significantly higher in the primary school students (17.8%) than the high school students (11.6%) (p< 0.001). MSSA carriage was also higher in students of higher socioeconomical status than the students of lower status (p< 0.05). A statistically significant relationship was not determined between the nasal carriage and the risk factors (history of hospitalisation or surgical operation in the previous one year, use of antibiotics or history of skin/soft tissue infection in the last 6 months, presence of children < 15 years old in the family, presence of healthcare workers in the same house, living in a crowded house). Penicillin and erythromycin resistance was found in 93.6% and 14.2% of MSSA strains, respectively. No resistance was detected against ciprofloxacin, co-trimoxazole, linezolid and vancomycin. There was a statistically significant difference between erythromycin resistance and antibiotic use within the last six months and the number of family members (p< 0.05). In conclusion, current treatment regimens still seem to be affective and safe for the empirical treatment of community-acquired S.aureus infections. Although CA-MRSA infections seem not to be a serious threat in our region yet, it is essential to carry out prevalence studies in the different populations of the community.
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    Evaluation of patients with zygomycosis
    (Turkiye Klinikleri Journal of Medical Sciences, 2014) Kaya O.; Alp Çavuş S.; Turhan Ö.; Işikgöz Taşbakan M.; Pullukçu H.; Ertuǧrul M.B.; Şenol Ş.; Çetin Ç.B.; Özhak Baysan B.; Sayin Kutlu S.; Metin D.Y.; Avci M.; Mermut G.; Avkan Oǧuz V.; Yapar N.
    Aim: Zygomycosis is a severe angioinvasive infection caused by Zygomycetes. We retrospectively investigated 16 cases of zygomycosis. Materials and methods: The data of patients, who had been followed between 2004 and 2010 in 8 tertiary-care teaching hospitals, were reviewed. Demographic characteristics, underlying diseases, and clinical signs and symptoms of the patients, as well as diagnostic methods, data obtained by radiological imaging methods, and the therapies, were recorded. Therapeutic approaches, antifungal agents and duration of use, and the characteristics of the cases were identified. Results: The study included 11 female and 5 male subjects. The most common symptoms and clinical signs were fever (n = 9) and retro-orbital pain (n = 7). Rhinocerebral zygomycosis was the most common form. The mean time elapsed for diagnosis was 14.26 ± 13.96 (range: 2-52) days. Antifungal therapy was given to 15 patients (94%). In addition to antifungal therapy, 12 patients underwent surgical intervention 1 to 4 times. The mean duration of receiving antifungal therapy was 61.4 ± 58.02 (range: 1-180) days. The median duration of treatment was 62.5 (range: 42-180) days in survivors. Conclusion: Zygomycosis is an infectious disease with high mortality despite antifungal therapy and surgical interventions. © TÜBİTAK.
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    Diagnostic and prognostic value of procalcitonin and sTREM-1 levels in sepsis
    (Turkiye Klinikleri Journal of Medical Sciences, 2015) Bayram H.; Tünger Ö.; Çivi M.; Yüceyar M.H.; Ulman C.; Dinç Horasan G.; Çetin Ç.B.
    Background/aim: Sepsis is still a major cause of morbidity and mortality despite the improvements in diagnosis and treatment. The aim of this study was to investigate the values of procalcitonin and soluble triggering receptor expressed on myeloid cells-1 (sTREM-1) in the diferential diagnosis of patients with sepsis and noninfectious systemic infammatory response syndrome (NI-SIRS) and measure their importance in the prognosis of patients with sepsis. Materials and methods: This prospective study included 41 NI-SIRS and 33 sepsis patients hospitalized in Celal Bayar University Hospital, Manisa, Turkey. Blood samples were taken from NI-SIRS patients on days 0 and 3 and from sepsis patients on days 0, 3, 4, 7, and 14. Clinical status of the patients was determined with the SOFA scoring system. Results: The SOFA scoring system and procalcitonin and sTREM-1 measurements were significant in the differential diagnosis of sepsis and NI-SIRS patients. The SOFA scoring system was considered the most important indicator in determining the prognosis of sepsis patients. Procalcitonin and sTREM-1 levels increased progressively in nonsurvivors and decreased in survivors, but changes were statistically in significant. Conclusion: In the differentiation of sepsis and NI-SIRS, and evaluation of the prognosis of sepsis, combined measurements of procalcitonin and sTREM-1 levels are important. © TÜBİTAK.
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    Colistin efficacy in the treatment of multidrug-resistant and extremely drug-resistant gram-negative bacterial infections
    (Turkiye Klinikleri Journal of Medical Sciences, 2016) Çetin Ç.B.; Özer Türk D.; Şenol Ş.; Dinç Horasan G.; Tünger Ö.
    Background/aim: Colistin is used as a salvage therapy for multidrug-resistant and extremely drug-resistant gram-negative bacterial infections. Our aim was to evaluate colistin efficiency and toxicity in the treatment of these resistant gram-negative bacterial infections. Materials and methods: This is a retrospective study carried out in a tertiary care hospital during 2011–2013. Study data were collected from the medical records and consultations of the infectious diseases clinic. Results: The study group included 158 patients with nosocomial infections and 136 (86.1%) of them were hospitalized in the ICU. Respiratory tract infections were the most commonly observed ones (n = 103, 65.2%). The most frequently isolated microorganism was Acinetobacter baumannii (72.2%). A total of 98 (62.0%) patients had clinical cure. There was no statistically significant difference between monotherapy (n = 3/6, 50.0%) and combination therapies (n = 95/152, 62.5%) according to clinical response. Underlying ultimately fatal disease, previous renal disease, and total parenteral nutrition were independent risk factors for poor clinical response. Nephrotoxicity developed in 80 (50.6%) patients and clinical cure was statistically unrelated with nephrotoxicity. Conclusion: Colistin may be used as an effective agent for multidrug-resistant and extremely drug-resistant gram-negative bacterial infections with close monitoring of renal functions, especially for older and critically ill patients. © TÜBİTAK.
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    Community-acquired pneumonia: Importance of molecular methods for etiological diagnosis and clinical features; [Toplumda gelişen pnömoni: Etyolojik tanıda moleküler yöntemlerin önemi ve klinik özellikler]
    (AVES İbrahim KARA, 2018) Özer-Türk D.; Tünger Ö.; Şakar-Coşkun A.; Gazi H.; Şanlıdağ T.; Kurhan F.; Çetin Ç.B.; Şenol Ş.
    Objective: This study aims to make an early identification for the diagnosis of community-acquired pneumonia (CAP), to increase the rate of etiological diagnosis and to distinguish bacterial and viral pathogens with the use of multiplex polymerase chain reaction (PCR) in addition to conventional methods, and to compare cases in the light of clinical and laboratory results. Methods: Ninety two CAP patients who were hospitalized and followed at our hospital between January-November 2013 were included in this study. Conventional culture and multiplex PCR were used to identify the causative microorganisms in the respiratory tract samples of the patients. Demographic data, risk factors, clinical, radiological and laboratory results, treatment and follow-up results of the cases were recorded. Statistical Package for the Social Sciences (SPSS) for Windows. Version 15.0 (SPSS Inc., Chicago, IL, USA) program was used in the analysis of the data. Results: CURB-65 score was determined ≥2 in 80.4% of the cases and 14.1% was followed in the intensive care unit. Of the patients, 42 (45.7%) were found to have bacterial and 20 (21.7%) were found to have viral agents while in 30 (32.6%) patients an agent could not be demostrated. Bacterial etiology was detected with conventional culture methods in 15 (16.3%) and with multiplex PCR in 42 (45.6%) cases. The difference between them was found to be statistically significant (p<0.001). It was found out that mostly bacterial factors were responsible for the CAP cases which were seen in fall or winter, and the etiology of the cases which were seen in spring and summer could not be determined in general (p<0.05). Variables such as sputum production, sore throat, auscultation findings and corticosteroid use were found to be statistically significant among bacterial, viral and unidentified etiology groups. Conclusions: It was demonstrated that molecular methods are beneficial for the early diagnosis of CAP. It was also thought that early diagnosis of viral etiology can prevent the unnecessary use of antibiotics as well as contributing to the patient management. © 2018, AVES İbrahim KARA. All rights reserved.
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    Mortality-associated factors of candidemia: a multi-center prospective cohort in Turkey
    (Springer Science and Business Media Deutschland GmbH, 2022) Kutlu M.; Sayın-Kutlu S.; Alp-Çavuş S.; Öztürk Ş.B.; Taşbakan M.; Özhak B.; Kaya O.; Kutsoylu O.E.; Şenol-Akar Ş.; Turhan Ö.; Mermut G.; Ertuğrul B.; Pullukcu H.; Çetin Ç.B.; Avkan-Oğuz V.; Yapar N.; Yeşim-Metin D.; Ergin Ç.
    Candidemia may present as severe and life-threatening infections and is associated with a high mortality rate. This study aimed to evaluate the risk factors associated with 30-day mortality in patients with candidemia. A multi-center prospective observational study was conducted in seven university hospitals in six provinces in the western part of Turkey. Patient data were collected with a structured form between January 2018 and April 2019. In total, 425 episodes of candidemia were observed during the study period. Two hundred forty-one patients died within 30 days, and the 30-day crude mortality rate was 56.7%. Multivariable analysis found that SOFA score (OR: 1.28, CI: 1.154–1.420, p < 0.001), parenteral nutrition (OR: 3.9, CI: 1.752–8.810, p = 0.001), previous antibacterial treatment (OR: 9.32, CI: 1.634–53.744, p = 0.012), newly developed renal failure after candidemia (OR: 2.7, CI: 1.079–6.761, p = 0.034), and newly developed thrombocytopenia after candidemia (OR: 2.6, CI: 1. 057–6.439, p = 0.038) were significantly associated with 30-day mortality. Central venous catheter removal was the only factor protective against mortality (OR: 0.34, CI:0.147–0.768, p = 0.010) in multivariable analysis. Candidemia mortality is high in patients with high SOFA scores, those receiving TPN therapy, and those who previously received antibacterial therapy. Renal failure and thrombocytopenia developing after candidemia should be followed carefully in patients. Antifungal therapy and removing the central venous catheter are essential in the management of candidemia. © 2021, The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.