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  1. Home
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Browsing by Author "Şenol Akar Ş."

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    Necrotising fasciitis: Clinical evaluation and treatment results of 18 patients; [Nekrotizan Fasiit: 18 Hastanın Klinik Durumlarının ve Tedavi Sonuçlarının Değerlendirilmesi]
    (Galenos, 2019) Öztürk A.M.; Süer O.; Erdem H.A.; Yildirim Şimşir I.; Şenol Akar Ş.; Özkayin N.; Işikgöz Taşbakan M.; Akyol D.
    Introduction: Necrotizing fasciitis (NF) is a complicated and rapidly spreading soft tissue infection that affects the superficial fascia, skin, and subcutaneous tissue. In this study, we evaluated patients who were diagnosed with NF and treated in two tertiary-care educational university hospitals. Materials and Methods: Patients diagnosed with NF in three centers (Ege University Department of Orthopedics and Traumatology and Department of Infectious Diseases and Clinical Microbiology and Celal Bayar University Department of Infectious Diseases and Clinical Microbiology) between November 2016 and December 2018 were retrospectively analyzed. The patients’ demographic characteristics, significant risk factors for infection, sites of infection, models of surgical treatment, department(s) that performed the surgery, causative infectious agents, empirical and agent-specific treatment regimens and their duration, length of hospital stay, need for intensive care, and one month survival were evaluated. Results: Eighteen patients (10 females, mean age 53.7 [19-86 years]) who were diagnosed with NF were included in the study. Diabetes mellitus, trauma/surgery history, and decubitus wound were the most common predisposing factors. The most common anatomic site was lower extremity (n=10, 55.5%). All patients underwent surgical debridement. The most commonly isolated microorganisms were Escherichia coli (n=4), Klebsiella pneumoniae, Proteus mirabilis, and Acinetobacter baumannii (each n=3). Empirical treatment was initiated with meropenem in eight patients (32%) and tigecycline in four patients (12.5%), and the antibiotic was changed in five patients based on culture results. The mean duration of antibiotic therapy was 35.5 (9-68) days. The average hospital stay was 55 (11-186) days. Six patients (33.3%) required intensive care during followup. The mortality rate was 16.6%. Conclusion: NF is a fulminant disease, and early diagnosis and effective multidisciplinary treatment are crucial for reducing mortality rates. When the diagnosis is suspected, early surgical debridement should be performed and empirical antibiotherapy should be started immediately. ©Copyright 2019 by the Infectious Diseases and Clinical Microbiology Specialty Society of Turkey.
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    Factors affecting side effects, seroconversion rates and antibody response after inactivated SARS-CoV-2 vaccination in healthcare workers; [Sağlık çalışanlarında İnaktif SARS-CoV-2 aşılaması sonrası yan etkiler, serokonversiyon oranları ve antikor yanıtını etkileyen faktörler]
    (Ankara Microbiology Society, 2021) Şenol Akar Ş.; Akçali S.; Özkaya Y.; Gezginci F.M.; Cengi̇Z Özyurt B.; Deniz G.; Karadağ Yalçin F.; Özer D.; Dündar Erbay P.; Eser E.
    In this study, it was aimed to prospectively evaluate the efficacy, side effects and seroconversion data of inactive severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2), CoronaVac® (Sinovac, China) vaccine in healthcare workers. A total of 1053 healthcare workers who were initially seronegative (COV2T® SARS-CoV-2 Total Siemens, USA) and vaccinated with inactivated SARS-CoV-2 were included in the study. Quantitative IgG antibodies (ADVIA Centaur® SARS-CoV-2 IgG, Siemens, USA) were investigated 28 days after the first vaccine (n= 939) and the second vaccine (n= 771). In addition, neutralizing antibodies were evaluated via “enzyme linked immunosorbent assay (ELISA)” test (ACE2-RBD Neutralization Assay, Dia-Pro, Italy) 28 days after the first vaccine. Antibody response of the vaccine was evaluated statistically by univariate (Chi-square, Fisher’s exact test, Student’s t test, Mann-Whitney U, one-way ANOVA and Kruskall Wallis ANOVA tests) analysis and linear regression models. The consistency between quantitative IgG test and neutralizing antibody test was also evaluated in blood samples taken 28 days after second vaccination. Statistical analysis was determined in logarithmically transformed data with statistical analysis with SPSS 23.0 and Stata, and type 1 error level was accepted as 0.05. At least one side effect was reported by 31.3% and 26.8% of the participants after the first and second vaccine, respectively. The most frequent side effect was pain at the injection site with a frequency of 20.4% vs 21.7%. The frequency of applying to a health center due to side effects was 1.0% after the first vaccine and 0.8% after the second vaccine. The percentage of those who produced sufficient quantitative IgG was found as 25.3% (95% CI= 22.5-28.1) 28 days after the first vaccine and 97.9% (95% CI= 96.91-98.93) after the second vaccine. Neutralizing test antibody positivity was found as 97.7% 28 days after the second vaccine. In univariate analysis, the characteristics that significantly increased the quantitative IgG response against inactivated SARS-CoV-2 vaccine were young age (p< 0.01), female gender (p< 0.01), being a non-smoker (p< 0.001), not having a chronic disease (p= 0.019), having had the flu vaccine this year (p= 0.012), not being overweight or obese (p= 0.020), and having a SARS-CoV2 infection prior to vaccination (p< 0.001). In addition, allied health personnel showed significantly lower antibody responses than the other workers (p< 0.001). Multiple linear regression models revealed that, female gender, younger age, smoking and previous COVID-19 polymerase chain reaction test positivity significantly affected the quantitative IgG response after vaccination. A 99% agreement was found between the ELISA-based neutralizing antibody test and the quantitative IgG test (Kappa p= 0.783) performed on the 28th day after the second vaccination. CoronaVac® provides adequate antibody response in 25% of healthcare workers aged 18-64, after 28 days from a single vaccine, and 97% after 28 days from the second vaccine. Antibody response was significantly higher in younger ages, women, non-smokers, and those who had previously encountered SARS-CoV-2. Phase 3 and phase 4 results are needed to show effectiveness of this vaccine in real life. © 2021 Ankara Microbiology Society. All rights reserved.
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    Antibody Sustainability in SARS-CoV-2 Healthcare Professionals’ Patient Cohort; [Sağlık Çalışanları SARS-CoV-2 Hasta Kohordunda Antikor Sürdürülebilirliği]
    (Ankara Microbiology Society, 2022) Eser E.; Şenol Akar Ş.; Akçali S.; Ecemiş T.; Erbay Dündar P.; Çiçek K.; Akman D.; Tüzün E.; Şanli Erkekoğlu G.; Buran Z.C.; Öztürk Arikan Z.Ö.; Karadağ Yalçin F.
    In this study, it was aimed to evaluate one-year follow-up of severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) specific antibodies formed against the virus binding site, in a coronavirus disease-2019 (COVID-19) positive case cohort (n= 413) between the period March 2020 to December 2020 in Manisa Celal Bayar University Hospital, until July 2021. SARS-CoV-2 antibodies were determined by the chemiluminescent enzyme immunoassay (CLIA) method. Values of 1.0 and above were considered positive. Chi-square tests and Joinpoint regression analysis (version 4.7.0) were used in the statistical analyses. The mean age of the participants was 34.9 ± 9.3 and 60.2% of them were women. Between 21-30 days after the diagnosis of COVID-19, total antibody level was above the threshold value in 72.2% (n= 126) of the participants, while this rate increased to 79.1% (n= 240) in 31-60 day interval. In the following period, this rate decreased to 38.8% (n= 108) in days 211st to 240th. Antibody response could not be detected in 76 (20.7%) of 367 employees who have initially been followed up. The percentage of total antibody positivity prevalence ranged from 98.9% to 96.1% in the 31-210th day after diagnosis, in the follow-up of 291 employees whose total antibody positivity was detected after diagnosis. According to the results of the Joinpoint regression analysis, after the diagnosis of COVID-19, the curve showing the percentage of antibody positivity was broken at two points: The first breaking point was observed in 181-210th days (6-7 months) (p= 0.069), and the second breaking point was in 271-300th days (9-10 months) (p< 0.001). As a result, the highest antibody positivity rates were detected after the 30th day of the disease onset and antibody positivity was maintained in the first seven months after diagnosis; the antibody positivity rate decreased to 25% at the end of the first year. © 2022 Ankara Microbiology Society. All rights reserved.
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    Efficacy of Homologous and Heterologous Vaccine Applications on SARS-CoV-2 Omicron Variant: Cohort of Manisa Celal Bayar University Healthcare Workers; [Homolog ve Heterolog Aşı Uygulamalarının SARS-CoV-2 Omicron Varyantı Üzerindeki Etkililiği: Manisa Celal Bayar Üniversitesi Sağlık Çalışanları Kohordu]
    (Ankara Microbiology Society, 2023) Çi̇Çek K.; Özkaya Y.; Eser E.; Buran Z.C.; Öztürk Arikan Z.Ö.; Akçali S.; Erbay Dündar P.; Cengi̇Z Özyurt B.; Şenol Akar Ş.; Özer D.; Karadağ Yalçin F.
    This study was aimed to determine the efficacy of homologous (only CoronaVac or only Pfizer-BioNTech) and heterologous (CoronaVac and Pfizer-BioNTech) vaccines during the period when the severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) Omicron variant was dominant in Türkiye. Coronavirus disease-2019 (COVID-2019) infection was confirmed by reverse transcriptase polymerase chain reaction and data on vaccination status against COVID-19 were evaluated during the period of 15 January 2022-1 May 2022 when the SARS-CoV-2 Omicron variant was dominant among 1854 employees followed in the SARS-CoV-2 Vaccine Cohort of Manisa Celal Bayar University (MCBU) Hospital Health Workers. Two separate reference groups were used in the evaluation of vaccine efficacy: those who were never vaccinated and those who received only two doses of CoronaVac. The efficacy of homologous and heterologous vaccine models was evaluated with relative risks and attributable risk percentages. MS Excel, SPSS 23.0 and STATA 14.1 package programs were used for statistical analysis. The mean age of the participants was 36.6 ± 10.0. During the period from January 15th to May 1st 2022, 372 hospital workers were infected with COVID-19. Taking the never vaccinated as the reference group, the most effective model was found to be only the three or more doses of the Pfizer-BioNTech primary vaccination model (85.8%, 95% CI= 40.7-96.6). Models consisting of a single dose of CoronaVac (6.5%, 95% CI= -56.3-44.2) or a single dose of Pfizer-BioNTech (17.7%, 95% CI= -30.2-48.0) booster dose administered after two doses of primary CoronaVac vaccination was not found to be effective against the SARS-CoV-2 Omicron variant. When only two doses of primary CoronaVac vaccination model was taken as the reference group, the model consisting of two doses CoronaVac followed by two Pfizer-BioNTech booster doses was effective as 38.4% (95% CI= 15.4-55.3), whereas three doses of Pfizer-BioNTech booster model was effective as 56.4% (95% CI= 33.9-71.3). To conclude, none of the models other than the homologous or heterologous vaccine models containing at least three doses of Pfizer-BioNTech vaccine were effective compared to those unvaccinated. Compared with those who received only two doses of primary Coronavac, models with at least three doses of Pfizer-BioNTech reminder doses were more effective against the Omicron variant than other models. © 2023 Ankara Microbiology Society. All rights reserved.

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