Browsing by Author "Pullukcu H."

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    Carbapenem versus fosfomycin tromethanol in the treatment of extended-spectrum beta-lactamase-producing Escherichia coli-related complicated lower urinary tract infection
    (Maney Publishing, 2010) Senol S.; Tasbakan M.; Pullukcu H.; Sipahi O.R.; Sipahi H.; Yamazhan T.; Arda B.; Ulusoy S.
    The aim of this observational prospective study was to compare the effect of fosfomycin tromethanol (FT) and carbapenems (meropenem or imipenem cilastatin) in the treatment of extended-spectrum beta-lactamase (ESBL)-producing Escherichia coli-related complicated lower urinary tract infection (CLUTI). Inclusion criteria were: patients who were aged >18 yr with dysuria or problems with frequency or urgency in passing urine; those with >20 leukocytes/mm3 in urine microscopy and culture-proven ESBL-producing carbapenem or FT-sensitive E. coli in the urine (>10 5 cfu/mm3); no leukocytosis or fever; and who were treated with FT (oral 3 g sachet x 1 every other night, three times) or carbapenems between March 2005 and January 2006 in our outpatient clinic and hospital. A total of 47 CLUTI attacks in 47 patients (27 FT group, 20 carbapenem group) were observed prospectively. Clinical and microbiological success in the carbapenem and FT groups was similar (19/20 vs 21/27 and 16/20 vs 16/27 p>0.05). Drug acquisition costs were significantly lower in the FT group (p<0.001). Although it is not a randomized controlled study, these data show that FT may be a suitable, effective and cheap alternative in the treatment of ESBL-producing E. coli-related CLUTI. © E.S.I.F.T. srl.
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    Evaluation of species distribution and risk factors of candidemia: A multicenter case-control study
    (2010) Yapar N.; Pullukcu H.; Avkan-Oguz V.; Sayin-Kutlu S.; Ertugrul B.; Sacar S.; Cetin B.; Kaya O.
    This study was planned to determine the risk factors of candidemia, and the most common Candida species causing bloodstream infections. A case-control study which included adult patients was conducted over a 1-year period at tertiary-care educational hospitals in Turkey. A total of 83 candidemia episodes were identified during the study period. Candida albicans was the most common species recovered (45.8%) followed by Candida tropicalis (24.1%) Candida parapsilosis (14.5%) and Candida glabrata which was isolated from only four (4.8%) patients. Presence of a urethral catheter (odds ratio [OR] 2.38; 95% confidence interval [CI] 1.095.19; P 0.02), previous use of antibiotics (OR 2.61; 95% CI 1.056.46; P 0.03), RBC transfusions (OR 2.14; 95% CI 1.163.94; P 0.01) and parenteral nutrition (OR 4.44; 95% CI 2.438.11; P < 0.01) were found as independent risk factors for candidemia. TPN (Total Parenteral Nutrition) was an independent risk factor for both C. albicans and non-Candida albicans Candida species (P < 0.001). Most of the risk factors were invasive procedures and former medications. We conclude that a great number of candidemia cases are preventable by means of reduction of unnecessary invasive procedures and the use of antimicrobials. © 2011 ISHAM.
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    The importance of the contribution of rapid test, serological and molecular methods in the diagnosis of two imported malaria cases with atypical microscopy; [Mikroskopide Atipik Gorunumlu Dis Kaynakli Iki Sitma Olgusunda Hizli Test, Serolojik ve Molekuler Yontemlerin Taniya Katkisinin Onemi]
    (Ankara Microbiology Society, 2017) Zorbozan O.; Pullukcu H.; Sahar E.A.; Karakavuk M.; Can H.; Tunali V.; Doskaya M.; Turgay N.; Toz S.; Ozbilgin A.
    Malaria is a widespread and life-threatening disease in tropical and subtropical regions. In patients with typical clinical symptoms, malaria is considered as a preliminary diagnosis if there is a travel history to malaria-endemic areas. The basis of the laboratory diagnosis of malaria is the microscopic examination of Giemsa stained smears. On the other hand, the diagnosis and differentiation of Plasmodium species with microscopic examination may have some difficulties. In the first case, adifferent appearance from the classical Plasmodium vivax erythrocytic forms in infected erythrocytes were detected in 1% of all erythrocytes in thin smear blood preparations of a 26-year-old male with complaints of fever and chills and a story of travel to Nigeria. It was observed that parasitic nuclei were not prominent, and were located in the cytoplasm irregularly as chromatin or dye particles, nucleus fragments similar to Schiiffner's granules in the form of scattered and granular spots were present in some erythrocytes, the cytoplasm of some Plasmodium erythrocytic forms were irregular and nuclei were not seen. There were no Schiiffner's granules in any of the infected erythrocytes. PMvax was detected by the rapid diagnostic test (OptiMAL, DiaMed GmbH, Switzerland), which searches for the antigens of Plasmodium species, in the peripheral blood sample of the patients. The P.vlvax 18S rRNA gene was also detected by the multiplex real-time polymerase chain reaction. Antibodies against Plasmodium species were searched by using the Pan Malaria Antibody CELISA (CeLLabs Pty Ltd, Brookvale, Australia) kit in the patient's serum sample and the optical density (OD) value of the patient sample was measured five times the OD value of the positive control. In the second case, adifferent appearance from the classical P.faldparum erythrocytic forms in infected erythrocytes were detected in 12% of all erythrocytes in thin smear blood preparations of a 31-year-old male who has been suffering from persistent fever, severe headache, pain in the eyes and was known to be working in Nigeria. It was observed that some Plasmodium trophozoites have 1 /3 of the size of erythrocytes such as P.vivax and have non-granular cytoplasm, some erythrocytic forms were round and the nucleus and cytoplasm were hardly distinguished, some of them were seen as crescent and close to the nucleus of the cytoplasm and some erythrocytic forms had characteristically a single nucleus and a scattered cytoplasm, similar to mature trophozoites of P.vivax. Although the Plasmodium young trophozoites were similar to Rvtvax in means of magnitude, the forms in which the nude adhered to the erythrocyte wall were common. There were no Rfalciparum gametocyte forms. Rfalciparum like young trophozoite was observedonly in one of the four smears. P.falciparum was detected by the commercial rapid diagnostic test and Rfalciparum 18S rRNA gene was also detected by the multiplex real-time polymerase chain reaction. Antibody formation against Plasmodium species was not detected in the ELISA test. In these case reports, the importance of the support of rapid diagnostic tests, serological and molecular methods to microscopic diagnosis and species determination of two imported malaria cases were demonstrated.
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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.