Browsing by Author "Senol Akar, S"

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    Evaluation of Achromobacter xylosoxidans subsp. denitrificans Infections at an University Hospital
    Senol Akar, S; Dindar Demiray, EK; Alkan, S; Özer, D; Kurutepe, S
    Introduction: Infections due to Achromobacter xylosoxidans (AX) type bacteria are very rare. There are few case reports from our country but knowledge about practical therapeutical applications is scarce. In this study we aimed to report AX denitrificans infections and clinical approach at our hospital. Materials and Methods: This study comprised patients over 18 years old who were hospitalised at Manisa Celal Bayar University Hafsa Sultan Hospital and who were positive for AX. denitrificans between 01.01.2016-31.12.2019. Data about these patients were obtained retrospectively from hospital records. Demographic clinical and bacteriologic data were analysed by suitable methods. Results: AX. denitrificans was detected in 16 cultures of 10 patients. Growth was detected from wound biopsy cultures in 11 specimens (68.7%). Nine patients were male and the mean age was 51.3 +/- 17. Seven of the patients had been hospitalised in the same clinic at different time intervals. The most common diagnosis was surgical site infection. All of AX. denitrificans induced infections were health care associated infections (HAI). Risc factors were found as being hospitalised and/or operated at the plastic and reconstructive surgery ward, antibiotic consumption within the last month and history of collagen tissue disorders. At the time of diagnosis with AX. denitrificans infection, 10 patients were using ampirical antibiotic for vairous reasons. One patient passed away before culture result was obtained. The most common ampirical antibiotic was found as third generation cephalosporins. When culture results were identified in 50% of the patients were receiving appropriate antibiotherapy. All 16 culture growths revealed sensitivity towards piperacillin/tazobactam. Conclusion: Even though AX. denitrificans is a rare community and hospital derived infectious agent, it should be kept in mind in clinics that show clustering and suitable ampiric therapy should be applied to keep the infection under control.
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    Comparison of Two Different Commercial SARS-CoV-2 PCR Diagnostic Kits
    Senol Akar, S; Akçali, S
    Introduction: In our country RT-PCR is the only method used to diagnose COVID-19 infection, caused by SARS-CoV-2, one of the greatest epidemic in world history. In this study we aimed to compare two most frequently used commercial diagnostic kits. Materials and Methods: A total of 100 samples which were referred to our laboratory were used in this study. These nucleic acid samples were diagnosed as positive (50) or negative (50) by Coronex (R) COVID-19 (Ver.2.0) Multipleks RT-qPCR Diagnosis Kit (DS Bio and Nano Technology, Ankara, Turkey) and kept at -20 degrees C. The samples were cross checked with RealStar (R) SARS-CoV-2 RT-PCR Kit 1.0 (Altona Diagnostic, Hamburg, Germany). Extraction of the samples was performed by QlAsymphony (Qiagen, Hollanda). Data was evaluated with kappa analysis and t test. Results: All of the 50 positive samples were positive with Real Star (R) as well. Two of the negative samples were found positive when studied with Real Star (R) . There was a high concordance between the two kits (Kappa= 0.96). Mean Ct values were found as 24.1 +/- 4.9 and 19.6 +/- 4.2 for Real Stat (R) and Coronex (R), respectively. The Ct value was found less than 20 in 51.9% of the 52 positive samples studied with Real Star (R). Conclusion: There is a high concordance between the two commercial kits. Both kits may be used with confidence in symptomatic patients for the diagnosis of COVID-19.
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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
    Çiçek, K; Özkaya, Y; Eser, E; Buran, ZC; Öztürk Arikan, ZÖ; Akçali, S; Erbay Dündar, P; Cengiz Özyurt, B; Senol Akar, S; Özer, D; Karadag Yalçin, F
    This study was aimed to determine the efficacy of homologous (only CoronaVac or only Pfizer-BioN- Tech) 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 T0rkiye. Coro- navirus 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 fol- lowed in the SARS-CoV-2 Vaccine Cohort of Manisa Celal Bayar University (MCBU) Hospital Health Work-ers. 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 heter- ologous 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 consist-ing 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 dos-es of Pfizer-BioNTech reminder doses were more effective against the Omicron variant than other models.
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    Factors Affecting Side Effects, Seroconversion Rates and Antibody Response After Inactivated SARS-CoV-2 Vaccination in Healthcare Workers
    Senol Akar, S; Akçali, S; Özkaya, Y; Gezginci, FM; Cengiz Özyurt, B; Deniz, G; Karadag 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 (R) (Sinovac, China) vaccine in healthcare workers. A total of 1053 healthcare workers who were initially seronegative (COV2T (R) SARS-CoV-2 Total Siemens, USA) and vaccinated with inactivated SARS-CoV-2 were included in the study. Quantitative IgG antibodies (ADVIA Centaur (R) 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=96.9198.93) 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 (R) 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.