Browsing by Author "Senol S."

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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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    The course of spinal tuberculosis (Pott disease): Results of the multinational, multicentre Backbone-2 study
    (Elsevier B.V., 2015) Batirel A.; Erdem H.; Sengoz G.; Pehlivanoglu F.; Ramosaco E.; Gülsün S.; Tekin R.; Mete B.; Balkan I.I.; Sevgi D.Y.; Giannitsioti E.; Fragou A.; Kaya S.; Cetin B.; Oktenoglu T.; Celik A.D.; Karaca B.; Horasan E.S.; Ulug M.; Senbayrak S.; Kaya S.; Arslanalp E.; Hasbun R.; Ates-Guler S.; Willke A.; Senol S.; Inan D.; Güclü E.; Ertem G.T.; Koc M.M.; Tasbakan M.; Ocal G.; Kocagoz S.; Kusoglu H.; Güven T.; Baran A.I.; Dede B.; Karadag F.Y.; Yilmaz H.; Aslan G.; Al-Gallad D.A.; Cesur S.; El-Sokkary R.; Sirmatel F.; Savasci U.; Karaahmetoglu G.; Vahaboglu H.
    We aimed to describe clinical, laboratory, diagnostic and therapeutic features of spinal tuberculosis (ST), also known as Pott disease. A total of 314 patients with ST from 35 centres in Turkey, Egypt, Albania and Greece were included. Median duration from initial symptoms to the time of diagnosis was 78 days. The most common complications presented before diagnosis were abscesses (69%), neurologic deficits (40%), spinal instability (21%) and spinal deformity (16%). Lumbar (56%), thoracic (49%) and thoracolumbar (13%) vertebrae were the most commonly involved sites of infection. Although 51% of the patients had multiple levels of vertebral involvement, 8% had noncontiguous involvement of multiple vertebral bodies. The causative agent was identified in 41% of cases. Histopathologic examination was performed in 200 patients (64%), and 74% were consistent with tuberculosis. Medical treatment alone was implemented in 103 patients (33%), while 211 patients (67%) underwent diagnostic and/or therapeutic surgical intervention. Ten percent of the patients required more than one surgical intervention. Mortality occurred in 7 patients (2%), and 77 (25%) developed sequelae. The distribution of the posttreatment sequelae were as follows: 11% kyphosis, 6% Gibbus deformity, 5% scoliosis, 5% paraparesis, 5% paraplegia and 4% loss of sensation. Older age, presence of neurologic deficit and spinal deformity were predictors of unfavourable outcome. ST results in significant morbidity as a result of its insidious course and delayed diagnosis because of diagnostic and therapeutic challenges. ST should be considered in the differential diagnosis of patients with vertebral osteomyelitis, especially in tuberculosis-endemic regions. Early establishment of definitive aetiologic diagnosis and appropriate treatment are of paramount importance to prevent development of sequelae. © 2015 European Society of Clinical Microbiology and Infectious Diseases.
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    Comparison of brucellar and tuberculous spondylodiscitis patients: Results of the multicenter "backbone-1 Study"
    (Elsevier Inc., 2015) Erdem H.; Elaldi N.; Batirel A.; Aliyu S.; Sengoz G.; Pehlivanoglu F.; Ramosaco E.; Gulsun S.; Tekin R.; Mete B.; Balkan I.I.; Sevgi D.Y.; Giannitsioti E.; Fragou A.; Kaya S.; Cetin B.; Oktenoglu T.; Dogancelik A.; Karaca B.; Horasan E.S.; Ulug M.; Inan A.; Kaya S.; Arslanalp E.; Ates-Guler S.; Willke A.; Senol S.; Inan D.; Guclu E.; Tuncer-Ertem G.; Meric-Koc M.; Tasbakan M.; Senbayrak S.; Cicek-Senturk G.; Sirmatel F.; Ocal G.; Kocagoz S.; Kusoglu H.; Guven T.; Baran A.I.; Dede B.; Yilmaz-Karadag F.; Kose S.; Yilmaz H.; Aslan G.; Algallad D.A.; Cesur S.; El-Sokkary R.; Bekiroǧlu N.; Vahaboglu H.
    Background Context No direct comparison between brucellar spondylodiscitis (BSD) and tuberculous spondylodiscitis (TSD) exists in the literature. Purpose This study aimed to compare directly the clinical features, laboratory and radiological aspects, treatment, and outcome data of patients diagnosed as BSD and TSD. Study Design A retrospective, multinational, and multicenter study was used. Patient Sample A total of 641 (TSD, 314 and BSD, 327) spondylodiscitis patients from 35 different centers in four countries (Turkey, Egypt, Albania, and Greece) were included. Outcome Measures The pre- and peri- or post-treatment spinal deformity and neurologic deficit parameters, and mortality were carried out. Methods Brucellar spondylodiscitis and TSD groups were compared for demographics, clinical, laboratory, radiological, surgical interventions, treatment, and outcome data. The Student t test and Mann-Whitney U test were used for group comparisons. Significance was analyzed as two sided and inferred at 0.05 levels. Results The median baseline laboratory parameters including white blood cell count, C-reactive protein, and erythrocyte sedimentation rate were higher in TSD than BSD (p<.0001). Prevertebral, paravertebral, epidural, and psoas abscess formations along with loss of vertebral corpus height and calcification were significantly more frequent in TSD compared with BSD (p<.01). Surgical interventions and percutaneous sampling or abscess drainage were applied more frequently in TSD (p<.0001). Spinal complications including gibbus deformity, kyphosis, and scoliosis, and the number of spinal neurologic deficits, including loss of sensation, motor weakness, and paralysis were significantly higher in the TSD group (p<.05). Mortality rate was 2.22% (7 patients) in TSD, and it was 0.61% (2 patients) in the BSD group (p=.1). Conclusions The results of this study show that TSD is a more suppurative disease with abscess formation requiring surgical intervention and characterized with spinal complications. We propose that using a constellation of constitutional symptoms (fever, back pain, and weight loss), pulmonary involvement, high inflammatory markers, and radiological findings will help to differentiate between TSD and BSD at an early stage before microbiological results are available. © 2015 Elsevier Inc.
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    Association between hematologic parameters and in-hospital mortality in patients with infective endocarditis
    (Elsevier (Singapore) Pte Ltd, 2015) Zencir C.; Akpek M.; Senol S.; Selvi M.; Onay S.; Cetin M.; Akgullu C.; Elbi H.; Gungor H.
    Early and accurate risk prediction is an important clinical demand in patients with infective endocarditis (IE). The platelet-to-lymphocyte ratio (PLR) is an independent predictor of worse prognosis in various cardiovascular diseases. The aim of this study was to determine the value of PLR in the prediction of in-hospital mortality among IE patients. We retrospectively analyzed the clinical, laboratory, and echocardiographic data of 59 adult patients with definite IE and in 40 adult controls. In-hospital mortality occurred in 16 (27%) patients. Vegetation size, levels of high-sensitive C-reactive protein and procalcitonin, neutrophil-to-lymphocyte ratio, and PLR were significantly higher in the in-hospital-mortality-positive group than in the in-hospital-mortality-negative group (p = 0.004, p = 0.009, p = 0.030, p = 0.001, and p = 0.008, respectively). Lymphocyte count was, however, significantly lower in the in-hospital-mortality-positive group (p = 0.004). In the receiver-operating characteristic analysis, PLRs over 191.01 predicted in-hospital mortality with 56.3% sensitivity and 81.4% specificity [area under the curve 0.725, 95% confidence interval (CI) 0.594-0.833; p = 0.0027]. In the multivariate analysis, PLR was found to be an independent predictor of in-hospital mortality in patients with IE (odds ratio 1.022, 95% CI 1.003-1.042; p = 0.021). In conclusion, higher PLR may predict in-hospital mortality in patients with IE. © 2015, Kaohsiung Medical University. Published by Elsevier Taiwan LLC. All rights reserved.
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    Variables determining mortality in patients with Acinetobacter baumannii meningitis/ventriculitis treated with intrathecal colistin
    (Elsevier B.V., 2017) Ceylan B.; Arslan F.; Sipahi O.R.; Sunbul M.; Ormen B.; Hakyemez İ.N.; Turunc T.; Yıldız Y.; Karsen H.; Karagoz G.; Tekin R.; Hizarci B.; Turhan V.; Senol S.; Oztoprak N.; Yılmaz M.; Ozdemir K.; Mermer S.; Kokoglu O.F.; Mert A.
    Aim To examine the variables associated with mortality in patients with Acinetobacter baumannii-related central nervous system infections treated with intrathecal colistin. Materials and methods This multi-centre retrospective case control study included patients from 11 centres in Turkey, as well as cases found during a literature review. Only patients with CNS infections caused by multidrug-resistant or extensively drug-resistant Acinetobacter baumannii treated with intrathecal colistin were included in this study. The variables associated with mortality were determined by dividing the patients into groups who died or survived during hospitalisation, and who died or survived from Acinetobacter meningitis. Results Among the 77 cases enrolled in the study, 35 were found through a literature review and 42 were cases from our centres. Forty-four cases (57.1%) were male and the median age was 48 years (range: 20–78 years). Thirty-seven patients (48%) died during hospitalisation. The variables associated with increased all-cause mortality during hospitalisation included old age (odds ratio, 1.035; 95% confidence interval (CI), 1.004–1.067; p = 0.026) and failure to provide cerebrospinal fluid sterilisation (odds ratio, 0.264; 95% confidence interval, 0.097–0.724; p = 0.01). There is a trend (P = 0.062) towards higher mortality with using of meropenem during meningitis treatment. Fifteen cases (19%) died from meningitis. There were no significant predictors of meningitis-related mortality. Conclusions The mortality rate for central nervous system infections caused by multidrug-resistant or extensively drug-resistant Acinetobacter baumannii is high. Old age and failure to provide CSF sterilisation are associated with increased mortality during hospitalisation. © 2016