Browsing by Author "Tasbakan, MI"

Now showing 1 - 4 of 4
  • No Thumbnail Available
    Item
    Necrotising Fasciitis: Clinical Evaluation and Treatment Results of 18 Patients
    Öztürk, AM; Akyol, D; Süer, O; Erdem, HA; Simsir, IY; Akar, SS; Özkayin, N; Tasbakan, MI
    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 Escherichio coli (n=4), Klebsiella pneumoniae, Proteus mirabilis, and Acinetobacter boumannii (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 follow-up. 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.
  • No Thumbnail Available
    Item
    Antifungal Prophylaxis in Solid Organ Transplant Recipients
    Senol, S; Kutsoylu, OE; Kaya, O; Avci, M; Tasbakan, MI; Oguz, VA; Baysan, BÖ; Çavus, SA; Çetin, CB; Ergin, C; Ertugrul, B; Kutlu, SS; Kutlu, M; Mermut, G; Metin, DY; Öztürk, B; Pullukçu, H; Turhan, Ö; Yapar, N
    Solid organ transplantation (SOT) is a treatment method that improves quality of life and survival of patients with end-stage organ failure. Immunosuppressive treatments given to these patients may predispose to the development of invasive fungal infections (IFI). The incidence of IFI in SOT recipients, which is between 5% and 42%, depends on the organ to be transplanted. Although Candida spp., followed by Aspergillus spp. are the most common microorganisms, among fungal pathogens, this situation varies according to transplant type. The mortality rate associated with these IFI can be high. Therefore, antifungal prophylaxis may be necessary for SOT recipients. Many transplantation centers employ antifungal strategies according to their own experience because of the lack of randomized controlled studies. If the antifungal prophylaxis is given to all patients, antimicrobial resistance and drug-drug interactions may occur. Therefore, it is important to identify patients at a high risk of developing IFI. In this paper, epidemiology, risk factors, literature data and antifungal prophylaxis associated with IFI in liver, kidney, small intestine, pancreas, heart, and lung transplant recipients are reviewed.
  • No Thumbnail Available
    Item
    ABSTRACT Are Family Physicians and Medical Students Aware of Chronic Hepatitis C Infection?
    Nazli, A; Sertcelik, A; Kahraman, H; Erdem, HA; Mermer, S; Çaglayan, D; Kivrak, EE; Tasbakan, MI
    Introduction: Chronic hepatitis C is a public health problem that can result in cirrhosis, liver cancer, and death, which can be cured with current treatments. In our study, we evaluated the level of knowledge and awareness of medical school students and family physicians about chronic hepatitis C.Materials and Methods: Our study was carried out between 01.06.2022 and 01.08.2022, between the 1st and 6th grade medical students, family physicians (family medicine residents, family medicine specialists) using an online questionnaire.Results: In our study, 536 medical faculty students and 162 family physicians were recruited. Two hundred seventy one (50.6%) of the students were male and the median age was 23.0 (2.0) years. Of the family physicians, 84 (51.2%) were male, the median age was 30 (24-68) years and the median time in the profession was 14.5 (1-40) years. Students answered 69.2% of the questions correctly, and family physicians answered 73% correctly. While the students knew the transmission routes of hepatitis C mostly (97.2%), they got the less information about the testing (34.9%) and treatment (21.9%). Family physicians answered the questions about the transmission routes of hepatitis C with a high rate (99.4%), and the questions about the groups that should be tested (28%) and the questions about the treatment of hepatitis C less correctly (29.4%). In the multivariate analysis, the factors affecting the median knowledge score of the students were male gender (p= 0.019), the student's class (p= 0.002), having Infectious diseases and clinical microbiology committee (p= 0.005) and gastroenterology committee (p= 0.027). The only factor affecting the median knowledge score of family physicians was the use of online presentations by experts in their fields as a source of information (p= 0.003). 67% of the students and 87.2% of the family physicians answered the question How do you manage the person when the anti-HCV screening test is positive? as I will refer the patient to the infectious diseases and clinical microbiology or gastroenterology .Conclusion: In our study, it was found that awareness of screening and treatment was low in both groups. Considering that the main factors related to the level of knowledge of medical students are having committee of the gastroenterology and infectious diseases and clinical microbiology, and online presentations of experienced teachers in family physicians, preparing a special content for these groups may be useful in raising awareness and level of knowledge.
  • No Thumbnail Available
    Item
    Investigation of Bacterial and Viral Etiology in Community Acquired Central Nervous System Infections with Molecular Methods
    Kahraman, H; Tünger, A; Senol, S; Gazi, H; Avci, M; Örmen, B; Türker, N; Atalay, S; Köse, S; Ulusoy, S; Tasbakan, MI; Sipahi, OR; Yamazhan, T; Gülay, Z; Çavus, SA; Pullukçu, H
    In this multicenter prospective cohort study, it was aimed to evaluate the bacterial and viral etiology in community-acquired central nervous system infections by standart bacteriological culture and multiplex polymerase chain reaction (PCR) methods. Patients hospitalized with central nervous system infections between April 2012 and February 2014 were enrolled in the study. Demographic and clinical information of the patients were collected prospectively. Cerebrospinal fluid (CSF) samples of the patients were examined by standart bacteriological culture methods, bacterial multiplex PCR (Seeplex meningitis-B ACE Detection (Streptococcus pneumoniae, Neisseria meningitidis, Haemophilus influenzae, Listeria monocytogenes, Group B streptococci) and viral multiplex PCR (Seeplex meningitis-V1 ACE Detection kits herpes simplex virus-1 (HSV1), herpes simplex virus-2 (HSV2), varicella zoster virus (VZV), cytomegalovirus (CMV), Epstein Barr virus (EBV) and human herpes virus 6 (HHV6)) (Seeplex meningitis-V2 ACE Detection kit (enteroviruses)). Patients were classified as purulent meningitis, aseptic meningitis and encephalitis according to their clinical, CSF (leukocyte level, predominant cell type, protein and glucose (blood/CSF) levels) and cranial imaging results. Patients who were infected with a pathogen other than the detection of the kit or diagnosed as chronic meningitis and other diseases during the follow up, were excluded from the study. A total of 79 patients (28 female, 51 male, aged 42.1 +/- 18.5) fulfilled the study inclusion criteria. A total of 46 patients were classified in purulent meningitis group whereas 33 were in aseptic meningitis/encephalitis group. Pathogens were detected by multiplex PCR in 41 patients. CSF cultures were positive in 10 (21.7%) patients (nine S.pneumoniae, one H.influenzae) and PCR were positive for 27 (58.6%) patients in purulent meningitis group. In this group one type of bacteria were detected in 18 patients (14 S.pneumoniae, two N.meningitidis, one H.influenzae, one L.monocytogenes). Besides, it is noteworthy that multiple pathogens were detected such as bacteria-virus combination in eight patients and two different bacteria in one patient. In the aseptic meningitis/encephalitis group, pathogens were detected in 14 out of 33 patients; single type of viruses in 11 patients (seven enterovirus, two HSV1, one HSV2, one VZV) and two different viruses were determined in three patients. These data suggest that multiplex PCR methods may increase the isolation rate of pathogens in central nervous system infections. Existence of mixed pathogen growth is remarkable in our study. Further studies are needed for the clinical relevance of this result.