Browsing by Author "Tunger, O"

Now showing 1 - 8 of 8
  • No Thumbnail Available
    Item
    Non-albicans Candida species in blood stream infections
    Cetin, CB; Senol, S; Degerli, K; Tunger, O
  • No Thumbnail Available
    Item
    Evaluation of nosocomial Candida infections
    Senol, S; Dindar, K; Cetin, CB; Demirci, M; Degerli, K; Ozten, D; Tunger, O
  • No Thumbnail Available
    Item
    Rational antibiotic use
    Tunger, O; Karakaya, Y; Cetin, CB; Dinc, G; Borand, H
    Background: Development of resistance to antimicrobial agents and increase of cost as the result of unnecessary and inappropriate use of antibiotics has become a global health problem. Therefore many strategies, which are aimed at optimizing antibiotic therapy, have been developed until now. In Turkey, an antibiotic restriction policy as a governmental solution was applied to decrease the antibiotic use and especially costs by Ministry of Health in 2003. The aim of this study is to evaluate the rational antibiotic use and the impact of the implementation of new restriction policy, with their reinforcement by infectious disease specialist, on the hospital wide use of antibiotics. Methodology: The data of the inpatients received antibiotics (n=495) during January-June 2006 were compared with our previous study performed by the same methodology before the restriction policy in 1998. In both studies, prospective active daily surveillance of patients was performed by three infectious disease specialists. The appropriateness of antibiotic therapy was determined using the criteria described by Kunin and Jones. The data were analyzed by using SPSS for Windows. Results: While the rate of antibiotic use decreased from 16.6% to 11.3%, rational use increased after the restriction policy (p<0.001). Besides the specific antibiotic use increasing, prophylactic antibiotic use was found decreased (p<0.001). Mostly determined irrationality was the prophylactic uses in both studies. As expected, infectious disease specialist examinations resulted in an increase in the appropriate antibiotic use. Conclusions: The restriction policy was effective in decreasing the antibiotic consumption and increasing the rational antibiotic prescription in our hospital.
  • No Thumbnail Available
    Item
    Comparison of the efficacy of combination and monotherapy with caspofungin and liposomal amphotericin B against invasive candidiasis
    Tunger, O; Bayram, B; Degerli, K; Dinc, G; Cetin, BC
    Objective: To investigate if combination therapy with liposomal amphotericin B (LAmB), and caspofungin (CAS) is superior to monotherapies in an experimental model with azole-resistant Candida albicans Methods: This study was carried out between October 2006 and August 2007 in Celal Bayar University, Manisa, Turkey. A total of 144 mice were included in the study, and divided into 4 groups as: control (n=36), CAS treatment group (n=36), LAmB treatment group (n=36), and combination therapy group (n=36). Treatment efficacy was assessed by determining survival, as well as the decrease in tissue fungal densities. Results: The fungal densities in tissues were significantly reduced, and the survival rates were prolonged with either CAS only, or LAmB only, or with combination therapy compared to those of controls (p<0.05). There was no significant difference between monotherapy groups. Decrease in tissue fungal densities were significant in CAS and LAmB (1mg/kg) combination group, compared to CAS (1mg/kg) and LAmB (1mg/kg) groups (p=0.004 for CAS, p=0.009 for LAmB). Survival rates were similar in both treatment groups. Conclusion: The combination treatment was superior with 1mg/kg of doses of LAmB and CAS in terms of reducing the tissue fungal burden. Although with combination therapy the survival rates prolonged in all subgroups, no significant difference between the combination and monotherapies could be shown. Additional studies with a large number of cases are warranted to investigate the superiority of combination therapy.
  • No Thumbnail Available
    Item
  • No Thumbnail Available
    Item
    Clinical aspects and risk factors of nosocomial Stenotrophomonas maltophilia Bacteremia episodes in a Turkish intensive care unit
    Tunger, O; Vural, S; Cetin, CB; Keles, G; Borand, H; Gazi, H
    Stenotrophomonas maltophilia is an important nosocomial pathogen with increasing frequency in recent years, especially in immunocompromised and clinically debilitated patients. The aim of this study is to describe the characteristics of 35 episodes of S. maltophilia bacteremia at Celal Bayar University hospital in Turkey over a 3-year period from January 2003 to December 2005. Cases were identified with microbiology laboratory records and clinical data were collected from the medical record of each patient. The source of bacteremia was central venous catheter (CVC) in 65.7% (23) and respiratory tract infection in 2.9% (1) of episodes while the source of bacteremia was unknown in 11 (31.4%) episodes of bacteremia. Factors significantly associated with mortality were age of >= 65 years, APACHE score of >= 16, the presence of the total parenterall nutrition, anemia, low creatinine clearance level and shock. The most sensitive antibiotic was found as trimethoprim-sulfamethoxazole (91.4%) in antibiotic susceptibility testing of the isolates. Susceptibilities of piperacillin-tazobactam and netilmicin which frequently used antibiotics as an empirical therapy were 62.8% and 68.6%, respectively.
  • No Thumbnail Available
    Item
    Retrospective evaluation of zygomycosis patients
    Cetin, CB; Dogan, G; Temiz, P; Tunger, O
  • No Thumbnail Available
    Item
    Serologic examinations of hepatitis, cytomegalovirus, and rubella in patients with Bell's palsy
    Unlu, Z; Aslan, A; Ozbakkaloglu, B; Tunger, O; Surucuoglu, S
    Objective: The aim of this retrospective case review was to investigate serologic evidence of cytomegalovirus, rubella virus, and hepatitis A, B, and C viruses in patients with Bell's palsy. Design: A total of 24 patients with idiopathic facial paralysis, without a history of trauma, any evidence of a tumor on high-resolution computed tomographic imaging, or any otologic disease, and 33 healthy individuals as a control group were included in this study. Facial paralysis of the patient was evaluated with the House-Brackmann grading scale. Specific immunoglobulin G and M titers were determined for cytomegalovirus, rubella, hepatitis A, hepatitis B, and hepatitis C by enzyme-linked immunosorbent assay. Results: Serologic positivity for hepatitis B was found in 15 of 21 Bell's palsy patients, compared with 32.1% in the control group. The difference was statistically significant. There was no difference in the prevalence of serologic positivity for cytomegalovirus, hepatitis A, and rubella between the patient and control groups. In one Bell's palsy patient, serologic evidence of recent cytomegalovirus infection was indicated by changes in antibody titers between samples taken on presentation and on the 16th day. There was no serologic evidence of hepatitis C in either Bell's palsy patients or the control group. Conclusion: There seems to be an association between hepatitis B and idiopathic facial paralysis. In addition, cytomegalovirus might contribute to the development of Bell's palsy in some ceases with Bell's palsy. Further studies are required to confirm these data.