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Öğe Antibiotic use in acute respiratory infections in health care providers and their family members(Turkiye Klinikleri, 2006) Önlen, Yusuf; Özer, Cahit; Ako?lu, Ertap; Sangün, Özlem; Özer, Burçin; Savaş, Lütfü; Incecik, FarukObjective: The aim of this study was to evaluate the diagnoses and treatment of respiratory infections in health care providers and their family members, and also to investigate the antibiotic types and prescription rates according to specialty and institute of the attending physician. Metarial and Methods: All doctor visits of health care providers and their family members at Antakya City center, in Primary Health Care Centers, State Hospital and Mustafa Kemal University School of Medicine, between November 2004 and May 2005 were retrospectively evaluated. Cases of upper respiratory tract infections, acute tonsillitis, acute pharyngitis, acute sinusitis, acute otitis media, acute bronchitis, tracheobronchitis and bronchiolitis were included in the study while pneumoniae and inpatient treatments were excluded. Specialty and institution of the attending physician, medications used and diagnoses of patients were determined. Results: Of the 1145 patients, 611 (53.4%) were females and 534 (46.6%) were males, with a mean age of 19.33 ± 15.44 years (range: 1-66 years). Antibiotic use did not differ according to gender (p= 0.208) and age (p= 0.276). The most frequent diagnoses were upper respiratory tract infections (70.3%), acute tonsillopharyngitis (12.5%), acute bronchitis (8.5%), acute sinusitis (5.5%) and acute otitis media (3.0%). Overall antibiotic prescription rate was 88.0% and the most frequently prescribed antibiotics were amoxicilline-clavulonate (36,9%), second generation cephalosporins (10.3%) and macrolides (8.6%). There was no significant statistical difference between the health care steps or the institution (p= 0.283) and specialties of physicians (p= 0.193) according to the antibiotic prescription rate. Conclusion: We found that antibiotics were frequently prescribed for acute respiratory tract infections among health care providers and their families; and age and gender of the patient or the institution of the physician had no effect on this issue. Copyright © 2006 by Türkiye Klinikleri.Öğe Candida albicans dışı mayaların tanımlanmasında VITEK 2 YST kart ile API 20C AUX sisteminin karşılaştırılması(2012) İnci, Melek; Atalay, Mustafa Altay; Koç, Ayşe Nedret; Özer, Burçin; Kılınç, Çetin; Durmaz, SüleymanAmaç: Bu çalışmada çeşitli klinik örneklerden soyutlanan Candida albicans dışı mayaların tür düzeyinde tanımlanmasında VITEK 2 YST kart (bioMérieux, Fransa) kullanılarak elde edilen sonuçların API 20C AUX (bioMérieux, Fransa) sistemi ile karşılaştırılması amaçlandı. Gereç ve yöntem: Yirmi sekiz idrar, 10 kan, 3 vajinal akıntı örneğinden soyutlanan ve germ tüp testi negatif olarak bulunan 41 C.albicans dışı maya izolatı VITEK 2 YST kart (bioMérieux, Fransa) ile tanımlandı. Ayrıca mısır unu-Tween 80 agardaki mikroskobik morfoloji ve API 20C AUX (bioMérieux, Fransa) ticari kiti ile yapılan karbonhidrat asimilasyonu değerlendirildi. Bulgular: Her iki sistemle izolatların 34’ü (%82.9) aynı tür olarak tanımlanırken, 7’sinde (%17.1) farklı sonuçlar elde edildi. API 20C AUX sistemi ile Candida glabrata olarak tanımlanan 5 izolat VITEK 2 YST kart ile Candida tropicalis (n:2), Candida krusei, Candida lipolitica ve Candida kefyr olarak, C.tropicalis olarak tanımlanan bir başka izolat Candida parapsilosis olarak, C.parapsilosis olarak tanımlanan bir diğer izolat ise C.tropicalis olarak tanımlandı. Sonuç: VITEK 2 YST kart sistemi ile API 20C AUX sistemi arasında C.albicans dışı mayaların tür düzeyinde tanımlanmasında büyük oranda benzerlik bulunmasına karşın, özellikle C.glabrata, başta olmak üzere C.tropicalis ve C.parapsilosis türlerinin tanımlanmasında dikkatli olunması gerektiği kanaatine varıldı.Öğe A case of allergic bronchopulmonary aspergillosis with atypical clinical presentation(2012) Akoğlu Genç, Sebahat; Özer, Burçin; Babayiğit, Cenk; Balcı, Ali; Karazincir, Sinem; Dikmen, NurselAllerjik bronkopulmoner aspergilloz (ABPA) astım ya da kistik fibrozisli hastalarda görülen ve Aspergillus fumigatus ’a karşı gelişen yaygın bir hipersensitivite reaksiyonudur. Astımı olmayan hastalarda da nadiren bildirilmiştir. Burada atipik klinik bulgularla gelen ve “High attenuation mucoid impaction” saptanan bir ABPA olgusu sunulmaktadır. Amaç, ABPA’nın atipik klinik bulgularla ortaya çıkabileceğini vurgulamaktır.Öğe Comparing seropositivity of HBV, HCV and HIV in health care workers with those admitted to hospital(2010) Özer, Burçin; Inci, Melek; Duran, Nizami; Sapan, Eyüp; Alagöz, Gülcan Erkaslan; Motor, Vicdan KöksaldiThe aim of this study is to compare the seropositivity of HBV, HCV and HIV in health care workers of Mustafa Kemal University Hospital with the people admitted to hospital. In the study 230 health care workers and 499 controls who admitted to the hospital with several complaints, totally 729 people were included between November 2009 and January 2010. hepatitis B surface antigen (HBsAg), Hepatitis B surface antibody (anti-HBs), HCV antibody (anti-HCV) and HIV antigen and antibody (HIV Ag/Ab) were investigated using electrochemiluminescent immunological method (Elecsys 2010, Roche, Japan) in blood samples obtained from subjects. The seropositivity of HBsAg was found 0.4%, in health care workers while it was found as 5.8% in controls, and the seropositivity of anti-HBs was found 57.8% in health care workers while it was found 37.5 % in controls (p=0.001 and p=0.001). The seropositivity of anti-HCV was found 0.4% in health care workers and 2.6% in patients (p=0.001). The positivity of HIV Ag/Ab was not observed in both groups. The higher seropositivity of HBsAg and Anti-HCV in controls than health care workers showed that infections can be transmitted via blood and body fuids of patients. Higher surface antibody rates in health care workers might be an indicator of success of immunization against hepatitis B. The health care workers should accept all blood and body fuid of patients as contaminated and take necessary preventive measure. © 2010 OMÜ Tüm Haklari Saklidir.Öğe Effects of probiotic use on bacterial translocation in created rat models with biliary obstructions(Atatürk Üniversitesi, 2019) Çelikkaya, Mehmet Emin; Akçora, Bülent; Hakverdi, Sibel; Özer, Burçin; Ulutaş, Kemal Türker; Duran, NizamiObjective: The aim of this study was to investigate the protective effects of the combined use of probiotic strains on the development of bacterial translocation in addition to liver and intestinal tissue damage due to biliary obstruction in rats. Materials and Methods: Here, 3 groups each consisting of 10 rats were created:group 1 (sham group), group 2 (obstructive jaundice), and group 3 (obstructive jaundice+probiotic). Groups 1 and 2 were given 1 cc physiological saline solution by oral gavage twice a day; group 3 was given a probiotic solution that included Lactobacillus acidophilus, Lactobacillus rhamnosus, Bifidobacterium bifidum, Enterococcus faecium, and Bifidobacterium longum microorganisms by oral gavage twice a day. Results: Markers for liver damage were also found to be significantly improved (p<0.05) in the treatment group (group 3). Whencompared with groups 2 and 3 in terms of liver histology, damage was found to be significantly more severe in group 2 (p<0.01). With regard to ileal villous depth and ileal inflammation, the pathology was found to be significantly more severe in group 2 than that in group 3 (p<0.05). In blood, spleen, and mesenteric lymph node cultures, group 2 showed a microbiological growth rate of 33.8–58.8%, whereas group 3 showed a microbiological growth rate of 14.3–28.6%. This reduction was evaluated to be statistically significant (p<0.05). Conclusion: Our study showed that the combined use of a probiotic in bile duct obstructions reduced bacterial translocation and alleviated pathological changes arising in the liver and terminal ileum histologyÖğe The elevation of liver enzymes due to hepatitis B vaccine(TIP ARASTIRMALARI DERNEGI, 2006) Önlen, Yusuf; Savaş, Lütfü; Özer, Burçin; Iris, Nur Efe[No abstract available]Öğe The high rate of Candida parapsilosis candidemia among non-burn patients with polytrauma in the surgical intensive care units of a university hospital(İnönü Üniversitesi Tıp Fakültesi, 2020) Bal, Tayibe; Çabalak, Mehmet; Özer, Burçin; Çömez, Mehmet Selim; Önlen, YusufAim: Candidemia is a life-threatening infection that has been reported to be associated with poorer outcomes in trauma patients. The present study aimed to investigate the epidemiology of candidemia in non-burn patients with polytrauma. Material and Methods: We conducted a retrospective, single-center, observational study of polytrauma patients with candidemia admitted to the surgical intensive care units of a university hospital in Turkey between 2013 and 2017 on. Results: The incidence of candidemia was 127 episodes per 1000 intensive care unit admissions in polytrauma patients. Nonalbicans Candida species accounted for 75.5% of all candidemia episodes. C. parapsilosis (51.05%) was the predominant species, followed by C. albicans (24.52%) and C. tropicalis (12.21%). The highest crude mortality rate (72%) was observed in patients with C. parapsilosis candidemia. In multivariate analyses, who had undergone prior gastrointestinal surgery were 7.1 times more likely to have C. parapsilosis candidemia than those with other strains. Conclusion: Our study, remarkable, demonstrated a high incidence of Candidemia had in polytrauma patients, and non-albicans Candida species were the most frequently isolated candida species. According to our study findings, a prior history of gastrointestinal surgery may help predict C. parapsilosis, as the causative agent of candidemia in polytrauma patients. However, since our study was observational and limited to such a small number of patients, the results obtained should be applied with caution.Öğe İmmünkompetan hastada primer nokardiyal vertebra osteomiyeliti(2015) Bal, Tayibe; Önlen, Yusuf; Serarslan, Yurdal; Kaya, Mustafa Emrah; Özer, BurçinNokardiya türleri, immünsüpresif hastalarda vertebral osteomiyelitin nadir bir sebebidir ve literatürde bildirilmiş az sayıda olgu bulunmaktadır. Nokardiyoz genellikle akciğerlerden orijin alan, beyin gibi diğer organlara yayılma eğiliminde olan kronik bakteriyel bir infeksiyondur. Bu makalede pulmoner tutulumu olmayan, immünkompetan bir primer nokardiyal vertebra osteomiyeliti olgusu sunulmuştur. Olguda bir buçuk yıl önce başlayan bel ağrısı ve spinal hareketlerde kısıtlılık yakınmaları saptanmıştır. L2 vertebra, paraspinal bölge ve psoas kası içerisinde saptanan multiple apseleri cerrahi ve medikal tedaviye rağmen tekrarlamıştır. Operasyon bölgesindeki akıntıdan alınan materyalin kültüründe 3. günde Nocardia spp. izole edilmiştir. Tür tayini yapılamadığından trimetoprim sülfametoksazol, meropenem ve amikasin ile üçlü kombinasyon tedavisi başlanmıştır. Tedavinin 7. gününde operasyon bölgesindeki akıntı kesilmiştir. Hastada apselerin cerrahi drenajı, L2 vertebra korpusu eksizyonu ve uygun medikal tedavi sonrasında kontrol lomber vertebra MR’larında apse görülmemiştir. Bu olgu, tüberküloz ve brusellozun dışlandığı granülomatöz vertebral osteomyelit olgularında Nokardiya türlerinin de olası patojenlerden biri olabileceğini vurgulamak amacıyla paylaşılmıştır.Öğe Investigation of toxin genes in staphylococcus aureus strains isolated in Mustafa Kemal University Hospital(2011) Demir, Cemil; Aslantaş, Özkan; Duran, Nizami; Ocak, Sabahattin; Özer, BurçinAim: Th e aim of this study was to investigate the presence of genes encoding staphylococcal enterotoxins (SEs), exfoliative toxins (ETAs, ETBs), and toxic shock syndrome toxin-1 (TSST-1) by polymerase chain reaction (PCR) in Staphylococcus aureus strains isolated from various clinical samples from the Mustafa Kemal University Hospital. In addition, PCRbased restriction fragment length polymorphism (RFLP) analysis of the coa gene was employed to genotype the isolates. Materials and methods: A total of 120 S. aureus strains isolated from various clinical samples (blood, wounds, urine, conjuctival swabs, and tracheal aspirate) over a 1 year period, 2007-2008, were used in this study. Results: Almost 65.8% of the isolates possessed at least one toxin gene. Th e genes most frequently found were seg-sei (40.8%), followed by sea (30%) and eta (19.2%). Overall, 35 toxin genotypes were observed, among which the genotypes seg-sei, sea-seg-sei, and sea-see predominated at the rate of 8.3%, 5.8%, and 5%, respectively. Four coagulase genotype patterns were observed, with molecular sizes ranging from 570 to 970 bp. Coa-based RFLP analysis revealed 7 diff erent patterns using AluI. Conclusion: Our results have revealed that toxin genes were very prevalent among S. aureus isolates, and the toxigenic isolates were independent of the genotypes obtained by PCR-RFLP of the coa gene (P > 0.05).Öğe Investigation of Toxin Profiles of Methicillin Resistant and Sensitive Staphylococcus aureus Strains Isolated from Various Clinical Specimens(2021) Bayırlı, Mücella; Aslantaş, Özkan; Özer, BurçinAim: This study aimed to investigate the superantigenic (SAg) toxin, exfoliative toxin (ET), hemolysin (HLY), leukotoxin (LUK) genes and accessory gene regulator (agr) types in Staphylococcus aureus isolates from various clinical materials. Material and Methods: A total of 190 S. aureus isolates were investigated for the presence of toxin genes, mecA gene and agr types using by polymerase chain reaction (PCR). Results: mecA gene was detected in 87 (45.8%) isolates. Of the 190 S. aureus isolates examined, 83.7% (n=159) were found to be positive for SAg genes. The seg (41.1%) was determinedtobethemostcommontoxingene,followedbysei(38.9%),selo(38.9%), selm (28.4%), sea (%25.8), and tst (18.4%) genes, respectively. Seventy one different SAg toxin profiles were identified. Type I ?Sa? encoding seg, sei, selm, seln and selo was the most commonmobilegeneticelement(MGE),whichwasdetectedin37isolates(19.5%). Thehla,hlb,hld,hlgandhlg2genesweredetectedin92.6%(n=176),1.6%(n=3), 98.9% (n=188), 1.1% (n=2) and 31.6% (n=60) of the isolates, respectively. The pvl gene was detected in 12.6% (n=11) of methicillin resistant S. aureus (MRSA) and 14.6% (n=15) of methicillin sensitive S. aureus (MSSA), respectively (p=0.701). While none of the isolates carried lukM gene, 67% (n=69) of MSSA and 69% (n=60) of MRSA isolates were found to be positive for lukED gene (p=0.519). Conclusion: High occurrence and diversity of toxin genes among S. aureus isolates could be explained by horizontal transmission of toxin genes through MGEs.Öğe Investigation of Toxin Profiles of Methicillin Resistant and Sensitive Staphylococcus aureus Strains Isolated from Various Clinical Specimens(Duzce University Medical School, 2021) Bayirli, Mücella; Aslantaş, Özkan; Özer, BurçinAim: This study aimed to investigate the superantigenic (SAg) toxin, exfoliative toxin (ET), hemolysin (HLY), leukotoxin (LUK) genes and accessory gene regulator (agr) types in Staphylococcus aureus isolates from various clinical materials. Material and Methods: A total of 190 S. aureus isolates were investigated for the presence of toxin genes, mecA gene and agr types using by polymerase chain reaction (PCR). Results: mecA gene was detected in 87 (45.8%) isolates. Of the 190 S. aureus isolates examined, 83.7% (n=159) were found to be positive for SAg genes. The seg (41.1%) was determined to be the most common toxin gene, followed by sei (38.9%), selo (38.9%), selm (28.4%), sea (%25.8), and tst (18.4%) genes, respectively. Seventy one different SAg toxin profiles were identified. Type I ?Sa? encoding seg, sei, selm, seln and selo was the most common mobile genetic element (MGE), which was detected in 37 isolates (19.5%). The hla, hlb, hld, hlg and hlg2 genes were detected in 92.6% (n=176), 1.6% (n=3), 98.9% (n=188), 1.1% (n=2) and 31.6% (n=60) of the isolates, respectively. The pvl gene was detected in 12.6% (n=11) of methicillin resistant S. aureus (MRSA) and 14.6% (n=15) of methicillin sensitive S. aureus (MSSA), respectively (p=0.701). While none of the isolates carried lukM gene, 67% (n=69) of MSSA and 69% (n=60) of MRSA isolates were found to be positive for lukED gene (p=0.519). Conclusion: High occurrence and diversity of toxin genes among S. aureus isolates could be explained by horizontal transmission of toxin genes through MGEs. © 2021, Duzce University Medical School. All rights reserved.Öğe Investigations of ALS1 and HWP1 genes in clinical isolates of Candida albicans(2013) İnci, Melek; Atalay, Mustafa Altay; Özer, Burçin; Evirgen, Ömer; Duran, Nizami; Köksaldı Motor, Vicdan; Koç, Ayşe Nedret; Önlen, Yusuf; Kılınç, Çetin; Durmaz, SüleymanAim: To explore the presence of ALS1 and HWP1 genes by multiplex polymerase chain reaction (PCR) in Candida albicans strains. Materials and methods: By using the multiplex PCR method, the presence of agglutinin-like sequence 1 (ALS1) and hyphal wall protein 1 ( HWP1) genes were investigated in 206 C. albicans strains that were isolated from various clinical samples. Phenotypic identification of slime formation by microplate and tube adherence tests was performed. Results: The presence of the ALS1 gene was detected in 53.9% of all strains, while the HWP1 gene was present in 5.3%. Slime formation was phenotypically detected in the 62.2% of the strains in which the ALS1 and/or the HWP1 gene was found, using the microplate and/ or tube adherence test. The genes evaluated were found to be present in the 76.7% of strains in which slime formation was detected by phenotypic tests. There was a moderate correlation between the presence of the ALS1 gene and the microplate method, yet there was no correlation when using the tube adherence test. Conclusion: It was concluded that various genes other than those evaluated could be present in slime formation of C. albicans, and the presence of the genes may not always be represented in the phenotype.Öğe Klinik örneklerden izole edilen Acinetobacter kökenlerinde antibiyotik direnci ve IMP-1, IMP-2, VIM-1, VIM-2 tipi Metallo-β-Laktamazların araştırılması(2015) Ocak, Merve; Özer, Burçin; İnci, Melek; Duran, NizamiAmaç: Bu çalışmada klinik örneklerden izole edilen Acinetobacter kökenlerinde metallo-?-laktamaz (MBL) üretimi ve blaIMP-1, blaIMP-2, blaVIM-1 ve blaVIM-2 genlerinin araştırılması amaçlandı. Yöntemler: Mart 2009-Haziran 2012 tarihleri arasında mikrobiyoloji laboratuvarına gönderilen klinik örneklerden izole edilen 150 Acinetobacter kökeni çalışmaya dahil edildi. Kökenlerin antimikrobiyal duyarlılıkları otomatize sistemle, MBL üretimi E test® ile araştırıldı. blaIMP-1, blaIMP-2, blaVIM-1 ve blaVIM-2 genlerinin saptanması için polimeraz zincir reaksiyonu (PCR) yöntemi kullanıldı. Bulgular: Kökenlerin %94'ü Acinetobacter baumannii, %6'sı A. lwoffii olarak idantifiye edildi. Kökenlerin en duyarlı olduğu antibiyotikler sırasıyla gentamisin (%41.3), amikasin (%36.7), imipenem (%25.3) olarak saptandı. Seftriakson (%92), levofloksasin (%84.7), seftazidim (%84), piperasilin-tazobaktam (%84) ise en dirençli oldukları antibiyotiklerdi. Kökenlerin 67 (%44.7)'si Etest®ile MBL-pozitif olarak bulundu. MBL-pozitif bulunan kökenlerin imipeneme, meropeneme, seftazidime, seftriaksona, gentamisine, piperasilin-tazobaktama daha dirençli olduğu saptandı. Hiçbir kökende blaIMP-1, blaIMP-2, blaVIM-1 ve blaVIM-2 geni saptanmadı.Sonuçlar: Çalışmamızda Acinetobacter kökenlerinin %44.7'sinde MBL üretimi saptanmış olup hiçbirinde blaIMP-1, blaIMP-2, blaVIM-1 ve blaVIM-2 geni tespit edilmemiştir. Klimik Dergisi 2015; 28(1): 23-7Öğe Nasal carriage of methicillin-resistant coagulase negative staphylococci (MR-CoNS) among veterinarians and veterinary students(2015) Yılmaz, Mehmet Ali; Aslantaş, Özkan; Özer, Burçin; Yılmaz, Ebru ŞebnemBu çalışmada veteriner hekimler (n=89) ve veteriner fakültesi öğrencileri (n=83) arasında nazal metisilin dirençli koagulaz negatif stafilokok (MD-KNS) taşıyıcılığının saptanması amaçlandı. Ayrıca, izolatların tür dağılımı, antimikrobiyal duyarlılıkları, antibiyotik direnç genleri ve stafilokokal kaset kromozom mec (SCCmec) tipleri de araştırıldı. MD-KNS veteriner hekimlerin %43,8'inden (38/89) ve öğrencilerin %44,6'sından (37/83) izole edildi. MD-KNS suşlarının tamamı kinopristin-dalfopristine duyarlı bulunurken; izolatların %64,5'ı çoğul dirençlilik gösterdi. MD-KNS suşları direnç genlerinin tek veya farklı kombinasyonlarını taşıdı. Hem veteriner hekimlerden hem de öğrencilerden izole edilen MD-KNS suşlarında SCCmec tip IV ve V en yaygın tipler olarak belirlendi. Bu çalışma, veteriner hekimler ve veteriner fakültesi öğrenciler arasında nazal çoğul dirençli MD-KNS taşıyıcılık oranının yüksek olduğunu göstermektedirÖğe Üriner sistem infeksiyonlarında laboratuvar testlerinin tanı değerleri(2007) Özer, Burçin; Söğüt, Sadık; Duran, Nizam; Özer, Cahit; Kuvandık, Güven; Çetin, MeryemBu çalışmada üriner sistem infeksiyonu (ÜSİ) tanısında kullanılan laboratuvar testlerinin tanı değerlerinin karşılaştırılması amaçlanmıştır. Üniversite hastanesinin çeşitli klinik ve polikliniklerinden gönderilen tam idrar tetkiki (TİT) ve kültürü istenen idrar örnekleri çalışmaya dahil edilmiştir. Santrifüj edilmemiş idrarın bir damlası Gram yöntemi ile boyanarak incelenmiştir. Kültürde 104 cfu/ml üreme olması ÜSİ için referans olarak alınmıştır. İdrarda glikoz, bilirubin, ürobilinojen, keton, dansite, pH, eritrosit, protein, nitrit, askorbik asit, lökosit miktarları strip kullanılarak saptanmıştır. İdrar sedimenti mikroskopta incelenmiştir. Kültür altın standart kabul edilerek testlerin duyarlılığı, seçiciliği, pozitif ve negatif prediktif değerleri hesaplanmıştır. Çalışmaya TİT ve idrar kültürü istenen %59.7'si kadın 575 hasta dahil edilmiştir. İdrarların %33.9'unda anlamlı üreme saptanmıstır. En sık izole edilen etkenler sırasıyla E. coli, Klebsiella, Staphylococcus, Enterococcus ve Streptococcus idi. Protein, nitrit, eritrosit, lökosit varlığı ve Gram boyamada lökosit ve bakteri görülmesiyle kültür arasında istatistiksel olarak anlamlı ilişki bulunmuştur (p<0,05). Gram boyamada bakteri ve lökosit saptanmasının duyarlılık ve seçiciliği sırasıyla %89.8, %86.4, %88.9 ve %87.2 bulunmuştur. Sedimentte lökosit, Gram boyamada lökosit ve bakteri, strip ile eritrosit, protein, nitrit ve lökosit varlığının saptanmasının negatif prediktif değerleri yüksek olarak saptanmıştır.
