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Öğe Caffeic acid phenethyl ester suppresses oxidative stress in Escherichia coli-induced pyelonephritis in rats(Springer, 2007) Celik, Sefa; Gorur, Sadik; Aslantas, Ozkan; Erdogan, Suat; Ocak, Sabahattin; Hakverdi, SibelAlthough oxidative damage is known to be involved in inflammatory-mediated tissue destruction, modulation of oxygen free radical production represents a new approach to the treatment of inflammatory diseases. Caffeic acid phenethyl ester (CAPE), an active component of propolis from honeybee hives, has antioxidant, anti-inflammatory and antibacterial properties. For that reason, we aimed to investigate the efficiency of CAPE administration in preventing oxidative damage in pyelonephritis (PYN) caused by Escherichia coli. In this study, 35 Wistar rats were grouped as follows: control, PYN 24 h, PYN 48 h, PYN 72 h, CAPE 24 h, CAPE 48 h and CAPE 72 h. E. coli (1 x 10(9) c.f.u.) were inoculated into the rats in both PYN and CAPE groups via urethral catheterization. Ten mu M/kg-body weight CAPE was injected to the rats in all CAPE groups 24 h before E. coli infection, and injections were repeated at 24-h intervals. Rats were sacrificed 24 h, 48 h and 72 h after infection in both PYN and CAPE groups. Malondialdehyde (MDA) and nitric oxide (NO) levels were significantly increased in kidneys of PYN groups. The activities of the antioxidant enzymes, catalase (CAT), superoxide dismutase (SOD), glutathione peroxidase (GSH-Px), and xanthine oxidase (XO) were also elevated by E. coli. However, CAPE administration reduced MDA and NO levels, as well as XO activity, although it increased SOD and GSH-Px activities. Histopathological examination showed that CAPE reduced the inflammation grade induced by E. coli. In conclusion, CAPE administrations decrease the oxidative damage occurring in PYN and therefore could be used for medical management of bacterial nephropathy.Öğe Comparison of bacterial isolates cultured from hemodialysis patients and other patients with diabetic foot and their antimicrobial resistance(Taylor & Francis Ltd, 2007) Cetin, Meryem; Ocak, Sabahattin; Kuvandik, Guven; Aslan, BahadirThe aim of this study was to compare microbial findings and their resistance to antibiotics between hemodialysis patients and patients without end-stage renal failure with diabetic foot infections. An 18-month-long descriptive study analyzed bacterial isolates obtained from 32 hemodialysis (HD) patients with diabetic foot infection in an Antakya hemodialysis center and 65 patients with diabetic foot infection admitted to the Education and Research Hospital of Mustafa Kemal University, Turkey. No significant difference in the mean number of pathogens per patient was found between the dialysis patients and other patients (2.3 vs. 2.1, respectively) (p > 0.05). While the occurrence of gram-positive bacteria in the HD patients was found to be 59.0%, this rate in the other patients was 53.1% (p > 0.05). While most frequent bacterial species isolated in the HD patients were S. aureus (22.9%), followed by coagulase-negative Staphylococcus spp. (CNS) (19.7%), the microorganisms in the other patients were found as CNS (20.7%), followed S. aureus (18.0%). The data recommend that antibiotic therapy in HD patients with diabetic foot infection should be more closely guided by culture findings and antimicrobial susceptibility results.Öğe Distribution of Candida species in women with vulvovaginal symptoms and their association with different ages and contraceptive methods(Informa Healthcare, 2007) Cetin, Meryem; Ocak, Sabahattin; Gungoren, Arif; Hakverd, Ali UlviThe aim of this study was to determine the frequency and distribution of Candida spp. within different age groups and different contraceptive methods users in women with vulvovaginal symptoms. The study included 569 female outpatients who had visited the Education and Research Hospital of Mustafa Kemal University, Turkey, between Jaunary 2004 and June 2005. Among 569 women with symptoms of vulvovaginitis, 240 (42.2%) were positive for Candida spp., of which 106 (44.2%) were C. albicans and 134 (55.8%) were non-albicans spp. The age group 26-30 y had the highest frequency of Candida spp. (23.7%). Candida spp. were isolated from 44.2% of contraceptive method users, and 37.9% of noncontraceptive users (p > 0.05). The isolation rate of C. albicans was higher among oral-contraceptive users (57.5%) than IUCD users (38.5%), coitus interruptus (48.5%) and condom users (42.8%). These results indicate that factors associated with age and contraceptive method used may influence the occurrence and distribution of Candida spp. in women with vulvovaginal symptoms.Öğe Duodenal bölge tutulumu ile seyreden mortal nötropenik enterokolit olgusu(2022) Yaqoobi, Hasibullah; Bal, Tayibe; Çabalak, Mehmet; Önlen, Yusuf; Ocak, SabahattinNötropenik enterokolit çoğunlukla akut lösemili hastalar gibi mukozal hasarı indükleme potansiyeli yüksek hastalığı olanları ve yoğun kemoterapötik rejimleri alan hastaları etkilemektedir. Burada kemoterapi devamında ateş, karın ağrısı, bulantı, kusma, karında şişkinlik, ishal, ağız içinde yara şikayetleri ile başvuran, batın BT’ de diffüz duodenum duvar kalınlaşması saptanan 34 yaşında akut lenfoblastik lösemi tanılı nötropenik enterokolit olgusu sunulmuştur. Olgumuzu sunmaya değer kılan duodenal bölge tutulumu ile seyreden nötropenik enterokolit olmasıdır.Öğe Effects of intrauterine device and oral contraceptive on vaginal flora and epithelium(Saudi Med J, 2007) Ocak, Sabahattin; Cetin, Meryem; Hakverdi, Sibel; Dolapcioglu, Kenan; Gungoren, Arif; Hakverdi, Ali U.Objectives: To investigate the microbial and cytopathological changes and genital symptoms in oral contraceptive pill (OCP) and intrauterine contraceptive device (IUCD) users. Methods: Included in the study were 34 women using OCP and 34 women using IUCD for 24 to 36 months period and 34 women as control group. We conducted the study between March to September 2005 in Antakya Maternity Hospital, Turkey. Vaginal discharge was subjected to wet mount examination, gram staining, and culture. Cervical smears were examined and reported using the Bethesda system as reference. Results: In the IUCD group, women with intermediate score was 20.6%, while those with bacterial vaginosis was 11.7%. In the OCP group however, women with intermediate score was 8.8%, while those with bacterial vaginosis was 5.9%. Compared to the control group, these rates were 2.9% for those with intermediate score and 2.9% for those with bacterial vaginosis. Escherichia coli vaginal colonization increased by 5-fold in the IUCD users (P<0.05). Cervical erosion was found in 14.7% of the women using IUCD as compared to the other groups (p<0.05). Actinomyces like organisms was detected in 11.7% of the IUCD users (P<0.05). Conclusion: The use of IUCD clearly alter the normal vaginal flora, although OCP appears to have minimal effects on the vaginal microbial flora. The data support the hypothesis that IUCD might change cervico vaginal environment, and suggests that women with IUCD may be at a higher risk for vulvovaginal infection.Öğe The evaluation of immune responses to hepatitis B vaccination in diabetic and non-diabetic haemodialysis patients and the use of tetanus toxoid(Wiley, 2008) Ocak, Sabahattin; Eskiocak, Ali FuatAim: The aim of this study was to investigate whether haemodialysis (HD) patients suffering from diabetes mellitus could be considered at risk for the development of the protective antibodies to hepatitis B (HB) vaccination and, to evaluate the effectiveness of tetanus toxoid (TT) administrated 2 days before HB vaccination. Methods: Forty-nine HD patients were divided into two groups: group A (19 diabetic patients) and group B (30 non-diabetic patients). A dose of 40 mg recombinant HB vaccine was injected intramuscularly to the patients at 0, 1, 2 and 6 months. Results: After the completion of the course, the patients in group A were found to have a lower protective antibody rates than the patients in group B (57.8% vs 70%) (P > 0.05). After the administration of additional booster doses during 12 months, the protective antibody to hepatitis B surface antigen (HBsAb) levels were detected in 78.9% and 96.6% of the patients in group A and group B, respectively (P > 0.05). The patients not having protective HBsAb levels were administered TT and HB vaccines, and after course, all of them have produced protective HBsAb levels. Conclusion: The present study showed that diabetic patients on HD may carry a greater risk of not seroconverting than non-diabetic ones for antibody response to HB vaccination. The use of TT 2 days before HB vaccination may be a useful and effective method of enhancing the immune response to HB vaccination, especially in the patients with diabetes mellitus on HD.Öğe Examination of the Reasons for Change in Treatment in Patients Infected with Human Immunodeficiency Virus(Galenos Publ House, 2023) Cabalak, Mehmet; Bal, Tayibe; Polat, Eda Selin; Ocak, Sabahattin; Onlen, YusufIntroduction: Highly active antiretroviral therapy (HAART) has significantly reduced morbidity and mortality in patients infected with Human immunodeficiency virus (HIV). Despite this success, the sustainability of the initial treatment regimen has become difficult as patients continue the treatment for life. Highly active antiretroviral therapy regimen change may often be necessary due to intolerance/toxicity, pregnancy, comorbidities, difficulty in patient compliance and failure to achieve virological suppression. In this study, it was aimed to examine the reasons for HAART change in patients followed up for HIV/AIDS in Hatay Mustafa Kemal University, Tayfur Ata Sokmen Faculty of Medicine Hospital. Materials and Methods: In this retrospective, cross-sectional, single-center study, 151 patients followed up at Hatay Mustafa Kemal University, Tayfur Ata Sokmen Medical Faculty Hospital for HIV between January 2018 and December 2020 were included in the study. Results: One hundred-seventeen (77.5%) of the cases were male and 34 (22.5%) were female. The mean age was 39.08 +/- 14.2 years (20-83). Treatment changes were made in 35 (23.2%) of the cases. The most common reason for treatment change was intolerance/toxicity (19) in 12.6% of cases. Other reasons for change; pregnancy was six (4%), treatment non-compliance was four (2.6%), patient request was three (2%), and physician decision was three (2%). No drug changes were detected in the cases due to virological failure. Conclusion: There is generally little data available in Turkey on the reasons for regime change in HIV patients using HAART. Therefore, the data we will obtain in this study can help draw a long-term plan for HAART drug management.Öğe Falciparum malaria originating in foreign country: four cases(2007) Onlen, Yusuf; Culha, Gülnaz; Ocak, Sabahattin; Savaş, Lütfü; Güllü, MuratMalaria has been commonly determined in tropical and subtropical regions and the Plasmadium (P.) vivax generally occurs in our country, Turkey. However, in the people who have been travelling abroad from Turkey P. falciparum and P. malaria were also detected. The diagnosis was confirmed by microscopy of Giemsa stained thin and thick blood slides in four cases, at a magnification of 1000. The diagnosis of four cases was made by seeing the gametocytes of P.falciparum in thin blood films. The cases were found in Hatay region and the patients are those working abroad. The cases are presented in order to emphasize on the necessity of giving education on public health and taking the precautions for the prevention of the disease and in order to draw attention to malaria diseases caused by different species from abroad and to the fact that it can be seen in local cases as well.Öğe Genotype distribution of Hepatitis C Virus in Hatay province of Turkey(Galenos Yayınevi, 2020) Çabalak, Mehmet; Bal, Tayibe; Demir, Mehmet; Ocak, Sabahattin; Önlen, YusufObjectives: The treatment duration and response of chronic hepatitis C (CHC) are closely related to the genotypes of hepatitis C virus (HCV). This study aimed to determine the genotype distributions among CHC patients in the Hatay province of Turkey. Materials and Methods: In this study, demographic data of 589 patients who received a therapy for CHC at the infectious diseases and gastroenterology clinics between June 2016 and May 2019 were retrieved from the hospital information system and medical charts of the patients and were retrospectively reviewed. Results: The most common HCV genotype in our study was genotype 1b (66.9%), followed by genotype 2 (10.5%), genotype 1a (7.3%), genotype 4 (7.1%), genotype 3 (7%), and mixed genotype (1.2%). Six of the mixed genotypes were identified as 1b+4, while one was 1a+3. There was a statistically significant difference between females and males with regards to the HCV genotypes (p<0.001). Patients with genotype 1b tended to be older, while patients with genotypes 3 and 4 tended to be younger. Conclusion: Genotype 1b is the most common HCV genotype in Hatay province, and it is followed by genotypes 2, 1a, 4 and 3. Compared to the studies conducted in previous years in Turkey, our study identified a lower rate for genotype 1b, along with an increase in the distribution rates of the other genotypes. Monitoring the changes in HCV genotype distribution is of vital importance to develop effective strategies in the treatment of HCVÖğe Hatay ilindeki importe sıtma olgularının retrospektif analizi : 10 yıl içerisinde 75 olgu(Türkiye Parazitoloji Derneği, 2019) Şahin, Selma İlkay; Çabalak, Mehmet; Bal, Tayibe; Ocak, Sabahattin; Önlen, Yusuf; Çulha, GülnazAmaç: Endemik olmayan ülkelerde görülen importe sıtma olguları gecikmiş tanı ve tedaviye sekonder artmış komplikasyon oranı ve mortalite riski taşımaktadır. Bu çalışma ile kliniğimizde son 10 yılda takip edilen importe sıtma olgularının insidansının ve klinik özelliklerinin irdelenmesi amaçlanmıştır. Yöntemler: Bu retrospektif çalışmaya Ocak 2008 - Aralık 2017 tarihleri arasında kliniğimizde importe sıtma tanısı ile takip edilmiş 75 olgu dahil edilmiştir. Olgulara ait epidemiyolojik, laboratuvar, tedavi ve klinik seyre ilişkin verilere sistem kayıtlarından ulaşılmıştır. Bulgular: Olguların 74’ü erkek, 1’i kadın olup ortanca yaş 51(23-64) olarak saptanmıştır. Olguların tamamı Sahra altı Afrika ülkelerine seyahat etmiş ve hiçbiri seyahat öncesinde kemoprofilaksi almamıştır. Tüm olgularda etkenin Plasmodium falciparum olduğu görülmüştür. İmporte sıtma olgu sayısı 2015 sonrasında düşme eğilimindeydi. En sık görülen bulgular sırasıyla ateş (%100), trombositopeni (%84) ve anemi (%72) olarak saptanmıştır. Olguların %8’i ciddi seyirli sıtma olgusu olmakla birlikte ölümle sonuçlanan olgu görülmemiştir. Sonuç: Son yıllarda ülkemizden bildirilen importe sıtma olgu sayısındaki artışa rağmen bölgemizde bu sayıda düşüş olduğu görülmektedir. Ülkemiz importe sıtma olgularının en sık görüldüğü ülkeler arasında yer aldığından, ateş yüksekliği ve trombositopeni ile başvuran olgularda sıtmanın endemik olduğu bir bölgeye seyahat öyküsü olup olmadığı sorgulanmalıdır.Öğe HBV, HCV, HIV and VDRL Seropositivity in Blood Donors in Hatay(Galenos Yayincilik, 2005) Ocak, Sabahattin; Duran, Nizami; Savas, Lutfu; Onlen, Yusuf; Dibek, M. AliIn this study, seroprevalence of HBsAg, anti-HCV, anti-HIV and VDRL were screened in the blood donors by donor screening tests in blood centers of Antakya State Hospital, Antakya Maternity Hospital and Iskenderun Kizilay Blood Bank between 2003 and 2004 retrospectively. A total of 12.026 (97.6%) male and 287 (2.3%) female donors were screened for HBV, HCV, and HIV using commercially available ELISA kits, VDRL test for syphilis. A total of 12.313 donors were screened. The seropositivity rates of HBsAg and anti-HCV were found as 249 (2.02%) and 65 (0.52%) respectively. Only 3 (0.02%) donors for HIV and 4 (0.03%) donors for VDRL were positive. Three patients with HIV seropositivity by ELISA technique were found negative by Western blot and accepted as false seropositivity. In conclusion, in our region, while the seroprevalence of HBsAg and VDRL were less than that reported in previous some studies carried out in Turkey, anti-HCV seropositivity was similar to among as compared to the other sides of Turkey.Öğe İmmünsüpresif tedavi alacak hastalarda hepatit serolojisi(Harran Üniversitesi Tıp Fakültesi Dekanlığı, 2020) Çabalak, Mehmet; Bal, Tayibe; Ocak, SabahattinAmaç: İmmünsupresif ilaç kullananlarda, hepatit B reaktivasyon riskine yönelik tarama yapılması önerilmektedir.Bu çalışmada immünsüpresif tedavi öncesi, Enfeksiyon hastalıkları kliniğine yönlendirilen hastalarda hepatit Bvirüsü (HBV), hepatit C virüsü (HCV) ve hepatit A virüsü (HAV) sonuçları retrospektif olarak irdelenmesiamaçlandı.Materyal ve Metod: Çalışmamızda Ocak 2018 - Aralık 2018 tarihleri arasında immünsüpresif tedavi öncesi,Enfeksiyon hastalıkları kliniğine yönlendirilen 148 hastanın hepatit B yüzey antijeni (HBsAg), hepatit B yüzeyantikoru (Anti-HBs), hepatit B core protein antikoru (Anti-HBc IgG), anti hepatit C virüs antikoru (Anti-HCV) ve antihepatit A virüs antikoru (Anti-HAV) hasta dosyalarından ve hastane otomasyon sisteminden retrospektif olarakincelendi.Bulgular: HBsAg pozitiflik oranı %4,1, Anti-HBs pozitiflik oranı %31,8, İzole Anti-HBc IgG pozitiflik oranı %1,4 veiki hastada ise Anti-HBs bakılmamıştı. Anti-HCV pozitifliği %1,4 tespit edildi. Hastaların %79,7 Anti-HAVbakılmamış, Anti-HAV pozitifliği %12,2 ve Anti-HAV negatifliği %8,1 olarak saptandı.Sonuç: İmmünsüpresif tedavi öncesi tarama yapılmasına rağmen bazı taramaların eksik yapıldığı tespit edildi.Bu nedenle bu hastaları takip eden hekimlere eğitim verilmesi ve özellikle HBV enfeksiyonu konusunda farkındalıkoluşturulmasını önermekteyiz.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 Lamivudine Experience in Acute Hepatitis B Developing in a Patient Under Chemotherapy(Aves, 2014) Bal, Tayibe; Onlen, Yusuf; Isitemiz, Feride; Koksaldi-Motor, Vicdan; Evirgen, Omer; Kokoglu, Omer Faruk; Ocak, SabahattinAcute hepatitis B (AHB) results 90% in spontaneous healing and often does not require antiviral therapy. It may rarely result in severe liver damage as fulminant hepatitis. The possibility of fulminant hepatitis is high in immunosuppressed patients than in immunocompetent patients. Although the exact cause is unexplained, immunosuppression associated with chemotherapy may increase the possibility of fulminant hepatitis by increasing hepatitis B virus replication in immunosuppressed patients. According to this hypothesis, in immunosuppressed patients with AHB, maintaining viral load suppression with lamivudine therapy may cause less host response and may be effective in preventing risk of fulminant hepatitis. A case in which AHB developed while receiving maintenance chemotherapy for haematological malignancy is presented. Based on similar cases in the literature, the patient was treated with lamivudine and maintenance chemotherapy was continued. In the fourth week of treatment, transaminase levels were normal and anti-HBs was positive. In immunocompromised patients in whom AHB develops, many questions such as the effectiveness of lamivudine treatment, duration of treatment, whether or not to suspend the chemotherapy and when to continue the chemotherapy are still unanswered. Lamivudine experience in this case is reported because there is no guide for this subject in the literature except few case reports.Öğe Morganella morganii-associated arthritis in a diabetic patient(Springer, 2008) Cetin, Meryem; Ocak, Sabahattin; Kuvandik, Guven; Aslan, Bahadir; Temiz, Muhyittin; Aslan, AhmetThis case report involves a 60-year-old diabetic man who developed septic arthritis as a result of the pathogen Morganella morganii. The patient had complaints of elevated body temperature, malaise, rigors and pain in the left knee, despite no history of trauma. On examination of the knee, erythema, warmth, tenderness and swelling was observed. Arthrocentesis performed on his left knee indicated the presence of straw-coloured, cloudy fluid without crystals. Bacterial identification based on biochemical and automated methods indicated the growth of M morganii. M morganii was also isolated from the exudate of a diabetic ulcer in the left foot, with antibiotic susceptibilities identical to those from the knee effusion. This case indicates that M morganii may be considered as a possible cause of septic arthritis in diabetic patients, especially those with diabetic foot infections.Öğe Mustafa Kemal üniversitesi tıp fakültesi yoğun bakım ünitesi’nde 2011 yılında sağlık hizmeti ile ilişkili infeksiyonların değerlendirilmesi(2012) Köksaldı Motor, Vicdan; Evirgen, Ömer; Yula, Erkan; Erden, Ersin Şükrü; Ocak, Sabahattin; Önlen, YusufBu çalışmada, hastanemiz yoğun bakım ünitesinde 2011 yılında gelişen sağlık hizmeti ile ilişkili infeksiyonların değerlendirilmesi amaçlanmıştır. Yoğun bakım ünitesinde hastaya dayalı, aktif, prospektif sürveyans yapılmıştır. Hastane infeksiyonu tanısında Hastalık Kontrol ve Önleme Merkezi (CDC) tanı kriterleri kullanılmıştır. İzole edilen infeksiyon etkenleri konvansiyonel yöntemler ve VİTEK2 Compact (bioMérieux, Fransa) otomatize sistemle tanımlanmıştır. Antibiyotik duyarlılık testleri Klinik ve Laboratuvar Standartları Enstitüsü (CLSI) kriterlerine göre disk difüzyon yöntemi ile yapılmıştır. Çalışma boyunca yoğun bakım ünitesinde 415 hasta 3654 hasta günü izlenmiştir. Bu sürede 70 hastane infeksiyonu tanımlanmış, hastane infeksiyonu hızı % 16.9; hastane infeksiyonu insidans dansitesi binde 19.2 olarak hesaplanmıştır. Hastane infeksiyonu tanısı alan hastalardan 71 mikroorganizma izole edilmiş, bunların 36’sını Gram negatif bakteriler, 17’sini Gram pozitif bakteriler ve 18’ini kandida türleri oluşturmuştur. Tüm sağlık hizmeti ile ilişkili infeksiyonların yaklaşık yarısı kateter ilişkili üriner sistem infeksiyonu (% 47.1), % 35.7’si kan dolaşımı infeksiyonu ve % 17.1’i ventilatör ilişkili pnömoni olarak tespit edilmiştir. Sürveyans çalışmaları sonucu her merkezin mikroorganizma dağılımı ve direnç durumlarını belirleyerek bu doğrultuda akılcı antibiyotik kullanımına önem vermesi, dirençli mikroorganizmalarla mücadelede başarı sağlayacaktır.Öğe The prevalence and resistance patterns of Pseudomonas aeruginosa in intensive care units in a university hospital(2005) Savaş, Lütfü; Duran, Nizami; Savaş, Nazan; Önlen, Yusuf; Ocak, SabahattinThe intensive care units (ICUs) are burdened with a high frequency of nosocomial infections often caused by multiresistant nosocomial pathogens. Pseudomonas aeruginosa has emerged as one of the most problematic Gram-negative pathogens. The objective of this study was to identify frequency of Pseudomonas aeruginosa from the various clinical samples in ICUs, and to investigate resistance patterns against various antibiotics widely used for treatment. This study was carried out between September 2000-September 2002. Antimicrobial susceptibility testing was performed by the disc diffusion method according to NCCLS (National Commitee for Clinical and Laboratory Standards) guidelines. The following antibiotics were tested: imipenem, meropenem, aztreonam, ciprofloxacin, ceftazidime, cefepime, piperacillin, norfloxacin and the aminoglycosides (gentamicin, netilmicin, tobramycin, and amikacin). Pseudomonas aeruginosa were isolated from 16.4 % (152/928) of the patients in ICUs. The highest Pseudomonas aeruginosa isolation was obtained in the burns unit (26.9%, 78/290) followed by, cardiovascular surgical ICU (17.6%, 13/74) general surgical ICU (24/164, 14.6 %), internal ICU (17/180, 9.4%) and coronary ICU (20/220, 9.1%). There is a statististically significant difference between surgical ICU and medical internal ICU (P < 0.05). The most effective antibiotics were carbapenems (imipenem and meropenem) and the resistance rates were detected as 15% and 20.4%, respectively among 152 Pseudomonas aeruginosa strains. In conclusion, the frequency of Pseudomonas aeruginosa was found to be high in patients treated at ICUs. The results demonstrate that the resistance rates are alarmingly high. To reduce the emergence and spread of antimicrobial-resistant pathogens in ICUs, monitoring and optimization of antimicrobial use should be considered carefully. These findings suggest that the resistance rates of aminoglycosides, 3th generation antibiotics and quinolone are increasing progressively in Turkey.Öğe PREVALENCE OF METHICILLIN-SENSITIVE AND METHICILLIN-RESISTANT STAPHYLOCOCCI IN INTENSIVE CARE UNITS IN A UNIVERSITY HOSPITAL(Modestum Ltd, 2005) Savas, Lutf; Duran, Nizami; Onlen, Yusuf; Savas, Nazan; Ocak, Sabahattin; Iris, Nur EfeAim: The intensive care units (ICUs) are burdened with a high frequency of nosocomial infections often caused by multiresistant nosocomial pathogens. Coagulase-negative staphylococci (CoNS) and Staphylococcus aureus are reported as important causative agents of nosocomial infections. The objective of this study was to identify frequency of methicillin resistant and susceptible staphylococci from the various clinical samples in ICUs, and to investigate resistance patterns against various antibiotics used broadly for treatment. Methods: Originating from four selected ICUs and burn center in a University hospital, a total of 241 staphylococci strains from blood, respiratory tract, urine and wound sites were processed in our central laboratory to assess their occurrence rates and antimicrobial susceptibility profiles. Susceptibility tests of isolates were performed according to disc diffusion method recommended by National Committee for Clinical Laboratory Standards (NCCLS). Results: Staphylococci strains were isolated from 40.4% of the patients in ICUs. The rates of methicillin resistant and susceptible Staphylococcus aureus were 24.1% and 9.96%, respectively. Out of 241 isolates, 14.5% methicillin sensitive CoNS and 15.8% methicillin resistant staphylococci were isolated. The highest staphylococci isolation (47.3 %) was obtained in cardiovascular surgical ICU which is followed by general surgical ICU (45.1%), burn center (39.8%), coronary ICU (39.4%) and internal ICU (33.9%). There is statististically significant difference between surgical ICU and internal ICU. None of the isolated staphyloccocci showed resistance against vancomycin. Penicillin resistance was found to be 100% in methicillin resistant Staphylococcus aureus strains while it was 76% in methicillin sensitive Staphylococcus aureus. There is significant difference between two groups. Conclusion: Frequency of staphylococci was found to be high in patients treated at intensive care units. Antibiotic resistance patterns of methicillin resistant Staphylococcus aureus strains were found to be quite higher than that of methicillin susceptible staphylococcci.Öğe Preventive effect of rolipram, a phosphodiesterase 4 enzyme inhibitor, on oxidative renal injury in acute ascending pyelonephritis model in rats(Elsevier Science Inc, 2008) Goeruer, Sadik; Celik, Sefa; Hakverdi, Sibel; Aslanta, Oezkan; Erdogan, Suat; Aydin, Muhsin; Ocak, SabahattinOBJECTIVES To evaluate the effects of rolipram, a phosphodiesterase 4 enzyme inhibitor, on Escherichia coli-induced renal oxidative damage in an acute pyelonephritis (PYN) rat model. METHODS A total of 35 male Wistar albino rats were randomly divided into 7 groups (n = 5) as follows: control (uninfected), PYN 24 hours, PYN 48 hours, PYN 72 hours, PYN + rolipram 24 hours, PYN + rolipram 48 hours, and PYN + rolipram 72 hours. Ascending PYN was induced in the study groups by E. coli inoculation into the bladder, and the urethras were then occluded by collodium for 4 hours. Rolipram injections (1 mg/kg) were started before bacterial inoculation and repeated at 24-hour intervals in the PYN + rolipram groups until death. The rats were killed at the indicated times. Malondialdehyde and nitric oxide levels and superoxide dismutase and catalase activities were determined in kidney homogenates. Histopathologic examinations were also performed. RESULTS Tissue malondialdehyde and nitric oxide levels and superoxide dismutase and catalase activities were significantly increased in the kidneys from the PYN groups. However, rolipram administration reduced renal malondialdehyde and nitric oxide levels and enhanced superoxide dismutase and catalase activities. The histopathologic examinations demonstrated that rolipram treatment reduced the inflammation grade in the kidney specimens. CONCLUSIONS The results of our study have shown that rolipram has a protective effect on renal tissue from E. coli-induced oxidative injury. Therefore, phosphodiesterase 4 inhibitors might be a novel therapeutic option for the prevention and/or management of acute PYN.Öğe Protective effects of caffeic acid phenethyl ester, vitamin C, vitamin E and N-acetylcysteine on vancomycin-induced nephrotoxicity in rats(Wiley, 2007) Ocak, Sabahattin; Gorur, Sadik; Hakverdi, Sibel; Celik, Sefa; Erdogan, SuatThe objective of this study was to compare the beneficial effects of caffeic acid phenethyl ester (CAPE), vitamin C, vitamin E and N-acetylcysteine on vancomycin-induced nephrotoxicity. Thirty rats were randomly devided into six groups: (i) control; (ii) vancomycin, 200 mg/kg administrated via intraperitoneal route; (iii) vancomycin plus CAPE - vancomycin with 10 mu mol/kg CAPE; (iv) vancomycin plus vitamin C - vancomycin (intraperitoneally) with 200 mg/dl vitamin C in drinking water; (iv) vancomycin plus vitamin E - vancomycin with 1000 mg/kg body weight vitamin E (intramuscularly); and (vi) vancomycin plus N-acetylcysteine - vancomycin with 10 mg/kg body weight (intraperitoneally) of N-acetylcysteine. Vancomycin treatments were started I day after the first administrations of these agents and continued for 7 days. At the end of the experiments, catalase activity was significantly decreased by vancomycin in kidney homogenates (P < 0.05). Vitamin E, vitamin C, N-acetylcysteine and CAPE administrations decreased the blood urea nitrogen levels increased by vancomycin, although significant differences were detected only in the vitamins E and C groups (P < 0.05). Increased renal malondialdehyde and nitric oxide levels by vancomycin were significantly suppressed by agents used in the study (P < 0.05). Histopathological examination demonstrated prominent damages in the vancomycin-treated group. Vitamin E was the most beneficial agent on vancomycin-induced tubular damage, followed by vitamin C, N-acetyleysteine and CAPE treatments, respectively. The data suggest that vitamin E, as well as vitamin C, N-acetyleysteine and CAPE, could be useful for reducing the detrimental effects on vancomycin-induced toxicity in kidneys.
