Browsing by Author "İnan, Dilara"

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Assessment of the requisites of microbiology based infectious disease training under the pressure of consultation needs
(BMC, 2011) Erdem, Hakan; Koruk, Suda Tekin; Koruk, İbrahim; Keten, Derya Tozlu; Kılıç, Aysegül Ulu; Öncül, Oral; Güner, Rahmet; Birengel, Serhat; Mert, Gürkan; Alpat, Saygın Nayman; Tülek, Necla Eren; Demirdal, Tuna; Elaldi, Nazif; Hatipoglu, Çiğdem Ataman; Yılmaz, Emel; Mete, Bilgul; Kurtaran, Behice; Ceran, Nurgül; Karabay, Oğuz; İnan, Dilara; Cengiz, Melahat; Sacar, Suzan; Dede, Behiye Yücesoy; Yılmaz, Sibel; Agalar, Canan; Bayındır, Yaşar; Alpay, Yeşim; Tosun, Selma; Yılmaz, Hava; Bodur, Hürrem; Erdem, Hüseyin A.; Dikici, Nebahat; Dizbay, Murat; Öncu, Serkan; Sezak, Nurbanu; Sarı, Tuba; Sipahi, Oğuz R.; Uysal, Serhat; Yeniz, Esma; Kaya, Selcuk; Ulcay, Asım; Kurt, Halil; Beşirbellioğlu, Bulent A.; Vahaboğlu, Haluk; Taşova, Yeşim; Usluer, Gaye; Arman, Dilek; Diktaş, Hüsrev; Ulusoy, Sercan; Leblebicioğlu, Hakan; Yılmaz, Emel; Uludağ Üniversitesi/Tıp Fakültesi/Enfeksiyon Hastalıkları ve Klinik Mikrobiyoloji Anabilim Dalı.; 0000-0002-3894-1231; 22037135100
Background: Training of infectious disease (ID) specialists is structured on classical clinical microbiology training in Turkey and ID specialists work as clinical microbiologists at the same time. Hence, this study aimed to determine the clinical skills and knowledge required by clinical microbiologists. Methods: A cross-sectional study was carried out between June 1, 2010 and September 15, 2010 in 32 ID departments in Turkey. Only patients hospitalized and followed up in the ID departments between January-June 2010 who required consultation with other disciplines were included. Results: A total of 605 patients undergoing 1343 consultations were included, with pulmonology, neurology, cardiology, gastroenterology, nephrology, dermatology, haematology, and endocrinology being the most frequent consultation specialties. The consultation patterns were quite similar and were not affected by either the nature of infections or the critical clinical status of ID patients. Conclusions: The results of our study show that certain internal medicine subdisciplines such as pulmonology, neurology and dermatology appear to be the principal clinical requisites in the training of ID specialists, rather than internal medicine as a whole.
Demographic characteristics and transmission risk factors of patients with hepatitis c virus in Turkey: The EPI-C, a multicenter and cross-sectional trial
(Galenos Yayıncılık, 2021-09-21) Tabak, Fehmi; Şirin, Göktuğ; Demir, Mehmet; Aladağ, Murat; Sümer, Sua; Kurtaran, Behice; Tosun, Selma; Yamazhan, Tansu; Bozkurt, İlkay; Gürbüz, Yunus; Batirel, Ayşe; Senateş, Ebubekir; Kandemir, Fatma Özlem; Topal, Firdevs; Doğanay, Hamdi Levent; Sezgin, Orhan; Mıstık, Reşit; Köse, Sükran; Yılmaz, Yusuf; İnan, Dilara; Köksal, İftihar; Parlak, Emine; Akdoğan, Meral; Güner, Rahmet; Mıstık, Reşit; Bursa Uludağ Üniversitesi/Tıp Fakültesi/Enfeksiyon Hastalıkları ve Klinik Mikrobiyoloji Kliniği.; 0000-0002-1548-8526; DFY-3761-2022
Objectives: To describe the prevalence of risk factors in patients infected with hepatitis C virus (HCV).Materials and Methods: Patients who were aged >18 years visiting outpatient clinics and diagnosed as having HCV infection were enrolled in this cross-sectional, multicenter study conducted in 71 cities. Patient data on socio-demographic and clinical characteristics and pre-defined risk factors were collected.Results: Among 1,018 patients, 53.0% were women. The mean age was 57.2 +/- 14.3 years and 34.8% had been diagnosed as having HCV infection >10 years before enrollment. Almost half of the patients (45.5%) were diagnosed during their regular check-up visits, and only 16.8% were diagnosed because of signs or symptoms of HCV. Genotype 1 and sub-genotype 1 b were detected in 87.9% and 73.7% of the patients, respectively. At least one risk factor was present in 94.8% of the patients. The most frequently reported risk factor was major dental procedures (79.2%), followed by major surgical operations (56.9%) and minor surgical interventions (42.3%).Conclusion: Our results revealed that most of the patients with HCV infection underwent major dental procedures.
Efficacy and tolerability of antibiotic combinations in Neurobrucellosis: Results of the Istanbul study
(American Society of Microbiology, 2012-03) Erdem, Hakan; Kılıç, Ayşegül Ulu; Kılıç, Selim; Karahocagil, Mustafa; Shehata, Ghaydaa; Tülek, Necla Eren; Yetkin, Funda; Çelen, Mustafa Kemal; Ceran, Nurgül; Gül, Hanefi Cem; Mert, Gürkan; Koruk, Suda Tekin; Dizbay, Murat; İnal, Ayşe Seza; Alpat, Saygın Nayman; Bosilkovski, Mile; İnan, Dilara; Saltoğlu, Neşe; Abdel-Baky, Laila; Adeva-Bartolome, Maria Teresa; Ceylan, Bahadır; Saçar, Suzan; Turhan, Vedat; Elaldı, Nazif; Tufan, Zeliha Koçak; Uğurlu, Kenan; Dokuzoğuz, Başak; Yılmaz, Hava; Gündeş, Sibel; Güner, Rahmet; Özgüneş, Nail; Ulçay, Asım; Ünal, Serhat; Dayan, Saim; Görenek, Levent; Karakaş, Ahmet; Tasova, Yeşim; Usluer, Gaye; Bayındır, Yaşar; Kurtaran, Behice; Sipahi, Oğuz Reşat; Leblebicioğlu, Hakan; Yılmaz, Emel; Uludağ Üniversitesi/Tıp Fakültesi/Enfeksiyon Hastalıkları ve Klinik Mikrobiyoloji Anabilim Dalı.; 22037135100
No data on whether brucellar meningitis or meningoencephalitis can be treated with oral antibiotics or whether an intravenous extended-spectrum cephalosporin, namely, ceftriaxone, which does not accumulate in phagocytes, should be added to the regimen exist in the literature. The aim of a study conducted in Istanbul, Turkey, was to compare the efficacy and tolerability of ceftriaxone-based antibiotic treatment regimens with those of an oral treatment protocol in patients with these conditions. This retrospective study enrolled 215 adult patients in 28 health care institutions from four different countries. The first protocol (P1) comprised ceftriaxone, rifampin, and doxycycline. The second protocol (P2) consisted of trimethoprim-sulfamethoxazole, rifampin, and doxycycline. In the third protocol (P3), the patients started with P1 and transferred to P2 when ceftriaxone was stopped. The treatment period was shorter with the regimens which included ceftriaxone (4.40 +/- 2.47 months in P1, 6.52 +/- 4.15 months in P2, and 5.18 +/- 2.27 months in P3) (P = 0.002). In seven patients, therapy was modified due to antibiotic side effects. When these cases were excluded, therapeutic failure did not differ significantly between ceftriaxone-based regimens (n = 5/166, 3.0%) and the oral therapy (n = 4/42, 9.5%) (P = 0.084). The efficacy of the ceftriaxone-based regimens was found to be better (n = 6/166 [3.6%] versus n = 6/42 [14.3%]; P = 0.017) when a composite negative outcome (CNO; relapse plus therapeutic failure) was considered. Accordingly, CNO was greatest in P2 (14.3%, n = 6/42) compared to P1 (2.6%, n = 3/ 117) and P3 (6.1%, n = 3/ 49) (P = 0.020). Seemingly, ceftriaxone-based regimens are more successful and require shorter therapy than the oral treatment protocol.
HIV-1 transmitted drug resistance mutations in newly diagnosed antiretroviral-naive patients in Turkey
(Mary Ann Liebert, 2016-01-01) Sayan, Murat; Sargın, Fatma; İnan, Dilara; Sevgi, Dilek Y.; Çelikbaş, Aysel K.; Yaşar, Kadriye; Kaptan, Figen; Kutlu, Selda; Fışgın, Nuriye T.; İnci, Ayşe; Ceran, Nurgül; Karaoğlan, İlkay; Çağatay, Atahan; Çelen, Mustafa K.; Koruk, Suda T.; Ceylan, Bahadir; Yıldırmak, Taner; Korten, Volkan; Willke, Ayşe; Akalın, Halis; Uludağ Üniversitesi/Tıp Fakültesi/Enfeksiyon Hastalıkları Anabilim Dalı.; AAU-8952-2020; 57207553671
HIV-1 replication is rapid and highly error-prone. Transmission of a drug-resistant HIV-1 strain is possible and occurs within the HIV-1-infected population. In this study, we aimed to determine the prevalence of transmitted drug resistance mutations (TDRMs) in 1,306 newly diagnosed untreated HIV-1-infected patients from 21 cities across six regions of Turkey between 2010 and 2015. TDRMs were identified according to the criteria provided by the World Health Organization's 2009 list of surveillance drug resistance mutations. The HIV-1 TDRM prevalence was 10.1% (133/1,306) in Turkey. Primary drug resistance mutations (K65R, M184V) and thymidine analogue-associated mutations (TAMs) were evaluated together as nucleos(t)ide reverse transcriptase inhibitor (NRTI) mutations. NRTI TDRMs were found in 8.1% (107/1,306) of patients. However, TAMs were divided into three categories and M41L, L210W, and T215Y mutations were found for TAM1 in 97 (7.4%) patients, D67N, K70R, K219E/Q/N/R, T215F, and T215C/D/S mutations were detected for TAM2 in 52 (3.9%) patients, and M41L + K219N and M41L + T215C/D/S mutations were detected for the TAM1 + TAM2 profile in 22 (1.7%) patients, respectively. Nonnucleoside reverse transcriptase inhibitor-associated TDRMs were detected in 3.3% (44/1,306) of patients (L100I, K101E/P, K103N/S, V179F, Y188H/L/M, Y181I/C, and G190A/E/S) and TDRMs to protease inhibitors were detected in 2.3% (30/1,306) of patients (M46L, I50V, I54V, Q58E, L76V, V82A/C/L/T, N83D, I84V, and L90M). In conclusion, long-term and large-scale monitoring of regional levels of HIV-1 TDRMs informs treatment guidelines and provides feedback on the success of HIV-1 prevention and treatment efforts.
Inappropriate antimicrobial use in Turkish pediatric hospitals: A multicenter point prevalence survey
(Elsevier, 2010-01) Ceyhan, Mehmet; Yıldırım, İnci; Ecevit, Çiğdem Ömür; Aydoğan, Aysel; Örnek, Ahmet Haydar; Salman, Nuran; Somer, Ayper; Hatipoğlu, Nevin; Camcıoğlu, Yıldız; Alhan, Emre; Hacımustafaoğlu, Mustafa Kemal; Çelebi, Solmaz; İnan, Dilara; Kurt, Neşe Çitak; Öner, Ahmet Faik; Gülümser, Özlem; Güneş, Adalet Meral; Coşkun, Yavuz; Çelik, Ümit; Uludağ Üniversitesi/Tıp Fakültesi/Çocuk Sağlığı ve Hastalıkları Anabilim Dalı.; 9843305700
Objectives: Although well-defined principles of rational antimicrobial use are available, inappropriate prescribing patterns are reported worldwide. Accurate information on the usage of antimicrobials, including factors associated with and influencing their use, is valuable for improving the quality of prescription practices. Methods: In this cross-sectional point prevalence survey, data on patients hospitalized in 12 different children's hospitals were collected on a single day. Appropriateness of prescription was compared between the types of antimicrobials prescribed, indications, wards, and presence of/consultation with an infectious disease physician (IDP). Results: A total 711 of 1302 (54.6%) patients evaluated were receiving one or more antimicrobial drugs. The antimicrobial prescription rate was highest in pediatric intensive care (75.7%) and lowest in the surgery wards (37.0%). Of the 711 patients receiving antimicrobials, 332 patients (46.7%) were found to be receiving at least one inappropriately prescribed drug. Inappropriate use was most frequent in surgery wards (80.2%), while it was less common in oncology wards (31.8%; p < 0.001). Respiratory tract infection was the most common indication for antimicrobial use (29.4%). Inappropriate use was more common in deep-seated infections (54.7%) and respiratory infections (56.5%). Fluoroquinolones were used inappropriately more than any other drugs (81.8%, p = 0.021). Consultation with an IDP appears to increase appropriate antimicrobial use (p = 0.008). Conclusions: Inappropriate antimicrobial use remains a common problem in Turkish pediatric hospitals. Consultation with an IDP and prescribing antimicrobial drugs according to microbiological test results could decrease the inappropriate use of antimicrobials.
Integrase strand transfer inhibitors (INSTIs) resistance mutations in HIV-1 infected Turkish patients
(Taylor & Francis, 2016) Sayan, Murat; Gündüz, Alper; Ersöz, G.; İnan, Asuman; Deveci, Aydın; Günal, Özgür; Sargın, Fatma; Karagöz, Gül; İnci, Ayşe; İnan, Dilara; Ulcay, Asım; Karaoğlan, İlkay; Kaya, S.; Kutlu, Selda S.; Süer, Kaya; Çağatay, Atahan; Akalın, Halis; Uludağ Üniversitesi/Tıp Fakültesi/Enfeksiyon Hastalıkları Anabilim Dalı.; AAU-8952-2020; 57207553671
Objectives: Integrase strand transfer inhibitor (INSTI) is a new class of antiretroviral (ARV) drugs designed to block the action of the integrase viral enzyme, which is responsible for insertation of the HIV-1 genome into the host DNA. The aim of this study was to evaluate for the first time INSTI resistance mutations in Turkish patients. Methods: This study was conducted in Turkey, between April 2013 and April 2015 using 169 HIV-1-infected patients (78 ARV naive patients and 91 ARV-experienced patients). Laboratory and clinical characteristics of ARV naive and ARV-experienced patients were as follows: gender (M/F): 71/7 and 80/11, median age: 38 and 38.4; median CD4+ T-cell: 236 and 216 cells/mm3, median HIV-1 RNA: 4.95+ E5 and 1.08E+ 6 copies/ml. Population-based seqeunces of the reverse transcriptase, protease, and integrase domains of the HIV-1 pol gene were used to detect HIV-1 drug resistance mutations. Result: INSTI resistance mutations were not found in recently diagnosed HIV-1-infected patients. However, ARV-experienced patients had major resistance mutations associated with raltegravir and elvitegravir; the following results were generated: F121Y, Y143R, Q148R and E157Q (6/91 - 6.6%). Conclusions: The prevalence of INSTI resistant mutations in ART-experienced patients suggested that resistance testing must be incorporated as an integral part of HIV management with INSTI therapies.
Molecular identification of HIV-1 in the presence of hepatitis B virus and hepatitis C virus Co-infections
(Galenos Yayıncılık, 2020-02-24) Sayan, Murat; Özgüler, Müge; Yıldırım, Figen; Yıldırmak, Taner; Gündüz, Alper; Dokuzoğuz, Başak; Çelen, Mustafa Kemal; İnan, Dilara; Ersöz, Gülden; Karaoğlan, İlkay; Ceran, Nurgül; Heper, Yasemin; Bursa Uludağ Üniversitesi/Tıp Fakültesi/Enfeksiyon Hastalıkları ve Klinik Mikrobiyoloji Anabilim Dalı.; 0000-0002-6635-5416; AAH-6506-2021; 56191003300
Background: Because of their similar modes of transmission, the simultaneous infection of viral hepatitis and human immunodeficiency virus are increasingly seen as a big problem related to human health. Aims: To determine the drug mutations in hepatitis B virus and/or hepatitis C virus co-infected human immunodeficiency virus-1 patients in Turkey. Study Design: Retrospective cross-sectional study. Methods: The present study was conducted between 2010 and 2017. HBsAg, anti-hepatitis C virus, and anti-human immunodeficiency vim were tested with ELISA. All anti-human immunodeficiency virus positive results by ELISA were verified for anti-human immunodeficiency virus positivity by a Western blot test, and Antihuman immunodeficiency virus positive patients with HBsAg andior anti-hepatitis C virus positivity were included in the study. Subtyping and genotypic resistance analyses were performed by population sequencing of the viral protease and reverse transcriptase regions of the human immunodeficiency virus-1 pol gene. Results: We detected 3896 human immunodeficiency virus-1 positive patients whose sera were sent from numerous hospitals across the country to our polymerase chain reaction unit for detection of drug resistance mutations and whose molecular laboratory tests were completed. Viral hepatitis co-infections were detected in 4.3% (n=170) of patients. Hepatitis B virus and hepatitis C virus co-infection were observed in 3.2% and 0.5% of all human immunodeficiency virus-I infected patients, respectively. The major human immunodeficiency virus-1 subtype detected was group M, subtype B (62.9%). However, 13.5% of drug resistance mutation motifs were found in human immunodeficiency virus-1 genomes of patients included in the study. Conclusion: Due to similar transmission routes, HIV1 patients are at risk of hepatitis B and C virus co-infection. However, antiretroviral drug resistance mutation model is similar to patients with hepatitis negative.
Outcomes of initial antiretroviral treatment (ART) among recently diagnosed HIV patients in HIV-TR cohort, 2011-2012
(John Wiley & Sons Ltd, 2014-11) Korten, Volkan; Gökengin, Deniz; Fincancı, Muzaffer; Yıldırmak, Taner; Uzun Kes, Nuray; Fisgin, Nuriye Taşdelen; İnan, Dilara; Eraksoy, Haluk; Kaptan, Figen; Akalın, Halis; Uludağ Üniversitesi/Tıp Fakültesi/Enfeksiyon Hastalıkları Anabilim Dalı.; AAU-8952-2020
Real-world data from Turkey: Is sofosbuvir/ledipasvir with or without ribavirin treatment for chronic hepatitis c really effective?
(Aves, 2021-02-01) Demirtürk, Neşe; Aygen, Bilgehan; Çelik, İlhami; Mıstık, Reşit; Akhan, Sıla; Barut, Şener; Ural, Onur; Batırel, Ayşe; Şimşek, Funda; Ersöz, Gülden; İnan, Dilara; Kınıklı, Sami; Türker, Nesrin; Bilgin, Hüseyin; Gürbüz, Yunus; Tülek, Necla; Tarakcı, Hüseyin; Yıldız, Orhan; Türkoğlu, Emine; Güzel, Deniz Kamalak; Şimşek, Sümeyra; Tuna, Nazan; Demir, Nazlım Aktuğ; Çağatay, Atahan; Çetinkaya, Rıza Aytaç; Karakeçili, Faruk; Hakyemez, İsmail Necati; Ertem, Günay Tuncer; Örmen, Bahar; Korkmaz, Pınar; Şili, Uluhan; Kuruüzüm, Ziya; Şener, Alper; Özel, Selcan Arslan; Öztürk, Sinan; Süer, Kaya; Çelen, Mustafa Kemal; Konya, Petek; Asan, Ali; Saltoğlu, Neşe; Doğan, Nurhan; Şimşek, Sümeyra; Bursa Uludağ Üniversitesi/Tıp Fakültesi/Enfeksiyon Hastalıkları ve Klinik Mikrobiyoloji Anabilim Dalı.; DTA-4765-2022
Background: In this study, we aimed to investigate the efficacy and safety of sofosbuvir-based therapies in the treatment of chronic hepatitis C in real-world clinical practice.Methods: Data from patients with chronic hepatitis C treated with SOF/LDV +/- RBV or SOF/RBV in 31 centers across Turkey between April 1, 2017, and August 31, 2018, were recorded in a nationwide database among infectious disease specialists. Demographics, clinical, and virological outcomes were analyzed.Results: A total of 552 patients were included in the study. The mean age of the patients was 51.28 +/- 14.2, and 293 (55.8%) were female. The majority had HCV genotype 1b infection (65%), 75.04% of the patients underwent treatment, and non-cirrhosis was present at baseline in 381 patients (72.6%). SOF/LDV +/- RBV treatment was given to 477 patients and 48 patients received SOF/RBV according to HCV genotype. The total SVR12 rate was 99% in all patients. Five patients experienced disease relapse during the study and all of them were genotype 2. In patients infected with HCV GT2, SVR12 was 77.3%. SVR was 100% in all patients infected with other HCV genotypes. All treatments were well tolerated by patients without causing severe adverse events. Side effects and side effects-associated treatment discontinuation rates were 28.2% and 0.4%, respectively. Weakness (13.7%) was the common side effect.Conclusion: The present real-world data of 525 patients with HCV genotypes 1, 1a, 1b, 3, 4, and 5 who underwent SOF/LDV +/- RBV treatment in Turkey demonstrated a high efficacy and safety profile. HCV GT2 patients should be treated with more efficacious treatment.