Browsing by Author "Sayan, Murat"
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Item Evaluation of clinical, laboratory, and therapeutic features of 145 tularemia cases: The role of quinolones in oropharyngeal tularemia(Wiley, 2008-01) Meriç, Meliha; Willke, Ayse; Finke, Ernst-Jurgen; Grunow, Roland; Sayan, Murat; Erdoğan, Sarper; Gedikoğlu, Suna; Uludağ Üniversitesi/Tıp Fakültesi/Mikrobiyoloji Anabilim Dalı.; 6603407548Tularemia outbreaks have occurred in various regions of Turkey in recent years. In this study, clinical (145 patients) and laboratory (97 patients) features of patients with oropharyngeal tularemia were evaluated during the tularemia outbreak in the district of Golcuk in Kocaeli, Turkey. We analyzed the risk factors for therapeutic failure and prolonged recovery time, and compared the efficacy of three antibiotic groups, namely aminoglycoside, tetracycline and quinolone. The most common physical sign and laboratory findings in patients were lymphadenopathy (LAP) and increased erythrocyte sedimentation rate, respectively. Treatment failure was observed in 55 of the 145 (38%) patients during one-year follow-up and the most successful results were obtained in the quinolone group. It was determined that antimicrobial therapy initiated 14 days after onset of symptoms was a statistically significiant risk factor, reducing the success rate (p=0.0001, OR=13.10, 95% CI=5.69-30.15) and prolonging the recovery period (p=0.001, OR=3.23, 95% CI=1.63-6.40) in oropharyngeal tularemia cases. These results suggest that antimicrobial treatment should be started early, and quinolones such as moxifloxacin and ciprofloxacin seem to be new alternatives in the treatment of oropharyngeal tularemia.Item HCV NS3 inhibitors resistance mutations in the telaprevir started Turkish patients with chronic HCV(Elsevier, 2014-04) Sayan, Murat; Akhan, Sıla; Aygen, Bilgehan; Koruk, Suda Tekin; Demirtürk, Nurbanu; Ural, Onur; Mıstık, Reşit; Uludağ Üniversitesi.Item 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; 57207553671HIV-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.Item 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; 57207553671Objectives: 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.Item 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; 56191003300Background: 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.Item An outbreak of oropharyngeal tularaemia linked to natural spring water(Microbiology, 2009-01) Wilke, Ayşe; Meriç, Meliha; Grunow, Roland; Sayan, Murat; Finke, Ernst-Jurgen; Splettstoesser, W.; Seibold, Erik; Erdoğan, Sarper; Ergönül, Önder; Yumuk, Zeki; Gedikoğlu, Suna; Uludağ Üniversitesi/Tıp Fakültesi/Mikrobiyoloji Anabilim Dalı.; 6603407548A tularaemia outbreak was investigated involving 188 suspected cases in the Kocaeli region of Turkey between December 2004 and April 2005. A case-control study comprising 135 laboratory-confirmed cases and 55 controls was undertaken to identify risk factors for the development of the outbreak and to evaluate laboratory diagnostic methods. Tularaemia was confirmed by a microagglutination test (MAT) titre of >= 1 :160 in 90 of the patients. In MAT-negative sera, 23/44 (52 %) were positive by ELISA with Francisella tularensis LPS and 1/9 (111 %) by Western blotting with this antigen. A species-specific PCR was positive in 16/25 (64 %) throat swabs and 8/13 (62 %) lymph node aspirates. Multivariate analysis showed that drinking natural spring water was the leading risk factor for the development of tularaemia (P=0.0001, odds ratio 0.165, 95 % CI 0.790-0.346). The outbreak ceased after abandonment of the suspected natural water springs.Item Su kaynaklı küçük bir tularemi salgını(Ankara Mikrobiyoloji Derneği, 2008-01) Meriç, Meliha Koç; Sayan, Murat; Willke, Ayşe; Gedikoǧlu, Suna; Uludaǧ Üniversitesi/Tıp Fakültesi/Klinik Mikrobiyoloji ve Mikrobiyoloji Anabilim Dalı.; 6603407548Bu çalışmada 22 Ocak – 8 Mart 2005 tarihleri arasında Kocaeli ili, Karamürsel ilçesi Pazarköy köyünde saptanan küçük bir tularemi salgının incelenmesi ve alınan kontrol önlemlerinin sunulması amaçlanmıştır. Aynı köyden gelen iki hastaya orofarinjiyal tularemi tanısı konulmasının ardından, o bölgede saha taraması yapılmış, hastalar muayene edilmiş, hastalardan ve salgının kaynağı olabileceği düşülen pınar sularından örnekler alınmıştır. Boğaz sürüntüsü, lenf nodu aspiratları ve filtre edilen su örneklerinden kültür yapılmış, hastaların serum örneklerinde mikroaglütinasyon (MA) testi ile Francisella tularensis antikorları taranmıştır. Filtre edilmiş su örneklerinde gerçek zamanlı polimeraz zincir reaksiyonu (PCR) ile F.tularensis DNA’sı araştırılmıştır. Klinik özellikleri ve MA test sonuçlarına (≥1/80) dayanarak toplam 17 hastaya tularemi tanısı konulmuş; hastaların 16’sı orofarinjiyal, biri ülseroglandüler tularemi olarak tanımlanmıştır. Hastaların yaşları 27-80 yıl arasında değişmekte olup (ortalama yaş: 48±17 yıl), 10’u (%59) kadındır. En yaygın saptanan semptomlar halsizlik (%100), boyunda şişlik (%94) ve boğaz ağrısı (%88), en sık belirlenen klinik bulgu ise servikal lenfadenopati (%94) olmuştur. Yapılan kültürlerin hiçbirisinde F.tularensis üretilememiş, buna karşın pınar sularından alınan örneklerde gerçek zamanlı PCR ile F.tularensis DNA’sı gösterilmiştir. Hastalar streptomisin, doksisiklin ya da siprofloksasin ile tedavi edilmiş ve tümünde iyileşme saptanmıştır. Pınar sularının toplandığı deponun temizlenmesi ve suların klorlanması ile salgın kontrol altına alınmıştır.Item Transmitted antiretroviral drug resistance mutations in newly diagnosed HIV-1 positive patients in Turkey(John Wiley & Sons Ltd, 2014-11) Sayan, Murat; Sargın, Fatma; Dilara, İnan; Sevgi, Dilek Yıldız; Kocagül Çelikba, Aysel; Kart Yaşar, Kadriye; Kaptan, Figen; Kutlu, Selda; Fışgın Taşdelen, Nuriye; İnci, Ayşe; Ceran, Nurgül; Karaoğlan, İlkay; Çağatay, Atahan; Celen, Mustafa K.; Koruk, Suda Tekin; Ceylan, Bahadır; Yıldırmak, Taner; Korten, Volkan; Willke, Ayşe; Akalın, Halis; Uludağ Üniversitesi/Tıp Fakültesi/Enfeksiyon Hastalıkları ve Klinik Mikrobiyoloji Anabilim Dalı.