Person: YILMAZ, EMEL
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YILMAZ
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EMEL
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Publication The distribution of mature and/or immature myeloid cells and their role in effective anti-viral immune responses in COVID-19 positive patients(Wiley, 2021-08-01) Ermiş, Diğdem Yöyen; Dömbaz, Fatma; Karaçay, Mehmet; Etgü, Onur; Kızmaz, Muhammed Ali; Şimşek, Abdurrahman; Çağan, Eren; Aşan, Ali; Yılmaz, Emel; Kazak, Esra; Pınar, İbrahim Ethem; Bal, Salih Haldun; Arslan, Gözde; Karaca, Mert; Özkocaman, Vildan; Özkalemtaş, Fahir; Akalın, Emin Halis; Budak, Ferah; Oral, Haluk Barbaros; YÖYEN ERMİŞ, DİĞDEM; Dombaz, Fatma; Karaçay, Mehmet; Etgü, Onur; Kızmaz, Muhammed Ali; ŞİMŞEK, ABDURRAHMAN; YILMAZ, EMEL; KAZAK, ESRA; PINAR, İBRAHİM ETHEM; BAL, SALİH HALDUN; Arslan, Gözde; KARACA, MERT; ÖZKOCAMAN, VİLDAN; Özkalemtaş, Fahir; AKALIN, EMİN HALİS; BUDAK, FERAH; ORAL, HALUK BARBAROS; Bursa Uludağ Üniversitesi/Tıp Fakültesi/İmmünoloji Ana Bilim Dalı.; Bursa Uludağ Üniversitesi/Sağlık Bilimleri Enstitüsü.; Bursa Uludağ Üniversitesi/Tıp Fakültesi/Rasit Durusoy Kan Bankası.; Bursa Uludağ Üniversitesi/Tıp Fakültesi/Hemotoloji Anabilim Dalı.; Bursa Uludağ Üniversitesi/Tıp Fakültesi/Enfeksiyon Hastalıkları ve Klinik Mikrobiyoloji Anabilim Dalı.; 0000-0001-7288-3250; 0000-0001-5334-7911; 0000-0001-8850-0269; 0000-0002-8856-7356; 0000-0003-1785-3539; 0000-0001-7530-1279; 0000-0001-7625-9148; 0000-0003-0463-6818; KHE-5423-2024; AAU-8952-2020; HKN-2347-2023; JGM-6601-2023; JFS-2013-2023; AAG-7381-2021; K-7285-2012; IZP-9398-2023; F-4657-2014; JWP-2738-2024; GYL-2038-2022; DWR-5356-2022; CXY-4200-2022; CPT-2053-2022; GDP-0005-2022; AAG-8459-2021; FQJ-3657-2022; FQG-8981-2022Publication The diagnostic utility of the "Thwaites' system" and "lancet consensus scoring system" in tuberculous vs. non-tuberculous subacute and chronic meningitis: multicenter analysis of 395 adult patients(Bmc, 2020-10-23) Sulaiman, Tarek; Medi, Sai; Erdem, Hakan; Şenbayrak, Seniha; Öztürk-Engin, Derya; İnan, Asuman; Civljak, Rok; Nechifor, Mihai; Akbulut, Ayhan; Crisan, Alexandru; Özgüler, Müge; Namiduru, Mustafa; Savic, Branislava; Dulovic, Olga; Pehlivanoğlu, Filiz; Şengöz, Gönül; Yaşar, Kadriye; İnal, Ayşe Seza; Parlak, Emine; Johansen, Işık Somuncu; Kurşun, Ebru; Parlak, Mehmet; Yılmaz, Emel; Yılmaz, Gülden; Gül, Hanefi Cem; Öncül, Oral; Simeon, Soline; Tattevin, Pierre; Ulu-Kılıç, Ayşegül; Alabay, Selma; Beovic, Bojana; Catroux, Melanie; Hansmann, Yves; Harxhi, Arjan; Şener, Alper; Özkaya, Hacer Deniz; Cağ, Yasemin; Agalar, Canan; Vahaboğlu, Haluk; Uğur, Berna Kaya; Hasbun, Rodrigo; YILMAZ, EMEL; Bursa Uludağ Üniversitesi/Tıp Fakültesi/Enfeksiyon Hastalıkları ve Klinik Mikrobiyoloji Anabilim Dalı.; HJZ-6992-2023Background Tuberculous meningitis (TBM) represents a diagnostic and management challenge to clinicians. The "Thwaites' system" and "Lancet consensus scoring system" are utilized to differentiate TBM from bacterial meningitis but their utility in subacute and chronic meningitis where TBM is an important consideration is unknown. Methods A multicenter retrospective study of adults with subacute and chronic meningitis, defined by symptoms greater than 5 days and less than 30 days for subacute meningitis (SAM) and greater than 30 days for chronic meningitis (CM). The "Thwaites' system" and "Lancet consensus scoring system" scores and the diagnostic accuracy by sensitivity, specificity, and area under the curve of receiver operating curve (AUC-ROC) were calculated. The "Thwaites' system" and "Lancet consensus scoring system" suggest a high probability of TBM with scores <= 4, and with scores of >= 12, respectively. Results A total of 395 patients were identified; 313 (79.2%) had subacute and 82 (20.8%) with chronic meningitis. Patients with chronic meningitis were more likely caused by tuberculosis and had higher rates of HIV infection (P < 0.001). A total of 162 patients with TBM and 233 patients with non-TBM had unknown (140, 60.1%), fungal (41, 17.6%), viral (29, 12.4%), miscellaneous (16, 6.7%), and bacterial (7, 3.0%) etiologies. TMB patients were older and presented with lower Glasgow coma scores, lower CSF glucose and higher CSF protein (P < 0.001). Both criteria were able to distinguish TBM from bacterial meningitis; only the Lancet score was able to differentiate TBM from fungal, viral, and unknown etiologies even though significant overlap occurred between the etiologies (P < .001). Both criteria showed poor diagnostic accuracy to distinguish TBM from non-TBM etiologies (AUC-ROC was <. 5), but Lancet consensus scoring system was fair in diagnosing TBM (AUC-ROC was .738), sensitivity of 50%, and specificity of 89.3%. Conclusion Both criteria can be helpful in distinguishing TBM from bacterial meningitis, but only the Lancet consensus scoring system can help differentiate TBM from meningitis caused by fungal, viral and unknown etiologies even though significant overlap occurs and the overall diagnostic accuracy of both criteria were either poor or fair.Publication Evaluation of the roles of regulatory B (Breg) cells and B cell exhaustion in COVID-19(Wiley, 2021-08-01) Budak, Ferah; Çağan, Eren; Kızmaz, Muhammed Ali; Şimşek, Abdurrahman; Dombaz, Fatma; Tezcan, Gülçin; Asan, Ali; Bal, S. Haldun; Ermiş, Diğdem Yöyen; Demir, H. İbrahim; Ediger, Dane; Yılmaz, Emel; Oral, Haluk Barbaros; Akalın, E. Halis; BUDAK, FERAH; Kızmaz, Muhammed Ali; ŞİMŞEK, ABDURRAHMAN; Dombaz, Fatma; TEZCAN, GÜLÇİN; BAL, SALİH HALDUN; YÖYEN ERMİŞ, DİĞDEM; Demir, H. İbrahim; EDİGER, DANE; YILMAZ, EMEL; ORAL, HALUK BARBAROS; AKALIN, EMİN HALİS; Bursa Uludağ Üniversitesi/Tıp Fakültesi/İmmünoloji Anabilim Dalı.; Bursa Uludağ Üniversitesi/Diş Hekimliği Fakültesi/Temel Bilimler Bölümü.; Bursa Uludağ Üniversitesi/Tıp Fakültesi/Göğüs Hastalıkları Anabilim Dalı.; Bursa Uludağ Üniversitesi/Tıp Fakültesi/Klinik Mikrobiyoloji ve Enfeksiyon Hastalıkları Anabilim Dalı.; 0000-0001-7625-9148; 0000-0001-5334-7911; 0000-0001-8850-0269; 0000-0001-7288-3250; 0000-0002-5956-8755; 0000-0002-8856-7356; 0000-0001-7585-7971; 0000-0002-2954-4293; 0000-0003-1785-3539; 0000-0003-0463-6818; 0000-0001-7530-1279; AAG-7381-2021; AAH-3843-2020; K-7285-2012; F-4657-2014; IZP-9398-2023; AAU-8952-2020; HKN-2347-2023; DWR-5356-2022; KBR-5535-2024; GYL-2038-2022; GPN-1473-2022; AAE-9142-2019; GDP-0005-2022Publication Insight into pain syndromes in acute phase of mild-to-moderate covid-19: Frequency, clinical characteristics, and associated factors(Wiley, 2021-10-26) Karli, Necdet; KARLI, HAMDİ NECDET; Gullu, Gizem; GÜLLÜ, GİZEM; Kilic, Erhan; KILIÇ, ERHAN; Dinc, Yasemin; DİNÇ, YASEMİN; Ursavas, Ahmet; URSAVAŞ, AHMET; Yilmaz, Emel; YILMAZ, EMEL; Zarifoglu, Mehmet; ZARİFOĞLU, MEHMET; Bursa Uludağ Üniversitesi/Tıp Fakültesi.; 0000-0002-3894-1231; IUQ-6999-2023; AAI-3169-2021; IZQ-0662-2023; AAD-1271-2019Background Pain has been frequently described as a clinical feature of COVID-19, and the main pain syndromes that have been associated with the acute phase of this disease so far are headache, myalgia, arthralgia, and neuropathic pain. Understanding the characteristics of pain symptoms is crucial for a better clinical approach. Methods Patients who were diagnosed as having COVID-19 using reverse transcription-polymerase chain reaction were included in the study. Patients were asked to complete a 51-item questionnaire via a phone interview, which included questions on demographics, acute COVID-19 symptoms, the presence of pain symptoms, and their characteristics in the acute phase of COVID-19. Results A total of 222 out of 266 patients with COVID-19 participated in the study, yielding a response rate of 83.5%. A total of 159 patients reported at least one kind of pain syndrome with a prevalence of 71.6%. Myalgia was reported in 110 (49.6%) patients, headache in 109 (49.1%), neuropathic pain symptoms in 55 (24.8%), and polyarthralgia in 30 (13.5%) patients. A total of 66 patients reported only one type of pain, 46 reported two types, 42 reported three types, and five patients reported all four types of pain. Logistic regression analysis showed that there were significant associations between these pain syndromes and a strong association was found between neuropathic pain and headache. Conclusion Pain is a frequently observed symptom of mild-to-moderate COVID-19. There are significant relationships between pain syndromes in COVID-19, which may be due to a sequence of common etiologic factors. Significance This study described the main pain syndromes associated acute phase of mild-to-moderate COVID-19 and its associated features. Headaches and pain of neuropathic characteristics were prevalent in this sample.Publication Healthcare-associated stenotrophomonas maltophilia bacteraemia: Retrospective evaluation of treatment and outcome(Springernature, 2021-10-20) Tuncel, Tekin; Akalın, Halis; Payaslıoğlu, Melda; Yılmaz, Emel; Kazak, Esra; Heper, Yasemin; Özakın, Cüneyt; Tuncel, Tekin; AKALIN, EMİN HALİS; PAYASLIOĞLU, AYŞE MELDA; YILMAZ, EMEL; KAZAK, ESRA; HEPER, YASEMİN; ÖZAKIN, CÜNEYT; Bursa Uludağ Üniversitesi/Tıp Fakültesi/Enfeksiyon Hastalıkları ve Klinik Mikrobiyoloji Anabilim Dalı.; 0000-0001-7530-1279; 0000-0003-1785-3539; AAU-8952-2020; EBR-5383-2022; FQO-1207-2022; GDP-0005-2022; AAG-8459-2021; CTY-9474-2022; JNH-9929-2023IntroductionStenotrophomonas maltophilia (SM) is one of the common gram-negative pathogens that cause nosocomial infections. The aim of the present study is to evaluate the treatment and outcome of SM bacteraemia.Materials and MethodsWe retrospectively evaluated antimicrobial treatment in adult patients with nosocomial SM bacteraemia, with the 14th and 30th-day mortality as the outcome.ResultsIn total, 140 adult patients with SM bacteraemia who were diagnosed between January 1, 2002, and December 31, 2016 were enrolled in the present study. Seventy-one (50.7%) patients were in the intensive care unit (ICU). The 14th and the 30th-day mortality rates were 32.9% (n=46) and 45.7% (n=64), respectively. Female sex (OR, 7.47; 95% CI 1.61-34.47, p<0.01), steroid use within the last month (OR, 10.2; 95% CI 1.27-82.27, p=0.029), Pittsburgh bacteraemia score (PBS) >= 4 (OR, 39.9; 95% CI 4.96-321.32, p<0.001) and solid organ malignancy (OR, 9.6; 95% CI 1.73-53.72, p<0.01) were independent risk factors for 14th day mortality. Removal of the catheter was an independent protective factor for both 14th (OR, 0.05; 95% CI 0.22-0.010, p<0.001) and 30th day (OR, 0.039;95% CI 0.164-0.009, p<0.001) mortality. We did not detect any difference between treatment regimens including trimethoprim-sulfamethoxazole (TMP/SMX) or levofloxacin in terms of mortality. We found that TMP/SMX and levofloxacin combination did not significantly improve patient prognosis.ConclusionDue to the high mortality rates associated with nosocomial SM bacteraemia, adequate antibiotic therapy should be initiated immediately in the suspicion of infection, and prompt removal of any indwelling central venous catheter is important.Publication Conventional culture and molecular screening methods for detection of vancomycin-resistant enterococci activity(Carbone Editore, 2016-01-01) Karakecili, Faruk; Cilo, Burcu Dalyan; Akın, Hicran; Ağca, Harun; Sınırtaş, Melda; Özakın, Cüneyt; Yılmaz, Emel; Akalın, Halis; Cilo, Burcu Dalyan; Akın, Hicran; AĞCA, HARUN; Sınırtaş, Melda; ÖZAKIN, CÜNEYT; YILMAZ, EMEL; AKALIN, EMİN HALİS; Uludağ Üniversitesi/Tıp Fakültesi/Microbiooji Bölümü; 0000-0002-7368-7187; 0000-0002-2651-2034; 0000-0002-3894-1231; 0000-0001-7530-1279; IVV-5845-2023; AAH-4027-2021; AAU-8952-2020; AAG-8392-2021; ISU-9626-2023Introduction: Early identification of vancomycin-resistant enterococci (VRE) colonization by screening patients is necessary in tends of preventing spread and development of infection. The purpose of this study was to investigate the presence of VRE using and real time polymerase chain reaction (RT-PCR) and to compare the results and costs.Materials and methods: Patients in the risk group attending our hospital and planned for treatment with hospitalization were included. Two rectal swab specimens were taken. One swab specimen was inoculated into enterococci broth for CCSM. Resistant gene investigation was performed with the other specimen by using RT-PCR. The costs of the two methods were then compared.Results: VRE were detected in 75 (6.63%) of the 1130 patients screened using the two methods. Resistance gene was determined in 69 (6.1%) patients using RT-PCR and 32 (2.8%) with CCSM. RT-PCR results were negative in 6 patients with VRE growth determined using CCSM. VRE was detected with CCSM in all 26 patients in whom vanA genotype VRE were determined using RT-PCR, but no growth was determined with CCSM in any of the 43 patients in whom vanB genotype VRE were detected. Results obtained in 3 days using CCSM and within 4 hours using RT-PCR. Costs were 58 $ with CCSM and 46 $ with RT-PCR.Conclusion: VRE colonization being detected faster with RT-PCR than CCSM. When the costs in isolation of patients until VRE screening test results emerged were compared, VRE screening with RT-PCR was cost-effective. RT-PCR was markedly superior to CCSM in determining VanB type resistance. Due to the late results from CCSM and its failure to detect VanB type resistance, we think that RT-PCR can be an alternative to CCSM or that the two techniques can usefully be combined depending on the hospital conditions.Publication Hamsi scoring in the prediction of unfavorable outcomes from tuberculous meningitis: Results of haydarpasa-II study(Springer, 2015-04-01) Erdem, Hakan; Öztürk-Engin, Derya; Tireli, Hülya; Kılıçoğlu, Gamze; Defres, Sylviane; Gülsün, Serda; Şengöz, Gönül; Crisan, Alexandru; Johansen, Isik Somuncu; Inan, Asuman; Nechifor, Mihai; Al-Mahdawi, Akram; Civljak, Rok; Özgüler, Müge; Savic, Branislava; Ceran, Nurgul; Cacopardo, Bruno; İnal, Ayşe Seza; Namiduru, Mustafa; Dayan, Saim; Kayabaş, Üner; Parlak, Emine; Khalifa, Ahmad; Kursun, Ebru; Sipahi, Oguz Resat; Yemisen, Mucahit; Akbulut, Ayhan; Bitirgen, Mehmet; Popovic, Natasa; Kandemir, Bahar; Luca, Catalina; Parlak, Mehmet; Stahl, Jean Paul; Pehlivanoğlu, Filiz; Simeon, Soline; Ulu-Kılıç, Ayşegül; Yasar, Kadriye; Yılmaz, Gülden; Yılmaz, Emel; Beovic, Bojana; Catroux, Melanie; Lakatos, Botond; Sunbul, Mustafa; Öncül, Oral; Alabay, Selma; Şahin-Horasan, Elif; Köse, Sükran; Shehata, Ghaydaa; Andre, Katell; Dragovac, Gorana; Gül, Hanefi Cem; Karakaş, Ahmet; Chadapaud, Stephane; Hansmann, Yves; Harxhi, Arjan; Kirova, Valerija; Masse-Chabredier, Isabelle; Öncü, Serkan; Şener, Alper; Tekin, Recep; Elaldi, Nazif; Deveci, Özcan; Özkaya, Hacer Deniz; Karabay, Oguz; şenbayrak, Seniha; Ağalar, Canan; Vahaboğlu, Haluk; YILMAZ, EMEL; Uludağ Üniversitesi/Tıp Fakültesi/Enfeksiyon Hastalıkları ve Klinik Mikrobiyoloji Anabilim Dalı; HJZ-6992-2023Predicting unfavorable outcome is of paramount importance in clinical decision making. Accordingly, we designed this multinational study, which provided the largest case series of tuberculous meningitis (TBM). 43 centers from 14 countries (Albania, Croatia, Denmark, Egypt, France, Hungary, Iraq, Italy, Macedonia, Romania, Serbia, Slovenia, Syria, Turkey) submitted data of microbiologically confirmed TBM patients hospitalized between 2000 and 2012. Unfavorable outcome was defined as survival with significant sequela or death. In developing our index, binary logistic regression models were constructed via 200 replicates of database by bootstrap resampling methodology. The final model was built according to the selection frequencies of variables. The severity scale included variables with arbitrary scores proportional to predictive powers of terms in the final model. The final model was internally validated by bootstrap resampling. A total of 507 patients' data were submitted among which 165 had unfavorable outcome. Eighty-six patients died while 119 had different neurological sequelae in 79 (16 %) patients. The full model included 13 variables. Age, nausea, vomiting, altered consciousness, hydrocephalus, vasculitis, immunosuppression, diabetes mellitus and neurological deficit remained in the final model. Scores 1-3 were assigned to the variables in the severity scale, which included scores of 1-6. The distribution of mortality for the scores 1-6 was 3.4, 8.2, 20.6, 31, 30 and 40.1 %, respectively. Altered consciousness, diabetes mellitus, immunosuppression, neurological deficits, hydrocephalus, and vasculitis predicted the unfavorable outcome in the scoring and the cumulative score provided a linear estimation of prognosis.Publication Antibody response to hepatitis B vaccination in isolated anti-Hbc IgG positive cases(Galenos Yayıncılık, 2012-08-01) Kazak, Esra; Yılmaz, Emel; Mıstık, Reşit; Akalın, Halis; Akgöz, Semra; Göral, Güher; KAZAK, ESRA; YILMAZ, EMEL; Mıstık, Reşit; AKALIN, EMİN HALİS; Göral, Güher; Uludağ Üniversitesi/Tıp Fakültesi/Enfeksiyon Hastalıkları ve Klinik Mikrobiyoloji Anabilim Dalı.; Uludağ Üniversitesi/Tıp Fakültesi/Tıbbi Mikrobiyoloji Anabilim Dalı.; 0000-0001-7530-1279; AAU-8952-2020; AAG-8459-2021; HTL-9425-2023; DFY-3761-2022; JGX-8396-2023Objective: We aimed to investigate the antibody response secondary to 1 dose of hepatitis B vaccine and factors affecting this response in isolated cases of anti-HBc IgG positive cases.Materials and Methods: Fortyone people who were positive for isolated anti-HBc and negative for other markers of hepatitis B were recruited in the study. The level of anti-HBs was measured at the 10th and 30th day after the administration of hepatitis B vaccine to these 41 people. HBV-DNA was searched with PCR in people who did not developed a secondary antibody response to one dose of vaccination at Day 10 and 30.Results: Anti-HBs was found to be at protective levels (>= 10 IU/mL) in 27 (65.8 %) out of 41 people included in the study. The antibody response developed in 27 people with one dose of vaccination was thought to be a secondary response, and the 14 people who did not form anti-HBs and were found to be negative for HBVDNA by PCR were thought to have false anti-HBc positivity and be inactive HBs Ag carriers (HBs Ag falling below the measurable level in time and presence of antiHBe or preS, S, precor, cor mutant strain infection). There was a highly significant correlation between antibody levels at Day 10 and Day 30 (p< 0.001). In addition, when the antibody levels of people who developed secondary response at Day 10 were investigated, antibody levels of non-smokers were found to be (0-1000 IU/mL; 194.3 +/- 327.2 IU/mL) significantly higher compared to smokers (0-70 IU/mL; 12 +/- 21.8 IU/mL) (p= 0.015). No statistically significant difference was determined between the antibody responses at Day 10 and Day 30 of people with a history of diabetes mellitus (DM), malignity, chronic diseases, alcohol consumption, previous HBsAg positivity and HBV-DNA positivity, anti-HCV positivity, and hepatitis B carriers in the family (p> 0.05).Conclusion: An anamnestic response is suggested in people who give anti-HBs response to one dose of hepatitis B vaccine. However, a false anti-HBc IgG positivity or undetectable levels of HBs Ag should be considered in people who do not give antibody response. According to our results smoking affects the level of antibody response negatively. But we need further studies involving more people.Publication Aspergillus infections in intensive care units: Before and after the COVID-19 pandemic(Bilimsel Tıp Yayınevi, 2022-01-01) Tüzemen, Nazmiye Ülkü; Önal, Uğur; Akalın, Emin Halis; Kazak, Esra; Heper, Yasemin; İşçimen, Remzi; Kelebek Girgin, Nermin; Yılmaz, Emel; Özakın, Cüneyt; Şöhret Kahveci, Ferda; Ener, Beyza; TÜZEMEN, NAZMİYE ÜLKÜ; ÖNAL, UĞUR; AKALIN, EMİN HALİS; KAZAK, ESRA; HEPER, YASEMİN; İŞÇİMEN, REMZİ; KELEBEK GİRGİN, NERMİN; YILMAZ, EMEL; ÖZAKIN, CÜNEYT; KAHVECİ, FERDA ŞÖHRET; ENER, BEYZA; Bursa Uludağ Üniversitesi/Tıp Fakültesi/Tıbbi Mikrobiyoloji Anabilim Dalı.; Bursa Uludağ Üniversitesi/Tıp Fakültesi/İnfeksiyon Hastalıkları ve Klinik Mikrobiyoloji Anabilim Dalı.; Bursa Uludağ Üniversitesi/Tıp Fakültesi/Anestezi ve Reanimasyon Anabilim Dalı.; 0000-0003-3544-3509; 0000-0001-6194-3254; 0000-0001-7530-1279; 0000-0002-5882-1632; 0000-0002-3894-1231; ACQ-7832-2022; AAU-8952-2020; JCO-3678-2023; A-4290-2018; CTY-9474-2022; DWL-9897-2022; GBC-7197-2022; HJZ-6992-2023; JKC-3728-2023; IMY-6211-2023; CNK-0895-2022Introduction: Aspergillus species have begun to cause invasive pulmonary aspergillosis (IPA) with increasing frequency in patients with known risk factors in intensive care units (ICU). An international multicenter cohort study (AspICU) established criteria for diagnosis of invasive pulmonary aspergillosis (IPA) in intensive care units. In our study, patients with Aspergillus spp. growth in deep tracheal aspirate (DTA) samples in ICU were evaluated according to AspICU criteria.Materials and Methods: This study is a retrospective study. DTA samples were collected from the Pandemic and Reanimation ICU and performed in the Medical Microbiology Laboratory by separated two periods; pre-pandemic (1 March 2019-31 December 2019) and post-pandemic (1 March 2020-31 December 2020). Cases with Aspergillus spp. growth in the DTA samples in the Pandemic ICU were evaluated as COVID 19 associated pulmonary aspergillosis (CAPA) according to AspICU criteria.Results: While Aspergillus spp. was grown in the DTA of three patients in 2019 and five patients in 2020 in the Reanimation ICU, and 11 patients in the Pandemic ICU. Growths belonging to one patient from both Reanimation (2019) and Pandemic ICUs were considered as colonization. Other growths were interpreted as IPA according to AspICU criteria. When the incidence rates according to 10000 patient days were compared, the incidence rate increased significantly in 2020 (19.1) (p< 0.001) compared to 2019 (3.4); In 2020, it was determined that it increased significantly in the Pandemic ICU (40.4) (p< 0.001) compared to Reanimation ICU (9.2).Conclusion: It should not be forgotten that intensive care patients are also at risk for IPA, especially after viral infections (such as COVID-19, Influenza). Although the incidence of IPA was not very high, it was observed that it tended to increase according to our study. The diagnosis of IPA is problematic, therefore it is necessary to increase awareness and sample diversity and to use biomarkers more widely other than hematology patients.Publication Fatal pneumococcal purpura fulminans in an asplenic patient(Doc Design Informatics Co Ltd, 2008-08-01) Kahveci, Ferda; Kuruefe, Necmi Riza; KELEBEK GİRGİN, NERMİN; Kelebek-Girgin, Nermin; Akalin, Halis; Yılmaz, Emel; YILMAZ, EMEL; AKALIN, EMİN HALİS; Özcan, Berin; Bursa Uludağ Üniversitesi/Tıp Fakültesi/Klinik Mikrobiyoloji Anabilim; Bursa Uludağ Üniversitesi/Tıp Fakültesi/Anestezi ve Reanimasyon Anabilim; 0000-0001-7530-1279; AAU-8952-2020Splenectomized patients are at an increased risk of serious infection with encapsulated bacteria such as Streptococcus pneumoniae. Purpura fulminans is a rare complication of Streptococcus pneumoniae infections, and occurs with acute onset characterized by cutaneous ecchymoses, symmetrical gangrene of the extremities, renal failure and disseminated intravascular coagulation. A 41-year-old woman admitted to the emergency department with shivering, high fever and sore throat persisting for 2 days. It was learned that she had had a splenectomy 30 years ago and she was not regularly vaccinated with pneumococcal vaccine. After taking blood cultures, treatment with intravenous antibiotic was started. Within a short time, haemorrhagic and ecchimotic rashes occurred on her face and were spread throughout the body. Her condition rapidly deteriorated and she died within 36 hours. Streptococcus pneumoniae was identified in her blood culture.