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10 result(s) for "Tekol, Serap Demir"
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Coinfection in SARS-CoV-2 Infected Children Patients
Introduction: The aim of this study is to determine the coinfections with other respiratory pathogens in SARS-CoV-2 infected children patients in a pediatric unit in Istanbul. Methodology: This retrospective descriptive study was conducted in a 1000-bedded tertiary education and research hospital in Istanbul. All children hospitalized with the diagnosis of SARS-CoV-2 infection had been investigated for respiratory agents in nasopharyngeal secretions. Laboratory confirmation of SARS-CoV-2 and the other respiratory pathogens were performed using reverse transcriptase-polymerase chain reaction (RT-PCR). Results: A total of 209 hospitalized children with suspected SARS-CoV-2 infection between March 2020-May 2020 were enrolled in this study. Among 209 children, 93 (44.5%) were RT-PCR positive for SARS-CoV-2 infection, and 116 (55.5%) were RT-PCR negative. The most common clinical symptoms in all children with SARS-CoV-2 infection were fever (68.8%) and cough (57.0%). The other clinical symptoms in decreasing rates were headache (10.8%), myalgia (5.4%), sore throat (3.2%), shortness of breath (3.2%), diarrhea (2.2%) and abdominal pain in one child. In 7 (7.5%) patients with SARS-CoV-2 infection, coinfection was detected. Two were with rhinovirus/enterovirus, two were with Coronavirus NL63, one was with adenovirus, and one was with Mycoplasma pneumoniae. In one patient, two additional respiratory agents (rhinovirus/enterovirus and adenovirus) were detected. There was a significantly longer hospital stay in patients with coinfection (p = 0.028). Conclusions: Although the coinfection rate was low in SARS-CoV-2 infected patients in our study, we found coinfection as a risk factor for length of hospital stay in the coinfected patient group.
Temporal Trends in HIV-1 Subtypes and Antiretroviral Drug Resistance Mutations in Istanbul, Türkiye (2021–2024): A Next-Generation Sequencing Study
HIV-1 genotyping and drug resistance tests are routinely performed in virology laboratories in some countries, aiding clinical management. In Istanbul, between January 2021 and March 2024, plasma samples from 1029 HIV-1-infected patients were analyzed using the NGS method, and mutation and drug resistance results were retrospectively evaluated alongside demographic data. Subtype B (54.4%) was most frequent in Turkish patients, while Subtype A1 (43.5%) was predominant among foreign nationals. The most common CRFs were CRF02_AG (3.8%) and CRF56_cpx (1.6%). According to the change in detection rates during the study period, Subtype B decreased, and Subtype A increased. The most frequent mutations detected were A62V (38.7%) and M184V (22.4%) for NRTIs; E138A (55.5%) and E138G (11.5%) for NNRTIs; M46I (33.3%) and M46L (25%) for PIs; and E92Q and G for INIs (total rate: 35.2%). Darunavir/ritonavir had the highest sensitivity rate, while resistance rates for NNRTIs and INIs increased over time. We anticipate that this study, in which we evaluate the routine use of an FDA-approved NGS kit alongside integrated bioinformatics data analysis and automated reporting software for the first time in Türkiye, will contribute to both national and international molecular epidemiological data and public health strategies by providing reliable results that align with international standarts.
Salmonella gastroenteritis in children: six-year experience in İstanbul, Turkey
Introduction: The aim of this study was to evaluate the demographic and clinical characteristics and treatment outcomes of children with Salmonella gastroenteritis. Methodology: We retrospectively reviewed the medical records of pediatric patients aged between 1 month and 18 years with the diagnosis of Salmonella gastroenteritis between May 2015 and December 2021. Results: A total of 172 children diagnosed with Salmonella gastroenteritis, including 113 outpatients and 59 hospitalized children, were included in this study. There were 95 (55.2%) males and 77 (44.8%) females with a median age of 59.5 months (interquartile range [IQR]: 33.5–96 months, min–max: 1–205 months). The most common clinical symptoms were diarrhea (n = 166, 96.5%), fever (n = 113, 65.7%) and abdominal pain (n = 73, 42.4%). Bloody diarrhea was seen in 19.2% of patients. Fifty (29.1%) of the Salmonella species could not be typed. Serogroup D (n = 106, 61.6%) was the predominant serogroup isolated from stool cultures, followed by serogroup B (n = 16, 9.3%). 62.2% of the isolates were susceptible to ampicillin, 97.7% to ciprofloxacin, 98.8% to trimethoprim-sulfamethoxazole, and 98.8% to ceftriaxone. Fever, vomiting, and underlying disease occurred more frequently in hospitalized patients than in outpatients (p: 0.005, p: 0.000, p: 0.000, respectively). C-reactive protein value was found to be higher in hospitalized patients (p: 0.000). Conclusions: Salmonella should be considered as a causative agent in pediatric patients with abdominal pain, fever, and bloody-mucous diarrhea, and patients with severe clinical conditions should be hospitalized and antibiotic therapy initiated if indicated.
Primary cutaneous nocardiosis of the ankle caused by N. brasiliensis: a case report
Nocardia is a genus of aerobic, Gram-positive bacteria known for their filamentous and branching morphology. N. brasiliensis is the most common species causing cutaneous nocardiosis. We present a 67-year-old woman who developed abscesseson the back of her right ankle after walking barefoot on soil. Cultures from the cutaneous lesions grew N. brasiliensis. Antibiotic therapy with trimethoprim-sulfamethoxazole given for a month provided near-complete resolution of her lesions.
Gastrointestinal dysfunction in Parkinson's disease: Absence of anti-gliadin antibodies
Background and Objectives: Parkinson disease (PD), which is a neurodegenerative disorder, includes several gastrointestinal symptoms that are similar to those of Celiac disease (CD). However, the presence of celiac antibodies in PD patients has not yet been studied. Our aim in this study is to compare anti-transglutaminase (ATA) and antigliadin antibodies (AGA) as well as gastrointestinal symptoms and nutrition habits between patients with Parkinson's disease (PD) and healthy controls. Methods and Study Design: Serum AGA IgG and IgA and the ATA antibodies IgA and IgG were studied in 102 PD patients and 91 healthy controls. Gastrointestinal symptoms, specifically constipation, were investigated using the gastrointestinal system rating scale (GSRS) and the consti- pation rating scale (CRS). Dietary habits were also investigated and compared between the groups. Results: No significant differences were found between the two groups in terms of celiac antibodies. As expected, the hypoki- netic GSRS and CRS scores were significantly higher in the PD group (p<0.001). Dietary habits, especially car- bohydrate-rich diets, had a negative impact on gastrointestinal symptoms in the PD patients. Conclusions: Stud- ies have suggested a connection between PD and CD, which infers a probable non-celiac gluten intolerance and the need to offer PD patients an elimination diet. However, the results of our study did not support any link be- tween celiac antibodies and PD. Notwithstanding, the negative impact of a carbohydrate-rich diet in PD patients still leaves a question regarding gluten sensitivity in these patients.
Diagnostic and therapeutic impact of PCR in uveitis: real-world data from intraocular fluid analysis of 45 uveitis patients in a tertiary referral center in Turkey
Purpose To evaluate the diagnostic utility and real-world clinical impact of polymerase chain reaction (PCR) analysis of aqueous humor (AH) and vitreous samples in patients with uveitis including suspected infectious and mixed (infectious/non-infectious) etiologies. Although intraocular PCR is a well-established diagnostic technique, its contribution to diagnostic revision and clinical decision-making in routine practice remains incompletely characterized. This study addresses this gap by assessing the impact of PCR on diagnostic revision, clinical management and regional epidemiological patterns in a tertiary referral center in Turkey. Methods A retrospective review was conducted on 45 eyes of 45 patients with uveitis. PCR testing was performed on AH ( n  = 24) and vitreous samples ( n  = 21) for Herpes simplex virus (HSV), Varicella zoster virus (VZV), Cytomegalovirus (CMV), Toxoplasma gondii , and Mycobacterium tuberculosis based on clinical suspicion. Pathogen-specific uniplex real-time PCR assays providing qualitative and quantitative results were used. PCR findings were evaluated in conjunction with clinical presentation to assess their contribution to diagnostic revision, diagnostic certainty, and clinical management. Results The mean patient age was 47.4 ± 17.3 years, and 51.1% of the patients were female; 28.9% were immunosuppressed. Overall PCR positivity was 42.2% (19/45). PCR positivity was higher in immunosuppressed patients than in immunocompetent patients (62.0% vs. 34.4%), although this difference did not reach statistical significance ( p  = 0.094). PCR positivity was higher in AH samples than in vitreous samples (50.0% vs. 33.3%). PCR analysis led to diagnostic revision in 33.3% (15/45) of patients and influenced clinical management decisions in 80.0% of cases. Positive PCR results were significantly associated with diagnostic certainty ( p  = 0.006), whereas PCR-negative patients had a markedly higher likelihood of requiring diagnostic and therapeutic modification compared to PCR-positive patients (OR 21.0, 95% CI 2.4–182, p  = 0.001). Conclusion PCR analysis of intraocular fluids provides meaningful diagnostic value in the evaluation of uveitis. Both positive and negative results inform clinical decision-making by guiding diagnostic revision and supporting appropriate management strategies. These findings provide region-specific epidemiological data and reinforce intraocular PCR as a key adjunct in complex uveitis cases where clinical features alone are insufficient.
Direct Detection of Viral Infections from Swab Samples by Probe‐Gated Silica Nanoparticle‐Based Lateral Flow Assay
Point‐of‐care diagnosis is crucial to control the spreading of viral infections. Here, universal‐modifiable probe‐gated silica nanoparticles (SNPs) based lateral flow assay (LFA) is developed in the interest of the rapid and early detection of viral infections. The most superior advantage of the rapid assay is its utility in detecting various sides of the virus directly from the human swab samples and its adaptability to detect various types of viruses. For this purpose, a high concentration of fluorescein and rhodamine B as a reporting material was loaded into SNPs with excellent loading capacity and measured using standard curve, 4.19 μmol ⋅ g−1 and 1.23 μmol ⋅ g−1, respectively. As a model organism, severe acute respiratory syndrome coronavirus‐2 (CoV‐2) infections were selected by targeting its nonstructural (NSP9, NSP12) and envelope (E) genes as target sites of the virus. We showed that NSP12‐gated SNPs‐based LFA significantly outperformed detection of viral infection in 15 minutes from 0.73 pg ⋅ mL−1 synthetic viral solution and with a dilution of 1 : 103 of unprocessed human samples with an increasing test line intensity compared to steady state (n=12). Compared to the RT‐qPCR method, the sensitivity, specificity, and accuracy of NSP12‐gated SNPs were calculated as 100 %, 83 %, and 92 %, respectively. Finally, this modifiable nanoparticle system is a high‐performance sensing technique that could take advantage of upcoming point‐of‐care testing markets for viral infection detections. Here, universal‐modifiable probe‐gated silica nanoparticles (SNPs) based lateral flow assay (LFA) is developed in the interest of the rapid and early detection of viral infections. The most superior advantage of the rapid assay is its utility in detecting various sides of the virus directly from the human swab samples and its adaptability to detect various types of viruses. The NSP12, NSP9, and E gene targets of CoV‐2 were used as detection targets.
Gastrointestinal dysfunction in Parkinson's Disease: absence of anti-gliadin antibodies
Background and Objectives: Parkinson disease (PD), which is a neurodegenerative disorder, includes several gastrointestinal symptoms that are similar to those of Celiac disease (CD). However, the presence of celiac anti-bodies in PD patients has not yet been studied. Our aim in this study is to compare anti-transglutaminase (ATA) and antigliadin antibodies (AGA) as well as gastrointestinal symptoms and nutrition habits between patients with Parkinson's disease (PD) and healthy controls. Methods and Study Design: Serum AGA IgG and IgA and the ATA antibodies IgA and IgG were studied in 102 PD patients and 91 healthy controls. Gastrointestinal symptoms, specifically constipation, were investigated using the gastrointestinal system rating scale (GSRS) and the constipation rating scale (CRS). Dietary habits were also investigated and compared between the groups. Results: No significant differences were found between the two groups in terms of celiac antibodies. As expected, the hypokinetic GSRS and CRS scores were significantly higher in the PD group (p<0.001). Dietary habits, especially carbohydrate-rich diets, had a negative impact on gastrointestinal symptoms in the PD patients. Conclusions: Studies have suggested a connection between PD and CD, which infers a probable non-celiac gluten intolerance and the need to offer PD patients an elimination diet. However, the results of our study did not support any link between celiac antibodies and PD. Notwithstanding, the negative impact of a carbohydrate-rich diet in PD patients still leaves a question regarding gluten sensitivity in these patients.
Intensive care unit-acquired rectal colonization and subsequent infections with carbapenem-resistant bacteria: a cross-sectional study
Purpose Nosocomial infections caused by carbapenem-resistant bacteria (CRB) present a worldwide threat. We examined the incidence and clinical outcomes of ICU-acquired gastrointestinal colonization with CRB detected through routine weekly surveillance of rectal swabs. Methods This retrospective study included adult patients admitted to the ICU between January 1, 2020 and December 31, 2022, whose rectal swab cultures yielded CRB colonization after at least 72 h of ICU admission. Results Of 4,673 eligible patients, 493 had at least one positive rectal swab culture for CRB (prevalence 10.5%) after a mean of 17.8 days from ICU admission. The most common CRB species was Klebsiella pneumoniae (41.8%), followed by Acinetobacter baumannii (32.3%), Pseudomonas aeruginosa (21.3%) and Escherichia coli (8.1%). Following colonization, 240 patients (48.7%) developed CRB infections after a mean of 11.4 days and 29.2 days from the first positive rectal culture and from ICU admission, respectively. The overall agreement between the baseline rectal and final cultures was 82.1%. CRB-infected patients had higher frequencies of burns at baseline (p < 0.001), carbapenem (p = 0.015) and colistin (p < 0.001) use during ICU stay, need for intubation (p = 0.002) and nasogastric tube (p = 0.021), prolonged ICU stay (p < 0.001), and mortality (p = 0.006). Conclusion Our findings showed that nearly one in every 10 ICU patients acquired CRB colonization despite preventive efforts, ending up with CRB infections in nearly half.
Candidemia in Turkey demonstrates nationwide predominance of non-albicans Candida and Candida auris detection
In recent years, evolving patterns in candidemia epidemiology, including increasing proportions of non-albicans Candida (NAC) species and the emergence of Candida auris, have been reported. We aimed to characterize contemporary candidemia epidemiology in Turkey and to assess the association between guideline adherence and 30-day mortality. In this nationwide retrospective multicenter cohort study, adult patients with blood culture-confirmed candidemia diagnosed between January 2022 and December 2023 in 20 hospitals were included. Species identification was standardized and confirmed using MALDI-TOF MS. A total of 398 candidemia episodes were analyzed. Although Candida albicans remained the single most common species (34.7%), NAC species predominated overall (65.3%), mainly driven by Candida parapsilosis (26.6%), while C. auris accounted for 6.5% of cases and was detected across multiple centers. Crude mortality was 68.3% and 30-day mortality was 56.3%. Failure to remove central venous catheters (CVC) was independently associated with higher 30-day mortality. Kaplan-Meier analysis demonstrated significant differences in 30-day survival across EQUAL Candida score categories in the overall candidemia cohort (log-rank p = 0.02) and among patients with CVC-related candidemia cohort (log-rank p = 0.008). Collectively, our findings provide a contemporary nationwide overview of candidemia in Turkey, highlighting the predominance of NAC species, the multicenter detection of C. auris, and the clinical importance of early source control.