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Öğe A 6-year prospective surveillance study for healthcare associated infections in a neurology unit(Riyadh Armed Forces Hospital, 2008) Geyik, Mehmet F.; Hosoglu, Salih; Aluclu, Mehmet U.; Celen, Mustafa K.; Ayaz, CelalObjective: To assess the epidemiology of healthcare-associated infections (HAIs) in a neurology unit in a university hospital. Methods: The study was carried out prospectively at Dicle University Hospital, Diyarbakir, Turkey (1050-bed) between 1st January 1999 and 31st December 2004. Active surveillance for HAIs was performed by the infection control team, using the criteria proposed by the Centers for Diseases Control and Prevention (CDC) and National Nosocomial Infections Surveillance System (NNIS) methodology. Results: During the 6-year follow up period, 219 HAIs episodes were detected in 203 patients out of 3323 in patients. The mean length of stay of patients with HAI was 28 5 days, while that of patients without infections was 11 +/- 1 days. Eighty-two patients died with HAIs, while 1330 died in the patients without infections. The overall incidence rates (HAI/100) and incidence densities (HAI/1000 days of stay) of HAIs were 6.6% and 4.4/1,000 patients-days. The most common HAIs by primary site were urinary tract infection (44.2%) and decubitus infection (30.4%). The most prevalent microorganisms were Escherichia coli (27%), Klebsiella species (14%), Pseudomonas aeruginosa (13%), Enterobacter species (12%), coagulase-negative Staphylococci (10%) and Staphylococcus aureus (7%). Conclusion: The results may contribute to observe the magnitude and characteristics of HAIs and to plan and evaluate policies and guidelines of infection control in neurology units.Öğe The accuracy and validity of a weekly point-prevalence survey for evaluating the trend of hospital-acquired infections in a university hospital in Turkey(Elsevier Sci Ltd, 2011) Ustun, Cemal; Hosoglu, Salih; Geyik, Mehmet Faruk; Parlak, Zafer; Ayaz, CelalObjective: To evaluate the validity of a weekly point-prevalence survey (WPS) by comparing it with a prospective-active incidence survey (PIS). Methods: WPS and PIS were conducted at a tertiary referral hospital between January and December 2006. Each Wednesday, an infection control team reviewed all clinical records of patients with hospital-acquired infections (HAIs) by WPS. Routine PIS was conducted with daily visits by the same team. The Rhame and Sudderth formula was used for converting the data between WPS and PIS. Results: During the study period, 1287 HAIs were detected in 37 466 patients by WPS. The mean observed prevalence and calculated prevalence were 5.42% and 5.45%, respectively. The reanimation intensive care unit (ICU) (49.4%) and burns unit (27.6%) had the highest prevalence rates. Pneumonia (0.94%) and urinary tract infections (0.37%) were the most frequent infections. Overall 602 HAIs were detected in 545 patients by PIS. The mean observed incidence and calculated incidence were 2.42/1000-admissions and 2.41/1000-admissions, respectively. The Critical care ICU (37.0/1000-admissions) and burns unit (24.8/1000-admissions) had the highest incidences of HAI. Pneumonia (0.64/1000-admissions) and urinary tract infections (0.37/1000-admissions) were the most frequent infections. Conclusions: This study confirms a close relationship between prevalence and incidence data. WPS may be a useful method for following HAIs when PIS cannot be performed. (C) 2011 International Society for Infectious Diseases. Published by Elsevier Ltd. All rights reserved.Öğe Acute hepatitis: a rare complication of Epstein-Barr virus (EBV) infection(J Infection Developing Countries, 2010) Ulug, Mehmet; Celen, Mustafa Kemal; Ayaz, Celal; Geyik, Mehmet Faruk; Hosoglu, SalihInfectious Mononucleosis (IM), a benign lymphoproliferative disease, is the best known clinical syndrome caused by Epstein-Barr Virus (EBV). It usually resolves over a period of weeks or months without sequelae but may occasionally be complicated by a wide variety of neurologic, hematologic, hepatic, respiratory, and psychological complications. In this report we describe a patient with acute hepatitis following EBV-IM in a previously healthy woman. A 26-year-old woman who presented with fever, generalized weakness, nausea, sore throat, yellowing of skin, and a generalized skin rash was admitted to our clinic. Tonsillar enlargement, pharyngeal erythema, palatal petechiae, lymphadenopathy, and jaundice were noted. Significant atypical lymphocytes (> 10%) were seen on the peripheral blood smear. Liver function tests such as ALT: 303 U/L, AST: 172 U/L, ALP: 193 U/L and total bilirubin: 7.3 mg/dl were elevated. Serological tests for EBV infection were consistent with acute infection (EBV virus capsid antigen was reactive with IgM and IgG antibodies). The Monospot test was also positive. On the seventh day, liver function tests and bilirubin had risen to peak level and platelets were decreased. The patient was managed supportively and her critical condition improved and was finally stabilized. Although the prognosis for IM is very favorable, a variety of acute complications may occur.Öğe Analysis of antimicrobial consumption and cost in a teaching hospital(Elsevier Science London, 2014) Bozkurt, Fatma; Kaya, Safak; Tekin, Recep; Gulsun, Serda; Deveci, Ozcan; Dayan, Saim; Hosoglu, SalihBackground: The aim of this study is to compare the periods before and after the intervention applied using the ATC/DDD method in order to ascertain the rational use of antibiotics in a newly established hospital. Method: The appropriateness of the hospital's antibiotic use, consumption rates and the costs were calculated and compared with other hospitals. Based on these data, an intervention has been planned in order to raise the quality of antibiotic use. The periods before and after the intervention were compared. Between 16 May 2011 and 23 May 2012, data were collected from all hospital units by the infectious diseases specialists and a point prevalence survey was conducted. Anatomical therapeutic chemical classification and the defined daily dose (DDD) methodology were used to calculate the antibiotic consumption. Results: On two specific days in 2011 and 2012, 194 out of 307 patients (63.2%) and 224 out of 412 patients (54.4%) received antibiotic treatment, respectively. In 2011 and 2012, the percentage of appropriate antibiotic use was 51% and 64.3%, respectively. Both in 2011 and 2012, inappropriate antibiotic use was found to be significantly higher in surgical clinics in comparison to the internal diseases clinics and the ICU. This was caused by the high rates of inappropriate perioperative antimicrobial prophylaxis observed in surgical clinics. During both years, approximately one-third of the antibiotics were prescribed for the purposes of perioperative prophylaxis, while 88.5% and 43.7% of these, respectively, were inappropriate and unnecessary. Cephalosporins, fluoroquinolones, combinations of penicillins (including ii-lactamase inhibitors) and carbapenems were the most frequently prescribed antibiotics during the study periods. The mean total antibiotic consumption was 93.6 DDD/100 bed-days and 63.1 DDD/100 bed-days, respectively. The cost of total antibacterial consumption was (sic) 7901.33 for all the patients ((sic) 40.72 per infected patient) and sic 6500.26 ((sic) 29.01 per infected patient), respectively. Conclusion: Each hospital should follow and assess their antibiotic use expressed in DDD in order to compare their antibiotic use with national and international hospitals (WHO, 2009 [14]). (C) 2013 King Saud Bin Abdulaziz University for Health Sciences. Published by Elsevier Ltd. All rights reserved.Öğe Antibiotic consumption in Turkish hospitals; a multi-centre point prevalence study(Taylor & Francis Ltd, 2017) Guclu, Ertugrul; Ogutlu, Aziz; Karabay, Oguz; Demirdal, Tuna; Erayman, Ibrahim; Hosoglu, Salih; Turhan, VedatThis multi-centre study aimed to determine the antibiotic consumption in Turkish hospitals by point prevalence. Antibiotic consumption of 14 centres was determined using the DDD method. Among hospitalized patients, 44.8% were using antibiotics and the total antibiotic consumption was 674.5 DDD/1000 patient-days (DPD). 189.6 (28%) DPD of the antibiotic consumption was restricted while 484.9 (72%) DPD was unrestricted. Carbapenems (24%) and beta lactam/beta lactamase inhibitors (ampicillin-sulbactam or amoxicillin-clavulanate; 22%) were the most commonly used restricted and unrestricted antibiotics. Antibiotics were most commonly used in intensive care units (1307.7 DPD). Almost half of the hospitalized patients in our hospitals were using at least one antibiotic. Moreover, among these antibiotics, the most commonly used ones were carbapenems, quinolones and cephalosporins, which are known to cause collateral damage. We think that antibiotic resistance, which is seen at considerably high rates in our hospitals, is associated with this level of consumption.Öğe Are sinus-track cultures reliable for identifying the causative agent in chronic osteomyelitis?(Springer, 2009) Ulug, Mehmet; Ayaz, Celal; Celen, Mustafa Kemal; Geyik, Mehmet Faruk; Hosoglu, Salih; Necmioglu, SerdarThe infection of bone that contains bone marrow called osteomyelitis, and is caused by different microorganisms. In this study, we aimed to determine the diagnostic value and accuracy of cultures of material from a sinus track compared with those of cultures of bone specimens that have been controversial. Prospective study was conducted at Hospital University of Dicle, a 1,090-bed university-based hospital located in DiyarbakA +/- r, Turkey. Between May 2005 and September 2006, sinus-track cultures were compared with those of bone cultures from 43 patients with chronic osteomyelitis. The patients' mean age was 30.6 +/- A 3.6 years, and 29 (67%) male and 14 (33%) female. Organisms isolated from bone cultures were Staphylococcus 69% (29/42), Escherichia coli 9.5% (4/42), Pseudomonas aeruginosa 9.5% (4/42), Proteus mirabilis 7% (3/42), respectively. Cultures of sinus track and bone specimens gave identical results in 38% of patients. The value of bone culture in the therapy of osteomyelitis must be emphasized; it is the only reliable means of determining the responsible agent, up on which the antibiotic therapy is based. The correlation between sinus track and bone cultures was 38%, i.e., failure in the treatment for 6 patients out of 10.Öğe ASSESSMENT OF THE LABORATORY TRANSMISSION OF BRUCELLOSIS IN AN ENDEMIC REGION(Carbone Editore, 2014) Deveci, Ozcan; Tekin, Recep; Aslan, Emel; Hosoglu, Salih; Bozkurt, Fatma; Dayan, Saim; Demirpence, OzlemObjectives: Laboratory-acquired brucellosis (LB) has been one of the most commonly reported laboratory-associated bacterial infections in both endemic and non-endemic countries. Brucellosis is endemic in Turkey. The aim of this study is to describe the risk factors of LB among laboratory healthcare workers. Material and method: A regional survey study was conducted by face-to-face interview in 7 hospitals from Diyarbakir, Mardin and Batman province, in southeaster Anatolia in Turkey. A structured survey questionnaire was administered to the Laboratory healthcare workers, employed in infectious diseases clinics and microbiology departments, who were at risk of Brucella infection. Result: Of the 136 laboratory workers, 13 (9.5%) had a history of laboratory-acquired brucellosis. Logistic regression analysis identified factors independently associated with an increased risk of LB including lack of biosafety cabinet (P<0.005) and a lack of compliance in the use of the same (P<0.005). Using a biosafety cabinet (P<0.005), existence of biosafety cabinet (P<0.005), full adherence to glove use (P<0.005) and male gender(P<0.005) were found to be protective factors. Conclusion: Increased adherence to personal protective equipment and use of biosafety cabinets should be priority targets to prevent LB.Öğe Audit of quality of perioperative antimicrobial prophylaxis(Springer, 2009) Hosoglu, Salih; Aslan, Selda; Akalin, Serife; Boşnak, VuslatObjective To assess the perioperative antibiotic prophylaxis (PAP) prescriptions in a general hospital, Diyarbakir, Turkey. Method An evaluative audit in a prospective cohort included into the study between February and June 2003. All clean and clean-contaminated elective surgical procedures in six surgical wards were recorded. Using the ATC-DDD system, density of antimicrobial use was calculated per procedure. Results Totally 331 of 391 (84.7%) study procedures received PAP. PAP was indicated in 45% of PAP non-received group and not indicated in 15.1% of received group. Only 18.4% of PAP lasted less than 24 h. The most common prescribed agents were the first generation cephalosporins (85.8%) and aminoglycosides (24.2%). Timing of the initial dose was inappropriate in 135 procedures (40.8%). Only in 44 procedures (13.3%) all steps of PAP were found justified and correct in PAP received group. The mean dosage number of PAP (+/- SD) for per operation was 8.7 +/- A 12.5. The density of antimicrobial use was calculated as 330.2 DDD/100-operation. The density of antimicrobial use per operation was 3.3 DDD. Conclusion The density of antimicrobial use in PAP is very high. To improve the appropriateness of PAP, measure of antibiotic use is urgently required.Öğe Bacillus Calmette-Guerin is a preventive factor in mortality of childhood tuberculous meningitis(Elsevier Sci Ltd, 2014) Kelekci, Selvi; Karabel, Musemma; Karabel, Duran; Hamidi, Cihat; Hosoglu, Salih; Gurkan, M. Fuat; Tas, M. AliObjectives: Studies have been done that have focused on the efficacy of bacillus Calmette-Guerin (BCG) vaccination in the prevention of cases of childhood tuberculous meningitis (TBM). However the efficacy of the vaccination in the prevention of mortality has not been sufficiently evaluated. This study aimed to determine the main features of TBM cases in childhood and to evaluate the factors related to mortality, proving the protective effect of BCG vaccination in childhood TBM. Methods: In a retrospective approach, all consecutive cases of TBM in children that occurred between 1997 and 2005, at Dicle University Hospital, were studied. The following data were evaluated: demographic aspects, admission symptoms, radiology and laboratory findings, BCG vaccination status, tuberculin skin test (TST) positivity, and mortality rates. Results: In total, 172 cases of childhood TBM were evaluated (mean age 53.3 +/- 55.7 months; 109 boys (63.4%)). The majority of these cases (70.4%) had typical TBM symptoms on admission. BCG vaccination data were available for 152 (88.4%) cases and 29 of them (19.1%) were positive. The TST was performed for 143 patients (83.1%) and 28 (19.6%) were found positive. Hydrocephalus was identified in 118 patients (68.6%) on computed tomography examination. A shunt was placed in 79 cases (45.9%). In total, 24 patients (14.0%) died in the hospital. TST negativity was a significant factor for mortality (p = 0.012). BCG positivity was found to be a preventive factor from mortality (p = 0.05). Conclusions: BCG vaccination is effective in the prevention of TBM-associated mortality in childhood. TST negativity may be a sign of a poor prognosis in TBM cases. (C) 2013 The Authors. Published by Elsevier Ltd on behalf of International Society for Infectious Diseases. All rights reserved.Öğe Brucellar epididymo-orchitis in southeastern part of Turkey: an 8 year experience(Elsevier Brazil, 2010) Celen, Mustafa Kemal; Ulug, Mehmet; Ayaz, Celal; Geyik, Mehmet Faruk; Hosoglu, SalihObjective: the different clinical and laboratory features and response to treatment of patients with acute brucellar epididymo-orchitis (BEO) reporting to the reference hospital in Southeastern Anatolia of Turkey. Material and methods: in this study, 27 male patients with brucellosis, who presented with epididymitis or epididymo-orchitis (EO) at the university hospital in Diyarbakir from 1998 to 2006, were included. They were compared with the other male patients. Positive blood culture or high agglutination titers of >= 1/160 and positive clinical manifestations of brucellosis were the main criteria for diagnosing brucellosis. Results: fourteen patients had unilateral EO. Leukocytosis was present in 10 patients; all of them had initial agglutination titers of >= 1/160 and 10 patients had a positive blood culture. All patients received combined therapy with streptomycin for the first 21 days (or oral rifampicin for 6-8 weeks) with doxycycline or tetracycline for 6-8 weeks. All showed improvement, fever subsided in 3-7 days, and the scrotal enlargement and tenderness regressed. Only one patient had a relapse within one year. Conclusion: in brucellosis-endemic areas, clinicians encountering EO should consider the likelihood of brucellosis. In this study, young age was the most common risk factor, and leukocytosis and high CRP level were the most common laboratory findings. Most cases were unilateral. All patients responded to medical management very well. Conservative management with combination antibiotic therapy was adequate for managing BEO. Conclusively, brucellosis must be considered as a cause of orchitis, especially in endemic regions like Turkey.Öğe A Case of Necrotizing Fasciitis due to Intramuscular Injection and Review of the Literature(Aves, 2009) Ulug, Mehmet; Celen, Mustafa Kemal; Geyik, Mehmet Faruk; Hosoglu, Salih; Ayaz, CelalNecrotizing fasciitis is a life-threatening soft-tissue infection characterized by progressive necrosis of the skin, subcutaneous tissue, and fascia. A twenty-three year-old female patient presented with erythema and pain in the left thigh; both had started 15 days previously. Physical examination revealed swelling, warmth in the left thigh and pain related to passive movement. During follow up, the area involved developed echymotic bullous lesions which shortly spread to the perineal region. Despite appropriate antibiotic therapy and supportive management, the lesions progressed and surgical debridement was carried out. Deep wound and blood cultures revealed Staphylococcus aureus. Clearly, the mortality and morbidity can be decreased with clinical awareness, early diagnosis, effective surgical debridement, and intensive supportive care. In this study, we present a rare case of necrotizing fasciitis in an adult who had no predisposing factor and discuss its clinical manifestations and the best therapeutic choice for this potential life threatening disease, together with a review of the literature.Öğe Churg-Strauss syndrome occurring during omalizumab treatment(Aves, 2015) Bekcibasi, Muhammed; Barutcu, Sezgin; Celen, Mustafa Kemal; Dayan, Saim; Hosoglu, Salih[Abstract Not Available]Öğe Clinical, radiological and laboratory findings in 185 children with tuberculous meningitis at a single centre and relationship with the stage of the disease(Biomed Central Ltd, 2015) Gunes, Ali; Uluca, Unal; Aktar, Fesih; Konca, Capan; Sen, Velat; Ece, Aydin; Hosoglu, SalihBackground: A delay in the diagnosis and treatment of tuberculosis meningitis (TBM) may lead to increased mortality and morbidity. The aim of this study was to describe the clinical, radiological and laboratory findings of TBM on a cohort of 185 pediatric patients at a single centre over a 10 year period and to investigate relationship between the stage of the disease. Methods: The hospital records of 185 TBM children that presented to the Pediatric Clinics of Dicle University Hospital were retrospectively evaluated. The age, gender, family history of tuberculosis, result of Mantoux skin test, status of BCG vaccination, stage of TBM at hospitalization, and clinical, laboratory and radiological features were recorded. Clinical staging of TBM was defined as follows: Stage I, no focal neurological findings and Glasgow Coma Scale (GCS) score 15; Stage II, GCS 15 presenting with focal neurological deficit or all the patients with GCS 10-14; Stage III, all the patients with GCS < 10. Relationships between results and stages of TBM were investigated. Results: The mean age of the patients was 53.5 +/- 44.9 months (4 months-18 years). 121 (65.4 %) of the patients were male and 64 (34.6 %) female. Family history of tuberculosis was defined in 62 (33.5 %) patients. Forty five (24.3 %) children had BCG vaccination scar. Mantoux skin test was interpreted as positive in 35 (18.9 %) patients. Sixty-eight (36.8 %) children were at stage I TBM, 57 (30.8 %) at stage II and 60 (32.4 %) were at stage III on admission. Mean duration of hospitalization was 23.9 +/- 14.1 days. Totally, 90 patients (48.6 %) had abnormal chest X-ray findings (parenchymal infiltration in 46 (24.9 %), mediastinal lymphadenopathy in 36 (19.5 %), miliary opacities in 25 (13.5 %), pleural effusion in 2 (1.1 %), and atelectasis in 2 (1.1 %) patients). One hundred sixty seven (90.3 %) patients had hydrocephalus in cranial computerized tomography. There were 24 (13.0 %) patients with positive culture for Mycobacterium tuberculosis and 3 (1.6 %) patients with positive acid-fast bacilli in cerebrospinal fluid. Overall mortality rate was 24 (13.0 %). Among the findings; patients at Stage III had less frequent positive chest X-ray abnormality, miliary opacities and BCG vaccination scar when compared with patients at Stage I and II (p = 0,005; p = 0,007, p = 0.020, respectively). Conclusions: Children with TBM and positive chest X-ray findings at hospital admission were more frequently diagnosed at Stage I, and BCG vaccination might be protective from the Stage III of the disease.Öğe Critical evaluation of antimicrobial use - A Turkish university hospital example(J Infection Developing Countries, 2013) Hosoglu, Salih; Parlak, Zafer; Geyik, Mehmet Faruk; Palanci, YilmazIntroduction: Antimicrobials are being used unnecessarily for different reasons. The aims of this study were: assessment of the quality of antimicrobial use and determination of the factors related to correct use. Method: Antimicrobial practice at Dicle University Hospital (DUH) was evaluated with a point prevalence approach. Using a standardized data collection form, the patients' data (clinic, epidemiology, laboratory and antimicrobial use) was collected. Possible influential factors on antimicrobial use were examined. Results: In the surveillance study 1,350 inpatients were evaluated; 461 (34.1%) of them were using antimicrobials for treatment and 187 (13.9%) for prophylaxis. Antimicrobial indication was found in 355 of 461 patients (77.0%), and the number of antimicrobials was 1.8 per patient in the treatment group. The most common reason for antimicrobial use was community-acquired infection (57.9%). Pneumonia (20.4%), skin and soft tissue infections (9.11%) and urinary tract infections (7.9%) were the most common infectious diseases. Positive culture results were available for 39 patients (8.5.0%) when antimicrobial treatment started. All steps of antimicrobial use were found appropriate in 243 patients (52.7%). In multivariate analyses, clinical manifestation of infection at the beginning (p<0.001), presence of leukocyte counting (p<0.001) and prescription by an infectious disease specialist were found significantly positive factors for wholly appropriate antimicrobial use. Hospitalization with a diagnosis other than infection was found a significantly negative factor for appropriate antimicrobial use (p=0.001). Conclusion: The quality of antimicrobial use could be improved with better clinical and laboratory diagnosis and consultation with infectious diseases specialistsÖğe Cytopenia in adult brucellosis patients(Medknow Publications & Media Pvt Ltd, 2018) Kaya, Safak; Elaldi, Nazif; Deveci, Ozcan; Eskazan, Ahmet Emre; Bekcibasi, Muhammed; Hosoglu, SalihBackground & objectives: Brucellosis can lead to haematological abnormalities including cytopenia confusing with haematological malignancies. The aim of this study was to compare the main characteristics of brucellosis patients without cytopenia (Group 1) and with cytopenia (Group 2). Methods: This five-year period study which was performed in two referral hospitals in Turkey, included all adult brucellosis patients. Abnormally, low counts of leucocyte or haemoglobin or platelets in a patient were considered as cytopenia. The demographics, clinical, laboratory, treatment and outcome data were analyzed. Results: A total of 484 brucellosis patients were enrolled. Among the cases, 162 (33.5%) of them had cytopenia. One hundred and four (21.5%) had anaemia, 88 (18.8%) had thrombocytopenia, 71 (14.6%) had leucopenia and 28 (5.8%) had pancytopenia. The mean age of group 2 was 35.01 +/- 16.05 yr and it was 33.31 +/- 14.39 yr in group 1. While there was no difference between the groups in terms of duration of treatment, the median length of hospital stay (LOS) was significantly longer in group 2 (9 vs 10 days; P<0.001). The most frequently applied combination therapy consisted of doxycycline plus rifampicin and doxycycline plus streptomycin regimens. No significant difference was observed in terms of duration of treatment, LOS and restoration time of cytopenia between the patients who received either of these combinations. Interpretation & conclusions: Our findings suggested that the patients with cytopenia should be investigated for brucellosis, especially if living in, or with a history of travel to, endemic areas, in view of the increase in world travel.Öğe Development of pneumatoceles after viral infection(Saudi Med J, 2006) Celen, Mustafa K.; Ayaz, Celal; Ozmen, Esen; Hosoglu, Salih; Geyik, Mehmet F.[Abstract Not Available]Öğe The effects of Saccharomyces boulardii on bacterial translocation in rats with obstructive jaundice(Royal Coll Surgeons England, 2006) Geyik, Mehmet Faruk; Aldemir, Mustafa; Hosoglu, Salih; Ayaz, Celal; Satilmis, Selda; Buyukbayram, Huseyin; Kokoglu, Omer FarukINTRODUCTION The aim of this study was to investigate the effect of Saccharomyces boulardii treatment on preventing bacterial translocation in an obstructive jaundice animal model. MATERIALS AND METHODS Sixty adult rats were divided into five groups: group 1 - the sham-operated group; group 2 - the common bile duct ligation group; group 3 - the S. boulardii group; group 4 - the ampicillin-sulbaktam group; and group 5 the S. boulardii plus ampicillin-sulbaktam group. The saline, antibiotics and S. boulardii were given, respectively, for a 7-day period as a single dose per day via temporary orogastric intubation. Seven days following the obstructive jaundice, the animal had laparatomy under sterile conditions. Segments of ileum were removed for histopathological examination. Blood, liver, spleen and mesenteric lymph nodes were taken for microbiological culture. RESULTS Bacterial translocation rates were 0% in the sham-operated group, 83% in group 2, 42% in group 3, 42% in group 4 and 33% in group 5. Bacterial translocation significantly increased in group 2 compared to groups 3, 4 and 5 (P = 0.001). The bacterial counts (CFU/g) of group 2 were significantly higher than those of groups 3, 4 and 5 (P = 0.001). Histopathological examination of ileum specimens revealed a significant decrease in the heights of villi in groups 2-5 compared to the sham-operated group (P = 0.001). The mean villus height in groups 3 and 5 was significantly higher than that of group 4 (P = 0.001). CONCLUSIONS S. boulardii was found to be effective in the successful control of translocation and improvement of intestinal barrier function.Öğe The efficacy of dexamethasone treatment in massive enteric bleeding in typhoid fever(Sage Publications Inc, 2009) Hosoglu, Salih; Ustun, Cemal; Geyik, Mehmet Faruk[Abstract Not Available]Öğe Epidemiology and risk factors for ESBL-producing Klebsiella pneumoniae: a case control study(J Infection Developing Countries, 2010) Demirdag, Kutbettin; Hosoglu, SalihIntroduction: Increased production of extended-spectrum beta-lactamases (ESBLs) has become an important issue for treatment of severe Klebsiella pneumoniae (K. pneumoniae) infections. This study aimed to evaluate risk factors of infection from ESBL-producing K. pneumoniae (ESBL-KP). Methodology: Risk factors were evaluated using a retrospective case control design. Fifty-two patients admitted to Firat University Hospital (FUH) with invasive infections from ESBL-KP were employed as cases. Patients admitted to FUH with non-ESBL-producing K. pneumoniae invasive infection were chosen as controls. Potential risk factors of the cases and controls were evaluated using hospital charts. Pulsed-field Gel Electrophoresis (PFGE) was used to show the relatedness of ESBL-KP strains. Results: In univariate analysis, the following factors were found significant for ESBL-KP: pre-infection hospital stay, nosocomial origin, central venous catheterization, surgical intervention, antibiotic use longer than one week, and previous hospitalization. In contrast, stepwise logistic regression analysis showed that two variables, previous antibiotic use (p = 0.000) and surgical intervention (p = 0.006), remained significantly associated with risk for infection with an ESBL-KP. Molecular epidemiology identified several clusters among the ESBL-producing isolates. Conclusions: Antibiotic use and surgical intervention were significant associated factors for infections with ESBL-KP.Öğe THE EVALUATION OF GERIATRIC INFECTIONS DICLE EXPERIENCE(Nobel Ilac, 2010) Ulug, Mehmet; Celen, Mustafa Kemal; Geyik, Mehmet Faruk; Hosoglu, Salih; Ayaz, CelalObjective Although successes have been achieved in the treatment of the infectious diseases with antibiotics in nowadays infectious diseases are still serious problem in the elderly This study was conducted in order to determine the pattern of clinical infectious diseases in hospitalized elderly Patients C. Material and Method In this study the data of all elderly patients aged 65 and older were hospitalized to our clinic between May 2000 and May 2005 were evaluated retrospectively We reviewed 301 patients for diagnostic studies risk factors isolated microorganisms and morbidity and mortality rates Results Infections as a cause of hospitalization were identified as the following frequency sepsis (19 2%) pneumonia (17 9%) acute gastroenteritis (16 9%) acute bacterial meningitis (5 3%) and urinaty tract infection (3 6%) respectively E colt was the most isolated microorganism in these patients Hypertension chronic obstructive pulmonary disease and diabetes were seen as risk factors in our patients Seventy three patients died during hospital stay due to their infection and chronic diseases Conclusion Under diagnosis of the elderly diseases is very common due to many factors related to elderly family members and health workers Prognosis is rather worse especially in sepsis due to pneumonia and urinary tract infections
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