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    Assessment of the laboratory transmission of brucellosis in an endemic region
    (Acta Medica Mediterranea, 2014) Deveci O.; Tekin R.; Aslan E.; Hosoglu S.; Bozkurt F.; Dayan S.; Demirpence O.
    Objectives: 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.
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    Characteristics of acute bacterial meningitis in Southeast Turkey
    (2004) Ayaz C.; Geyik M.F.; Hosoglu S.; Celen M.K.; Akalin S.; Kokoglu O.F.
    BACKGROUND: Acute bacterial meningitis (ABM) remains a significant worldwide cause of death in adults. Even in the antibiotic era, the mortality rate in ABM remains significant and has been reported in the range of 8-40%. AIM: The aim of this study was to assess the characteristics of epidemiology, clinical manifestations, treatment modalities and outcome of patients with ABM in Southeast Turkey. SETTINGS AND DESIGN: This retrospective study included all cases of community-acquired ABM diagnosed and treated in Dicle University Hospital between June 1996 and December 2002. METHODS AND PATIENTS: The study group consisted of 186 adult patients (110 male, 76 female) with ABM, those patients who are older than 14 years, followed up at Dicle University Hospital from June 1996 to December 2002. Patients' charts were retrospectively reviewed, clinical characteristics were recorded and final data were analyzed. STATISTICAL ANALYSIS: In statistical analyses, the Chi-square test was used for binary variables and Student's t-test for continuous variables. RESULTS: The patients' mean age was 30.2 ± 15.3 years (range 74 to 90 years). On admission, typical symptoms of meningitis were found in most of the patients: headache in 92.5%, fever in 88.2%, and nuchal rigidity in 80.1%. The main predisposing factor for ABM was otitis media (40 patients, 21.5%) and closed head trauma (12 patients, 6.5%). Streptococcus pneumonia was the most common identified pathogen. Twenty-nine patients (15.6%) died during hospitalization period. In multivariate analyses, the significant mortality factor was found as initial level of consciousness, low cerebrospinal fluid/blood glucose ratio, high erythrocyte sedimentation rate and initial treatment by penicillin G. CONCLUSIONS: Although still remains as a serious infection, early diagnosis and effective treatment may reduce fatal outcome and improve the course of the disease in patients with ABM. Ceftriaxone should be considered as the drug of choice for initial empirical therapy, while waiting culture results and vancomycin must be withheld for patients having increased risk of penicillin resistant pneumococci strains.
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    Clinical and laboratory presentation of typhoid fever
    (2001) Yaramis A.; Yildirim I.; Katar S.; Özbek M.N.; Yalçin I.; Tas M.A.; Hosoglu S.
    A total of 314 children with clinical and/or laboratory diagnosis of typhoid fever admitted to the Dicle University Hospital pediatric infectious diseases ward were reviewed for demographic data such as age, sex, clinical features, and results of laboratory tests. There were 187 male and 127 female patients, with a mean age of 9.6 years ranging from 6 months to 16 years. Eleven of all the children were less than one year of age, while 23 were under the age of five years. Predominant symptoms were fever, abdominal pain, vomiting, and headache. Hepatomegaly was almost twice as frequently observed as splenomegaly. Common clinical signs of typhoid fever in adults such as relative bradycardia and spots were seldom documented. A febrile convulsion was the presenting symptom in nine of the patients, all of whom were under the age of five years. Intestinal perforation was present in five of the patients. Antibiotic susceptibility tests in 67 cases revealed resistance rates of 17% for ampicillin, 5% for trimethoprim-sulfamethoxazole, 4% for ceftriaxone, and 6% for sulbactam-ampicillin. No resistance was detected against the quinolones and chloramphenicol. Elevated serum alanine and aspartate aminotransferase (50 > /U/L) levels were observed in 32% of our patients. At presentation, 38% of all patients were anemic (Hb <12 g/dl), 10% were thrombocytopenic (<105/mm3). Except the two bacteriologically confirmed typhoid fever patients died during the period of observation, all patients survived from their severe illness completely.
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    Comparison of lamivudine and alpha-interferon combination with alpha-interferon alone in the treatment of HBeAg-positive chronic hepatitis B
    (2006) Ayaz C.; Celen M.K.; Colak H.; Hosoglu S.; Geyik M.F.
    Aim: To compare the efficacy of a combination of a-interferon (IFN-a) and lamivudine with IFN-a alone in the treatment of patients with HBeAg-positive chronic hepatitis B (CHB). Methods: Sixty-eight treatment-naove patients with HBeAg-positive CHB were randomized to receive either 9 MU of IFN-a2a three times a week and lamivudine 100 mg daily (Group 1), or IFN-a2a alone in the same dosage (Group 2), for 12 months. Serum ALT, HBeAg, anti-HBe and HBV DNA were tested at the end of treatment and 6 months later. Complete response was defined as normal ALT, negative HBeAg and negative HBV DNA, six months after stopping treatment. Results: Of the 68 patients, 64 completed the study. In Group 1 (n=31), mean (SD) ALT levels decreased from 124 (59) IU/L to 39 (18) IU/L at 12 months; corresponding values in Group 2 (n=33) were 128 (57) and 56 (11) IU/L (p<0.05). Absence of HBV DNA at the end of treatment was more common in Group 1 (28/31) than in Group 2 (22/33; p<0.022). The number of patients with seroconversion to anti-HBe (4/31 [13%] vs. 4/33 [12%], respectively; p>0.05), as also those with complete response (4/31 [13%] and 4/33 [12%], respectively; p>0.05) six months after completion of treatment was similar in Group 1 and Group 2 . Conclusion: Combination treatment with IFN-a and lamivudine was better than IFN-a monotherapy in normalization of ALT and clearance of HBV DNA; however, it did not have a better sustained response rate than IFN-a alone. © 2004 Indian Journal of Gastroenterology.
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    An outbreak due to multidrug-resistant Klebsiella pneumoniae in Neonatal Intensive Care Unit
    (1997) Hosoglu S.; Ayaz C.; Devecioglu C.; Boşnak Mehmet; Geyik M.F.
    An outbreak of neonatal septicemia due to Klebsiella pneumonias have been detected in Neonatal Care Unit, Dicle University Hospital, between the period of October 1996-March 1997. Septicemia was diagnosed in 105 cases by clinical features and routine laboratory findings but only 68 (64.8%) of them were included to the study by at least one blood culture positivity. Cultivation of the blood samples was performed in PEDS Plus/F Medium BACTEC 9240 system. The beta lactamase production and the antibiotic susceptibilities were tested on Sceptor panel and MIC Identification panel respectively, and all the 30 K. pneumoniae strains were found beta lactamase positive and multidrug resistant. K. pneumoniae (44.1%) was followed by coagulase-negative Staphylococci (22%) and Enterobacter spp. (11.8%) those isolated from blood cultures. As the identical strain of K. pneumoniae was isolated from the environmental cultures of nursery in Obstetrics Department as well, it is concluded that the source of the infection was the environment. The majority of K. pneumoniae strains showed high sensitivity to ciprofloxacin (100%) and imipenem (96.6%) but they were resistant to ceftazidime, tobramicin, mezlocillin, ticarcillin, cefazolin, gentamycin and ampicillin. After an education programme given to the personnel, only one case was detected in March 1997.
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    The role of trace elements in Helicobacter pylori infected patients
    (2011) Bozkurt F.; Gulsun S.; Ustun C.; Geyik M.F.; Hosoglu S.
    Objective: To evaluate the effect of trace elements in patients with Helicobacter pylori associated chronic gastritis Design: Prospective study Settings: Clinical services of the clinical microbiology and infectious diseases and gastroenterology clinics at Dicle University, Turkey Subjects: A total of 92 patients with variable severity of chronic gastritis (45 Helicobacter pylori positive and 47 Helicobacter pylori negative gastritis) and 90 age and sex matched healthy subjects were included in the study conducted between October 2006 and November 2008. Intervention: Histopathologic examination, culture of Helicobacter pylori and urease tests were performed for each patient. The atomic absorption spectrophotometer was used in the measurement of trace elements in the serum. Main Outcome Measures: Serum copper and zinc levels were significantlyelevatedinpatientswithHelicobacter pylori associated gastritis compared to Helicobacter pylori negative gastritis and healthy controls (p < 0.0001). Serum copper, zinc and Cu/Zn levels in patients with Helicobacter pylori negative chronic gastritis was not significantlydifferentfromthe serum levels in healthy controls (p > 0.05). Conclusions: Our results suggest a relationship between Helicobacter pylori associated chronic gastritis and the elevation of trace element levels in serum. This study confirmsthattheelevation of trace element levels in serum (Cu and Zn levels) will be helpful in the diagnosis of Helicobacter pylori associated chronic gastritis in the abscence of invasive procedures, and is useful in predicting the severity of infection in patients with chronic gastritis.