Aim: To evaluate clinical, laboratory, radiological and demographic data of H3N2 pneumonia cases ... more Aim: To evaluate clinical, laboratory, radiological and demographic data of H3N2 pneumonia cases admitted to Pulmonology department during H3N2 pandemic season and compare with non-H3N2 community acquired pneumonia (CAP) cases. Methods: The study population consisted of all CAP cases admitted to our Pulmonology department between December 2013 – February 2014 influenza season. The patient files were evaluated for physical findings, laboratory data, radiological findings, treatment and outcome of cases. H3N2 was diagnosed by polymerase chain reaction (PCR) of throat swabs. The clinical, radiological and laboratory findings of H3N2 pneumonia cases were compared with non-H3N2 pneumonia cases. Mann Whitney U, Ki-square, Fisher9s exact, logistic regression analysis by forward stepwise method were used for statistical analyses. P value Results: During H3N2 pandemic season, 69 cases were diagnosed as CAP; 62 (89,8%) were non-H3N2 CAP, 7(10,2%) were H3N2 pneumonia. The demographic data, CURB-65, PSI scores, clinical, radiological and laboratory findings of two gorups were similar (p>0,05). The rates of treatment failure and/or transport to intensive care unit with need of invasive mechanical ventilation were significantly higher in H3N2 group (71,4% vs. 25,8%, p=0,024; OR: 7,18; 95%CI: 1,26 – 40,77). Mortality rates were similar in both groups ((p>0.05). Conclusion: The need of MV and intensive care treatment is more frequent in H3N2 pneumonia cases. Correct diagnosis, close follow-up and intensive care support is of vital importance in patients admitted due to CAP during influenza season and suspected to have viral pneumonia.
Influenza and other respiratory viruses, Jan 21, 2015
Influenza is a global public health problem. However, severe influenza only recently has been add... more Influenza is a global public health problem. However, severe influenza only recently has been addressed in routine surveillance. The Global Influenza Hospital Surveillance Network (GIHSN) was established to study the epidemiology of severe influenza in consecutive seasons in different countries. Our objective is to describe the GIHSN approach and methods. The GIHSN uses prospective active surveillance to identify consecutive influenza admissions in permanent residents of well-defined geographic areas in sites around the world. A core common protocol is followed. After consent, data are collected on patient characteristics and clinical outcomes, respiratory swabs are obtained, and the presence of influenza virus and subtype or lineage is ascertained by polymerase chain reaction. Data are collated and analyzed at the GIHSN coordination center. GIHSN has run its activities for two consecutive influenza seasons, 2012-2013 and 2013-2014, and hospitals in Brazil, China, France, Russia, Tu...
Scandinavian Journal of Infectious Diseases, May 1, 2003
This report presents a case of blood and ascitic fluid culture-proven spontaneous bacterial perit... more This report presents a case of blood and ascitic fluid culture-proven spontaneous bacterial peritonitis caused by Brucella melitensis in a 67-y-old male with congestive heart failure. Ten cases of reported previously brucella peritonitis are reviewed, 3 of which were ascitic fluid culture negative.
Febrile neutropenic cancer patients are at risk for development of serious infections, morbidity ... more Febrile neutropenic cancer patients are at risk for development of serious infections, morbidity and mortality. The aim of this study was to determine the type and frequency of infections and to evaluate some prognostic risk factors. 220 episodes of neutropenic fever in 177 cancer patients have been reviewed. Infections could be documented microbiologically in 38 (17.3%) episodes and suspected clinically in 29 (13.2%). The most common focus of infection was the lower respiratory tract (11.4%) followed by the urinary tract (6.4%). The most frequently isolated pathogen was Escherichia coli (31%) followed by Klebsiella pneumoniae (18%), Pseudomonas aeruginosa (13%) and Streptococcus pneumoniae (13%). The median durations of neutropenia and fever were 4 and 3 days, respectively. Mortality was seen in 25 patients (11.4%). Its rate was higher in documented infections except for non-bacteremic microbiologic infections in which no death was seen. Hypotension and shock were the most significant determinants of poor prognosis. The management of these special patients should be given adequate attention and be considered important since the success of therapy depends on revealing of etiologic agents.
Infectious complications after renal transplantation (RT) are associated with significant morbidi... more Infectious complications after renal transplantation (RT) are associated with significant morbidity. They continue to be the most frequent cause of mortality. We investigated the incidence of infections, the causative pathogens, and risk factors contributing to this complication during the first year. We included demographic and clinical data of the 124 patients who underwent RT in our hospital from December 2004 to June 2010. for statistical analysis. Fifty (40.3%) RT recipients developed 80 episodes of infection: urinary tract (n = 68; 85%), intraabdominal (n = 4; 5%), surgical wound (n = 3; 3.8%), or central venous catheter (n = 3; 4%). Eight (10%) were bacteremic. The most commonly isolated bacteria scene (76/80) was Escherichia coli (n = 43; 56.5%) followed by Klebsiella spp. (n = 10; 13.2%) and Pseudomonas spp. (n = 10; 13.2%). Cytomegalovirus infection was detected in 2 recipients; fungal and mycobacterial infections, in no case. It was noteworthy that 52.8% of E. coli and Klebsiella spp. produced extended-spectrum beta-lactamase. Ninety percent of infections developed within 6 months after transplantation. When we compared infected versus noninfected cases, the presence of a double J catheter was the most significant risk factor (P = .018; odds ratio [OR] = 0.234; 95% confidence interval [CI] = 0.070-0.781). In contrast to the initial years after the start of RT in our hospital the incidence of infection decreased over time together with a decrease number and durations of catheterization (P = .008; OR = 2.707; 95% CI = 1.292-5.672). Urinary tract infections were the predominant problem with most isolates resistant to extended-spectrum antibiotics. Therefore, invasive catheters and prophylactic antibiotics should not be used for longer than necessary and infection control measures implemented to decrease the incidence of infections and bacterial resistance.
Flora Infeksiyon Hastalıkları ve Klinik Mikrobiyoloji Dergisi, 2009
Introduction: Although various laboratory parameters have been shown to be useful in determining ... more Introduction: Although various laboratory parameters have been shown to be useful in determining the presence of infection and the prognosis in febrile neutropenic patients, none of these parameters are appropriate for routine use because of their high cost. C-reactive protein (CRP), used for years as a valuable parameter to follow various infections is inexpensive but it is not defined definitely for the follow up of febrile neutropenic patients. The aim of this study was to determine the diagnostic and prognostic value of CRP in febrile neutropenic patients. Five hundred and thirty eight episodes of adult cancer patients followed between January 2001 and December 2007 were included in this study and CRP was tested in the first 48 hours and at the end of the episode. Patients and Methods: Nephelometric method (Dade Behring BNII, Germany) was used for CRP measurement. CRP levels were compared between the groups established according to the infection detected and mortality. SPSS 11.5...
Flora Infeksiyon Hastalıkları ve Klinik Mikrobiyoloji Dergisi, 2009
Introduction: Although the approach to febrile neutropenic patients seems to be standardized, it ... more Introduction: Although the approach to febrile neutropenic patients seems to be standardized, it constitutes a heterogeneous group. As several studies have defined risk groups among them, treatment approaches have changed and monotherapy became the most important one. Patients and Methods: The aim of this study was to compare the efficacy of beta-lactam monotherapy and beta-lactam and amikacin combination therapy for the empirical treatment. Febrile neutropenic episodes of adult cancer patients followed between May 1997 and December 2007 were evaluated retrospectively. Six hundred and forty four episodes in which ceftazidime, cefepime, cefoperazone/sulbactam and piperacillin/tazobactam were given with or without amikacin as empirical treatment were included in this study. Out of 644 episodes, 551 received monotherapy and 93 received combination therapy. Results: A total of 257 (39.9%) episodes presented infections, documented as bacteremia in 92 (14.3%), documented microbiologically...
Aim: To evaluate clinical, laboratory, radiological and demographic data of H3N2 pneumonia cases ... more Aim: To evaluate clinical, laboratory, radiological and demographic data of H3N2 pneumonia cases admitted to Pulmonology department during H3N2 pandemic season and compare with non-H3N2 community acquired pneumonia (CAP) cases. Methods: The study population consisted of all CAP cases admitted to our Pulmonology department between December 2013 – February 2014 influenza season. The patient files were evaluated for physical findings, laboratory data, radiological findings, treatment and outcome of cases. H3N2 was diagnosed by polymerase chain reaction (PCR) of throat swabs. The clinical, radiological and laboratory findings of H3N2 pneumonia cases were compared with non-H3N2 pneumonia cases. Mann Whitney U, Ki-square, Fisher9s exact, logistic regression analysis by forward stepwise method were used for statistical analyses. P value Results: During H3N2 pandemic season, 69 cases were diagnosed as CAP; 62 (89,8%) were non-H3N2 CAP, 7(10,2%) were H3N2 pneumonia. The demographic data, CURB-65, PSI scores, clinical, radiological and laboratory findings of two gorups were similar (p>0,05). The rates of treatment failure and/or transport to intensive care unit with need of invasive mechanical ventilation were significantly higher in H3N2 group (71,4% vs. 25,8%, p=0,024; OR: 7,18; 95%CI: 1,26 – 40,77). Mortality rates were similar in both groups ((p>0.05). Conclusion: The need of MV and intensive care treatment is more frequent in H3N2 pneumonia cases. Correct diagnosis, close follow-up and intensive care support is of vital importance in patients admitted due to CAP during influenza season and suspected to have viral pneumonia.
Influenza and other respiratory viruses, Jan 21, 2015
Influenza is a global public health problem. However, severe influenza only recently has been add... more Influenza is a global public health problem. However, severe influenza only recently has been addressed in routine surveillance. The Global Influenza Hospital Surveillance Network (GIHSN) was established to study the epidemiology of severe influenza in consecutive seasons in different countries. Our objective is to describe the GIHSN approach and methods. The GIHSN uses prospective active surveillance to identify consecutive influenza admissions in permanent residents of well-defined geographic areas in sites around the world. A core common protocol is followed. After consent, data are collected on patient characteristics and clinical outcomes, respiratory swabs are obtained, and the presence of influenza virus and subtype or lineage is ascertained by polymerase chain reaction. Data are collated and analyzed at the GIHSN coordination center. GIHSN has run its activities for two consecutive influenza seasons, 2012-2013 and 2013-2014, and hospitals in Brazil, China, France, Russia, Tu...
Scandinavian Journal of Infectious Diseases, May 1, 2003
This report presents a case of blood and ascitic fluid culture-proven spontaneous bacterial perit... more This report presents a case of blood and ascitic fluid culture-proven spontaneous bacterial peritonitis caused by Brucella melitensis in a 67-y-old male with congestive heart failure. Ten cases of reported previously brucella peritonitis are reviewed, 3 of which were ascitic fluid culture negative.
Febrile neutropenic cancer patients are at risk for development of serious infections, morbidity ... more Febrile neutropenic cancer patients are at risk for development of serious infections, morbidity and mortality. The aim of this study was to determine the type and frequency of infections and to evaluate some prognostic risk factors. 220 episodes of neutropenic fever in 177 cancer patients have been reviewed. Infections could be documented microbiologically in 38 (17.3%) episodes and suspected clinically in 29 (13.2%). The most common focus of infection was the lower respiratory tract (11.4%) followed by the urinary tract (6.4%). The most frequently isolated pathogen was Escherichia coli (31%) followed by Klebsiella pneumoniae (18%), Pseudomonas aeruginosa (13%) and Streptococcus pneumoniae (13%). The median durations of neutropenia and fever were 4 and 3 days, respectively. Mortality was seen in 25 patients (11.4%). Its rate was higher in documented infections except for non-bacteremic microbiologic infections in which no death was seen. Hypotension and shock were the most significant determinants of poor prognosis. The management of these special patients should be given adequate attention and be considered important since the success of therapy depends on revealing of etiologic agents.
Infectious complications after renal transplantation (RT) are associated with significant morbidi... more Infectious complications after renal transplantation (RT) are associated with significant morbidity. They continue to be the most frequent cause of mortality. We investigated the incidence of infections, the causative pathogens, and risk factors contributing to this complication during the first year. We included demographic and clinical data of the 124 patients who underwent RT in our hospital from December 2004 to June 2010. for statistical analysis. Fifty (40.3%) RT recipients developed 80 episodes of infection: urinary tract (n = 68; 85%), intraabdominal (n = 4; 5%), surgical wound (n = 3; 3.8%), or central venous catheter (n = 3; 4%). Eight (10%) were bacteremic. The most commonly isolated bacteria scene (76/80) was Escherichia coli (n = 43; 56.5%) followed by Klebsiella spp. (n = 10; 13.2%) and Pseudomonas spp. (n = 10; 13.2%). Cytomegalovirus infection was detected in 2 recipients; fungal and mycobacterial infections, in no case. It was noteworthy that 52.8% of E. coli and Klebsiella spp. produced extended-spectrum beta-lactamase. Ninety percent of infections developed within 6 months after transplantation. When we compared infected versus noninfected cases, the presence of a double J catheter was the most significant risk factor (P = .018; odds ratio [OR] = 0.234; 95% confidence interval [CI] = 0.070-0.781). In contrast to the initial years after the start of RT in our hospital the incidence of infection decreased over time together with a decrease number and durations of catheterization (P = .008; OR = 2.707; 95% CI = 1.292-5.672). Urinary tract infections were the predominant problem with most isolates resistant to extended-spectrum antibiotics. Therefore, invasive catheters and prophylactic antibiotics should not be used for longer than necessary and infection control measures implemented to decrease the incidence of infections and bacterial resistance.
Flora Infeksiyon Hastalıkları ve Klinik Mikrobiyoloji Dergisi, 2009
Introduction: Although various laboratory parameters have been shown to be useful in determining ... more Introduction: Although various laboratory parameters have been shown to be useful in determining the presence of infection and the prognosis in febrile neutropenic patients, none of these parameters are appropriate for routine use because of their high cost. C-reactive protein (CRP), used for years as a valuable parameter to follow various infections is inexpensive but it is not defined definitely for the follow up of febrile neutropenic patients. The aim of this study was to determine the diagnostic and prognostic value of CRP in febrile neutropenic patients. Five hundred and thirty eight episodes of adult cancer patients followed between January 2001 and December 2007 were included in this study and CRP was tested in the first 48 hours and at the end of the episode. Patients and Methods: Nephelometric method (Dade Behring BNII, Germany) was used for CRP measurement. CRP levels were compared between the groups established according to the infection detected and mortality. SPSS 11.5...
Flora Infeksiyon Hastalıkları ve Klinik Mikrobiyoloji Dergisi, 2009
Introduction: Although the approach to febrile neutropenic patients seems to be standardized, it ... more Introduction: Although the approach to febrile neutropenic patients seems to be standardized, it constitutes a heterogeneous group. As several studies have defined risk groups among them, treatment approaches have changed and monotherapy became the most important one. Patients and Methods: The aim of this study was to compare the efficacy of beta-lactam monotherapy and beta-lactam and amikacin combination therapy for the empirical treatment. Febrile neutropenic episodes of adult cancer patients followed between May 1997 and December 2007 were evaluated retrospectively. Six hundred and forty four episodes in which ceftazidime, cefepime, cefoperazone/sulbactam and piperacillin/tazobactam were given with or without amikacin as empirical treatment were included in this study. Out of 644 episodes, 551 received monotherapy and 93 received combination therapy. Results: A total of 257 (39.9%) episodes presented infections, documented as bacteremia in 92 (14.3%), documented microbiologically...
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