Person: SÜMBÜL, BİLGE
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Publication Metadata only Prognostic value of procalcitonin in infection-related mortality of cancer patients(2016-05-01) Sedef, Ali Murat; Kose, Fatih; Sumbul, Ahmet Taner; Dogan, Ozlem; Kursun, Ebru; Yurdakul, Zafer; Gultepe, BİLGE; Mertsoylu, Huseyin; Sezer, Ahmet; Ozyilkan, Ozgur; SÜMBÜL, BİLGEPurpose: Infectious diseases are a major cause of morbidity and mortality in cancer patients. Tumor-induced inflammatory responses may increase the value of classical inflammatory markers in blood, so these markers may not be as useful in cancer patients as in non-cancer patients. Serum procalcitonin (PCT) is a sensitive and specific biomarker for severe infection, and has been shown to be unaffected by tumor-induced inflammatory response. In this study we aimed to evaluate the possible role of PCT in mortality in cancer patients with infection.Publication Metadata only Evaluation of nasal fluid beta-defensin 2 levels in children with allergic rhinitis(2017-06-01) DILEK, Fatih; EMIN, Ozkaya; Gultepe, BİLGE; Yazici, MEBRURE; Cakir, ERKAN; GEDIK, Ahmet Hakan; SÜMBÜL, BİLGE; YAZICI, MEBRURE; ÇAKIR, ERKANAim: Knowledge about the role of the innate immune system in the pathogenesis of allergic diseases has been expanding in recent years. Defensins are antimicrobial peptides that are components of the innate immune system. Defensins have strong efficacy against bacterial, viral, and fungal infections. Moreover, they have regulatory functions in many physiologic processes such as antitumoral immunity, chemotaxis, inflammation, and wound healing. In this study, we aimed to investigate a-defensin 2 levels in the nasal fluids of children with allergic rhinitis.Publication Metadata only Can D-dimer levels predict the treatment outcome in a patient with tuberculosis?(2014-07-01T00:00:00Z) Dulger, Ahmet Cumhur; Karadaş, Sevdegül; Gonullu, Hayriye; Beyazal, Mehmet; Bulut, Gulay; Gultepe, BİLGE; SÜMBÜL, BİLGETuberculous peritonitis is a leading cause of mortality and morbidity particularly in the developing world. Delay in initiation of treatment distinctively increases mortality. Treatment response to anti-tuberculosis drugs is usually observed by regression of symptoms and clearance of ascites. With initiation of treatment, laboratory values including CA-125 levels generally return to normal levels in 3 months. However, there is still no consensus about treatment response during the follow-up period. Serum D-dimer level is used as an inflammation marker in some cases. A case with Tuberculous peritonitis successfully monitorised by serum D-dimer levels is presented.Publication Metadata only <i>Clostridium difficile</i> infection: Is there a change in the underlying factors? Inflammatory bowel disease and <i>Clostridium difficile</i>.(2019-11-01T00:00:00Z) Durdu, B; Bolukcu, S; Okay, G; Hakyemez, IN; Gultepe, BİLGE; Koc, MELİHA; Aslan, T; SÜMBÜL, BİLGE; OKAY, GÜLAY; DURDU, BÜLENT; MERİÇ KOÇ, MELİHAPublication Metadata only Higher Seroprevalence of Hepatitis B Virus Antigen in Patients with Cystic Hydatid Disease than in Patients Referred to Internal Medicine Clinics in Turkey(2014-02-01T00:00:00Z) Esen, Ramazan; Gultepe, BİLGE; Dulger, Ahmet Cumhur; GULTEPE, Ilhami; Karadaş, Sevdegül; Ebinc, Senar; SÜMBÜL, BİLGETurkey remains an intermediate area for prevalence of hepatitis B virus (HBV) surface antigenemia. The sheepraising areas of Turkey also pose a high risk for cystic hydatid disease (CHD). Both HBV infection and CHD are major public health issues particularly in eastern parts of Turkey; however, there is no data regarding HBV infection in patients who have had CHD. The aims of this study were to evaluate the association between HBV infection and CHD and suggest ways to reduce HBV infection which is still widespread in Turkey. A retrospective study was conducted with 94 adult patients with active CHD referred to the hepatology department, Yuzuncuyil University School of Medicine from December 2010 to December 2012. All subjects came from rural areas of the region and underwent ultrasonography of abdomen which detected CHD of the liver. All the patients were serologically positive for Echinococcus granulosus. The control group consisted of 500 patients (300 men and 200 women) referred to the internal medicine clinics for other reasons. The patients with CHD and in the control group were tested for the existence of HBs antigen according to the standard procedures. The seroprevalence of HBs antigen was significantly higher in patients with active CHD than those in the control group (12.7% vs 5.2%; P=0.0017). Our data indicate that there is significant association between HBV infection and CHD. All patients with CHD should be screened for HBV infection.Publication Metadata only Investigation of Antibiotic Resistance Patterns and Reduced Vancomycin Susceptibilities of Methicillin-Resistant Staphylococcus aureus Isolates: A Multi-Center Study(2015-04-01) Cikman, Aytekin; Aydin, Merve; Gulhan, Baris; Parlak, Mehmet; Gultepe, BİLGE; Kalayci, Yildiz; BILMEN, Fulya Bayindir; Solmaz, Sinem; Ozekinci, Tuncer; SÜMBÜL, BİLGEThe aims of this study were to determine the minimum inhibitory concentration (MIC) values of vancomycin, teicoplanin, daptomycin, quinupristin/dalfopristin, linezolid, tigecycline, chloramphenicol, rifampicin, ofloxacin and tetracycline and to investigate the reduced vancomycin susceptibility among methicillin-resistant Staphylococcus aureus (MRSA) strains isolated in hospitals located in different geographical regions of Turkey. A total of 100 MRSA strains isolated from patients (of which 50% were from intensive care units) hospitalized in seven centers in Turkey [Istanbul (n= 15), Ankara (n= 15), Izmir (n= 15), Adana (n= 15), Diyarbakir (n=15), Erzincan (n= 15), Van (n= 10)], between August 201 3 August 2014, were included in the study. Fourty-three strains were isolated from blood, whereas 21 were from lower respiratory tract, 17 from wounds, eight from catheters, six from urine, four from nasal swab and one from cerebrospinal fluid samples. Methicillin resistance of the isolates was determined by using cefoxitin (30 mu g) disk with standard disk diffusion method, while the MIC values of other antibiotics were determined with E-test in accordance with the recommendations of Clinical and Laboratory Standards Institute (CLSI). MIC results obtained for quinupristin-dalfopristin (Q/D) were evaluated according to the CLSI criteria used for methicillin-susceptible S.aureus and for tigecycline according to the criteria recommended by the Food and Drug Administration for MRSA. Primarily, agar screening method (ASM) was used for determination of vancomycin-intermediate S.aureus (VISA) and heterogeneous VISA (hVISA) strains. Brain heart infusion agar containing 6 mu g/ml vanconnycin was used in ASM, and the strains with suspicion of VISA/hVISA were screened by standard E-test and macro E-test methods. All MRSA strains were susceptible to vancomycin, teicoplanin, daptomycin, Q/D and linezolid by E-test method; and their rates of susceptibility for tigecycline, chloramphenicol, rifampicin, ofloxacin and tetracycline were detected as 89%, 97%, 40%, 39% and 32%, respectively. MIC50/MIC90 values were 1.5/2 mu g/ml for vancomycin, 2/4 mu g/ml for teicoplanin, 0.19/0.38 mu g/ml for daptomycin, 0.19/0.38 mu g/ml for Q/D, 0.75/1 mu g/ml for linezolid, 0.19/0.75 mu g/ml for tigecycline, 3/6 mu g/ml for chloramphenicol, 32/32 mu g/ml for rifampicin, 32/32 mu g/ml for ofloxacin and 32/64 mu g/ml for tetracycline, respectively. For the evaluation of reduced vancomycin susceptibility, 2% (2/100) of MRSA strains were defined as VISA and 5% (5/100) as hVISA with ASM. One of those seven isolates identified as VISA/hVISA with ASM was evaluated as suspected hVISA by using both standard E-test and macro E-test methods. In conclusion, no MRSA resistant strain to vancomycin, teicoplanin, daptomycin, Q/D and linezolid was determined in our study. However tigecycline resistance (11%) was found higher than expected. As the glycopeptide resistance is increasing in the world and because of the intense use of these drugs in Turkey, the rates of vancomycin resistance among MRSA strains should be investigated periodically.Publication Metadata only Investigation of Extended Spectrum Beta-Lactamase (ESBL) Genes in ESBL-Producing Escherichia coli and Klebsiella pneumoniae Strains(2018-01-01T00:00:00Z) Bektas, Abdullah; Guducuoglu, Huseyin; Gursoy, Nafia Canan; Berktas, Mustafa; Gultepe, BİLGE; Parlak, Mehmet; OTLU, BARIŞ; Takerekoglu, Mehmet Sait; SÜMBÜL, BİLGEIntroduction: Extended spectrum beta-lactamase (ESBL)-producing Enterobacteriaceae is an important health problem all over the world. In this study, it was aimed to determine the ESBL genes in Escherichia coli and Klebsiella pneumoniae strains isolated for approximately four-year period.Publication Metadata only Investigation of the changing etiology and risk factors of prosthetic joint infections : a university hospital surveillance study from 2011-2017.(2020-03-01T00:00:00Z) Okay, G; Bolukcu, S; Durdu, B; Gultepe, BİLGE; Tuncay, İ; Koc, MM; OKAY, GÜLAY; SÜMBÜL, BİLGE; TUNCAY, İBRAHİMPublication Metadata only Distribution of bla(OXA) Genes in Acinetobacter baumannii Strains: A Multicenter Study(2013-10-01T00:00:00Z) Ciftci, Ihsan Hakki; Asik, Gulsah; KARAKECE, Engin; Oksuz, Lutfiye; YAGCI, Server; Cetin, Emel Sesli; Ozdemir, Mehmet; Atasoy, Ali Riza; Kocoglu, Esra; Gul, Mustafa; KURTOLU, Muhammet Guzel; Cakirlar, Fatma Koksal; Seyrek, Adnan; Berktas, Mustafa; Gultepe, BİLGE; Ayyildiz, Ahmet; SÜMBÜL, BİLGEAcinetobacter baumannii is the most important agent of nosocomial infections within the Acinetobacter genus. This gram-negative coccobacillus is intrinsically resistant to many antibiotics used in antimicrobial therapy, and capable of developing resistance including carbapenems. The objective of this study was to develop a multiplex real time polymerase chain reaction (qPCR) kit for OXA subgroups in A.baumannii, and to investigate the distribution of OXA subgroups in A.baumannii strains isolated from geographically different regions of Turkey. A total of 834 A.baumannii clinical isolates collected from different state and university medical centers in 13 provinces (Afyonkarahisar, Ankara, Bolu, Elazig, Erzurum, Isparta, Istanbul, Kahramanmaras, Konya, Sakarya, Van) between 2008-2011, were included in the study. The isolates were identified by conventional methods and automated systems [Vitek2 (bioMerieux, ABD) and Phoenix (BD Diagnostic, MD)]. The susceptibility profiles of the isolates were studied with automated systems and standard disc diffusion method. All samples were subjected to qPCR to detect bla(OXA-51-like), bla(OXA-23-like) and bla(OXA-58-like) genes. A conventional PCR method was also used to detect bla(OXA-24-like) gene. The resistance rates observed during the study period were as follows: 96.8% for amoxicillin-clavulanate, 86.8% for ciprofloxacin, 74.7% for gentamicin, 71.7% for amikacin, 73.5% for cefaperozone-sulbactam, 72.1% for imipenem and 73% for meropenem. Six hundred and two (72.2 %) isolates were resistant to both imipenem and meropenem. Colistin was found to be the most effective antibiotic against A.baumannii isolates with 100% susceptibility rate. All isolates were positive for bla(OXA-51-like) gene, however bla(OXA-24-like) gene could not be demonstrated in any isolate. Total positivity rates of bla(OXA-23-like) and bla(OXA-58-like) genes were found as 53.7% and 12.5%, respectively, while these rates were 74.4% and 17.3% in carbapenem-resistant isolates, respectively. Twenty-five isolates were positive-for both bla(OXA-23-like) and bla(OXA-58-like) genes. All of the carbapenem-resistant isolates have OXA type genes like with the exception of bla(OXA-24-like) gene. The positivity rates for bla(OXA-23-like) and bla(OXA-58-like) genes varied for each center. In addition, there was a decrease in the frequency of bla(OXA-58-like) gene, however both bla(OXA-23-like) gene and carbapenem resistance rates increased during the study period. In conclusion, high rates of resistance to carbapenems were also remarkable but A.baumannii strains keep on sensitivity to colistin. Both bla(OXA-23-like) and bla(OXA-58-like) genes were shown to be widespread in carbapenem-resistant A.baumannii clinical isolates. However, bla(OXA-23-like) gene positive strains were increased throughout the study. Currently, multiplex qPCR is the best way for rapid diagnosis of resistant bacteria for prevention of hospital-acquired infections. The multiplex qPCR kit developed in this study could be useful for rapid diagnosis and identify the frequencies of bla(OXA-23-like), bla(OXA-51-like) and bla(OXA-58-like) genes in carbapenem-resistant A.baumannii clinical isolates.Publication Metadata only Beyond anti-microbial properties: The role of cathelicidin in allergic rhinitis(2016-07-01) DILEK, F.; Gultepe, BİLGE; OZKAYA, EMİN; YAZICI, M.; GEDIK, A. H.; SÜMBÜL, BİLGE; ÖZKAYA, EMİN; ÇAKIR, ERKANBackground: Cathelicidin, an anti-microbial peptide, is a component of the innate immune system. Cathelicidin has anti-microbial, anti-inflammatory and immunoregulatory functions. Knowledge about the role of the innate immune system in the pathogenesis of allergic diseases has expanded in recent years. We measured levels of the LL-37 peptide in the nasal fluids of children with allergic rhinitis (AR) and investigated the possible role of this peptide in the pathogenesis of AR.