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SÜMBÜL, BİLGE

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    PublicationOpen Access
    Discordance between Serum Neutralizing Antibody Titers and the Recovery from COVID-19
    (2020-09-25T00:00:00Z) Koç, Mm; Kalkan, Yazıcı; Çetin, Nesibe Selma; Doymaz, Mz; Sümbül, B; Durdu, B; YAZICI, MERVE; MERİÇ KOÇ, MELİHA; ÇETİN, NESİBE SELMA; KARAASLAN, ELİF; OKAY, GÜLAY; DURDU, BÜLENT; SÜMBÜL, BİLGE; DOYMAZ, MEHMET ZIYA
    The recent pandemic of COVID-19 has caused a tremendous alarm around the world. Details of the infection process in the host have significant bearings on both recovery from the disease and on the correlates of the protection from the future exposures. One of these factors is the presence and titers of neutralizing Abs (NAbs) in infected people. In the current study, we set out to investigate NAbs in the recovered subjects discharged from the hospital in full health. Serum samples from a total of 49 documented consecutive COVID-19 subjects were included in the study. All the subjects were adults, and serum samples collected during the discharge were tested in viral neutralization, enzyme immunoassay (EIA), and Western immunoblot tests against viral Ags. Even though a majority of the recovered subjects had raised significant NAb titers, there is a substantial number of recovered patients (10 out of 49) with no or low titers of NAbs against the virus. In these cohorts as well as in patients with high NAb titers, viral Ag binding Abs were detectable in EIA tests. Both NAb titers and EIA detectable Abs are increased in patients experiencing a severe form of the disease, and in older patients the Ab titers were heightened. The main conclusion is that the recovery from SARS-CoV-2 infection is not solely dependent on high NAb titers in affected subjects, and this recovery process is probably produced by a complex interplay between many factors, including immune response, age of the subjects, and viral pathology.
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    PublicationOpen Access
    Is there a link between pre-existing antibodies acquired due to childhood vaccinations or past infections and COVID-19? A case control study
    (2021-02-01T00:00:00Z) SÜMBÜL, BİLGE; Sumbul, Hilmi Erdem; OKYAY, RAMAZAN AZİM; Gulumsek, Erdinc; ŞAHİN, AHMET RIZA; Boral, Baris; Kocyigit, Burhan Fatih; Alfishawy, Mostafa; Gold, Jeffrey; Tasdogan, Ali Muhittin; SÜMBÜL, BİLGE
    Background: There is growing evidence indicating that children are less affected from COVID-19. Some authors speculate that childhood vaccinations may provide some cross-protection against COVID-19. In this study, our aim was to compare the circulating antibody titers for multiple childhood vaccine antigens, as an indicator of the state of immune memory between patients with COVID-19 and healthy controls, with a specific aim to identify the association between disease severity and antibody titrations which may indicate a protective function related to vaccine or disease induced memory. Methods: This study is a case-control study including 53 patients with COVID-19 and 40 healthy volunteers. COVID-19 severity was divided into three groups: asymptomatic, mild and severe. We measured the same set of antibody titers for vaccine antigens, and a set of biochemical and infection markers, in both the case and control groups. Results: Rubella (p = 0.003), pneumococcus (p = 0.002), and Bordetella pertussis (p < 0.0001) titers were found to be significantly lower in the case group than the control group. There was a significant decline in pneumococcus titers with severity of disease (p = 0.021) and a significant association with disease severity for Bordetella pertussis titers (p = 0.014) among COVID patients. Levels of AST, procalcitonin, ferritin and D-dimer significantly increased with the disease severity. Discussion: Our study supports the hypothesis that pre-existing immune memory, as monitored using circulating antibodies, acquired from childhood vaccinations, or past infections confer some protection against COVID-19. Randomized controlled studies are needed to support a definitive conclusion
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    PublicationOpen Access
    Screening of mecC Gene in Methicillin Resistant Staphylococcus aureus Isolates
    (2022-04-01T00:00:00Z) Ceylan, Ayse Nur; SÜMBÜL, BİLGE; DOYMAZ, Mehmet Ziya; SÜMBÜL, BİLGE; DOYMAZ, MEHMET ZIYA
    Objective: The diagnosis and treatment of mecC positive methicillin resistant Staphylococcus aureus (MRSA) isolates pose a significant problem in clinical microbiology and infectious disease practices. The studies on the frequency of mecC positive isolates in Turkey is rather scarce. In the present study, we aimed to investigate the presence of mecA, mecC, spa and pvu genes in MRSA strains isolated from various clinical specimens submitted to Clinical Microbiology Laboratories of Bezmialem Vakıf Hospital. Methods: We performed nucleic acid extraction and multiplex polymerase chain reaction (PCR) to 126 MRSA strains to detect mecC, mecA, spa and pvl genes. Results: According to the multiplex PCR results of 126 MRSA strains studied, 126 (100%) had mecA, 107 (85%) had spa, and 3 (2%) had pvl genes. We performed another polymerase chain reaction protocol and spa genes were identified in 19 of specimens, which were found negative priorly. Conclusion: Considering the factors that a university medical center where the study was conducted provided a tertiary healthcare service to a large metropolitan area in Istanbul and none of the isolates carried mecC gene might indicate that mecC gene carrying MRSA isolates did not pose a significant public health threat in Turkey.
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    PublicationOpen Access
    Sonication of explants enhances the diagnostic accuracy of synovial fluid and tissue cultures and can help determine the appropriate antibiotic therapy for prosthetic joint infections.
    (2022-01-24T00:00:00Z) ALIYEV, ORKHAN; YILDIZ, FATİH; KAYA, HAKAN BATUHAN; Aghazada, AGHAMAZAHIR; SÜMBÜL, BİLGE; Citak, Mustafa; TUNCAY, İBRAHİM; ALIYEV, ORKHAN; YILDIZ, FATİH; KAYA, HAKAN BATUHAN; AGHAZADAA, AGHAMAZAHIR; SÜMBÜL, BİLGE; TUNCAY, İBRAHİM
    Purposes This study aimed to evaluate the sensitivity and specificity of the sonication cultures according to the International Consensus Meeting 2018 criteria and to evaluate the effect of sonication on the antibiotic treatment of patients.
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    PublicationOpen Access
    Temporal trends and patterns in antimicrobial-resistant Gram-negative bacteria implicated in intensive care unit-acquired infections: A cohort-based surveillance study in Istanbul, Turkey
    (2018-09-01) GULTEPE, Bilge; Kritsotakis, Evangelos; Lee, Andrew C. K.; Torun, PERİHAN; Hakyemez, Ismail N.; Aslan, Turan; DURDU, BÜLENT; TORUN, PERİHAN; SÜMBÜL, BİLGE
    Objectives: This study assessed trends and patterns in antimicrobial-resistant intensive care unit (ICU)-acquired infections caused by Gram-negative bacteria (GNB) in Istanbul, Turkey.
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    PublicationOpen Access
    High prevalence of chronic hepatitis D virus infection in Eastern Turkey: urbanization of the disease
    (2016-04-01) Dulger, Ahmet Cumhur; Suvak, Burak; Gonullu, Hayriye; GONULLU, Edip; Gultepe, BİLGE; Aydın, İbrahim; Batur, Abdussamet; Karadaş, Sevdegül; Olmezi, Sehmus; SÜMBÜL, BİLGE
    Introduction: Both hepatitis B virus (HBV) and hepatitis D virus (HDV) infection play an increasingly important role in liver diseases. The main objective of this study was to investigate the socio-epidemiological, laboratory and radiological aspects of both HBV and HDV infection near the Iranian border of Turkey. Material and methods: The study included 3352 patients with HBV and HDV infection. Socioepidemiological, laboratory and radiological aspects of the study subjects were retrospectively examined. Comorbid metabolic diseases were not assessed due to the retrospective design of the study. Results: Most of the study subjects were HBe antigen negative. No significant difference in terms of HBV-DNA levels or HBe antigen seropositivity was detected between the city centre and rural areas (p > 0.005). The mean HBV-DNA level in the anti-HDV-positive group was significantly lower than in the anti-HDV-negative group (p < 0.001). The rate of HDV-RNA positivity in women was higher than in their male counterparts (p = 0.017). Anti-HDV-IgG was detected in 18.4% of tested subjects who came from an urban area. In contrast, 12.5% of subjects of the rural group had a positive result for anti-HDV-IgG. Among 134 ultrasonographically evaluated delta hepatitis patients, 37.3% had liver cirrhosis. On the other hand, in 1244 patients with hepatitis B monoinfection, there were 90 patients with liver cirrhosis. Radiologically, the rate of hepatic steatosis in delta hepatitis patients was lower than in those with HBV monoinfection. Conclusions: Hepatitis D virus infection was particularly prevalent among the urban population as well as in female subjects. More broadly, the current observations are the first to suggest an inverse correlation between delta hepatitis and ultrasonography-proven hepatic steatosis.
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    PublicationOpen Access
    The relationship between serum histon levels and the severity of acute pancreatitis.
    (2019-09-01) Biberci, Keskin; Şentürk, H; Köker, İH; Sümbül, Gültepe; İnce, AT; İNCE, ALİ TÜZÜN; SÜMBÜL, BİLGE; ŞENTÜRK, HAKAN
    Background/Aims: Despite various scoring systems and imaging methods, it is hard to predict the severity and the course of acute pancreatitis (AP), thereby necessitating better and more reliable markers. Since inflammation plays a key role in the pathogenesis of AP, we sought to determine whether histone, which is a novel inflammatory marker, may play a role in the prediction of severity and prognosis. Materials and Methods: A total of 88 consecutive adult patients (>18 years) with a first AP episode were prospectively enrolled in the study. Severe AP was defined as having a revised Atlanta score >3 in the first 48 h after admission. Circulating histone 3 and 4 levels were measured using the enzyme-linked immunosorbent assay method. Results: Eighty-eight consecutive adult patients with a first episode of AP were divided into two groups according to severity, in which 56 (63.6%) were assigned to the mild AP group and 32 (36.4%) to the severe AP group. White blood cell, hemoglobin, creatinine, and aspartate aminotransferase levels were significantly higher in the severe AP group. However, there was no difference in serum histone levels between the groups, and there was no correlation between revised Atlanta score and serum histone levels either. Conclusion: Serum histone levels did not significantly differ between the severe and mild AP groups. Therefore, these markers may not provide additional benefit for determining the severity of AP.
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    PublicationOpen Access
    Usefulness of oxidative stress marker evaluation at admission to the intensive care unit in patients with COVID-19
    (2021-07-01T00:00:00Z) Daşkaya, Hayrettin; Yılmaz, Sinan; Uysal, Harun; Sümbül, Bilge; Karaaslan, Kazım; DAŞKAYA, HAYRETTİN; YILMAZ, SİNAN; UYSAL, HARUN; ÇALIM, MUHITTIN; SÜMBÜL, BİLGE; YURTSEVER, İSMAİL; KARAASLAN, KAZıM
    Objective:Two critical processes in the coronavirus disease 2019 (COVID-19) pandemic involve assessing patients- intensive care needs and predicting disease progression during patients- intensive care unit (ICU) stay. We aimed to evaluate oxidative stress marker status at ICU admission and ICU discharge status in patients with COVID-19.Methods:We included patients in a tertiary referral center ICU during June-December 2020. Scores of Acute Physiology and Chronic Health Evaluation II (APACHE II), Sequential Organ Failure Assessment (SOFA), and clinical severity, radiologic scores, and healthy discharge status were noted. We collected peripheral blood samples at ICU admission to evaluate total antioxidants, total oxidants, catalase, and myeloperoxidase levels.Results:Thirty-one (24 male, 7 female) patients were included. At ICU admission, patients- mean APACHE II score at ICU admission was 17.61 ± 8.9; the mean SOFA score was 6.29 ± 3.16. There was no significant relationship between clinical severity and oxidative stress (OS) markers nor between radiological imaging and COVID-19 data classification and OS levels. Differences in OS levels between patients with healthy and exitus discharge status were not significant.Conclusions:We found no significant relationship between oxidative stress marker status in patients with COVID-19 at ICU admission and patients- ICU discharge status.
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    PublicationOpen Access
    Relationships Between Bronchoscopy, Microbiology, and Radiology in Noncystic Fibrosis Bronchiectasis
    (2021-05-01T00:00:00Z) NURSOY, MUSTAFA ATİLLA; KILINÇ SAKALLI, Ayşe Ayzıt; ABDİLLAHİ, FATOUMA KHALİF; USTABAŞ KAHRAMAN, Feyza; Al Shadfan, Lina Muhammed; SÜMBÜL, BİLGE; Bilgin, Sabriye Sennur; ÇAKIR, FATMA BETÜL; DAŞKAYA, HAYRETTİN; ÇAKIR, Erkan; NURSOY, MUSTAFA ATİLLA; ABDİLLAHİ, FATOUMA KHALİF; USTABAŞ KAHRAMAN, FEYZA; SÜMBÜL, BİLGE; ÇAKIR, FATMA BETÜL; DAŞKAYA, HAYRETTİN; ÇAKIR, ERKAN
    Background: Published data on the correlations of bronchoscopy findings with microbiological, radiological, and pulmonary function test results in children with noncystic fibrosis (CF) bronchiectasis (BE) are unavailable. The aims of this study were to evaluate relationships between Bronchoscopic appearance and secretion scoring, microbiological growth, radiological severity level, and pulmonary function tests in patients with non-CF BE. Methods: Children with non-CF BE were identified and collected over a 6-year period. Their medical charts and radiologic and bronchoscopic notes were retrospectively reviewed. Results: The study population consisted of 54 female and 49 male patients with a mean age of 11.7 ± 3.4 years. In the classification according to the bronchoscopic secretion score, Grade I was found in 2, Grade II in 4, Grade III in 9, Grade IV in 17, Grade V in 25, and Grade VI in 46 patients. When evaluated according to the Bhalla scoring system, 45 patients had mild BE, 37 had moderate BE, and 21 had severe BE. Microbial growth was detected in bronchoalveolar lavage fluid from 50 of the patients. Forced expiratory volume in 1 s (FEV1) and functional vital capacity decreased with increasing bronchoscopic secretion grade (P = 0.048 and P = 0.04), respectively. The degree of radiological severity increased in parallel with the bronchoscopic secretion score (P = 0.007). However, no relationship was detected between microbiological growth rate and radiological findings (P = 0.403). Conclusions: This study showed that bronchoscopic evaluation and especially scoring of secretions correlate with severe clinical condition, decrease in pulmonary function test, worsening in radiology scores, and increase in microbiological bacterial load in patients. Flexible endoscopic bronchoscopy should be kept in mind in the initial evaluation of non-CF BE patients.
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    PublicationOpen Access
    Can serum histone H4 levels predict mucosal healing in Crohn-s disease?
    (2021-01-01T00:00:00Z) KÖKER, İBRAHİM HAKKI; SÜMBÜL, BİLGE; KİREMİTÇİ, SERCAN; KOÇHAN, KORAY; İNCE, ALİ TÜZÜN; BİBERCİ KESKİN, Elmas; ŞENTÜRK, HAKAN; KÖKER, İBRAHİM HAKKI; SÜMBÜL, BİLGE; KİREMİTÇİ, SERCAN; KOÇHAN, KORAY; İNCE, ALİ TÜZÜN; BİBERCİ KESKİN, ELMAS; ŞENTÜRK, HAKAN
    Introduction: Mucosal healing (MH) has been a treatment target with the introduction of biological agents in Crohn's disease (CD). Histone H4 increases in chronic inflammation. Aim: Our goal was to investigate the role of serum histone H4 in predicting MH. Material and methods: The study included 44 patients who applied to the endoscopy unit for ileocolonoscopic evaluation with the diagnosis of ileocecal CD and 26 healthy controls. After ileocolonoscopic evaluation, we divided the patients into 2 groups: those with and those without MH, according to the presence of endoscopic ulcer or erosion findings. Blood samples were taken from these patients to analyse serum histone H4 before the endoscopic procedure. We first compared serum histone H4 levels between CD patients and the healthy control group and then between those with and those without MH among the CD patients. Finally, we compared CRP, ESR, and serum histone H4 levels in patients with CD according to the presence of MH and symptoms. Results: Serum histone H4 levels were significantly higher in ileocolonic CD patients compared to the healthy control group (p = 0.002). Also, serum histone H4 levels were significantly higher in CD patients with no MH (p = 0.028) or symptomatic patients (p = 0.033). We did not find a significant difference in C-reactive protein and erythrocyte sedimentation rate levels between CD patients in the presence of MH (p = 0.281 and p = 0.203, respectively) or symptoms (0.779 and 0.652, respectively). Conclusions: Serum histone H4 might be a useful biomarker for MH prediction in ileocolonoscopic CD patients. Validation is needed for large numbers of patients.