Person: SÜMBÜL, BİLGE
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Publication Open 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 ZIYAObjective: 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.Publication Open 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, BİLGEIntroduction: 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.Publication Open 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, HAKANBackground/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.Publication Open 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, KAZıMObjective: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.Publication Open Access Efficacy and safety profile of COVID-19 vaccine in cancer patients: a prospective, multicenter cohort study(2022-01-01T00:00:00Z) YASİN, Ayşe İrem; Aydin, Sabin Goktas; SÜMBÜL, BİLGE; KORAL, LOKMAN; ŞİMŞEK, MELİH; Geredeli, Caglayan; Ozturk, Akin; Perkin, Perihan; Demirtas, Derya; Erdemoglu, Engin; HACIBEKİROĞLU, İLHAN; Cakir, Emre; Tanrikulu, Eda; Coban, Ezgi; Ozcelik, Melike; Celik, Sinemis; Teker, Fatih; AKSOY, ASUDE; Firat, Sedat T.; Tekin, Omer; Kalkan, Ziya; Turken, Orhan; Oven, Bala B.; Dane, Faysal; Bilici, Ahmet; Isikdogan, Abdurrahman; ŞEKER, Mesut; TÜRK, HACI MEHMET; Gumus, Mahmut; YASİN, AYŞE İREM; SÜMBÜL, BİLGE; ŞİMŞEK, MELİH; ŞEKER, MESUT; TÜRK, HACI MEHMETAim: To compare the seropositivity rate of cancer patients with noncancer controls after inactive SARS-CoV-2 vaccination and evaluate the factors affecting seropositivity. Method: Spike IgG antibodies against SARS-CoV-2 were measured in blood samples of 776 cancer patients and 715 noncancer volunteers. An IgG level ≥50 AU/ml is accepted as seropositive. Results: The seropositivity rate was 85.2% in the patient group and 97.5% in the control group. The seropositivity rate and antibody levels were significantly lower in the patient group (p < 0.001). Age and chemotherapy were associated with lower seropositivity in cancer patients (p < 0.001). Conclusion: This study highlighted the efficacy and safety of the inactivated vaccine in cancer patients.Publication Open Access Risk Factors Affecting Patterns of Antibiotic Resistance and Treatment Efficacy in Extreme Drug Resistance in Intensive Care Unit-Acquired Klebsiella Pneumoniae Infections: A 5-Year Analysis(2019-01-07) KOC, Meliha Meric; Durdu, BÜLENT; HAKYEMEZ, Ismail N.; Akkoyunlu, YASEMİN; Daskaya, HAYRETTİN; Gultepe, BİLGE; ASLAN, Turan; DURDU, BÜLENT; MERİÇ KOÇ, MELİHA; AKKOYUNLU, YASEMİN; DAŞKAYA, HAYRETTİN; SÜMBÜL, BİLGEBACKGROUND: We investigated the factors affecting antibiotic resistance in the intensive care unit (ICU)-related hospital-acquired infections caused by Klebsiella pneumoniae (KP-HAI) and the effects of antibiotics used for high-level antibiotic resistance on patient survival. MATERIAL AND METHODS: This retrospective study was performed at the adult ICU of Bezmialem Vakif University Hospital. Patients who were followed up between 01 January 2012 and 31 May 2017 were evaluated. Each KP strain was categorized according to resistance patterns and analyzed. The efficiency of antibiotic therapy for highly-resistant KP-HAI was determined by patients’ lifespans. RESULTS: We evaluated 208 patients. With the prior use of carbapenem, antibiotics against resistant Gram-positives, and tigecycline, it was observed that the resistance rate of the infectious agents had a significant increase. As the resistance category increases, a significant decrease was seen in the survival time. We observed that if the treatment combination included trimethoprim-sulfamethoxazole, the survival time became significantly longer, and tigecycline-carbapenem-colistin and tigecycline-carbapenem combination patients showed significantly shorter survival times. CONCLUSIONS: When the resistance increases, delays will occur in starting suitable and effective antibiotic treatment, with increased sepsis frequency and higher mortality rates. Trimethoprim-sulfamethoxazole can be an efficient alternative to extend survival time in trimethoprim-sulfamethoxazole-susceptible KP infections that have extensive drug resistance.Publication Open Access Helicobacter Pylory infection in patients with esophageal squamous cell carcinoma(2017-03-01) POYRAZOGLU, Omer Bilgehan; Dulger, Ahmet Cumhur; Gultepe, BİLGE; SÜMBÜL, BİLGEObjective:: Esophageal squamous cell carcinoma is one of the most common esophageal diseases in the developing world, but the relationship between esophageal squamous cell carcinoma and Helicobacter pylori infection remains a neglected topic. The primary objective of this study was to determine the association between Helicobacter pylori infection and esophageal squamous cell carcinoma. A second purpose was to determine the incidence and factors associated with Helicobacter pylori infection following esophagectomy. Method:: The microorganism was identified by testing the gastric biopsy materials from 95 esophageal squamous cell carcinoma patients (66 females; 39 were esophagectomized) for urease activity in a medium containing urea and a power of hydrogen detection reagent and comparing the results with those from a healthy population. Differences in patient characteristics were assessed with chi-square tests and t-tests for categorical and continuous factors, respectively. Results:: The patients with esophageal squamous cell carcinoma had a significantly lower prevalence of Helicobacter pylori compared with the healthy population (p<0.001). The naive and esophagectomized patients, in contrast, showed no significant differences in Helicobacter pylori infection (p>0.005). Patients with esophageal squamous cell carcinoma showed a significant association between leukocytosis and hypoglobulinemia and the presence of Helicobacter pylori infection (p=0.023 and p=0.045, respectively). Conclusion:: These results suggest that Helicobacter pylori is not an etiological factor in patients with esophageal squamous cell carcinoma. We found a statistically significant negative correlation between esophageal squamous cell cancer and Helicobacter pylori infection. These findings may guide new strategies for esophageal squamous cell carcinoma therapy.Publication Open Access Hand, Foot, and Mouth Disease Caused by Coxsackievirus A6: A Preliminary Report from Istanbul.(2019-01-01) Ceylan, AN; Turkmen, AV; Turel, O; Gultepe, BİLGE; Inan, E; Doymaz, MEHMET ZİYA; TÜREL, ÖZDEN; SÜMBÜL, BİLGE; VEHAPOĞLU TÜRKMEN, AYSEL; DOYMAZ, MEHMET ZIYAHand, foot, and mouth disease (HFMD) is caused by various serotypes of Enterovirus genus. Coxsackievirus A16 (CV-A16) and enterovirus A71 (EV-A71) were known to be the only responsible agents for these epidemics; however, this opinion was challenged after the detection that coxsackievirus A6 (CV-A6) was the responsible species for the outbreak in Finland in 2008. HFMD is frequently seen in Turkey, and no detailed study on its clinical and microbiological epidemiology has previously been reported. The present study addresses this question. Twenty-seven patient samples collected between 2015 and 2017 were included in the study. Typing was conducted by RT-PCR and the sequencing applied directly to patient's samples and as well as to the viral cultures with pan-enterovirus and serotype-specific primers. The presence of Enterovirus in 12 of 27 HFMD samples was shown with RT-PCR. The causative agent for three of these 12 samples was CV-A16, one of the most frequent two serotypes around the world, and the remaining nine samples was CV-A6. The findings of the study are relevant since it pertains to the molecular epidemiology of HFMD in Turkey, a gateway country where different serotypes might be circulating and transmitted. The findings also support the notion that CV-A6 cases are rising in number, which has caused more severe clinical features and widespread rashes in recent outbreaks. Hand, foot, and mouth disease (HFMD) is caused by various serotypes of Enterovirus genus. Coxsackievirus A16 (CV-A16) and enterovirus A71 (EV-A71) were known to be the only responsible agents for these epidemics; however, this opinion was challenged after the detection that coxsackievirus A6 (CV-A6) was the responsible species for the outbreak in Finland in 2008. HFMD is frequently seen in Turkey, and no detailed study on its clinical and microbiological epidemiology has previously been reported. The present study addresses this question. Twenty-seven patient samples collected between 2015 and 2017 were included in the study. Typing was conducted by RT-PCR and the sequencing applied directly to patient’s samples and as well as to the viral cultures with pan-enterovirus and serotype-specific primers. The presence of Enterovirus in 12 of 27 HFMD samples was shown with RT-PCR. The causative agent for three of these 12 samples was CV-A16, one of the most frequent two serotypes around the world, and the remaining nine samples was CV-A6. The findings of the study are relevant since it pertains to the molecular epidemiology of HFMD in Turkey, a gateway country where different serotypes might be circulating and transmitted. The findings also support the notion that CV-A6 cases are rising in number, which has caused more severe clinical features and widespread rashes in recent outbreaks.Publication Open Access The relationship of Serum Histone H3.3 and H4 with chronic Hepatitis B(2020-09-01T00:00:00Z) Sümbül, Bilge; Şentürk, Hakan; Köker, İbrahim Hakkı; Koçhan, Koray; İnce, Ali Tüzün; Biberci Keskin, Elmas; İNCE, ALİ TÜZÜN; BİBERCİ KESKİN, ELMAS; SÜMBÜL, BİLGE; KOÇHAN, KORAY; KÖKER, İBRAHİM HAKKI; ŞENTÜRK, HAKANObjective: To determine the role of serum histone H3.3 and H4 in patients with chronic hepatitis B to explore any relationship between the two.Methods: The prospective controlled clinical pilot study was conducted in the Gastroenterology Clinic of Bezmialem Vakif University, Istanbul, Turkey, from January to October 2017, and comprised biopsy-proven patients with chronic hepatitis B and healthy controls. Demographics, hepatitis B virus deoxyribonucleic acid quantity, hepatitis B e-antigen, aspartate aminotransferase, alanine transaminase, international normalized ratio, total/direct bilirubin, albumin and thrombocyte counts as well as histological activity index and fibrosis scores were noted. Data was analysed using SPSS 22.Results: Of the 140 subjects, 70(50%) each were cases and controls. The overall mean age of the sample was 43.38±15.07 years (range: 18-70 years). There was positive correlation of histone H3.3 with hepatitis B virus deoxyribonucleic acid, aspartate aminotransferase, alanine transaminase and international normalized ratio levels. Histone H4 levels only correlated with hepatitis B virus deoxyribonucleic acid and international normalized ratio. Hepatitis B e-antigen positivity was present in 14(20%) of the cases.Conclusion: Histone H3.3 levels appeared to be associated with pathophysiological changes in chronic hepatitis B patients, suggesting that future treatments should target H3.3.Keywords: Histone H3.3, Histone H4, Extracellular histone, Chronic Hepatitis B, HBV.(JPMA 70: 1596; 2020)DOI:https://doi.org/10.5455/JPMA.19365Publication Open Access Evaluation of 257 extra pulmonary tuberculosis cases at the Tuberculosis Control Dispensary, Van, Turkey.(2018-05-01) SUNNETCIOGLU, M; BARAN, AI; BINICI, I; ESMER, F; Gultepe, BİLGE; SÜMBÜL, BİLGEAbstract Objective: To determine whether there were any changes in demographic and clinical features of extrapulmonary tuberculosis cases. Methods: This retrospective study was conducted at Yuzuncu Yil University, Van, Turkey, and comprised records of extrapulmonary tuberculosis patients treated between January 2009 and July 2014 at the tuberculosis control dispensary. Descriptive and clinical data, including age, gender, site of involvement, diagnostic method and coexisting systemic diseases, were noted. Any changes in terms of these parameters were investigated on a yearon-year basis. SPSS 20 was used for data analysis. Results: There were 257 cases detected. Of them, 50(19.45%) related to 2009, 61(23.75%) to 2010, 24(9.33%) to 2011, 50(19.45%) to 2012, 47(18.28%) to 2013 and 25(9.72%) to 2014. Although lymph nodes were by far most frequently affected in 2009, 2010, 2011 and 2013; pleura was most commonly involved in 2012 and 2014. Age and gender distribution displayed no changes between 2009 and 2014 (p>0.05). However, diagnostic method of choice and frequency of co-existent systemic disorders displayed remarkable alterations in this period (p<0.05). Conclusion: Improved insight of clinicians for atypical demographic and clinical features at presentation may provide reduction of rates of morbidity and mortality due to extrapulmonary tuberculosis.