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DURDU, BÜLENT

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BÜLENT
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DURDU
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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
    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
    Analysis of infectious spondylodiscitis: 7-years data
    (2018-11-01) Koc, Meliha Meric; Okay, GÜLAY; Akkoyunlu, YASEMİN; Bolukcu, SİBEL; Durdu, BÜLENT; Hakyemez, Ismail Necati; OKAY, GÜLAY; AKKOYUNLU, YASEMİN; BOLUKÇU, SİBEL; DURDU, BÜLENT; HAKYEMEZ, İSMAİL NECATİ; MERİÇ KOÇ, MELİHA
    Objective: Infectious spondylodiscitis (SD) is an infectious disease that is rare and difficult to diagnose due to its non-specific clinical features. In this study, we aimed to describe the clinical and diagnostic features of infectious spondylodiscitis. Methods: All patients who were diagnosed with SD at our hospital during a 7-year period from January 1, 2011 through December 31, 2017 were included in the study. Spondylodiscitis is divided into the following three types: pyogenic, tuberculous, and brucellar. Clinical and laboratory data were collected retrospectively from the medical records of the patients. Results: Of the 118 patients, 66 (55.9%) were female, 81 (68.6%) had pyogenic SD (PSD), 21 (17.8%) had tuberculous SD (TSD), and 16 (13.6%) had brucellar SD (BSD). The mean age was 59.3 ± 14.6 years. Leucocytosis was significantly higher in patients with PSD (p=0.01) than in patients with other types of SD. Thoracic involvement (47.6%) was significantly higher in patients with TSD (p=0.005) than in other patients. Sacral involvement (12.5%) was significantly higher in patients with BSD (p=0.01) than in other patients. Paravertebral abscess formation (42.8%) occurred most frequently in patients with TSD. Microbiologic agents were defined in 50% (18/36) of the surgical specimens and in 12.5% of the fine needle aspiration biopsy (FNAB) specimens. Staphylococcus aureus was the most common microbiological agent in patients with PSD. Spinal surgery was defined as a risk factor for PSD (p = 0.0001). Binary logistic regression analysis revealed that female gender, thoracic involvement and night sweats were the predictive markers for TSD (OR 4.5 [95% CI 1.3-15.3] and OR 5 [95% CI 1.7-14.6]). Conclusion: PSD is the most frequent form of SD. Leucocytosis is most common in patients with PSD. Thoracic involvement and paraspinal abscess were prominent in patients with TSD. Sacral involvement was most common in patients with BSD. Thoracic involvement, female gender and night sweats were the predictive markers for TSD. The microbiological culture positivity rate was higher in surgical specimens compared to FNAB specimens. The need for surgical treatment was most common in patients with TSD.
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    PublicationOpen Access
    COVİD-19 infection in a membranous nephropathy patient treated with rituximab.
    (2020-09-04T00:00:00Z) Elcioglu, Omer Celal; Artan, Ayse Serra; Mirioglu, Safak; Gursu, Meltem; Durdu, Bulent; Koc, Meliha Meric; Okyaltirik, Fatmanur; Gultekin, Mehmet Ali; Kazancioglu, Rümeyza; ELÇİOĞLU, ÖMER CELAL; MİRİOĞLU, ŞAFAK; GÜRSU, MELTEM; DURDU, BÜLENT; MERİÇ KOÇ, MELİHA; OKYALTIRIK, FATMANUR; GÜLTEKİN, MEHMET ALİ; KAZANCIOĞLU, RÜMEYZA
    While COVID-19 pandemic continues to afect our country and most countries in the world, we have to make some changes both in our social life and our approach to healthcare. We have to struggle with the pandemic on one hand and also try to follow up and treat our patients with chronic diseases in the most appropriate way. In this period, one of our group of patients who are challenging us for follow-up and treatment are those who should start or continue to use immunosuppressive therapy. In order to contribute to the accumulation of knowledge in this area, we wanted to report a patient who was followed up with the diagnosis of COVID-19 and had been administered rituximab very recently due to a nephrotic syndrome caused by membranous nephropathy.
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    PublicationOpen Access
    A case of meralgia paresthetica caused by prone positioning in a COVID-19 patient with acute respiratory distress syndrome
    (2022-01-01T00:00:00Z) Karaaslan, Tahsin; Avarisli, Aysenur; DURDU, BÜLENT; DAŞKAYA, HAYRETTİN; DURDU, BÜLENT; DAŞKAYA, HAYRETTİN
    COVID-19 critically ill patients usually require prone positioning for the treatment of respiratory failure caused by Acute Respiratory Distress Syndrome (ARDS). Prone position provides a better ventilation-perfusion compatibility, resulting in a significant improvement in oxygenation and a decrease in mortality, but prolonged prone positioning may cause Meralgia Paresthetica (MP), one of the most common mononeuropathies of the lower limb. The early diagnosis of MP is crucial to avoid a permanent damage with pain and disability, and to start immediately the correct treatment. In this article, we report a rare case of MP in a critically ill COVID-19 patient with ARDS, with the main aim to create awareness for MP among the medical team working.
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    PublicationOpen Access
    Prevalence and mortality of cancer among people living with HIV and AIDS patients: a large cohort study in Turkey
    (2020-03-01T00:00:00Z) Aydin, Ozlem Altuntas; Gunduz, Alper; Sargin, Fatma; Mete, Bilgul; Karaosmanoglu, Hayat Kumbasar; Sevgi, Dilek Yildiz; Yemisen, Mucahit; Durdu, Bulent; Dokmetas, Ilyas; Tabak, Fehmi; DURDU, BÜLENT
    Background: Cancer is responsible for elevated human immunodeficiency virus (HIV)-related mortality but there are insufficient data about cancer in HIV-positive patients in Turkey.
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    PublicationOpen 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, BİLGE
    BACKGROUND: 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.
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    PublicationOpen Access
    Investigation the Relationship Between Body Mass Index and Mortality in COVID-19 Patients
    (2021-02-01T00:00:00Z) BOLUKÇU, SİBEL; ÖZMEN, MEHMET EMİN; EKŞİ, ÇAĞLA; OKAY, GÜLAY; SÜMBÜL, BİLGE; KAÇMAZ, ASİYE BAHAR; DURDU, BÜLENT; AKKOYUNLU, YASEMİN; MERİÇ KOÇ, MELİHA; BOLUKÇU, SİBEL; ÖZMEN, MEHMET EMİN; EKŞİ, ÇAĞLA; OKAY, GÜLAY; SÜMBÜL, BİLGE; KAÇMAZ, ASİYE BAHAR; DURDU, BÜLENT; AKKOYUNLU, YASEMİN; MERİÇ KOÇ, MELİHA
    Objective: Obesity might be a risk factor for patients with Coronavirus disease-19 (COVID-19). We aimed to investigate the association of the obesity with intensive care need and mortality caused by severe acute respiratory syndrome-CoV-2 (SARS-CoV-2) infection in this retrospective cohort. Methods: Between March 11th and May 1st, 135 patients, who were treated in our clinic, were enrolled in the study. Body mass index (BMIs) of the patients were grouped according as WHO criteria (<25 kg/m(2): normal, 25 30 kg/m(2): overweight, >30 kg/m(2): obese). Results: Of our patients, 34.1% (n=46) were obese. Mean BM! of the mortality group was 31.2 kg/m(2) and was not different from that of the survivors (p=0.09), However, mean BMI of the patients, in whom intensive care was needed, teas 31.2 kg/m(2) and higher than that of those intensive care was nut needed (p=0.04). In subgroup analyses, obesity (BMI >31) kg/m(2)) was more common among mortality group versus survivors in males older than 60 years old (p=0.03). Conclusion: Obesity with associated disorders are negative prognostic factors for COVID-19 and should be tackled as the end of the pandemic is obscure.
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    PublicationOpen Access
    Assessment of the 24th Week Success of Anti-Retroviral Therapy in the Action against HIV in Istanbul Database: Results from a Region with Increasing Incidence
    (2019-05-01) Bolukçu, Sibel; METE, BİLGÜL; Gündüz, Alper; Karaosmanoglu, Hayat Kumbasar; Sargın, Fatma; DURDU, BÜLENT; Aydin, Ozlem Altuntas; Yildiz, Dilek; DÖKMETAŞ, İLYAS; Asian, Turan; TABAK, ÖMER FEHMİ; BOLUKÇU, SİBEL; DURDU, BÜLENT
    We aimed to assess the 24-week virological and immunological success of the treatment of treatment-naive and treatment-experienced patients included in the Action against HIV in Istanbul (ACTHIV-IST) database. The ACTHIV-IST database was screened retrospectively from January 2012 to January 2014. The data for these patients such as age, sex, treatment-naive or treatment-experienced status, date of diagnosis, date of commencing antiretroviral therapy, antiretroviral therapy regimen, CD4+ cell count, and viral load before and after therapy were analyzed. In the 24th week of antiretroviral therapy, there were 40 (17.9%) and 29 (14.1%) virological and immunological failures, respectively. Virological failure (VF) was associated with a baseline viral load > 100,000 copies (p = 0.004). A CD4+ cell count lower than 200 cells/µl was not found to be associated with VF (p = 0.843). Immunological failure was substantially rare in patients with a baseline CD4+ cell count > 200 cells/µl (p = 0.005). Although an HIV-RNA 侑 100,000 copies/ml was protective against VF in the 24th week, in individuals with an HIV-RNA > 100,000 copies/ml, VF was 3.2 times more likely to occur. Baseline VF was the most predictive parameter to estimate 24th week virological success and VF. VF is an important prognostic parameter resulting in CD4+ cell depletion, AIDS-related events, and increased mortality.
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    PublicationOpen Access
    Mortality markers in nosocomial Klebsiella pneumoniae bloodstream infection
    (2016-10-28) Durdu, BÜLENT; Hakyemez, Ismail Necati; BOLUKÇU, SİBEL; OKAY, GÜLAY; ASLAN, Turan; DURDU, BÜLENT; HAKYEMEZ, İSMAİL NECATİ; BOLUKÇU, SİBEL; OKAY, GÜLAY; SÜMBÜL, BİLGE
    Purpose: Klebsiella pneumoniae is the most common endogen agent for nosocomial infections. In this study, mortality markers were investigated in patients with nosocomial K. pneumoniae blood stream infection (NKp BSI). Methods: The characteristics of patients >16 years who had NKp BSI diagnosis by daily active surveillance between January 2012 and January 2016 were retrospectively evaluated. Patients who died until 28th day of the clinical follow up and those who survived until this time were statistically compared in terms of various risk factors. Results: One hundred ninety patients were included into the study. Mortality rate was 47.9%, carbapenem resistance was 43.2%. Statistical analysis have shown that in presence of post-NKp BSI sepsis, septic shock, following in intensive care unit (ICU), meropenem resistance, kidney failure, NKp BSI secondary to pneumonia, use of invasive instruments such as central venous catheter (CVC), urinary catheter (UC) and mechanical ventilator (MV), colostomy, transfusion and hemodialysis mortality was significantly higher. In patients admitted into the hospital for neurological disorders, pancreaticobiliary tract (PBT) diseases and patients who have undergone endoscopic retrograde cholangiopancreatography (ERCP) and patients in whom NKp BSI secondary to PBT infection mortality rate was lower. Conclusions: Sepsis, septic shock, clinical conditions requiring ICU treatment and meropenem resistance increase mortality rates in NKp BSI significantly. Mortality was higher also in patients with NKp BSI secondary to pneumonia, in kidney failure and when invasive instruments were used. On the other hand, in patients who were admitted to the hospital for neurological disorders and PBT diseases mortality rate was lower.