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    Accuracy of consultations performed by infectious diseases trainees and factors associated with adherence to them
    (Elsevier Sci Ltd, 2007) Sipahi, Oguz Resat; Tasbakan, Meltem; Pullukcu, Husnu; Arda, Bilgin; Yamazhan, Tansu; Mizrakci, Serpil; Senol, Sebnem; Atalay, Sabri; Koseli, Demet; Arsu, Guray; Calik, Sebnem; Sipahi, Hilal; Buke, Cagri; Ulusoy, Sercan
    Objectives: Infectious diseases (ID) trainees should be familiar with duties relevant to consultation practice. In this study we aimed to analyze the ID trainee night/weekend shift consultation process in terms of consultant characteristics, types of recommendations, and compliance with recommendations. Methods: All consultations performed by ID trainees on the night shift and at the weekends between 10 June and 10 August 2004 were recorded prospectively on standardized forms. Infectious diseases specialists assessed the appropriateness of recommendations the day after each consultation. Recommendations were considered complied with if they were carried out within 72 hours of the consultation. Results: Of 440 consultations, 163 were for a clinically diagnosed infection (without specific antibiotic request) and 79 were for treatment continuation. Overall, 152 consultations were for requesting specific antibiotic(s), and 327 antibiotics were recommended or approved in 270 consultations. Eight of these recommendations were inappropriate. Overall compliance to ID recommendations was 75.3% (418/555). In univariate analysis, the compliance rate to non-treatment recommendations (microbiologic cultures, radiology, biochemistry, etc.) was found to be lower than the rate of compliance to antibiotic recommendations (186/308 vs. 232/247, p < 0.05). In addition, compliance to recommendations made by the first-year trainees was lower than to the recommendations made by the other trainees. In logistic regression analysis only recommendations including antibiotic treatment was associated with higher compliance (p = 0.0001, odds ratio = 10.2, 95% CI = 5.7-18.3). Conclusions: ID trainees are capable of evaluating patients and recommending appropriate antibiotics. Methodologies to improve the compliance to non-treatment-based recommendations and optimizing antibiotic selection seem to be necessary. (C) 2007 International Society for Infectious Diseases. Published by Elsevier Ltd. All rights reserved.
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    Attitudes towards HIV/AIDS and other sexually transmitted diseases in secondary school students in Izmir, Turkey: changes in time
    (Royal Soc Medicine Press Ltd, 2007) Yamazhan, Tansu; Gokengin, Deniz; Ertem, Ekin; Sertoz, Ruchan; Atalay, Sabri; Serter, Demir
    The aim of this study was to evaluate the changes in the sexual attitudes of young people in a period of 7 years (1997-2004). The participants in the first and the second surveys were 633 and 654 grade 10 students from six high schools located in the central district of Izmir, Turkey, chosen randomly according to the stratified sampling method. The rate of having had sexual experience was 11.3% and 22.8% in the first and second surveys, respectively (chi(2) P < 0.001).
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    Bacterial and viral etiology in hospitalized community acquired pneumonia with molecular methods and clinical evaluation
    (J Infection Developing Countries, 2014) Serin, Derya Caglayan; Pullukcu, Husnu; Cicek, Candan; Sipahi, Oguz Resat; Tasbakan, Sezai; Atalay, Sabri
    Introduction: Polymerase chain reaction (PCR) method has improved the diagnosis rates for patients with community-acquired pneumonia (CAP). We aimed to evaluate the bacterial and viral etiology of hospitalized CAP cases and compare clinical and laboratory findings of patients with pure bacterial and bacterial and viral (mixed) infections. Methodology: A total of 55 patients hospitalized with CAP were enrolled into the prospective study between February 2010 and December 2010. Clinical and laboratory follow-up were performed on days 0, 7 and 14. Deep tracheal aspiration samples were examined for bacterial and viral pathogens by multiplex PCR, and standard bacteriological culture method. Results: The etiological identification rate in 50 patients for bacteria, viruses and mixed virus-bacteria combination by PCR were 62%, 4%, 32%, respectively and 60% in 55 patients by bacterial culture method. Streptococcus pneumoniae concomitant with Haemophilus influenzae (36%) and rhinovirus (16%) was very common, whereas atypical pathogens (only Mycoplasma pneumoniae) were rare (6%). Rhinovirus was the most common viral agent (20%). Recently identified viruses, human coronavirus HKU1 and human bocavirus were not detected except for human metapneumovirus (one case). There was no significant difference in terms of mean age, immune status, leukocyte count, C-reactive protein (CRP) values, hospitalization duration and CURB-65 score between bacterial and mixed viral-bacterial detections. Advanced age (p < 0.01) and higher CURB-65 score (p = 0.01) were found to be associated with increased mortality. Conclusion: Concomitance of bacterial and viral agents is frequent and resemble with bacterial infections alone. Further studies are needed for the clinical significance of mixed detections.
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    HIV treatment satisfaction: HIVTSQ-12 factor analysis and associated factors in Türkiye
    (BMC, 2024) Akbulut, Ilkay; Varol, Zeynep Sedef; Odemis, Ilker; Erogul, Emel; Atalay, Sabri; Gokengin, Ayse Deniz
    BackgroundDespite global efforts, HIV/AIDS remains a significant public health challenge, with T & uuml;rkiye witnessing a consistent rise in annual diagnoses. Patient satisfaction with antiretroviral therapy (ART) is crucial for treatment adherence and effectiveness. This study examines treatment satisfaction levels among people living with HIV (PLWH) in T & uuml;rkiye and identifies associated factors.Materials and methodsA cross-sectional prospective cohort study was conducted at Tepecik Training and Research Hospital, Izmir, T & uuml;rkiye, involving 238-PLWH receiving ART. Data were collected through face-to-face interviews using the HIV Treatment Satisfaction Questionnaire (HIVTSQ-12) and demographic/clinical forms. Confirmatory Factor Analysis and descriptive statistics were employed for data analysis.ResultsParticipants exhibited high overall treatment satisfaction, with significant associations between satisfaction levels and socio-demographic/clinical factors. Individuals with lower education levels, no substance use, minimal alcohol consumption, and suppressed viral loads reported higher satisfaction scores.ConclusionThis study highlights the potential for personalizing HIV treatment strategies based on socio-demographic and clinical factors. Findings emphasize the need to promote healthy lifestyles, enhance health literacy, and implement anti-addiction programs to improve treatment adherence and satisfaction among PLWH. Based on the findings, there is a need to develop strategies aimed at improving treatment satisfaction and outcomes in HIV management.
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    Investigation of Bacterial and Viral Etiology in Community Acquired Central Nervous System Infections with Molecular Methods
    (Ankara Microbiology Soc, 2017) Kahraman, Hasip; Tunger, Alper; Senol, Sebnem; Gazi, Horu; Avci, Meltem; Ormen, Bahar; Turker, Nesrin; Atalay, Sabri; Kose, Sukran; Ulusoy, Sercan; Isikgoz Tasbakan, Meltem; Sipahi, Oguz Resat; Yamazhan, Tansu; Gulay, Zeynep; Cavus, Sema Alp; Pullukcu, Husnu
    In this multicenter prospective cohort study, it was aimed to evaluate the bacterial and viral etiology in community-acquired central nervous system infections by standart bacteriological culture and multiplex polymerase chain reaction (PCR) methods. Patients hospitalized with central nervous system infections between April 2012 and February 2014 were enrolled in the study. Demographic and clinical information of the patients were collected prospectively. Cerebrospinal fluid (CSF) samples of the patients were examined by standart bacteriological culture methods, bacterial multiplex PCR (Seeplex meningitis-B ACE Detection (Streptococcus pneumoniae, Neisseria meningitidis, Haemophilus influenzae, Listeria monocytogenes, Group B streptococci) and viral multiplex PCR (Seeplex meningitis-V1 ACE Detection kits herpes simplex virus-1 (HSV1), herpes simplex virus-2 (HSV2), varicella zoster virus (VZV), cytomegalovirus (CMV), Epstein Barr virus (EBV) and human herpes virus 6 (HHV6)) (Seeplex meningitis-V2 ACE Detection kit (enteroviruses)). Patients were classified as purulent meningitis, aseptic meningitis and encephalitis according to their clinical, CSF (leukocyte level, predominant cell type, protein and glucose (blood/CSF) levels) and cranial imaging results. Patients who were infected with a pathogen other than the detection of the kit or diagnosed as chronic meningitis and other diseases during the follow up, were excluded from the study. A total of 79 patients (28 female, 51 male, aged 42.1 +/- 18.5) fulfilled the study inclusion criteria. A total of 46 patients were classified in purulent meningitis group whereas 33 were in aseptic meningitis/encephalitis group. Pathogens were detected by multiplex PCR in 41 patients. CSF cultures were positive in 10 (21.7%) patients (nine S.pneumoniae, one H.influenzae) and PCR were positive for 27 (58.6%) patients in purulent meningitis group. In this group one type of bacteria were detected in 18 patients (14 S.pneumoniae, two N.meningitidis, one H.influenzae, one L.monocytogenes). Besides, it is noteworthy that multiple pathogens were detected such as bacteria-virus combination in eight patients and two different bacteria in one patient. In the aseptic meningitis/encephalitis group, pathogens were detected in 14 out of 33 patients; single type of viruses in 11 patients (seven enterovirus, two HSV1, one HSV2, one VZV) and two different viruses were determined in three patients. These data suggest that multiplex PCR methods may increase the isolation rate of pathogens in central nervous system infections. Existence of mixed pathogen growth is remarkable in our study. Further studies are needed for the clinical relevance of this result.
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    Pooled analysis of 2,408 cases of acute adult purulent meningitis from Turkey
    (Karger, 2008) Arda, Bilgin; Sipahi, Oguz Resat; Atalay, Sabri; Ulusoy, Sercan
    Objectives: The aim of this study was to systematically review the Turkish literature of acute adult purulent meningitis. Materials and Methods: The published series of three national databases and two international databases were searched to perform the review. In addition to the databases, abstracts of congresses held between 1994 and 2003 by the Turkish Clinical Microbiology and Infectious Diseases Association, Turkish Microbiology Association, and the Antibiotic and Chemotherapy Association were searched for reports about acute purulent meningitis. Results: Data for 2,408 patients with a diagnosis of acute purulent meningitis were obtained from 30 reports. In terms of clinical findings, 1,254 of 1,570 (79.8%) had fever (> 38 degrees C), 1,408 of 1,595 (88.2%) headache, 1,403 of 1,562 (89.8%) stiffness of the neck, and 649 of 784 (82.7%) leukocytosis (> 10,000/mm(3)). Cerebrospinal fluid culture yielded a pathogen in 873 of 2,260 (38.6%) patients. The most common pathogen was Streptococcus pneumoniae, followed by Neisseria meningitidis and Staphylococcus aureus. Overall mortality was 425 of 2,408 (17.6%). Pathogen-specific mortality was 60 of 202 (29.7%) for S. pneumoniae and 6 of 100 (6%) for N. meningitidis. Conclusion: Meningitis is a serious, life-threatening disease. More preventive measures should be sought to further decrease the mortality and morbidity related to acute purulent meningitis. Copyright (c) 2007 S. Karger AG, Basel.
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    Pregnancy and Neonatal Outcomes Among Women Living with HIV: A Multi-center, Descriptive Study in Turkey
    (2022) Atalay, Sabri; Albayrak, Hazal; Gökengin, Deniz; Akyol, Deniz; Ersan, Gürsel; İnan, Dilara; Yıldırım, Figen
    Objective: Most new confirmed cases in our country consist of young people in the 20-35 age group, which corresponds to the reproductive age in women. This study evaluated the impact of diagnosing and treating human immunodeficiency virus (HIV) during pregnancy on vertical transmission and birth outcomes. Methods: This multicentred descriptive study assessed the pregnancy and delivery process, prevention and treatment practices, breastfeeding and perinatal transmission rate. Results: Of the 55 pregnancies in women living with HIV, only 58.2% had HIV status, 81.2% were under antiretroviral therapy, and 46.2% needed treatment change. Lamivudine/zidovudine + lopinavir/ritonavir (32.7%) and tenofovir/emtricitabine + lopinavir/ritonavir (24.5%) were the two most used regiments. The mean duration of treatment in women starting the treatment during pregnancy was 19.5±7.9 weeks. Viral suppression at the delivery was similar among women who initiated treatment before and during pregnancy (p=0.659). Additionally, 89.1% of women were undetectable status (<50 copies/mL); however, 2% of them had >400 copies/mL at the delivery, and three newborns (5.5%) had HIV infections. None of the newborns had congenital anomalies. Conclusion: Our study findings revealed that addressing HIV status within routine pregnancy follow-ups and providing effective treatment before or starting from the early stage of the pregnancy have a crucial effect on protecting from the vertical transmission.
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    Tenofovir alafenamid prophylaxis for the prevention of HBV reactivation in immunosuppressed subjects: a multicenter study
    (Cukurova Univ, Fac Medicine, 2022) Akar, Sebnem Senol; Sonmez, Ufuk; Demirdal, Tuna; Sen, Pinar; Ozer, Deniz; Atalay, Sabri; Akyol, Deniz
    Purpose: Reactivation of hepatitis B may be prevented by antiviral therapy in immunosuppressed high risk patients. Entecavir (ETC) and tenofovir disoproksil fumarat (TDF) have been used for a long time and recently introduced tenofovir alafenamid (TAF) seems to be a good alternative with rare side effects. This multicentered study with a large patient population aimed to investigate the effectiveness of tenofovir alafenamid (TAF) in immunsuppressed subjects. Materials and Methods: The records of six training and research hospitals between January 1, 2019 and September 30, 2021 were retrospectively reviewed, and patients who were started antiviral prophylaxis for hepatitis B and followed up for at least 6 months while under immunosuppressive therapy were included in the study. Risk groups were determined according to the immunosuppressive treatment or chemotherapy they received, as well as hepatitis B serology, and were examined in terms of the presence of hepatitis B reactivation and its side effects. Results: The mean age of patients was found as 62.5 +/- 29. Out of 148 patients, 85 (57.4%) received TAF, 63 (42.6%) received either Entecavir (ETC) or tenofovir disoproksil fumarat (TDF). The majority (83.1%) was found as HBsAg (-) antiHBc (+) and 16.9% was HBsAg (+). HBV DNA was traced in 36% of chronic HBV patients. Most of the patients (69.6%) were receiving immunospuppressives for treatment of a haematologic malignancy and 89.2% was in the high risk treatment group. There was no difference between TAF and the other drugs in terms of risks. Reactivation was not seen in any of the treatment groups. Conclusion: TAF is as effective as TDF and ETC when used for prophylaxis in immunosuppressed HBV patients. Side effects on kidney and bone are not seen in TAF treatment groups which will probably play a role in preferring this new drug.