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Öğe Antimicrobial Susceptibility and Uropathogens Isolated From Children and Adults with Community-Acquired Urinary Tract Infections(Ortadogu Ad Pres & Publ Co, 2010) Yıldırım, Mustafa; Şahin, İdris; Gülcan, Aynur; Özdemir, Davut; Küçükbayrak, Abdülkadir; Uzun, Hakan; Kaya, DemetObjective: The aim of this study was to determine the distribution of uropathogens causing community-acquired urinary tract infections in Duzce, and their antimicrobial susceptibility patterns. Material and Methods: The study was conducted prospectively in the Duzce University Medical Faculty between July 2004-June 2006 and included outpatients. Identification of microbial growth and determination of antimicrobial susceptibility by the Kirby-Bauer disk diffusion technique were performed according to the Clinical and Laboratory Standards Institute. Results: In total, 702 bacterial isolates were examined in the study. E. coli (64.1%) was the most common urinary pathogen identified. Klebsiella spp. (9.0%), Proteus spp. (5.8%), Staphylococcus aureus (4.7%), Enterococcus spp. (4.3%), coagulase-negative Staphylococci (2.6%), S. agalactiae (2.1%) and P. aeruginosa (1.9%) were the next most common species isolated. Community acquired uropathogens isolated in our region were highly resistant to trimethoprim/sulfamethoxazole, amoxicillin and amoxicillin clavulanate. However, ciprofloxacin was active against pathogens examined in this study with susceptibilities between 64.7% and 88.8% for the most prevalent pathogens (E. coli, 81.0% susceptible). The susceptibility of gram-negative pathogens to the parenterall antibiotics seemed to be higher than the oral agents. Conclusion: Many oral antimicrobial agents do not seem to be appropriate for the empirical treatment of community-acquired urinary tract infections in our region due to very high rates of resistance. Some oral antibiotics such as ciprofloxacin and cefaclor should be used cautiously in adults.Öğe Assessment of HAV and HEV seroprevalence in children living in post-earthquake camps from Duzce, Turkey(Kluwer Academic Publ, 2004) Şencan, İrfan; Şahin, İdris; Kaya, Demet; Öksüz, Şükrü; Yıldırım, MustafaThe aim of the study was to investigate the prevalance of enterically transmitted hepatitis among children living in post-earthquake camps, and to assess the efficacy of the measurements during and after the disaster in Duzce and Golyaka. In the second half of 1999, North-western Turkey, was struck by two massive earthquakes in less than 3 months. The first, on 17 August 1999, involving Golyaka, was struck, measuring between 7.4 and 7.8 on the Richter scale. Irregularity about providing clean water and necessary sanitary facilities were observed after the first earthquake because of confusion. The second quake, on 12 November 1999, which rated 7.2 on the Richter scale, shook Duzce. Necessary precautions were applied rapidly at the second quake about shelter, clean drinking water, food and control of distribution of the aids by government and civil aid organisations. Anti-HEV(IgG) and anti-HAV(IgG) antibodies were determined in 476 sera of the children who was living in six camps. HAV prevalence of the children who were living in Duzce and Golyaka temporary houses was 44.4 and 68.8% respectively, OR: 0.37, CI 95%: 0.22-0.61, p = 0.0005. HEV prevalence of the children was 4.7 and 17.2% respectively, OR: 0.24, CI 95%: 0.11-0.51, p = 0.0007. In conclusion, HAV and HEV prevalence of children were lower than that in endemic areas but higher than that in developed countries. This study has pointed out the importance of providing urgent need of the sufficient sanitary facilities after disasters for preventing or reducing the incidence of enterically transmitted hepatitis, especially in the regions which were at risk for various disasters. Essential precautions such as providing clean water and food supply must be taken and an emergency action plan for preventing the infectious disease must be prepared before disasters such as earthquakes.Öğe Biliary infection and bacteremia caused by beta-lactamase-positive, ampicillin-resistant Haemophilus influenzae in a diabetic patient(Natl Inst Infectious Diseases, 2005) Öksüz, Şükrü; Öztürk, Elif; Şahin, Idris; Ertör, Osman; Kaya, DemetWe report the case of a 73-year-old female patient with diabetic nephropathy and cholelithiasis. She was admitted to our hospital with right upper abdominal pain, nausea, and vomiting. The patient had visited an outpatient clinic with the same complaints 2 days earlier, and had been prescribed antibiotics empirically (two doses ofloxacin orally). Blood cultures taken before the start of antibiotic treatment in our hospital were negative. The patient was treated With parenteral ampicillin/sulbactam + ciprofloxacin empirically. The empiric antibiotic treatment was discontinued after 7 days. Elective cholecystectomy was performed after her general condition improved. An-aerobic chocolate agar culture of the cholecystectomy material yielded Haemophilus influenzae type b. On postoperative day 3 the patient developed fever again. The fluids collected after cholecystectomy were evaluated microbiologically. H. influenzae type b was isolated from the samples and blood cultures. The patient was diagnosed with H. influenzae cholecystitis, and recovered after 10-day treatment with ampicillin/sulbactam + ciprofloxacin. The findings are discussed together with references for differential diagnosis. H. influenzae cholecystitis due to cholelithiasis, although rare, should be considered in elderly patients with a history of chronic diseases such as diabetes mellitus or nephropathy.Öğe Dermatophytes in the rural area of Duzce, Turkey(Blackwell Verlag Gmbh, 2004) Şahin, İdris; Öksüz, Şükrü; Kaya, Demet; Şencan, İrfan; Çetinkaya, ReyhanA total of 227 subjects (112 were male and 115 female), who were residents of the rural region of Duzce, were examined for dermatomycosis. A total of 120 samples (47 nail fragments, 73 skin scales) were collected from 81 patients for mycological analysis on the basis of the results of clinical evaluation. All specimens collected were analysed by direct microscopy and culture. Positive results were detected in the cultures of 53 (44.1%) of the 120 samples. About 46 (86.7%) samples also presented positive results in direct microscopy. In the cases of seven samples positive results were found in culture and negative results with direct microscopy. Both culture and direct microscopy presented negative results in 67 (55.8%) samples. The most frequently isolated aetiological agents were 33 Trichophyton rubrum (62.2%), and nine T. mentagrophytes (16.9%). In conclusion, traditional and religious habits such as cohabitation and performing ritual ablutions may affect the prevalence of dermatophyte infections. The performance of ritual ablutions is not in itself a risk factor for acquiring dermatophyte infection; rather it is not drying the extremities after ablutions, that is the main risk factor for this group. Tinea capitis was not found in any of the subjects in spite of the fact that it is one of the most common infectious conditions in children. This is the first paper to report the prevalence of fungal infections in Duzce, a western Black Sea region of Turkey.Öğe Dermatophytoses in forestry workers and farmers(Blackwell Verlag Gmbh, 2005) Şahin, İdris; Kaya, Demet; Parlak, Ali Haydar; Öksüz, Şükrü; Behçet, MustafaTo assess the frequency of superficial mycoses in forestry workers and farmers in the rural region of Duzce, a total of 467 residents of the rural region were examined for dermatomycosis infection. Of these, 349 were forestry workers and 118 farmers. All specimens collected were analysed by direct microscopy and culture. Tinea pedis et manus was found in 23 (19.4%), and onycomycosis in 21 (17.7%) farmers. Tinea pedis et manus was found in 50 (14.3%), and onycomycosis in 28 (8%) forestry workers. One tinea corporis, two tinea inguinalis and two erosio interdigitalis cases were determined in the farmer group but no cases of tinea corporis, tinea inguinalis, or erosio interdigitalis were found in the forestry group. In total, five tinea versicolor cases were found in the two groups on clinical examination but no agent positivity was yielded in mycological cultures. The most frequently isolated agent in the two groups was Trichophyton rubrum. The frequencies of superficial mycosis and onychomycosis were found to be higher in the farmer group than in the forestry group, although similar aetiological agents were isolated in both groups. The farmers had greater rates of contact with pathogenic fungi present in soil as well as from infected farm animals than the foresters; furthermore, animal husbandry, and the wearing of rubber shoes and nylon socks were more frequent in the farmer group. These results suggest that habits such as the wearing of rubber shoes and nylon socks, and the practice of animal husbandry may be the most important factors in determining the frequency of superficial mycoses and aetiological agents in forestry workers and farmers. To our knowledge, there is no previous report about dermatophytoses in forestry workers.Öğe Detection of brucella among voluntary blood donors in Turkey by using new real time PCR method(Blackwell Publishing, 2006) Yavuz, Tevfik; Kaya, Demet…Öğe Do baby wet wipes change periurethral aerobic flora?(Natl Inst Infectious Diseases, 2007) Şenses, Dursun A.; Öztürk, Cihadiye Elif; Yar, Nese Ersoz; Acar, Selda; Bahçebaşı, Talat; Kocabay, Kenan; Kaya, DemetThere is massive enteric bacterial colonization in the periurethral region during infancy. Fecal soiling is considered to be responsible for this colonization. We hypothesized that baby wet wipes containing chemical cleansing compounds, which are used for the cleaning of babies after diaper soiling, could be a contributing factor in this colonization. Thus, the effect on periurethral flora of two different methods of baby cleaning was compared. Periurethral culture samples were obtained from 173 infants who were cleaned with baby wet wipes (Group A, n = 96) or water and napkins (Group B, n = 77) after diaper soiling. The colonization of uropathogens and the presence of flora were analyzed. The results of the periurethral cultures were similar in both groups. The rates of uropathogen colonization only, uropathogen and skin flora colonization, and skin flora only or no growth in Groups A and B were 18.7, 61.5, and 19.8%, and 14.3, 66.2, and 19.5, respectively. The differences between the groups were statistically insignificant (P > 0.05); however, there was no significant difference in the frequency of uropathogen isolation between males and females. We therefore concluded that baby wet wipes are as safe as water for the cleaning of babies after diaper soiling.Öğe Fungal agents as a cause of surgical wound infections: An overview of host factors(H M P Communications, 2007) Kaya, Demet; Ağartan, Canan Aldırmaz; Yücel, MuhteremMicrobial virulence and host resistance are the determinants of the surgical infections. Bacteria are responsible for the majority of cases, but fungi are rare. The aim of this study was to evaluate the fungi causing surgical infections and discuss host factors predisposing the infection. Methods. A total of 824 surgical wound specimens had been evaluated. The specimens were cultured using 5% sheep blood, Sabouraud Dextrose, and Eosin methylene blue agars and the isolates were identified by classical methods and API identification system. Results. Growth was obtained in 455 (55.2%) out of 824 specimens. Nine (2%) of the agents of surgical infections were yeasts: Candida albicans was isolated in 5 (55.6%), C tropicalis in 3 (33.3%), and C glabrata in 1 (11.1%) specimen(s). Examining the characteristics of the patients, fungal infection could be explained with the presence of at least I predisposing factor. Immunosuppression was closely related with fungal growth. Conclusion. Predisposing factors impairing the immune system were detected in most of the patients showing the possibility of onset of fungal, predominantly Candidal infections. It is important for clinicians to be aware of fungal infections that may develop in this group under risk, particularly after surgery and all Candida species isolated from high-risk patients should be identified to species level, as non-albicans strains are often associated with resistance to antifungal agents.Öğe Intestinal parasitic infection in children in post-disaster situations years after earthquake(Wiley-Blackwell, 2004) Öztürk, Cihadiye Elif; Şahin, İdris; Yavuz, Taner; Öztürk, Ayhan; Akgünoğlu, Mustafa; Kaya, DemetBackround: Two earthquakes in the north-west region of Turkey destroyed 80% of the houses and schools in Duzce in 1999. This study was conducted to determine the parasitic infection rate associated with the post-earthquake unhealty living conditions and related epidemiological risk factors. Methods: Two populations living and studying in different socioeconomic conditions as a result of the earthquake were compared: Group 1 (study group) consisted of 326 children living and studying in transitory houses and classes. Group 2 (control) consisted of 127 children living in normal houses and studying in normal school classes. Fecal samples were obtained from both groups and examined for intestinal parasites' eggs and trofozoid forms. In addition, selotype procedure was applied to both populations. Epidemiological data determining the socioeconornic status of the populations were collected by questionnaire. Results: In group 1, Giardia lamblia (G. lamblia) cysts were observed in 10.4% of the fecal samples and Enterobius vermicularis (E. vermicularis) eggs were observed in 13.5% of selotype samples. In group 2, Giardia cysts were observed in 3.1% of the samples and E. vermicularis eggs were observed in 5.5% of selotype samples. The rate of Giardiasis and Enterobiasis was found to be significantly higher in children still living and studying in temporary houses and schools years after the earthquakes (P < 0.05). The following pidemiological and social factors arising after the earthquakes were associated with increased rate of G. lamblia and E. Vermicularis infections: number of communal toilets per child at school, socioeconomic level of the children, dimensions of the classrooms where the children are studying and living and frequency of hand-washing at school. These parameters are significantly different between the groups (P < 0.05). Conclusion: Giardiasis should be considered as an emerging disease in postdisaster situations and adequate prevention measures should be implemented in these circumstances. It should also be known that the rate of Enterobiasis is increased in populations living in crowded unhealthy conditions.Öğe An Outbreak of Oropharyngeal Tularemia with Cervical Adenopathy Predominantly in the Left Side(Yonsei Univ College Medicine, 2009) Şencan, İrfan; Şahin, İdris; Kaya, Demet; Öksüz, Şükrü; Özdemir, Davut; Karabay, OğuzPurpose: We describe the epidemiological and clinical characteristics and the efficacy of a delayed initiation to therapy in an oropharyngeal tularemia outbreak in Duzce, Turkey. Materials and Methods: Between March and June 2000, 22 patients with tularemia were diagnosed by microagglutination tests. Results: Oropharyngeal and ulceroglandular forms of the disease were discovered. Most of the cases were oropharyngeal (19 cases). The most common symptoms were sore throat (95.4%) and fever (90.9%). Lymphadenopathy (95.4%) and pharyngeal hyperemia (81.8%) were usually observed signs. The lymphadenopathies were localized especially in the left cervical region (66.7%), a finding that has not been previously reported in the literature. The time between the onset of the symptoms and diagnosis was 40.7 +/- 22.8 (10-90) days. The patients were treated with streptomycin plus doxycycline and ciprofloxacin. The patients' recoveries took up to 120 days. Conclusion: This report describes the first outbreak of tularemia in northwest Turkey. Tularemia may occur in any region where appropriate epidemiological conditions are found and should be kept ill mind for differential diagnosis in oropharyngeal symptoms. Late initiation of therapy may delay complete recovery. In this outbreak, cervical lymph nodes predominantly localized on the left side were found, which had not been previously reported.Öğe Phospholipase and proteinase activities in different Candida species isolated from anatomically distinct sites of healthy adults(Natl Inst Infectious Diseases, 2007) Öksüz, Şükrü; Şahin, İdris; Yıldırım, Mustafa; Gülcan, Aynur; Yavuz, Tevfik; Kaya, Demet; Koç, Ayşe NedretThe aim of the present study was to determine in vitro phospholipase and protease activities in 122 Candida spp. isolated from several anatomically distinct sites of healthy adults. C. albicans (66.4%) was the most frequently isolated Candida spp. C. glabrata (7.3%), C. tropicalis (6.3%) and C. kefyr (4.9%) were the most frequently isolated non-C. albicans Candida spp. Fifty (40.9%) of the isolates examined were phospholipase positive and 64 (52.4%) were protease positive. Forty-three (53.8%) of the C. albicans isolates tested were phospholipase producers-however, only a few strains of non-C. albicans Candida spp. behaved in the same way. Protease activity was detected in 46 (56.7%) of the C. albicans strains tested and in a few strains of non-C. albicans Candida spp. The levels of phospholipase and protease activities in commensal isolates were found to be lower than the levels of other enzyme activities previously reported in clinical Candida spp. isolates. The phospholipase activity of Candida spp. was found to be higher in oral (59.0%) and fecal (42.8%) isolates. The protease activity of Candida spp. was found to be higher in urogenital (55.1%) and skin (58.8%) isolates. We conclude that further investigations will be needed on the phospholipase and protease activity of Candida spp. in healthy subjects in order to clarify their contribution to fungal virulence.Öğe Prevalence of Toenail Onychomycosis in Patients with Type 2 Diabetes Mellitus and Evaluation of Risk Factors(Amer Podiatric Med Assoc, 2011) Gülcan, Aynur; Gülcan, Erim; Öksüz, Şükrü; Şahin, İdris; Kaya, DemetBackground: We sought to determine the frequency of toenail onychomycosis in diabetic patients, to identify the causative agents, and to evaluate the epidemiologic risk factors. Methods: Data regarding patients' diabetic characteristics were recorded by the attending internal medicine clinician. Clinical examinations of patients' toenails were performed by a dermatologist, and specimens were collected from the nails to establish the onycomycotic abnormality. All of the specimens were analyzed by direct microscopy and culture. Results: Of 321 patients with type 2 diabetes mellitus, clinical onychomycosis was diagnosed in 162; 41 of those diagnoses were confirmed mycologically. Of the isolated fungi, 23 were yeasts and 18 were dermatophytes. Significant correlations were found between the frequency of onychomycosis and retinopathy, neuropathy, obesity, family history, and duration of diabetes. However, no correlation was found with sex, age, educational level, occupation, area of residence, levels of hemoglobin A(1c) and fasting blood glucose, and nephropathy. The most frequently isolated agents from clinical specimens were yeasts. Conclusions: Long-term control of glycemia to prevent chronic complications and obesity and to promote education about the importance of foot and nail care should be essential components in preventing onychomycosis and its potential complications, such as secondary foot lesions, in patients with diabetes mellitus. (J Am Podiatr Med Assoc 101(1): 49-54, 2011)Öğe Synthesis and antimicrobial activity of 4-phenyl/cyclohexyl-5-(1-phenoxyethyl)-3-[N-(2-thiazolyl)acetamido]thio-4H-1,2,4-triazole derivatives(Elsevier France-Editions Scientifiques Medicales Elsevier, 2005) Zitouni, Gülhan Turan; Kaplancıklı, Zafer Asım; Yıldız, Mehmet Taha; Chevallet, Pierre; Kaya, DemetThe increasing clinical importance of drug-resistant fungal and bacterial pathogens has lent additional urgency to microbiological research and new antimicrobial compound development. For this purpose, new thiazole derivatives of triazoles were synthesized and evaluated for antifungal and antibacterial activity. The reaction of propionic acid hydrazides with various aryl/alkyl isothiocyanates gave thiosemicarbazides which furnished the mercaptotriazoles by alkali cyclization. The 4-phenyl/cyclohexyl-5-(1-phenoxyethyl)-3-[N-(2-thiazolyl)acetainido]thio-4H-1,2,4-triazole derivatives were synthesized by reacting the mercaptotriazoles with 2-chloi-o-N-(2-thiazolyl)acetamide. The chemical structures of the compounds were elucidated by IR, H-1-NMR, FAB(+)-MS spectral data. Their antimicrobial activities against Candida albicans (two strains), Candida glabrata, Escherichia coli, Staphylococcus aureus, Pseudomonas aeruginosa were investigated. The results showed that some of the compounds have very strong antifungal activity. (c) 2005 Elsevier SAS. All rights reserved.
