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    ANTIMICROBIAL SUSCEPTIBILITY OF ENTEROBAKTERIACEA SPECIES CAUSING COMMUNITY ACQUIRED URINARY TRACT INFECTION: A RETROSPECTIVE STUDY
    (Aves, 2007) Eroglu, Muzaffer; Kocoglu, Esra; Karabay, Oguz; Semercioz, Atilla
    Introduction: The rates of antibiotic resistance in common pathogenic bacteria have been increasing due to high and unnecessary antibiotic use. It can vary according to geographical and regional location. But little is known about the epidemiology of community-acquired antibiotic resistant enterobacteriacea spices in our region. The aim of this study is to assess the antimicrobial susceptibility of enterobacteriacea spices causing community-acquired urinary tract infection in our region. Materials and Methods: Medical records of AIBU microbiology laboratory from August 2004 to August 2006 were retrospectively reviewed to identify all adult patients with community acquired urinary tract infection (UTI). Patients, who had more than three episodes of UTI in the last year, hospitalization in the last month, pregnancy and those with upper UTI were excluded. Susceptibility testing for urinary tract isolates was performed if there were >= 100,000 colonies per milliliter. The resistance rates of ampicilline, ciprofloxacine, gentamisin, amikacin, nitrofurantoin and SXT were investigated by Kirby-Bauer disk diffusion technique. Antibacterial susceptibility testing was performed according to the Clinical and Laboratory Standards Institute criteria's (CLSI). Results: During the study period, 3575 urine samples were analyzed and the mean age was 47.2 years (range: 17-74). The overall female to male ratio was 4.8. A total of 305 patients were excluded due to contamination and 697 (21.3%) bacterial isolates were examined in the study. E. coli was the most causative agent (87.1%) and it was followed by Klebsiella pneumonia with a percentage of 9.6%. Highest and lowest antibiotic resistance to Escherichia coli was ampicillin (41%) and nitrofurantoin (0.05%), respectively. Conclusion: Resistance rates of SXT and kinolons are increasing in every day due to high and widespread antibiotic usage. In our region nitrofurantoin and amikacin may be better empiric choices in patients with community-acquired UTI, because their resistance rates are only 0.05% and 3.5%, respectively. Although nitrofurantoin has maintained excellent activity against almost all E. coli strains causing UTI, it is not active against some strains of Enterobacter, Klebsiella and most strains of Proteus species. Urine culture and antimicrobial susceptibility should be essential in the treatment of UTI. Antibiotic resistance rates are changing in every region. Physicians must be educated continuously about the antibiotic resistance and they should know the local antibiotic resistance rates in order to prescribe appropriate antibiotics. Local infection control guidelines must be prepared in every year.
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    Effect of Inhaler Budesonide on Nasal and Oropharyngeal Carriage of Staphylococcus aureus in Asthma Patients
    (Bilimsel Tip Publishing House, 2007) Talay, Fahrettin; Karabay, Oguz; Yilmaz, Fahrettin; Kocoglu, Esra
    We aimed to investigate the effect of inhaler budesonide spray that was used for one month to treat asthma on nasal and oropharyngeal carriage of Staphylococcus aureus. Fourty two asthma patients (32 female, 10 male) and 42 healthy control groups (33 female, 9 male) were accepted for this study. Oropharyngeal cultures were obtained from asthmatics admitted to the outpatient clinic of chest disease, before and after one- month 800 g/day inhaler budesonide therapy, evaluated for nasal and oropharyngeal carriage for S. aureus and compared with one single culture that was obtained from healthy controls. Three nasal and four oropharyngeal cultures were found to be positive for S. aureus in pretreatment cultures, and 4 nasal and 4 oropharyngeal cultures were positive after treatment. Five nasal and two oropharyngeal cultures were positive for S. aureus in control group. There was no difference in nasal and oropharyngeal S. aureus colonization in asthmatics before treatment compared to controls, and after treatment compared to pretreatment values (p > 0.05). There was no relationship between nasal and oropharyngeal colonization of S. aureus and gender, age, smoking, presence of atopy, and the degree of the illness in three groups (p > 0.05). We thought that the orally used inhaler steroid, budesonide which was administered to treat asthmatic do not affect the colonization of S. aureus in the nose and oropharynx.
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    ESCHERICHIA COLI SEPSIS THAT DEVELOPED AFTER PROSTATE NEEDLE BIOPSY IN A PATIENT UNDER CIPROFLOXACIN PROPHYLAXIS
    (Aves, 2006) Karabay, Oguz; Kocoglu, Esra; Uysal, Blent; Metin, Ahmet
    Introduction: Transrectal prostate biopsy (TPB) is frequently used for diagnosis in urological practice and complications such as hematuri, pain, voiding difficulty, asymptomatic bacteriurea, urinary infection are reported to occur. Quinolons have been used safely for TPB prophylaxis for many years. However, increasing resistance to quinolons, similar to many other antibiotics, may cause many problems in these patients too. In this paper, we present a patient with septic shock that developed after TPB despite to adequate and reliable oral siprofloxacin prophylaxis.
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    Evaluation of psychiatric morbidity and quality of life in inactive HbsAg carriers
    (Academic Journals, 2011) Kucukbayrak, Abdulkadir; Canan, Fatih; Alcelik, Aytekin; Aktas, Gulali; Kocoglu, Esra; Tas, Tekin
    Hepatitis B virus (HBV) infection develops in forms from asymptomatic carrier to cirrhosis. There are several studies examining the quality of life of patients with HBV in literature. However, only two studies have investigated the psychiatric morbidity in hepatitis B patients. In this study, we evaluated psychiatric morbidity and quality of life in inactive HbsAg carriers. This case-controlled study was performed among 26 healthy volunteers as control group and 31 inactive HbsAg carriers. Seven (22.5%) of our Hepatitis B patients were found to have an Axis I psychiatric diagnosis. For the carriers, the diagnoses made were major depression (3 patients), major depression with conversion disorder (1 patient), moderate depressive disorder (1 patient), cyclothymic disorder (1 patient), and obsessive-compulsive disorder (1 patient). No significant difference was found between carriers and controls in terms of quality of life scores and anxiety and depression scores. According to these findings, the patients with hepatitis should undergo psychiatric evaluation by a specialist. Also, physicians should be aware that emotional and psychiatric support is not necessary for all of the patients with hepatitis B.
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    Investigating the Relationship Between HBV DNA Levels and HBV Serological Markers
    (Galenos Yayincilik, 2013) Kocoglu, Esra; Tas, Tekin; Mengeloglu, Firat Zafer; Karabork, Seyda; Ceylan, Kubra
    Objective: In this study, it is aimed to investigate the relationship between the HBV DNA positivity and serological markers such as HBsAg, HBeAg and anti-HBe in patients with acute or chronic hepatitis. Materials and Methods: Data of 574 patients whose serum specimens were processed in microbiology laboratory between march 2010 and july 2012 were retrospectively analysed. Results: In the study, HBV DNA was detected in 44.8% of HBsAg-positive, in 67.1% of HBeAg-positive and in 35.9% of anti-HBE-positive patients. HBV DNA was detected in 61.2% of the patients both of whose HBsAg and HBeAg were positive. However, HBV DNA was positive in one of 29 patients (3.4%) who had negativity of both HBsAg and HBeAg. DNA positivity was 6.3% in HBsAg-negative patients and 37.7% in HBeAg-negative ones. In the study, HBeAg was negative in 79.4% of HBV DNA-positive patients; anti-HBeAg was negative in 17.7% of DNA-positive patients. DNA levels were found significantly high in HBeAg-positive patients (p<0.001) as well as DNA levels were significantly high in anti-HBenegative ones (p<0.001). Conclusion: In conclusion, serological markers may be insufficient either in diagnosis of HBV infection or in determining the viral replication. In this study, it is observed that evaluating those tests together is useful in laboratory diagnosis.