Person: DURMUŞOĞLU, LÜTFİYE
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DURMUŞOĞLU
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LÜTFİYE
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Publication Metadata only Can Legionnaires disease be diagnosed by clinical criteria? A critical review(ELSEVIER, 2001) DURMUŞOĞLU, LÜTFİYE; Mulazimoglu, L; Yu, VLPublication Open Access Community-acquired Klebsiella pneumoniae bacteremia: Global differences in clinical patterns(CENTER DISEASE CONTROL, 2002-02) DURMUŞOĞLU, LÜTFİYE; Ko, WC; Paterson, DL; Sagnimeni, AJ; Hansen, DS; Von Gottberg, A; Mohapatra, S; Casellas, JM; Goossens, H; Mulazimoglu, L; Trenholme, G; Klugman, KP; McCormack, JG; Yu, VLWe initiated a worldwide collaborative study, including 455 episodes of bacteremia, to elucidate the clinical patterns of Klebsiella pneumoniae. Historically, community-acquired pneumonia has been consistently associated with K. pneumoniae. Only four cases of community-acquired bacteremic K. pneumoniae pneumonia were seen in the 2-year study period in the United States, Argentina, Europe, or Australia; none were in alcoholics. In contrast, 53 cases of bacteremic K. pneumoniae pneumonia were observed in South Africa and Taiwan, where an association with alcoholism persisted (p=0.007). Twenty-five cases of a distinctive syndrome consisting of K. pneumoniae bacteremia in conjunction with community-acquired liver abscess, meningitis, or endophthalmitis were observed. A distinctive form of K. pneumoniae infection, often causing liver abscess, was identified, almost exclusively in Taiwan.Publication Metadata only Treatment of community-acquired pneumonia in hospitalised patients(Elsevier, 2001) DURMUŞOĞLU, LÜTFİYE; Mulazimoglu L.Community-acquired pneumonia (CAP) can be life-threatening. The prognosis is generally poorest in elderly patients and/or those with underlying chronic conditions, but fatalities can occur in all age groups. Current challenges in the clinical management of CAP are discussed, and the criteria for identifying those patients who should be treated in hospital with initial intravenous therapy are considered. Rapid initiation of therapy is important, using an agent that provides coverage against the most likely pathogens - Streptococcus pneumoniae and the atypical organisms. There is an increasing tendency to minimise the duration of intravenous therapy, with an early transition to oral therapy and the rapid return of the patient to the community. The efficacy of oral macrolides in the treatment of CAP is well established. Evidence for the use of intravenous azithromycin to provide effective and well-tolerated, first-line intervention in the hospitalized CAP patient is summarised. © 2001 Elsevier Science B.V. and International Society of Chemotherapy. All rights reserved.Publication Open Access A survey of antibiotic resistance in Streptococcus pneumoniae and Haemophilus influenzae in Turkey, 2004-2005(OXFORD UNIV PRESS, 2007-09-01) DURMUŞOĞLU, LÜTFİYE; Sener, Burcin; Tunckanat, Ferda; Ulusoy, Sercan; Tuenger, Alper; Soeyletir, Guener; Muelazimoglu, Luetfiye; Guerler, Nezahat; Oeksuez, Luetfiye; Koeksal, Iftihar; Aydin, Kemalettin; Yalcin, Ata Nevzat; Oeguenc, Dilara; Acar, Asli; Sievers, JoergObjectives: To determine the prevalence of antimicrobial resistance among Streptococcus pneumoniae and Haemophilus influenzae isolated in Turkey as part of Survey Of Antibiotic Resistance, a surveillance programme in the Africa and Middle East region examining the antimicrobial susceptibility of key bacterial pathogens involved in community-acquired respiratory tract infections (CARTIs). Methods: Susceptibility was evaluated against a range of antimicrobial agents using disc diffusion and Etest methods. Results: Six centres in five cities collected 301 S. pneumoniae and 379 H. influenzae isolates between October 2004 and November 2005. Among S. pneumoniae, the prevalence of isolates with intermediate susceptibility (MICs 0.12-1 mg/L) and resistance to penicillin (MICs >= 2 mg/L) was 24.6% and 7.6%, respectively; there was a wide variation between cities (2.4% to 36.9% intermediate and 0% to 23.8% resistant phenotypes). Macrolide-azalide resistance rates exceeded those of penicillin resistance in all cities. Overall, 5.0% of isolates were co-resistant to penicillin and erythromycin and 10.0% were multidrug-resistant ( joint resistance to erythromycin, co-trimoxazole and tetracycline). Agents tested to which over 90% of countrywide S. pneumoniae isolates remained susceptible were amoxicillin/clavulanate ( 98.7%), chloramphenicol (94.7%) and cefprozil (90.6%). Overall, the percentage of H. influenzae isolates producing beta-lactamase was 5.5%, differing widely across the country with the highest prevalence of b-lactamase production detected in Trabzon (14.0%) and no beta-lactamase-positive isolates found in Izmir. H. influenzae had the highest per cent susceptibility to amoxicillin/clavulanate (99.5%) and ofloxacin (99.2%) while > 20% were resistant to co-trimoxazole. Conclusions: Prevalence of penicillin and macrolide-azalide resistance among S. pneumoniae appears to be on the increase in Turkey while overall beta-lactamase production in H. influenzae remains relatively low. To adequately monitor the spread of drug-resistant phenotypes among these two important CARTI pathogens, ongoing collection of resistance surveillance data isPublication Metadata only Characterization of biodegradable chitosan microspheres containing vancomycin and treatment of experimental osteomyelitis caused by methicillin-resistant Staphylococcus aureus with prepared microspheres(ELSEVIER SCIENCE BV, 2006) DURMUŞOĞLU, LÜTFİYE; Cevher, Erdal; Orhan, Zafer; Mulazimoglu, Lutfiye; Sensoy, Demet; Alper, Murat; Yildiz, Ayca; Ozsoy, YildizThe biodegradable chitosan microspheres containing vancomycin hydrochloride (VANCO) were prepared by spray drying method with different polymer:drug ratios ( 1: 1, 2:1, 3:1 and 4: 1). Thermal behaviour, particle size and distribution, morphological characteristics, drug content, encapsulation efficiency, in vitro release assessments of formulations have been carried out to obtain suitable formulation which shows sustained-release effect when implanted. Sterilized VANCO loaded microspheres were implanted to proximal tibia of rats with methicillin-resistant Staphylococcus aureus (MRSA) osteomyelitis. Intramuscular (IM) injection of VANCO for 21 days was applied to another group for comparison. After 3 weeks of treatment, bone samples were analysed with a microbiological assay. According to the results, encapsulation efficiency and yield of microspheres in all formulations were higher than 98% and 47%, respectively. Particle sizes of microspheres were smaller than 6 mu m. All microsphere formulations have shown sustained-release effect. In vitro drug release rate decreased due to the increase in polymer:drug ratio but no significant difference was seen between these results (p > 0.05). Based on our in vivo data, rats implanted VANCO-loaded chitosan inicrospheres and administered IM injection showed 3354 3366 and 52500 25635 colony forming, unit of MRSA in 1g bone samples (CFU/g), respectively. As a result, implanted VANCO-loaded microspheres were found to be more effective than IM route for the treatment of experimental osteomyelitis. (c) 2006 Elsevier B.V. All rights reserved.Publication Open Access An unusual native tricuspid valve endocarditis caused by Candida colliculosa(BLACKWELL PUBLISHING LTD, 2003-04) DURMUŞOĞLU, LÜTFİYE; Kaygusuz, I; Mulazimoglu, L; Cerikcioglu, N; Toprak, A; Oktay, A; Korten, VCandida colliculosa , which grew in blood cultures of a 71-year-old retired man with fever of unknown origin that had lasted for 7 months, in conjunction with transthoracic echocardiography, demonstrating a 20-mm vegetation, superior to the tricuspid valve, herniating into the right atrial cavity. The finding led to the diagnosis of fungal endocarditis. Fluconazole, 600 mg daily, was commenced for 8 days; followed by amphotericin B, 1 mg/kg daily. On the fourth day of the amphotericin B treatment, the patient underwent replacement of the infected tricuspid valve. Even though the initial postoperative period was relatively uncomplicated, the patient died after a gross aspiration on the 67th day of his hospital stay, despite aggressive cardiovascular support and antimicrobial therapy. This is the first report of a native tricuspid valve fungal endocarditis due to C. colliculosa or Torulaspora delbrueckii , which is not known to be a human pathogen.Publication Metadata only Preparation and characterisation of natamycin: gamma-cyclodextrin inclusion complex and its evaluation in vaginal mucoadhesive formulations(ELSEVIER SCIENCE INC, 2008) DURMUŞOĞLU, LÜTFİYE; Cevher, Erdal; Sensoy, Demet; Zloh, Mire; Mulazimoglu, LutfiyeNovel formulations of vaginal bioadhesive tablets were prepared where the natamycin was complexed with gamma-cyclodextrin (NT-gamma CyD)to increase the solubility and stability of NT in aqueous solutions and reduce the side effects of the drug without decreasing antimycotic activity. Favourable interactions between the NT and gamma CyD and formation of the 1:1 inclusion complex were observed. The MIC90 of both NT alone and NT-gamma CyD complexes were below 0.0313 mu g mL(-1), suggesting that complexation with gamma CyD has effectively increased the antimycotic activity of NT, thus indicating the clinical usefulness of NT-gamma CyD complexes. The sustained drug release of NT was achieved to over 8 h periods by altering the polymer component of formulations which was responsible for differences in water absorption and erosion behaviour of the tablets. Bioadhesion studies have clearly indicated that enhancement of mucoadhesion was achieved by inclusion of Carbopol (R) 934P and by tailoring the ratio of Carbopol (R) 934P in the formulation, a high mucoadhesion to vaginal mucosa can be achieved. Hence, the formation of complex between NT and gamma CyD and effective combination with polymers attain a bioadhesive and sustained release formulation of NT suitable for vaginal delivery and the effective treatment of Candida infections. (C) 2008 Wiley-Liss, Inc. and the American Pharmacists Association.Publication Metadata only Antibiotic prophylaxis in elective thoracic surgery: Cefuroxime versus cefepime(GEORG THIEME VERLAG KG, 2003) DURMUŞOĞLU, LÜTFİYE; Turna, A; Kutlu, CA; Ozalp, T; Karamustafaoglu, A; Maulazimoglu, L; Bedirhan, MABackground: Infection is one of the major morbidity factors after thoracic surgery. Although different prophylactic regimens have been used to prevent this complication, the ideal prophylactic agent, dose and duration of administration remain unknown. Methods: All patients included underwent elective lung resection. 102 selected patients consecutively scheduled for major thoracic surgery were enrolled in this study and randomized into either the cefuroxime group (n=50) or the cefepime group (n=52). Results: Twelve pathologic bacterium strains were isolated in the cefepime group, whereas only 5 pathogenic strains were isolated in the cefuroxime group; the difference was statistically significant (p=0.04). Two empyemas (3.8%) in the cefepime group were noted, while the cefuroxime group showed no cases of empyema (p=0.16). Overall infection rate (pneumonia + bronchopneumonia + empyema) were 14.0% and 26.7% in the cefuroxime and the cefepime groups, respectively (p=0.12). Using chest radiography, pulmonary infiltration was found to be more frequent in the cefuroxime group (p=0.002). Conclusion: Cefuroxime as a prophylactic agent in major thoracic surgical operations was marginally more effective than cefepime, and presented an additional cost advantage.Publication Open Access Antibiotic therapy for Klebsiella pneumoniae bacteremia: Implications of production of extended-spectrum beta-lactamases(OXFORD UNIV PRESS INC, 2004-07-01) DURMUŞOĞLU, LÜTFİYE; Paterson, DL; Ko, WC; Von Gottberg, A; Mohapatra, S; Casellas, JM; Goossens, H; Mulazimoglu, L; Trenholme, G; Klugman, KP; Bonomo, RA; Rice, LB; Wagener, MM; McCormack, JG; Yu, VLThe prevalence of extended-spectrum beta-lactamase (ESBL) production by Klebsiella pneumonia approaches 50% in some countries, with particularly high rates in eastern Europe and Latin America. No randomized trials have ever been performed on treatment of bacteremia due to ESBL-producing organisms; existing data comes only from retrospective, single-institution studies. In a prospective study of 455 consecutive episodes of Klebsiella pneumoniae bacteremia in 12 hospitals in 7 countries, 85 episodes were due to an ESBL-producing organism. Failure to use an antibiotic active against ESBL-producing K. pneumoniae was associated with extremely high mortality. Use of a carbapenem ( primarily imipenem) was associated with a significantly lower 14-day mortality than was use of other antibiotics active in vitro. Multivariate analysis including other predictors of mortality showed that use of a carbapenem during the 5-day period after onset of bacteremia due to an ESBL-producing organism was independently associated with lower mortality. Antibiotic choice is particularly important in seriously ill patients with infections due to ESBL-producing K. pneumoniae.Publication Metadata only Antibiotic Usage Policies(2007-01-01) DURMUŞOĞLU, LÜTFİYE; DURMUŞOĞLU L.