Person: KORTEN, VOLKAN
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KORTEN
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VOLKAN
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Publication Open Access Miliary Tuberculosis Induced Acute Liver Failure(HINDAWI LTD, 2015) BİLGİN, HÜSEYİN; Toptas, Tayfur; Ilhan, Birkan; Bilgin, Huseyin; Dincses, Elif; Ozdogan, Osman; Kaygusuz-Atagunduz, Isik; Odabasi, Zekaver; Korten, Volkan; Firatli-Tuglular, TulinHepatobiliary tuberculosis is uncommon even in endemic countries. It is associated with a high mortality and is even diagnosed early in the disease course. Acute liver failure (ALF) caused by tuberculosis bacilli has been reported in only a few reports. All previous cases have been diagnosed by postmortem examination. Time to antituberculosis treatment is very critical. In case of suggestive findings on clinical and radiologic examination, antituberculosis treatment should be initiated immediately. Drug use can be a challenge in patients with ALF. However, as long as the other possible causes of ALF can be excluded and hepatotoxic drugs were avoided during the early course of treatment, such a highly fatal presentation of tuberculosis can be treated safely. Here, we report a case of acute liver failure as a presentation of miliary tuberculosis. He was treated successfully with antituberculosis treatment.Publication Open Access Successful treatment of an invasive fungal infection caused by Talaromyces sp. with voriconazole(ELSEVIER SCIENCE BV, 2015-06) BİLGİN, HÜSEYİN; Sili, Uluhan; Bilgin, Huseyin; Masania, Rikesh; Eryuksel, Emel; Cimsit, Nun I. Cagatay; Ayranci, Gulcicek; Richardson, Malcolm; Korten, VolkanInvasive fungal infections (lFl) are on the rise due to increasing numbers of immunosuppressed and critically ill patients. A malignant-looking pulmonary nodule in an immunosuppressed patient may indeed be caused by a fungal organism. We report a patient, who was eventually diagnosed with an IFI caused by an agent of hyalohyphomycosis, Talaromyces sp determined via molecular methods and succesfully treated with voriconazole. (C) 2015 The Authors, International Society for Human and Animal Mycology Published by Elsevier B.V.Publication Open Access The need for an antibiotic stewardship program in a hospital using a computerized pre-authorization system(ELSEVIER SCI LTD, 2019-05) ERTÜRK ŞENGEL, BUKET; Sengel, Buket Erturk; Bilgin, Huseyin; Bilgin, Beyza Oren; Gidener, Tolga; Saydam, Simge; Pekmezci, Aslihan; Ergonul, Onder; Korten, VolkanObjectives: Antimicrobial stewardship programs (ASPs) have an important role in the appropriate utilization of antibiotics. Some of the core strategies recommended for ASPs are pre-authorization and prospective audit and feedback. In Turkey, a unique nationwide antibiotic restriction program (NARP) has been in place since 2003. The aim of this study was to measure the effect of a prospective audit and feedback strategy system along with the NARP. Methods: A prospective quasi-experimental study was designed and implemented between March and June 2017. A computerized pre-authorization system was used as an ASP strategy to approve the antibiotics. During the baseline period, patients with intravenous (IV) antibiotic use >= 72 h were monitored without intervention. In the second period, feedback and treatment recommendations were given to attending physicians in the case of IV antibiotic use >= 72 h. The modified criteria of Kunin et al. and Gyssens et al. were followed for appropriateness of prescribing. Days of therapy (DOT) and length of stay (LOS) were calculated and compared between the two study periods. Results: A total of 866 antibiotic episodes among 519 patients were observed. A significant reduction in systemic antibiotic consumption was observed in the intervention period (575 vs. 349 DOT per 1000 patient-days; p < 0.001). On multivariate analysis, prospective audit and feedback (odds ratio 1.5, 95% confidence interval 1.09-2.04; p = 0.011) and pre-authorization of restricted antibiotics (odds ratio 1.7; 95% confidence interval 1.2-2.31; p = 0.002) were the predictors of appropriate antimicrobial use. Mean LOS was decreased by 2.9 days (p = 0.095). Conclusions: This study showed that the antimicrobial restriction program alone was effective, but the system should be supported by a tailored ASP, such as prospective audit and feedback. (C) 2019 The Author(s). Published by Elsevier Ltd on behalf of International Society for Infectious Diseases.Publication Open Access Hand hygiene knowledge, perception and practice of healthcare workers in a Turkish university hospital intensive care unit(J INFECTION DEVELOPING COUNTRIES, 2019-08-31) BİLGİN, HÜSEYİN; Sili, Uluhan; Ay, Pinar; Bilgin, Huseyin; Hidiroglu, Seyhan; Korten, VolkanIntroduction: While improvement of hand hygiene (HH) compliance is considered as the best approach to reduce healthcare-associated infections, the instructional interventions in HH among healthcare workers of intensive care unit (ICU) of our hospital was not successful enough. The following study was conducted to evaluate HH knowledge, perception, practice and effectiveness of the trainings among healthcare workers of ICU in our hospital. Methodology: A cross-sectional study was conducted in the ICU containing 8 medical and 16 surgical beds with 284 filled questionnaires about HH knowledge and 1187 observed opportunities for HH compliance. Results: Overall observed HH compliance rate was 40.6%; lowest compliance was 21.7% for before clean/aseptic procedure indication and highest compliance was 68.6% for after touching a patient indication. Although > 90% healthcare workers correctly identified the World Health Organization's five indications for HH, 82 -85% failed to recognize non-indications, i.e. when it was not necessary to perform HH. Our study showed that 15.1% of healthcare workers neither received nor felt the need for HH training. Conclusions: Despite regular HH trainings, healthcare workers could not differentiate when HH was not required which suggested failure to understand HH rationale. This may explain poor HH compliance rates. A systematic study is needed in order to find out the reasons behind of this noncompliance and improve HH training methods for educating healthcare workers.Publication Metadata only Risk factors, characteristics, and outcomes of candidemia in an adult intensive care unit in Turkey(MOSBY-ELSEVIER, 2017) ÖZBEN SADIÇ, BESTE; Tigen, Elif Tukenmez; Bilgin, Huseyin; Gurun, Hande Perk; Dogru, Arzu; Ozben, Beste; Cerikcioglu, Nilgun; Korten, VolkanThirty-six patients with candidemia and 37 control patients were included consecutively to determine the characteristics of candidemia episodes. The patients with candidemia had higher mortality with higher Sequential Organ Failure Assessment scores and frequency of use of a central venous catheter, total parenteral nutrition, and broad-spectrum antibiotics; chronic renal failure with replacement therapy; and longer stay in an intensive care unit. Candida albicans was the predominant species followed by Candida glabrata, Candida tropicalis, and Candida parapsilosis. All isolates of C glabrata were itraconazole-resistant. (C) 2017 Association for Professionals in Infection Control and Epidemiology, Inc. Published by Elsevier Inc. All rights reserved.