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KORTEN, VOLKAN

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    PublicationOpen Access
    A rare Case of otitis media-associated polymicrobial anaerobic meningitis and brain abscess
    (2021-12-01) ERTÜRK ŞENGEL, BUKET; TİGEN, ELİF; OLUÇ, YUSUF; ÜLGER, NURVER; KORTEN, VOLKAN; ERTÜRK ŞENGEL B., TİGEN E., YILDIZ F., OLUÇ Y., ÜLGER N., KORTEN V.
    Otitis media-associated complications are widespread when it is not treated with appropriate antimicrobial treatment. Meningitis and brain abscess are the most reported intracranial complications of otitis media, usually caused by the direct spread of organisms from the contagious site. While anaerobic microorganisms are well-known in brain abscesses, they are not common in meningitis. When the clinical history and pathogenesis of otitis mediaassociated meningitis are combined, special methods to identify and cover anaerobic pathogens should be considered
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    Susceptibility of bacterial isolates from Turkey - A report from the Meropenem Yearly Susceptibility Test Information Collection (MYSTIC) Program
    (TAYLOR & FRANCIS LTD, 2007) KORTEN, VOLKAN; Eraksoy, H.; Basustaoglu, A.; Korten, V.; Kurt, H.; Ozturk, R.; Ulusoy, S.; Yaman, A.; Yuce, A.; Zarakolu, P.
    The study monitored the susceptibility of nosocomial pathogens to meropenem and comparator antimicrobial agents isolated as part of the Meropenem Yearly Susceptibility Test Information Collection (MYSTIC) Program from Turkish university hospitals. In terms of minimum inhibitory concentration 90% (MIC90) values, meropenem was two- and eight-fold more active than imipenem against Escherichia coli and Klebsiella pneumoniae, respectively. 40.5% of K. pneumoniae, 23.1% of Klebsiella oxytoca and 15.3% of E. coli isolates were extended-spectrum P-lactamase (ESBL) producers. Piperacillin/tazobactam was the most active agent against isolates of Pseudomonas aeruginosa, followed by meropenem and imipenem. Against Acinetobacter baumannii isolates, meropenem and imipenem were the most active agents. Continued surveillance by the MYSTIC Program appears to be prudent to help focus on effective empiric treatment regimens.
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    PublicationOpen Access
    An outbreak investigation of Burkholderia cepacia infections related with contaminated chlorhexidine mouthwash solution in a tertiary care center in Turkey
    (BMC, 2021-12) GÜL, FETHİ; Bilgin, Huseyin; Gelmez, Gulsen Altinkanat; Bayrakdar, Fatma; Sayin, Elvan; Gul, Fethi; Pazar, Nazli; Culha, Gulcan; Yildiz, Serap Suzuk; Cinel, Ismail; Korten, Volkan
    Background: We report a nosocomial outbreak caused by Burkholderia cepacia that occurred among six patients admitted in the medical and surgical intensive care unit between 04 March 2019 and 02 April 2019 in Istanbul, Turkey. Methods: The outbreak investigation was launched on 11 March 2019 five days after the detection of B. cepacia in four different patients. We defined potential reservoirs and started environmental screening. We sampled the liquid solutions used in patient care activities. Pulse-field gel electrophoresis (PFGE) was performed to determine the genetic relatedness of environmental and patient samples. Results: Burkholderia cepacia was isolated in tracheal aspiration cultures of six patients. Three out of six patients developed healthcare-associated pneumoniae due to B. cepacia. Environmental cultures in the ICUs revealed B. cepacia growth in 2% chlorhexidine-gluconate mouthwash solution that been used in the colonized patients as well as in samples obtained from the unused products. PFGE revealed the patient and a specific batch of chlorhexidine mouthwash solution samples had a 96% similarity. Conclusion: Contamination of medical solutions used in critical patient care could cause outbreaks and should be detected early by infection control teams.
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    PublicationOpen Access
    Diagnostic performance between RT-PCR and chest CT in outpatients with clinically suspected COVID-19
    (2023-08-01) TİGEN, ELİF; ERTÜRK ŞENGEL, BUKET; ÇİMŞİT, CANAN; APAYDIN KAYA, MEMNUNE ÇİĞDEM; KORTEN, VOLKAN; TİGEN E., ERTÜRK ŞENGEL B., ÇİMŞİT C., PERK GURUN H., APAYDIN KAYA M. Ç., KORTEN V.
    Objective: To investigate the diagnostic performance between chest computed tomography (CT) and reverse transcription-polymerase chain reaction (RT-PCR) in outpatients with suspected coronavirus disease 2019 (COVID-19). Patients and Methods: Between March and June 2020, a total of 812 patients with clinically suspected COVID-19 who underwent both chest CT and initial-single RT-PCR on admission to outpatient units were retrospectively enrolled. CT severity-score (CT-SS) was calculated and data were matched with PCR results. Results: Of 812 patients, 54% (439/812) had positive RT-PCR results, and 47% (425/812) had a positive chest CT scan. With RT-PCR results as reference, the sensitivity, specificity, accuracy of chest CT in defining COVID-19 infection were 60%, (95% CI 56-65%, 265/439 patients), 57% (95% CI 52-62%, 213/373), 59% (95% CI 55-62%, 478/812), respectively. Three hundred eighty-seven (47%) patients had no CT findings, 380/812 (46.8%) had mild, 45/812 (5.5%) had moderate, and no patients in the severe group Conclusion: Chest CT did not show high sensitivity for the diagnosis of COVID-19 for outpatients. We suggest RT-PCR should be the primary diagnostic tool. Chest CT might be considered if there is a strong clinical suspicion with repeatedly negative RT-PCR test results, ensuring infection prevention and control measures can be preserved.
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    PublicationOpen 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, Tulin
    Hepatobiliary 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.
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    PublicationOpen Access
    A qualitative study of hand hygiene compliance among health care workers in intensive care units
    (J INFECTION DEVELOPING COUNTRIES, 2019-02-28) TEKER SAYIN, AYŞE GÜLSEN; Ay, Pinar; Teker, Ayse Gulsen; Hidiroglu, Seyhan; Tepe, Pinar; Surmen, Aysen; Sili, Uluhan; Korten, Volkan; Karavus, Melda
    Introduction: Studies indicate that adherence to hand hygiene guidelines is at suboptimal levels. We aimed to explore the reasons for poor hand hygiene compliance. Methodology: A qualitative study based on the Theory of Planned Behavior as a framework in explaining compliance, consisting four focus group discussions and six in-depth interviews. Results: Participants mostly practiced hand hygiene depending on the sense of dirtiness and cleanliness. Some of the participants indicated that on-job training delivered by the infection control team changed their perception of emotionally based hand hygiene to indication based. Direct observations and individual feedback on one-to-one basis were the core of this training. There was low social cohesiveness and a deep polarization between the professional groups that led one group accusing the other for not being compliant. Conclusions: The infection control team should continue delivering one-to-one trainings based on observation and immediate feedback. But there is need to base this training model on a structured behavioral modification program and test its efficacy through a quasi-experimental design. Increasing social cohesiveness and transforming the blaming culture to a collaborative safety culture is also crucial to improve compliance. High workload, problems related to work-flow and turnover should be addressed.
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    COVID-19 tanısı ile antikoagulasyon altında gelişeninfekte retroperitoneal hematom
    (2021-05-26) ERTÜRK ŞENGEL, BUKET; KORTEN, VOLKAN; Marku M., ERTÜRK ŞENGEL B., Çolak G. M. , KORTEN V.
    Amaç C.auris sağlık bakımı ilişkili infeksiyonlara neden olan, birçok antifungale dirençli son derece virülan bir mantardır. Sağlık merkezlerinde salgınlara neden olduğundan erken tanı konulması gerekli önlemlerin alınması bakımından çok önemlidir. Ancak standart laboratuvar teknikleri ile tanımlanması zordur ve spesifik yöntemler kullanılmazsa yanlış tanımlanabilir. Bu yazı COVID-19 tanısı ile yoğun bakımında yatmakta olan hastalarda nadir ve infeksiyon kontrol açısından büyük risk oluşturan C.auris üremelerini anlatmaktadır. Olgular Hastaların demografik ve klinik özellikleri Tablo 1’de özetlenmiştir. Tüm hastaların 60 yaşın üzerinde olması, öncesinde geniş spektrumlu antibiyotik ve steroid kullanım öyküleri olması dikkat çekmektedir. İntrakranial kanama nedeniyle opere edilen Olgu 1’in yara yeri ve Olgu 2’nin ise genital bölge sürüntüsünde C.auris üremesi olmuştur ve etken olarak kabul edilmemişlerdir. Olgu 5’in ise inguinal bölge sürüntü kültürlerinin yanı sıra periferik kan ve idrar kateter kültürlerinde de üreme olduğundan etken olarak kabul edilmiştir. Hastalara ait klinik örneklerden üretilmiş maya kolonileri MALDI-TOF MS (VITEK MS, V3.0, BioMérieux) kullanılarak % 99.9 identifikasyon skoru oranlarıyla C.auris olarak tanımlanmıştır. Olgu 4 halen yatmakta olup diğer tüm hastalar kaybedilmiştir. Sonuç Ülkemizde şimdiye kadar C.auris ile infekte olgu raporlanmamıştır. C. auris üremeleri, COVID-19 nedeniyle yoğun bakım yatışlarının uzaması, COVID-19 seyrinde kullanılan immunsupresif tedaviler ve geniş spektrumlu antibiyotik kullanımları gibi faktörlere bağlı olabilir. Etkenin doğru tanınması ve tedavinin erken başlanması mortalite açısından çok önemlidir. Olgularımız hem COVID-19 hastalarında hem de Türkiye’de bildirilen ilk C.auris vakaları olması nedeniyle dikkat çekici özellik taşımaktadır.
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    PublicationOpen Access
    Crimean-Congo Hemorrhagic Fever in Turkey
    (2004-08) KORTEN, VOLKAN; Karti, S. Sami; Odabasi, Zekaver; Korten, Volkan; Yilmaz, Mustafa; Sonmez, Mehmet; Caylan, Rahmet; Akdogan, Elif; Eren, Necmi; Koksal, Iftihar; Ovali, Ercument; Erickson, Bobbie R.; Vincent, Martin J.; Nichol, Stuart T.; Comer, James A.; Rollin, Pierre E.; Ksiazek, Thomas G.
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    PublicationOpen 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, Volkan
    Invasive 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.
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