Person: ERTÜRK ŞENGEL, BUKET
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ERTÜRK ŞENGEL
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BUKET
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Publication Open 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 consideredPublication Open 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.Publication Metadata only 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.Publication Metadata only Outcomes of Fecal Carriage of Extended-spectrum beta-Lactamase After Transrectal Ultrasound-guided Biopsy of the Prostate(ELSEVIER SCIENCE INC, 2014) ERTÜRK ŞENGEL, BUKET; Tigen, Elif Tukenmez; Tandogdu, Zafer; Ergonul, Onder; Altinkanat, Gulsen; Gunaydin, Bilal; Ozgen, Mahir; Sariguzel, Nevin; Sengel, Buket Erturk; Odabasi, Zekaver; Cek, Mete; Tokuc, Resit; Turkeri, Levent; Mulazimoglu, Lutfiye; Korten, VolkanOBJECTIVE To determine the prevalence of extended-spectrum beta-lactamase (ESBL)-producing Enterobacteriaceae (PE) fecal carriage in patients that undergo transrectal ultrasonography-guided biopsy (TRUSbx) and its relationship with post-biopsy infections. METHODS A prospective clinical study in 4 different tertiary hospitals between 2008 and 2010 was conducted. Four hundred men with sterile urine who were to undergo a TRUSbx because of the suspicion of prostate cancer were included and followed for 14 days after biopsy. Rectal swab culture specimens were acquired immediately before the procedure. Demographic data, prophylaxis choice, quinolone or any other antibiotic consumption within the past 2 months, history of prostatitis, repeat biopsy, intensive care unit admission, hospitalization, urethral catheterization, diabetes mellitus (DM), and steroid usage were recorded. RESULTS ESBL carriage was detected in 19% of patients and quinolone use within the last 2 months; other antibiotic use within the last 2 months and DM were found to be significantly associated (P < .05). Symptomatic urinary tract infection (UTI) on the third day after biopsy was seen in 9% of patients and was associated with fluoroquinolone (FQ) consumption before biopsy. Although ESBL-PE carriage was associated with post-biopsy UTI symptoms, it was not found to be associated with post-biopsy symptomatic UTI. Urosepsis was seen in 2 patients (0.5%) after biopsy, and both the patients were ESBL-PE carriers. CONCLUSION The presence of ESBL-PE was associated with DM and FQ consumption before biopsy. ESBL-PE carriage was associated with a high rate of post-biopsy UTI symptoms requiring further elucidation; however, it was not associated with microbiologically proven infections. FQ consumption before TRUSbx was also associated with post-biopsy infections. (C) 2014 Elsevier Inc.Publication Open Access Marmara Üniversitesi Pendik Eğitim ve ID_x000D_ Araştırma Hastanesi’nde 2014-2018 Yılları_x000D_ Arasındaki Kronik Hepatit C Prevalansı,_x000D_ Genotip Dağılımı ve Tedavi Yanıtları(2020) ERTÜRK ŞENGEL, BUKET; Betül ERTÜRK ŞENGEL;Tuğçe BAŞARI;Elif TÜKENMEZ TİGEN;Rabia CAN SARINOĞLU;Barış CAN;ULUHAN SİLİ;Volkan KORTENHepatit C dünyada yaygın olarak görülen ve mortaliteye neden olabilen ciddi bir hastalıktır.Bu çalışmada Marmara Üniversitesi Pendik Eğitim ve Araştırma Hastanesi’nebaşvuran hastalarda anti-HCV seropozitiflik sıklığının ve kronik viral hepatit C (HCV)tanısı konarak tedavi verilen hastaların genotip dağılımları ile tedavi başarılarınındeğerlendirilmesi amaçlanmıştır. Çalışmada retrospektif olarak Ocak 2014-Aralık 2018tarihleri arasında anti-HCV istemi yapılan serum örnekleri taranmıştır. Reaktif bulunanörneklerin HCV RNA pozitiflikleri ile genotip dağılımları ve kronik HCV tanısı ile tedaviverilen hastaların kalıcı viral yanıt başarı oranları değerlendirilmiştir. Total 76,413 hastadan100,100 serum örneğinde anti-HCV istemi yapılmış ve 1,808 (% 2,36) hastadapozitif bulunmuştur. Bu hastaların 1,286’sında (% 71) HCV RNA bakılmış ve 291 (% 23)hastada pozitif saptanmıştır. HCV RNA tespit edilen hastalarda 129’una (% 44) hastanemizdekronik HCV tanısı ile tedavi verilmiştir. En sık genotip 1b saptanmış olup, tedavisonrası 24’üncü haftada kalıcı viral yanıt hastaların % 87’sinde elde edilmiştir. Sonuçolarak antiviral tedavi ile virolojik başarı oranları yüz güldürücü olsa da halen tanı vetedavi alması gereken ancak tespit edilemeyen hasta sayısı da oldukça yüksektir.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 Clinical pharmacist-led medication reconciliation service in patients with infectious disease during COVID-19 pandemic(2021-10-29) ERTÜRK ŞENGEL, BUKET; SANCAR, MESUT; OKUYAN, BETÜL; KORTEN, VOLKAN; ENVER C., ERTÜRK ŞENGEL B., SANCAR M., KORTEN V., OKUYAN B.Publication Metadata only C. auris outbreak in COVID-19 intensive care unit(2022-04-26) ERTÜRK ŞENGEL, BUKET; TİGEN, ELİF; ODABAŞI, ZEKAVER; KORTEN, VOLKAN; ERTÜRK ŞENGEL B., TİGEN E., SAYIN E., SEVDALİYEVA A., ÇERİKÇİOĞLU N., CİNEL İ., KORTEN V., ODABAŞI Z.Publication Open Access Occupation-Related Injuries Among Healthcare Workers: Incidence, Risk Groups, and the Effect of Training(CUREUS INC, 2021-04-06) ERTÜRK ŞENGEL, BUKET; Sengel, Buket Erturk; Tigen, Elif Tukenmez; Bilgin, Huseyin; Dogru, Arzu; Korten, VolkanBackground and objective Occupation-related injuries (ORIs) are undesirable and harmful situations among healthcare workers (HCWs) and may have serious consequences. In this study, we aimed to identify and analyze ORI incidences, risk groups, and the outcomes of a training program to prevent them. Materials and methods Between January 2011 and December 2019, HCWs who applied for infection prevention and control (IPC) due to ORIs (percutaneous needlestick and sharp-object injury or contact with blood or body fluids) were included in the study. Their characteristic features, vaccine histories, injury types, viral serologies, and administered prophylaxis were recorded. After 2014, a periodic ORI training program was started. We used joinpoint regression analysis to compare the ORI incidences before and after the education program. Results During the nine-year study period, 965 ORIs were registered. The mean age of HCWs was 39.3 +/- 8.4 years, and 67.9% of them were female. The total injury incidence for all professions was 34.1 (95% CI: 33.1-37.5) per 1,000 HCWs. The injury incidences were significantly higher in nurses compared to other HCWs (p<0.01). Most of the injuries occurred in the ward setting (37%). HCWs were injured most commonly while administering treatment (36.7%). The trend analysis for the incidence of injuries showed no significant change throughout the study period. The trend in personal protective equipment (PPE) use showed a significant increase (annual percentage change: 1.7, p<0.01). Conclusions The major finding of this study with respect to its implication on the healthcare system is that nurses are an important risk group for ORIs. Although the ORI incidence did not change during the study period, a significantly increased use of appropriate PPE following a systematic training program implementation was observed.Publication Open Access Determination of fosfomycin susceptibility in carbapenemase-producing K. pneumoniae strains isolated prior to clinical use of the intravenous formulation in Turkey(MARMARA UNIV, FAC MEDICINE, 2021-05-25) ERTÜRK ŞENGEL, BUKET; Altinkanat Gelmez, Gulsen; Can, Baris; Erturk Sengel, Buket; Korten, Volkan; Soyletir, GunerObjectives: The incidence of infections caused by carbapenem-resistant Enterobacteriaceae has increased worldwide. Limitations in the development of new antimicrobial agents have led clinicians to reconsider the clinical efficiency of old antibiotics, such as intravenous formulation of fosfomycin, in the treatment of multidrug-resistant Gram-negative bacterial infections. We investigated the fosfomycin susceptibility of carbapenemase-producing Klebsiella pneurnoniae strains isolated prior to the clinical use of the intraveno US formulation of fosfomycin in Turkey. Materials and Methods: A total of the 155 K. pneurnoniae isolates which previously characterized at the molecular level for their carbapenemase were included in this study. The minimum inhibitory concentration of fosfomycin was determined by the agar dilution method. Results: Overall, 65.1% of the isolates were susceptible to fosfom ycin. The MIC50 and MIC90 values were 32 and 256 mg/L, respectively. According to our results, at least two-third of carbapenemase-positive K. pneumoniae are susceptible to fosfomycin. Conclusions: Although, the susceptibility of fosfomycin, which has just been put into the clinical use of intravenous formulation in Turkey, is not very high, it can be considered as an alternative adjunct antimicrobial for the treatment of systemic infections caused by carbapenentase-positive K. pneumoniae isolates.