Person: BİLGİLİ, BELİZ
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BİLGİLİ
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BELİZ
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Publication Open Access Reduction of nosocomial infections in the intensive care unit using an electronic hand hygiene compliance monitoring system(2021-12-01) GÜL, FETHİ; YAKUT, NURHAYAT; BİLGİLİ, BELİZ; KASAPOĞLU, UMUT SABRİ; ARSLANTAŞ, MUSTAFA KEMAL; KEPENEKLİ KADAYİFCİ, EDA; Akkoc G., Soysal A., GÜL F., KEPENEKLİ KADAYİFCİ E., Arslantas M. K., Yakut N., BİLGİLİ B., Demir S. O., Haliloglu M., Kasapoglu U. S., et al.Introduction: Healthcare-associated infection is an important cause of mortality and morbidity worldwide. Well-regulated infection control and hand hygiene are the most effective methods for preventing healthcare-associated infections. This study evaluated and compared conventional hand hygiene observation and an electronic hand-hygiene recording and reminder system for preventing healthcare-associated infections. Methodology: This pre-and post-intervention study, employed an electronic hand-hygiene recording and reminder system for preventing healthcare-associated infections at a tertiary referral center. Healthcare-associated infection surveillance was recorded in an anesthesia and reanimation intensive care unit from April 2016 to August 2016. Hand-hygiene compliance was observed by conventional observation and an electronic recording and reminder system in two consecutive 2-month periods. healthcare-associated infections were calculated as incidence rate ratios. Results: The rate of healthcare-associated infections in the electronic hand-hygiene recording and reminder system period was significantly decreased compared with that in the conventional hand-hygiene observation period (incidence rate ratio = 0.58; 95% confident interval = 0.33-0.98). Additionally, the rate of central line-associated bloodstream infections and the rate of ventilator-associated pneumonia were lower during the electronic hand hygiene recording and reminder system period (incidence rate ratio= 0.41; 95% confident interval = 0.11-1.30 and incidence rate ratio = 0.67; 95% confident interval = 0.30-1.45, respectively). Conclusions: After implementing the electronic hand hygiene recording and reminder system, we observed a significant decrease in healthcare-associated infections and invasive device-associated infections. These results were encouraging and suggested that electronic hand hygiene reminder and recording systems may reduce some types of healthcare-associated infections in healthcare settings.Publication Open Access Renal Resistive Index is Unsusceptible to Systemic Hemodynamics in Fluid Responsive Critically III Patients(GALENOS YAYINCILIK, 2019-11-12) BİLGİLİ, BELİZ; Gul, Fethi; Bilgili, Beliz; Arslantas, Mustafa Kemal; Ayhan, Secil Ozcan; Cinel, IsmailObjective: The primary goal of fluid resuscitation in critically ill patients is to improve oxygen delivery to ensure adequate organ perfusion. Little evidence is known about renal response to fluids in the acute phase, so renal monitoring after the fluid challenge is fundamental during critical care stay. This study aimed to evaluate changes in the renal resistive index (RRI) and to compare these changes with hemodynamic parameters after fluid challenge in fluid responsive critically ill patients. Materials and Methods: Thirty patients older than 18 years who underwent sedation and received mechanical ventilation were prospectively studied. Twenty patients were fluid responsive and were included in the study. An increase of cardiac output (CO) by 10% or more after PLR measured by ultrasonic CO monitor suspected fluid responsiveness. 500 mL of isotonic solution was administered intravenously for 30 minutes. CO measurements were performed at 0, 1 and 30 minutes. RRI and mean arterial pressure (MAP) were measured by Doppler ultrasonography at 0 and 30 minutes. Repeated measures ANOVA method was used for statistical analysis and p<0.05 was considered significant. Results: CO increased significantly after fluid challenge when compared to baseline (from 3.48 +/- 1.14 to 4.34 +/- 1.43 L/min, p<0.001). MAP increased significantly after fluid administration when compared to baseline (80 +/- 19 to 86 +/- 17, p=0.002). RRI did not significantly differ from baseline after fluid challenge (62 +/- 9 to 60 +/- 10, p=0.11). There was a negative correlation between RRI and MAP at baseline and after fluid challenge. Conclusion: The effect of hemodynamic changes on renal perfusion after fluid challenge is controversial. In our study, 500 mL of crystalloid treatment for 30 minutes increased MAP and CO, but did not contribute to the improvement of RRI in patients who were fluid responsive. We found that fluid challenge did not improve RRI in the early phase of the fluid resuscitation in fluid responsive critically ill patients and RRI is unsusceptible to systemic hemodynamic changes during this period.Publication Open Access Sequential Measurements of Pentraxin 3 Serum Levels in Patients with Ventilator-Associated Pneumonia: A Nested Case-Control Study(HINDAWI LTD, 2018) BİLGİLİ, BELİZ; Bilgin, Huseyin; Haliloglu, Murat; Yaman, Ali; Ay, Pinar; Bilgili, Beliz; Arslantas, Mustafa Kemal; Ozdemir, Filiz Ture; Haklar, Goncagul; Cinel, Ismail; Mulazimoglu, LutfiyePurpose. The main purpose of this study was to investigate the dynamics of pentraxin 3 (PTX3) compared with procalcitonin (PCT) and C-reactive protein (CRP) in patients with suspicion of ventilator-associated pneumonia (VAP). Materials and Methods. We designed a nested case-control study. This study was performed in the Surgical Intensive Care Unit of a tertiary care academic university and teaching hospital. Ninety-one adults who were mechanically ventilated for >48 hours were enrolled in the study. VAP diagnosis was established among 28 patients following the 2005 ATS/IDSA guidelines. Results. The median PTX3 plasma level was 2.66 ng/mL in VAP adults compared to 0.25 ng/mL in non-VAP adults (p < 0.05). Procalcitonin and CRP levels did not significantly differ. Pentraxin 3, with a 2.56 ng/mL breakpoint, had 85% sensitivity, 86% specificity, 75% positive predictive value, and 92.9% negative predictive value for VAP diagnosis (AUC = 0.78). Conclusions. With the suspicion of VAP, a pentraxin 3 plasma breakpoint of 2.56 ng/mL could contribute to the decision of whether to start antibiotics.Publication Metadata only Comparing the accuracy of predictors of mortality in ventilator associated pneumonia(2016-04-20) BİLGİLİ, BELİZ; KASAPOĞLU, UMUT SABRİ; CİNEL, İSMAİL HAKKI; HALİLOĞLU M., BİLGİLİ B., KASAPOĞLU U. S., SAYAN İ., SÜZER ASLAN M., YALÇIN A., CİNEL İ. H.Publication Metadata only BACTERIAL BURDEN OF THYROID SHIELDS(CARBONE EDITORE, 2017) BİLGİLİ, BELİZ; Bilgili, Beliz; Cizmeci, Zeynep; Erkilinc, Mehmet; Kural, Alev; Tanriverdi, Bulent; Bilgili, Mustafa GokhanIntroduction: The aim of this study was to assess the role of thyroid shield as an infection source in operation room and to evaluate the effectiveness of the sterilization method that is routinely used in the institution. Materials and methods: Samples were obtained from the front faces of 14 thyroid shields using swabs humidified with sterile normal saline. After sampling, shields were cleansed, disinfected and sampling was repeated after 5 minutes. Microorganisms growing in the media were passaged and typed individually and their sensitivity to antibiotics was determined. Growing microorganisms in cultures were compared. Results: At least one pathogenic bacterium was isolated from 13 of the 14 thyroid shields sampled prior to their disinfection. Corynebacterium spp. and methicillin-resistant Staphylococcus epidermidis were most frequently isolated. More than one pathogenic bacterium was isolated from four thyroid shields, and methicillin-resistant microorganisms were isolated from eight thyroid shields. After disinfection, bacterial growth was observed only on two thyroid shields. Conclusion: Thyroid shields are liable to bacterial colonization. In surgical procedures performed under fluoroscopic guidance, appropriate disinfection of thyroid shields before every use is an efficient method for reducing bacterial burden.Publication Metadata only Dirençli septik şokta desmopressin(2015-12-06) BİLGİLİ, BELİZ; KASAPOĞLU, UMUT SABRİ; CİNEL, İSMAİL HAKKI; HALİLOĞLU M., BİLGİLİ B., KASAPOĞLU U. S., SAYAN İ., ÇİFTÇİ M., CİNEL İ. H.Publication Open Access MSC transplantation in eight severe covid-19 patients: can cytokine storm be reversed(2020-05-01) BİLGİLİ, BELİZ; Bilgili B.Background: In this clinical case report, we evaluated the clinical and the efficacy outcomes of Mesenchymal Stem Cells (MSCs) transplantation in eight severe COVID-19 patients with pneumonia Methods: MSCs were administered to eight severe/critically severe patients, unresponsive to treatment algorithms patients were also reviewed without MSC transplantation. Results: could not achieve clinical improvement and passed away. In all eight patients, compared to the baseline, there was a significant decrease in CRP (p=0.036), fibrinogen (p=0.012) and Hb (p=0.03) values on post treatment day 5. While there was an increase in lymphocyte count between baseline and post treatment, the change didn’t reach statistical significance (p=0.06). There was no statistically significant change in ferritin, neutrophil count, respiratory rate, oxygen saturation, troponin and platelet count (p>0.05) between baseline and post-treatment day 5. Conclusion: Four patients were discharged from the ICU after MSC transplantation. Although there was an immediate significant improvement in their prognostic markers, the other four patients remained in critically severe condition and passed away. In two severe patients, the recovery was faster after MSC transplantation than the other two critically severe recovered patients. This may indicate the potential benefit of MSC transplantation performed in an earlier clinical stage. Moreover, we can advise MSC transplantation when the poor prognostic markers (decrease in lymphocyte number, increase in fibrinogen and CRP) are observed in the severe COVID-19 patients, to overcome alveolar damage due to “cytokine storm.” This observation may introduce an algorithm for a supportive treatment with MSC transplantation for COVID-19 patients, which needs to be confirmed by broader randomized controlled trials.Publication Metadata only Yoğun bakım ünitesinde konvelesan plazma kullanımının covid-19 hastalarında mortalite üzerindeki etkisi(2022-03-17) GÜL, FETHİ; BİLGİLİ, BELİZ; CİNEL, İSMAİL HAKKI; Sabah M. S., Gül F., Bilgili B., Kaplan S. T., Oktay B. D., Cinel İ. H.Publication Metadata only The Assessment of Intravascular Volume with Inferior Vena Cava and Internal Jugular Vein Distensibility Indexes in Children Undergoing Urologic Surgery(TAYLOR & FRANCIS INC, 2018) BİLGİLİ, BELİZ; Bilgili, Beliz; Haliloglu, Murat; Tugtepe, Halil; Umuroglu, TumayPurpose: The purpose of this work is to assess the predictive value, for fluid responsiveness (FR), of the inferior vena cava distensibility index (IVC-DI) and internal jugular vein distensibility index (IJV-DI) in pediatric surgical patients. Material and Methods: Prior to being placed under general anesthesia, 24 surgical patients were enrolled. Baseline parameters were recorded with the patient in the semirecumbent position (Stage 1). Next, the passive leg raising (PLR) maneuver was carried out and a second measurement was recorded (Stage 2). Patients with an increase in the cardiac index (CI) of >10%, induced by PLR, were considered to be responders (R), otherwise they were classified as nonresponders (NR). At both stages, CI and DI of the IVC and IJV were measured. Results: Responders had higher IVC-DI and IVJ-DI than NR in stage 1 (both p <.001). In stage 2, IVC-DI and IJV-DI were not different in R and NR groups (p =.164, p =.201). Utilizing cut-off values of > 22.7% for IVC-DI and > 25% for IJV-DI, these parameters had positive correlation coefficients, both in R and NR of, respectively, 0.626 and 0.929. Conclusions: The IVC-DI predicts FR in anesthetized pediatric patients and correlates well with the IJV-DI; both may be used as prediction markers of FR in children.Publication Open Access Vitamin D level is associated with mortality predictors in ventilator-associated pneumonia caused by Acinetobacter baumannii(J INFECTION DEVELOPING COUNTRIES, 2016-06-30) BİLGİLİ, BELİZ; Haliloglu, Murat; Bilgili, Beliz; Haliloglu, Ozlem; Yavuz, Dilek Gogas; Cinel, IsmailIntroduction: Vitamin D plays a role in host defense and is known to be associated with mortality in patients in the intensive care unit (ICU). We aimed to evaluate the relationships between vitamin D levels and predictors of mortality in patients with ventilator-associated pneumonia (VAP) caused by extensively drug-resistant Acinetobacter baumanii (XDR A. baumanii). Methodology: A retrospective single-center study was conducted in an 18-bed adult ICU of a teaching hospital, including all patients with VAP due to XDR A. baumanii. Levels of 25(OH) D, procalcitonin (PCT), C-reactive protein (CRP), n-terminal pro-BNP (NT-proBNP), as well as clinical scores (Sequential Organ Failure Assessment [SOFA], Acute Physiology And Chronic Health Evaluation [APACHE II], Clinical Pulmonary Infection Score [CPIS) were recorded. Results: Forty-for patients were studied over six months. All patients had vitamin D deficiency. The 28-day mortality in patients with 25(OH) D levels <= 10 ng/mL was higher than in patients with 25(OH) D > 10ng/mL (p = 0.001). The fourth-and seventh-day SOFA scores (p=0.04 and p=0.001) and first-and fourth-day procalcitonin levels (p = 0.03 and p = 0.004) were higher in patients with 25(OH) D levels <= 10 ng/mL. The clinical scores (SOFA, CPIS, and CEPPIS) and biomarkers (NT-proBNP, PCT) were negatively correlated with 25(OH) D levels in all study groups. Conclusions: Severe vitamin D deficiency was associated with adverse outcome in VAP due to XDR A. baumanii. Vitamin D levels may be a prognostic predictor of VAP. It is also important to evaluate the effect of rapid vitamin D replacement on mortality.