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İLKİ, ZEYNEP ARZU

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ZEYNEP ARZU

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20202
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Author: AKSU, MEHMET BURAK × Has files: true ×

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    PublicationOpen Access
    Atypical Cell'' Parameter in Automated Urine Analysis for the Diagnosis of Bladder Cancer: A Retrospective Pilot Study
    (GALENOS YAYINCILIK, 2020-04-01) FİLİNTE, DENİZ; Tinay, Ilker; Sahin, Bahadir; Saracoglu, Sertac; Yanilmaz, Ozgur; Aksu, Mehmet Burak; Ayas, Ramazan; Filinte, Deniz; Cam, Haydar Kamil; Ilki, Arzu
    Objective: To evaluate the application of an automated urine analyzer (AUA) for the diagnosis of bladder cancer (BC) Materials and Methods: A retrospective data analysis of 2365 urine specimens from the department of urology has been performed and matched with those patients, who have undergone cystoscopic evaluation or surgical treatment for different urological pathologies during 2018. After matching, clinical records of the patients has been further evaluated in order to select patients with recent or previous BC diagnosis. To assess the diagnostic efficacy of AUA, patients were divided into five groups according to the patient history of BC and healthy controls. Results: A total of 106 patients are included in this study and the majority (69.8%) of the patients are follow-up patients with previous diagnosis and treatment of non-muscle invasive BC (NMIBC). For patients with low-risk NMIBC (n=27), the sensitivity and specificity were calculated as 75% and 100%. For patients with high-risk NMIBC (n=47), who were previously treated with intravesical BCG, the sensitivity and specificity were calculated as 54.5% and 83.3%. All patients in radical cystectomy group (n=7) with muscle invasive BC had positive urine analyses results for atypical cells. And none of the patients in the control group (n=8) had positive AUA results and cystoscopic evaluation also did not show any bladder mass suspicious for BC. Conclusion: The results of this retrospective pilot study showed acceptable sensitivity and specificity rates of the fluorescence flow cytometry based AUA and the results of the low-risk group are especially valuable regarding its potential use to decide on performing a follow-up cystoscopy or not. A prospective study is currently on progress to validate the findings of the current study.
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    PublicationOpen Access
    An alternative for urine cultures: Direct identification of uropathogens from urine by MALDI-TOF MS
    (AKADEMIAI KIADO ZRT, 2020-10-21) ALTINKANAT GELMEZ, GÜLŞEN; Ilki, Arzu Aksit; Ozsoy, Sevim; Gelmez, Gulsen; Aksu, Burak; Soyletir, Guner
    Urinary tract infections are one of the most common bacterial infections and rapid diagnosis of the infection is essential for appropriate antibiotic therapy. The goal of our study was to identify urinary pathogens directly by MALDI-TOF MS and to perform antibiotic susceptibility tests in order to shorten the period spent for culturing. Urine samples submitted for culture to the Clinical Microbiology Laboratory were enrolled in this study. Urine samples were screened for leukocyte and bacteria amount by flow cytometry. Samples with bacterial load of 10(6)-10(7)/mL were tested directly by MALDI-TOF MS and antibiotic susceptibility tests (AST) were performed. In total, 538 positive urine samples were evaluated in our study. MALDI-TOF MS identified the microorganism directly from the urine sample in 91.8% of these samples and the concordance rate of conventional identification and direct detection was 95.8% for Gram-negatives at the genus and species level. Escherichia coli (n:401) was the most frequently isolated microorganism, followed by Klebsiella pneumoniae (n:57). AST results were generated for 111 of these urine samples and the concordance was 90% and 87% for E. coli and K. pneumoniae, respectively. Our results showed that screening of urine samples with flow cytometry to detect positive samples and identification of uropathogens directly by MALDI-TOF MS with an accuracy of over 90% can be a suitable method particularly for Gram-negative bacteria in clinical microbiology laboratories.