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TİGEN, ELİF

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2020 - 202428
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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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    Drug eruption: A mimicker of Coronavirus disease-2019 rash
    (2022-01-01) ERGUN, SAFİYE ATLAS TÜLİN; SEVEN, SEDA; SEÇKİN GENÇOSMANOĞLU, DİLEK; TİGEN, ELİF; AKTAŞ, MERYEM; ERGUN S. A. T., Ergenc I., SEVEN S., SEÇKİN GENÇOSMANOĞLU D., CÖMERT ÖZER E., AKTAŞ M., TİGEN E.
    Severe acute respiratory syndrome-coronavirus-2 (SARS-CoV-2) infections can be associated with several cutaneous lesions, among which maculopapular rash is the most common. A maculopapular rash can also be induced by medications used for Coronavirus disease-2019 (COVID-19) treatment. The distinction between viral rash and drug eruption may be difficult especially in case of several medication use for COVID-19. Thus, this study aimed to describe cutaneous manifestations in six patients with COVID-19 and highlight dues for distinguishing SARS-CoV-2-related rash and drug eruption. Between March and June 2020, 1,492 patients were hospitalized for COVID-19 and treated with hydroxychloroquine in Marmara University Hospital. Among them, six cases were consulted for possible COVID-19-related rash or drug reaction. Hydroxychloroquine was given as monotherapy in one patient. All six patients developed an erythematous, symmetrical, and maculopapular eruption that mainly affected the trunk, axilla, and genitocrural region, 5-21 days after the onset of COVID-19 symptoms. Five patients developed rash in 4-11 days after treatment completion. Pruritus was severe. All were treated with topical corticosteroids and oral antihistamines, which provided partial relief. The resolution of the eruption was typically slow, which took a few weeks. A long period between the COVID-19 symptoms and the eruption, as well as slow recovery, is in favor of drug eruption. The effects of co-existent viral infection, a well-known promoting drug eruption factor, in facilitating adverse drug reaction in patients with COVID-19 needs further observations and research.
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    PublicationOpen Access
    Favipiravir Use in Kidney Transplant Recipients with COVID-19: A Single-Center Experience
    (2022-02) TİGEN, ELİF; Kaya, Burcu; Barutcu Atas, Dilek; Tukenmez Tigen, Elif; Asicioglu, Ebru; Arikan, Hakki; Tuglular, Serhan; Velioglu, Arzu
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    PublicationOpen 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 KORTEN
    Hepatit 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.
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    Prevalence of HIV-associated neurocognitive disorder (HAND) in Turkey and assessment of Addenbrooke's Cognitive Examination Revised (ACE-R) test as a screening tool
    (WILEY, 2021) TİGEN, ELİF; Korten, V; Ay, U.; Hari, E.; Tigen Tukenmez, E.; Gencer, S.; Akca Kalem, S.; Demirtas Tatlidede, A.; Gurvit, I. H.
    Objectives We aimed to assess the Addenbrooke's Cognitive Examination Revised (ACE-R) and three questions (3Qs, European Aids Clinical Society Guidelines) as potential screening tools for HIV-associated neurocognitive disorder (HAND). In addition, we tried to determine the prevalence and associated factors for HAND among people living with HIV (PLWH) in Turkey. Methods Persons living with HIV were enrolled from two teaching hospitals between March 2018 and September 2018. Participants underwent screening tools, a neuropsychological test battery (NTB) and an assessment of activities of daily living. HAND was diagnosed according to Frascati's criteria and applying the Global Deficit Score (GDS) approach. A receiver operating characteristic (ROC) curve analysis was performed to compare the predictive accuracy of ACE-R to that of the NP test battery. Factors associated with HAND were evaluated using multivariate logistic regression analysis. Results The study sample included 162 participants (94% male). The HAND prevalence was 45.7% [asymptomatic neurocognitive impairment (ANI), 37.7%; mild neurocognitive disorder (MND), 7.4%; HIV-associated dementia (HAD), 0.6%] according to the Frascati criteria and 31.5% (ANI, 25.9%; MND, 4.9%; HAD, 0.6%) using the GDS. In the ROC analysis, the ACE-R showed an area under the curve of 0.68 at a cut-off score of 89. The sensitivity, specificity and correct classification rate of screening tests for HAND diagnosis were as follows: ACE-R (62.2%, 67%, 64.8%) and 3Qs (10.8%, 88.6%, 53%). In multivariate analysis, only education level (adjusted odds ratio [aOR] = 0.84, 95% CI: 0.76-0.92,P <= 0.001) was an independent risk factor for HAND. Conclusions HAND is a common comorbidity in PLWH in Turkey. The sensitivities and specificities of 3Qs and the ACE-R as screening tools are lower than desired.
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    Rectal colonization with multidrug-resistant gram-negative bacteria in patients with hematological malignancies: a prospective study
    (TAYLOR & FRANCIS LTD, 2020) TİGEN, ELİF; Komurcu, Burak; Tukenmez Tigen, Elif; Toptas, Tayfur; Firatli Tuglular, Tulin; Korten, Volkan
    Objectives To investigate the risk factors for rectal colonization with carbapenem-resistantEnterobacteriaceae(CRE) and extended-spectrum ss-lactamase-producingEnterobacteriaceae(ESBL-E) in hematological malignant patients with febrile neutropenia (FN); rate of rectal colonization and infection/colonization with CRE and ESBL-E; whether empirical treatment can be revised. Methods Adult patients receiving chemotherapy were included. Rectal swab cultures of patients were screened for CRE and ESBL-E using selective chromogenic agars. Results Fifty-seven FN episodes of 57 patients were studied. Rectal colonization rates were 40.4% (23/57) and 8.8% (5/57) for ESBL-E and CRE, respectively. ESBL-E bacteremia was diagnosed in 2 (8.6%) ESBL-E colonized patients, while CRE bacteremia was detected in 1 (20%) CRE colonized patient. Amikacin (100%) and carbapenem (93%) were the most effective antibiotics against gram-negative enteric bacteria. Beta-lactam usage within the last 3 months was a significant risk factor for ESBL-E colonization. Conclusions For the treatment of FN patients either colonized with ESBL-E or having significant risk factors for ESBL-E infection, aminoglycoside containing combinations may become an alternative to carbapenems due to their high sensitivity rates. When CRE colonized hematological cancer patients develop FN or if they are hemodynamically unstable, CRE covering empiric antibiotherapy should be preferred due to high mortality rates of CRE bacteremia.
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    PublicationOpen Access
    The Impact of C Reactive Protein in _x000D_ Prediction of the Outcome in Infective _x000D_ Endocarditis
    (2021-04-30) TİGEN, ELİF; Serap ŞİMŞEK YAVUZ;Sibel DOĞAN KAYA;Denef BERZEG DENİZ;Elif TÜKENMEZ TİGEN;Serpil ÖZTÜRK;Şirin MENEKŞE;Mutlu Şeyda ÖCALMAZ;Seniha BAŞARAN;Ayfer ŞENSOY;Yeşim UYGUN KIZMAZ;Ezgi ÖZBEK;Haluk ERAKSOY
    Objective: A simple and widely available test is needed to monitor the response to the treatment and predict adverse outcomes in patients with infective endocarditis (IE). We aimed to detect the role of C-reactive protein (CRP) level in the prognosis of IE.Materials and Methods: The patients diagnosed as probable or definite IE between 2015 and 2016 from five medical centers were included in the study. Clinical and laboratory features of the patients recorded on previously prepared forms retrospectively. Comparison of CRP levels between survived and dead patients were made by repeated-measures variance analysis. Receiver operating characteristic (ROC) curves at baseline, the first, second, third and fourth week of antimicrobial treatment were constructed to explain the ability of CRP level to predict mortality. Multivariate analysis was performed to predict the risk factors for mortality. Results: In total, 111 cases of IE were included. Serum CRP levels were higher in patients with mortality at every measurement. Comparing baseline CRP, lower than a double or triple decrease of serum CRP level at the third or fourth week of treatment or any increase under treatment were related to mortality. According to the ROC curve analysis, the highest overall accuracy in death prediction was at the fourth week CRP level (c=0.74); the CRP level of ≥50 mg/L was 86% sensitive and 78% specific to predict mortality. The presence of chronic renal failure (OR 14.386) and the fourth week CRP level (OR 1.016) were independent risk factors in terms of mortality. Conclusion: Being an easily performed and widely available test, CRP is a useful tool to follow up the response to the treatment and predict outcome among patients with IE. In the fourth week of treatment, a CRP level of ≥50 mg/L should be regarded as an alarming sign of poor outcome and should lead to investigation and appropriate management of complications.
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    PublicationOpen Access
    Cryptococcus meningitis presented with multiple cerebral infarcts in an immunocompetent patient
    (ELSEVIER SCI LTD, 2021) ERTÜRK ŞENGEL, BUKET; Sengel, Buket Erturk; Tigen, Elif Tukenmez; Sarinoglu, Rabia Can; Midi, Ipek; Cerikcioglu, Nilgun; Odabasi, Zekaver
    Cryptococcus neoformans is generally observed with immunosuppressive conditions. Rarely, it may be seen in immunocompetent individuals and presented with non-specific conditions. We described an immunocompetent case of cryptococcal meningitis presented with multiple cerebral infarcts. Despite the late diagnosis and emergence of hydrocephalus during treatment, the patient was recovered without any sequelae. In immunocompetent patients, the conventional diagnostics tests may be negative because of the low fungal load. If it is available, the Biofire FilmArray meningitis panel has high sensitivity and specificity for diagnosis. (C) 2021 The Authors. Published by Elsevier Ltd.
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    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.