Browsing by Author "Ozel, Ayse Serra"

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Detection of Candida (Candidozyma) Auris by Molecular Methods and Investigation of Clinical Symptoms of Patients in a Tertiary Hospital in Istanbul
(K Faisal Spec Hosp Res Centre, 2025) Akkaya, Yuksel; Erdin, Begum Nalca; Aydin, Irfan; Ozel, Ayse Serra; Yilmaz, Ahmet Munir; Cilkiz, Mustafa; Toraman, Zulal Asci
BACKGROUND: Candidozyma auris is resistant to many antifungals, spreads rapidly and causes deaths in patient groups with comorbid factors. OBJECTIVES: The aim of this study was to determine the virulence of C. auris, antifungal resistance genes and clinical characteristics of the patients. DESIGN: Retrospective cohort SETTING: Single-center MATERIAL AND METHODS: This study was conducted between August 2022 and December 2023 at & Uuml;mraniye Training and Research Hospital. ITS1-5.8S-ITS2 and ITS1-ITS4 gene regions of the rDNA gene of C. auris isolates identified by VITEK MS v.3.2 were amplified by polymerase chain reaction (PCR) method. These regions were partially sequenced using the Sanger method. The presence of C. aurisspecific CDR1, ERG11, MDR1, ACT1, SAP5, HYR3, ALS5, IFF4, FUR1, PLB3, PGA26 and PGA52 gene regions were determined by PCR. Antifungal susceptibility testing of C. auris was performed with VITEK 2 Compact AST YS08 and SYO. MAIN OUTCOME MEASURES: Variations in C. auris isolates, antifungal resistance and clinical characteristics of patients SAMPLE SIZE: Forty-four isolates from 31 patients RESULTS: According to gene regions, nine different variations were identified in our hospital, with VAR-1 being the most common. Twenty-five (80.6%) of the patients died and isolation of the causative agent was between days 1-30 in 13 (41.9%) patients. Antibiotic use, ICU admission rate, and central venous catheter use in patients were 29 (93.6%), 28 (90.3%), and 21 (67.7%), respectively. Hypertension, diabetes mellitus (DM) and septic shock were found in 14 (45.2%), 13 (41.9%) and 10 (32.3%) patients, respectively. Antifungal resistance rates of the isolates were determined as 97.7% and 84.1% for amphotericin B and fluconazole, respectively. No resistance to micafungin and caspofungin was detected. The survival rate with echinocandin use was 22% (4 patients). CONCLUSION: Identification of gene regions is valuable in determining the pathogenicity of C. auris. . Due to the presence of comorbidi- ties in patients with C. auris, , it is not possible to determine the exact proportion of deaths attributable to C. auris alone. LIMITATIONS: Single center setting; gene regions could not be ex- pressed.
Citation - WoS: 2
Citation - Scopus: 2
Hepatitis B Immunization Data of Patients Living With Hiv/Aids: a Multi-Centre Study
(Natl inst Public Health, 2022) Ozturk, Servet; Ozel, Ayse Serra; Ergen, Pinar; Senbayrak, Seniha; Agalar, Canan
Objectives: Human immunodeficiency virus (HIV) and hepatitis B virus (HBV) are the two leading viruses that cause the greatest number of virus-related morbidities in the world. HIV/HBV coinfection is correlated with high morbidity and mortality. For this particular reason hepatitis B vaccination is crucial for people living with HIV. Methods: Patients who are being followed-up for HIV/AIDS and who have received a hepatitis B vaccine in 4 HIV clinics over a 5-year time period have been studied. Our multi-centered, retrospective, cross-sectional and observational study investigates factors that affect hepatitis B vaccination immune response of individuals living with HIV. The patients have been studied for the parameters such as age, sex, CD4 count at the time of diagnosis or vaccination, HIV-RNA levels, comorbidities, vaccine dosage, success of immunization after vaccination, and the demographics of the patients who have and have not developed immunity. Results: Of 645 patients that are being followed-up in our clinics, 158 received hepatitis B vaccine; 39 of these 158 patients have been excluded from the study because they did not fulfil the inclusion criteria. Finally, 119 patients were evaluated in the study, 17 of the patients (14.3%) were females and 102 (85.7%) were males. The median age was 41.11 +/- 10.09 (min-max: 18-75). Twenty-three of the patients (19.3%) were at the stage of AIDS during diagnosis while 80.7% were at the stage of HIV infection. Ninety-one of the patients (76.5%) have been administered a single dose hepatitis B vaccine on the standard 0, 1st, 6th month vaccination schedule, whereas 23.5% were administered a double dose on the same vaccination schedule. When further evaluated to find whether the patient was able to develop sufficient immunity (anti-HBs >= 10), it was found that the immune response was statistically significantly higher in the patients whose CD4 count was greater than 200 at the time of the first diagnosis and vaccination (p = 0.05 and p = 0.001, respectively). The patients have also been evaluated according to the number of doses they received (1 vs. 2). The immune response of the patients who received two doses was statistically significantly higher (p = 0.041). Conclusion: We can conclude that in the patients with CD4 count less than 200 at the time of their diagnosis and vaccination a high dose recombinant hepatitis B vaccine should definitely be administered as the normal dose and higher dose have similar side effect profiles and the higher dose provides greater immunity.