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  • Küçük Resim
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    Bruselloz şüpheli olgularda brusella seropozitifliğinin araştırılması: dört yıllık retrospektif bir değerlendirme
    (2019) Taner, Zeynep; Dinç, Harika Öykü; Demirci, Mehmet; Gareayaghi, Nesrin; Kurt, Aykut; Özbey, Doğukan; Kocazeybek, Bekir Sami
    Amaç: Brucella cinsi bakterilerle oluşan bruselloz, sistemik bir enfeksiyon hastalığı olup dünyanın birçok ülkesinde yaygın olarak saptanmakta ve ülkemizde de oldukça sık görülmektedir. Çalışmamızın amacı, İstanbul ve çevre illerdeki yerleşim bölgelerinden dört yıllık dönemde bruselloz kuşkusu ile merkezimize başvuran 6.045 olgudan alınan serum örneklerinde bruselloz serolojik göstergelerini retrospektif olarak değerlendirmek ve sonuçları yine merkezimizde 2005-2011 yılları arasında gerçekleştirilmiş çalışmanın verileriyle karşılaştırarak değişkenlikleri irdelemektedir. Yöntem: Çalışmamıza Mart 2013- Mart 2017 tarihleri arasında İstanbul Üniversitesi-Cerrahpaşa, Cerrahpaşa Tıp Fakültesi Hastanesi Tıbbi Mikrobiyoloji Laboratuvarı Seroloji/ELISA birimine gönderilen bruselloz şüpheli olgulara ait serum örnekleri dahil edilmiştir. Örneklerden Brucella Serum Aglütinasyon (SAT), Coombs’lu Wright (CT) ve Rose-Bengal (RB) testleri yapılmıştır. Bulgular: Dört yıllık değerlendirme sonucunda, bruselloz şüpheli 6045 olgunun 107 (%1.8)’si seropozitif, 5938 (%98.2)’i seronegatif bulunmuştur. Brusella seropozitif 107 olgunun 73 (%68.2)’ü RB ve SAT ile eş zamanlı pozitif bulunmuş, 34 (%31.7) olgu ise RB ve SAT test sonuçları arasında uyumsuzluk görülmesi nedeniyle, CT sonucuna göre brusella seropozitif olarak belirlenmiştir. Brusella seropozitiflik oranı kadınlarda (%58) erkeklere (%42) göre daha yüksek olsa da istatistiksel olarak anlamlı bir fark bulunmamıştır. Olguların %28’inde aile içi aynı kaynaktan bulaş, %48’inde kırsal kesimde yaşama öyküsü saptanmıştır. Sonuç: Verilerimizin retrospektif değerlendirmesi sonucunda, bu çalışmada İstanbul ve çevre illerinde saptadığımız bruselloz seropozitiflik oranı (%1.8), aynı merkezde bir önceki dönem elde edilen orana göre (%3) düşük bulunmuştur. Bruselloz seropozitifliğinin oransal düşüklüğünde, son yıllarda görsel ve yazılı iletişim araçlarındaki artışla hayvansal kaynaklı beslenme konusunda daha bilinçli ve hijiyen kurallarına uyan insan kitlelerindeki artışın rolü olabileceğini düşünmekteyiz.
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    Öğe
    Challenging Vavricka: questioning compatibility of the mandatory tetanus vaccination with ECHR
    (2024) Paksoy, Meliha Şermin; Taner, Zeynep
    The compatibility of mandatory vaccinations with human rights has become a very current issue with the COVID-19 pandemic and the Vavřička ruling by the European Court of Human Rights. This ruling has faced criticism for not conducting examinations related to disease and vaccines based on direct scientific evidence. In this analysis, an assessment will be made based on direct scientific evidence about tetanus and its vaccine. The prevailing reason for mandatory tetanus vaccination is to protect the health of the vaccinated individual. Competent adults have the right to refuse treatment. This rule also applies to preventive medical interventions, including tetanus vaccination. As a rule, parents are entitled to give consent for medical interventions on their children. If an immediate and serious threat permanently endangers the minor's life, medical intervention can be carried out against the parents' will. The limitation of parental autonomy is more disputed when the minor's life is not immediately threatened. With respect to tetanus vaccination as a preventive medical intervention, it does not eliminate an immediate and serious risk of harm. As a result, interference with the parent's discretion on tetanus vaccination as a preventive medical intervention should be evaluated for its compatibility with the current legal approach to medical interventions on minors and patient rights.
  • Küçük Resim
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    Çocukluk yaş grubu gastroenteritlerinde rotavirüs ve adenovirüs sıklığı: Ocak 2013-Aralık 2018 Cerrahpaşa Tıp Fakültesi verileri
    (2019) Dinç, Harika Öykü; Taner, Zeynep; Özbey, Doğukan; Gareayaghi, Nesrin; Sirekbasan, Serhat; Kocazeybek, Bekir Sami
    Amaç: Gastroenterit kuşkusu ile laboratuvarımıza Ocak 2013-Aralık 2018 yılları arasında rotavirüs ve adenovirüs antijen testi istenen hastalarda dışkı örneğinden antijen pozitifliğinin dağılımı ve demografik verilerle ilişkisinin retrospektif değerlendirilmesi amaçlanmıştır. Yöntem: Rotavirüs ve adenovirüs antijen varlığı dışkı örneklerinden immünokromatografik yöntem testi (RIDA Quick Rotavirüs/Adenovirus Combi, T-Biopharm, Almanya) kullanılmış olup, ticari kitin önerileri doğrultusunda çalışıldı. Bulgular: Çocuklarda 0-5 yaş arası 1.359 kişide rotavirüs, 1.270 kişide adenovirüs antijen taraması yapıldı. Test uygulanan tüm dışkı örneklerinin 194 (%14.3)’ünde rotavirüs antijeni, 39 (%3.1)’unda adenovirüs antijeni saptandı. Rotavirüs antijen pozitifliği en sık 0-1 yaş (n=141, %72.7) grubunda olup, mevsimsel olarak en sık kış aylarında saptandı. Adenovirüs antijen pozitifliği ise 0-24 ay yaş grubu (n=20, %51.3) arasında saptanmış olup, kış mevsimlerinde sık dağılım söz konusudur. Sonuç: Çocuklarda gastroenterit etkeni olarak en sık görülen rotavirüs, merkezimizden önceki döneme ait yapılan çalışmaya göre daha düşük oranda saptanmıştır. Adenovirüs ise; Türkiye’nin diğer bölgeleriyle aynı orana sahiptir
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    Enterotoksijenik bacteroides fragilis ve fusobacterium nucleatum bağırsak kolonizasyonunun kolorektal kanser ile ilişkisi: kolon biyopsileri ile yapılan bir olgu kontrol çalışması
    (2023) Öztürk Bakar, Yeşim; Demiryas, Süleyman; Kılınçarslan, Ayşe Ceylan; Demirci, Mehmet; Kepil, Nuray; Bakar, Murat Tuğberk; Taner, Zeynep; Tokuç, Edip; Ziyad, Muhuyedin Abdırahman; Taşkı, İhsan; Kocazeybek, Bekir Sami; Tokman, Hrisi Bahar
    In recent years, it has been shown that some bacteria may be associated with colorectal cancer (CRC). In this study, it was aimed to investigate the role of Fusobacterium nucleatum and enterotoxigenic Bacteroides fragilis (ETBF) in the etiology of CRC by comparing the amounts of these bacteria in colon biopsy tissues of patients with CRC and healthy individuals. The amounts of F.nucleatum and ETBF were determined by quantitative polymerase chain reaction (qPCR) in colon biopsy samples taken from 35 CRC and 35 healthy individuals, and the results were compared in the patient and control groups. The detection rate and amounts of F.nucleatum were found to be statistically significantly higher in tissues of female patients with CRC compared to male patients (p= 0.003, p= 0.013, respectively). There was no statistically significant difference between the tissues of female and male patients with CRC in terms of detection rate and amount of ETBF (p= 0.521, p= 0.515, respectively). It was found that in the 50-74 age group, the amount of ETBF was statistically significantly higher in women and men with CRC compared to the controls (p= 0.005, p= 0.047, respectively), while the amount of F.nucleatum was statistically significantly higher in female patients compared to controls. However, no difference was found between male patients and controls (p= 0.009, p= 0.083). It was determined that the detection rate and amount of F.nucleatum in the tissues of patients with CRC, regardless of age and gender, were not statistically different from the controls (p= 0.473, p= 0.995, respectively), however, the detection rate of ETBF and the amount of ETBF were found to be statistically significantly higher (p= 0.002, p= 0.004, respectively). It has been determined that ETBF can play a role in the etiology of CRC in both men and women, and F.nucleatum only in women, in the age range of 50-74 years, when routine screenings for CRC are performed.
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    Firmicutes/Bacteroidetes Ratio in the Gut Microbiota and IL-10, IL-6, IL-8, TLR2, TLR4, TLR5 Gene Expressions in Type 2 Diabetes
    (Clin Lab Publ, 2022) Bahar-Tokman, Hrisi; Demirci, Mehmet; Keskin, Fatma E.; Cagatay, Penbe; Taner, Zeynep; Ozturk-Bakar, Yesim; Ozyazar, Mucahit
    Background: The aim of this study was to determine the Firmicutes/Bacteroidetes ratio in the gut microbiota and IL-1 beta, IL-6, IL-8, TLR2, TLR4 and TLR5 gene expression levels in the blood of adult type 2 diabetes (T2D) patients and compare it with that of adult nondiabetic healthy controls (HC). Methods: Between May 2016 and April 2017, 99 T2D patients and 99 HCs were enrolled in the study. Bacteroidetes and Firmicutes levels were assessed from stool sample DNA and IL-1 beta, IL-6, IL-8, TLR2, TLR4, and TLR5 gene expression levels assesed from blood sample RNA via gPCR from both T2D patients and healthy controls. Results: The Firmicutes/Bacteroidetes ratio detected in the stool of type 2 diabetes patients was found to be higher with a statistically significant difference (p < 0.0001). Gene expression levels of IL-1 beta, IL-6, IL-8, TLR2, TLR4, and TLR5 were found to be upregulated. Conclusions: The highest upregulation was detected in IL-6 with 11 fold in T2D patients comparing with HCs. F/B ratio and gene expression levels were elevated in T2D patients. Firmicutes were positively correlated with studied gene expressions. A better understanding of the complex interaction between gut microbiota, environment, and diabetes will allow for more effective prevention and treatment strategies for T2D.
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    Investigation of isepamicin, chloramphenicol and minocycline sensitivity in carbapenem-resistant enterobacteriaceae
    (Aves, 2018) Karakullukçu, Asiye; Borsa, Barış Ata; Kuşkucu, Mert Ahmet; Bakır, Esra; Taner, Zeynep; Özalp, Veli Cengiz; Aygun, Gökhan
    Objective: In this study, we aimed to determine the resistance mechanisms of carbapenem-resistant Enterobacteriaceae (CRE), and evaluate the prospective alternative treatment options. Methods: Between October 2014 and July 2015, rectal swabs routinely obtained from hospitalized patients were included in the study. The isolated Gram-negative enteric bacteria were identified to the species level by using standard conventional microbiological methods. Determined carbapenem resistance in enteric bacteria was confirmed by using meropenem Etest (R) (bioMerieux, Marcy l'Etoile, France), and the resistance mechanisms were investigated with MAST-ID (TM) Discs (Mast Diagnostics Ltd, Bootle, Merseyside, UK). Antibiotic susceptibilities of the CRE were determined by disk diffusion method using isepamicin, chloramphenicol, and minocycline disks (Oxoid, Basingstoke, Hampshire, UK). Results: Of the 3,323 rectal swabs sent to the laboratory during the study period, totally 84 (2.5%) CRE were isolated with one strain from each patient. Of the 84 CRE, 74 (88%) were Klebsiella pneumoniae and 10 (12%) were Escherichia coli. Among the 84 CRE, 66 (78.5%) with OXA-48, 11 (13.1%) with OXA48 + metallo-beta-lactamase (MBL), 1 (1.2%) with only MBL and 1 (1.2%) with AmpC + porin loss were detected, none of the strains were positive for KPC. In 5 (6%) strains, none of the resistance mechanisms were found. Of the 84 CRE, 80 (95.2%), 77 (91.6%) and 14 (16.6%) were found to be susceptible to isepamicin, chloramphenicol and minocycline, respectively. Conclusions: The OXA-48 type, endemic in Turkey, was also the most commonly detected carbapenemase in the study. It has been observed that isepamicin and chloramphenicol can be the potential antibiotics in the treatment of KDE-related infections.
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    Karbapeneme Dirençli Enterik Bakterilerde İsepamisin, Kloramfenikol ve Minosiklin Duyarlılığının Araştırılması
    (2018) Karakullukçu, Asiye; Borsa, Barış Ata; Kuşkucu, Mert Ahmet; Bakır, Esra; Taner, Zeynep; Özalp, Veli Cengiz; Aygün, Gökhan
    Amaç: Bu çalışmada, karbapeneme dirençli enterik bakteri(KDE)’lerin direnç özelliklerinin belirlenmesi ve ileriye yönelikalternatif tedavi seçeneklerinin değerlendirilmesi amaçlanmıştır.Yöntemler: Ekim 2014-Temmuz 2015 tarihleri arasında, yatanhastalardan rutin olarak elde edilen rektal sürüntü örnekleriçalışmaya alındı. İzole edilen enterik bakteriler standard konvansiyonelmikrobiyolojik yöntemlerle idantifiye edildi. Saptanankarbapenem direnci meropenem Etest® (bioMérieux,Marcy l'Etoile, Fransa) yöntemiyle doğrulanıp, direnç mekanizmalarıMAST-ID™ Discs (Mast Diagnostics Ltd, Bootle,Merseyside, Birleşik Krallık) karbapenemaz aktivite testdiskleriyle araştırıldı. Kökenlerin duyarlılıkları, disk difüzyonyöntemiyle isepamisin, kloramfenikol ve minosiklin diskleri(Oxoid, Basingstoke, Hampshire, Birleşik Krallık) kullanılarakdeğerlendirildi.Bulgular: Çalışma dönemi içerisinde laboratuvara gönderilen3323 rektal örnekten, her hastaya ait bir köken olmak üzere toplam84 (%2.5) KDE izole edildi. Bu kökenlerin 74 (%88)'ü Klebsiellapneumoniae ve 10 (%12)'u Escherichia coli idi. Kökenlerin66 (%78.5)’sında OXA-48, 11 (%13.1)’inde OXA-48 + metallo-β-laktamaz (MBL), 1 (%1.2)’inde sadece MBL, 1 (%1.2)’inde sadeceAmpC + porin kaybı saptanırken, hiçbirinde KPC pozitifliğisaptanmadı; 5 (%6)'inde ise test edilen direnç mekanizmalarındanhiçbirine rastlanmadı. Toplam 84 KDE'nin 80 (%95.2)’iisepamisine, 77 (%91.6)’si kloramfenikole ve 14 (%16.6)’ü minosiklineduyarlı olarak saptandı.Sonuçlar: Türkiye'de endemik olan OXA-48 tipi, çalışmada daen çok tespit edilen karbapenemaz oldu. KDE'lere bağlı infekÖzgün siyonların tedavisinde isepamisin ve kloramfenikol gündemegelebilecek antibiyotikler olabilir.Klimik Dergisi 2018; 31(1): 50-5.
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    Nasopharynceal carriace of potential pathogenic bacteria in healthy children living in Istanbul
    (Galenos Yayincilik, 2020) Gönüllü, Nevriye; Yıldız, Sevilay; Aydoğan, Okan; Taner, Zeynep; Özdemir, Sinem; Akyol, Selcan; Çakırlar, Fatma Köksal
    Aim: The purpose of this study was to determine the prevalence of nasopharyngeal carriage of potentially pathogenic bacteria (especially Streptococcus pneumoniae, Haemophilus influenzae, Moraxella catarrhalis) in healthy 1-7 years old children and risk factors affecting it. Methods: A total of four hundred forty-five healthy children (1-7 years old) from the European side of Istanbul (10 different units) were included in this cross-sectional study. Isolated microorganisms were identified by standard laboratory methods and the results were evaluated. Risk factors affecting the prevalence of nasopharyngeal carriage were also evaluated. Results: In the study, 139 (31.2%) of the samples were positive. S. pneumoniae two (0.4%), H. influenzae 50 (11.2%); of them type b 10 (2.2%), H. parainfluenzae 10 (2.2%), M. catarrhalis 14 (3.1%), S. aureus 35 (7.9%), Group A beta hemolytic streptococci (Streptococcus pyogenes) 13 (2.9%), Group B streptococci (S. agalactiae) 18 (4.0%), Non A Non B streptococci 16 (3.6%) were detected. The results obtained from different sites (places) were found to be variable in terms of pathogen density. Conclusion: Nasopharyngeal carriage rates found in our study were generally lower than in some studies on this subject. However, when the samples taken from different places were evaluated one by one, it was seen that the colonization rate reached 45.9% in crowded and poor building properties (small, poorly ventilated, unhealthy buildings). The highest rate of H. influenzae carriage in the 2-3 age group was 33.3%. In this study, crowded and unhealthy school environments and low maternal education level have been determined as risk factors for increased nasopharyngeal carriage rate. Results of such studies vary depending on the region, sample frequency, individual and social factors. Further studies are needed in order to achieve healthier results.
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    Similar bacterial signatures in the gut microbiota of type 1 and type 2 diabetes patients and its association with G protein-coupled receptor 41 and 43 gene expression
    (Springer Science and Business Media Deutschland GmbH, 2022) Demirci, Mehmet; Taner, Zeynep; Keskin, Fatma E.; Ozyazar, Mucahit; Kiraz, Nuri; Kocazeybek, Bekir S.; Tokman, Hrisi Bahar
    Purpose: There are conficting reports regarding the abundance of short-chain fatty acids producing bacteria in the gut microbiota in patients with type 1 and type 2 diabetes. We aimed to determine the amount of Akkermansia muciniphila, Anaerobutyricum hallii, Bifdobacterium adolescentis, Bifdobacterium longum, Collinsella aerofaciens, Faecalibacterium prausnitzii, Lacticaseibacillus rhamnosus, and Parabacteroides distasonis in the gut microbiota in patients with type1 and type2 diabetes, compared with the healthy controls and analyze the correlation between the gene expression levels of two short-chain fatty acids receptors GPR41 and GPR43. Methods: Forty type 1, 40 type 2 stool and blood samples of diabetes patients, and 40 healthy control samples were studied. DNA and RNA were extracted, and bacteria were detected using a Microbial DNA qPCR Assay kit. Gene expressions were detected with GPR41 and GPR43 primers via in-house qPCR. Results: Compared with healthy controls, B.longum and F.prausnitzii abundance were signifcantly decreased in patients with type1 and type2 diabetes, A.hallii abundance was increased in patients with type1 and decreased in type2 diabetes contrarily A.muciniphila abundance was decreased in patients with type1 and increased in type2 diabetes. GPR43 gene expression was upregulated in both patients group, however GPR41 was upregulated only in patients with type2 diabetes. Conclusions: Elevated B. longum and F. prausnitzii abundances were detected in the gut microbiota of patients with type1 and type2 diabetes and compared with healthy controls. B. longum and F.prausnitzii abundances were also correlated with the GPR43 gene expression level in type1 diabetes patients. Extensive studies determining bacteria producing short-chain fatty acids in gut microbiota, and their contribution in the pathogenesis of diabetes, are needed to understand better the mechanism of these diseases.