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Öğe Asymptomatic Bacteriuria in Pregnant Women: Frequency, Antimicrobial Susceptibility Profile, Causative Microorganisms and Risk Factors(Bilimsel Tip Yayinevi, 2020) Tokak, Semih; Eric Horasanli, JuleIntroduction: Asymptomatic bacteriuria (ASB) is defined as the presence of bacteria in the urine without significant symptoms of urinary tract infections. ASB occurs during pregnancy and is associated with negative maternal and perinatal outcomes when not treated during pregnancy. The aim of this study was to determine the frequency of ASB, related to risk factors, microorganisms causing bacteriuria and antibiotic susceptibility in pregnant women who presented to the gynecology and obstetrics clinic in our region. Materials and Methods: All pregnant women aged 18 years and over who were admitted to the gynecology and obstetrics clinics of our university hospital between January 1, 2017 and January 1, 2019 were included. Demographic characteristics, clinical risk factors, laboratory findings, and clinical records of the patients were obtained. Urine was collected aseptically. Obtained samples were cultured by routine macroscopy, microscopy examination and appropriate media. Microbial isolates were detected by conventional methods. Kirby Bauer disc diffusion method was used to determine the antimicrobial susceptibility of all bacterial isolates. Data were analyzed with SPSS version 24 software and in all cases, p values less than 0.05 were considered statistically significant. Results: A total of 410 pregnant women were included into the study. Thirty-two patients with ASB were included in the case group and the remaining 378 patients without ASB were included in the control group. Mean age was 30.29 +/- 5.61 years (18-45 years). The prevalence of asymptomatic bacteriuria was 7.8%. There was a statistically significant difference between the parity and ASB. According to the result of statistical analysis, the risk of having ASB in pregnant women who have already given two births has proved a 0.056 fold increase compared with the women who have given only one birth and a 0.045 fold increase for the pregnant women who have given three births compared with the pregnant women who have given two births (Parity; 1; OR: 0.184; 95% CI: (0.023-0.957), 2; OR: 0.056; 95% CI: (0.006-0.580), 3; OR: 0.045 95% CI: (0.002 p<.005). The most common microorganisms were Escherichia coli (59.4%) followed by Enterobacter aerogenes (15.7%) and Staphylococcus aureus (9.4%). The isolates showed susceptibility to commonly used antimicrobials such as nitrofurantoin (93.75%), amikadn (93.75%), tetracycline (93.10%) and trimethoprim-sulfamethoxazole (87.5%). Conclusion: The prevalence of ASB is significantly higher in pregnant women. It is important to screen and treat the disease during pregnancy because it causes a clinical picture that poses a risk for miscarriage and preterm birth. Screening and treatment of pregnant women in terms of ASB will also prevent pregnancy complications and associated adverse birth outcomes. Antibiotic susceptibility test results should be considered in the treatment of pregnant women.Öğe A case of Human Parechovirus Infection in an Infant with Meningitis(Aves Yayincilik, Ibrahim Kara, 2021) Tokak, Semih; Ozdemir, Mehmet; Gulseren, Yasemin Derya; Caksen, HuseyinHuman parechovirus is a potentially serious viral infection in neonates and infant and its importance increasing by years. In young infants, the typical clinical presentation includes fever, severe irritability, and rash, often leading to descriptions of hot, red, angry babies. We report a case of a 43-day-old girl with a fever that required hospitalization and in which human parechovirus was identified in the cerebrospinal fluid. Blood, urine, and cerebrospinal fluid bacterial cultures of the patient were negative and the patient has improved.Öğe Determination of Epidemiology and Seasonal Distribution of Viral Agents Detected in Children with Respiratory Tract Infection(Aves Yayincilik, Ibrahim Kara, 2019) Tokak, Semih; Gulseren, Yasemin Derya; Ozdemir, MehmetObjective: The aim of this study was to determine the viral pathogens in the respiratory tract infections of children who applied to various outpatient clinics of our hospital and to investigate their seasonal distribution. Material and Methods: Between January 2016 and January 2017, 997 children (45.1% female, 54.9% male, 0 month-17 years) who were diagnosed with upper or lower respiratory tract infection were included in the study. Twenty-one viral respiratory pathogens were analyzed by multiplex polymerase chain reaction method by using Fast Track FTD kit (Fast Track Diagnosis, Luxemburg). Results: One or more respiratory viruses were detected in 761 (76.3%) of 997 patients and no virus was detected in 236 (22.8%) of the patients. In our study, distrubition of respiratory tract viruses were as; Adenovirus (2.76%), Bocavirus (4.20%), Coronavirus 229E (0.92%), Coronavirus OC43 (6.96%), Enterovirus (6.04%), Metapneumovirus A (4.60%), Metapneumovirus B (4.47%), Parainfluenza 1 (0.13%), Parainfluenza 2 (1.18%), Parainfluenza 3 (8.80%), Parainfluenza 4 (1.18%), Parainfluenza 4a (0.13%), Parainfluenza 4b (0.13%), Rhinovirus (48.75%), RSVA/B (37.84%), Influenza B (3.02%) and Parechovirus (6.57%). When we observe the seasonal distribution of viral agents, RSV was the most common agent in winter and it was rhinovirus in spring, summer and autumn season. Conclusion: Approximately 80% of the patients included in the study had a viral agent that may be responsible for clinical symptoms. For this reason, the rapid and sensitive diagnosis of viruses causing viral respiratory infections will reduce the cost of treatment, reduce unnecessary use of antibiotics and prevent the development of resistance to antibiotics and will guide the clinician to prevent the infections caused by these viruses.Öğe Investigation of Respiratory Tract Pathogen Human Parechoviruses in Konya, Turkey(Georg Thieme Verlag Kg, 2020) Tokak, Semih; Ozdemir, Mehmet; Tasbent, Fatma EsenkayaObjective This study aims to better understand the epidemiological characteristics of parechoviruses and to determine the genotype distribution in Konya, Turkey. Methods In this study, nasal and throat swab samples taken from 1,110 children who were diagnosed with respiratory tract infection (bronchitis, pneumonia, asthmatic bronchitis, and other respiratory diseases) and applied to various pediatric polyclinics of Meram Medical Faculty Hospital, Necmettin Erbakan University between September 2017 and March 2019 were evaluated. Human parechovirus (HPeV) RNA was investigated by multiplex polymerase chain reaction (PCR) in respiratory tract samples. Specific genotypes of the positive samples were identified by real-time PCR amplification of the VP1 region followed by sequence analysis. Results Of the total of 1,110 samples, 4 were positive for HPeV. Of these, HPeV1 was the most predominant genotype ( n = 3), followed by HPeV4 ( n = 1). HPeV infections were detected throughout the year in Konya, Turkey. Conclusion Although the number of positive samples for HPeV is low, these findings provide information about the genetic diversity and epidemiological of HPeV genotypes circulating in pediatric patients in Turkey. This is the first study to detect prevalence and genotyping of HPeV in respiratory tract infections in Turkey. HPeVs should be considered as causative agents especially in infants with sepsis, meningitis, or encephalitis, and routine testing panels for HPeV detection should be available in hospital laboratories. Further studies using molecular epidemiological methods will be beneficial for identifying genotypes of all HPeVs involved in the etiology and for better monitoring of these infections.Öğe Konya bölgesindeki solunum yolu patojeni olan insan parechoviruslarının (HPeV) araştırılması(Necmettin Erbakan Üniversitesi Sağlık Bilimleri Enstitüsü, 2019) Tokak, Semih; Özdemir, Mehmetİnsan parechovirusu (HPeV) Picornaviridae familyasında Parechovirus cinsini oluşturan, zarfsız, tek iplikli RNA virusudur. Bu viruslara olan ilgi son 20 yılda, insan ve hayvan hastalıkları ile ilişkileri nedeniyle önemli oranda artmıştır. HPeV'ler yaygın patojenler olup dünya genelinde özellikle küçük çocukları enfekte etmektedir. HPeV'lerin bulaşma yolu fekal-oral yolla meydana geldiği görülmekte olup çoğu HPeV enfeksiyonu solunum yolu enfeksiyonu ve gastroenterit ile ilişkili olarak hafif seyirlidir. HPeV'ler, dünya çapında yayılan yaygın patojenler olan 19 genotip (HPeV1-19) içermektedir. Bu çalışma ile Parechovirusların epidemiyolojik özelliklerini daha iyi anlaşılması ve bölgemizdeki genotip dağılımını belirlenmesi amaçlanmaktadır. Bu çalışma için Konya'da solunum yolu enfeksiyon şüphesi olan hastalardan Eylül 2017 ile Mart 2019 arasında solunum yolu örnekleri toplandı. Çalışmaya toplam 2200 solunum yolu örneği dahil edildi. Solunum yolu örneklerinde multipleks PZR ile HPeV RNA araştırıldı ve pozitif bulunan HPeV'lerin spesifik genotipleri RT-PZR ile VP1 bölgesinin amplifikasyonununa ardından sekans analizi ile tanımlandı. Multipleks PZR ile analiz edilen 2200 solunum yolu numunesinin 11'inde (%0.5) HPeV tespit edildi. HPeV pozitif örnekler daha sonra yapılan RT PZR ve sekans analizinin ardından HPeV1 (n: 3), HPeV4 (n: 1) olarak genotiplendirildi. HPeV öncelikle 3 yaşın altındaki çocuklarda tespit edildi. HPeV'lerin, Ocak-Kasım aylarında belirgin bir mevsimsel artışa sahip olmak üzere yıl boyunca dağılım gösterdiği belirlendi. Elde edilen bulgular Konya'da solunum yolu örneklerinde HPeV1 ve HPeV4'genotiplerinin dolaşımda olduğunu göstermiştir. Bu çalışma ülkemizdeki solunum yolu enfeksiyonlarında HPeV'nin neden olduğu ilk çalışmadır. HPeV'ler özellikle yenidoğanlarda, sepsis, menenjit veya ensefalitli küçük çocuklarda etken olarak göz önünde bulundurulmalı ve HPeV tespiti için rutin test panelleri hastane laboratuvarlarında bulunmalıdır. Moleküler epidemiyolojik yöntemler kullanılarak yapılan ileri çalışmalar etiyolojide yer alan tüm HPeV'lerin genotiplerinin belirlenmesi ve bu enfeksiyonların daha iyi izlenmesi için oldukça yararlı olacaktır.
