Publications by authors named "Dolunay GÜlmez KivanÇ"

3 Publications

  • Page 1 of 1

Clinical implications of fungal isolation from sputum in adult patients with cystic fibrosis.

Turk J Med Sci 2021 Jan 12. Epub 2021 Jan 12.

Background/aim: Cystic fibrosis is an autosomal recessive disease with a defect in mucociliary activity that is characterized by recurrent pulmonary infections. Bacterial agents most frequently implicated in airway colonization and infection are Haemophilus influenzae, Staphylococcus spp. and Pseudomonas spp. Fungal isolation from sputum species is more common in adults. However, growth of fungal agent only in sputum culture in patients with cystic fibrosis is insufficient for the diagnosis of fungal diseases. There is limited and contraversial data about the clinical significance of fungal isolation in sputum cultures. The aim of the present study was to investigate the clinical outcomes including characteristics, lung function, therapy modalities and frequency of exacerbations and clinical significance of fungal isolation from sputum samples in adult patients with CF.

Materials And Methods: This retrospective cohort study included patients who have been admitted between October 2017 and January 2019 in an Adult Cystic Fibrosis Unit. Patients were grouped according to fungal pathogenicity as; fungal disease group, colonization group, and non-isolated group. The data of the last one year, including patients demographics, clinical data, laboratory results, treatment modalities, results of cultured bacteria and fungus from sputum samples, respiratory function parameters, frequency of exacerbation and hospitalization were compared between groups.

Results: A total of 330 sputum samples from 88 adult patients with CF were collected during the preceeding one year. Patients were divided into three groups, fungal disease group (n = 10, 11.4%), colonization group (n = 49, 55.7%), and non-isolated group (n = 29, 32.9%). Presence of pulmonary exacerbation and number of admission to emergency department and the number of positive cultures for bacteria from sputum were significantly higher in the fungal disease group (p = 0.03, p = 0.01 and p ?0.001). Patients in the fungal disease group had higher rate of administered antibiotics by parenteral route than other groups (p = 0.001) whereas lung function parameters were similar. Use of nutritional supplementation and parenteral antibiotherapy in the preceeding one year were the factors associated with elevated risk of fungal isolation.

Conclusion: Frequent use of parenteral antibiotics and use of nutritional supplementation were found to be independent risk factors for fungal isolation from sputum in adult CF patients.
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January 2021

Comparison of PCR, culturing and Pap smear microscopy for accurate diagnosis of genital Actinomyces.

J Med Microbiol 2013 May 1;62(Pt 5):727-733. Epub 2013 Feb 1.

Hacettepe University, Faculty of Medicine, Department of Obstetrics and Gynecology, 06100 Sıhhiye, Ankara, Turkey.

Members of the genus Actinomyces, Gram-positive, non-spore-forming anaerobic bacteria, are normal inhabitants of the mucosal surfaces of the oral, gastrointestinal and genital tracts. Identification of these bacteria using conventional methods is generally difficult because of their complex transport and growth requirements and their fastidious and slow-growing nature. However, in recent years, the advancement of molecular techniques has provided much improved identification and differentiation of closely related Actinomyces species. The aim of the present study was to evaluate the efficacy of the PCR technique in the diagnosis of genital Actinomyces in comparison with culturing and Papanicolaou (Pap) smear microscopy. Multiple sampling was conducted from 200 women using smear microscopy, culturing and PCR. Cyto-brushes were smeared on glass slides and stained using the routine Pap technique. Culturing was performed from a sterile swab, and Actinomyces were determined using the BBL Crystal ANR ID kit. PCR was performed from a second swab, and the Actinomyces type was determined using type-specific primers designed in our laboratory. Only one vaginal fluid sample (0.5%) revealed Actinomyces-like organisms on Pap smear examination. Actinomyces were detected in nine samples (4.5%) using the BBL Crystal ANR ID kit. Using PCR, eight samples (4%) were found positive for Actinomyces. No specimens that gave positive results by Pap smear microscopy and culturing could be confirmed by PCR. Pap smear microscopy and culturing were both found to have zero sensitivity for Actinomyces. PCR appears to be a sensitive and reliable diagnostic method for the detection of Actinomyces, which are difficult to cultivate from genital samples. PCR can be used for diagnostic confirmation in cases diagnosed by conventional methods, to prevent false-positive results.
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May 2013

Comparative evaluation of antimicrobial effects of Er:YAG, diode, and CO₂ lasers on titanium discs: an experimental study.

J Oral Maxillofac Surg 2012 May 28;70(5):1064-9. Epub 2012 Jan 28.

Faculty of Dentistry, Department of Oral and Maxillofacial Surgery, Blacksea Technical University, Trabzon, Turkey.

Purpose: This study examined carbon dioxide (CO(2); 10,600 nm), diode (808 nm), and erbium (Er):yttrium-aluminum-garnet (YAG; 2,940 nm) laser applications on Staphylococcus aureus contaminated, sandblasted, large-grit, acid-etched surface titanium discs and performed a comparative evaluation of the obtained bactericidal effects and the applicability of these effects in clinical practice.

Materials And Methods: This study was carried out in 5 main groups: Er:YAG laser in very short pulse (VSP) emission mode, Er:YAG laser in short pulse (SP) emission mode, diode laser with a 320-nm fiber optic diode laser with an R24-B handpiece, and CO(2) laser. After laser irradiation, dilutions were spread on sheep blood agar plates and, after an incubation period of 24 hours, colony-forming units were counted and compared with the control group, and the bactericidal activity was assessed in relation to the colony counts.

Results: The CO(2) laser eliminated 100% of the bacteria at 6 W, 20 Hz, and a 10-ms exposure time/pulse with a 10-second application period (0.8-mm spot size). The continuous-wave diode laser eliminated 97% of the bacteria at 1 W using a 10-second application with a 320-μm optic fiber, 100% of the bacteria were killed with a 1-W, 10-second continuous-wave application with an R14-B handpiece. The Er:YAG laser eliminated 100% of the bacteria at 90 mJ and 10 Hz using a 10-second application in a superpulse mode (300-ms exposure time/pulse). The Er:YAG laser also eliminated 99% to 100% of the bacteria in VSP mode at 90 mJ and 10 Hz with a 10-second application.

Conclusions: The results of this study show that a complete, or near complete, elimination of surface bacteria on titanium surfaces can be accomplished in vitro using a CO(2), diode, or Er:YAG laser as long as appropriate parameters are used.
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May 2012