Researcher:
Keske, Şiran

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Şiran

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Keske

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Keske, Şiran

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2017 - 201912020 - 202310

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Researcher Of Publications: search.filters.isAuthorOfPublication.ca61c595-9651-440f-825b-ba8d9ada2631

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    A complicated case of monkeypox and viral shedding characteristics
    (Elsevier, 2023) N/A; N/A; Kapmaz, Mahir; Uymaz, Derya Salim; Özcan, Gülin; Barlas, Tayfun; Esken, Gülen Güney; Manici, Mete; Keske, Şiran; Kuşkucu, Mert Ahmet; Can, Füsun; Ergönül, Önder; Doctor; Teaching Faculty; Researcher; Researcher; Researcher; Faculty Member; Faculty Member; Researcher; Faculty Member; Faculty Member; Koç Üniversitesi İş Bankası Enfeksiyon Hastalıkları Uygulama ve Araştırma Merkezi (EHAM) / Koç University İşbank Center for Infectious Diseases (KU-IS CID); N/A; School of Medicine; Graduate School of Health Sciences; N/A; N/A; School of Medicine; School of Medicine; N/A; School of Medicine; School of Medicine; Koç University Hospital; N/A; N/A; N/A; N/A; N/A; N/A; N/A; N/A; N/A; 175554; N/A; N/A; N/A; 113502; 125555; N/A; 103165; 110398
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    High prevalence of ArmA-16S rRNA methyltransferase among aminoglycoside-resistant Klebsiella pneumoniae bloodstream isolates
    (Microbiology Society, 2022) Isler, Burcu; Falconer, Caitlin; Çınar, Güle; Aslan, Abdullah Tarık; Forde, Brian; Harris, Patrick; Şimşek, Funda; Tülek, Necla; Demirkaya, Hamiyet; Menekşe, Şirin; Akalin, Halis; Balkan, İlker İnanç; Aydın, Mehtap; Tigen, Elif Tükenmez; Demir, Safiye Koçulu; Arabacı, Çiğdem; Yağcı, Serap; Hazırolan, Gülşen; Gönen, Mehmet; Saltoğlu, Neşe; Azap, Özlem; Akova, Murat; Paterson, David L.; N/A; Keske, Şiran; Doğan, Özlem; Ergönül, Önder; Can, Füsun; Kapmaz, Mahir; Özer, Berna; Vatansever, Cansel; Bakır, Veli Oğuzalp; Faculty Member; Faculty Member; Faculty Member; Faculty Member; Doctor; Researcher; Master Student; PhD Student; Koç Üniversitesi İş Bankası Enfeksiyon Hastalıkları Uygulama ve Araştırma Merkezi (EHAM) / Koç University İşbank Center for Infectious Diseases (KU-IS CID); School of Medicine; School of Medicine; School of Medicine; School of Medicine; N/A; N/A; Graduate School of Health Sciences; Graduate School of Sciences and Engineering; N/A; N/A; N/A; Koç University Hospital; N/A; N/A; N/A; 125555; 170418; 110398; 103165; N/A; N/A; N/A; N/A
    Introduction. Aminoglycosides are used for the treatment of carbapenemase-producing Klebsiella pneumoniae (CPK) infections. 16S rRNA methyltransferases (RMTs) confer resistance to all aminoglycosides and are often cocarried with NDM. Hypothesis/Gap Statement. There is a dart of studies looking at the aminoglycoside resistance mechanisms for invasive CPK isolates, particularly in OXA-48 endemic settings. Aim. We aimed to determine the prevalence of RMTs and their association with beta lactamases and MLSTs amongst aminoglycoside-resistant CPK bloodstream isolates in an OXA-48 endemic setting. Methodology. CPK isolates (n=181), collected as part of a multicentre cohort study, were tested for amikacin, gentamicin and tobramycin susceptibility using custom-made sensititre plates (GN2XF, Thermo Fisher Scientific). All isolates were previously subjected to whole-genome sequencing. Carbapenemases, RMTs, MLSTs and plasmid incompatibility groups were detected on the assembled genomes. Results. Of the 181 isolates, 109(60 %) were resistant to all three aminoglycosides, and 96 of 109(88 %) aminoglycoside-resistant isolates carried an RMT (85 ArmA, 10 RmtC, 4 RmtF1; three isolates cocarried ArmA and RmtC). Main clonal types associated with ArmA were ST2096 (49/85, 58 %) and ST14 (24/85, 28 %), harbouring mainly OXA-232 and OXA-48 +NDM, respectively. RmtC was cocarried with NDM (5/10) on ST395, and NDM +OXA-48 or NDM +KPC (4/10) on ST14, ST15 and ST16. All RMT producers also carried CTX-M-15, and the majority cocarried SHV-106, TEM-150 and multiple other antibiotic resistance genes. The majority of the isolates harboured a combination of IncFIB, IncH and IncL/M type plasmids. Non-NDM producing isolates remained susceptible to ceftazidime-avibactam. Conclusion. Aminoglycoside resistance amongst CPK bloodstream isolates is extremely common and mainly driven by clonal spread of ArmA carried on ST2096 and ST14, associated with OXA-232 and OXA48 +NDM carriage, respectively.
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    Approach to fever in the returning traveler
    (Massachusetts Medical Society (MMS), 2017) N/A; Ergönül, Önder; Keske, Şiran; Faculty Member; Faculty Member; School of Medicine; School of Medicine; Koç University Hospital; 110398; 125555
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    The role of isolation of the patients on hospital admission for prevention of nosocomial infections
    (DOC Design and Informatics, 2021) Madran, Bahar; Akbaba, Gözde; Dönmez, Hanife Ebru; Beşli, Yeşim; N/A; Keske, Şiran; Yerlikaya, Aslıhan; Ergönül, Önder; Faculty Member; Undergraduate Student; Faculty Member; Koç Üniversitesi İş Bankası Enfeksiyon Hastalıkları Uygulama ve Araştırma Merkezi (EHAM) / Koç University İşbank Center for Infectious Diseases (KU-IS CID); School of Medicine; School of Medicine; School of Medicine; 125555; N/A; 110398
    Objective: Contact precautions (CP) for the prevention of multidrug-resistant organisms (MDROs) in endemic countries is a critical element of infection control (IC) practices. In this study, we assessed the effectiveness of empiric CP on admission to the hospital in an MDRO endemic region. Methods: The study was carried out in a 300-bed private hospital from January 2016 to September 2018. The CP indications on the day of hospital admission were decided based on determining risk factors such as long term care patients (Group 1), patients with catheters and/or interventions (Group 2), transferred from another hospital (Group 3), patients with known colonisation with MDRO (Group 4), patients with other risk factors (Group 5). Results: In total, 539 consequent patients were observed. The mean age was 63.4 years, and 57% of the patients were male. Most of the patients were from Turkey (94%); however, the rest were mainly from Middle-Eastern and North-African countries. Among 101 out of 539 (18.7%) patients, at least one pathogen was grown, and among 73 out of 539 patients (13.5%), CP requiring pathogen was isolated. The CP requiring pathogens were detected in group 2 (24%), group 1 (19.4%) and group 3 (13%). The most common pathogens were ESBLproducing Enterobacterales (5.8%), carbapenemase-producing Enterobacterales (3.9%), Pseudomonas spp. (3.53%), Acinetobacter spp. (2.97%), vancomycin-resistant enterococci (2.6%) and methicillin-resistant Staphylococcus (1.86%). Conclusion: Risk assessment-based isolation precautions from the day of hospitalisation in an MDRO endemic country were found to be important among high-risk patients such as patients with catheters and/or interventions, long-term care patients and patients transferred from another medical centre. Implementation of risk-based CP than the culture-based IC strategies might be an effective approach in an MDRO endemic region while pending culture results.
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    Effectiveness of favipiravir in COVID-19: a live systematic review
    (Springer, 2021) N/A; N/A; N/A; N/A; N/A; N/A; N/A; N/A; Department of Industrial Engineering; N/A; Özlüşen, Batu; Kozan, Şima; Akcan, Rüştü Emre; Kalender, Mekselina; Yaprak, Doğukan; Peltek, İbrahim Batuhan; Keske, Şiran; Gönen, Mehmet; Ergönül, Önder; Undergraduate Student; PhD Student; Undergraduate Student; Undergraduate Student; Undergraduate Student; Undergraduate Student; Faculty Member; Faculty Member; Faculty Member; Department of Industrial Engineering; Koç Üniversitesi İş Bankası Enfeksiyon Hastalıkları Uygulama ve Araştırma Merkezi (EHAM) / Koç University İşbank Center for Infectious Diseases (KU-IS CID); School of Medicine; School of Medicine; School of Medicine; School of Medicine; School of Medicine; School of Medicine; School of Medicine; College of Engineering; School of Medicine; N/A; N/A; N/A; N/A; N/A; N/A; 125555; 237468; 110398
    We performed a systematic review and meta-analysis for the effectiveness of Favipiravir on the fatality and the requirement of mechanical ventilation for the treatment of moderate to severe COVID-19 patients. We searched available literature and reported it by using PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines. Until June 1, 2021, we searched PubMed, bioRxiv, medRxiv, ClinicalTrials.gov, Cochrane Central Register of Controlled Trials (CENTRAL), and Google Scholar by using the keywords "Favipiravir" and terms synonymous with COVID-19. Studies for Favipiravir treatment compared to standard of care among moderate and severe COVID-19 patients were included. Risk of bias assessment was performed using Revised Cochrane risk of bias tool for randomized trials (RoB 2) and ROBINS-I assessment tool for non-randomized studies. We defined the outcome measures as fatality and requirement for mechanical ventilation. A total of 2702 studies were identified and 12 clinical trials with 1636 patients were analyzed. Nine out of 12 studies were randomized controlled trials. Among the randomized studies, one study has low risk of bias, six studies have moderate risk of bias, and 2 studies have high risk of bias. Observational studies were identified as having moderate risk of bias and non-randomized study was found to have serious risk of bias. Our meta-analysis did not reveal any significant difference between the intervention and the comparator on fatality rate (OR 1.11, 95% CI 0.64-1.94) and mechanical ventilation requirement (OR 0.50, 95% CI 0.13-1.95). There is no significant difference in fatality rate and mechanical ventilation requirement between Favipiravir treatment and the standard of care in moderate and severe COVID-19 patients.
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    PublicationOpen Access
    Management of COVID-19 cases in Kosova
    (Design Oriented Community (DOC), 2022) Ahmeti, Salih; Namani-Avdiu, Sadije; Berisha, Lindita Ajazaj; Vishaj, Arben; Sadik, İzzet; Alimusaj, Mentor; Hoti, Faik; Ahmet, Hysen; Sait, Bilgin; Keske, Şiran; Çakar, Nahit; Ergönül, Önder; Faculty Member; Faculty Member; Faculty Member; Koç Üniversitesi İş Bankası Enfeksiyon Hastalıkları Uygulama ve Araştırma Merkezi (EHAM) / Koç University İşbank Center for Infectious Diseases (KU-IS CID); School of Medicine; Koç University Hospital; 125555; 198906; 110398
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    PublicationOpen Access
    The seroprevalence of SARS-CoV-2 antibodies among health care workers before the era of vaccination: a systematic review and meta-analysis
    (Elsevier, 2021) Arribas, Jose Ramon; Pshenichnaya, Natalia; Petrosillo, Nicola; Department of Industrial Engineering; Kayı, İlker; Keske, Şiran; Karanfil, Özge; Gönen, Mehmet; Ergönül, Önder; Faculty Member; Faculty Member; Faculty Member; Department of Industrial Engineering; Koç Üniversitesi İş Bankası Enfeksiyon Hastalıkları Uygulama ve Araştırma Merkezi (EHAM) / Koç University İşbank Center for Infectious Diseases (KU-IS CID); School of Medicine; Graduate School of Health Sciences; College of Engineering; Koç University Hospital; 168599; N/A; 125555; 294019; 237468; 110398
    Background: the prevalence of SARS-CoV-2 infection among health care workers (HCWs) provides information about the spread of COVID-19 within health care facilities, and the risk groups. Objectives: We aimed to describe the rate of SARS-CoV-2 seroprevalence and its determinants among HCWs. Data sources: we used Web of Science, PubMed, Scopus, MEDLINE, EBSCOhost and Cochrane Library. Study eligibility criteria: we included the reports of SARS-CoV-2 seroprevalence with a sample size of minimum 1000 HCWs. Methods: the study was registered at the International Prospective Register of Systematic Reviews (PROSPERO, no. CRD42021230456). We used PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) statement. The keywords were “COVID-19”, “SARS-CoV-2”, “Coronavirus”, “seroprevalence”, “health care workers” and “risk factors”. Results: in total 4329 reports were retrieved, duplications were removed; after filtering according to the title and abstract, 25 studies were selected. Risk of bias was assessed in 25 studies; it was low in 13 studies, medium in four studies, and high in eight studies. In meta-analysis using the random effect model, the weighted average of seroprevalence was calculated as 8% (95% CI 6–10%). The pooled seroprevalence rates of the selected variables that have a rate above the average were male HCWs with 9% (95% CI 7–11%); HCWs from ethnic minorities with 13% (95% CI 9–17%); high exposure 9% (95% CI 6–13%); exposure to the virus outside the health care setting 22% (95% CI 14–32%). Conclusions: our analysis indicates a SARS-CoV-2 seroprevalence rate of 8% among studies that included >1000 HCWs for the year 2020, before vaccinations started. The most common risk factors associated with higher seroprevalence rate were ethnicity, male gender and having a higher number of household contacts. Working as a frontline HCW was inconsistent in its association with higher seroprevalence.
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    PublicationOpen Access
    ESCMID guidelines on testing for SARS-CoV-2 in asymptomatic individuals to prevent transmission in the health care setting
    (Elsevier, 2022) Carrara, Elena; Ong, David S.Y.; Hussein, Khetam; Johansson, Anders F.; Presterl, Elisabeth; Tsioutis, Constantinos; Tschudin-Sutter, Sarah; Tacconelli, Evelina; Keske, Şiran; Faculty Member; School of Medicine; Koç University Hospital; 125555
    Scope: this guideline addresses the indications for direct testing of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in asymptomatic individuals in health care facilities, with the aim to prevent SARS-CoV-2 transmissions in these settings. The benefit of testing asymptomatic individuals to create a safe environment for patients and health care workers must be weighed against potential unintended consequences, including delaying necessary treatments owing to false positive results and lower quality of care owing to strict isolation measures. Methods: a total of nine PICOs (population, intervention, comparison, outcome) on the topic of testing asymptomatic individuals was selected by the panel members. Subsequently, a literature search for existing guidelines and systematic reviews was performed on PubMed, Epistemonikos, and RecMap using relevant filters available in each database. Data on article/recommendation type, setting, target population, intervention, and quality of the evidence were extracted. Credibility of the systematic reviews was evaluated using the AMSTAR tool, and level of agreement with available recommendation was evaluated with the AGREE II score. Because the evidence available from systematic reviews was deemed insufficiently updated to formulate relevant recommendations, an additional search targeting relevant guidance documents from major public health institutions and original studies was performed. Provisional recommendations were discussed via web conferences until agreement was reached, and final recommendations were formulated according to the grade approach. Recommendations: recommendations were formulated regarding systematic testing in asymptomatic individuals upon admission to a health care setting, during hospital stay, before elective procedures, and before scheduled nonsurgical procedures. Moreover, recommendations regarding testing of asymptomatic visitors, personal caregivers, and health care workers in health care facilities were presented. Recommendations also were given on contact tracing in asymptomatic patients or health care workers and the possibility of a negative screening test to shorten the quarantine period. Furthermore, if applicable, recommendations were specified to transmission rate and vaccination coverage.
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    PublicationOpen Access
    The effectiveness of bundle applications in the prevention of central line-associated bloodstream infections: nine years of observation
    (Design Oriented Community (DOC), 2022) N/A; Keske, Şiran; Bakır, Veli Oğuzalp; Ergönül, Önder; Faculty Member; Faculty Member; School of Medicine; Graduate School of Sciences and Engineering; N/A; 125555; N/A; 110398
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    COVID-19 severity among healthcare workers: overweight male physicians at risk
    (Multidisciplinary Digital Publishing Institute (MDPI), 2022) Madran, Bahar; Akbaba, Gözde; Şencalı, Özgür; Bozkurt, İsmail; Akbulut, Zeliha; Keske, Şiran; Ergönül, Önder; Faculty Member; Faculty Member; School of Medicine; Koç University Hospital; N/A; N/A; N/A; 125555; 110398
    We performed a prospective longitudinal cohort study in two healthcare settings. In total, 909 HCWs out of 3982 (23.35%) were diagnosed with COVID-19 before the vaccination era. Eighty-five per cent of COVID-19 positive HCWs (n = 774) were asymptomatic or mild, and 15% were moderate or severe. The mean age of the infected HCWs in the moderate or severe group was higher than the mild or asymptomatic group (35.4 vs. 31.3 years, p < 0.001). Thirty-two per cent of HCWs were male and the rate of male gender was more frequent in the moderate/severe group (p = 0.009). The rate of those who have cardiovascular diseases (p = 0.003) and diabetes mellitus (p = 0.044) were significantly higher among the HCWs with moderate or severe COVID-19. In multivariate analysis, male gender (OR:1.65, CI:1.11-2.46, p = 0.013), BMI > 30 (OR: 1.9, CI: 1.09-3.51, p = 0.024), and being physician (OR: 2.56, CI:1.45-4.52, p = 0.001) were found to be associated with moderate or severe COVID-19.