Browsing by Author "Kurt Azap, Ozlem"

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Evaluation of Clinical Approach and Outcomes Staphylococcus aureus Bacteremia
(2023) Yanik Yalcin, Tugba; Erol, Cigdem; Demirkaya, Melike Hamiyet; Durukan, Elif; Kurt Azap, Ozlem; 0000-0002-3171-8926; 0000-0001-5996-8639; 0000-0002-8579-5564; 0000-0002-2535-2534; 38633900; AAK-4089-2021; AAA-4708-2022; AAJ-8621-2021; AAJ-1219-2021
Objective: Despite appropriate treatment and early diagnosis methods, Staphylococcus aureus bacteremia (SAB) is still associated with a high mortality rate. This study aims to evaluate the clinical features and approaches to SAB and to analyze the parameters that may affect 7-day and 30-day mortality. Materials and Methods: Adult patients with SAB data between 2011 and 2018 were evaluated retrospectively. Clinical data, patient demographics, and 7-day and 30-day mortality rates were obtained from their medical records.Results: In total, 144 patients were included in the study; 57.6% (83/144) of patients were men, and the mean age was 65.2 +/- 16.5 years. The most common source of infection was the central-line catheter (38.9%), followed by intra-abdominal (21%), respiratory (16.7), infective endocarditis (5.6%), and osteoarticular foci (2.1%). Fifteen percent (15%) of the strains were methicillin resistant. Transthoracic echocardiography (TTE) was performed for 80.6% (116/144) patients. Infectious diseases specialist consultation within 96 hours from blood culture signal was requested in 79.9%. Overall, 7-day mortality was 11.8%, and 30-day mortality was 21.5%. Staying in intensive care units (ICU) increased the risk of 30-day mortality by 1.1 times, and respiratory-focused SAB increased the risk by 4.3 times.Conclusion: SAB is still a big threat. Staphylococcal pneumonia remains a severe infection. Several prognostic factors influence mortality. Identifying the source, ensuring source control, and appropriate initial therapy as soon as possible are critical for reducing mortality and morbidity in SAB.
Invasive Group A Beta-Hemolytic Streptococcal (iGAS) Infections: Is There a Public Health Threat?
(2023) Kurt Azap, Ozlem; 0000-0002-3171-8926; 38633905; AAK-4089-2021
Ophthalmologic Examination and Echocardiography Should be the Essential Components of Candidemia Bundle
(2023) Erol, Cigdem; Sari, Nuran; Yanik Yalcin, Tugba; Yesilkaya, Aysegul; Asena, Leyla; Gur Gungor, Sirel; Kurt Azap, Ozlem; 0000-0002-6848-203X; 0000-0001-5996-8639; 0000-0002-2535-2534; 0000-0001-6178-8362; 0000-0002-3171-8926; 0000-0002-3165-4520; 38633906; E-5914-2016; AAA-4708-2022; AAJ-1219-2021; AAD-5967-2021; AAK-4089-2021
Objective: Candidemia is the most common form of invasive candidiasis, and it is associat-ed with end-organ involvement, prolonged hospitalization, increased mortality, and higher healthcare costs. Candidemia can lead to metastatic heart and ocular infections. This study aimed to define the incidence, characteristics, and mortality of candidemia episodes and compare the data with our center's previous results.Materials and Methods: In this single-center retrospective observational study, we enrolled 250 patients over 18 years diagnosed with candidemia between January 2015 and December 2020. We obtained patients' demographic, clinical, laboratory, and therapeutic data from medical records. An ophthalmologic examination and screening with echocardiography were carried out within the first week after candidemia diagnosis.Results: There were 275 candidemia episodes from 250 patients. The incidence of candidem-ia was 2.8/1000 admissions and 5.68/ 10,000 inpatient days, higher than our previous results (1.23/1000 and 3.29/10,000). The median age was 65 (interquartile range [IQR]=52-75) years. Malignancies were the most frequent comorbidity (50%). The most common type was Candida albicans (n=115, 41.8%). Candida glabrata (n=61, 22.2%) was common, particularly in surgical patients, patients with malignancy, and critically ill patients. There was Infectious disease consultation in 93.3% (257) episodes. The ophthalmoscopic examination was made in 145 episodes (52.7%), and ophthalmitis was detected in 16 (11.0%). Echocardiography was per-formed in 139 (50.5%) episodes; one case had an endocarditis diagnosis. The 30-day mortal-ity was 44.7% (n=123). Mortality rates in C. glabrata and Candida krusei infections were high-er (54.1% and 66.7). The factors related to mortality were intensive care unit requirement (p=0.0001), chronic liver disease (p=0.005), corticosteroid usage (p=0.0001), previous antibiotic usage (p=0.013), multiple antibiotic usage (p=0.020), and CVC related candidemia (p=0.010).Conclusion: Because of the life-threatening complications such as endocarditis, increased mortality rates, and higher healthcare costs, systematic and comprehensive candidemia bundle applications would be effective strategies for providing an effective antifungal stew-ardship program.