Tıp Fakültesi / Faculty of Medicine

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    Infections in Liver Transplant Recipients
    (2014) Arslan, Hande; https://orcid.org/0000-0002-5708-7915; 24635787; ABG-7034-2021
    Liver transplant is a life-saving procedure for many end-stage liver diseases. Despite measures such as the use of protective barriers, antimicrobial prophylaxis, and vaccination, infections still represent a major cause of morbidity and mortality after liver transplant. This article reviews major infectious concerns after liver transplant.
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    In vitro Susceptibility of Tigecycline against Multidrug-Resistant Gram-Negative Strains: Etest versus Agar Dilution
    (2014) Ozkok, Sezen; Togan, Turhan; Yesilkaya, Aysegul; Timurkaynak, Funda; Azap, Ozlem Kurt; Arslan, Hande; https://orcid.org/0000-0003-0225-6416; https://orcid.org/0000-0002-3171-8926; https://orcid.org/0000-0002-5708-7915; 25791941; A-8902-2013; AAK-4089-2021; ABG-7034-2021
    Background and Aim: Tigecycline is a semi-synthetic tetracycline with activity against most multidrug-resistant (MDR) bacteria. Methods: We studied in vitro activity of tigecycline by agar dilution (AD) and Etest methods to evaluate their correlation. The study included 206 isolates of extended-spectrum beta-lactamase (ESBL)-producing Escherichia coli, Klebsiella pneumoniae and MDR Acinetobacter baumannii recovered from blood cultures of patients of Baskent University between 2008 and 2010. Results: ESBL-producing E. coli had MIC50 /MIC90 values of 0.5/0.5 mu g/ml by AD and 0.25/0.5 mu g/ml by Etest. ESBL-producing K. pneumoniae had MIC50 /MIC90 values of 1/2 mu g/ml by AD and 0.75/2 mu g/ml by Etest, whereas MDR A. baumannii had MIC50 /MIC90 values of 4/4 mu g/ml by AD and 2/4 mu g/ml by Etest. The correlation between AD and Etest was weak for ESBL-producing E. coli and strong for ESBL-producing K. pneumoniae and MDR A. baumannii. Tigecycline MIC values for ESBL-producing E. coli were lower than the tigecycline concentration, while they were higher than the concentrations attainable by treatment doses for A. baumannii. Conclusion: Tigecycline is an appropriate agent in the treatment of E. coli bacteremia, but it is not for treating A. baumannii bacteremia. Tigecycline could be used for K. pneumoniae bacteremia treatment after determining its MIC value. Determining the MIC value by gold-standard methods is more appropriate due to the correlation between Etest and AD at high MIC values. (C) 2015 S. Karger AG, Basel
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    Daptomycin Vs. Glycopeptides in The Treatment of Febrile Neutropenia: Results of The Izmir Matched Cohort Study
    (2019) Sipahi, Oguz Resat; Kahraman, Hasip; Erdem, Huseyin Aytac; Yetkin, Funda; Kaya, Selcuk; Demirdal, Tuna; Tunccan, Ozlem Guzel; Karasahin, Omer; Oruc, Ebru; Cag, Yasemin; Kurtaran, Behice; Ulug, Mehmet; Kutlu, Murat; Avci, Meltem; Oztoprak, Nefise; Arda, Bilgin; Pullukcu, Husnu; Tasbakan, Meltem; Yamazhan, Tansu; Kandemir, Ozlem; Dizbay, Murat; Sipahi, Hilal; Ulusoy, Sercan; https://orcid.org/0000-0001-7956-7306; 30498901; GVT-0626-2022
    PurposeIn this multicentre, retrospective, matched cohort study we aimed to evaluate the outcomes of neutropenic fever cases that were treated with daptomycin or a glycopeptide (vancomycin or teicoplanin).MethodsData and outcomes of adult (aged>18-years old) patients with neutropenic fever [(1) without clinical and radiological evidence of pneumonia, (2) who were treated with daptomycin or a glycopeptide (teicoplanin or vancomycin) for any reason and for at least 72 h] were extracted from the hospital databases. Matching was performed with all of the three following criteria: (1) underlying disease, (2) reason for starting daptomycin or glycopeptide (microbiologic evidence vs. microbiologic evidence, clinical infection vs. clinical infection and empirical therapy vs. empirical therapy) and (3) neutropenic status.ResultsOverall 128 patients [(69/123) (56.1%) in the daptomycin cohort (D) and 59/123 (48%) in the glycopeptide cohort (G)] had a resolution of fever at the end of 72h antibiotic treatment (p=0.25). There was no significant difference in cured, improved and (cured+improved) rates between (D) and (G) cohorts as well as fever of unknown origin cases or microbiologically confirmed infections or clinically defined infections subgroups (p>0.05). There was also no significant difference (p>0.05), in terms of persistent response in the (D) versus (G) cohorts,ConclusionsThese findings suggest that although not better, daptomycin efficacy is comparable to vancomycin if used as empiric therapy in the treatment of adult febrile neutropenia. We conclude that daptomycin may be used at least as a salvage therapy alternative to glycopeptides in the treatment of adult febrile neutropenia cases. A large, randomized-controlled trial may further consolidate the evidence related to this question.