Tıp Fakültesi / Faculty of Medicine

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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.
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    The Diagnostic Value of Monocyte Chemoattractant Protein-1, Compared with Procalcitonin, C-reactive Protein, and Lactate in Bacteremia Estimation for Patients with Febrile Neutropenia
    (2020) Odemis, Ilker; Kose, Sukran; Senger, Suheyla Serin; Akbulut, Ilkay; Celik, Didem; 0000-0003-2638-0163
    Bacteremia in the febrile neutropenic patients significantly increases the mortality. It takes a long time to complete the blood culture for the diagnosis of bacteremia. Therefore, quick and specific markers are needed for the prediction of bacteremia. The purpose of this study are to compare the diagnostic value of lactate, procalcitonin, C-reactive protein (CRP) and monocyte chemoattractant protein-1 (MCP-1) levels in a patient with febrile neutropenia, and to evaluate its usefulness in predicting bacteremia. This study was designed to be prospective case-control study. Forty-eight patients and forty control cases aged 18 years or older who were monitored between May 2016 and May 2017 were included in the study. P-value as <0.05 was accepted to be significant. Significantly increased values were determined by the level of inflammatory markers of patients compared to the control group. The highest diagnostic odds ratio were found to be in MCP-1. For patients with febrile neutropenia, CRP (83.3%), and MCP-1 (81.2%) were the most sensitive markers while lactate (85.0%), MCP-1 (75%), and procalcitonin (75%) were the most specific markers. CRP was the only beneficial biomarker in the estimation of bacteremia. No significant results were observed for any biomarker for the prediction of the gram positive/negative discrimination of bacteria in the blood culture. We believe that CRP MCP-1, and lactate levels can be taken into consideration for diagnosis, and CRP can be beneficial in the estimation of bacteremia.
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    An Unexpected Pseudomonas Luteola Bacteremia: Case Report
    (2015) Turan, Hale; Togan, Turhan
    Pseudomonas luteola has rarely been reported as a human pathogen. It was showed in previous studies showed that P. luteola may cause septicemia, bacteremia, peritonitis, and endocarditis in patients with underlying disease or with indwelling devices. In this article we report a case of P. luteola bacteremia without any source. We successfully treated our patient with ceftriaxone and ciprofloxacin combination.