Tıp Fakültesi / Faculty of Medicine
Permanent URI for this collectionhttps://hdl.handle.net/11727/1403
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Item Infections in Liver Transplant Recipients(2014) Arslan, Hande; https://orcid.org/0000-0002-5708-7915; 24635787; ABG-7034-2021Liver 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.Item 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-7034-2021Background 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, BaselItem 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-0626-2022PurposeIn 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.Item Bloodstream Infections: Etiologic Agents and Their Antibiotic Resistance Rates(2016) Aydin, Mehtap; Kasikcioglu, Cemre; Nargiz-Kosucu, Sibel; Timurkaynak, Funda; Arslan, Hande; 0000-0002-5708-7915; ABG-7034-2021Objective: In this study, we aimed to investigate the etiological agents of bloodstream infections (BSIs) and their antibiotic resistance rates. Methods: The rates of antibiotic resistance of the microorganisms isolated from blood cultures in the microbiology laboratory between 2012 and 2013 were evaluated retrospectively. Blood cultures were performed by using BACTEC (TM) 9120 (Becton Dickinson, Sparks, MD, USA) automated system. Microorganisms that were isolated were identified by routine microbiological methods. Results: In our study, BSIs were most frequently detected in the cardiovascular surgery clinic. Out of 95 bacteria isolated from blood culture, 61 (64.2) were Gram-negative bacteria (46% enteric, 18% nonfermentative), 20 (21%) were Candida spp. and 14 (15%) were Gram-positive bacteria. The most effective antibiotics for enteric bacteria were found as colistin, followed by imipenem, meropenem and amikacin and for nonfermentative Gram-negative bacteria as colistin, cefepime, piperacillin-tazobactam, imipenem and amikacin. Conclusions: When the resistance rates were compared within two years, significant increases in resistance were observed for quinolones and ceftazidime in nonfermentative bacteria, and for carbapenems in enteric bacteria. Regular monitoring of etiological agents of BSIs and their antibiotic resistance rates will guide the selection of empiric therapy.Item The Distribution and Antimicrobial Susceptibility Profiles of Etiologic Agents Isolated From Bacteremia Episodes Among Immunocompromised Patients(2017) Demirkaya, Melike Hamiyet; Yesilkaya, Aysegul; Akcil-Ok, Mehtap; Kurt-Azap, Ozlem; 0000-0002-3171-8926; AAK-4089-2021Objective: Bacteremia is the leading cause of morbidity and mortality among immunocompromised patients. The aim of this study is to evaluate the etiology of bacteremia and the antibiotic susceptibilities of etiologic agents among immunocompromised patients followed up from January 1, 2012 to July 30, 2013. Methods: Immunocompromised patients, both inpatient and outpatient treated in our hospital, were followed prospectively. The definition of "immunocompromised patients" consisted of solid organ (kidney, liver) transplantation recipients and hemato-oncologic malignancy patients with a history of chemotherapy in the previous month before bacteremia. Results: This prospective study comprised of 167 bacteremia episodes of 130 consecutive immunocompromised patients. The most isolated group of bacteria was Gram-negative bacteria. Escherichia coli was the most commonly (30.8%) isolated bacteria and the second was coagulase-negative staphylococci (15.1%). Fifty one percent of the E. coli isolates were extended-spectrum beta-lactamasepositive. Acinetobacter baumannii was the second most common bacteria of Gram-negative agents and the ratio of multiple drug-resistant (MDR) isolates among Acinetobacter isolates was 73%. Conclusions: Gram-negative bacteria are the most common causative agents of bacteremia in immunocompromised patients in our hospital. The rising ratio of MDR A. baumannii is a striking problem which causes difficult-to-treat infections.