PubMed İndeksli Açık & Kapalı Erişimli Yayınlar
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Item Inappropriate use of ivermectin during the COVID-19 pandemic: primum non nocere!(2022) Barac, Aleksandra; Bartoletti, Michele; Azap, Ozlem; Bussini, Linda; Ergonul, Onder; Krause, Robert; Ramon Pano-Pardo, Jose; Power, Nicholas R.; Rodriguez-Bano, Jesus; Sibani, Marcella; Szabo, Balint Gergely; Tsiodras, Sotirios; Verweij, Paul E.; Martin Quiros, Alejandro; Zollner-Schwetz, Ines; 35337977Item Comparison Of Ceftazidime-Avibactam Susceptibility Testing Methods Against OXA-48-Like Carrying Klebsiella Blood Stream Isolates(2022) Isler, Burcu; Vatansever, Cansel; Ozer, Berna; Cinar, Gule; Aslan, Abdullah Tarik; Stewart, Adam; Simos, Peter; Falconer, Caitlin; Bauer, Michelle J.; Forde, Brian; Harris, Patrick; Simsek, Funda; Tulek, Necla; Demirkaya, Hamiyet; Menekse, Sirin; Akalinj, Halis; Balkan, Ilker Inanc; Aydin, Mehtap; Tigen, Elif Tukenmez; Demir, Safiye Koculu; Kapmaz, Mahir; Keske, Siran; Dogan, Ozlem; Arabaci, Cigdem; Yagci, Serap; Hazirolan, Gulsen; Bakir, Veli Oguzalp; Gonen, Mehmet; Saltoglu, Nese; Azap, Alpay; Azap, Ozlem; Akova, Murat; Ergonul, Onder; Paterson, David L.; Can, Fusun; 35843111Ceftazidime-avibactam exhibits good in vitro activity against carbapenem resistant Klebsiella carrying OXA-48-like enzymes. We tested two hundred unique carbapenem resistant Klebsiella blood stream isolates (71% with single OXA-48-like carbapenemases, including OXA-48, n = 62; OXA-232, n = 57; OXA-244, n = 17; OXA-181, n = 5) that were collected as part of a multicentre study against ceftazidime-avibactam using Etest (bioMerieux, Marcyl'Etoile, France), 10/4 mg disc (Thermo Fisher) and Sensititre Gram Negative EURGNCOL Plates (Lyophilized panels, Sensititre, Thermo Fisher) with the aim of comparing the performances of the Etest and disc to that of Sensititre. Ceftazidime-avibactam MIC50/90 was 2/> 16 mg/L for the entire collection and was 2/4 mg/L for single OXA-48-like producers. Categorical and essential agreements between the Etest and Sensititre were 100% and 97%, respectively. Categorical agreement between the disc and Sensititre was 100%. Etest and 10/4 mg discs are suitable alternatives to Sensititre for ceftazidime-avibactam sensitivity testing for OXA-48-like producers. (C) 2022 Elsevier Inc. All rights reserved.Item Characteristics And Outcomes Of Carbapenemase Harbouring Carbapenem-Resistant Klebsiella Spp. Bloodstream Infections: A Multicentre Prospective Cohort Study In An OXA-48 Endemic Setting(2022) Isler, Burcu; Ozer, Berna; Cinar, Gule; Aslan, Abdullah Tarik; Vatansever, Cansel; Falconer, Caitlin; Dolapci, Istar; Simsek, Funda; Tulek, Necla; Demirkaya, Hamiyet; Menekse, Sirin; Akalin, Halis; Balkan, Ilker Inanc; Aydin, Mehtap; Tigen, Elif Tukenmez; Demir, Safiye Koculu; Kapmaz, Mahir; Keske, Siran; Dogan, Ozlem; Arabaci, Cigdem; Yagci, Serap; Hazirolan, Gulsen; Bakir, Veli Oguzalp; Gonen, Mehmet; Chatfield, Mark D.; Forde, Brian; Saltoglu, Nese; Azap, Alpay; Azap, Ozlem; Akova, Murat; Paterson, David L.; Can, Fusun; Ergonul, Onder; 35301623A prospective, multicentre observational cohort study of carbapenem-resistant Klebsiella spp. (CRK) bloodstream infections was conducted in Turkey from June 2018 to June 2019. One hundred eighty-seven patients were recruited. Single OXA-48-like carbapenemases predominated (75%), followed by OXA-48-like/NDM coproducers (16%). OXA-232 constituted 31% of all OXA-48-like carbapenemases and was mainly carried on ST2096. Thirty-day mortality was 44% overall and 51% for ST2096. In the multivariate cox regression analysis, SOFA score and immunosuppression were significant predictors of 30-day mortality and ST2096 had a non-significant effect. All OXA-48-like producers remained susceptible to ceftazidime-avibactam.Item ESCMID COVID-19 Living Guidelines: Drug Treatment And Clinical Management(2022) Bartoletti, Michele; Azap, Ozlem; Barac, Aleksandra; Bussini, Linda; Ergonul, Onder; Krause, Robert; Ramon Pano-Pardo, Jose; Power, Nicholas R.; Sibani, Marcella; Szabo, Balint Gergely; Tsiodras, Sotirios; Verweij, Paul E.; Zollner-Schwetz, Ines; Rodriguez-Bano, Jesus; https://orcid.org/0000-0002-3171-8926; 34823008; AAK-4089-2021Scope: In January 2021, the ESCMID Executive Committee decided to launch a new initiative to develop ESCMID guidelines on several COVID-19-related issues, including treatment of COVID-19. Methods: An ESCMID COVID-19 guidelines task force was established by the ESCMID Executive Committee. A small group was established, half appointed by the chair, and the remaining selected with an open call. Each panel met virtually once a week. For all decisions, a simple majority vote was used. A long list of clinical questions using the PICO (population, intervention, comparison, outcome) format was developed at the beginning of the process. For each PICO, two panel members performed a literature search with a third panellist involved in case of inconsistent results. Voting was based on the GRADE approach. Questions addressed by the guideline and recommendations: A synthesis of the available evidence and recommendations is provided for each of the 15 PICOs, which cover use of hydroxychloroquine, bamlanivimab alone or in combination with etesevimab, casirivimab combined with imdevimab, ivermectin, azithromycin and empirical antibiotics, colchicine, corticosteroids, convalescent plasma, favipiravir, remdesivir, tocilizumab and interferon beta-1a, as well as the utility of antifungal prophylaxis and enoxaparin. In general, the panel recommended against the use of hydroxychloroquine, ivermectin, azithromycin, colchicine and interferon beta-1a. Conditional recommendations were given for the use of monoclonal antibodies in high-risk outpatients with mild-moderate COVID-19, and remdesivir. There was insufficient evidence to make a recommendation for use of favipiravir and antifungal prophylaxis, and it was recommended that antibiotics should not be routinely prescribed in patients with COVID-19 unless bacterial coinfection or secondary infection is suspected or confirmed. Tocilizumab and corticosteroids were recommended for treatment of severe COVID-19 but not in outpatients with non-severe COVID-19. Scope: The aim of the present guidance is to provide evidence-based recommendations for management of adults with coronavirus disease 2019 (COVID-19). More specifically, the goal is to aid clinicians managing patients with COVID-19 at various levels of severity including outpatients, hospitalized patients, and those admitted to intensive care unit. Considering the composition of the panel, mostly clinical microbiologists or infectious disease specialists with no pulmonology or intensive care background, we focus only on pharmacological treatment and do not give recommendations on oxygen supplement/support. Similarly, as no paediatricians were included in the panel; the recommendations are only for adult patients with COVID-19. Considering the current literature, no guidance was given for special populations such as the immunocompromised. (C) 2021 European Society of Clinical Microbiology and Infectious Diseases. Published by Elsevier Ltd. All rights reserved.Item Changes in Antimicrobial Resistance and Outcomes of Health Care-Associated Infections(2021) Aydin, Mehtap; Azak, Emel; Bilgin, Huseyin; Menekse, Sirin; Asan, Ali; Mert, Habibe Tulin Elmaslar Habibe Tulin Elmaslar; Yulugkural, Zerrin; Altunal, Lutfiye Nilsun; Hatipoglu, Cigdem Ataman; Ertem, Gunay Tuncer; Altunok, Elif Sargin; Demirkaya, Melike Hamiyet; Ceviker, Sevil Alkan Sevil Alkan; Akgul, Fethiye; Memis, Zeynep; Konya, Petek; Azap, Alpay; Aydin, Gule; Korkmaz, Derya; Karakoc, Zehra Cagla; Yapar, Derya; Karakecili, Faruk; Gunal, Ozgur; Keske, Siran; Kapmaz, Mahir; Kader, Cigdem; Demirel, Aslihan; Ergonul, Onder; 33586014To describe the change in the epidemiology of health care-associated infections (HAI), resistance and predictors of fatality we conducted a nationwide study in 24 hospitals between 2015 and 2018. The 30-day fatality rate was 22% in 2015 and increased to 25% in 2018. In BSI, a significant increasing trend was observed for Candida and Enterococcus. The highest rate of 30-day fatality was detected among the patients with pneumonia (32%). In pneumonia, Pseudomonas infections increased in 2018. Colistin resistance increased and significantly associated with 30-day fatality in Pseudomonas infections. Among S. aureus methicillin, resistance increased from 31 to 41%.Item Effect of initial antifungal therapy on mortality among patients with bloodstream infections with different Candida species and resistance to antifungal agents: A multicentre observational study by the Turkish Fungal Infections Study Group(2020) Dogan, Ozlem; Yesilkaya, Aysegul; Menekse, Sirin; Guler, Ozlem; Karakoc, Cagla; Cinar, Gule; Kapmaz, Mahir; Aydin, Mehtap; Keske, Siran; Sahin, Suzan; Haciseyitoglu, Demet; Yalcin, Demet; Tekin, Suda; Atac, Nazli; Albayrak, Ozgur; Aksu, Ekin Deniz; Can, Fusun; Ergonul, Onder; 32335275This study aimed to describe the effect of initial antifungal therapy on patient mortality and to detail the current distribution and resistance patterns of Candida spp. among patients with candidaemia. A prospective observational study was performed among consecutive patients with candidaemia from 10 Turkish medical centres between January 2015 and November 2018. The primary outcome was 10-day mortality. Species were identified using MALDI-TOF/MS. A total of 342 patients with candidaemia were included, of which 175 (51.2%) were male and 68 (19.9%) were aged <18 years. The most common species were Candida albicans (47.4%), Candida parapsilosis (26.6%), Candida tropicalis (9.6%) and Candida glabrata (7.6%). Among all Candida spp., the 10-day case fatality rate (CFR) was 32.2%. The CFR was highest in patients with C. albicans (57.3%) and lowest in patients with C. parapsilosis (21.8%). The resistance rate to fluconazole was 13% in C. parapsilosis, with no significant effect on mortality. No resistance to echinocandins was detected. In the multivariate analysis, being in the ICU [OR = 2.1 (95% CI 1.32-3.57); P = 0.002], renal failure [OR = 2.4 (1.41-3.97); P = 0.001], total parenteral nutrition [OR = 2 (1.22-3.47); P = 0.006], C. albicans infection [OR = 1.7 (1.06-2.82); P = 0.027] and echinocandin as primary agent [OR = 0.6 (0.360.99); P = 0.047] were significantly associated with mortality. Candidaemia is a deadly infection. Fluconazole resistance is emerging, although it was not significantly related to mortality. Using an echinocandin as the primary agent could be life-saving. (c) 2020 Elsevier B.V. and International Society of Chemotherapy. All rights reserved.Item Emerging Escherichia coli O25b/ST131 Clone Predicts Treatment Failure in Urinary Tract Infections(2015) Can, Fusun; Azap, Ozlem Kurt; Seref, Ceren; Ispir, Pelin; Arslan, Hande; Ergonul, Onder; 25378460Background. We described the clinical predictive role of emerging Escherichia coli O25b/sequence type 131 (ST131) in treatment failure of urinary tract infection. Methods. In this prospective observational cohort study, the outpatients with acute cystitis with isolation of E. coli in their urine cultures were assessed. All the patients were followed up for clinical cure after 10 days of treatment. Detection of the E. coli O25:H4/ST131 clone was performed by multiplex polymerase chain reaction (PCR) for phylogroup typing and using PCR with primers for O25b rfb and allele 3 of the pabB gene. Results. In a cohort of patients with diagnosis of acute urinary cystitis, 294 patients whose urine cultures were positive with a growth of >10(4) colony-forming units/mL of E. coli were included in the study. In empiric therapy, ciprofloxacin was the first choice of drug (27%), followed by phosphomycin (23%), trimethoprim-sulfamethoxazole (TMP-SMX) (9%), and cefuroxime (7%). The resistance rate was 39% against ciprofloxacin, 44% against TMP-SMX, and 25% against cefuroxime. Thirty-five of 294 (12%) isolates were typed under the O25/ST131 clone. The clinical cure rate was 85% after the treatment. In multivariate analysis, detection of the O25/ST131 clone (odds ratio [ OR], 4; 95% confidence interval [ CI], 1.51-10.93; P = .005) and diabetes mellitus (OR, 2.1; 95% CI,.99-4.79; P = .05) were found to be significant risk factors for the treatment failure. In another multivariate analysis performed among quinolone-resistant isolates, treatment failure was 3 times more common among the patients who were infected with ST131 E. coli (OR, 3; 95% CI, 1.27-7.4; P = .012). Conclusions. In urinary tract infections, the E. coli ST131 clone seems to be a consistent predictor of treatment failure.