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Öğe Antimicrobial susceptibility pattern of Escherichia coli andKlebsiella pneumoniae isolated from patients with urinarytract infections in a tertiary care hospital(2021) Doğan, Ahmet; Köse, Adem; Gezer, Yakup; Ersoy, Yasemin; Bayindir, Yasar; Özden, Mehmet; Memisoglu, Funda; Altunisik Toplu, SibelAim: To determine etiological microorganisms from urine samples in patients diagnosed with UTI and to detect the antimicrobial susceptibility pattern of Escherichia coli and Klebsiella pneumoniae in a Tertiary Care Hospital.Materials and Methods: A cross-sectional study was conducted using urine culture samples and sensitivity reports collected retrospectively from our laboratory records over a period from Jan 2013 to Dec 2017.Results: A total of 729 urine culture isolates from 660 patients were included. Two-hundred eighty-four (41.8%) of the patients were male and 384 (58.2%) were female. The most common microorganisms were 46.4% E. coli, 18.2% K. pneumoniae and 12.1% Enterococcus spp., respectively. A total of 284 urine culture isolates produced extended spectrum beta-lactamases (ESBL), of which 186 (65.5%) were E. coli and 98 (34.5%) were K. pneumoniae. The most susceptible antimicrobials are meropenem, imipenem, amikacin, and fosfomycin, respectively. We determined that the antimicrobial drugs with the lowest susceptibility rates for both E. coli and K. pneumoniae were amoxicillin-clavulanate (24.5%), trimethoprim-sulfamethoxazole (30.7%) and ceftriaxone (43.2%). Additionally, their susceptibilities have gradually decreased. Ertapenem susceptibility has decreased more in K. pneumoniae isolates than E. coli.Conclusion: Antimicrobial resistance and ESBL-producing for both E. coli and K. pneumoniae have been increasing over the years. Our findings may contribute to choosing the proper antibiotic for the empirical treatment of UTI and preventing treatment failure.Öğe Bloodstream Infections in COVID-19 Positive and COVID-19 Negative Patient Groups Followed Up in the Intensive Care Unit: Case-Control Study(2022) Doğan, Ahmet; Gezer, Yakup; Kalaycı, Hacer ÖzlemAim: Bloodstream infections are one of the most important problems we encounter in patients followed up in intensive care units. In our study, we aimed to comparatively examine the demographic characteristics and bacteremia epidemiology of patients who were followed up for SARS-CoV-2 (COVID-19) positivity or other reasons in the intensive care units. Material and Methods: 192 cases (>18 age) whose blood cultures were studied were included in the study. The blood culture results of a total of 60 cases, 30 of which were positive for COVID-19 in the study group and 30 were negative for COVID-19 in the control group, were examined. Results: Thirteen (43.3%) of the patients in the case group were female, 17 (56.7%) were male, and the mean age of the group was 63.8±19 (22-88). In the control group, 15 (50%) were female, 15 (50%) were male, and the mean age of the group was 76.1±17.6 (48-92). There was no statistically significant difference between the two groups in terms of sex (p=0.605), comorbid conditions (excluding sepsis (p=0.005)), the number of isolates produced (p=0.260), the amount of blood culture set (p=0.118), bacteremia risk factors and mortality rates (p=0.612). However, there were differences in mean age (p=0.000), skin contamination (p=0.028) and prednisolone treatment (p=0.000). Conclusion: The risk of bloodstream infection in patients hospitalized in the intensive care units due to COVID-19 is not different from the group of patients hospitalized for non-COVID-19 reasons.Öğe Efficacy of colchicine treatment in COVID-19 patients: A case-control study(2022) Doğan, Ahmet; Karakök, Taliha; Gezer, YakupAim: Various clinical studies have been conducted on many alternative options in treating COVID-19 since the beginning of the pandemic process. This study aimed to investigate the effectiveness of colchicine treatment in patients hospitalized in clinical wards due to COVID-19. Methods: The study was retrospectively planned between October 2020 and October 2021. A total of 110 cases who received colchicine + standard treatment (favipiravir + corticosteroid + anticoagulant + symptomatic treatment) were included in the study group. The control group included randomly selected 220 patients who received only standard treatment. All cases' demographic characteristics, features of antibiotic and corticosteroid treatment, comorbidities, and clinical courses were recorded. Patients who received treatment for less than three days due to COVID-19, patients aged >95 years and <18 years, and those transferred to the clinical wards from the intensive care unit were excluded from the study. The groups were compared regarding treatment failure, including the number of intensive care unit admissions and mortality due to COVID-19 infection. Results: While the mean age was 59.4 years in the study group, it was 65.0 years in the control group (p=0.001). The most common coexisting disease was hypertension (63%). There were significant differences between the groups in the proportions of antibiotic use (p=0.002) and high-dose corticosteroid use (p=0.004). The values of white blood cell count (p=0.003), urea (p=0.029), D-dimer (p=0.021), creatine kinase-myocardial band (p=0.003) and troponin (p<0.001) were statistically different. There was no difference in terms of intensive care unit admission (p=0.174), the mortality rate (p=1.000), and treatment failure (p=0.505). Conclusions: According to the results of our study, colchicine treatment does not affect the prognosis of COVID-19 patients. There is a need for prospective studies investigating the role of colchicine treatment in COVID-19 infections.Öğe Evaluation of the patient with lymphadenopathy: Is it always easy to reach the correct diagnosis?(2021) Köse, Adem; Doğan, Ahmet; Bayindir, Yasar; Ersoy, Yasemin; Özden, Mehmet; Memişoğlu, Funda; Toplu, SibelLymphadenopathy (LAP) is a common clinical problem in adult patients and should be thoroughly evaluated in a tertiary hospital to investigate its reasons. In this study,we aimed to present the demographic characteristics, etiology, diagnosis and follow-up results of the patients who applied with LAP symptoms and findings. This studywas designed to include adult patients with neck, armpit, or groin swelling accompanied by symptoms, such as fever, night sweats, weight loss, cough and sputum betweenJanuary 2010 and August 2017, retrospectively. Patients’ data were collected from electronic files. Patients were diagnosed using radiological, histopathological,bacteriological, serological and other microbiological methods. Two hundred-thirty patients were included in this study. The mean age was 43.12±17.06 SD in males and45.74±16.64 in females. On admission, the most common symptoms were night sweats (31%), fever (23%), weight loss (17%) and cough and/or sputum (13%) in orderof frequency. However, 16% of the patients were asymptomatic. In this study, 157 (68.26%) patients were diagnosed. Tuberculosis (n=76; 33%), malignancies (n=28,12.1%) and tularemia (N=14; 6.1%) were the most common diseases causing LAP that was most commonly located in the bilateral cervical chain. Lymphadenopathyshould be evaluated comprehensively concerning diagnosing or ruling out many diseases that must be treated necessarily. Knowledge and awareness of the diseases as acause of LAP may contribute to the early and correct diagnosis. Therefore, undiagnosed patients should be followed, and the institutions should develop policies for thispurpose, such as telemedicine applications.Öğe Fusarium Fungemia After Electric Burn: A Case Report(2023) Ersoy, Yasemin; Doğan, Ahmet; Duman, Yücel; Fırat, CemalFusarium bloodstream infections, which are mostly seen in immunosuppressive patients, are serious life-threatening infec- tions. Here, we present a 35-year-old male patient who was being followed up for electric shock due to Fusarium fungemia, which developed while receiving antibacterial therapy. It was thought that the patient’s central venous catheter, use of broad-spec- trum antibiotics, and severe burn could be the most important risk factors. The patient was successfully treated by withdraw- ing the catheter and administering Liposomal Amphotericin-B 3 mg/kg daily for 3 weeks. Blood culture is critical in burn patients, and Fusarium infections should also be considered.Öğe Yoğun bakım ihtiyacı olan pnömonili hastalarda atipik pnömoni ve viral pnömoni etkenlerinin araştırılması(İnönü Üniversitesi, 2018) Doğan, Ahmet; Ersoy, Yasemı?nÖZET Yoğun Bakım İhtiyacı Olan Pnömonili Hastalarda Atipik Pnömoni ve Viral Pnömoni Etkenlerinin Araştırılması Giriş ve Amaç: Pnömoniler hem hastane kaynaklı hem de toplum kaynaklı enfeksiyonlar içerisinde önemli role sahiptir. Yoğun bakım ihtiyacı olan toplum kökenli ve hastane kökenli tüm pnömonili hastalarda amprik tedavi kritik öneme sahip olup, tedavi muhtemel etkenleri kapsamalıdır. Bakteriyel etkenlere yönelik çok sayıda çalışma olmasına karşın viral ve atipik etkenleri saptamaya yönelik ülkemizde az sayıda çalışma vardır. Bu çalışmada yoğun bakım ihtiyacı olan pnömonili hastalarda atipik pnömoni ve viral pnömoni etkenlerini belirlemeyi ve mortaliteye etkisini araştırmayı amaçladık. Gereç ve Yöntem: Çalışmaya prospektif olarak 1 Kasım 2016-30 Ekim 2017 tarihleri arasında hastanemiz Reanimasyon, Beyin Cerrahi, Nöroloji, Göğüs Hastalıkları ve Dahiliye yoğun bakım ünitelerine yatış esnasında klinik ve laboratuar bulguları ile toplumdan gelen pnömoni (TGP) tanısı konan veya yattıktan sonraki günlerde hastanede gelişen pnömoni (HGP) tanısı alan 18 yaş üzerindeki hastalardahil edildi. Hastalara ait klinik özellikler kaydedildi. Hastalardan balgam veya trakeal aspirat örnekleri standart bakteriyel kültür için gönderildi. Atipik pnömoni etkenlerinden olan Mycoplasma pneumoniae, Chlamydia pneumoniae ve Legionella pneumophiliae ve viral etkenlerin tespiti için trakeal aspirat veya balgam örnekleri alındı. L. pneumophiliae'nın tespiti amacıyla "Buffered Charcoal Yeast Extract (BCYE)" besiyerine ekim yapıldı. Ayrıca, aynı hastalardan viral pnömoni etkenlerinden respiratuvar sinsityal virüs (RSV), İnsan metapnömovirüs (HMPV), rinovirüs (RV), enterovirüs (EV), parainfluenza virüs (PIV), influenza A (InfA), influenza B (InfB), insan bokavirüs (HBoV), adenovirüs için nazofarinks sürüntü örneğinden in-house multipleks polimeraz zincir reaksiyonu (PZR) yöntemiyle spesifik DNA/RNA araştırıldı. Bulgular: Çalışmaya 200 hasta dahil edildi. Hastaların 126'sı (%63) erkek, 74'ü (%37) kadındı. Hastaların 65'i (%32,5) TGP, 135'i (%67,5) HGP'idi. Ateş hastaların %32,5'inde, dispne %61'inde, takipne %56'sında, pürülan balgam %95,5'inde, artan öksürük şikayeti %7,5'inde saptandı. Tüm hastaların akciğer radrografisinde infiltrasyon alanları mevcuttu. Hastaların 83'ünde (%41,5) bakteriyel bir veya daha fazla etken saptanırken, sekizinde (%4) ise M. pneumoniae tespit edildi. Otuzbir (%15,5) hastada bir viral etken,15 vakada ise (%7,5) bakteri-virüs karışık etken olduğu görüldü. Hem TGP hemde HGP olgularının %6'sında influenza saptandı. Hiçbir hastada Legionella üremesi olmadı. L. pneumoniae ve C. pneumoniae PZR tüm hastalarda negatif sonuçlandı. Mortalite oranları TGP vakalarında %17, HGP vakalarında %29,6 bakteriyel etken saptanan vakalarda %27,5 viral etken saptanan vakalarda %25,8, bakteri-virüs karışık etken saptanan vakalarda %26,6 ve etken saptanmayan vakalarda %23,2 olarak gözlendi. Sonuç: Hastanede gelişen pnömoni ve TGP hastalarında atipik pnömoni etkenlerinden sadece M. pneumoniae az sayıda hastada saptanırken, viral etkenlerden amprik tedavide önemi olan influenza'nın nadir olduğu tespit edildi. Anahtar kelimeler: Atipik pnömoni, viral pnömoni, toplumdan gelen pnömoni, hastanede gelişen pnömoni, yoğun bakım,