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    Ceftazidime-Avibactam: A Retrospective Analysis of Multicenter Real-World Data and Factors Affecting Mortality
    (Doc Design Informatics Co Ltd, 2025) Aktug-Demir, Nazlim; Temocin, Fatih; Ural, Onur; Gulten, Ezgi; Inal, Ayse Seza; Kader, Cigdem; Ersoy, Yasemin
    Objective: Multidrug-resistant Gram-negative bacteria cause difficult-to-treat infections associated with high mortality. Carbapenems are widely used; however, their overuse has led to the emergence of carbapenem-resistant bacteria. This study aimed to evaluate the indications, clinical and microbiological efficacy, and side effects of ceftazidime-avibactam (CAZ-AVI) and to identify factors influencing mortality, based on data from a large multicenter patient cohort in T & uuml;rkiye. Materials and Methods: Patients with carbapenem-resistant but CAZ-AVI-susceptible Gram-negative bacterial infections who received CAZ-AVI treatment were retrospectively reviewed. Results: A total of 1245 patients were included. The most common indication for CAZ-AVI use was hospital-acquired pneumonia (47.8%). Klebsiella pneumoniae was the predominant pathogen (81.3%). CAZ-AVI was used as a monotherapy in 80% of cases. Clinical side effects were observed in 8 (0.64%) patients, while laboratory abnormalities occurred in 73 (5.86%). The 7-day, 14-day, and 28-day all-cause mortality rates were 13.8%, 28.9%, and 45.2%, respectively. Microbiological eradication was achieved in 82.3% of patients. Higher Sequential Organ Failure Assessment (SOFA) and Acute Physiology and Chronic Health Evaluation II (APACHE II) scores at admission, requirement for continuous renal replacement therapy, mechanical ventilation, and elevated C-reactive protein levels were identified as independent risk factors for mortality. Conclusion: This large multicenter real-world analysis demonstrates that CAZ-AVI is an effective treatment option for severe infections with high mortality, such as those caused by carbapenem-resistant Enterobacterales and Pseudomonas aeruginosa.
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    From awareness to action: A nationwide survey of infectious diseases and clinical microbiology physicians' perspectives on artificial intelligence in clinical practice
    (Sage Publications Ltd, 2025) Gulten, Ezgi; Derin, Okan; Arslan, Eyup; Atasoy Tahtasakal, Ceren; Temocin, Fatih; Memisoglu, Funda; Aktug Demir, Nazlim
    Background: The integration of artificial intelligence (AI) into clinical practice is gaining momentum globally, yet specialty-specific perspectives remain underexplored. This study aimed to assess the awareness, knowledge, attitudes, expectations, and concerns of infectious diseases and clinical microbiology (IDCM) physicians regarding AI applications in their field. Methods: A cross-sectional, online survey was distributed between May and June 2025 to IDCM physicians across T & uuml;rkiye. The questionnaire included multiple-choice, Likert-type, and open-ended items assessing sociodemographic characteristics, AI familiarity, clinical use, and perceptions. Descriptive and inferential statistics, along with thematic analysis of qualitative responses, were employed. Results: In total, 387 IDCM physicians completed the survey. While 0.5% (n = 2) reported prior long-term/extensive AI training, 88.9% (n = 344) agreed that IDCM physicians should be actively involved in AI system development. Notably, 23.0% (n = 89) had already used AI tools, primarily ChatGPT (n = 69, 77.5%). Regarding accountability, 68.2% (n = 264) assigned responsibility for erroneous AI-generated decisions to physicians. Familiarity with AI showed a strong association with academic title (p < .001). Total knowledge scores were significantly higher among university hospital physicians (p < .001), whereas total attitude scores differed across age (p = .003), academic title (p = .001), and years of experience (p = .006). Thematic analysis of 97 open-ended responses revealed high expectations for AI in enhancing decision support, timeliness, and operational efficiency. However, major concerns included ethical risks, algorithmic bias, data reliability, and potential erosion of clinical autonomy. Conclusions: This study provides comprehensive insights into IDCM physicians' perspectives on AI. Findings highlight strong interest but limited preparedness, underscoring the need for targeted education, ethical safeguards, and inclusive policy frameworks to ensure responsible AI integration.