Yazar "Yalcin, Metin" seçeneğine göre listele

Listeleniyor 1 - 2 / 2
  • Küçük Resim Yok
    Öğe
    Resistance Genes and Mortality in Carbapenem-resistant Klebsiella pneumoniae Bacteremias: Effects of the COVID-19 Pandemic
    (Galenos Publ House, 2024) Kurt, Ahmet Furkan; Tanriverdi, Elif Seren; Yalcin, Metin; Bayramlar, Osman Faruk; Kaya, Sibel Yildiz; Karaali, Ridvan; Kuskucu, Mert Ahmet
    Background: Emerging carbapenem-resistant Klebsiella pneumoniae (K. pneumoniae) (CRKP) bacteremias are presenting significant public health risks due to limited treatment options and increased mortality. K. pneumoniae isolates exhibit carbapenem resistance rates that vary from 25% to 50% throughout the European continent, including our country. Aims: To assess the characteristics of CRKP bacteremia, a condition that has recently demonstrated an increasing prevalence in our center. We sought to ascertain the resistance rates of isolated strains to antibiotics other than carbapenems, identify the responsible carbapenemase genes, evaluate the efficacy of antibiotics, determine mortality rates, explore clonality among strains, and investigate the influence of the COVID-19 pandemic on all these factors. Study Design: Retrospective observational study. Methods: This study included patients aged 18 and older who had experienced meropenem-resistant K. pneumoniae bacteremia. Meropenem resistance was confirmed by employing the Kirby-Bauer disk diffusion method. Meropenem minimum inhibitory concentration (MIC) levels were determined using the gradient test, while colistin MIC levels were ascertained using the disk elution technique. Carbapenemase genes were evaluated via colony polymerase chain reaction (PCR), and clonality analysis was performed using the arbitrarily primed PCR technique. Results: The study comprised 230 patients, with a mean age of 63.1 +/- 15.9 years, of whom 58.7% were male. Oxacillinase-48 (OXA-48) was detected in 74.8% of the patients, New Delhi metallo-beta-lactamase (NDM) in 12.6%, OXA-48 + NDM in 7.8%, and KPC in 4.8%. The 14-day and 30-day mortality rates were 57% and 69.6%, respectively. Multivariate analysis of the 30-day mortality revealed several crucial factors, including bacteremia development in the intensive care unit, the occurrence of bacteremia during the COVID-19 pandemic, polymicrobial bacteremia, the use of indwelling intravenous catheters, a platelet count of <= 140,000/ mu l, procalcitonin levels of >= 6 mu g/l, and a Charlson comorbidity score >= 3. Notably, the OXA-48 and KPC genes were upregulated significantly during the COVID-19 pandemic, while the NDM gene groups were downregulated. Additionally, both 14-day and 30-day mortality rates increased significantly. Conclusion: In this study, the most prevalent carbapenemase gene was OXA-48; however, there has been a recent increase in KPC genes. No dominant epidemic strain was identified through clonality analysis. The clustering rate was 68% before the pandemic, increasing to 85.7% during the pandemic. The significance of infection control measures is underscored by the rise in both clustering and mortality rates during the COVID-19 pandemic.
  • Küçük Resim
    Öğe
    The results of perforated peptic ulcer surgery; A single center experience of 86 patients
    (2018) Oter, Volkan; Yalcin, Metin; Kafadar, Mehmet Tolga; Oter, Serdar
    Aim: At the present time, eradication of the Helicobacter pylori infection is dramatically reduced the risk of the peptic ulcer disease. Whereas, complication rate of the peptic ulcer, such as perforations or bleedings have not been reduced significantly yet. The aim of the current study is to analyze the surgical treatment outcomes of our experiences in 86 patients with peptic ulcer perforation. Material and Methods: Between January 2012 and December 2017, 86 patients who were operated emergently for perforated peptic ulcer disease with Graham’s omental patch procedure in our hospital were included in this study. Demographic, clinical data, diagnostic studies, surgical procedures, operative findings, postoperative complications and patient follow-up were analyzed. Results: The mean age was 41.57±16.09 years. Out of 86 cases there were 65 (75.6%) male patients and 21 (24.4%) female patients. The mean operation time was 66.98±18.61 minutes. The mean hospital stay period was 7.95±2.02. In three months of follow-up period, endoscopy was done to all of these patients and peptic ulcer disease was not seen in any of them. Conclusion: Our findings revealed that Graham’s omental patch repair is still a useful method for perforated peptic ulcer disease. Low complication rates, low duration of hospital stay and also low postoperative morbidity can be achieved with good preoperative and postoperative supportive care in open surgery for peptic ulcer perforation. Laparoscopic surgery should be performed only in the presence of experienced surgeon and also in the presence of sufficient laparoscopic materials.