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    Comparative Evaluation of In Vitro Activities of Carbapenemes Against Gram-Negative Pathogens: Turkish Data of COMPACT Study
    (Ankara Microbiology Soc, 2011) Korten, Volkan; Soyletir, Guner; Yalcin, Ata Nevzat; Ogunc, Dilara; Dokuzoguz, Basak; Esener, Harika; Ulusoy, Sercan; Tunger, Alper; Aygen, Bilgehan; Sumerkan, Bulent; Arman, Dilek; Dizbay, Murat; Akova, Murat; Hascelik, Gulsen; Eraksoy, Haluk; Basaran, Seniha; Koksal, Iftihar; Bayramoglu, Gulcin; Akalin, Halis; Sinirtas, Melda
    The aim of this study was to determine the in vitro activities of doripenem, imipenem, and meropenem against clinical gram-negative isolates. A total of 596 clinical isolates were obtained from intensive care unit (ICU) and non-ICU patients in 10 centers over Turkey between September-December 2008. The origin of the isolates was patients with nosocomial pneumonia (42.4%), bloodstream infections (%40.4), and complicated intraabdominal infections (17.1%). Of the isolates, 51.8% were obtained from ICU patients. The study isolates consisted of Pseudomonas spp. in 49.8%, Enterobacteriaceae in 40.3%, and other gram-negative agents in 9.9%. The minimum inhibitory concentrations (MIC) for doripenem, imipenem and meropenem were determined for all isolates in each center using Etest (R) strips (AB Biodisk, Solna, Sweden). Of the isolates, 188 (31.5%) were resistant to at least one of the carbapenems. MIC(50) of doripenem against Pseudomonas spp. was 1 mg/L which was similar to that of meropenem and two-fold lower than imipenem. Susceptibility to carbapenems in P.aeruginosa was 64% for doripenem at an MIC level of 2 mg/L, 53.9% and 63% for imipenem and meropenem at an MIC level of 4 mg/L, respectively. Doripenem and meropenem showed similar activity with the MIC(90) of 0.12 mg/L whereas imipenem was four-fold less active at 0.5 mg/L. Against other gram-negative pathogens, mostly Acinetobacter spp., MIC(50) was 8 mg/L for doripenem and 32 mg/L for other two carbapenems. P.aeruginosa isolates were inhibited 84.2% with doripenem and 72.1% with meropenem at the MIC level of 8 mg/L. Doripenem generally showed similar or slightly better activity than meropenem and better activity than imipenem against pathogens collected in this study. Against Pseudomonas spp., doripenem was the most active of the three carbapenems. Doripenem and meropenem were equally active against Enterobacteriaceae and at least four-fold more active than imipenem. It was concluded that doripenem seemed to be a promising agent in the treatment of nosocomial pneumonia, blood stream infections and intraabdominal infections particularly in patients who were under risk of developing antimicrobial resistance.
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    Correlation between intrahepatic hepatitis B virus cccDNA levels and other activity markers in patients with HBeAg-negative chronic hepatitis B infection
    (Lippincott Williams & Wilkins, 2011) Guner, Rahmet; Karahocagil, Mustafa; Buyukberber, Mehmet; Kandemir, Ozlem; Ural, Onur; Usluer, Gaye; Inan, Dilara; Koksal, Iftihar; Baykam, Nurcan; Hizel, Kenan; Yamazhan, Tansu; Esen, Saban; Tasyaran, Mehmet A.
    Objective The aim of this study was to demonstrate the relation between intrahepatic (IH) hepatitis B virus (HBV) covalently closed circular DNA (cccDNA) levels and the other HBV replicative intermediates and hepatocyte expression of HBV antigens. Patients and methods Patients with hepatitis B surface antigen (HBsAg) positivity, hepatitis B early antigen negativity, serum HBV DNA levels 10(4) copies/ml or more, and constantly or intermittently increased alanine aminotransferase levels were included. Results Fifty-nine patients were included. There was a good correlation between the levels of IH HBV cccDNA and serum HBV DNA (P<0.001). Serum HBsAg levels were weakly correlated with IH HBV cccDNA levels and moderately correlated with serum HBV DNA (r=0.322, P=0.017; r=0.489, P=0.001, respectively). There were no significant correlation between serum HBsAg level and histologic activity index groups (P=0.691), but stage 0, 1, and greater than 2 fibrosis groups were positively correlated with serum HBsAg levels (P=0.019). IH cccDNA and serum HBV DNA were significantly different in hepatitis B core antigen staining groups (P=0.008 and <0.001, respectively) but there was no significant correlation between HBsAg staining groups and HBV replication markers. There was a weak correlation between serum HBsAg levels and IH HBsAg and hepatitis B core antigen levels (r=0.333, P=0.012; r=0.366, P=0.006, respectively). In multivariate analysis, alanine aminotransferase, age, fibrosis stage, and serum HBsAg quantitation were the most important factors predicting IH HBV cccDNA level. Conclusion Histopathologic damage, serum HBV DNA levels, and IH HBV replication markers have a more complex and dynamic process. However, both serum and IH HBV replication markers provide important knowledge about the activity of the disease. Eur J Gastroenterol Hepatol 23:1185-1191 (C) 2011 Wolters Kluwer Health | Lippincott Williams & Wilkins.
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    Daclatasvir Plus Asunaprevir Dual Therapy for Chronic HCV Genotype 1b Infection: Results of Turkish Early Access Program
    (Mexican Assoc Hepatology, 2017) Koklu, Seyfettin; Koksal, Iftihar; Akarca, Ulus Salih; Balkan, Ayhan; Guner, Rahmet; Demirezen, Aylin; Sahin, Memduh; Akhan, Sila; Ozaras, Resat; Idilman, Ramazan
    Background. Daclatasvir and asunaprevir dual therapy is approved for the treatment of HCV genotype 1b infection in several countries. Aim. To evaluate the efficacy and safety of daclatasvir and asunaprevir dual therapy in Turkish patients. Material and methods. Sixty-one patients with HCV genotype 1b were enrolled in the Turkish early access program. Most of the patients were in difficult-to-treat category. Patients were visited at each 4 week throughout the follow-up period. Laboratory findings and adverse events were recorded at each visit. Results. Fifty-seven of 61 enrolled patients completed 24 weeks of treatment. Two patients died as a result of underlying diseases at 12-14th weeks of treatment. Two patients stopped the treatment early as a consequence of virological breakthrough, and 2 patients had viral relapse at the post-treatment follow-up. Overall SVR12 rates were 90% (55/61) and 93.2% (55/59) according to intention-to-treat (ITT) and per protocol (PP) analysis respectively. In ITT analysis, SVR12 was achieved by 93% (13/14) in relapsers, 80% (12/15) in interferon-ineligible patients and 91% (20/22) in previous nonresponder patients. SVR12 rates were 86.5% and 91.4% in patients with cirrhosis according to ITT and PP analysis respectively. SVR12 was 95.8% in non-cirrhosis group in both analysis. Patients with previous protease inhibitor experience had an SVR12 of 87.5%. Common adverse events developed in 28.8% of patients. There were no treatment related severe adverse event or grade-4 laboratory abnormality. Conclusions. Daclatasvir and asunaprevir dual therapy is found to be effective and safe in difficult-to-treat Turkish patients with HCV genotype 1b infection.
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    Eliminating Viral Hepatitis in Turkey: Achievements and Challenges
    (Galenos Publ House, 2022) Akarca, Ulus Salih; Baykam, Nurcan; Guner, Rahmet; Gunsar, Fulya; Idilman, Ramazan; Kaymakoglu, Sabahattin; Koksal, Iftihar
    After the declaration Global Health Sector Strategy on Viral Hepatitis by the World Health Organization in 2016, the Turkish Government defined a national strategy covering 2018-2023 to reach goals by 2030. Following a participatory decision process and a series of workshops, the strategy was built on eight separate subheadings. Apart from the official Prevention and Control Program, two separate road maps for hepatitis B and C were developed to obtain targets accessible with the cooperation of the Viral Hepatitis Society and the Turkish Association for the Study of the Liver in 2018 and 2020, respectively. Up to 2023, achievements and the current situation of the National Viral Hepatitis Prevention and Control Program and the hepatitis B virus and hepatitis C virus road maps were assessed in detail on June 28th, 2022, by the subject matter experts in Turkey. Besides the officially reported achievement rate (42%) of the Program in 2021, participants mentioned undesirable effects of the coronavirus disease-2019 pandemic, unregulated migration, low levels of professional and public awareness, and barriers to access to anti-viral treatment. Recommendations focused on increasing the efficiency of screening and surveillance by integrating the viral carrier identity of individuals into the national health information system, simplifying the drug supplement and treatment initiation process and insisting on education to raise awareness.
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    International Nosocomial Infection Control Consortium (INICC) national report on device-associated infection rates in 19 cities of Turkey, data summary for 2003-2012
    (Bmc, 2014) Leblebicioglu, Hakan; Erben, Nurettin; Rosenthal, Victor Daniel; Atasay, Begum; Erbay, Ayse; Unal, Serhat; Senol, Gunes; Willke, Ayse; Ozgultekin, Asu; Altin, Nilgun; Bakir, Mehmet; Oncul, Oral; Ersoz, Gulden; Ozdemir, Davut; Yalcin, Ata Nevzat; Ozdemir, Halil; Yildizdas, Dincer; Koksal, Iftihar; Aygun, Canan; Sirmatel, Fatma; Sener, Alper; Tuna, Nazan; Akan, OTzay Arikan; Turgut, Huseyin; Demiroz, A. Pekcan; Kendirli, Tanil; Alp, Emine; Uzun, Cengiz; Ulusoy, Sercan; Arman, Dilek; Ozgunes, Ilhan; Usluer, Gaye; Kilic, Atila; Arsan, Saadet; Cabadak, Hatice; Sen, Suha; Gelebek, Yasemin; Zengin, Humeyra; Topeli, Arzu; Alper, Yusuf; Meric, Meliha; Azak, Emel; Inan, Asuman; Turan, Guldem; Haznedaroglu, Tuncer; Gorenek, Levent; Acar, Ali; Cesur, Salih; Engin, Aynur; Kaya, Ali; Kuyucu, Necdet; Geyik, Mehmet Faruk; Aydin, Ozlem Cetinkaya; Erdogan, Nurse Selvi; Turhan, Ozge; Gunay, Nurgul; Gumus, Eylul; Dursun, Oguz; Esen, Saban; Ulger, Fatma; Dilek, Ahmet; Yilmaz, Hava; Sunbul, Mustafa; Gokmen, Zeynel; Ozdemir, Sonay Incesoy; Horoz, Ozden Ozgur; Yylmaz, Gurdal; Kaya, Selcuk; Ulusoy, Hulya; Kucukoduk, Sukru; Ustun, Cemal; Baysal, Abant Izzet; Otkun, Metin; Tulunay, Melek; Oral, Mehmet; Unal, Necmettin; Cengiz, Mustafa; Yilmaz, Leyla; Sacar, Suzan; Sungurtekin, Hulya; Ugurcan, Dogac; Yetkin, M. Arzu; Bulut, Cemal; Erdinc, F. Sebnem; Hatipoglu, Cigdem Ataman; Ince, Erdal; Ciftci, Ergin; Odek, Caglar; Yaman, Ayhan; Karbuz, Adem; Aldemir, Bilge; Kilic, Aysegul Ulu; Arda, Bilgin; Bacakoglu, Feza; Hizel, Kenan
    Background: Device-associated healthcare-acquired infections (DA-HAI) pose a threat to patient safety, particularly in the intensive care unit (ICU). We report the results of the International Infection Control Consortium (INICC) study conducted in Turkey from August 2003 through October 2012. Methods: A DA-HAI surveillance study in 63 adult, paediatric ICUs and neonatal ICUs (NICUs) from 29 hospitals, in 19 cities using the methods and definitions of the U.S. NHSN and INICC methods. Results: We collected prospective data from 94,498 ICU patients for 647,316 bed days. Pooled DA-HAI rates for adult and paediatric ICUs were 11.1 central line-associated bloodstream infections (CLABSIs) per 1000 central line (CL)-days, 21.4 ventilator-associated pneumonias (VAPs) per 1000 mechanical ventilator (MV)-days and 7.5 catheter-associated urinary tract infections (CAUTIs) per 1000 urinary catheter-days. Pooled DA-HAI rates for NICUs were 30 CLABSIs per 1000 CL-days, and 15.8 VAPs per 1000 MV-days. Extra length of stay (LOS) in adult and paediatric ICUs was 19.4 for CLABSI, 8.7 for VAP and 10.1 for CAUTI. Extra LOS in NICUs was 13.1 for patients with CLABSI and 16.2 for patients with VAP. Extra crude mortality was 12% for CLABSI, 19.4% for VAP and 10.5% for CAUTI in ICUs, and 15.4% for CLABSI and 10.5% for VAP in NICUs. Pooled device use (DU) ratios for adult and paediatric ICUs were 0.54 for MV, 0.65 for CL and 0.88 for UC, and 0.12 for MV, and 0.09 for CL in NICUs. The CLABSI rate was 8.5 per 1,000 CL days in the Medical Surgical ICUs included in this study, which is higher than the INICC report rate of 4.9, and more than eight times higher than the NHSN rate of 0.9. Similarly, the VAP and CAUTI rates were higher compared with U. S. NHSN (22.3 vs. 1.1 for VAP; 7.9 vs. 1.2 for CAUTI) and with the INICC report (22.3 vs. 16.5 in VAP; 7.9 vs. 5.3 in CAUTI). Conclusions: DA-HAI rates and DU ratios in our ICUs were higher than those reported in the INICC global report and in the US NHSN report.
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    Low recurrence rate of hepatocellular carcinoma following ledipasvir and sofosbuvir treatment in a real-world chronic hepatitis C patients cohort
    (Wiley, 2019) Idilman, Ramazan; Demir, Mehmet; Aladag, Murat; Erol, Cihan; Cavus, Bilger; Iliaz, Raim; Koklu, Hayrettin; Cakaloglu, Yilmaz; Sahin, Memduh; Ersoz, Galip; Koksal, Iftihar; Karasu, Zeki; Ozgenel, Meric; Turan, Ilker; Gunduz, Feyza; Ataseven, Huseyin; Akdogan, Meral; Kiyici, Murat; Koksal, Aydin Seref; Akhan, Sila; Gunsar, Fulya; Tabak, Fehmi; Kaymakoglu, Sabahattin; Akarca, Ulus S.; Akarsu, Mesut; Alkim, Huseyin; Araz, Filiz; Ates, Fehmi; Aygen, Bilgehan; Balik, Ismail; Barut, Huseyin S.; Baysal, Birol; Bolat, Aylin; Celik, Ilhami; Cosgun, Suleyman; Ensaroglu, Fatih; Gokcan, Hale; Gurel, Selim; Gursoy, Sebnem; Inkaya, Ahmet Cagan; Kamilli, Cemil; Kav, Taylan; Kuruuzum, Ziya; Onder, Fatih O.; Ormeci, Necati; Ozbakir, Omer; Ozenirler, Seren; Ozer, Birol; Ozkan, Hasan; Poturoglu, Sule; Senates, Ebubekir; Simsek, Halis; Toka, Bilal; Unal, Hakan; Yaras, Serkan; Yildirim, Abdullah E.; Yildirim, Beytullah; Yilmaz, Bulent; Yilmaz, Hasan; Yozgat, Ahmet; Yurdaydin, Cihan
    The aims of the present study were to evaluate the efficacy and tolerability of ledipasvir/sofosbuvir (LDV/SOF) with or without ribavirin in the treatment of chronic hepatitis C (CHC) in patients with advanced liver disease and to analyse whether the use of LDV/SOF treatment is associated with a new occurrence of hepatocellular carcinoma (HCC) during and after LDV/SOF treatment. The Turkish Early Access Program provided LDV/SOF treatment to a total of 200 eligible CHC patients with advanced liver disease. The median follow-up period was 22months. All patients were Caucasian, 84% were infected with genotype 1b, and 24% had a liver transplantation before treatment. The sustained virological response (SVR12) was 86.0% with ITT analysis. SVR12 was similar among patients with Child-Pugh classes A, B and C disease and transplant recipients. From baseline to SVR12, serum ALT level and MELD score were significantly improved (P<0.001). LDV/SOF treatment was generally well tolerated. Only one patient developed a new diagnosed HCC. Seventeen of the 35 patients, who had a history of previous HCC, developed HCC recurrence during the LDV/SOF treatment or by a median follow-up of 6months after treatment. HCC recurrence was less commonly observed in patients who received curative treatment for HCC compared with those patients who received noncurative treatment (P=0.007). In conclusion, LDV/SOF with or without ribavirin is an effective and tolerable treatment in CHC patients with advanced liver disease. Eradication is associated with improvements in liver function and a reduced risk of developing a new occurrence of HCC. Ledipasvir and sofosbuvir with or without ribavirin is an effective and tolerable treatment in hepatitis C virus-infected patients with advanced liver disease. Eradication is associated with improvements in liver function and reduces the risk of developing a new occurrence of hepatocellular carcinoma.
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    SWITCHING TO TENOFOVIR ALAFENAMIDE IN HBV: NATIONWIDE REAL LIFE DATA OF EFFICACY AND SAFETY FROM TURKEY
    (Wiley, 2021) Tabak, Fehmi; Yoruk, Gulsen; Koksal, Iftihar; Erdem, Hazal; Yildiz, Dilek; Ince, Nevin; Yamazhan, Tansu
    [No Abstract Available]
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    Time-dependent analysis of extra length of stay and mortality due to ventilator-associated pneumonia in intensive-care units of ten limited-resources countries: findings of the International Nosocomial Infection Control Consortium (INICC)
    (Cambridge Univ Press, 2011) Rosenthal, V. D.; Udwadia, F. E.; Munoz, H. J.; Erben, N.; Higuera, F.; Abidi, K.; Medeiros, E. A.; Fernandez Maldonado, E.; Kanj, S. S.; Gikas, A.; Barnett, A. G.; Graves, N.; Guzman, Sandra; Flynn, Luis Pedro; Rausch, Diego; Spagnolo, Alejandro; Benchetrit, Guillermo; Bonaventura, Claudio; de los Angeles Caridi, Maria; Messina, Adriana; Ricci, Beatriz; Frias, Maria Laura; Churruarin, Griselda; Sztokhamer, Daniel; Soroka, Luisa C.; Forciniti, Silvia; Blasco, Marta; Lezcano, Carmen B.; Lastra, Carlos Esteban; Viegas, Monica; Di Nubila, Beatriz Marta Alicia; Lanzetta, Diana; Fernandez, Leonardo J.; Rossetti, Maria Adelaida; Romani, Adriana; Migazzi, Claudia; Barolin, Clarisa; Martinez, Estela; Kobylarz, Alicia; Grinberg, Gorki; Ferreira, Iselde Buchner; Cechinel, Raquel Bauer; Angelieri, Daniela Bicudo; Nouer, Simone; Vianna, Rosa; Machado, Ana Lucia; Gama, Elaine; Blanquet, Doris; Zanandrea, Bruna Boaria; Rohnkohl, Carolina; Regalin, Marcos; Salomao, Reinaldo; Maretti da Silva, Maria Angela; de Jesus Silva, Clelia Heloisa; Vilins, Margarete; Blecher, Sergio; Spessatto, Jamile Leda; Pasini, Ricardo Scopel; Ferla, Shaline; Grinberg, Gorki; Sussmann, Otto; Mojica, Beatriz Eugenia; Villamil Gomez, Wilmer; Ruiz Vergara, Guillermo; Arrieta, Patrick; Rojas, Catherine; Beltran, Humberto; Paez, Jerson; Sussmann, Otto; Torres Navarrete, Maria del Pilar; Dajud, Luis; Mendoza, Mariela; Arrieta, Patrick; Alvarez Moreno, Carlos; Linares, Claudia; Osorio, Laline; Barahona Guzman, Nayide; Rodriguez Ferrer, Marena; Sarmiento Villa, Guillermo; Lagares Guzman, Alfredo; Olarte, Narda; Valderrama, Alberto; Garzon Agudelo, Julio; Rodriguez Calderon, Maria Eugenia; Chaniotaki, Kalliopi; Tsioutis, Constantinos; Bampalis, Dimitris; Todi, Subhash Kumar; Bhakta, Arpita; Bhattacharjee, Mahuya; Kumar, R. Krishna; Radhakrishnan, Kavitha; Ansari, Reshma; Poojary, Aruna; Koppikar, Geeta; Bhandarkar, Lata; Jadhav, Shital; Sen, Nagamani; Subramani, Kandasamy; Karlekar, Anil; Rodrigues, Camilla; Hegd, Ashit; Kapadia, Farahad; Sahu, Samir; Gopinath, Ramachadran; Ravindra, Nallagonda; Myatra, Sheila Nainan; Divatia, J. V.; Kelkar, Rohini; Biswas, Sanjay; Raut, Sandhya; Sampat, Sulochana; Kumar, Rishi; Chakravarthy, Murali; Gokul, B. N.; Sukanya, R.; Pushparaj, Leema; Dwivedy, Arpita; Shetty, Suvin; Binu, Sheena; Zahreddine, Nada; Sidani, Nisreen; Jurdi, Lamia Alamaddni; Kanafani, Zeina; Sanchez Lopez, Martha; Torres Hernandez, Hector; Chavez Gomez, Amalia; Morales, Jaime Rivera; Valero Rodriguez, Julian Enrique; Sobreyra Oropeza, Martha; Sigfrido Rangel-Frausto, Manuel; Martinez Soto, Jose; Armas Ruiz, Alberto; Campuzano, Roberto; Mena Brito, Jorge; Abouqal, Redouane; Madani, Naoufel; Zeggwagh, Amine Ali; Dendane, Tarek; Barkat, Amina; Bouazzaoui, Naima Lamdouar; Meryem, Kabiri; Cuellar, Luis; Rosales, Rosa; Castillo Bravo, Luis Isidro; Linares Caceres, Maria; Atencio Espinoza, Teodora; Sarmiento Lopez, Favio; Mayorga Espichan, Manuel Jesus; Echenique, Liliana; Castaneda Sabogal, Alex; Paredes Goicochea, Iliana; Arroyo Sanchez, Abel; Rios Alva, Guillermo; Garcia Ventura, Jorge; Ramrez Aguilar, Miguel; Segura Plasencia, Niler; Rodriguez, Teofilo; Yalcin, A. Nevzat; Turhan, Ozge; Keskin, Sevim; Gumus, Eylul; Dursun, Oguz; Ozdemir, Davut; Guclu, Ertugrul; Erdogan, Selvi; Ulusoy, Sercan; Arda, Bilgin; Bacakoglu, Feza; Alp, Emine; Aygen, Bilgehan; Arman, Dilek; Hizel, Kenan; Ozdemir, Kesver; Uzun, Cengiz; Sardan, Yesim Cetinkaya; Yildirim, Gonul; Topeli, Arzu; Sirmatel, Fatma; Cengiz, Mustafa; Yilmaz, Leyla; Ozgultekin, Asu; Turan, Guldem; Akgun, Nur; Ozturk, Recep; Dikmen, Yalim; Aygun, Gokhan; Akan, Ozay Arikan; Tulunay, Melek; Oral, Mehmet; Unal, Necmettin; Koksal, Iftihar; Yylmaz, Gurdal; Senel, A. C.; Sozen, Ebru Emel; Ersoz, Gulden; Kaya, Ali; Kandemir, Ozlem; Leblebicioglu, Hakan; Esen, Saban; Ulger, Fatma; Dilek, Ahmet; Aygun, Canan; Kucukoduk, Sukru; Ozgunes, Ilhan; Usluer, Gaye; Turgut, Huseyin; Sacar, Suzan; Sungurtekin, Hulya; Ugurcan, Dogac
    Ventilator-associated pneumonias (VAPs) are a worldwide problem that significantly increases patient morbidity, mortality, and length of stay (LoS), and their effects should be estimated to account for the timing of infection. The purpose of the study was to estimate extra LoS and mortality in an intensive-care unit (ICU) due to a VAP in a cohort of 69 248 admissions followed for 283 069 days in ICUs from 10 countries. Data were arranged according to the multi-state format. Extra LoS and increased risk of death were estimated independently in each country, and their results were combined using a random-effects meta-analysis. VAP prolonged LoS by an average of 2.03 days (95% CI 1.52-2.54 days), and increased the risk of death by 14% (95% CI 2-27). The increased risk of death due to VAP was explained by confounding with patient morbidity.
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    Withdrawal of Staphylococcus aureus from intensive care units in Turkey
    (Mosby-Elsevier, 2013) Erdem, Hakan; Dizbay, Murat; Karabey, Selma; Kaya, Selcuk; Demirdal, Tuna; Koksal, Iftihar; Inan, Asuman; Erayman, Ibrahim; Ak, Oznur; Ulu-Kilic, Aysegul; Karasahin, Omer; Akbulut, Ayhan; Elaldi, Nazif; Yilmaz, Gulden; Candevir, Aslihan; Gul, Hanefi Cem; Gonen, Ibak; Oncul, Oral; Aslan, Turan; Azak, Emel; Tekin, Recep; Tufan, Zeliha Kocak; Yenilmez, Ercan; Arda, Bilgin; Gungor, Gokay; Cetin, Birsen; Kose, Sukran; Turan, Hale; Akalin, Halis; Karabay, Oguz; Dogan-Celik, Aygul; Albayrak, Adem; Guven, Tumer; Celebi, Guven; Ozgunes, Nail; Ersoy, Yasemin; Sirmatel, Fatma; Oztoprak, Nefise; Balkan, Ilker Inanc; Bayazit, Fatma Nurhayat; Ucmak, Hasan; Oncu, Serkan; Ozdemir, Davut; Ozturk-Engin, Derya; Bitirgen, Mehmet; Tabak, Fehmi; Akata, Filiz; Willke, Ayse; Gorenek, Levent; Ahmed, Salman Shaheer; Tasova, Yesim; Ulcay, Asim; Dayan, Saim; Esen, Saban; Leblebicioglu, Hakan; Altun, Begin; Unal, Serhat
    Background: In the past, Staphylococcus aureus infections have displayed various patterns of epidemiologic curves in hospitals, particularly in intensive care units (ICUs). This study aimed to characterize the current trend in a nationwide survey of ICUs in Turkey. Methods: A total of 88 ICUs from 36 Turkish tertiary hospitals were included in this retrospective study, which was performed during the first 3 months of both 2008 (period [P] 1) and 2011 (P2). A P value <=.01 was considered significant. Results: Although overall rates of hospital-acquired infection (HAI) and device-associated infection densities were similar in P1 and P2, the densities of HAIs due to S aureus and methicillin-resistant S aureus (MRSA) were significantly lower in P2 (P < .0001). However, the proportion of HAIs due to Acinetobacter was significantly higher in P2 (P < .0001). Conclusions: The incidence of S aureus infections is declining rapidly in Turkish ICUs, with potential impacts on empirical treatment strategies in these ICUs. Copyright (C) 2013 by the Association for Professionals in Infection Control and Epidemiology, Inc. Published by Elsevier Inc. All rights reserved.