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Öğe Comparative evaluation of in vitro activities of carbapenemes against gram-negative pathogens: Turkish data of COMPACT study [Karbapenemlerin gram-negatif patojenlere kar§i in vitro aktivitelerinin karşilaştirmali deg`erlendirmesi: COMPACT çalis§masi türkiye verisi](2011) Korten V.; Söyletir G.; Yalçin A.N.; Ögünç D.; Dokuzoguz B.; Esener H.; Ulusoy S.; Tünger A.; Aygen B.; Sümerkan B.; Arman D.; Dizbay M.; Akova M.; Hasçelik G.; Eraksoy H.; Başaran S.; Köksal I.; Bayramoglu G.; Akalin H.; Sinirtş M.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¯strips (AB Biodisk, Solna, Sweden). Of the isolates, 188 (31.5%) were resistant to at least one of the carbapenems. MIC50 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 gramnegative 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 imi-penem. 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. Carbapenem; doripenem; in vitro activity; gram-negative pathogen.Öğe Hemophagocytic lymphohistiocytosis in adults: Low incidence of primary neoplasm as a trigger in a case series from Turkey(Universita Cattolica del Sacro Cuore, 2018) Arslan F.; Alp S.; Büyükasık Y.; Ozkan M.C.; Şahin F.; Basaran S.; Cagatay A.A.; Eraksoy Ö.H.; Aksu K.; Ertunç B.; Korten V.; Ceylan B.; Mert A.Hemophagocytic Lymphohistiocytosis (HLH) is an indicator of an exaggerated immune response and eventually adverse outcomes. This study aimed to investigate the clinical and laboratory features and outcomes of patients with HLH. The medical records of 26 HLH adult patients (? 16 years of age) were retrospectively analyzed. Gender, age, the duration of fever, time to diagnosis, etiology and laboratory data were extracted from the records. The mean age was 38 ± 18 years, and 15 (58%) patients were female. A total of nine cases had infectious diseases; four cases had rheumatologic diseases, three cases had hematological malignancies while nine cases could not have a definitive diagnosis. The median time to detection of HLH was 20 days (IQR: 8-30 d). Of the 25 patients, 11 (44%) died. The erythrocyte sedimentation rates of the surviving and non-surviving patients were 39 ± 22 mm/h and 15 ± 13 mm/h, respectively. When a long-lasting fever is complicated by bicytopenia or pancytopenia (especially), clinicians should promptly consider the possibility of HLH syndrome to improve patients' prognosis. © 2018 Slovensko Kemijsko Drustvo. All Rights Reserved.Öğe In vitro susceptibility of respiratory isolates of Streptococcus pneumoniae and Streptococcus pyogenes to telithromycin and 11 other antimicrobial agents: Turkish results of e-BASKETT-II surveillance study [Solunum yolu enfeksi·yonu etkenleri· Streptococcus pneumoniae ve Streptococcus pyogenes'i·n teli·tromi·si·n ve 11 anti·mi·krobi·k i·laca i·n vi·tro duyarliligi: E-BASKETT-II sürveyans çalişmasinin türki·ye sonuçlari](2007) Gür D.; Mülazimoglu L.; Ünal S.; Balik I.; Azap A.; Öztürk R.; Yilmaz M.; Yaman A.; Saltoglu N.; Ayaz C.; Çakir N.; Yüce A.; Özinel Ma.; Sümerkan B.; Arslan H.; Arman D.; Zarakolu P.; Ersoy Y.; Firat M.; Eraksoy H.; Çagatay A.; Köksal I.; Çaylan R.; Vahaboglu H.; Willke A.; Korten V.; Leblebicioglu H.; Günaydin M.; Usluer G.; Özgüneş I.; Gedikoglu S.; Özakin C.In respiratory tract infections, therapy is often empirical and there is a need for local data on the rate of resistance to available antimicrobials. In this multicentre study which is a part of the international e-BASKETT-II surveillance study, respiratory isolates of Streptococcus pneumoniae (n=260) and Streptococcus pyogenes (n=312) collected between September 2002 and June 2003 from 18 hospitals in Turkey were tested against penicillin G, amoxicillin, cefuroxime, ceftriaxone, erythromycin, clarithromycin, azithromycin, clindamycin, telithromycin, tetracycline, levofloxacin and vancomycin. Antibiotic susceptibilities were determined with disk diffusion method and confirmed with broth dilution method following the CLSI guidelines. Isolates which were resistant to erythromycin were genotyped by polymerase chain reaction. In S.pneumoniae 11.5% of the isolates were highly and 22.7% were intermediately resistant to penicillin. Rate of resistance to erythromycin, clarithromycin, azithromycin was 17.3%, and 21.5% of the isolates were resistant to tetracycline. Resistance to levofloxacin and vancomycin was not observed and only one isolate was found intermediately resistant (MIC=2µg/mL) to telithromycin. Genotypes in erythromycin-resistant isolates were ermB (77.8%), mefA (17.8%) and ermB+mefA (2.2%). S.pyogenes isolates were uniformly susceptible to beta-lactams and vancomycin, and only one isolate was intermediately resistant to levofloxacin. Macrolide resistance was observed in 1.3% of the isolates and three out of these harboured the mefA gene. One isolate with an MIC of 4µg/mL for telithromycin had ermB gene. Telithromycin has demonstrated a good in vitro activity against macrolide-resistant respiratory tract isolates. As a result, e-BASKETT-II surveillance study has been one of the most extensive in vitro studies comparing telithromycin to available antimicrobial agents for respiratory tract infections in Turkey.Öğe Susceptibility of bacterial isolates from Turkey - A report from the meropenem yearly susceptibility test information collection (MYSTIC) program(E.S.I.F.T. srl, 2007) Eraksoy H.; Basustaoglu A.; Korten V.; Kurt H.; Ozturk R.; Ulusoy S.; Yaman A.; Yuce A.; Zarakolu P.The study monitored the susceptibility of nosocomial pathogens to meropenem and comparator antimicrobial agents isolated as part of the Meropenem Yearly Susceptibility Test Information Collection (MYSTIC) Program from Turkish university hospitals. In terms of minimum inhibitory concentration 90% (MIC 90) values, meropenem was two- and eight-fold more active than imipenem against Escherichia coli and Klebsiella pneumoniae, respectively. 40.5% of K. pneumoniae, 23.1% of Klebsiella oxytoca and 15.3% of E. coli isolates were extended-spectrum ß-lactamase (ESBL) producers. Piperacillin/ tazobactam was the most active agent against isolates of Pseudomonas aeruginosa, followed by meropenem and imipenem. Against Acinetobacter baumannii isolates, meropenem and imipenem were the most active agents. Continued surveillance by the MYSTIC Program appears to be prudent to help focus on effective empiric treatment regimens. © E.S.I.F.T. srl.
