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Öğe ABSTRACT Are Family Physicians and Medical Students Aware of Chronic Hepatitis C Infection?(Bilimsel Tip Yayinevi, 2022) Nazli, Arzu; Sertcelik, Ahmet; Kahraman, Hasip; Erdem, Huseyin Aytac; Mermer, Sinan; Caglayan, Derya; Kivrak, Esra ErdemIntroduction: Chronic hepatitis C is a public health problem that can result in cirrhosis, liver cancer, and death, which can be cured with current treatments. In our study, we evaluated the level of knowledge and awareness of medical school students and family physicians about chronic hepatitis C.Materials and Methods: Our study was carried out between 01.06.2022 and 01.08.2022, between the 1st and 6th grade medical students, family physicians (family medicine residents, family medicine specialists) using an online questionnaire.Results: In our study, 536 medical faculty students and 162 family physicians were recruited. Two hundred seventy one (50.6%) of the students were male and the median age was 23.0 (2.0) years. Of the family physicians, 84 (51.2%) were male, the median age was 30 (24-68) years and the median time in the profession was 14.5 (1-40) years. Students answered 69.2% of the questions correctly, and family physicians answered 73% correctly. While the students knew the transmission routes of hepatitis C mostly (97.2%), they got the less information about the testing (34.9%) and treatment (21.9%). Family physicians answered the questions about the transmission routes of hepatitis C with a high rate (99.4%), and the questions about the groups that should be tested (28%) and the questions about the treatment of hepatitis C less correctly (29.4%). In the multivariate analysis, the factors affecting the median knowledge score of the students were male gender (p= 0.019), the student's class (p= 0.002), having Infectious diseases and clinical microbiology committee (p= 0.005) and gastroenterology committee (p= 0.027). The only factor affecting the median knowledge score of family physicians was the use of online presentations by experts in their fields as a source of information (p= 0.003). 67% of the students and 87.2% of the family physicians answered the question How do you manage the person when the anti-HCV screening test is positive? as I will refer the patient to the infectious diseases and clinical microbiology or gastroenterology .Conclusion: In our study, it was found that awareness of screening and treatment was low in both groups. Considering that the main factors related to the level of knowledge of medical students are having committee of the gastroenterology and infectious diseases and clinical microbiology, and online presentations of experienced teachers in family physicians, preparing a special content for these groups may be useful in raising awareness and level of knowledge.Öğe Assessment of Compliance with Bundle Programs for the Prevention of Bloodstream Infections(Bilimsel Tip Yayinevi, 2024) Kahraman, Hasip; Erdem, Huseyin Aytac; Mermer, Sinan; Erdem Kivrak, Esra; Caglayan, Derya; Karakoc, Ebru; Erben, NurettinIntroduction: Bloodstream infections are a significant public health problem in hospitals, leading to increased hospital stays, costs, mortality, and morbidity. This study aims to evaluate compliance with the National Healthcare -Associated Infections Prevention Bundle Guidelines, published in March 2021. Materials and Methods: This study was conducted as a multicenter research between August and September 2022, involving physicians and nurses providing services in adult, pediatric, and neonatal intensive care units. Surveys were administered to collect data on participants' demographic information, professional experiences, and practices related to catheter insertion and care. Results: The study included 156 nurses and 81 physicians from 24 different centers. Among the participating physicians, 41 were female, with an average age of 36.4 +/- 9.1 years. It was observed that physicians had a compliance rate of 95% for hand hygiene before catheter insertion and 100% for using sterile gloves. The utilization rates for masks, sterile gowns, and caps were found to be 95%, 72.8%, and 56%, respectively. It was noted that a sterile full -body drape was used in 81% of cases. For skin antisepsis, 75.3% of physicians used povidone-iodine, 13.6% used chlorhexidine, 9.9% used povidone-iodine/alcohol, and 1.2% used chlorhexidine/ alcohol. Additionally, 76.5% of physicians reported waiting for the antiseptic to dry, while 19.9% stated that they would continue with the procedure despite being warned about the inadequate maintenance of sterility during the process. In the study, 136 (87.2%) of the participating nurses were female, with an average age of 31.7 +/- 7.6 years. Hand hygiene compliance before catheter contact was 96.8%, while it was 99.4% after contact. 94.9% of the participants reported providing disinfection before touching the catheter, and 90.4% stated they performed disinfection after contact. The usage rate of checklists during catheter insertion was 87.2%, and during catheter care, it was 86.5%. 28 (34.6%) of the physicians and 74 (47.4%) of the nurses reported receiving training on bloodstream infection prevention bundles within the last year. Conclusion: The National Healthcare -Associated Infections Prevention Bundle Guidelines are an important step to reduce hospital infections in our country. Nevertheless, there is an observed lack of standardization across different hospitals in the implementation of these guidelines. It is believed that integrating bundle practices into routine applications and promoting behavioral changes can lead to improvements in infection rates in our country.Öğe Brucella melitensis shunt infection(Wolters Kluwer Medknow Publications, 2013) Mermer, Sinan; Sipahi, Oguz Resat; Aydemir, Sohret; Tasbakan, Meltem; Pullukcu, Husnu; Arda, Bilgin; Yamazhan, Tansu; Ulusoy, SercanÖğe Carbapenem-resistant Klebsiella pneumoniae meningitis: A case report(Taylor & Francis Ltd, 2016) Mermer, Sinan; Aydemir, Sohret; Ozgiray, Ergin; Sipahi, Oguz ResatÖğe A Case Report: Mycobacterium fortuitum spondylodiscitis(Galenos Yayincilik, 2018) Mermer, Sinan; Cavusoglu, Cengiz; Ozcem, Selin Bardak; Tasbakan, Meltem; Pullukcu, Husnu; Arda, Bilgin; Yamazhan, Tansu; Ulusoy, Sercan; Sipahi, Oguz ResatÖğe Ceftaroline versus vancomycin in the treatment of methicillin-resistant Staphylococcus aureus (MRSA) in an experimental MRSA meningitis model(Elsevier Sci Ltd, 2020) Mermer, Sinan; Turhan, Tuncer; Bolat, Elif; Aydemir, Sohret; Yamazhan, Tansu; Pullukcu, Husnu; Sipahi, Oguz ResatObjectives: the aim of this study was to compare the antibacterial activity of ceftaroline versus vancomycin in the treatment of methicillin-resistant Staphylococcus aureus (MRSA) meningitis in an experimental rabbit meningitis model. Methods: the antibacterial activity of ceftaroline was compared with vancomycin in the treatment of meningitis induced by MRSA strain ATCC 43300 in an experimental rabbit meningitis model. Quantitative cerebrospinal fluid (CSF) cultures were performed at the beginning of antibiotic treatment and 24 h and 73 h after the first antibiotic dose. Furthermore, in vitro time-kill data were investigated at 0, 2, 4, 6, 8, 12 and 24 h in sterile human serum. Results: the difference between the control group versus both treatment groups was significant when comparing the decrease in colony counts in CSF both at 24 h and 73 h after the first antibiotic dose (P < 0.05). At the end of the experiment, there was a significant difference in survival between both the ceftaroline-treated group and the vancomycin-treated group versus the control group, but not between the two treatment groups. Conclusion: These results suggest that the antibacterial activity of both ceftaroline and vancomycin are similar in the treatment of MRSA meningitis in an experimental rabbit meningitis model. (C) 2020 the Authors. Published by Elsevier Ltd on behalf of International Society for Antimicrobial Chemotherapy.Öğe Çok İlaca Dirençli Kemik-Eklem Tüberkülozu: Tanı ve Tedavide Zorlu Süreç(2019) Taşbakan, Meltem Işıkgöz; Mermer, Sinan; Çavuşoğlu, Cengiz; Taşbakan, Mehmet Sezai; Mermut, Gülşen; Pullukçu, HüsnüTüberküloz, dünyada bilinen en eski hastalıklardan birisi olup, özellikle ülkemizde halen önemli bir mortalite ve morbidite nedenidir. Tanı ve tedavideki gelişmelere rağmen anti-tüberküloz ilaçlara karşı oluşan direnç günümüzde de ciddi bir sorun olmaya devam etmektedir. Bu bildiride çok ilaca dirençli bir kemik-eklem tüberkülozu olgusu sunulmuştur.Öğe Comparison of the Effectiveness of Ceftobiprole and Vancomycin in a Rabbit Model of Methicillin-Resistant Staphylococcus aureus-Induced Meningitis(Karger, 2024) Mermer, Sinan; Turhan, Tuncer; Bolat, Elif; Aydemir, Sohret; Sipahi, Hilal; Sipahi, Oguz ResatIntroduction: Nosocomial meningitis may occur after procedures affecting the central nervous system or following traumatic injury. The causative infectious organism is commonly Staphylococcus aureus, a Gram-positive bacterium. The aim of the present study was to compare the effectiveness of two antibacterial agents, ceftobiprole and vancomycin, in an animal model of methicillin-resistant S. aureus (MRSA) meningitis. Method: The strain of MRSA used was ATCC 43300. The animals were divided into three groups and infected intracisternally with MRSA. Controls received no antibiotherapy while the ceftobiprole group received 25 mg/kg and the vancomycin group received 20 mg/kg intravenously. Blood and cerebrospinal fluid (CSF) samples were collected at three time points. All animals were euthanized at 73 h after start of treatment. Results: There was a significant difference (p < 0.05) between both treatment groups and the control animals at 24 h (drug trough) and 73 h (1 h after third dose) after start of treatment in terms of CSF bacterial levels. At 73 h, there was a significant difference in survival between the control group and the two treatment groups but no difference between the treated animal survival rates. Conclusion: Intravenous treatment with ceftobiprole and vancomycin appears to be equally effective in a rabbit model of MRSA meningitis.Öğe Diyabetli Hastalarda Gelişen Her Ayak Yarası Diyabetik Ayak Enfeksiyonu Mudur? Bir Kaposi Sarkomu Olgusu(2019) Çetinkalp, Şevki; Mermer, Sinan; Sağduyu, İlgen Ertam; Akalın, Taner; Taşbakan, Meltem…Öğe Empirical cefepime plus vancomycin versus ceftazidime plus vancomycin versus meropenem plus vancomycin in the treatment of healthcare-associated meningitis: results of the multicenter ephesus study(Bmc, 2023) Sipahi, Oğuz Reşat; Akyol, Deniz; Örmen, Bahar; Çicek-Şentürk, Gönül; Mermer, Sinan; Önal, Uğur; Amer, FatmaBackground Herein, we analyzed the efficacy of main antibiotic therapy regimens in the treatment of healthcare-associated meningitis (HCAM).Materials/methods This retrospective cohort study was conducted in 18 tertiary-care academic hospitals Turkey, India, Egypt and Romania. We extracted data and outcomes of all patients with post-neurosurgical meningitis cases fulfilling the study inclusion criteria and treated with empirical therapy between December 2006-September 2018.Results Twenty patients in the cefepime + vancomycin-(CV) group, 31 patients in the ceftazidime + vancomycin-(CFV) group, and 119 patients in the meropenem + vancomycin-(MV) group met the inclusion criteria. The MV subgroup had a significantly higher mean Glasgow Coma Score, a higher rate of admission to the intensive care unit within the previous month, and a higher rate of antibiot herapy within the previous month before the meningitis episode (p < 0.05). Microbiological success on Day 3-5, end of treatment (EOT) clinical success (80% vs. 54.8%% vs 57.9%), and overall success (EOT success followed by one-month survival without relapse or reinfection 65% vs. 51.6% vs. 45.3%), EOT all cause mortality (ACM) and day 30 ACM (15% vs. 22.6% vs. 26%) did not differ significantly (p > 0.05) among the three cohorts. No regimen was effective against carbapenem-resistant bacteria, and vancomycin resulted in an EOT clinical success rate of 60.6% in the methicillin-resistant staphylococci or ampicillin-resistant enterococci subgroup (n = 34).Conclusions Our study showed no significant difference in terms of clinical success and mortality among the three treatment options. All regimens were ineffective against carbapenem-resistant bacteria. Vancomycin was unsuccessful in approximately 40% of cases involving methicillin-resistant staphylococci or ampicillin-resistant enterococci.Öğe Hodgkin's Lymphoma Mimicking Chronic Osteomyelitis(Galenos Yayincilik, 2021) Akyol, Deniz; Mermer, Sinan; Pullukcu, Husnu; Sipahi, Oguz Resat; Sabah, Dundar; Isikgoz Tasbakan, Meltem[No Abstract Available]Öğe Intralesional epidermal growth factor therapy for diabetic foot ulcers: an evaluation of 15 cases(Tubitak Scientific & Technical Research Council Turkey, 2017) Isikgoz Tasbakan, Meltem; Yildirim Simsir, Ilgin; Mermer, Sinan; Uysal, Serhat; Ozturk, Murat; Cetinkalp, SevkiBackground/aim: Intralesional recombinant epidermal growth factor (EGF) is a new treatment approach for diabetic foot ulcer, approved in 2006. EGF therapy is given as an adjunct to the standard treatment regimen of antibiotics, surgery, and hyperbaric oxygen. EGF accelerates the healing of diabetic foot ulcers and reduces healing time. This single-center study was conducted to evaluate the outcomes of intralesional EGF therapy in patients with diabetic foot ulcers. Materials and methods: We present the data of the follow-up patients treated in our clinics. Fifteen patients with diabetic foot ulcers or infections, who had been followed up and treated in our clinics, were included in this retrospective study. All patients were administered intralesional injections of 75 mu g of EGF after treatment for infection on their diabetic foot ulcers, three times a week on alternate days. The patients were monitored with respect to treatment response and side effects of EGF. Results: Thirteen patients (86.7%) developed new granulation tissue, 10 patients (66.7%) had complete wound closure, and three patients (20%) showed partial wound closure. No serious side effects requiring discontinuation of EGF therapy were observed. A total of twenty-one bacterial agents were isolated in thirteen patients, and no bacterial growth was observed in the tissue cultures of two patients. Pseudomonas aeruginosa was the most common isolated infectious agent in the tissue cultures (n: 6, 28%). Conclusion: Intralesional injection of EGF on top of the standard treatment regimen appears to be a useful adjuvant therapy option in selected patients.Öğe Is Every Foot Wound a Diabetic Foot Infection in Diabetic Patients? A Case of Kaposi Sarcoma(Galenos Yayincilik, 2019) Cetinkalp, Sevki; Mermer, Sinan; Ertam Sagduyu, Ilgen; Akalin, Taner; Isikgoz Tasbakan, Meltem[No abstract available]Öğe Kocuria rosea Meningitis(Mary Ann Liebert, Inc, 2014) Sipahi, Oguz Resat; Mermer, Sinan; Aydemir, Sohret; Ozgiray, Erkin; Cilli, Feriha; Oner, KazimÖğe Tavşanda metisiline dirençli staphylococcus aureus ile oluşturulmuş deneysel menenjit modelinde seftarolin, seftobiprol, televansin ile vankomisinin bakteriyolojik etkinliklerinin karşılaştırılması(Ege Üniversitesi, Tıp Fakültesi, 2016) Mermer, Sinan; Sipahi, Oğuz ReşatAmaç: Bu çalışmada tavşanda metisiline dirençli S. aureus kökeni ile (MRSA) oluşturulmuş deneysel menenjit modelinde seftarolin ve vankomisinin antibakteriyel etkinliklerinin karşılaştırılması amaçlandı. Yöntem: Menenjit, standart ATCC 43300 MRSA kökeninin Yeni Zelanda tavşanlarının sisterna magnaları içine doğrudan inokülasyonu ile oluşturuldu. Tavşanlar 28 saatlik enkübasyon süresinin ardından kontrol, seftarolin ve vankomisin olmak üzere üç gruba ayrıldı. Seftarolin grubuna 10 mg/kg seftarolin (Astra Zeneca, Cambridge, Britanya) günde iki kez, vankomisin grubuna 20 mg/kg vankomisin (Koçak Farma, İstanbul, Türkiye) günde iki kez verildi, kontrol grubuna ilaç verilmedi. Tedaviye başlandıktan sonra sıfırıncı, 24. ve 73. saatlerde alınan BOS örneklerinden kantitatif kültür yapıldı. Yirmidördüncü ve 73. saatte alınan serum ve BOS örneklerinde biyolojik yöntemle ilaç seviyesi ölçümü yapıldı. Seftarolin ilaç düzeyi için, K. rhizophilia ATCC 9341 kökeni, vankomisin ilaç düzeyi için ise B. subtilis ATCC 6633 kökeni kullanıldı. Steril insan serumunda 0,2,4,6,8,12 ve 24. saatlerde in vitro zamana karşı öldürme verileri araştırıldı. Bulgular: Yirmisekiz saatlik enkübasyon süresinin sonunda 47 tavşandan 30’u menenjit kriterlerini sağlıyordu. Alınan BOS örneklerindeki bakteri miktarları logaritma 10 cinsinden hesaplandığında enkübasyon süresinin sonunda kontrol grubunda 3,968±0,521 kob/mL, seftarolin grubunda 3,974±0,603 kob/mL, vankomisin grubunda 3,967±0,527 kob/mL bakteri vardı (p>0,05). Deney sırasında 24. saatte sağ kalan tavşanlar açısından gruplar arasında anlamlı fark yoktu (p>0,05). Deney sonunda seftarolin ve vankomisin grupları ile kontrol grubu arasında sağkalım açısından anlamlı fark varken (p<0.05), iki tedavi grubu arasında anlamlı fark yoktu (p>0,05). Tedavinin 24. saatinde BOS’daki bakteri miktarı tedavi gruplarında kontrol grubuna göre istatistiksel olarak anlamlı şekilde düştü (kontrol: 3,682±3,543 kob/mL, seftarolin: -2,608±3,279kob/mL, vankomisin: -2,167±3,612 kob/mL). Seftarolin ve vankomisin grupları arasında anlamlı fark yoktu. BOS’da saptanabilir düzeyin üzerinde seftarolin (≥0,12 mg/L) saptanan tavşanlarda, seftarolinin BOS’a geçiş oranı %38.3 ile %70 arasında değişmekteydi (ortalama %51±15). Vankomisin (saptanabilir düzey: ≥0,5 mg/L) grubunda BOS’a geçiş oranı ise, ölçülebilen iki tavşanda %14,7 ve %35,5 idi. İn vitro zamana karşı öldürme verilerinde seftarolin vankomisine kıyasla daha kuvvetli bakterisidal etki göstermiş olsa da 24. saatin sonunda aradaki farkın nispeten kapandığı ve vankomisinin de en azından x10 MIC düzeyinde insan serumunu steril hale getirmeyi başardığı saptandı. Sonuç: Bu bulgular MRSA ile oluşturulmuş tavşan menenjiti modelinde seftarolinin antibakteriyel etkinliğinin en az vankomisin kadar olduğunu düşündürmektedir.Öğe Tavşanda metisiline dirençli staphylococcus aureus ile oluşturulmuş deneysel menenjit modelinde seftarolin, seftobiprol, televansin ile vankomisinin bakteriyolojik etkinliklerinin karşılaştırılması(Ege Üniversitesi, 2016) Turhan, Tuncer; Sipahi, Oğuz Reşat; Mermer, SinanAmaç: Bu çalışmada tavşanda metisiline dirençli S. aureus kökeni ile (MRSA) oluşturulmuş deneysel menenjit modelinde seftarolin ve vankomisinin antibakteriyel etkinliklerinin karşılaştırılması amaçlandı. Yöntem: Menenjit, standart ATCC 43300 MRSA kökeninin Yeni Zelanda tavşanlarının sisterna magnaları içine doğrudan inokülasyonu ile oluşturuldu. Tavşanlar 28 saatlik enkübasyon süresinin ardından kontrol, seftarolin ve vankomisin olmak üzere üç gruba ayrıldı. Seftarolin grubuna 10 mg/kg seftarolin (Astra Zeneca, Cambridge, Britanya) günde iki kez, vankomisin grubuna 20 mg/kg vankomisin (Koçak Farma, İstanbul, Türkiye) günde iki kez verildi, kontrol grubuna ilaç verilmedi. Tedaviye başlandıktan sonra sıfırıncı, 24. ve 73. saatlerde alınan BOS örneklerinden kantitatif kültür yapıldı. Yirmidördüncü ve 73. saatte alınan serum ve BOS örneklerinde biyolojik yöntemle ilaç seviyesi ölçümü yapıldı. Seftarolin ilaç düzeyi için, K. rhizophilia ATCC 9341 kökeni, vankomisin ilaç düzeyi için ise B. subtilis ATCC 6633 kökeni kullanıldı. Steril insan serumunda 0,2,4,6,8,12 ve 24. saatlerde in vitro zamana karşı öldürme verileri araştırıldı. Bulgular: Yirmisekiz saatlik enkübasyon süresinin sonunda 47 tavşandan 30'u menenjit kriterlerini sağlıyordu. Alınan BOS örneklerindeki bakteri miktarları logaritma 10 cinsinden hesaplandığında enkübasyon süresinin sonunda kontrol grubunda 3,968+0,521 kob/mL, seftarolin grubunda 3,974+0,603 kob/mL, vankomisin grubunda 3,967+0,527 kob/mL bakteri vardı (p>0,05). Deney sırasında 24. saatte sağ kalan tavşanlar açısından gruplar arasında anlamlı fark yoktu (p>0,05). Deney sonunda seftarolin ve vankomisin grupları ile kontrol grubu arasında sağkalım açısından anlamlı fark varken (p<0.05), iki tedavi grubu arasında anlamlı fark yoktu (p>0,05). Tedavinin 24. saatinde BOS'daki bakteri miktarı tedavi gruplarında kontrol grubuna göre istatistiksel olarak anlamlı şekilde düştü (kontrol: 3,682+3,543 kob/mL, seftarolin: -2,608±3,279kob/mL, vankomisin: -2,167+3,612 kob/mL). Seftarolin ve vankomisin grupları arasında anlamlı fark yoktu. BOS'da saptanabilir düzeyin üzerinde seftarolin (>0,12 mg/L) saptanan tavşanlarda, seftarolinin BOS'a geçiş oranı %38.3 ile %70 arasında değişmekteydi (ortalama %51±15). Vankomisin (saptanabilir düzey: >0,5 mg/L) grubunda BOS'a geçiş oranı ise, ölçülebilen iki tavşanda %14,7 ve %35,5 idi. İn vitro zamana karşı öldürme verilerinde seftarolin vankomisine kıyasla daha kuvvetli bakterisidal etki göstermiş olsa da 24. saatin sonunda aradaki farkın nispeten kapandığı ve vankomisinin de en azından x10 MIC düzeyinde insan serumunu steril hale getirmeyi başardığı saptandı. Sonuç: Bu bulgular MRSA ile oluşturulmuş tavşan menenjiti modelinde seftarolinin antibakteriyel etkinliğinin en az vankomisin kadar olduğunu düşündürmektedir.;Menenjit, metisiline dirençli Staphylococcus aureus, MRSA, seftarolin, vankomisin, hayvan modeli, tavşan, bioassay.;Meningitis, methicillin resistant Staphylococcus aureus, MRSA, ceftaroline, vancomycin, animal model, rabbit, bioassay.Öğe Tigecycline in the management of post-neurosurgical spondylodiscitis: a review of eight cases(Elsevier Sci Ltd, 2014) Sipahi, Oguz Resat; Kahraman, Hasip; Mermer, Sinan; Pullukcu, Husnu; Tasbakan, Meltem; Arda, Bilgin; Yamazhan, Tansu; Yurtseven, Taskin; Aydemir, Sohret; Ulusoy, SercanBackground: Tigecycline is a relatively new glycylcycline antimicrobial, active in vitro against a variety of Gram-positive and Gram-negative organisms. In this study we evaluated the outcomes of spondylodiscitis cases treated with tigecycline-including therapies retrospectively. Methods: All adult (age > 18 years) cases with a diagnosis of spondylodiscitis, who were treated with a tigecycline-including therapy between 2007 and 2011, were included in the study. The primary efficacy outcome was clinical success with tigecycline at the end of induction, while the secondary efficacy outcome was maintenance of success through 3 months following completion of induction. Results: A total of eight spondylodiscitis cases fulfilled the study inclusion criteria. All cases had back pain, restricted mobility, magnetic resonance findings associated with spondylodiscitis, and microbiology or pathological findings related to spondylodiscitis. All had post-neurosurgical spondylodiscitis. In five cases, tigecycline was started in accordance with the antibacterial susceptibility results from intervertebral tissue biopsy cultures, whereas in three it was started empirically. All cases had received several different antibacterials with failure before receiving tigecycline. The mean duration of tigecycline treatment was 37 +/- 21 days. One case was lost to follow-up after 2 days of tigecycline. Primary and secondary success was achieved in the remaining seven cases. Conclusions: These limited data suggest that tigecycline may have a role in the treatment of refractory spondylodiscitis cases. (C) 2014 The Authors. Published by Elsevier Ltd on behalf of International Society for Infectious Diseases.Öğe Tigecycline in the treatment of multidrug-resistant Acinetobacter baumannii meningitis: Results of the Ege study(Elsevier Science Bv, 2018) Sipahi, Oguz Resat; Mermer, Sinan; Demirdal, Tuna; Ulu, Ashhan Candevir; Fillatre, Pierre; Ozcem, Selin Bardak; Kaya, Safak; Sener, Alper; Bulut, Cemal; Tekin, Recep; Kahraman, Hasip; Ozgiray, Erkin; Yurtseven, Taskin; Sipahi, Hilal; Arda, Bilgin; Pullukcu, Husnu; Tasbakan, Meltem; Yamazhan, Tansu; Aydemir, Sohret; Ulusoy, SercanObjectives: In this study we retrospectively reviewed A. baumannii meningitis cases treated with tigecycline including regimens and evaluated the efficacy of tigecycline in the therapy. Patients and Methods: Study was performed in seven tertiary-care educational hospitals from five cities of Turkey and one center from France. We extracted data and outcomes of all adult (aged > 18) patients with culture proven A. baumannii meningitis treated with tigecycline including antibiotic therapy until April 2016. Results: A total of 23 patients (15 male and eight female) fulfilled our inclusion criteria. All Acinetobacter strains were carbapenem-resistant and susceptible to tigecycline. Six cases received tigecycline monotherapy while 17 received tigecycline including combination therapy (10 with colistin, 4 with netilmicin, 3 with amikacin, 4 with meropenem). Seven of 23 cases (30%) died during the tigecycline including therapy (1 in monotherapy, 4 in colistin, 2 in netilmicin, 1 amikacin, one case received tigecycline + netilmicin followed by tigecycline + colistin). Hence, overall end of treatment (EOT) success was 70%. However, since further 27% died due to additional nosocomial infections, overall clinical success (relieved symptoms at the EOT and one-month post therapy survival without any relapse or reinfection) decreased to 43%. Conclusion: We conclude that tigecycline may be an alternative in the salvage treatment of nosocomial multi drug-resistant Acinetobacter spp. meningitis. Acinetobacter spp. Meningitis.Öğe Variables determining mortality in patients with Acinetobacter baumannii meningitis/ventriculitis treated with intrathecal colistin(Elsevier Science Bv, 2017) Ceylan, Bahadir; Arslan, Ferhat; Sipahi, Oguz Resat; Sunbul, Mustafa; Ormen, Bahar; Hakyemez, Ismail N.; Turunc, Tuba; Yildiz, Yesim; Karsen, Hasan; Karagoz, Gul; Tekin, Recep; Hizarci, Burcu; Turhan, Vedat; Senol, Sebnem; Oztoprak, Nefise; Yilmaz, Mesut; Ozdemir, Kevser; Mermer, Sinan; Kokoglu, Omer F.; Mert, AliAim: To examine the variables associated with mortality in patients with Acinetobacter baumannii-related central nervous system infections treated with intrathecal colistin. Materials and methods: This multi-centre retrospective case control study included patients from 11 centres in Turkey, as well as cases found during a literature review. Only patients with CNS infections caused by multidrug-resistant or extensively drug-resistant Acinetobacter baumannii treated with intrathecal colistin were included in this study. The variables associated with mortality were determined by dividing the patients into groups who died or survived during hospitalisation, and who died or survived from Acinetobacter meningitis. Results: Among the 77 cases enrolled in the study, 35 were found through a literature review and 42 were cases from our centres. Forty-four cases (57.1%) were male and the median age was 48 years (range: 20-78 years). Thirty-seven patients (48%) died during hospitalisation. The variables associated with increased all-cause mortality during hospitalisation included old age (odds ratio, 1.035; 95% confidence interval (Cl), 1.004-1.067; p = 0.026) and failure to provide cerebrospinal fluid sterilisation (odds ratio, 0.264; 95% confidence interval, 0.097-0.724; p = 0.01). There is a trend (P=0.062) towards higher mortality with using of meropenem during meningitis treatment. Fifteen cases (19%) died from meningitis. There were no significant predictors of meningitis-related mortality. Conclusions: The mortality rate for central nervous system infections caused by multidrug-resistant or extensively drug-resistant Acinetobacter baumannii is high. Old age and failure to provide CSF sterilisation are associated with increased mortality during hospitalisation. (C) 2016 Published by Elsevier B.V.
