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Öğe Accuracy of consultations performed by infectious diseases trainees and factors associated with adherence to them(Elsevier Sci Ltd, 2007) Sipahi, Oguz Resat; Tasbakan, Meltem; Pullukcu, Husnu; Arda, Bilgin; Yamazhan, Tansu; Mizrakci, Serpil; Senol, Sebnem; Atalay, Sabri; Koseli, Demet; Arsu, Guray; Calik, Sebnem; Sipahi, Hilal; Buke, Cagri; Ulusoy, SercanObjectives: Infectious diseases (ID) trainees should be familiar with duties relevant to consultation practice. In this study we aimed to analyze the ID trainee night/weekend shift consultation process in terms of consultant characteristics, types of recommendations, and compliance with recommendations. Methods: All consultations performed by ID trainees on the night shift and at the weekends between 10 June and 10 August 2004 were recorded prospectively on standardized forms. Infectious diseases specialists assessed the appropriateness of recommendations the day after each consultation. Recommendations were considered complied with if they were carried out within 72 hours of the consultation. Results: Of 440 consultations, 163 were for a clinically diagnosed infection (without specific antibiotic request) and 79 were for treatment continuation. Overall, 152 consultations were for requesting specific antibiotic(s), and 327 antibiotics were recommended or approved in 270 consultations. Eight of these recommendations were inappropriate. Overall compliance to ID recommendations was 75.3% (418/555). In univariate analysis, the compliance rate to non-treatment recommendations (microbiologic cultures, radiology, biochemistry, etc.) was found to be lower than the rate of compliance to antibiotic recommendations (186/308 vs. 232/247, p < 0.05). In addition, compliance to recommendations made by the first-year trainees was lower than to the recommendations made by the other trainees. In logistic regression analysis only recommendations including antibiotic treatment was associated with higher compliance (p = 0.0001, odds ratio = 10.2, 95% CI = 5.7-18.3). Conclusions: ID trainees are capable of evaluating patients and recommending appropriate antibiotics. Methodologies to improve the compliance to non-treatment-based recommendations and optimizing antibiotic selection seem to be necessary. (C) 2007 International Society for Infectious Diseases. Published by Elsevier Ltd. All rights reserved.Öğe Acute Purulent Meningitis or Opportunistic Infection Due to HIV?(Bilimsel Tip Yayinevi, 2018) Akdag, Damla; Pullukcu, Husnu; Mermut, Gulsen; Yamazhan, Tansu; Isikgoz Tasbakan, Meltem; Ulusoy, SercanÖğe Antibacterial resistance patterns and incidence of hospital-acquired Staphylococcus aureus bacteremia in a tertiary care educational hospital in Turkey: a perspective from 2001 to 2013(Tubitak Scientific & Technical Research Council Turkey, 2017) Sipahi, Oguz Resat; Uysal, Serhat; Aydemir, Sabire Sohret; Pullukcu, Husnu; Tasbakan, Meltem; Tunger, Alper; Cilli, Fatma Feriha; Yamazhan, Tansu; Arda, Bilgin; Sipahi, Hilal; Ulusoy, SercanBackground/aim: Staphylococcus aureus is an important nosocomial pathogen and a successful antimicrobial-resistance developer. In this study we retrospectively evaluated the resistance patterns and incidence of microbiologically confirmed nosocomial bacteremia (MCNB) related S. aureus strains between 2001 and 2013. Materials and methods: Any patient in whom S. aureus was isolated in at least one set of blood cultures (sent to the bacteriology laboratory 72 h after hospital admission) was considered to have MCNB. Results: The methicillin-resistant S. aureus (MRSA) rate in 2001 was 73.8% whereas it was 36.2% in 2013. When the 2001-2003 and 2011-2013 periods were compared, resistance to oxacillin, levofloxacin, gentamicin, erythromycin, and clindamycin decreased significantly (P < 0.05). When we evaluated the total S. aureus, MRSA, and methicillin-sensitive S. aureus (MSSA) bacteremia rates per 1000 days and 1000 patients, there was an increase in the 2004-2005 period, which was followed by a slight decrease until 2013 (P < 0.05). There was a plateau in MCNB-related S. aureus rates between 2008 and 2011. Conclusion: There was a decrease in overall S. aureus and MRSA bacteremia incidence as well as MRSA rates except for a plateau between 2008 and 2011. This steady decrease in the resistance rates is most probably due to the 2003 budget application and application of antimicrobial stewardship.Öğe Antibiotic resistance surveillance over a 4-year period (2000-2003) in Turkey: results of the MYSTIC Program(Elsevier Science Inc, 2007) Korten, Volkan; Ulusoy, Sercan; Zarakolu, Pinar; Mete, BirgulThe Meropenem Yearly Susceptibility Test Information Collection (MYSTIC) Program is a global study that provides antimicrobial susceptibility data in centers prescribing meropenem. The activity of meropenem and 7 broad-spectrum antimicrobials have been examined against 5208 bacterial isolates from 9 Turkish centers between 2000 and 2003. Cumulative susceptibility rates against all species of Enterobacteriaceae combined were ranked as follows: meropenem (99.3%), imipenem (97.6%), cefepime (80.0%), piperacillin-tazobactam (73.6%), ceftazidime (70.3%), ciprofloxacin (70.1%), cefotaxime (66.9%), and tobramycin (67.2%). The production of extended-spectrum beta-lactamases (ESBLs) was detected in 48.7% of Klebsiella pneumoniae and in 19.5% of Escherichia coli isolates. Of ESBL producing K. pneumoniae isolates, 75.7% were resistant to tobramycin, 40.3% to ciprofloxacin, and 48.3% to piperacillin-tazobactam. Only piperacillin/ tazobactam and carbapenems were active against more than 50% of Pseudomonas aeruginosa at the National Committee for Clinical Laboratory Standards-susceptible breakpoint, and the carbapenems were the most active compounds against Acinetobacter spp. These data confirm the continued potency of meropenem against Enterobacteriaceae in units where it is actively being prescribed. (c) 2007 Elsevier Inc. All rights reserved.Öğe Aplastik anemili bir olguda Mukormukozis(2006) Tasbakan, Mı; Arda, Bilgin; Soyer, Nur; Sıpahı, Oğuz Reşat; Kandiloğlu, Gülşen; Tombuloğlu, Murat; Ulusoy, Sercan…Öğe Are Soap, Paper Towel and Alcohol-based Disinfectants Easily Accessible in Intensive Care Units in Turkey?: Results of the Phokai Study(Galenos Yayincilik, 2018) Uyan, Ayse; Durmus, Gul; Sezak, Nurbanu; Ozdemir, Burcu; Kaygusuz, Turkkan; Oztoprak, Nefise; Ozdemir, Keyser; Aksoy, Firdevs; Ozgultekin, Asu; Koc, Meliha Meric; Oncul, Ahsen; Cagan Aktas, Sabahat; Isik, Burcu; Celebi, Giiven; Evik, Guliiz; Ozger, Selcuk; Harman, Rezan; Dindar Demiray, Emine Kubra; Ozkoren Calik, Sebnem; Alkan Ceviker, Sevil; Yildiz, Ilknur Esen; Isik, Mehmet Emirhan; Senol, Gunes; Sari, Sema; Dogan, Mustafa; Ugurlu, Kenan; Arslan, Mustafa; Akgul, Fethiye; Koc, Filiz; Kurekci, Yeim; Caglayan, Derya; Ucar, Mehmet; Gozukucuk, Ramazan; Elmaslar Mert, Habibe Tulin; Alay, Handan; Erdogan, Haluk; Demirel, Aslihan; Dogan, Nilgun; Kocak, Funda; Guven, Emre; Unsal, Guieser; Sipahi, Hilal; Yamazhan, Tansu; Arda, Bilgin; Ulusoy, Sercan; Sipahi, Oguz ResatIntroduction: Hand hygiene is one of the most effective infection control measures to prevent the spread of healthcare-associated infections (HCAI). Water, soap, paper towel and hand disinfectant must be available and adequate in terms of effective hand hygiene. The adequacy of hand hygiene products or keeping water-soap and paper towel is still a problem for many developing countries like Turkey. In this multicenter study, we analyzed the adequacy in number and availability of hand hygiene products. Materials and Methods: This study was performed in all intensive care units (ICUs) of 41 hospitals (27 tertiary-care educational, 10 state and four private hospitals) from 22 cities located in seven geographical regions of Turkey. We analyzed water, soap, paper towel and alcohol-based hand disinfectant adequacy on four different days, two of which were in summer during the vacation time (August, 27th and 31st 2016) and two in autumn (October, 12th and 15th 2016). Results: The total number of ICUs and intensive care beds in 41 participating centers were 214 and 2357, respectively. Overall, there was no soap in 3-11% of sinks and no paper towel in 10-18% of sinks while there was no alcohol-based hand disinfectant in 1-4.7% of hand disinfectant units on the observation days. When we compared the number of sinks with soap and/or paper towel on weekdays vs. weekends, there was no significant difference in summer. However, on autumn weekdays, the number of sinks with soap and paper towel was significantly lower on weekend days (p<0.0001, p<0.0001) while the number of hand disinfectant units with alcohol-based disinfectant was significantly higher (p<0.0001). Conclusion: There should be adequate and accessible hand hygiene materials for effective hand hygiene. In this study, we found that soap and paper towels were inadequate on the observation days in 3-11% and 10-18% of units, respectively. Attention should be paid on soap and paper towel supply at weekends as well.Öğe Are We Close to Zeroing the Ventilator-associated Pneumonia Rate?(Galenos Yayincilik, 2022) Bulut Avsar, Cansu; Dikis, Demet; Korkmaz Erken, Pervin; Bahcivan, Esra; Bacakoglu, Feza; Sipahi, Oguz Resat; Ulusoy, SercanIntroduction: Ventilator-associated pneumonia (VAP) is one of the major hospital-acquired infections in the intensive care unit (ICU). The Centers for Disease Control and Prevention (CDC) made changes in the definitions of VAP. In this study, we aimed to prospectively evaluate patients in the tertiary-level chest diseases ICU between December 2016 and May 2017 in terms of ventilator-related events using the new surveillance criteria for patients requiring invasive mechanical ventilation. Materials and Methods: Patients in the chest diseases ICU were prospectively evaluated in terms of VAP development, and the incidence was calculated according to the old and new CDC criteria. Results: A total of 82 patients (31 women, 51 men) were followed up in the chest diseases ICU. Twenty-four patients who met the new surveillance criteria (survived >4 days) with 1632 patient-days and 601 ventilator days were included in the study. The incidences of VAP according to the old and new criteria were 31.6 and 1.6 per 1000 ventilator days, respectively. Conclusion: Our data suggest that new CDC definitions underdiagnose pneumonia in the daily practice. We may conclude that it does not seem rational to switch to the newer VAP definitions in the daily practice from the elder CDC definitions.Öğe Bir üniversite hastanesindeki sağlık personelinin el hijyeni uyum oranlarının değerlendirilmesi: Prospektif bir çalışma(2020) Dikiş, Demet; Şimşek, Sera; Kepeli, Nurhayat; Küçükler, Nilgün Deniz; Ulusoy, Behiye; Korkmaz, Nilay Bilgili; Ulusoy, SercanAmaç: Bu çalışmanın amacı, 2014 ve 2018 yılları arasında yoğun bakım ünitelerinde (YBÜ) sağlık çalışanlarının el hijyeni uyum oranını saptamaktır. Gereç ve Yöntem: Bu araştırma yedi YBÜ’de (Çocuk Sağlığı ve Hastalıkları, Yenidoğan, İç Hastalıkları, Anestezi ve Reanimasyon, Göğüs Hastalıkları, Nöroloji ve Kalp Damar Cerrahisi) çalışan doktor, hemşire ve yardımcı sağlık personelinin el hijyeni uyumunu değerlendiren prospektif, gözlemsel bir çalışmadır. El hijyeni uyumu enfeksiyon kontrol hemşireleri tarafından Dünya Sağlık Örgütü (DSÖ) beş endikasyonuna göre Ocak 2014 ile Aralık 2018 arasında haberli gözlem şeklinde yapılmıştır. Ayrıca, yüksek ve düşük el hijyeni uyumluluğuna sahip bireylere kişisel geri bildirimler verilmiştir. Bulgular: Toplam 24153 el hijyeni fırsat gözlemi (2014: 5695, 2015: 5307, 2016: 4563, 2017: 4821, 2018: 3767) yapıldı. Çalışmamızda 2014'ün ilk döneminde el hijyeni uyum oranı %25,6 idi. Tüm çalışanların el hijyeni uyum oranı sırasıyla; 2014: %32,0, 2015: %55,7, 2016: %61,0, 2017: %55,6 ve 2018: %68,1 olmuştur. Mesleklere göre; el hijyeni uyum oranları hemşirelerde %37 ile %70, yardımcı sağlık personelinde %20 ile %51, doktorlarda %28 ile %49 arasındaydı. Sonuç: Hastanemizde el hijyeni kurallarına uyum, sürekli çabalarla nispeten zayıf seviyelerden ortalama seviyelere yükselmiştir. El hijyeni uyum oranlarını %70'lerin üstüne çıkarmak için daha fazla destekleyici çalışmaya ihtiyaç vardır.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 A CASE OF CEREBRAL ABSCESS DUE TO METHICILLIN-RESISTANT STAPHYLOCOCCUS AUREUS WHICH IS TREATED WITH LINEZOLID plus RIFAMPIN COMBINATION(Ankara Microbiology Soc, 2010) Sipahi, Oguz Resat; Cagiran, Inanc; Yurtseven, Taskin; Tasbakan, Meltem Isikgoz; Arda, Bilgin; Tunger, Alper; Ulusoy, SercanMethicillin-resistant Staphylococcus aureus (MRSA) is a rare cause of cerebral abscesses, however it is a relatively more common etiologic agent in post-neurosurgical abscesses and the main antibacterial therapy option is vancomycin. In this report, a case of brain abscess due to MRSA which did not respond neither to moxifloxacin + vancomycin nor vancomycin + rifampin combination therapies, and merely treated by linezolid + rifampin combination, has been presented. Fifty-one years old female patient who was operated 40 days ago for subarachnoid bleeding and aneurysm in middle cerebral artery bifurcation, was hospitalized due to purulent leakage from the operation area. She did not have fever and her physical examination, including the neurologic system, was normal. Computerized tomography revealed an approximately 1 cm lesion compatible with subdural empyema and cerebral abscess in the right frontoparietal area in supratentorial sections. The patient was operated for wound revision and moxifloxacin was initiated. Since the operation materials revealed MRSA growth, vancomycin (4 x 500 mg, IV) was added to the treatment. The isolate was identified by conventional methods, and antibiotic susceptibility test performed by disk diffusion method showed that it was susceptible to levofloxacin, linezolid, rifampin, vancomycin and teicoplanin. Since no clinical response was obtained in two weeks, moxifloxacin was switched to rifampin (300 mg 1 x 2). On the 10(th) day of vancomycin + rifampin therapy, radiological findings showed development of cerebritis and therefore vancomycin was changed with linezolid (2 x 600 mg, IV). The control CT of the patient revealed regression of the brain lesion and linezolid + rifampin treatment continued for six weeks. The patient did not develop any hematological, liver or renal toxicity during the therapy and the radiological findings regressed. No relapse were detected in the one year follow-up period. This case suggested that linezolid might be a treatment alternative in the therapy of vancomycin-refractory MRSA brain abscess.Öğe A case of chronic hepatitis B with primary adefovir resistance(Ankara Microbiology Soc, 2007) Yamazhan, Tansu; Sertoz, Ruchan; Pullukcu, Husnu; Tasbakan, Meltem; Ulusoy, Sercan; Erensoy, SeldaImplementation of antiviral therapy leads to the emergence of mutant strains during the treatment in chronic hepatitis B. Hepatitis 6 virus (HBV) with primary antiviral resistance may be rarely encountered. In this report, a chronic hepatitis B case who had never received adefovir dipivoxil but had primary adefovir resistance, was presented. HBeAg positive 25-year-old male patient was treated with interferon (IFN)alpha (thrice a week 10 MU) and lamivudine (100 mg/daily) combination for one year. At the end of this treatment although HBV-DNA was under the detectable limit and ALT levels returned to normal, anti-HBe antibodies did not develop. During the course of lamivudin treatment on the third year virus was found to be resistant to lamivudin [FLM+YMDD+YIDD+YVDD (Inno-LiPA HBV DR, Innogenetics Ghent, Belgium)] and adefovir was added to the lamivudin therapy. At the end of eight months of combination therapy, ALT levels did not return to normal and HBV-DNA was still in detectable levels. On the 11(th) month resistance to adefovir was analysed and rtA181T mutation was found by DNA sequence analysis (Big Dye Terminator Cycle Sequencing kit, Applied Biosystems, USA). Since there had been no response to adefovir from the initiation of the therapy, primary adefovir resistance was suspected. Primary adefovir resistance was confirmed by the detection of the same mutation in pre-adefovir treatment serum sample of the patient. Lamivudin was re-added to the therapy, however, HBV-DNA still remained positive on the third month of this combination therapy. The patient got out of routine follow-up after this period.Öğe 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 Chronic hepatitis B monitoring and treatment patterns in five European countries with different access and reimbursement policies(Int Medical Press Ltd, 2014) Arama, Victoria; Leblebicioglu, Hakan; Simon, Krzysztof; Zarski, Jean Pierre; Niederau, Claus; Habersetzer, Francois; Vermehren, Johannes; Bludzin, Wieslawa; Jinga, Mariana; Ulusoy, Sercan; Klauck, Isabelle; Morais, Edith; Bjork, Stefan; Lescrauwaet, Benedicte; Kamar, Driss; Zeuzem, StefanBackground: In Europe, health-care policies are determined at a national level and differ between countries. This analysis from a prospective, longitudinal, non-interventional study aimed to describe patterns in the clinical monitoring and treatment of chronic hepatitis B (CHB) in five European countries. Methods: Country-specific cohorts of adult patients with compensated CHB managed in clinics in Germany, France, Poland, Romania and Turkey were followed for up to 2 years between March 2008 and December 2010. Results: A total of 1,267 patients were included. Baseline age and gender distribution were similar across countries for patients who were treated (n=567) and untreated (n=700) at baseline. Most treated patients were receiving monotherapy at baseline, most frequently with entecavir or tenofovir in Germany, France and Turkey, and with lamivudine in Poland and Romania. Use of pegylated interferon was more frequent in Poland and Romania than in other countries. In Romania monotherapy with entecavir increased after it became reimbursed in 2008. Hospitalizations during follow-up were more frequent in Romania (1.45 hospital days/patient-year) and Poland (1.81 days/patient-year) than in Turkey, France and Germany (0.00, 0.05 and 0.10 days/patient-year, respectively); clinic visits were more frequent in Poland (3.20 versus 0.30-1.78 visits/patient-year across other countries). Conclusions: These results illustrate country-specific patterns in the management of CHB patients across Europe. Observed monitoring patterns, hospitalization rates and other health-care utilization may be related to cost and reimbursement issues; however, further study in individual countries would be required to confirm these (post hoc) observations.Öğe Clinical Evaluation of Fifteen Cases of Hydatid Disease(Galenos Yayincilik, 2015) Uysal, Serhat; Uyan, Ayse; Tasbakan, Meltem Isikgoz; Sipahi, Oguz Resat; Yamazhan, Tansu; Pullukcu, Husun; Mermut, Gulsen; Ertem, Ekin; Ulusoy, SercanIntroduction: Hydatid disease is a zoonotic infection caused by the cestode Echinococcus spp. It is transmitted by ingestion of infectious cestode eggs, especially through dog feces. The two organs most commonly affected are the liver and the lung. In this paper, a series of 15 cases with symptomatic hydatid cysts hospitalized in our clinic and evaluated via consultations are presented. Materials and Methods: Patients, who were treated with hydatid disease between April 2006 and June 2015, were included in the study. Demographic characteristics, symptoms (fever, abdominal pain, pruritus, weakness, icterus, cough, sputum, nausea-vomiting), signs (hepatomegaly, splenomegaly), radiological-laboratory findings, complications, involvements of other body parts and treatment modalities were evaluated retrospectively. Results: Ten (66.7%) of the patients were female. The mean age of the patients was 52.3 +/- 18.3 year. Twelve (80%) patients had at least one cystic lesion in the liver. Four cases were complicated with a lung cyst, three with spondylodiscitis, three with splenic cyst, two with renal cyst, two with amoebic liver abscess, one with intraabdominal dissemination and one case was complicated with anaphylactic shock. Seven patients (46.7%) had leukocytosis and three (20%) had eosinophilia. All patients received treatment with albendazole p.o 2x400 mg tablets. The mean duration of treatment was 27.4 +/- 18.5 weeks. Conclusion: Hydatid cyst is an infectious disease that may cause severe organ involvement. Patients with hydatid cyst in any part of the body should be checked carefully for other system involvement, including the liver, abdominal and/ or retroperitoneal organs.Öğe Çocukluk çağı infeksiyonlarının erişkinlerdeki özelliklerinin irdelenmesi(1998) Büke, A.Çağrı; Yüksel, Esma; Solak, Özlem; Ulusoy, Sercan1990-1997 yılları arasında Ege Üniversitesi Tıp Fakültesi Klinik Mikrobiyoloji ve Enfeksiyon Hastalıkları Anabilim Dalı'nda kabakulak, kızamık ve su çiçeği tanısı ile yatan 15-45 yaşları arasındaki toplam 139 erişkin olgu klinik ve la-boratuvar özellikleri yanısıra komplikasyonlan yönünden incelendi. Altmışdört kabakulaktı olgunun 57 (% 89)'sinde parotis, beşinde (% 7) submandibular, ikisinde (% 3) hem parotis hem de submandibular tükrük bezinde şişlik saptandı. Hastalığı izleyen üç ile dokuz gün içerisinde 25 (% 39) olguda orşit, altı (% 9) olguda meningoensefalit, iki (% 3) olguda pankreatit ve bir (% 2) olguda labirentit gelişti. Hastaların tümü şifa ile iyileşti. Elli-beş kızamıklı olgunun tümünde ateş ve tipik döküntü saptandı; dört (% 7) olguda transaminaz yüksekliği, üç (% 5) olguda pnömoni, iki (% 4) olguda bronşit, ve bir (% 2) olguda otitis media gelişti. Olguların tümü şifa ile iyileşti. Yirmi su çiçekli olgunun tümünde döküntü görüldü. Olguların hiçbirisinde komplikasyon gelişmedi. Sonuç olarak, çocukluk çağlarında görülen hastalıkların genç erişkin ve erişkin dönemlerde daha gürültülü seyrettiği ve farklı komplikasyonlara yol açtıkları belirlendi.Öğe 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, MeldaThe 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.Öğe Daptomycin versus Vancomycin in Treatment of Methicillin-Resistant Staphylococcus aureus Meningitis in an Experimental Rabbit Model(Amer Soc Microbiology, 2013) Bardak-Ozcem, Selin; Turhan, Tuncer; Sipahi, Oguz Resat; Arda, Bilgin; Pullukcu, Husnu; Yamazhan, Tansu; Isikgoz-Tasbakan, Meltem; Sipahi, Hilal; Ulusoy, SercanIn this study, we aimed to compare the antibacterial activities of daptomycin and vancomycin in the treatment of methicillin-resistant Staphylococcus aureus (MRSA) meningitis (induced by MRSA strain ATCC 43300) in an experimental rabbit meningitis model. After an 8-h period of treatment, bacterial counts decreased significantly in both treatment groups compared to the control group (P<0.05). However, there was no statistically significant difference between treatment groups. Our results suggest that the antibacterial activity of daptomycin is similar to vancomycin for treatment in the experimental MRSA meningitis model in rabbits.Öğe Daptomycin versus Vancomycin in Treatment of Methicillin-Resistant Staphylococcus aureus Meningitis in an Experimental Rabbit Model(Amer Soc Microbiology, 2013) Bardak-Ozcem, Selin; Turhan, Tuncer; Sipahi, Oguz Resat; Arda, Bilgin; Pullukcu, Husnu; Yamazhan, Tansu; Isikgoz-Tasbakan, Meltem; Sipahi, Hilal; Ulusoy, SercanIn this study, we aimed to compare the antibacterial activities of daptomycin and vancomycin in the treatment of methicillin-resistant Staphylococcus aureus (MRSA) meningitis (induced by MRSA strain ATCC 43300) in an experimental rabbit meningitis model. After an 8-h period of treatment, bacterial counts decreased significantly in both treatment groups compared to the control group (P<0.05). However, there was no statistically significant difference between treatment groups. Our results suggest that the antibacterial activity of daptomycin is similar to vancomycin for treatment in the experimental MRSA meningitis model in rabbits.Öğe Daptomycin vs. glycopeptides in the treatment of febrile neutropenia: results of the Izmir matched cohort study(Springer Heidelberg, 2019) Sipahi, Oguz Resat; Kahraman, Hasip; Erdem, Huseyin Aytac; Yetkin, Funda; Kaya, Selcuk; Demirdal, Tuna; Tunccan, Ozlem Guzel; Karasahin, Omer; Oruc, Ebru; Cag, Yasemin; Kurtaran, Behice; Ulug, Mehmet; Kutlu, Murat; Avci, Meltem; Oztoprak, Nefise; Arda, Bilgin; Pullukcu, Husnu; Tasbakan, Meltem; Yamazhan, Tansu; Kandemir, Ozlem; Dizbay, Murat; Sipahi, Hilal; Ulusoy, SercanPurposeIn this multicentre, retrospective, matched cohort study we aimed to evaluate the outcomes of neutropenic fever cases that were treated with daptomycin or a glycopeptide (vancomycin or teicoplanin).MethodsData and outcomes of adult (aged>18-years old) patients with neutropenic fever [(1) without clinical and radiological evidence of pneumonia, (2) who were treated with daptomycin or a glycopeptide (teicoplanin or vancomycin) for any reason and for at least 72 h] were extracted from the hospital databases. Matching was performed with all of the three following criteria: (1) underlying disease, (2) reason for starting daptomycin or glycopeptide (microbiologic evidence vs. microbiologic evidence, clinical infection vs. clinical infection and empirical therapy vs. empirical therapy) and (3) neutropenic status.ResultsOverall 128 patients [(69/123) (56.1%) in the daptomycin cohort (D) and 59/123 (48%) in the glycopeptide cohort (G)] had a resolution of fever at the end of 72h antibiotic treatment (p=0.25). There was no significant difference in cured, improved and (cured+improved) rates between (D) and (G) cohorts as well as fever of unknown origin cases or microbiologically confirmed infections or clinically defined infections subgroups (p>0.05). There was also no significant difference (p>0.05), in terms of persistent response in the (D) versus (G) cohorts,ConclusionsThese findings suggest that although not better, daptomycin efficacy is comparable to vancomycin if used as empiric therapy in the treatment of adult febrile neutropenia. We conclude that daptomycin may be used at least as a salvage therapy alternative to glycopeptides in the treatment of adult febrile neutropenia cases. A large, randomized-controlled trial may further consolidate the evidence related to this question.Öğe Did the pandemic have an impact on influenza vaccination attitude? a survey among health care workers(Biomed Central Ltd, 2011) Arda, Bilgin; Durusoy, Raika; Yamazhan, Tansu; Sipahi, Oguz Resat; Tasbakan, Meltem; Pullukcu, Husnu; Erdem, Esra; Ulusoy, SercanBackground: Health care workers' (HCWs) influenza vaccination attitude is known to be negative. The H1N1 epidemic had started in mid 2009 and made a peak in October-November in Turkey. A national vaccination campaign began on November 2(nd), 2009. Despite the diligent efforts of the Ministry of Health and NGOs, the attitudes of the media and politicians were mostly negative. The aim of this study was to evaluate whether HCWs' vaccination attitudes improved during the pandemic and to assess the related factors. Methods: This cross-sectional survey was carried out at the largest university hospital of the Aegean Region-Turkey. A self-administered questionnaire with 12 structured questions was applied to 807 HCWs (sample coverage 91.3%) before the onset of the vaccination programme. Their final vaccination status was tracked one week afterwards, using immunization records. Factors influencing vaccination rates were analyzed using ANOVA, t-test, chi-square test and logistic regression. Results: Among 807 participants, 363 (45.3%) were doctors and 293 (36.6%) nurses. A total of 153 (19.0%) had been vaccinated against seasonal influenza in the 2008-2009 season. Regarding H1N1 vaccination, 143 (17.7%) were willing to be vaccinated vs. 357 (44.2%) unwilling. The number of indecisive HCWs was 307 (38.0%) one week prior to vaccination. Only 53 (11.1%) stated that they would vaccinate their children. Possible side effects (78%, n = 519) and lack of comprehensive field evaluation before marketing (77%, n = 508) were the most common reasons underlying unwillingness or hesitation. Among the 749 staff whose vaccination status could be tracked, 228 (30.4%) actually received the H1N1 vaccine. Some of the 'decided' staff members had changed their mind one week later. Only 82 (60%) of those willing, 108 (37%) of those indecisive and 38 (12%) of those unwilling were vaccinated. Indecisive HCWs were significantly younger (p = 0.017). Females, nurses, and HCWs working in surgical departments were more likely to reject vaccination (p < 0.05). Doctors, HCWs working in medical departments, and HCWs previously vaccinated against seasonal influenza were more likely to accept vaccination (p < 0.05). Being younger than 50 and having been vaccinated in the previous season were important predictors of attitude towards pandemic influenza vaccination. Conclusions: Vaccination rates increased substantially in comparison to the previous influenza season. However, vaccination rates could have been even higher since hesitation to be vaccinated increased dramatically within one week (only 60% of those willing and the minority of those indecisive were finally vaccinated). We speculate that this may be connected with negative media at the time.
