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    Antibiotic resistance rates and penicillin MIC distribution in patients with streptococcal pneumonia between 2013-2019, and use of antibiotics in clinical practice
    (Elsevier, 2022) Anar, Ceyda; Bicmen, Can; Guldaval, Filiz; Atay, Tuba; Gayaf, Mine; Balci, Gunseli; Alici, Ibrahim Onur; Doğan, Betül İkbal; Büyükşirin, Melih; Ayrancı, Aysu; Karadeniz, Gülistan; Polat, Gülru
    Purpose: The purpose of the present study is to investigate the antibiotic resistance rates and use of antibiotics in patients with streptococcal pneumonia in a reference tertiary care hospital for pulmonary diseases in Izmir, Turkey.Methods: A total of 1224 cases with streptococcal pneumonia between 2013 and 2019 were included in the study, retrospectively. Drug susceptibility testing for penicillin and other antibiotics were performed according to the recommendations of EUCAST criteria. Clinical data and general characteristics were collected and evaluated for each patient in accordance with the susceptibility testing report.Results: Totally, resistance rates for trimethophrim-sulfamethoxazole, penicillin (oxacillin), erythromycin, tetra-cycline, clindamycin and levofloxacin resistance were 63.5%, 39.8%, 37.7%, 37.6%, 28.8%, and 4.8%, respec-tively. Antibiotic resistance was not detected against vancomycin,teicoplanin and linezolid. Multidrug resistance rate was found to be 27.1%. It was observed that there was a statistically significant decrease in trimethophrim-sulfamethoxazole, penicillin (oxacillin), erythromycin, clindamycin and levofloxacin resistance rates by years (p: 0.000, 0.004, 0.000, 0.001, 0.010, respectively). The penicillin MIC distribution was higher at the range of 0.12-2 mu g/mL and there was statistical difference among the ranges of MIC values for the representative years (p:0.033). Among the antibiotics investigated, the most commonly used antibiotic was moxifloxacin.Conclusions: Trimethophrim-sulfamethoxazole resistance rate has been found higher than other antibiotics. As penicillin MIC values were at the range of 0.12-2 mu g/mL frequently, high doses of penicillin treatment might be required in some patients. It is noteworthy that significant decrease in resistance rates in penicillin, erythromycin, clindamycin and tetracycline could be due to the vaccination programme carried out since 2008 in Turkey. As the empiric use of quinolones is high it would be more appropriate to use it according to the susceptibility testing. It is important to determine the regional antimicrobial susceptibility for Streptococcus pneumoniae to select appropriate empirical antimicrobials in the clinical practice.
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    Ceftazidime-Avibactam Susceptibility of Klebsiella pneumoniae Isolates Obtained from Intensive Care Patients
    (2023) Senol, Gunes; Demirel, Mahmut Mete; Gunduz, Ayriz Tuba; Akan, Tuba; Bicmen, Can; Yildirim, Suleyman
    Objective: Antibiotic resistance encountered in agents causing intensive care unit (ICU) infections is a considerable problem in treatment. In recent years, multiple antibiotic resistances have been detected, especially in Klebsiella pneumonia iso- lates. Infections caused by these bacteria are difficult to handle and have a high mortality. In this study, the in vitro antimicrobial susceptibility rate of ceftazidime/ avibactam (CAZ-AVI). on K. pneumonia isolates obtained from the samples of ICU patients was investigated. Material and Methods: The study is designed as a cross-sectional cohort. CAZ-AVI susceptibility of K. pneumonia isolates obtained from patients diagnosed with ICU infection was studied by disc diffusion method. Results: Among 37 K. pneumonia isolates isolated from 20 blood, 16 bronchial aspi- rate and one urine samples from ICU patients, 31 (83.7%) were found to be CAZ-AVI susceptible and 6 (16.3%) were resistant. 12 of the isolates are panresistant. It was observed that 3 (25%) of the panresistant strains were resistant to CAZ-AVI and 9 (75%) were susceptible. Conclusion: In our study, it was determined that CAZ-AVI showed a low resistance rate even in K. pneumoniae strains that showed multi-antibiotic resistance. It was thought that it could be an alternative treatment option in ICU infections with antibiotic resistance problems.
  • Küçük Resim Yok
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    Determination of Confirmation Rate of Anti-HCV Test Pozitivity with HCV-RNA
    (2023) Şenol, Guneş; Coşkun, Meral; Kaftan, Osman; Bicmen, Can; Gunduz, Ayriz Tuba; Demirel, Mahmut Mete; Demirci, Ferhat
    Objective: Timely diagnosis of the disease is important to prevent late complications in hepatitis C infection. Anti-hepatitis C virus (HCV) tests are regularly requested in screening test panels. However, it is seen that even seropositive patients cannot be followed appropriately. In this study, it was aimed to reveal the missed opportunities in terms of diagnosis and treatment of HCV infection in the seropositive patient group detected by screening tests. Methods: It was investigated retrospectively whether the seropositive patients for HCV were followed up in accordance with the diagnosis of HCV infection protocol in our hospital. Results: A total of 9.878 anti-HCV tests were studied between November 2016 and February 2019, and 133 Anti-HCV positivity (1.3%) were detected. In total, HCV-RNA test was requested from only 58 (45%) of 129 patients. HCV-RNA was found positive in 12 (20.7%) patients. It was observed that S/CO value was above 10 in 28 (21.7%) of 71 patients in whom HCV-RNA was not wanted, and the probability of virus RNA being positive was high. Infectious diseases consultation was not requested from any of these patients; it was thought that there were missed opportunities for diagnosis of HCV infection. Conclusion: It will be very important to consult the infectious diseases branch of patients with anti-HCV positive, to organize in-service training seminars for physicians of other specialties, and to provide warnings in case of anti-HCV positivity on the hospital automation system in order to increase awareness and ensure that the patients are followed appropriately.