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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.
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    Risk Factors for Presence of Resistant Microorganisms in Sputum Cultures of Patients with Infectious Exacerbations of Chronic Obstructive Lung Disease
    (Bilimsel Tip Yayinevi, 2022) Buyuksirin, Melih; Senol, Gunes; Polat, Gulru; Ayranci, Aysu; Guldaval, Filiz; Serce Unat, Damla
    Introduction: Antibiotics reduce the risk of short-term mortality. Certain bacteria may be resistant to initial regimens which is related to mortality. The aim of this study was to find risk factors for the presence of resistant bacteria during exacerbation of Chronic Obstructive Pulmonary Disease (COPD). Materials and Methods: Ethics committee approval was obtained for the study. The patients hospitalized with an exacerbation of COPD between 2015 and 2020 were retrospectively ieviewed. The patients with a sputum culture result were divided into: Group A with conventional microorganisms (susceptible to initial antibiotic regimen) and Group B with non-conventional microorganisms (resistant to initial antibiotic regimen). The risk factors for Group B microorganisms were investigated. Results: One hundred and nineteen patients were included in the study. Median age was 68 (40-88) years. There were 22 patients in Group A and 97 in Group B. Most common microorganism in Group A was Haemophilus influenza (12.6%). Most encountered microorganisms in Group B were Pseudomonas aeruginosa (49.6%). Male sex (HR= 2.9; 95% CI= 0.9-9.5; p= 0.073), age >61 (HR=4.8; 95% CI= 1.7-13.6; p= 0.003), and >5 hospitalizations last year (HR= 8.2; 95% CI= 0.9-67.7; p= 0.051) were found to be independent risk factors for resistant microorganisms. Conclusion: Proposed risk factors for the isolation of multidrug resistant microorganism in patients hospitalized with COPD exacerbations should be considered when choosing the initial antibiotic regimen.

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