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Öğe Acinetobacter baumannii Infections and Antibiotic Resistance in Hospitalized Patients in an Education and Research Hospital: A Six-Year Analysis(Bilimsel Tip Yayinevi, 2020) Arslan Gulen, Tugba; Imre, Ayfer; Odemis, Ilker; Kayabas, UnerIntroduction: Acinetobacter baumanii causes difficulties in the treatment of nosocomial infections due to increasing resistance worldwide. With an increase in resistant infections, the use of colistin has come to the fore. We aimed to investigate the antimicrobial resistance profile of A. baumanii strains isolated from clinical specimens as hospital-acquired colonizations and infection agents and to evaluate the clinical and microbiologic responses and adverse effects of antibiotic regimens used in patients who were isolated because of having infectious agents. Materials and Methods: A retrospective descriptive study of 326 adult patients with nosocomial A. baumannii colonizations and infections was conducted between January 2012 and December 2017 in Nigde Education and Research Hospital. In addition, a total of 212 adult patients who received at least 72 hours of antimicrobial therapy were evaluated. Standard and automated methods were used to identify isolated strains and antibiotic susceptibility. The antimicrobial susceptibility profile change over the 6-year period was evaluated. Adverse effects, and clinical and microbiologic response were evaluated in patients receiving antimicrobial therapy. Analysis of the variables was performed using SASS 22.0 (IBM Corporation, Armonk, New York, United States). Results: When antimicrobial resistance rates were examined, it was seen that imipenem (99.7%), ampicillin sulbactam (81.6%), cefoperazone sulbactam (60.3%), netilmicin (89.4%), tobramycin (88.4%), gentamicin (83.1%), amikacin (91.6%) and tigecycline (33.7%) had resistance rates; colistin resistance was not detected in the isolates. Resistance rate to other antibiotic groups was 100%. The resistance rates of ampicillin sulbactam, cefoperazone sulbactam, gentamicin, amikacin, and tigecycline were found to be statistically significant (p< 0.05). There were no significant differences in terms of nephrotoxicity, and clinical and microbiologic response among patients in whom colistin was used in combination with carbapenem, ampicillin/sulbactam, cefoperazone/sulbactam, and tigecycline (p> 0.05). Conclusion: In accordance with the global data, antimicrobial resistance rate in A. baumanii isolates was found to be high in our study. Treatment regimens in which colistin is used with other antimicrobial agents have no superiority in terms of efficacy and adverse effects. There is a clear need for new and effective antimicrobial agents in the treatment of resistant A. baumanii infections.Öğe Choroidal thickness and retinal nerve fiber layer analysis in acute systemic brucellosis(Sage Publications Inc, 2021) Zor, Kursad Ramazan; Gulen, Tugba Arslan; Bicer, Gamze Yildirim; Kucuk, Erkut; Imre, Ayfer; Odemis, Ilker; Kayabas, UnerIntroduction This study aims to detect changes in choroidal thickness and retinal nerve fiber layer (RNFL) thickness in acute stage brucellosis. Methods Fnewly diagnosed patients with acute brucellosis and 19 healthy individuals as control group were included in the study. Choroidal thickness and RNFL thickness were measured using the Spectral Domain Cirrus OCT Model 400 (Carl Zeiss Meditec, Jena, Germany) for each participant in the patient and control group. Results In the brucella group, in the right eyes, the mean nasal choroidal thickness was 272.77 +/- 50.26 mu m (p = 0.689), the mean subfoveal choroidal thickness was 321.14 +/- 33.08 mu m (p = 0.590), the mean temporal choroidal thickness was 278.86 +/- 48.84 mu m (p = 0.478), and the mean RNFL thickness was 90.43 +/- 8.93 mu m (p = 0.567). In the left eyes, the mean nasal choroidal thickness was 282.29 +/- 48.93 mu m (p = 0.715), the mean subfoveal choroidal thickness was 316.79 +/- 39.57 mu m (p = 0.540), the mean temporal choroidal thickness was 284.93 +/- 50.57 mu m (p = 0.392), and the mean RNFL thickness was 92.64 +/- 8.95 mu m (p = 0.813). Conclusion No difference was found between the control and the brucella groups regarding to all choroidal regions and RNFL thickness.Öğe Seroprevalence of measles, mumps, rubella, and varicella zoster virus antibodies among healthcare students: analysis of vaccine efficacy and cost-effectiveness(Sociedad Espanola Quimioterapia, 2019) Odemis, Ilker; Kose, Sukran; Akbulut, Ilkay; Albayrak, HazalIntroduction. The aims of this study are to determine the seroprevalence for measles, mumps, rubella, and varicella zoster virus (VZV) in a cohort of nursing students, to evaluate vaccination response rates of nonimmune students, and to calculate the cost of vaccinating students based on seroprevalence screening. Material and methods. A cross-sectional study was conducted August 2015-November 2016 among 326 healthy nursing students aged 14.1-18.1 years. Serum IgG antibodies were measured by ELISA. Results were analyzed by the Chi-square test; a p-value of < 0.05 was considered statistically significant. Results. The number of seropositive participants (%) was 308 (94.5%) for rubella, 295 (90.5%) for VZV, 244 (74.9%) for measles, and 219 (67.2%) for mumps. A significant correlation was found between measles IgG and age. A relationship was also observed between VZV IgG and kindergarten attendance. Response rates to measles, rubella, VZV, and mumps vaccination were 96%, 92.3%, 87.5%, 78.8%, respectively. The total cost of vaccination after IgG screening was less than vaccination without screening. Conclusions. In this study, participants' immunity to measles and VZV was low. Prevaccination serological screening was cost-effectiveness method for preventing measles, mumps, rubella, and varicella infections. We believe that administering booster measles, mumps, and rubella (MMR) vaccine doses or developing a special MMR vaccination strategy for at-risk groups may prevent MMR outbreaks.Öğe The Effect of Antibiotic Resistance and Inappropriate Empirical Antibiotic Therapy on 3-Day and 28-Day Mortality in Bacteremic Patients in the Intensive Care Unit: 5-Year Retrospective Analysis(Duzce Univ, Fac Medicine, 2022) Odemis, Ilker; Arslan Gulen, TugbaAim: The aim of this study was to examine the effects of antibiotic resistance, empirical antibiotic therapy, and comorbid diseases on 3 -day and 28 -day mortality in patients with bloodstream infections. Material and Methods: Files of the patients with positive blood cultures results, between January 1(st), 2015, and January 1(st), 2020 were analyzed retrospectively. The primary outcome was 3 -day mortality and the secondary outcome was 28 -day mortality. Results: A total of 515 patients, 208 (40.4%) female and 307 (59.6%) male, were included in the study. The median age of the patients was 73 (range, 18-95) years. Vancomycin resistance was detected in 8 (3.4%) of 233 gram -positive bacteria. Third -generation cephalosporin, meropenem, and colistin resistance rates of the 282 gram -negative bacteria were found to be 72.7% (n=205), 53.2% (n=150), and 9.9% (n=28), respectively. The 3 -day and 28 -day mortality rates were 14.4% (n=74) and 64.3% (n=331), respectively. Charlson comorbidity index score (CCIS) (p=0.001) and acute physiology and chronic health evaluation (APACHE) II score (p=0.019) were found to be risk factors for 3 -day mortality. Risk factors for 28 -day mortality were; age (p<0.001), CCIS (p<0.001), APACHE II score (p=0.001), chronic obstructive pulmonary disease (p=0.007), hospital -acquired infection (p=0.033), and inappropriate antibiotic therapy (p<0.001). Conclusion: There was no association between antibiotic resistance and mortality, but inappropriate antibiotic treatment was found to increase the risk of 28 -day mortality. In addition, since high CCIS and APACHE II scores increase the risk of both 3 -day and 28 -day mortality, we think that considering these scoring systems will reduce the risk of mortality.
