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51. Antituberculosis drug resistance patterns in adults with tuberculous meningitis:results of haydarpasa-iv study

Author

Umit Savasci, Ebru Kurşun, Serkan Oncu, Melanie Catroux, Oğuz Reşat Sipahi, Arjan Harxhi, Rok Čivljak, Yves Hansmann, Bojana Beović, Alper Şener, Nazif Elaldi, Uner Kayabas, Haluk Vahaboglu, Gonul Sengoz, Sukran Kose, Ayşe Seza Inal, Mucahit Yemisen, Nuri Özkütük, Olga Dulovic, Selma Alabay, Emine Parlak, Asuman Inan, B. Lakatos, Recep Tekin, Gorana Dragovac, Soline Simeon, Mustafa Sunbul, Branislava Savic, Seniha Senbayrak, Aysegul Ulu-Kilic, Oral Oncul, Yasemin Cag, Gulden Yilmaz, Hakan Erdem, Hanefi Cem Gul, Emel Yilmaz, Isik Somuncu Johansen, Katell Andre, Özcan Deveci, Nurgul Ceran, Derya Ozturk-Engin, CHU Pontchaillou [Rennes], Centre hospitalier universitaire de Poitiers (CHU Poitiers), Service de maladies infectieuses et tropicales, Hôpital de Hautepierre [Strasbourg], Ege Üniversitesi, Çukurova Üniversitesi, OMÜ, [Senbayrak, Seniha -- Ozturk-Engin, Derya -- Ceran, Nurgul -- Inan, Asuman] Haydarpasa Numune Training & Res Hosp, Dept Infect Dis & Clin Microbiol, Istanbul, Turkey -- [Ozkutuk, Nuri] Celal Bayar Univ, Sch Med, Dept Med Microbiol, Manisa, Turkey -- [Erdem, Hakan -- Gul, Hanefi Cem -- Savasci, Umit] Gulhane Mil Med Acad, Dept Infect Dis & Clin Microbiol, Ankara, Turkey -- [Johansen, Isik Somuncu] Odense Univ Hosp, Dept Infect Dis Q, DK-5000 Odense, Denmark -- [Civljak, Rok] Univ Zagreb, Sch Med, Dept Infect Dis, Dr Fran Mihaljev Univ Hosp Infect Dis, Zagreb 41001, Croatia -- [Inal, Ayse Seza] Cukurova Univ, Sch Med, Dept Infect Dis & Clin Microbiol, Adana, Turkey -- [Kayabas, Uner] Inonu Univ, Sch Med, Dept Infect Dis & Clin Microbiol, Malatya, Turkey -- [Kursun, Ebru] Baskent Univ, Sch Med, Dept Infect Dis & Clin Microbiol, Adana, Turkey -- [Elaldi, Nazif] Cumhuriyet Univ, Sch Med, Dept Infect Dis & Clin Microbiol, Sivas, Turkey -- [Savic, Branislava] Univ Belgrade, Natl Reference Lab TB, Inst Microbiol & Immunol, Fac Med, Belgrade, Serbia -- [Simeon, Soline] Univ Hosp Pontchaillou, Dept Infect & Trop Dis, Rennes, France -- [Yilmaz, Emel] Uludag Univ, Sch Med, Dept Infect Dis & Clin Microbiol, Bursa, Turkey -- [Dulovic, Olga] Univ Belgrade, Clin Infect & Trop Dis, Clin Ctr Serbia, Fac Med, Belgrade, Serbia -- [Lakatos, Botond] St Laszlo Hosp, Dept Infect Dis, Budapest, Hungary -- [Sipahi, Oguz Resat] Ege Univ, Dept Infect Dis & Clin Microbiol, Sch Med, Izmir, Turkey -- [Sunbul, Mustafa] Ondokuz Mayis Univ, Sch Med, Dept Infect Dis & Clin Microbiol, Samsun, Turkey -- [Yemisen, Mucahit] Istanbul Univ, Cerrahpasa Med Sch, Dept Infect Dis & Clin Microbiol, Istanbul, Turkey -- [Alabay, Selma -- Ulu-Kilic, Aysegul] Erciyes Univ, Sch Med, Dept Infect Dis & Clin Microbiol, Kayseri, Turkey -- [Beovic, Bojana] Univ Med Ctr, Dept Infect Dis, Ljubljana, Slovenia -- [Cag, Yasemin] Lutfi Kirdar Training & Res Hosp, Dept Infect Dis & Clin Microbiol, Istanbul, Turkey -- [Catroux, Melanie] Univ Poitiers Hosp, Dept Infect Dis, Poitiers, France -- [Dragovac, Gorana] Univ Novi Sad, Fac Med, Dept Prevent & Control Dis, IPH Vojvodina, Novi Sad 21000, Serbia -- [Deveci, Ozcan -- Tekin, Recep] Dicle Univ, Sch Med, Dept Infect Dis & Clin Microbiol, Diyarbakir, Turkey -- [Sengoz, Gonul] Haseki Training & Res Hosp, Dept Infect Dis & Clin Microbiol, Istanbul, Turkey -- [Andre, Katell] Dax Hosp, Dept Infect Dis, Dax, France -- [Harxhi, Arjan] Univ Hosp Ctr Tirana, Infect Dis Serv, Tirana, Albania -- [Hansmann, Yves] Univ Hosp, Dept Infect Dis, Strasbourg, France -- [Oncu, Serkan] Adnan Menderes Univ, Sch Med, Dept Infect Dis & Clin Microbiol, Aydin, Turkey -- [Kose, Sukran] Tepecik Training & Res Hosp, Dept Infect Dis & Clin Microbiol, Izmir, Turkey -- [Oncul, Oral] GATA Haydarpasa Training Hosp, Dept Infect Dis & Clin Microbiol, Istanbul, Turkey -- [Parlak, Emine] Ataturk Univ, Sch Med, Dept Infect Dis & Clin Microbiol, Erzurum, Turkey -- [Sener, Alper] Onsekiz Mart Univ, Sch Med, Dept Infect Dis & Clin Microbiol, Canakkale, Turkey -- [Yilmaz, Gulden] Ankara Univ, Sch Med, Dept Infect Dis & Clin Microbiol, TR-06100 Ankara, Turkey -- [Vahaboglu, Haluk] Medeniyet Univ, Goztepe Training & Res Hosp, Dept Infect Dis & Clin Microbiol, Istanbul, Turkey, Inal, Ayse Seza -- 0000-0002-1182-7164, johansen, isik somuncu -- 0000-0002-2189-9823, Elaldi, Nazif -- 0000-0002-9515-770X, VAHABOGLU, Haluk -- 0000-0001-8217-1767, and Civljak, Rok -- 0000-0001-8766-7438

Subjects
Male, [SDV]Life Sciences [q-bio], Resistance, Antitubercular Agents, Drug resistance, urologic and male genital diseases, Medical microbiology, MDR, Prevalence, heterocyclic compounds, Cerebrospinal Fluid, Aged, 80 and over, biology, General Medicine, Middle Aged, 3. Good health, Europe, Infectious Diseases, Tuberculosis, Meningeal, Female, Meningitis, medicine.drug, Microbiology (medical), Adult, medicine.medical_specialty, Tuberculosis, Adolescent, Tuberculous meningitis, Mycobacterium tuberculosis, Young Adult, Internal medicine, Drug Resistance, Bacterial, medicine, Isoniazid, Humans, Ethambutol, Aged, Retrospective Studies, business.industry, Research, biochemical phenomena, metabolism, and nutrition, medicine.disease, biology.organism_classification, bacterial infections and mycoses, Survival Analysis, Immunology, business, Rifampicin
Abstract

WOS: 000364000400001, PubMed ID: 26538030, Background: Tuberculous meningitis (TBM) caused by Mycobacterium tuberculosis resistant to antituberculosis drugs is an increasingly common clinical problem. This study aimed to evaluate drug resistance profiles of TBM isolates in adult patients in nine European countries involving 32 centers to provide insight into the empiric treatment of TBM. Methods: Mycobacterium tuberculosis was cultured from the cerebrospinal fluid (CSF) of 142 patients and was tested for susceptibility to first-line antituberculosis drugs, streptomycin (SM), isoniazid (INH), rifampicin (RIF) and ethambutol (EMB). Results: Twenty of 142 isolates (14.1 %) were resistant to at least one antituberculosis drug, and five (3.5 %) were resistant to at least INH and RIF, [multidrug resistant (MDR)]. The resistance rate was 12, 4.9, 4.2 and 3.5 % for INH, SM, EMB and RIF, respectively. The monoresistance rate was 6.3, 1.4 and 0.7 % for INH, SM and EMB respectively. There was no monoresistance to RIF. The mortality rate was 23.8 % in fully susceptible cases while it was 33.3 % for those exhibiting monoresistance to INH, and 40 % in cases with MDR-TBM. In compared to patients without resistance to any firstline drug, the relative risk of death for INH-monoresistance and MDR-TBM was 1.60 (95 % CI, 0.38-6.82) and 2.14 (95 % CI, 0: 34-13: 42), respectively. Conclusion: INH-resistance and MDR rates seemed not to be worrisome in our study. However, considering their adverse effects on treatment, rapid detection of resistance to at least INH and RIF would be most beneficial for designing anti-TB therapy. Still, empiric TBM treatment should be started immediately without waiting the drug susceptibility testing.

Published
2015
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52. Mortality Indicators In Pneumococcal Meningitis: Therapeutic Implications

Author

Mustafa Gökhan Gözel, Füsun Zeynep Akçam, Nefise Oztoprak, Asim Ulcay, Derya Ozturk-Engin, Gonul Sengoz, Gunay Tuncer-Ertem, Saygin Nayman-Alpat, Yasemin Ersoy, Gülden Ersöz, Nazif Elaldi, Ayse Sagmak-Tartar, Oğuz Reşat Sipahi, Selçuk Kaya, Recep Tekin, Emsal Aydin, Hava Yilmaz, Nail Ozgunes, Alper Şener, Sibel Gundes, Ayşegül Yeşilkaya, Tumer Guven, Hakan Erdem, Birsen Cetin, Derya Seyman, Vedat Turhan, Oznur Ak, Kadriye Kart Yaşar, Ahmet Karakaş, Oral Oncul, Ahmet Çağkan İnkaya, Gonul Cicek-Senturk, Yasemin Akkoyunlu, Oguz Karabay, Hakan Leblebicioglu, Ilker Inanc Balkan, Aysegul Ulu-Kilic, Mustafa Hatipoglu, Aysun Yalci, Husrev Diktas, Ayşe Ertürk, Filiz Pehlivanoglu, Selma Alabay, Asuman Inan, Umit Savasci, Alper Gunduz, Ayhan Akbulut, Fatma Sirmatel, Haluk Vahaboglu, Esra Kazak, Saim Dayan, Sukran Kose, Selma Tosun, Abdullah Umut Pekok, İç Hastalıkları, BAİBÜ, Tıp Fakültesi, Dahili Tıp Bilimleri Bölümü, Sırmatel, Fatma, [Erdem, Hakan -- Hatipoglu, Mustafa -- Oncul, Oral -- Turhan, Vedat -- Ulcay, Asim] GATA Haydarpasa Training Hosp, Dept Infect Dis & Clin Microbiol, Istanbul, Turkey -- [Elaldi, Nazif -- Gozel, Mustafa G.] Cumhuriyet Univ, Sch Med, Dept Infect Dis & Clin Microbiol, Sivas, Turkey -- [Oztoprak, Nefise -- Seyman, Derya] Antalya Training & Res Hosp, Dept Infect Dis & Clin Microbiol, Antalya, Turkey -- [Sengoz, Gonul -- Pehlivanoglu, Filiz] Haseki Training & Res Hosp, Dept Infect Dis & Clin Microbiol, Istanbul, Turkey -- [Ak, Oznur] Lutfi Kirdar Training & Res Hosp, Dept Infect Dis & Clin Microbiol, Istanbul, Turkey -- [Kaya, Selcuk] Karadeniz Tech Univ, Sch Med, Dept Infect Dis & Clin Microbiol, Trabzon, Turkey -- [Inan, Asuman -- Ozturk-Engin, Derya] Haydarpasa Numune Training & Res Hosp, Dept Infect Dis & Clin Microbiol, Istanbul, Turkey -- [Nayman-Alpat, Saygin] Osmangazi Univ Sch Med, Dept Infect Dis & Clin Microbiol, Eskisehir, Turkey -- [Ulu-Kilic, Aysegul -- Alabay, Selma] Erciyes Univ, Sch Med, Dept Infect Dis & Clin Microbiol, Kayseri, Turkey -- [Pekok, Abdullah Umut] Private Erzurum Sifa Hosp, Dept Infect Dis & Clin Microbiol, Erzurum, Turkey -- [Gunduz, Alper] Sisli Etfal Training & Res Hosp, Dept Infect Dis & Clin Microbiol, Istanbul, Turkey -- [Yasar, Kadriye] Bakirkoy Dr Sadi Konuk Training & Res Hosp, Dept Infect Dis & Clin Microbiol, Istanbul, Turkey -- [Yilmaz, Hava -- Leblebicioglu, Hakan] Ondokuz Mayis Univ, Sch Med, Dept Infect Dis & Clin Microbiol, Samsun, Turkey -- [Cicek-Senturk, Gonul] Diskapi Yildirim Beyazit Training & Res Hosp, Dept Infect Dis & Clin Microbiol, Ankara, Turkey -- [Akcam, Fusun Z.] Suleyman Demirel Univ, Sch Med, Dept Infect Dis & Clin Microbiol, TR-32200 Isparta, Turkey -- [Inkaya, Ahmet C.] Hacettepe Univ, Sch Med, Dept Infect Dis & Clin Microbiol, Ankara, Turkey -- [Kazak, Esra] Uludag Univ, Sch Med, Dept Infect Dis & Clin Microbiol, Bursa, Turkey -- [Sagmak-Tartar, Ayse -- Akbulut, Ayhan] Firat Univ, Sch Med, Dept Infect Dis & Clin Microbiol, TR-23169 Elazig, Turkey -- [Tekin, Recep -- Dayan, Saim] Dicle Univ, Sch Med, Dept Infect Dis & Clin Microbiol, Diyarbakir, Turkey -- [Ersoy, Yasemin] Inonu Univ, Sch Med, Dept Infect Dis & Clin Microbiol, Malatya, Turkey -- [Sipahi, Oguz Resat] Ege Univ, Sch Med, Dept Infect Dis & Clin Microbiol, Izmir, Turkey -- [Guven, Tumer] Ankara Ataturk Training & Res Hosp, Dept Infect Dis & Clin Microbiol, Ankara, Turkey -- [Tuncer-Ertem, Gunay] Ankara Numune Training & Res Hosp, Dept Infect Dis & Clin Microbiol, Ankara, Turkey -- [Balkan, Ilker I.] Istanbul Univ, Cerrahpasa Med Sch, Dept Infect Dis & Clin Microbiol, Istanbul, Turkey -- [Cetin, Birsen] Koc Univ, Sch Med, Dept Infect Dis & Clin Microbiol, Istanbul, Turkey -- [Ersoz, Gulden] Mersin Univ, Sch Med, Dept Infect Dis & Clin Microbiol, Mersin, Turkey -- [Karakas, Ahmet] Gulhane Mil Med Acad, Dept Infect Dis & Clin Microbiol, Ankara, Turkey -- [Ozgunes, Nail -- Vahaboglu, Haluk] Medeniyet Univ, Goztepe Training & Res Hosp, Dept Infect Dis & Clin Microbiol, Istanbul, Turkey -- [Sener, Alper] Onsekiz Mart Univ, Sch Med, Dept Infect Dis & Clin Microbiol, Canakkale, Turkey -- [Yesilkaya, Aysegul] Baskent Univ, Sch Med, Dept Infect Dis & Clin Microbiol, TR-06490 Ankara, Turkey -- [Erturk, Ayse] Recep Tayyip Erdogan Univ, Sch Med, Dept Dept Infect Dis & Clin Microbiol, Rize, Turkey -- [Gundes, Sibel] Kocaeli Univ, Sch Med, Dept Dept Infect Dis & Clin Microbiol, Izmit, Turkey -- [Karabay, Oguz] Sakarya Univ, Sch Med, Dept Infect Dis & Clin Microbiol, Sakarya, Turkey -- [Sirmatel, Fatma] Abant Izzet Baysal Univ, Sch Med, Dept Infect Dis & Clin Microbiol, Bolu, Turkey -- [Tosun, Selma] Izmir Bozyaka Training & Res Hosp, Dept Infect Dis & Clin Microbiol, Izmir, Turkey -- [Yalci, Aysun] Ankara Univ, Sch Med, Dept Infect Dis & Clin Microbiol, TR-06100 Ankara, Turkey -- [Akkoyunlu, Yasemin] Bezmi Alem Vakif Univ, Sch Med, Dept Infect Dis & Clin Microbiol, Istanbul, Turkey -- [Aydin, Emsal] Kafkas Univ, Sch Med, Dept Infect Dis & Clin Microbiol, Kars, Turkey -- [Diktas, Husrev] Mil Hosp, Dept Infect Dis & Clin Microbiol, Tatvan, Turkey -- [Kose, Sukran -- Savasci, Umit] Tepecik Training & Res Hosp, Dept Infect Dis & Clin Microbiol, Izmir, Turkey -- Dept Infect Dis & Clin Microbiol, Sarikamis Mil Hosp, Kars, Turkey, Yesilkaya, Aysegul -- 0000-0003-0225-6416, Leblebicioglu, Hakan -- 0000-0002-6033-8543, VAHABOGLU, Haluk -- 0000-0001-8217-1767, Elaldi, Nazif -- 0000-0002-9515-770X, Gozel, Mustafa Gokhan -- 0000-0001-5187-7388, Kart Yasar, Kadriye -- 0000-0003-2963-4894, Karakas, Ahmet -- 0000-0002-0553-8454, Karabay, Oguz -- 0000-0003-0502-432X, Ersoy, Yasemin -- 0000-0001-5730-6682, hatipoglu, mustafa -- 0000-0001-9910-1650, Gunduz, Alper -- 0000-0001-9154-844X, HATİBOĞLU, MUSTAFA AZİZ, Ege Üniversitesi, and OMÜ

Subjects
Microbiology (medical), Streptococcus Pneumoniae, Adult, Male, medicine.medical_specialty, Adolescent, Turkey, Penicillin Resistance, Resistance, Microbial Sensitivity Tests, Penicillins, medicine.disease_cause, Cohort Studies, Young Adult, Vancomycin, Internal medicine, Streptococcus pneumoniae, medicine, Humans, Meningitis, Mortality, Intensive care medicine, pneumococcal meningitis, Aged, Retrospective Studies, Aged, 80 and over, business.industry, Meningitis, Pneumococcal, Ceftriaxone, General Medicine, Odds ratio, Middle Aged, medicine.disease, Penicillin, Confidence interval, Anti-Bacterial Agents, Cephalosporins, Treatment Outcome, Infectious Diseases, Drug Therapy, Combination, Female, business, Cohort study, medicine.drug
Abstract

WOS: 000329981700003, PubMed ID: 24211227, Background: The aim of this study was to delineate mortality indicators in pneumococcal meningitis with special emphasis on therapeutic implications. Methods: This retrospective, multicenter cohort study involved a 15-year period (1998-2012). Culture-positive cases (n = 306) were included solely from 38 centers. Results: Fifty-eight patients received ceftriaxone plus vancomycin empirically. The rest were given a third-generation cephalosporin alone. Overall, 246 (79.1%) isolates were found to be penicillin-susceptible, 38 (12.2%) strains were penicillin-resistant, and 22 (7.1%) were oxacillin-resistant (without further minimum inhibitory concentration testing for penicillin). Being a critical case (odds ratio (OR) 7.089, 95% confidence interval (CI) 3.230-15.557) and age over 50 years (OR 3.908, 95% CI 1.820-8.390) were independent predictors of mortality, while infection with a penicillin-susceptible isolate (OR 0.441, 95% CI 0.195-0.996) was found to be protective. Empirical vancomycin use did not provide significant benefit (OR 2.159, 95% CI 0.949-4.912). Conclusions: Ceftriaxone alone is not adequate in the management of pneumococcal meningitis due to penicillin-resistant pneumococci, which is a major concern worldwide. Although vancomycin showed a trend towards improving the prognosis of pneumococcal meningitis, significant correlation in statistical terms could not be established in this study. Thus, further studies are needed for the optimization of pneumococcal meningitis treatment. (C) 2013 The Authors. Published by Elsevier Ltd on behalf of International Society for Infectious Diseases. All rights reserved.

Published
2014

53. Withdrawal of Staphylococcus aureus from intensive care units in Turkey

Author

Saim Dayan, Nail Ozgunes, Hasan Ucmak, Turan Aslan, Begin Altun, Adem Albayrak, Nefise Oztoprak, Selçuk Kaya, Tuna Demirdal, Salman Shaheer Ahmed, Fehmi Tabak, Iftihar Koksal, Hanefi Cem Gul, Yasemin Ersoy, Yeşim Taşova, Oral Oncul, Mehmet Bitirgen, Ibak Gonen, Murat Dizbay, Selma Karabey, Hakan Erdem, Nazif Elaldi, Fatma Sirmatel, İbrahim Erayman, Oznur Ak, Oguz Karabay, Birsen Cetin, Emel Azak, Bilgin Arda, Ercan Yenilmez, Hakan Leblebicioglu, Tumer Guven, Ayşe Willke, Recep Tekin, Saban Esen, Asim Ulcay, Davut Ozdemir, Serhat Ünal, Asuman Inan, Zeliha Kocak Tufan, Ilker Inanc Balkan, Sukran Kose, Filiz Akata, Aygul Dogan-Celik, Fatma Nurhayat Bayazit, Ayhan Akbulut, Gulden Yilmaz, Ömer Karaşahin, Derya Ozturk-Engin, Gokay Gungor, Güven Çelebi, Serkan Oncu, Levent Gorenek, Halis Akalin, Aysegul Ulu-Kilic, Aslihan Candevir, Hale Turan, [Erdem, Hakan -- Oncul, Oral -- Yenilmez, Ercan -- Gorenek, Levent -- Ulcay, Asim] GATA Haydarpasa Training Hosp, Dept Infect Dis & Clin Microbiol, Istanbul, Turkey -- [Dizbay, Murat -- Karasahin, Omer] Gazi Univ, Sch Med, Dept Infect Dis & Clin Microbiol, Ankara, Turkey -- [Karabey, Selma] Istanbul Univ, Istanbul Sch Med, Dept Publ Hlth, Istanbul, Turkey -- [Kaya, Selcuk -- Koksal, Iftihar] Karadeniz Tech Univ, Sch Med, Dept Infect Dis & Clin Microbiol, Trabzon, Turkey -- [Demirdal, Tuna] Katip Celebi Univ, Sch Med, Dept Infect Dis & Clin Microbiol, Izmir, Turkey -- [Inan, Asuman -- Ozturk-Engin, Derya] Haydarpasa Numune Training & Res Hosp, Dept Infect Dis & Clin Microbiol, Istanbul, Turkey -- [Erayman, Ibrahim -- Bitirgen, Mehmet] Selcuk Univ, Meram Sch Med, Dept Infect Dis & Clin Microbiol, Konya, Turkey -- [Ak, Oznur] Lutfi Kirdar Kartal Training & Res Hosp, Dept Infect Dis & Clin Microbiol, Istanbul, Turkey -- [Ulu-Kilic, Aysegul -- Ahmed, Salman Shaheer] Erciyes Univ, Sch Med, Dept Infect Dis & Clin Microbiol, Kayseri, Turkey -- [Akbulut, Ayhan] Firat Univ, Sch Med, Dept Infect Dis & Clin Microbiol, TR-23169 Elazig, Turkey -- [Elaldi, Nazif] Cumhuriyet Univ, Sch Med, Dept Infect Dis & Clin Microbiol, Sivas, Turkey -- [Yilmaz, Gulden] Ankara Univ, Sch Med, Dept Infect Dis & Clin Microbiol, TR-06100 Ankara, Turkey -- [Candevir, Aslihan -- Tasova, Yesim] Cukurova Univ, Sch Med, Dept Infect Dis & Clin Microbiol, Adana, Turkey -- [Gul, Hanefi Cem] Gulhane Mil Med Acad, Dept Infect Dis & Clin Microbiol, Ankara, Turkey -- [Gonen, Ibak] Suleyman Demirel Univ, Sch Med, Dept Infect Dis & Clin Microbiol, TR-32200 Isparta, Turkey -- [Aslan, Turan] Bezmi Alem Univ, Sch Med, Dept Infect Dis & Clin Microbiol, Istanbul, Turkey -- [Azak, Emel -- Willke, Ayse] Kocaeli Univ, Sch Med, Dept Infect Dis & Clin Microbiol, Kocaeli, Turkey -- [Tekin, Recep -- Dayan, Saim] Dicle Univ, Sch Med, Dept Infect Dis & Clin Microbiol, Izmir, Turkey -- [Tufan, Zeliha Kocak] Ankara Numune Training & Res Hosp, Dept Infect Dis & Clin Microbiol, Ankara, Turkey -- [Arda, Bilgin] Ege Univ, Sch Med, Dept Infect Dis & Clin Microbiol, Izmir, Turkey -- [Gungor, Gokay] Sureyyapasa Chest Dis & Thorac Surg Educ & Res Ho, Resp Intens Care Unit, Istanbul, Turkey -- [Cetin, Birsen] Koc Univ, Sch Med, Dept Infect Dis & Clin Microbiol, Istanbul, Turkey -- [Kose, Sukran] Izmir Tepecik Training & Res Hosp, Dept Infect Dis & Clin Microbiol, Izmir, Turkey -- [Turan, Hale] Baskent Univ, Sch Med, Dept Infect Dis & Clin Microbiol, Konya, Turkey -- [Akalin, Halis] Uludag Univ, Sch Med, Dept Infect Dis & Clin Microbiol, Bursa, Turkey -- [Karabay, Oguz] Sakarya Univ, Sch Med, Dept Infect Dis & Clin Microbiol, Sakarya, Turkey -- [Dogan-Celik, Aygul -- Tabak, Fehmi] Trakya Univ, Sch Med, Dept Infect Dis & Clin Microbiol, Edirne, Turkey -- [Albayrak, Adem -- Esen, Saban -- Leblebicioglu, Hakan] Ondokuz Mayis Univ, Sch Med, Dept Infect Dis & Clin Microbiol, Samsun, Turkey -- [Guven, Tumer] Ataturk Training & Res Hosp, Dept Infect Dis & Clin Microbiol, Ankara, Turkey -- [Celebi, Guven] Bulent Ecevit Univ, Sch Med, Dept Infect Dis & Clin Microbiol, Zonguldak, Turkey -- [Ozgunes, Nail] Medeniyet Univ, Sch Med, Dept Infect Dis & Clin Microbiol, Istanbul, Turkey -- [Ersoy, Yasemin] Inonu Univ, Sch Med, Dept Infect Dis & Clin Microbiol, Malatya, Turkey -- [Sirmatel, Fatma] Abant Izzet Baysal Univ, Sch Med, Dept Infect Dis & Clin Microbiol, Bolu, Turkey -- [Oztoprak, Nefise] Antalya Training & Res Hosp, Dept Infect Dis & Clin Microbiol, Antalya, Turkey -- [Balkan, Ilker Inanc -- Tabak, Fehmi] Istanbul Univ, Cerrahpasa Med Sch, Dept Infect Dis & Clin Microbiol, Istanbul, Turkey -- [Bayazit, Fatma Nurhayat] Fatih Univ, Sch Med, Dept Infect Dis & Clin Microbiol, Ankara, Turkey -- [Ucmak, Hasan] Sutcu Imam Univ, Sch Med, Dept Infect Dis & Clin Microbiol, Kahramanmaras, Turkey -- [Oncu, Serkan] Adnan Menderes Univ, Sch Med, Dept Infect Dis & Clin Microbiol, Aydin, Turkey -- [Ozdemir, Davut] Duzce Univ, Sch Med, Dept Infect Dis & Clin Microbiol, Duzce, Turkey -- [Altun, Begin -- Unal, Serhat] Hacettepe Univ Ankara, Fac Med, Dept Med, Infect Dis Unit, Ankara, Turkey, Leblebicioglu, Hakan -- 0000-0002-6033-8543, UNAL, SERHAT -- 0000-0003-1184-4711, Candevir, Aslihan -- 0000-0001-9340-516X, Tufan, Zeliha Kocak -- 0000-0002-3294-014X, Gungor, Gokay -- 0000-0003-2294-489X, Elaldi, Nazif -- 0000-0002-9515-770X, Karabay, Oguz -- 0000-0003-0502-432X, Ersoy, Yasemin -- 0000-0001-5730-6682, Dizbay, Murat -- 0000-0003-4120-0781, Erdem, H, Dizbay, M, Karabey, S, Kaya, S, Demirdal, T, Koksal, I, Inan, A, Erayman, I, Ak, O, Ulu-Kilic, A, Karasahin, O, Akbulut, A, Elaldi, N, Yilmaz, G, Candevir, A, Gul, HC, Gonen, I, Oncul, O, Aslan, T, Azak, E, Tekin, R, Tufan, ZK, Yenilmez, E, Arda, Sakarya Üniversitesi/Tıp Fakültesi/Dahili Tıp Bilimleri Bölümü, Karabay, Oğuz, Akbulut Uludağ, Ahsen, Zonguldak Bülent Ecevit Üniversitesi, Ondokuz Mayıs Üniversitesi, Arda, B, Gungor, G, Cetin, B, Kose, S, Turan, H, Akalin, H, Karabay, O, Dogan-Celik, A, Albayrak, A, Guven, T, Celebi, G, Ozgunes, N, Ersoy, Y, Sirmatel, F, Oztoprak, N, Balkan, II, Bayazit, FN, Ucmak, H, Oncu, S, Ozdemir, D, Ozturk-Engin, D, Bitirgen, M, Tabak, F, Akata, F, Willke, A, Gorenek, L, Ahmed, SS, Tasova, Y, Ulcay, A, Dayan, S, Esen, S, Leblebicioglu, H, Altun, B, Unal, S, and Çukurova Üniversitesi

Subjects
Staphylococcus aureus, medicine.medical_specialty, Pediatrics, Turkey, Epidemiology, health care facilities, manpower, and services, Staphylococcus, education, Staphylococcal infections, medicine.disease_cause, Tertiary Care Centers, Intensive care, health services administration, medicine, Humans, Retrospective Studies, Cross Infection, biology, business.industry, Health Policy, Incidence (epidemiology), Incidence, Public Health, Environmental and Occupational Health, Retrospective cohort study, Staphylococcal Infections, Acinetobacter, medicine.disease, biology.organism_classification, Critical, Intensive Care Units, Infectious Diseases, Emergency medicine, Staphylococcus aureus infections, business
Abstract

WOS: 000326241700021, PubMed ID: 23663858, Background: In the past, Staphylococcus aureus infections have displayed various patterns of epidemiologic curves in hospitals, particularly in intensive care units (ICUs). This study aimed to characterize the current trend in a nationwide survey of ICUs in Turkey. Methods: A total of 88 ICUs from 36 Turkish tertiary hospitals were included in this retrospective study, which was performed during the first 3 months of both 2008 (period [P] 1) and 2011 (P2). A P value

Published
2013

54. Pulmonary infection caused by Talaromyces purpurogenus in a patient with multiple myeloma.

Author

Atalay A, Koc AN, Akyol G, Cakir N, Kaynar L, and Ulu-Kilic A

Subjects
Acinetobacter Infections complications, Aged, Antifungal Agents therapeutic use, Coinfection, Fatal Outcome, Female, Humans, Immunocompromised Host, Lung Diseases, Fungal complications, Lung Diseases, Fungal drug therapy, Opportunistic Infections complications, Opportunistic Infections drug therapy, Plasmacytoma complications, Plasmacytoma diagnosis, Pulmonary Disease, Chronic Obstructive complications, Species Specificity, Spinal Neoplasms complications, Spinal Neoplasms diagnosis, Sputum microbiology, Thoracic Vertebrae, Voriconazole therapeutic use, Lung Diseases, Fungal microbiology, Multiple Myeloma complications, Opportunistic Infections microbiology, Talaromyces isolation & purification
Abstract

A 66-year-old female patient with multiple myeloma (MM) was admitted to the emergency service on 29.09.2014 with an inability to walk, and urinary and faecal incontinence. She had previously undergone autologous bone marrow transplantation (ABMT) twice. The patient was hospitalized at the Department of Haematology. Further investigations showed findings suggestive of a spinal mass at the T5-T6-T7 level, and a mass lesion in the iliac fossa. The mass lesion was resected and needle biopsy was performed during a colonoscopy. Examination of the specimens revealed plasmacytoma. The patient also had chronic obstructive pulmonary disease (COPD) and was suffering from respiratory distress. After consultation with an infectious diseases specialist the patient was placed on an intravenous antibiotherapy with piperacillin/tazobactam (4.5g x 3) on 17.10.2014. During piperacillin/tazobactam treatment, the patient suffered from drowsiness, her general condition deteriorated, and she had rales on auscultation of the lungs. The patient underwent thoracic computerized tomography (CT) which showed areas of focal consolidation in the lower lobes of the two lungs (more prominent on the left), and increased medullary density. The radiology report suggested that fungal infection could not be ruled out based on the CT images. The sputum sample was sent to the mycology laboratory and direct microscopic examination performed with Gram and Giemsa staining showed the presence of septate hyphae; therefore voriconazole was added to the treatment. Slow growing (at day 10), grey-greenish colonies and red pigment formation were observed in all culture media except cycloheximide-containing Sabouraud dextrose agar (SDA) medium. The isolate was initially considered to be Talaromyces marneffei. However, it was subsequently identified by DNA sequencing analysis as Talaromyces purpurogenus. The patient was discharged at her own wish, as she was willing to continue treatment in her hometown. Unfortunately, the patient died on December 8, 2014. In conclusion, apart from T. marneffei, less common strains such as T. purpurogenus should be considered when clinical samples obtained from patients with haematologic/oncologic disorders show fungal colonies that form red pigments on the culture media and when microscopic examination suggests a morphological appearance similar to Penicillium species.

Published
2016

55. Report of an immunocompetent case with disseminated infection due to Nocardia otitidiscaviarum: Identification by 16S rRNA gene sequencing.

Author

Eren E, Ulu-Kilic A, Atalay A, Demiraslan H, Parkan O, and Koc N

Subjects
Aged, Amikacin therapeutic use, Anti-Bacterial Agents therapeutic use, Drug Therapy, Combination, Female, Humans, Meropenem, Nocardia isolation & purification, Nocardia Infections drug therapy, Thienamycins therapeutic use, Treatment Outcome, Immunocompetence, Nocardia genetics, Nocardia Infections diagnosis, Nocardia Infections microbiology, RNA, Ribosomal, 16S genetics
Abstract

Nocardia otitidiscaviarum belongs to the agents of opportunistic infections seen in immunocompromised patients, but may occur rarely in immunocompetent patients. In this report we described a case of a previously healthy 69-year-old woman with cerebral and retroperitoneal abscess due to Nocardia otitidiscaviarum. The patient was admitted to hospital because of loss of strength in her right arm and leg. Nocardia spp. was isolated from the abscess material. The intracranial lesions were drained by stereotactic craniotomy. The large abscess located around the left kidney was drained and microscopic examination of aspirated material showed Nocardia spp. For species identification, 16S rRNA gene sequencing was carried out and was 100% concordant with Nocardia otitidiscaviarum. Use of 16S rDNA gene sequencing for identification permits detection of rare aetiologic agents that cause brain abscesses.

Published
2016

56. Assessment of the requisites of microbiology based infectious disease training under the pressure of consultation needs.

Author

Erdem H, Tekin-Koruk S, Koruk I, Tozlu-Keten D, Ulu-Kilic A, Oncul O, Guner R, Birengel S, Mert G, Nayman-Alpat S, Eren-Tulek N, Demirdal T, Elaldi N, Ataman-Hatipoglu C, Yilmaz E, Mete B, Kurtaran B, Ceran N, Karabay O, Inan D, Cengiz M, Sacar S, Yucesoy-Dede B, Yilmaz S, Agalar C, Bayindir Y, Alpay Y, Tosun S, Yilmaz H, Bodur H, Erdem HA, Dikici N, Dizbay M, Oncu S, Sezak N, Sari T, Sipahi OR, Uysal S, Yeniiz E, Kaya S, Ulcay A, Kurt H, Besirbellioglu BA, Vahaboglu H, Tasova Y, Usluer G, Arman D, Diktas H, Ulusoy S, and Leblebicioglu H

Subjects
Cross-Sectional Studies, Dermatology methods, Humans, Neurology methods, Pulmonary Medicine methods, Turkey, Education, Medical, Continuing methods, Education, Medical, Continuing organization & administration, Infectious Disease Medicine education, Microbiology education, Needs Assessment, Referral and Consultation
Abstract

Background: Training of infectious disease (ID) specialists is structured on classical clinical microbiology training in Turkey and ID specialists work as clinical microbiologists at the same time. Hence, this study aimed to determine the clinical skills and knowledge required by clinical microbiologists., Methods: A cross-sectional study was carried out between June 1, 2010 and September 15, 2010 in 32 ID departments in Turkey. Only patients hospitalized and followed up in the ID departments between January-June 2010 who required consultation with other disciplines were included., Results: A total of 605 patients undergoing 1343 consultations were included, with pulmonology, neurology, cardiology, gastroenterology, nephrology, dermatology, haematology, and endocrinology being the most frequent consultation specialties. The consultation patterns were quite similar and were not affected by either the nature of infections or the critical clinical status of ID patients., Conclusions: The results of our study show that certain internal medicine subdisciplines such as pulmonology, neurology and dermatology appear to be the principal clinical requisites in the training of ID specialists, rather than internal medicine as a whole.

Published
2011
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