Empiric antibiotic therapy in acute uncomplicated urinary tract infections and fluoroquinolone resistance: a prospective observational study

<p>Abstract</p> <p>Background</p> <p>The aims of this study were to determine the antimicrobial susceptibility patterns of urinary isolates from community acquired acute uncomplicated urinary tract infections (uUTI) and to evaluate which antibiotics were empirically prescribed in the outpatient management of uUTI.</p> <p>Methods</p> <p>Among the patients which were admitted to outpatient clinics of Ankara University Medical Faculty, Ibni-Sina Hospital during 2005-2006, a total of 429 women between the age of 18 and 65 years old who were clinically diagnosed with uUTI and to whom prescribed empirical antibiotics were enrolled in this prospective observational study. Patients' demographical data, urine culture results, resistance rates to antimicrobial agents and prescribed empiric antimicrobial therapy were analyzed.</p> <p>Results</p> <p>Totally 390 (90.9%) patients among all study population were requested for urine culture by their physicians. 150 (38.5%) of these urine cultures were positive. The most common isolated uropathogen was <it>Escherichia coli (E. coli) </it>(71.3%). The variations of uropathogens according to age and menopause status were not significantly different.</p> <p>The resistance rates of <it>E. coli </it>isolates for ampicillin, ampicillin-sulbactam, amoxicillin-clavulonate, cefuroxime, ceftriaxone, fluoroquinolones (FQ), co-trimoxazole (TMP-SMX) and gentamicin were 55.1%, 32.7%, 32.7%, 23.4%, 15.9%, 25.2%, 41.1%, 6.1% respectively. FQ were the most common prescribed antibiotics (77.9%) (<it>P </it>< 0.001), followed by TMP-SMX (10.7%), fosfomycin (9.2%), nitrofurantoin (2.1%). Treatment durations were statistically longer than the recommended 3-day course (<it>P </it>< 0.001).</p> <p>Conclusion</p> <p>Empirical use of FQ in uUTI should be discouraged because of increased antimicrobial resistance rates.</p

Antibiotic usage in hospitalized patients: a one-day point prevalence study

Measurements are one of the most important means of evaluating the quality of antibiotic consumption. This study has evaluated the antibiotic consumption using one-day point prevalence study data collected from different hospitals in Turkey. This research was planned as a multicenter point surveillance study which aimed demonstrating the use of antibiotics among inpatients in Turkey. On the day of surveillance, demographic data from 21,920 inpatients, names of antibiotics used by the inpatients, number of antibiotics approved by infectious disease specialist (IDS), and the length of antibiotic use were recorded. These results showed that 30.3% of patients were using antibiotics and 57.7% of those were IDS-approved. The rate of IDS-approved antibiotic consumption was higher for internal medicine wards and in intensive care units, whereas non-IDS-approved antibiotics were used among inpatients of surgical wards.WOS:0005336927000012-s2.0-85084830447PubMed: 3239315

Urinary Tract Infections after Kidney Transplantation in Fourteen Medical Centers in Turkey

27th International Congress of the Transplantation-Society (TTS) -- JUN 30-JUL 05, 2018 -- Madrid, SPAINWOS: 000444541201323…Transplantat Soc, Soc Espanola Trasplante, Soc Madrilena Trasplant

Mucormycosis in Turkey

27th International Congress of the Transplantation-Society (TTS) -- JUN 30-JUL 05, 2018 -- Madrid, SPAINWOS: 000444541201322…Transplantat Soc, Soc Espanola Trasplante, Soc Madrilena Trasplant

Secondary Infections in Cancer Patients with Febrile Neutropenia

OBJECTIVE: Patients with neutropenia due to cancer chemotherapy are prone to severe infections. Cancer patients can experience >1 infectious episode during the same period of neutropenia. This study aimed to determine the etiological and clinical characteristics of secondary infectious episodes in cancer patients with febrile neutropenia and to identify the factors associated with the risk of secondary infectious episodes. METHODS: All cancer patients that received antineoplastic chemotherapy at Ankara University, School of Medicine, Department of Hematology between May 2004 and May 2005 and developed neutropenia were included in the study. Data were collected using survey forms that were completed during routine infectious diseases consultation visits. Categorical data were analyzed using the chi-square test, whereas Student’s t-test was used for continuous variables. Multivariate logistic regression analysis was performed to identify independent predictors of secondary infections (SIs). RESULTS: SIs were observed during 138 (53%) of 259 febrile neutropenic episodes. Of the 138 episodes, 89 (64.5%) occurred in male patients with a mean age of 40.9 years (range: 17-76 years). In total, 80% of the SIs were clinically or microbiologically documented. Factors on d 4 of the initial febrile episode were analyzed via a logistic regression model. The presence of a central intravenous catheter (OR: 3.01; P < 0.001), acute myeloid leukemia (AML) as the underlying disease (OR: 2.12; P = 0.008), diarrhea (OR: 4.59; P = 0.005), and invasive aspergillosis (IA) during the initial febrile episode (OR: 3.96; P = 0.009) were statistically significant risk factors for SIs. CONCLUSION: Among the cancer patients with neutropenia in the present study, AML as the underlying disease, the presence of a central venous catheter, diarrhea, and IA during the initial febrile episode were risk factors for the development of SIs

Cryptococcal Sepsis in a HIV/AIDS Patient: Clinical Findings, Diagnostic and Therapeutic Approach

Cryptococcus neoformans is an encapsulated yeast causing infection in patients with acquired immune deficiency syndrome (AIDS). With the introduction of highly active antiretroviral therapy (HAART), the incidence of infection due to Cryptococcus has significantly decreased. The era of HAART has not only affected the incidence ratebutalso the clinical presentation called immune reconstitution inflammatory syndrome as a consequence of the immune recovery of the host. In this paper, we presented a HIV/AIDS patient with cryptococcal sepsis and discussed clinical manifestations of cryptococcosis, diagnostic and therapeutic approach