Efficacy of colistin and non-colistin monotherapies in multi-drug resistant acinetobacter baumannii bacteremia/sepsis

Objective: This retrospective study aimed to investigate the efficacies of colistin and non-colistin monotherapies in multi-drug resistant Acinetobacter baumannii bacteremia (MDR-AB). Materials and methods: Cases with MDR-AB from 27 tertiary-referral hospitals between January 2009 and December 2012 were included. Patients' data that were on either colistin monotherapy (CM) or non-colistin monotherapy (NCM) were compared. Mortality on Day 14 was the primary endpoint, whereas microbiological eradication and clinical outcome were the secondary ones. Results: Eighty-four cases were included in the study with 36 being in the CM group and 48 in the NCM group. Thirty-eight (45.2%) cases were male and the mean age was 60.2 years. The mean durations of pre-MDR-AB hospital stay and intensive care unit stay were 25.8 days and 20.9 days, respectively. All of the cases had fever (>38°C). The mean Pitt bacteremia score (PBS) of the patients was calculated as 6.8, APACHE 2 score as 18.9 and the Charlson co-morbidity index (CCI) as 3.7 (CM: 3.6 vs. NCM: 3.9). Twenty (55.6%) cases in the CM group and 26 cases in the NCM group (54.2%) (p=0.81) died; 9 cases in the CM group (25%) and 16 cases in the NCM group (33.3%) had treatment failure (P=0.55). Bacteriological eradication was achieved in 20 (55.6%) cases in the CM group and in 36 cases (75%) in the NCM group (P=0.061). Conclusions: No significant difference could be identified between the colistin monotherapy and non-colistin monotherapy options in MDR-AB cases with respect to the results of efficacy and 14-day mortality

Temporal Trends in the Epidemiology of HIV in Turkey

Objective: The aim of this study was to analyze the temporal trends of HIV epidemiology in Turkey from 2011 to 2016.Methods: Thirty-four teams from 28 centers at 17 different cities participated in this retrospective study. Participating centers were asked to complete a structured form containing questions about epidemiologic, demographic and clinical characteristics of patients presented with new HIV diagnosis between 2011 and 2016. Demographic data from all centers (complete or partial) were included in the analyses. For the cascade of care analysis, 15 centers that provided full data from 2011 to 2016 were included. Overall and annual distributions of the data were calculated as percentages and the Chi square test was used to determine temporal changes.Results: A total of 2,953 patients between 2011 and 2016 were included. Overall male to female ratio was 5:1 with a significant increase in the number of male cases from 2011 to 2016 (p500 cells/mm(3) while 46.7% presented with a CD4 T cell count of <350 cells/mm(3). Among newly diagnosed cases, 79% were retained in care, and all such cases initiated ART with 73% achieving viral suppression after six months of antiretroviral therapy.Conclusion: The epidemiologic profile of HIV infected individuals is changing rapidly in Turkey with an increasing trend in the number of newly diagnosed people disclosing themselves as MSM. New diagnoses were mostly at a young age. The late diagnosis was found to be a challenging issue. Despite the unavailability of data for the first 90, Turkey is close to the last two steps of 90-90-90 targets.C1 [Erdinc, F. S.; Hatipoglu, C. A.] Ankara Numune Training & Res Hosp, Infect Dis & Clin Microbiol, Ankara, Turkey.[Dokuzoguz, B.; Inkaya, A. C.] Ankara Numune Training & Researh Hosp, Infect Dis & Clin Microbiol, Ankara, Turkey.[Unal, S.] Hacettepe Univ Hastaneleri, Dept Infect Dis & Clin Microbiol, Ankara, Turkey.[Komur, S.] Cukurova Univ, Dept Infect Dis & Clin Microbiol, Adana, Turkey.[Inan, D.] Akdeniz Univ, Dept Infect Dis & Clin Microbiol, Antalya, Turkey.[Karaoglan, I] Gaziantep Univ, Dept Infect Dis & Clin Microbiol, Gaziantep, Turkey.[Deveci, A.] Ondokuz Mayis Univ, Dept Infect Dis & Clin Microbiol, Samsun, Turkey.[Celen, M. K.] Dicle Univ, Dept Infect Dis & Clin Microbiol, Diyarbakir, Turkey.[Kose, S.] Izmir Tepecik Training & Res Hosp, Dept Infect Dis & Clin Microbiol, Izmir, Turkey.[Erben, N.] Eskisehir Osmangazi Univ, Dept Infect Dis & Clin Microbiol, Fac Med, Eskisehir, Turkey.[Senturk, G. C.] Diskapi Yildirim Beyazit Training & Res Hosp, Dept Infect Dis & Clin Microbiol, Ankara, Turkey.[Heper, Y.; Yilmaz, E.; Kazak, E.] Uludag Univ, Dept Infect Dis & Clin Microbiol, Bursa, Turkey.[Kutlu, S. S.] Pamukkale Univ, Dept Infect Dis & Clin Microbiol, Denizli, Turkey.[Sumer, S.] Selcuk Univ, Dept Infect Dis & Clin Microbiol, Konya, Turkey.[Kandemir, B.] Necmettin Erbakan Univ, Meram Med Fac Hosp, Dept Infect Dis & Clin Microbiol, Konya, Turkey.[Sirmatel, F.] Abant Izzet Baysal Univ, Dept Infect Dis & Clin Microbiol, Bolu, Turkey.[Bayindir, Y.; Ersoy, Y.; Yetkin, F.] Inonu Univ, Dept Infect Dis & Clin Microbiol, Malatya, Turkey.[Yildirmak, M. T.] Okmeydani Training & Res Hosp, Dept Infect Dis & Clin Microbiol, Istanbul, Turkey.[Kayaaslan, B.] Yildirim Beyazit Univ, Dept Infect Dis & Clin Microbiol, Fac Med, Ankara, Turkey.[Ozden, K.] Ataturk Univ, Dept Infect Dis & Clin Microbiol, Erzurum, Turkey.[Sener, A.] Canakkale Onsekiz Mart Univ, Dept Infect Dis & Clin Microbiol, Canakkale, Turkey.[Kara, A.] Hacettepe Univ, Dept Infect Dis, Ihsan Dogramaci Childrens Hosp, Ankara, Turkey.[Gunal, O.] Samsun Training & Res Hosp, Dept Infect Dis & Clin Microbiol, Samsun, Turkey.[Birengel, S.] Ankara Univ, Dept Infect Dis & Clin Microbiol, Fac Med, Ankara, Turkey.[Akbulut, A.] Firat Univ, Dept Infect Dis & Clin Microbiol, Elazig, Turkey.[Cuvalci, N. O.] Antalya Training & Res Hosp, Dept Infect Dis & Clin Microbiol, Antalya, Turkey.[Sargin, F.] Medeniyet Univ, Dept Infect Dis & Clin Microbiol, Goztepe Training & Res Hosp, Istanbul, Turkey.[Pullukcu, H.; Gokengin, D.] Ege Univ, Dept Infect Dis & Clin Microbiol, Izmir, Turkey