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Batirel A, Balkan II, Karabay O, Agalar C, Akalin S, Alici O, Alp E, Altay FA, Altin N, Arslan F, Aslan T, Bekiroglu N, Cesur S, Celik AD, Dogan M, Durdu B, Duygu F, Engin A, Engin DO, Gonen I, Guclu E, Guven T, Hatipoglu CA, Hosoglu S, Karahocagil MK, Kilic AU, Ormen B, Ozdemir D, Ozer S, Oztoprak N, Sezak N, Turhan V, Turker N, Yilmaz H. Comparison of colistin-carbapenem, colistin-sulbactam, and colistin plus other antibacterial agents for the treatment of extremely drug-resistant Acinetobacter baumannii bloodstream infections. Eur J Clin Microbiol Infect Dis 2014; 33:1311-22. [PMID: 24532009 DOI: 10.1007/s10096-014-2070-6] [Citation(s) in RCA: 120] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2013] [Accepted: 01/24/2014] [Indexed: 02/06/2023]
Abstract
The purpose of this investigation was to compare the efficacy of colistin-based therapies in extremely drug-resistant Acinetobacter spp. bloodstream infections (XDR-ABSI). A retrospective study was conducted in 27 tertiary-care centers from January 2009 to August 2012. The primary end-point was 14-day survival, and the secondary end-points were clinical and microbiological outcomes. Thirty-six and 214 patients [102 (47.7%): colistin-carbapenem (CC), 69 (32.2%): colistin-sulbactam (CS), and 43 (20.1%: tigecycline): colistin with other agent (CO)] received colistin monotherapy and colistin-based combinations, respectively. Rates of complete response/cure and 14-day survival were relatively higher, and microbiological eradication was significantly higher in the combination group. Also, the in-hospital mortality rate was significantly lower in the combination group. No significant difference was found in the clinical (p = 0.97) and microbiological (p = 0.92) outcomes and 14-day survival rates (p = 0.79) between the three combination groups. Neither the timing of initial effective treatment nor the presence of any concomitant infection was significant between the three groups (p > 0.05) and also for 14-day survival (p > 0.05). Higher Pitt bacteremia score (PBS), Acute Physiology and Chronic Health Evaluation II (APACHE II) score, Charlson comorbidity index (CCI), and prolonged hospital and intensive care unit (ICU) stay before XDR-ABSI were significant risk factors for 14-day mortality (p = 0.02, p = 0.0001, p = 0.0001, p = 0.02, and p = 0.01, respectively). In the multivariable analysis, PBS, age, and duration of ICU stay were independent risk factors for 14-day mortality (p < 0.0001, p < 0.0001, and p = 0.001, respectively). Colistin-based combination therapy resulted in significantly higher microbiological eradication rates, relatively higher cure and 14-day survival rates, and lower in-hospital mortality compared to colistin monotherapy. CC, CS, and CO combinations for XDR-ABSI did not reveal significant differences with respect to 14-day survival and clinical or microbiological outcome before and after propensity score matching (PSM). PBS, age, and length of ICU stay were independent risk factors for 14-day mortality.
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Affiliation(s)
- A Batirel
- Infectious Diseases and Clinical Microbiology, Kartal Dr. Lutfi Kirdar Education and Research Hospital, Semsi Denizer Cd. E-5 Karayolu Cevizli Mevkii, 34890, Kartal, Istanbul, Turkey,
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Kalaycioglu H, Korukluoglu G, Ozkul A, Oncul O, Tosun S, Karabay O, Gozalan A, Uyar Y, Caglayık DY, Atasoylu G, Altas AB, Yolbakan S, Ozden TN, Bayrakdar F, Sezak N, Pelıtlı TS, Kurtcebe ZO, Aydın E, Ertek M. Emergence of West Nile virus infections in humans in Turkey, 2010 to 2011. Euro Surveill 2012; 17:20182. [PMID: 22687827] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/01/2023] Open
Abstract
In 2010, 47 human cases of West Nile virus (WNV)infection, including 12 laboratory-confirmed and 35 probable cases, were identified in Turkey. These were the first cases detected during routine surveillance.The patients were from 15 provinces, mainly located in the western part of the country. Incidence was 0.19/100,000 with a maximum of 1.39 in Sakarya province.Forty of the total 47 cases showed neuroinvasive manifestation. Median age was 58 years with a range of four to 86. Ten of the patients died. Enhanced surveillance in humans and animals and mosquito control measures were implemented. The WNV infections were included in the national notifiable diseases list as of April 2011. In 2011, three probable and two confirmed cases of WNV infection were diagnosed in provinces where infections had been detected in the previous year, supporting a lower activity than 2010. However,detection of WNV infections in humans in 2010 and 2011 consecutively, may indicate that WNV has become endemic in the western part of Turkey. Field epidemiological studies were undertaken to understand more about the nature of infection in Turkey.
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Affiliation(s)
- H Kalaycioglu
- Refik Saydam National Public Health Agency, Ankara, Turkey.
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Kalaycioglu H, Korukluoglu G, Ozkul A, Oncul O, Tosun S, Karabay O, Gozalan A, Uyar Y, Caglayık DY, Atasoylu G, Altas AB, Yolbakan S, Ozden TN, Bayrakdar F, Sezak N, Pelıtlı TS, Kurtcebe ZO, Aydın E, Ertek M. Emergence of West Nile virus infections in humans in Turkey, 2010 to 2011. Euro Surveill 2012. [DOI: 10.2807/ese.17.21.20182-en] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
In 2010, 47 human cases of West Nile virus (WNV) infection, including 12 laboratory-confirmed and 35 probable cases, were identified in Turkey. These were the first cases detected during routine surveillance. The patients were from 15 provinces, mainly located in the western part of the country. Incidence was 0.19/100,000 with a maximum of 1.39 in Sakarya province. Forty of the total 47 cases showed neuroinvasive manifestation. Median age was 58 years with a range of four to 86. Ten of the patients died. Enhanced surveillance in humans and animals and mosquito control measures were implemented. The WNV infections were included in the national notifiable diseases list as of April 2011. In 2011, three probable and two confirmed cases of WNV infection were diagnosed in provinces where infections had been detected in the previous year, supporting a lower activity than 2010. However, detection of WNV infections in humans in 2010 and 2011 consecutively, may indicate that WNV has become endemic in the western part of Turkey. Field epidemiological studies were undertaken to understand more about the nature of infection in Turkey.
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Affiliation(s)
- H Kalaycioglu
- Refik Saydam National Public Health Agency, Ankara, Turkey
| | - G Korukluoglu
- Refik Saydam National Public Health Agency, Ankara, Turkey
| | - A Ozkul
- Ankara University, Faculty of Veterinary Medicine, Department of Virology, Ankara, Turkey
| | - O Oncul
- Refik Saydam National Public Health Agency, Ankara, Turkey
| | - S Tosun
- State Hospital, Manisa, Turkey
| | - O Karabay
- Training and Research Hospital, Sakarya, Turkey
| | - A Gozalan
- Refik Saydam National Public Health Agency, Ankara, Turkey
| | - Y Uyar
- Refik Saydam National Public Health Agency, Ankara, Turkey
| | - D Y Caglayık
- Refik Saydam National Public Health Agency, Ankara, Turkey
| | - G Atasoylu
- Provincial Health Directorate, Manisa, Turkey
| | - A B Altas
- Refik Saydam National Public Health Agency, Ankara, Turkey
| | - S Yolbakan
- Refik Saydam National Public Health Agency, Ankara, Turkey
| | - T N Ozden
- Provincial Health Directorate, Manisa, Turkey
| | - F Bayrakdar
- Refik Saydam National Public Health Agency, Ankara, Turkey
| | - N Sezak
- State Hospital, Manisa, Turkey
| | - T S Pelıtlı
- Ministry of Health, General Directorate of Primary Health Care, Ankara, Turkey
| | - Z O Kurtcebe
- Ministry of Health, General Directorate of Primary Health Care, Ankara, Turkey
| | - E Aydın
- Ministry of Health, General Directorate of Primary Health Care, Ankara, Turkey
| | - M Ertek
- Refik Saydam National Public Health Agency, Ankara, Turkey
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Abstract
Brucellosis is an important health issue in many parts of the world and clinicians are still seeking for better treatment choices. The aim of this study was to investigate the efficacy of moxifloxacin in an experimental brucellosis model and to compare its activity with rifampicin. Wistar albino rats infected with Brucella abortus were then randomized into 3 groups, which received rifampicin, moxifloxacin, and tap water, respectively. After 21 days, they were sacrificed and spleen, liver and blood cultures were performed. Spleen and liver cultures of all the animals yielded B. abortus in the control group, while these rates were 20% and 20% in the rifampicin group and 50% and 40% in the moxifloxacin group, respectively. The blood culture positivity was 66% in the control group and 10% in the moxifloxacin group. Blood cultures were all negative in the rifampicin group. As a conclusion, moxifloxacin might be an alternative choice in the treatment of brucellosis.
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Affiliation(s)
- N Sezak
- Dokuz Eylul University School of Medicine, Department of Infectious Disease and Clinical Microbiology, Izmur, Turkey.
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