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Ergönül Ö, Aydin M, Azap A, Başaran S, Tekin S, Kaya Ş, Gülsün S, Yörük G, Kurşun E, Yeşilkaya A, Şimşek F, Yılmaz E, Bilgin H, Hatipoğlu Ç, Cabadak H, Tezer Y, Togan T, Karaoğlan I, İnan A, Engin A, Alışkan HE, Yavuz SŞ, Erdinç Ş, Mulazimoglu L, Azap Ö, Can F, Akalın H, Timurkaynak F. Healthcare-associated Gram-negative bloodstream infections: antibiotic resistance and predictors of mortality. J Hosp Infect 2016; 94:381-385. [PMID: 27717604 DOI: 10.1016/j.jhin.2016.08.012] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2016] [Accepted: 08/02/2016] [Indexed: 12/28/2022]
Abstract
This article describes the prevalence of antibiotic resistance and predictors of mortality for healthcare-associated (HA) Gram-negative bloodstream infections (GN-BSI). In total, 831 cases of HA GN-BSI from 17 intensive care units in different centres in Turkey were included; the all-cause mortality rate was 44%. Carbapenem resistance in Klebsiella pneumoniae was 38%, and the colistin resistance rate was 6%. Multi-variate analysis showed that age >70 years [odds ratio (OR) 2, 95% confidence interval (CI) 1.22-3.51], central venous catheter use (OR 2.1, 95% CI 1.09-4.07), ventilator-associated pneumonia (OR 1.9, 95% CI 1.1-3.16), carbapenem resistance (OR 1.8, 95% CI 1.11-2.95) and APACHE II score (OR 1.1, 95% CI 1.07-1.13) were significantly associated with mortality.
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Affiliation(s)
- Ö Ergönül
- Koç University School of Medicine, Infectious Diseases and Clinical Microbiology Department, Istanbul, Turkey.
| | - M Aydin
- Başkent University School of Medicine, Istanbul Hospital, Infectious Diseases and Clinical Microbiology Department, Turkey
| | - A Azap
- Ankara University Medical Faculty, Infectious Diseases and Clinical Microbiology Department, Turkey
| | - S Başaran
- Istanbul University Istanbul Medical School, Infectious Diseases and Clinical Microbiology Department, Istanbul, Turkey
| | - S Tekin
- Koç University School of Medicine, Infectious Diseases and Clinical Microbiology Department, Istanbul, Turkey
| | - Ş Kaya
- Diyarbakır Training and Research Hospital, Infectious Diseases and Clinical Microbiology Department, Diyarbakır, Turkey
| | - S Gülsün
- Diyarbakır Training and Research Hospital, Infectious Diseases and Clinical Microbiology Department, Diyarbakır, Turkey
| | - G Yörük
- Istanbul Training and Research Hospital, Infectious Diseases and Clinical Microbiology Department, Istanbul, Turkey
| | - E Kurşun
- Başkent University School of Medicine, Adana Hospital, Infectious Diseases and Clinical Microbiology Department, Adana, Turkey
| | - A Yeşilkaya
- Başkent University School of Medicine, Ankara Hospital, Infectious Diseases and Clinical Microbiology Department, Ankara, Turkey
| | - F Şimşek
- Okmeydanı Training and Research Hospital, Infectious Diseases and Clinical Microbiology Department, Istanbul, Turkey
| | - E Yılmaz
- Uludağ University School of Medicine, Infectious Diseases and Clinical Microbiology Department, Bursa, Turkey
| | - H Bilgin
- Marmara University School of Medicine, Infectious Diseases and Clinical Microbiology Department, Istanbul, Turkey
| | - Ç Hatipoğlu
- Ankara Training and Research Hospital, Infectious Diseases and Clinical Microbiology Department, Ankara, Turkey
| | - H Cabadak
- Ankara Specialty Hospital, Infectious Diseases and Clinical Microbiology Department, Ankara, Turkey
| | - Y Tezer
- Ankara Specialty Hospital, Infectious Diseases and Clinical Microbiology Department, Ankara, Turkey
| | - T Togan
- Başkent University School of Medicine, Konya Hospital, Infectious Diseases and Clinical Microbiology Department, Konya, Turkey
| | - I Karaoğlan
- Gaziantep University School of Medicine, Infectious Diseases and Clinical Microbiology Department, Gaziantep, Turkey
| | - A İnan
- Haydarpaşa Numune Training and Research Hospital, Infectious Diseases and Clinical Microbiology Department, Istanbul, Turkey
| | - A Engin
- Cumhuriyet University School of Medicine, Infectious Diseases and Clinical Microbiology Department, Sivas, Turkey
| | - H E Alışkan
- Başkent University School of Medicine, Adana Hospital, Infectious Diseases and Clinical Microbiology Department, Adana, Turkey
| | - S Ş Yavuz
- Istanbul University Istanbul Medical School, Infectious Diseases and Clinical Microbiology Department, Istanbul, Turkey
| | - Ş Erdinç
- Ankara Training and Research Hospital, Infectious Diseases and Clinical Microbiology Department, Ankara, Turkey
| | - L Mulazimoglu
- Marmara University School of Medicine, Infectious Diseases and Clinical Microbiology Department, Istanbul, Turkey
| | - Ö Azap
- Başkent University School of Medicine, Ankara Hospital, Infectious Diseases and Clinical Microbiology Department, Ankara, Turkey
| | - F Can
- Koç University School of Medicine, Infectious Diseases and Clinical Microbiology Department, Istanbul, Turkey
| | - H Akalın
- Uludağ University School of Medicine, Infectious Diseases and Clinical Microbiology Department, Bursa, Turkey
| | - F Timurkaynak
- Başkent University School of Medicine, Istanbul Hospital, Infectious Diseases and Clinical Microbiology Department, Turkey
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Azap Ö, Togan T, Yesilkaya A, Arslan H, Haberal M. Antimicrobial susceptibilities of uropathogen Escherichia coli in renal transplant recipients: dramatic increase in ciprofloxacin resistance. Transplant Proc 2013; 45:956-7. [PMID: 23622597 DOI: 10.1016/j.transproceed.2013.03.006] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
Abstract
The urinary tract is the most common site of bacterial infections in renal transplant recipients. The management of urinary tract infections (UTI) in renal transplant recipients is becoming more difficult because of drug-resistant bacteria. The antimicrobial susceptibilities of uropathogen bacteria isolated from 398 patients who underwent renal transplantation between 2007 and 2011 were obtained from medical records. At least 1 UTI episode was diagnosed in 172 (43.2%) patients. Among the 703 bacteria isolated from these patients, Exherichia coli the most common pathogen, was isolated from 407/703 episodes (57.8%). Ciprofloxacin, co-trimoxazole, ceftriaxone, and gentamicin resistance rates were 59.4%, 85.7%, 40.7%, and 36.6%, respectively. Ninty six of 407 E. coli isolates (23.5%) were ESBL positive. Analysis of resistance rates in our center demonstrated ciprofloxacin resistance rate in uropathogenic E. coli to have increased gradually from 30.4% in 2003, 41.3% in 2007, and 59.4% in 2012. Instutional data regarding the etiologic agents and antimicrobial susceptibility results are important for proper management of patients with UTI.
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Affiliation(s)
- Ö Azap
- Department of Infectious Diseases, Faculty of Medicine, Baskent University, Ankara, Turkey.
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Abstract
We have cloned a gene that complements the cold-sensitive growth of cdc50-1 mutant strain of Saccharomyces cerevisiae at 14 degrees C. The CDC50 gene was found to be identical to YCR094w on chromosome III and contains 1173 nucleotides encoding 391 amino acids. We found a missense mutation at the first initiation codon of cdc50-1. The disruption of the CDC50 gene revealed that it is not essential for growth, but the disruptant caused the same cold-sensitive phenotype as cdc50-1, suggesting that the cdc50-1 is a null mutation resulted from the mutation in the first codon. The cdc50-1 mutant arrests at START in G1 phase at the non-permissive temperature. The CDC50 gene product has strong structural similarity to two other proteins in Saccharomyces cerevisiae encoded by YNR048w and YNL323w. The over-expression of either YNR048w or YNL323w suppressed the cdc50-1 mutant and the double disruption of either CDC50 and YNR048w or CDC50 and YNL323w resulted in a severe slow-growth phenotype. We conclude that these three genes constitute a family with redundant function. We also found that the CDC39 gene was a multicopy suppressor of cdc50-1 mutation, suggesting that the CDC50 family is involved in regulation of transcription via CDC39.
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Affiliation(s)
- M Radji
- Section of Animal Molecular Genetics, Department of Molecular Biology, Graduate School of Biological Sciences, Nara Institute of Science and Technology, 8916-5 Takayama, Ikoma City, Nara, Japan, 630-0101
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