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    Effectiveness of ciprofloxacin in the treatment of Acute Otitis Media
    (Ondokuz Mayis Universitesi, 2022) Mehel, Dursun Mehmet; Turgut, Nesrettin Fatih; Çeviker, Sevil ALKAN; Özdemir, Doğukan; Özgür, Abdulkadir
    Acute otitis externa is an infection of the outer ear canal that can occur at any age and is diagnosed by symptoms and examination findings. The aims of our study were to understand the seasonal frequency of acute otitis externa and to determine the susceptibility of causative bacteria to ciprofloxacin. Discharge samples were collected from the external ear canals of 76 patients diagnosed with acute otitis externa. The samples were evaluated and culture-antibiogram results were compiled. Routine microbiological methods were used for the reproduction of clinical material as bacterial and fungal cultures. The 76 enrolled patients were 18–80 years old (mean 41.6 years). Acute otitis externa occurred most frequently during summer, especially in July. Culture results revealed Pseudomonas aeruginosa growth in 30 cases (39.4%), Staphylococcus aureus in 18 cases (23.6%), and Serratia spp. in 5 cases (6.5%), while fungal growth was observed in 10 cases (13.1%). The antibiogram analyses determined ciprofloxacin resistance in P. aeruginosa in 13 patients (43.3%) and in S. aureus in 6 patients (33.3%). Acute otitis externa should be treated with antibiotics in accordance with culture antibiogram results, while keeping in mind that bacterial causes could be ciprofloxacin resistant. © 2022 Ondokuz Mayis Universitesi. All rights reserved.
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    The effect of prolonged intubation on ventilator associated pneumonia: endotracheal tube cuff is really steril or not?
    (MediHealth Academy Yayıncılık, 2023) Özdemir, Doğukan; Görgün, Selim; Çeçen, Ayşe; Alkan, Sevil; Çeçen, Yavuz; Mehel, Dursun Mehmet; Ünal, Asude
    Aims: Endotracheal tube (ETT) design, size, cuff material, cuff pressure and intubation duration are critical in preventing nosocomial pneumonia. We aimed to evaluate the possible infection focus potential of ETT cuff and pilot balloon, particularly in prolonged intubated patients. Methods: A total number of 66 patients who underwent orotracheal intubation and received conventional mechanical ventilation more than 48 hours in the intensive care unit (ICU), were included in this prospective cohort study. Results: The mean duration of intubation was 10.36±4.82 days. Bacteriologically confirmed positive tracheal aspirate culture was 18.2% (n=12). The most frequent positive culture was detected inside of ETT lumen with a percentage of 83.3% (n=55) and followed by cuff (27.3%, n=18), pilot balloon (13.6%, n=9), respectively. It was documented that rates of lung infections were significantly increased after 14 days (p=0.017) and rates of cuff positive cultures were significantly increased after 10 and 14 days of incubation (p= 0.001, p=0.004). The same type of bacteriological strains was identified from both pilot balloon (n=9) and ETT cuff (n=9), simultaneously. In the remaining 9-cuff positive patients pilot balloons were sterile and ETT lumens were positive culture with the same strains as identified from the cuff. There was a statistically significant positive correlation between the intubation duration and the number of infected ETT parts (p<0.001). Conclusion: ETT cuff was demonstrated to be a potential infection focus in the present study. In addition, it was observed that ETT cuff colonization increased in proportion to the intubation duration. We suggest changing ETT at appropriate time intervals in order to reduce ventilator-associated pneumonia in intubated patients.