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    Öğe
    Edirne ilinde 1996-2006 yılları arası antitüberküloz ilaç direnç oranlarındaki değişim
    (2010) Perincek, Gökhan; Tabakoğlu, Erhan; Otkun, Metin; Özdemir, Levent
    Amaç: İlimizde 1996 ve 2006 yılları arasında antitüberküloz ilaç direnç oranındaki değişimi saptamak. Gereç ve yöntem: Çalışmaya, 1996 ve 2006 yıllarında Mycobacterium tuberculosis üremesi saptanan hastalar alındı. İzoniazid, rifampisin, etambutol, streptomisin ve çoklu ilaç direnci saptanan hastaların bilgileri, SPSS 15 veri tabanına yüklendi ve istatistiksel inceleme yapıldı. Bulgular: Yapmış olduğumuz çalışmada; 1996 yılında 70 hastada Mycobacterium tuberculosis üremesi saptandı. Bunlardan 21?inde izoniazid, 8?inde rifampisin, 7?sinde etambutol, 27?sinde streptomisin ve 5?inde çok ilaca direnç saptandı. 2006 yılında ise; 47 hastada Mycobacterium tuberculosis üremesi saptandı. Hastaların 11?inde izoniazid, 4?ünde rifampisin, 1?inde etambutol, 2?sinde streptomisin ve 3?ünde çok ilaca direnç saptandı. Dirençli değişimi karşılaştırıldığında; izoniazid dirençli hasta sayısının 21?den 11?e (%30?dan %23.4?e), rifampisin dirençli hasta sayısının 8?den 4?e (%11?den %8.5?e), etambutol dirençli hasta sayısının 7?den 1?e (%13?ten %2.1?e), streptomisin dirençli hasta sayısının 27?den 2?ye (%39?dan %4.3?e) ve çok ilaca dirençli hasta sayısının da 5?ten 3?e (%7?den %6.4?e) gerilediği saptandı. Sonuç: İlimizde on yıllık süre zarfında antitüberküloz ilaç direncinde; izoniazid, rifampisin, etambutol ve çok ilaca direnç de ista- tistiksel olarak anlamlı bir düşüş olmazken, streptomisin direncindeki düşüş istatistiksel olarak anlamlı bulunmuştur (p<0.05).
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    Öğe
    In-Vitro Efficacy of Synergistic Antibiotic Combinations in Multidrug Resistant Pseudomonas Aeruginosa Strains
    (Yonsei Univ Coll Medicine, 2010) Dundar, Devrim; Otkun, Metin
    Purpose: Combination antibiotic treatment is preferred in nosocomial infections caused by Pseudomonas aeruginosa (P. aeruginosa). In vitro synergism tests were used to choose the combinations which might be used in clinic. The aim of this study was to investigate the synergistic efficacy of synergistic antibiotic combinations in multidrug resistant P. aeruginosa strains. Materials and Methods: Synergistic efficacies of ceftazidime-tobramycin, piperacillin/tazobactam-tobramycin, imipenem-tobramycin, imipenem-isepamycin, imipenem-ciprofloxacin and ciprofloxacin-tobramycin combinations were investigated by checkerboard technique in 12 multiple-resistant and 13 susceptible P. aeruginosa strains. Results: The ratios of synergy were observed in ceftazidime-tobramycin and piperacillin/tazobactam-tobramycin combinations as 67%, and 50%, respectively, in resistant strains, whereas synergy was not detected in other combinations. The ratios of synergy were observed in ceftazidime-tobramycin, piperacilllin/tazobactam-tobramycin, imipenem-tobramycin, imipenem-ciprofloxacin and imipenem-isepamycin combinations as 31%, 46%, 15%, 8%, 8%, and respectively, in susceptible strains, whereas synergy was not detected in ciprofloxacin-tobramycin combination. Antagonism was not observed in any of the combinations. Conclusion: Although the synergistic ratios were high in combinations with ceftazidime or piperacillin/tazobactam and tobramycin, die concentrations in these combinations could not usually reach clinically available levels. Thus, the solution of the problems caused by multiple resistant P. aeruginosa should be based on the prevention of the development of resistance and spread of the causative agent between patients.
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    Öğe
    Mycobacterium tuberculosis üremesi saptanan akciğer tüberkülozlu hastaların antitüberküloz ilaçlara direnç oranları
    (2011) Perincek, Gökhan; Tabakoğlu, Erhan; Otkun, Metin; Özdemir, Levent; Özdemir, Burcu
    Amaç: Mycobacterium tuberculosis üremesi saptanan akciğer tüberkülozlu olguların antitüberküloz ilaç direnç oranlarının belirlenmesi. Gereç ve Yöntem: Çalışmaya 2005-2007 yılları arasında Trakya Üniversitesi Tıp Fakültesi Hastanesi’nde kültürde Mycobacterium tuberculosis üremesi saptanan akciğer tüberkülozlu 134 hasta alındı. BACTEC 460 TB sistemi kullanılarak dört major antitüberküloz ilaca (H, R, streptomisin (SM), etambutol (EMB)) karşı gelişen direnç ve çok ilaca direnç oranları araştırıldı. Bulgular: Mycobacterium tuberculosis üremesi saptanan 134 akciğer tüberkülozlu olgunun 31’i bayan, 103’ü erkekti. Hastaların %58.2’sinde Erlich-Ziehhl Neelen (EZN) boyama ile Asido Rezistan Basil tespit edildi. Antitbc direnç oranları H %10.4, R %3, EMB %0.7, SM %0.7 olarak saptandı. Sonuç: Akciğer tüberkülozlu hastalarda belirlenen direnç paternlerinin izlenmesi, uygulanacak tedavi protokollerinin belirlenmesinde ve uzun vadede direnç gelişiminin önlenmesinde yararlı olacaktır. (Tur Toraks Der 2011; 12: 111-3)
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    Öğe
    Nosocomial infections and risk factors in intensive care unit of a university hospital in Turkey
    (De Gruyter Poland Sp Z O O, 2010) Ozer, Burcin; Tatman-Otkun, Muserref; Memis, Dilek; Otkun, Metin
    The aim of this study was to determine the types nosocomial infections (NIs) and the risk factors for NIs in the central intensive care unit (ICU) of Trakya University Hospital. The patients admitted to the ICU were observed prospectively by the unit-directed active surveillance method based on patient and the laboratory over a 9-month-period. The samples of urine, blood, sputum or tracheal aspirate were taken from the patients on the first and the third days of their hospitalization in ICU; the patients were cultured routinely. Other samples were taken and cultured if there was suspicion of an infection. Infections were considered as ICU-associated if they developed after 48 hours of hospitalization in the unit and 5 days after discharge from the unit if the patients had been sent to a different ward in the hospital. The rate of NIs in 135 patients assigned was found to be 68%. The most common infection sites were lower respiratory tract, urinary tract, bloodstream, catheter site and surgical wound. Hospitalization in ICU for more than 6 days and colonization was found to be the main risk factor for NIs. Prolonged mechanical ventilation and tracheostomy, as well as frequently changed nasogastric catheterization, were found to be risk factors for lower respiratory tract infections. For bloodstream infections, both prolonged insertion of and frequent change of arterial catheters, and for urinary tract infections, female gender, period and repeating of urinary catheterization were risk factors. A high prevalence rate of nosocomial infections was found in this study. Invasive device use and duration of use continue to greatly influence the development of nosocomial infection in ICU. Important factors to prevent nosocomial infections are to avoid long hospitalization and unnecessary device application. Control and prevention strategies based on continuing education of healthcare workers will decrease the nosocomial infections in the intensive care unit.
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    Öğe
    Resistance Rates of Antituberculosis Drugs in Pulmonary Tuberculosis Patients Producing Mycobacterium Tuberculosis
    (Aves, 2011) Perincek, Gokhan; Tabakoglu, Erhan; Otkun, Metin; Ozdemir, Levent; Ozdemir, Burcu
    Objective: Determination of antituberculosis drug resistance rate in pulmonary tuberculosis patients producing Mycobacterium tuberculosis. Material and Method: 134 pulmonary tuberculosis patients producing Mycobacterium tuberculosis in cultures in the Trakya University Medical Faculty Hospital between the years 2005-2007 were enrolled in the study. Four major antituberculosis drugs (H, R, streptomycin (SM), ethambutol (EMB)) resistance and multidrug resistance rates were investigated. using the BACTEC 460 TB system. Results: 134 pulmonary tuberculosis patients producing Mycobacterium tuberculosis were detected and 31 female patients were found and 103 male patients. Acid resistant bacilli were found in 58.2% of the patients with EZN. Antituberculosis resistance rates were established as H 10.4%, R 3%, EMB 0.7%, SM 0.7%. Conclusion: It was determined that a follow up of drug resistance patterns in patients with pulmonary tuberculosis will be useful in determining treatment protocols and preventing drug resistance.
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    Öğe
    The Change of Antituberculosis Drug Resistance Rate in Edirne Region in 1996 and 2006
    (Wolters Kluwer Medknow Publications, 2010) Perincek, Gokhan; Tabakoglu, Erhan; Otkun, Metin; Ozdemir, Levent
    Objective: To establish the change in the ratio of the a ntituherculosis drug resistance in Edirne region between 1996-2006. Materials and Methods: The patients, who were detected with Mycobacterium tuberculosis proliferation in the cultures, were enrolled to the study between 1996-2006. The patients, who were diagnosed with isoniazid, rifampisin, ethambutol, streptomycin and multi-drug resistance were selected and their data of was uploaded to SPSS software in order to perform statistical analysis. Results: We found the Mycobacterium tuberculosis proliferation of cultures in 70 patients in 1996, whew. 21 patients had isoniazid, 8 patients had rifampicin, 7 patients had ethambutol, r patients had streptomycin, and 5 patients had multi Burg resistance. En 2006, illyrobacterium tuberculosis proliferation was established in 47 patients. Of these, 11 patients had isoniazid, 8 had rifampisin, one patient had ethambutol, 2 patients had streptomycin and 3 patients had multi-durg resistance. We compared the changes in the resistance figures and found a decrease: of drug resistance as follows: in isoniazid, from 21 patients (301Y0) to 11 patients (23.4%); in rifampisin, from 8 patients (11%) to 4 patients (8.5%0; in ethambutol, from 7 patients (13'Yo) to one patient (2.1`,0; in streptomycin, from r patients (39%) to 2 patients (4.3%); in multi drug, from 5 patients (7%) to 3 patients (6.4`%). Conclusion: Although statistically significant decrease of drug resistance was not found in isoniazid, rifampisin, ethambutol and multi-drug, a significant drug resistance \vas estabished in streptomycin in Edirne region during the 10 years period.