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1.
Infect Dis Now ; 51(4): 362-367, 2021 Jun.
Article in English | MEDLINE | ID: mdl-33870888

ABSTRACT

OBJECTIVES: Daptomycin is highly effective against Gram-positive multidrug-resistant bacteria. Publications on daptomycin in osteomyelitis treatment are limited. PATIENTS AND METHODS: In this multicenter retrospective cohort study, the aim was to evaluate the outcomes of osteomyelitis cases having received daptomycin or teicoplanin. This multicenter retrospective cohort study gathered data from seven centers located in five cities of Turkey. Study inclusion criteria were as follows: (a) magnetic resonance imaging and/or direct X-ray revealed osteomyelitis or biopsy pathologic examination results concomitant with osteomyelitis. Chi-squareand Student t-tests were used for statistical comparison. RESULTS: A total of 72 patients, 38 cases in the daptomycin group and 34 cases in the teicoplanin group diagnosed with osteomyelitis fulfilling the study inclusion criteria, were included in the study. Clinical success at the end of induction therapy was achieved in 32/38 cases in the daptomycin cohort vs. 30/34 cases in the teicoplanin cohort (p: 0.73). CONCLUSION: Although this is a limited experience in a small but well-defined cohort, our data suggest that daptomycin may be a safe alternative to glycopeptides in osteomyelitis treatment. A randomized controlled clinical study involving larger cohorts may increase the available evidence.


Subject(s)
Anti-Bacterial Agents/therapeutic use , Daptomycin/therapeutic use , Osteomyelitis/drug therapy , Teicoplanin/therapeutic use , Adult , Aged , Cohort Studies , Drug Resistance, Multiple, Bacterial , Female , Glycopeptides/therapeutic use , Humans , Male , Middle Aged , Retrospective Studies , Treatment Outcome , Turkey , Vancomycin/therapeutic use
3.
Eur J Clin Microbiol Infect Dis ; 37(7): 1231-1240, 2018 Jul.
Article in English | MEDLINE | ID: mdl-29218468

ABSTRACT

Cryptococcal meningitis (CM) is mostly seen in immunocompromised patients, particularly human immunodeficiency virus (HIV)-positive patients, but CM may also occur in apparently immunocompetent individuals. Outcome analyses have been performed in such patients but, due to the high prevalence of HIV infection worldwide, CM patients today may be admitted to hospitals with unknown HIV status, particularly in underdeveloped countries. The objective of this multicenter study was to analyze all types of CM cases in an aggregate cohort to disclose unfavorable outcomes. We retrospectively reviewed the hospitalized CM patients from 2000 to 2015 in 26 medical centers from 11 countries. Demographics, clinical, microbiological, radiological, therapeutic data, and outcomes were included. Death, neurological sequelae, or relapse were unfavorable outcomes. Seventy (43.8%) out of 160 study cases were identified as unfavorable and 104 (65%) were HIV infected. On multivariate analysis, the higher Glasgow Coma Scale (GCS) scores (p = 0.021), cerebrospinal fluid (CSF) leukocyte counts > 20 (p = 0.038), and higher CSF glucose levels (p = 0.048) were associated with favorable outcomes. On the other hand, malignancy (p = 0.026) was associated with poor outcomes. Although all CM patients require prompt and rational fungal management, those with significant risks for poor outcomes need to be closely monitored.


Subject(s)
Antifungal Agents/therapeutic use , Meningitis, Cryptococcal/drug therapy , Meningitis, Cryptococcal/mortality , Adult , Cerebrospinal Fluid/microbiology , Comorbidity , Cryptococcus/classification , Cryptococcus/isolation & purification , Female , HIV Infections/complications , Humans , Immunocompromised Host , Male , Meningitis, Cryptococcal/diagnosis , Middle Aged , Retrospective Studies , Surveys and Questionnaires , Treatment Outcome
4.
Eur J Clin Microbiol Infect Dis ; 35(6): 903-10, 2016 Jun.
Article in English | MEDLINE | ID: mdl-26964538

ABSTRACT

Mass gatherings pooling people from different parts of the world-the largest of which is to Mecca, Saudi Arabia, for Hajj-may impose risks for acquisition and dissemination of infectious diseases. A substantial number of pilgrims to Hajj and Umrah are Turkish citizens (456,000 in 2014) but data are lacking on scale of the problem. We did a retrospective cross-sectional multicenter study in Turkey to explore the range of infections among inpatients who had recently returned from the Arabian Peninsula. Our inclusion criteria were patients who had acquired an infection during their trip to an Arabian Peninsula country, or who became symptomatic within 1 week of their return. The data were collected retrospectively for January 1, 2013 and March 1, 2015. 185 Turkish patients were recruited to the study across 15 referral centers with travel associated infectious diseases after returning from Arabian Peninsula countries (predominantly Saudi Arabia 163 [88.1 %] for religious purposes 162 [87.5 %]). Seventy four (40.0 %) of them were ≥ 65 years old with numerous comorbidities including diabetes (24.3 %) and COPD (14.1 %). The most common clinical diagnosis was respiratory tract infections (169 [91.5 %]), followed by diarrheal diseases (13 [7 %]), and there was one case of MERS-CoV. Patients spent a median of 5 (3-7) days as hospital inpatients and overall mortality was 1.1 %. Returning travellers from the Arabian Peninsula present as inpatients with a broad range of infectious diseases similar to common community acquired infections frequently seen in daily medical practices in Turkey.


Subject(s)
Infections/epidemiology , Travel , Comorbidity , Critical Care , Cross-Sectional Studies , Female , Follow-Up Studies , Humans , Infections/diagnosis , Infections/etiology , Infections/therapy , Intensive Care Units , Male , Microbiological Techniques , Middle East , Retrospective Studies , Serologic Tests , Turkey
5.
Clin Microbiol Infect ; 20(11): O847-53, 2014 Nov.
Article in English | MEDLINE | ID: mdl-24831227

ABSTRACT

This study reviewed the clinical, laboratory, therapeutic and prognostic data on genitourinary involvement of brucellosis in this largest case series reported. This multicentre study pooled adult patients with genitourinary brucellar involvement from 34 centres treated between 2000 and 2013. Diagnosis of the disease was established by conventional methods. Overall 390 patients with genitourinary brucellosis (352 male, 90.2%) were pooled. In male patients, the most frequent involved site was the scrotal area (n=327, 83.8%), as epididymo-orchitis (n=204, 58%), orchitis (n=112, 31.8%) and epididymitis (n=11, 3.1%). In female patients, pyelonephritis (n=33/38, 86.8%) was significantly higher than in male patients (n=11/352, 3.1%; p<0.0001). The mean blood leukocyte count was 7530±3115/mm3. Routine laboratory analysis revealed mild to moderate increases for erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP). The mean treatment duration and length of hospital stay were significantly higher when there were additional brucellar foci (p<0.05). Surgical operations including orchiectomy and abscess drainage were performed in nine (2.3%) patients. Therapeutic failure was detected in six (1.5%), relapse occurred in four (1%), and persistent infertility related to brucellosis occurred in one patient. A localized scrotal infection in men or pyelonephritis in women in the absence of leucocytosis and with mild to moderate increases in inflammatory markers should signal the possibility of brucellar genitourinary disease.


Subject(s)
Brucellosis/drug therapy , Brucellosis/pathology , Female Urogenital Diseases/drug therapy , Female Urogenital Diseases/pathology , Male Urogenital Diseases/drug therapy , Male Urogenital Diseases/pathology , Adolescent , Adult , Aged , Aged, 80 and over , Brucellosis/diagnosis , Female , Female Urogenital Diseases/diagnosis , Humans , Male , Male Urogenital Diseases/diagnosis , Middle Aged , Prognosis , Retrospective Studies , Young Adult
6.
Eur J Clin Microbiol Infect Dis ; 33(7): 1253-62, 2014 Jul.
Article in English | MEDLINE | ID: mdl-24557334

ABSTRACT

Brucellosis is a zoonotic disease that primarily affects the reticuloendothelial system. But, the extent of liver damage in due course of the disease is unclear. This study included 325 brucellosis patients with significant hepatobiliary involvement identified with microbiological analyses from 30 centers between 2000 and 2013. The patients with ≥5 times of the upper limit of normal for aminotransferases, total bilirubin level ≥2 mg/dl or local liver lesions were enrolled. Clinical hepatitis was detected in 284 patients (87.3 %) and cholestasis was detected in 215 (66.1 %) patients. Fatigue (91 %), fever (86 %), sweating (83 %), arthralgia (79 %), and lack of appetite (79 %) were the major symptoms. Laboratory tests showed anemia in 169 (52 %), thrombocytopenia in 117 (36 %), leukopenia in 81 (25 %), pancytopenia in 42 (13 %), and leukocytosis in 20 (6 %) patients. The most commonly used antibiotic combinations were doxycycline plus an aminoglycoside (n = 73), doxycycline plus rifampicin (n = 71), doxycycline plus rifampicin and an aminoglycoside (n = 27). The duration of ALT normalization differed significantly in three treatment groups (p < 0.001). The use of doxycycline and an aminoglycoside in clinical hepatitis showed better results compared to doxycycline and rifampicin or rifampicin, aminoglycoside, doxycycline regimens (p < 0.05). However, the length of hospital stay did not differ significantly between these three combinations (p > 0.05). During the follow-up, treatment failure occurred in four patients (1 %) and relapse was seen in three patients (0.9 %). Mortality was not observed. Hepatobiliary involvement in brucellosis has a benign course with suitable antibiotics and the use of doxycycline and an aminoglycoside regimen seems a better strategy in select patients.


Subject(s)
Brucellosis/complications , Brucellosis/pathology , Hepatitis/etiology , Hepatitis/pathology , Adult , Animals , Anti-Bacterial Agents/therapeutic use , Bilirubin , Brucellosis/drug therapy , Female , Humans , Male , Middle Aged , Retrospective Studies , Transaminases , Treatment Outcome , Young Adult
7.
Clin Microbiol Infect ; 19(2): E80-6, 2013 Feb.
Article in English | MEDLINE | ID: mdl-23210984

ABSTRACT

No detailed data exist in the literature on the accurate diagnosis of chronic brucellar meningitis or meningoencephalitis. A multicentre retrospective chart review was performed at 19 health centres to determine sensitivities of the diagnostic tests. This study included 177 patients. The mean values of CSF biochemical test results were as follows: CSF protein, 330.64 ± 493.28 mg/dL; CSF/ blood-glucose ratio, 0.35 ± 0.16; CSF sodium, 140.61 ± 8.14 mMt; CSF leucocyte count, 215.99 ± 306.87. The sensitivities of the tests were as follows: serum standard tube agglutination (STA), 94%; cerebrospinal fluid (CSF) STA, 78%; serum Rose Bengal test (RBT), 96%; CSF RBT, 71%; automated blood culture, 37%; automated CSF culture, 25%; conventional CSF culture, 9%. The clinician should use every possible means to diagnose chronic neurobrucellosis. The high seropositivitiy in brucellar blood tests must facilitate the use of blood serology. Although STA should be preferred over RBT in CSF in probable neurobrucellosis other than the acute form of the disease, RBT is not as weak as expected. Moreover, automated culture systems should be applied when CSF culture is needed.


Subject(s)
Brucellosis/diagnosis , Clinical Laboratory Techniques/methods , Meningitis, Bacterial/diagnosis , Adolescent , Adult , Aged , Brucellosis/microbiology , Cerebrospinal Fluid/chemistry , Cerebrospinal Fluid/cytology , Chronic Disease , Female , Humans , Male , Meningitis, Bacterial/microbiology , Middle Aged , Sensitivity and Specificity , Serum/chemistry , Young Adult
8.
J Trop Pediatr ; 49(4): 228-30, 2003 08.
Article in English | MEDLINE | ID: mdl-12929884

ABSTRACT

Although the treatment of asymptomatic bacteriuria (ABU) is recommended in certain conditions, and screening for ABU is generally not recommended in healthy children, high prevalence of ABU in infants in a former study from eastern Turkey, led us to conduct a study to discover ABU rates in schoolchildren in the province of Isparta, Turkey. Children (n = 10289) from 14 schools and aged 6-14 years participated voluntarily. Two clean-catch midstream urine samples were collected, and screened by microscope and culture for infection. Bacterial agents were identified by Gram's stain. Urological and radiological examinations were suggested to the parents of the children identified with ABU. Five thousand and seventy three participants (49.3 per cent) were girls and 5216 (50.7 per cent) were boys. The median age was 10 (6-14) years. The prevalence of ABU in the total population was 0.37 per cent. The prevalence for ABU was higher in female students 134 (0.67 per cent) vs. 4 (0.08 per cent)], [x 2 (df = 1) = 24.44, p < 0.01]. A decline of ABU from the first to the second screening was observed. In 30 (79 per cent) children with ABU, Escherichia coli was isolated. One year later 27 (71.1 per cent) of the 38 children with ABU were found to be culture negative. The prevalence of ABU in our sample population was consistent with the literature. Lower prevalence of ABU in boys may be linked to the high circumcision frequency in Turkey.


Subject(s)
Bacteriuria/epidemiology , Escherichia coli Infections/epidemiology , Escherichia coli/isolation & purification , Adolescent , Child , Cross-Sectional Studies , Female , Humans , Male , Mass Screening , Prevalence , Rural Population/statistics & numerical data , Turkey/epidemiology
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