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1. Comparison of colistin monotherapy and non-colistin combinations in the

Author

Balkan, II, Batirel, A, 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, Guciu, E, Guven, T, Hatipogiu, CA, Hosoglu, S, Karahocagil, MK, Kilic, AU, Ormen, B, Ozdemir, D, Ozer, S, Oztoprak, N, Sezak, N, Turhan, V, Turker, N, and Yilmaz, H

Subjects
Acinetobacter spp, Blood stream infection, colistin, monotherapy, multi drug resistant
Abstract

Objectives: To compare the efficacy of colistin (COL) monotherapy versus non-COL based combinations in the treatment of bloodstream infections (BSIs) due to multidrug resistant Acinetobacter spp.(MDR-A) . Materials and Methods: Retrospective data of 107 MDR-A BSI cases from 27 tertiary centers in Turkey were included. Primary End-Point: 14-day mortality. Secondary End-Points: Microbial eradication and clinical improvement. Results: Thirty-six patients in the COL monotherapy (CM) group and 71 in the non-COL based combinations (NCC) group were included in the study. Mean age was 59.98 20 years (range: 18-89) and 50.5% were male. Median duration of follow-up was 40 days (range: 9-297). The 14-day survival rates were 52.8% in CM and 47.23% in NCC group (P = 0.36). Microbiological eradication was achieved in 69% of CM and 83% of NCC group (P = 0.13). Treatment failure was detected in 22.9% of cases in both CM and NCC groups. Univariate analysis revealed that mean age (P = 0.001), Charlson comorbidity index (P = 0.03), duration of hospital stay before MDR-A BSI (P = 0.04), Pitt bacteremia score (P = 0.043) and Acute Physiology and Chronic Health Evaluation II score (P = 0.05) were significant in terms of 14-day mortality. Advanced age (P = 0.01) and duration of hospital stay before MDR-A BSI (P = 0.04) were independently associated with 14-day mortality in multivariate analysis. Conclusion: No significant difference was detected between CM and non-COL based combinations in the treatment of MDR-A BSIs in terms of efficacy and 14-day mortality.

Published
2015

2. report on device-associated infection rates in 19 cities of Turkey, data

Author

Leblebicioglu, H, Erben, N, Rosenthal, VD, Atasay, B, Erbay, A, Unal, S, Senol, G, Willke, A, Ozgultekin, A, Altin, N, Bakir, M, Oncul, O, Ersoz, G, Ozdemir, D, Yalcin, AN, Ozdemir, H, Yildizdas, D, Koksal, I, Aygun, C, Sirmatel, F, Sener, A, Tuna, N, Akan, OA, Turgut, H, Demiroz, AP, Kendirli, T, Alp, E, Uzun, C, Ulusoy, S, Arman, D, Ozgunes, I, Usluer, G, Kilic, A, Arsan, S, Cabadak, H, Sen, S, Gelebek, Y, Zengin, H, Topeli, A, Alper, Y, Meric, M, Azak, E, Inan, A, Turan, G, Haznedaroglu, T, Gorenek, L, Acar, A, Cesur, S, Engin, A, Kaya, A, Kuyucu, N, Geyik, MF, Aydin, OC, Erdogan, NS, Turhan, O, Gunay, N, Gumus, E, Dursun, O, Esen, S, Ulger, F, Dilek, A, Yilmaz, H, Sunbul, M, Gokmen, Z, Ozdemir, SI, Horoz, OO, Yylmaz, G, Kaya, S, Ulusoy, H, Kucukoduk, S, Ustun, C, Baysal, AI, Otkun, M, Tulunay, M, Oral, M, Unal, N, Cengiz, M, Yilmaz, L, Sacar, S, Sungurtekin, H, Ugurcan, D, Yetkin, MA, Bulut, C, Erdinc, FS, Hatipoglu, CA, Ince, E, Ciftci, E, Odek, C, Yaman, A, Karbuz, A, Aldemir, B, Kilic, AU, Arda, B, Bacakoglu, F, and Hizel, K

Subjects
infection, Urinary tract infection, Network, Ventilator-associated pneumonia, Catheter-associated urinary tract, health care facilities, manpower, and services, Central line-associated bloodstream infections, Bloodstream, VELOPING-COUNTRIES, MULTIDIMENSIONAL APPROACH, STRATEGY, IMPACT, INICC, International Nosocomial Infection Consortium, Turkey, Device-associated infection, Antibiotic resistance, Hospital infection, Nosocomial infection, Healthcare-associated
Abstract

Background: Device-associated healthcare-acquired infections (DA-HAI) pose a threat to patient safety, particularly in the intensive care unit (ICU). We report the results of the International Infection Control Consortium (INICC) study conducted in Turkey from August 2003 through October 2012. Methods: A DA-HAI surveillance study in 63 adult, paediatric ICUs and neonatal ICUs (NICUs) from 29 hospitals, in 19 cities using the methods and definitions of the U.S. NHSN and INICC methods. Results: We collected prospective data from 94,498 ICU patients for 647,316 bed days. Pooled DA-HAI rates for adult and paediatric ICUs were 11.1 central line-associated bloodstream infections (CLABSIs) per 1000 central line (CL)-days, 21.4 ventilator-associated pneumonias (VAPs) per 1000 mechanical ventilator (MV)-days and 7.5 catheter-associated urinary tract infections (CAUTIs) per 1000 urinary catheter-days. Pooled DA-HAI rates for NICUs were 30 CLABSIs per 1000 CL-days, and 15.8 VAPs per 1000 MV-days. Extra length of stay (LOS) in adult and paediatric ICUs was 19.4 for CLABSI, 8.7 for VAP and 10.1 for CAUTI. Extra LOS in NICUs was 13.1 for patients with CLABSI and 16.2 for patients with VAP. Extra crude mortality was 12% for CLABSI, 19.4% for VAP and 10.5% for CAUTI in ICUs, and 15.4% for CLABSI and 10.5% for VAP in NICUs. Pooled device use (DU) ratios for adult and paediatric ICUs were 0.54 for MV, 0.65 for CL and 0.88 for UC, and 0.12 for MV, and 0.09 for CL in NICUs. The CLABSI rate was 8.5 per 1,000 CL days in the Medical Surgical ICUs included in this study, which is higher than the INICC report rate of 4.9, and more than eight times higher than the NHSN rate of 0.9. Similarly, the VAP and CAUTI rates were higher compared with U. S. NHSN (22.3 vs. 1.1 for VAP; 7.9 vs. 1.2 for CAUTI) and with the INICC report (22.3 vs. 16.5 in VAP; 7.9 vs. 5.3 in CAUTI). Conclusions: DA-HAI rates and DU ratios in our ICUs were higher than those reported in the INICC global report and in the US NHSN report.

Published
2014

3. EFFICACY OF COLISTIN AND NON-COLISTIN MONOTHERAPIES IN MULTI-DRUG

Author

Karabay, O, Batirel, A, Balkan, II, Agalar, C, Akalin, S, Alici, O, Alp, E, Alta, 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, Guclui, E, Guven, T, Hatipoglu, CA, Hosoglu, S, Karahocagil, M, Kilic, AU, Ormen, B, Ozdemir, D, Ozer, S, Oztoprak, N, Sezak, N, Turhan, V, Turker, N, and Yilmaz, H

Subjects
resistant, sepsis, Acinetobacter baumannii, bacteremia, colistin, monotherapy, multi-drug
Abstract

Objective: This retrospective study aimed to investigate the efficacies of colistin and non-colistin monotherapies in multi-drug resistant Acinetobacter baumannii bacteremia (MDR-AB). Materials and methods: Cases with MDR-AB from 27 tertiary-referral hospitals between January 2009 and December 2012 were included. Patients' data that were on either colistin monotherapy (CM) or non-colistin monotherapy (NCM) were compared. Mortality on Day 14 was the primary endpoint, whereas microbiological eradication and clinical outcome were the secondary ones. Results: Eighty-four cases were included in the study with 36 being in the CM group and 48 in the NCM group. Thirty-eight (452%) cases were male and the mean age was 602 years. The mean durations of pre-MDR-AB hospital stay and intensive care unit stay were 25.8 days and 20.9 days, respectively. All of the cases had fever (>38 degrees C). The mean Pitt bacteremia score (PBS) of the patients was calculated as 6.8, APACHE 2 score as 18.9 and the Charlson co-morbidity index (CCI) as 3.7 (CM: 3.6 vs. NCM: 3.9). Twenty (55.6%) cases in the CM group and 26 cases in the NCM group (542%) (p=0.81) died; 9 cases in the CM group (25%) and 16 cases in the NCM group (33 3%) had treatment failure (P=0.55). Bacteriological eradication was achieved in 20 (55.6%) cases in the CM group and in 36 cases (75%) in the NCM group (P=0.061). Conclusions: No significant difference could be identified between the colistin monotherapy and non-colistin monotherapy options in MDR-AB cases with respect to the results of efficacy and 14-day mortality.

Published
2014

4. Comparison of colistin monotherapy and non-colistin combinations in the treatment of multi-drug resistant Acinetobacter spp. bloodstream infections: A Multicenter retrospective analysis

Author

Tumer Guven, Nilgün Altın, Serife Akalin, Nefise Oztoprak, Derya Ozturk Engin, Salih Hosoglu, Davut Ozdemir, Fatma Aybala Altay, N. Turker, Aysegul Ulu Kilic, Ibak Gonen, Aygul Dogan Celik, Vedat Turhan, Oguz Karabay, Salih Cesur, Ozlem Alici, Bülent Durdu, Mustafa Dogan, Ilker Inanc Balkan, Nural Bekiroglu, Canan Agalar, Ferhat Arslan, Emine Alp, Mustafa Kasim Karahocagil, Fazilet Duygu, Serdar Özer, Ayse Batirel, Bahar Ormen, Ertugrul Guclu, Nurbanu Sezak, Turan Aslan, Aynur Engin, Cigdem Ataman Hatipoglu, Hava Yilmaz, DURDU, BÜLENT, [Balkan, Ilker Inanc] Istanbul Univ, Cerrahpasa Med Fac, Istanbul, Turkey -- [Batirel, Ayse -- Ozer, Serdar] Kartal Dr Lutfi Kirdar Educ & Res Hosp, Istanbul, Turkey -- [Agalar, Canan -- Alici, Ozlem] Fatih Sultan Mehmet Educ & Res Hosp, Istanbul, Turkey -- [Arslan, Ferhat] Istanbul Medipol Univ, Fac Med, Istanbul, Turkey -- [Aslan, Turan] Bezmi Alem Univ, Fac Med, Istanbul, Turkey -- [Engin, Derya Ozturk] Haydarpasa Numune Educ & Res Hosp, Istanbul, Turkey -- [Bekiroglu, Nural] Marmara Univ, Fac Med, Istanbul, Turkey -- [Durdu, Bulent] Bakirkoy Sadi Konuk Educ & Res Hosp, Istanbul, Turkey -- [Turhan, Vedat] GATA Haydarpasa Educ & Res Hosp, Istanbul, Turkey -- [Karabay, Oguz -- Guciu, Ertugrul] Sakarya Univ, Fac Med, Sakarya, Turkey -- [Akalin, Serife] Pamukkale Univ, Fac Med, Denizli, Turkey -- [Alp, Emine -- Kilic, Aysegul Ulu] Erciyes Univ, Fac Med, Kayseri, Turkey -- [Altay, Fatma Aybala] Diskapi Educ & Res Hosp, Ankara, Turkey -- [Altin, Nilgun -- Cesur, Salih] Ankara Etlik Educ & Res Hosp, Ankara, Turkey -- [Celik, Aygul Dogan] Trakya Univ, Fac Med, Edirne, Turkey -- [Dogan, Mustafa] Namik Kemal Univ, Fac Med, Tekirdag, Turkey -- [Duygu, Fazilet] Gaziosmanpasa Univ, Fac Med, Tokat, Turkey -- [Engin, Aynur] Cumhuriyet Univ, Fac Med, Sivas, Turkey -- [Gonen, Ibak] Suleyman Demirel Univ, Fac Med, TR-32200 Isparta, Turkey -- [Guven, Tumer] Ankara Ataturk Educ & Res Hosp, Ankara, Turkey -- [Hatipogiu, Cigdem Ataman] Ankara Educ & Res Hosp, Ankara, Turkey -- [Hosoglu, Salih] Dicle Univ, Fac Med, Diyarbakir, Turkey -- [Karahocagil, Mustafa Kasim] Yuzuncu Yil Univ, Fac Med, Van, Turkey -- [Ormen, Bahar] Izmir Ataturk Educ & Res Hosp, Izmir, Turkey -- [Ozdemir, Davut -- Sezak, Nurbanu -- Turker, Nesrin] Duzce Univ, Educ & Res Hosp, Duzce, Turkey -- [Oztoprak, Nefise] Antalya Educ & Res Hosp, Antalya, Turkey -- [Yilmaz, Hava] Ondokuz Mayis Univ, Fac Med, Samsun, Turkey, Durdu, Bulent -- 0000-0002-0244-4006, Karabay, Oguz -- 0000-0003-0502-432X, altay, fatma aybala -- 0000-0002-7149-2968, OMÜ, Balkan, Ilker Inanc, Batirel, Ayse, Karabay, Oguz, Agalar, Canan, Akalin, Serife, Alici, Ozlem, Alp, Emine, Altay, Fatma Aybala, Altin, Nilgun, Arslan, Ferhat, Aslan, Turan, Bekiroglu, Nural, Cesur, Salih, Celik, Aygul Dogan, Dogan, Mustafa, Durdu, Bulent, Duygu, Fazilet, Engin, Aynur, Engin, Derya Ozturk, Gonen, Ibak, Guciu, Ertugrul, Guven, Tumer, Hatipogiu, Cigdem Ataman, Hosoglu, Salih, Karahocagil, Mustafa Kasim, Kilic, Aysegul Ulu, Ormen, Bahar, Ozdemir, Davut, Ozer, Serdar, Oztoprak, Nefise, Sezak, Nurbanu, Turhan, Vedat, Turker, Nesrin, Yilmaz, Hava, Balkan, II, Batirel, A, 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, Guciu, E, Guven, T, Hatipogiu, CA, Hosoglu, S, Karahocagil, MK, Kilic, AU, Ormen, B, Ozdemir, D, Ozer, S, Oztoprak, N, Sezak, N, Turhan, V, Turker, N, Yilmaz, H, Sakarya Üniversitesi/Tıp Fakültesi/Dahili Tıp Bilimleri Bölümü, Karabay, Oğuz, and Güçlü, Ertuğrul

Subjects
Male, Kaplan Meier method, Turkey, retrospective study, proportional hazards model, Antibiotics, Bacteremia, Comorbidity, Tertiary Care Centers, middle aged, chi square distribution, Pharmacology (medical), colistin, comparative study, APACHE, Aged, 80 and over, OUTCOMES, Acinetobacter/*drug effects/pathogenicity, Acinetobacter Infections/*drug therapy/microbiology/mortality, Adolescent, Adult, Aged, Anti-Bacterial Agents/adverse effects/*therapeutic use, Bacteremia/*drug therapy/microbiology/mortality, Chi-Square Distribution, Colistin/adverse effects/*therapeutic use, Drug Resistance, Multiple, Bacterial, Drug Therapy, Combination, Female, Humans, Kaplan-Meier Estimate, Length of Stay, Middle Aged, Multivariate Ana, adult, Remission Induction, Appropriate, clinical trial, ANTIMICROBIAL THERAPY, multi drug resistant Acinetobacter spp, antiinfective agent, Pitt bacteremia score, aged, Impact, multivariate analysis, Sulbactam, risk factor, monotherapy, pathogen clearance, Baumannii Bacteremia, hospitalization, Acinetobacter Infections, medicine.medical_specialty, bloodstream infection, Article, multidrug resistance, multidrug resistant Acinetobacter bloodstream infection, human, treatment failure, Retrospective Studies, Pharmacology, Proportional hazards model, microbiology, medicine.disease, major clinical study, mortality, disease assessment, drug efficacy, multicenter study, RISK-FACTORS, TIGECYCLINE, Colistin, Acinetobacter infection, Pediatrics, BAUMANNII BACTEREMIA, Time Factors, IMPACT, very elderly, Critically-Ill Patients, Turkey (republic), Risk Factors, time factor, Risk-Factors, pathogenicity, Pharmacology & Pharmacy, Univariate analysis, biology, Acinetobacter, MATCHED COHORT, Anti-Bacterial Agents, Blood stream infection, female, Treatment Outcome, young adult, tertiary care center, CRITICALLY-ILL PATIENTS, Charlson Comorbidity Index, medicine.drug, Research Article, combination drug therapy, medicine.drug_class, Outcomes, Young Adult, remission, length of stay, Internal medicine, Gram-Negative Bacteria, medicine, follow up, controlled study, GRAM-NEGATIVE BACTERIA, A Multicenter retrospective analysis-, INDIAN JOURNAL OF PHARMACOLOGY, cilt.47, ss.95-100, 2015 [Balkan I. I. , BATIREL A., Karabay O., AGALAR C., Akalin S., ALICI O., Alp E., ALTAY F. A. , ALTIN N., Arslan F., et al., -Comparison of colistin monotherapy and non-colistin combinations in the treatment of multi-drug resistant Acinetobacter spp. bloodstream infections], Proportional Hazards Models, Antimicrobial Therapy, business.industry, Retrospective cohort study, Multi drug resistant Acinetobacter spp, biology.organism_classification, drug effects, Multivariate Analysis, business
Abstract

WOS: 000349144300018, PubMed ID: 25821319, Objectives: To compare the efficacy of colistin (COL) monotherapy versus non-COL based combinations in the treatment of bloodstream infections (BSIs) due to multidrug resistant Acinetobacter spp.(MDR-A) . Materials and Methods: Retrospective data of 107 MDR-A BSI cases from 27 tertiary centers in Turkey were included. Primary End-Point: 14-day mortality. Secondary End-Points: Microbial eradication and clinical improvement. Results: Thirty-six patients in the COL monotherapy (CM) group and 71 in the non-COL based combinations (NCC) group were included in the study. Mean age was 59.98 20 years (range: 18-89) and 50.5% were male. Median duration of follow-up was 40 days (range: 9-297). The 14-day survival rates were 52.8% in CM and 47.23% in NCC group (P = 0.36). Microbiological eradication was achieved in 69% of CM and 83% of NCC group (P = 0.13). Treatment failure was detected in 22.9% of cases in both CM and NCC groups. Univariate analysis revealed that mean age (P = 0.001), Charlson comorbidity index (P = 0.03), duration of hospital stay before MDR-A BSI (P = 0.04), Pitt bacteremia score (P = 0.043) and Acute Physiology and Chronic Health Evaluation II score (P = 0.05) were significant in terms of 14-day mortality. Advanced age (P = 0.01) and duration of hospital stay before MDR-A BSI (P = 0.04) were independently associated with 14-day mortality in multivariate analysis. Conclusion: No significant difference was detected between CM and non-COL based combinations in the treatment of MDR-A BSIs in terms of efficacy and 14-day mortality.

Published
2015

5. EFFICACY OF COLISTIN AND NON-COLISTIN MONOTHERAPIES IN MULTI-DRUG RESISTANT ACINETOBACTER BAUMANNII BACTEREMIA/SEPSIS

Author

OĞUZ KARABAY, Batirel, A., Balkan, I. I., Agalar, C., Akalin, S., Alici, O., Alp, E., Alta, F. A., Altin, N., Arslan, F., Aslan, T., Bekiroglu, N., Cesur, S., Celik, A. D., Dogan, M., Durdu, B., Duygu, F., Engin, A., Engin, D. O., Gonen, I., Guclu, E., Guven, T., Hatipoglu, C. A., Hosoglu, S., Karahocagil, M., Kilic, A. U., Ormen, B., Ozdemir, D., Ozer, S., Oztoprak, N., Sezak, N., Turhan, V., Turker, N., Yilmaz, H., Karabay, O, Batirel, A, Balkan, II, Agalar, C, Akalin, S, Alici, O, Alp, E, Alta, 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, Guclui, E, Guven, T, Hatipoglu, CA, Hosoglu, S, Karahocagil, M, Kilic, AU, Ormen, B, Ozdemir, D, Ozer, S, Oztoprak, N, Sezak, N, Turhan, V, Turker, N, Yilmaz, H, Sakarya Üniversitesi/Tıp Fakültesi/Dahili Tıp Bilimleri Bölümü, Karabay, Oğuz, [Karabay, Oguz] Sakarya Univ, Hlth Sci Inst, Infect Dis & Clin Microbiol, TR-54000 Sakarya, Turkey -- [Batirel, Ayse] Kartal Dr Lutfi Kirdar Educ & Res Hosp, Infect Dis & Clin Microbiol, Istanbul, Turkey -- [Balkan, Ilker Inanc -- Ozer, Serdal] Istanbul Univ, Cerrahpasa Med Fac, Infect Dis & Clin Microbiol, Istanbul, Turkey -- [Agalar, Canan -- Alici, Ozlem] Fatih Sultan Mehmet Educ & Res Hosp, Infect Dis & Clin Microbiol, Istanbul, Turkey -- [Akalin, Serife] Pamukkale Univ, Fac Med, Infect Dis & Clin Microbiol, Denizli, Turkey -- [Alp, Emine -- Kilic, Aysegul Ulu] Erciyes Univ, Fac Med, Infect Dis & Clin Microbiol, Kayseri, Turkey -- [Alta, F. Aybala] Diskapi Educ & Res Hosp, Infect Dis & Clin Microbiol, Ankara, Turkey -- [Altin, N. -- Cesur, Salim] Ankara Etlik Educ & Res Hosp, Infect Dis & Clin Microbiol, Ankara, Turkey -- [Arslan, Ferhat] Istanbul Medipol Univ, Fac Med, Infect Dis, Istanbul, Turkey -- [Aslan, Turan] Bezmi Alem Univ, Fac Med, Infect Dis, Istanbul, Turkey -- [Bekiroglu, Nural] Marmara Univ, Fac Med, Biostat, Istanbul, Turkey -- [Celik, Aygul Dogan] Trakya Univ, Fac Med, Infect Dis, Edirne, Turkey -- [Dogan, Mustafa] Namik Kemal Univ, Fac Med, Infect Dis & Clin Microbiol, Tekirdag, Turkey -- [Durdu, Bulent] Bakirkoy Sadi Konuk Educ & Res Hosp, Infect Dis & Clin Microbiol, Istanbul, Turkey -- [Duygu, Fazilet] Gaziosmanpasa Univ, Fac Med, Infect Dis & Clin Microbiol, Tokat, Turkey -- [Engin, Aynur] Cumhuriyet Univ, Fac Med, Infect Dis & Clin Microbiol, Sivas, Turkey -- [Engin, Derya Ozturk] Haydarpasa Numune Educ & Res Hosp, Infect Dis & Clin Microbiol, Istanbul, Turkey -- [Gonen, Ibak] Suleyman Demirel Univ, Fac Med, Infect Dis & Clin Microbiol, TR-32200 Isparta, Turkey -- [Guven, Tumer] Ankara Ataturk Educ & Res Hosp, Infect Dis & Clin Microbiol, Ankara, Turkey -- [Hatipoglu, Cigdem Ataman] Ankara Educ & Res Hosp, Infect Dis & Clin Microbiol, Ankara, Turkey -- [Hosoglu, Salih] Dicle Univ, Fac Med, Infect Dis & Clin Microbiol, Diyarbakir, Turkey -- [Karahocagil, Mustafa] Yuzuncu Yil Univ, Fac Med, Infect Dis & Clin Microbiol, Van, Turkey -- [Ormen, Bahar] Izmir Ataturk Educ & Res Hosp, Infect Dis & Clin Microbiol, Izmir, Turkey -- [Ozdemir, Davut -- Sezak, Nurbanu -- Turker, N.] Duzce Univ, Educ & Res Hosp, Infect Dis & Clin Microbiol, Duzce, Turkey -- [Oztoprak, Nefise] Antalya Educ & Res Hosp, Infect Dis & Clin Microbiol, Antalya, Turkey -- [Turhan, Vedat] GATA Haydarpasa Educ & Res Hosp, Infect Dis & Clin Microbiol, Istanbul, Turkey -- [Yilmaz, Hava] Ondokuz Mayis Univ, Fac Med, Infect Dis & Clin Microbiol, Samsun, Turkey, Karabay, Oguz -- 0000-0003-0502-432X, and DURDU, BÜLENT

Subjects
Acinetobacter infection, Acinetobacter baumannii, antibiotic resistance, drug safety, loading drug dose, creatinine blood level, Gram negative sepsis, retrospective study, Bacteremia, blood culture, intensive care unit, mental disease, sepsis, meropenem, polycyclic compounds, cefoperazone plus sulbactam, colistin, APACHE, adult, nephrotoxicity, creatinine, Multi-Drug Resistant, neurologic disease, female, risk factor, monotherapy, multicenter study (topic), disease severity, tertiary care center, lipids (amino acids, peptides, and proteins), tigecycline, pathogen clearance, Charlson Comorbidity Index, seizure, multi-drug resistant, minimum inhibitory concentration, piperacillin plus tazobactam, visual disorder, Article, vertigo, male, multidrug resistance, Sepsis, Karabay O., BATIREL A., Balkan I. I. , AGALAR C., Akalin S., ALICI O., Alp E., ALTA F. A. , ALTIN N., Arslan F., et al., -EFFICACY OF COLISTIN AND NON-COLISTIN MONOTHERAPIES IN MULTI-DRUG RESISTANT ACINETOBACTER BAUMANNII BACTEREMIA/SEPSIS-, ACTA MEDICA MEDITERRANEA, cilt.30, ss.1137-1143, 2014, follow up, controlled study, human, bacteremia, treatment duration, Colistin, ataxia, biochemical phenomena, metabolism, and nutrition, Monotherapy, bacterial infections and mycoses, major clinical study, multi drug resistant acinetobacter baumannii bacteremia, drug efficacy, treatment outcome, bacteria, Acinetobacter Baumannii, imipenem
Abstract

WOS: 000364114800027, Objective: This retrospective study aimed to investigate the efficacies of colistin and non-colistin monotherapies in multi-drug resistant Acinetobacter baumannii bacteremia (MDR-AB). Materials and methods: Cases with MDR-AB from 27 tertiary-referral hospitals between January 2009 and December 2012 were included. Patients' data that were on either colistin monotherapy (CM) or non-colistin monotherapy (NCM) were compared. Mortality on Day 14 was the primary endpoint, whereas microbiological eradication and clinical outcome were the secondary ones. Results: Eighty-four cases were included in the study with 36 being in the CM group and 48 in the NCM group. Thirty-eight (452%) cases were male and the mean age was 602 years. The mean durations of pre-MDR-AB hospital stay and intensive care unit stay were 25.8 days and 20.9 days, respectively. All of the cases had fever (>38 degrees C). The mean Pitt bacteremia score (PBS) of the patients was calculated as 6.8, APACHE 2 score as 18.9 and the Charlson co-morbidity index (CCI) as 3.7 (CM: 3.6 vs. NCM: 3.9). Twenty (55.6%) cases in the CM group and 26 cases in the NCM group (542%) (p=0.81) died; 9 cases in the CM group (25%) and 16 cases in the NCM group (33 3%) had treatment failure (P=0.55). Bacteriological eradication was achieved in 20 (55.6%) cases in the CM group and in 36 cases (75%) in the NCM group (P=0.061). Conclusions: No significant difference could be identified between the colistin monotherapy and non-colistin monotherapy options in MDR-AB cases with respect to the results of efficacy and 14-day mortality.

Published
2014

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