Browsing by Author "Tasbakan, M"

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    Carbapenem Versus Fosfomycin Tromethanol in the Treatment of Extended-Spectrum Beta-Lactamase-Producing Escherichia coli-Related Complicated Lower Urinary Tract Infection
    Senol, S; Tasbakan, M; Pullukcu, H; Sipahi, OR; Sipahi, H; Yamazhan, T; Arda, B; Ulusoy, S
    The aim of this observational prospective study was to compare the effect of fosfomycin tromethanol (FT) and carbapenems (meropenem or imipenem cilastatin) in the treatment of extended-spectrum beta-lactamase (ESBL)producing Escherichia coli-related complicated lower urinary tract infection (CLUTI). Inclusion criteria were: patients who were aged >18 yr with dysuria or problems with frequency or urgency in passing urine; those with >20 leukocytes/mm(3) in urine microscopy and culture-proven ESBL-producing carbapenem or FT-sensitive E. coli in the urine (>10(5) cfu/mm(3)); no leukocytosis or fever; and who were treated with FT (oral 3 g sachet x 1 every other night, three times) or carbapenems between March 2005 and January 2006 in our outpatient clinic and hospital. A total of 47 CLUTI attacks in 47 patients (27 FT group, 20 carbapenem group) were observed prospectively. Clinical and microbiological success in the carbapenem and FT groups was similar (19/20 vs 21/27 and 16/20 vs 16/27 p>0.05). Drug acquisition costs were significantly lower in the FT group (p<0.001). Although it is not a randomized controlled study, these data show that FT may be a suitable, effective and cheap alternative in the treatment of ESBL-producing E. coli-related CLUTI.
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    The evaluation of antifungal consumption: a point-prevalence survey
    Senol, S; Eren-Kutsoylu, OO; Turhan, O; Alp-Cavus, S; Tasbakan, M; Ozturk, B; Sayin-Kutlu, S; Cetin, CB; Kaya, O; Ozhak, B; Pullukcu, H; Ertugrul, B; Kutlu, M; Mermut, G; Ergin, C; Metin, DY; Yapar, N; Avkan-Oguz, V
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    Mortality-associated factors of candidemia: a multi-center prospective cohort in Turkey
    Kutlu, M; Sayin-Kutlu, S; Alp-Cavus, S; Öztürk, SB; Tasbakan, M; Özhak, B; Kaya, O; Kutsoylu, OE; Senol-Akar, S; Turhan, Ö; Mermut, G; Ertugrul, B; Pullukcu, H; Çetin, ÇB; Avkan-Oguz, V; Yapar, N; Yesim-Metin, D; Ergin, Ç
    Candidemia may present as severe and life-threatening infections and is associated with a high mortality rate. This study aimed to evaluate the risk factors associated with 30-day mortality in patients with candidemia. A multi-center prospective observational study was conducted in seven university hospitals in six provinces in the western part of Turkey. Patient data were collected with a structured form between January 2018 and April 2019. In total, 425 episodes of candidemia were observed during the study period. Two hundred forty-one patients died within 30 days, and the 30-day crude mortality rate was 56.7%. Multivariable analysis found that SOFA score (OR: 1.28, CI: 1.154-1.420, p < 0.001), parenteral nutrition (OR: 3.9, CI: 1.752-8.810, p = 0.001), previous antibacterial treatment (OR: 9.32, CI: 1.634-53.744,p = 0.012), newly developed renal failure after candidemia (OR: 2.7, CI: 1.079-6.761, p=0.034), and newly developed thrombocytopenia after candidemia (OR: 2.6, CI: 1. 057-6.439, p =0.038) were significantly associated with 30-day mortality. Central venous catheter removal was the only factor protective against mortality (OR: 0.34, CI:0.147-0.768, p = 0.010) in multivariable analysis. Candidemia mortality is high in patients with high SOFA scores, those receiving TPN therapy, and those who previously received antibacterial therapy. Renal failure and thrombocytopenia developing after candidemia should be followed carefully in patients. Antifungal therapy and removing the central venous catheter are essential in the management of candidemia.
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    The course of spinal tuberculosis (Pott disease): results of the multinational, multicentre Backbone-2 study
    Batirel, A; Erdem, H; Sengoz, G; Pehlivanoglu, F; Ramosaco, E; Gulsun, S; Tekin, R; Mete, B; Balkan, II; Sevgi, DY; Giannitsioti, E; Fragou, A; Kaya, S; Cetin, B; Oktenoglu, T; Celik, AD; Karaca, B; Horasan, ES; Ulug, M; Senbayrak, S; Kaya, S; Arslanalp, E; Hasbun, R; Ates-Guler, S; Willke, A; Senol, S; Inan, D; Guclu, E; Ertem, GT; Koc, MM; Tasbakan, M; Ocal, G; Kocagoz, S; Kusoglu, H; Guven, T; Baran, AI; Dede, B; Karadag, FY; Yilmaz, H; Aslan, G; Al-Gallad, DA; Cesur, S; El-Sokkary, R; Sirmatel, F; Savasci, U; Karaahmetoglu, G; Vahaboglu, H
    We aimed to describe clinical, laboratory, diagnostic and therapeutic features of spinal tuberculosis (ST), also known as Pott disease. A total of 314 patients with ST from 35 centres in Turkey, Egypt, Albania and Greece were included. Median duration from initial symptoms to the time of diagnosis was 78 days. The most common complications presented before diagnosis were abscesses (69%), neurologic deficits (40%), spinal instability (21%) and spinal deformity (16%). Lumbar (56%), thoracic (49%) and thoracolumbar (13%) vertebrae were the most commonly involved sites of infection. Although 51% of the patients had multiple levels of vertebral involvement, 8% had noncontiguous involvement of multiple vertebral bodies. The causative agent was identified in 41% of cases. Histopathologic examination was performed in 200 patients (64%), and 74% were consistent with tuberculosis. Medical treatment alone was implemented in 103 patients (33%), while 211 patients (67%) underwent diagnostic and/or therapeutic surgical intervention. Ten percent of the patients required more than one surgical intervention. Mortality occurred in 7 patients (2%), and 77 (25%) developed sequelae. The distribution of the posttreatment sequelae were as follows: 11% kyphosis, 6% Gibbus deformity, 5% scoliosis, 5% paraparesis, 5% paraplegia and 4% loss of sensation. Older age, presence of neurologic deficit and spinal deformity were predictors of unfavourable outcome. ST results in significant morbidity as a result of its insidious course and delayed diagnosis because of diagnostic and therapeutic challenges. ST should be considered in the differential diagnosis of patients with vertebral osteomyelitis, especially in tuberculosis-endemic regions. Early establishment of definitive aetiologic diagnosis and appropriate treatment are of paramount importance to prevent development of sequelae. Clinical Microbiology and Infection (C) 2015 European Society of Clinical Microbiology and Infectious Diseases. Published by Elsevier Ltd. All rights reserved.
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    Comparison of brucellar and tuberculous spondylodiscitis patients: results of the multicenter Backbone-1 Study
    Erdem, H; Elaldi, N; Batirel, A; Aliyu, S; Sengoz, G; Pehlivanoglu, F; Ramosaco, E; Gulsun, S; Tekin, R; Mete, B; Balkan, II; Sevgi, DY; Giannitsioti, E; Fragou, A; Kaya, S; Cetin, B; Oktenoglu, T; DoganCelik, A; Karaca, B; Horasan, ES; Ulug, M; Man, A; Kaya, S; Arslanalp, E; Ates-Guler, S; Willke, A; Senol, S; Inan, D; Guclu, E; Tuncer-Ertem, G; Meric-Koc, M; Tasbakan, M; Senbayrak, S; Cicek-Senturk, G; Sirmatel, F; Ocal, G; Kocagoz, S; Kusoglu, H; Guven, T; Baran, AI; Dede, B; Yilmaz-Karadag, F; Kose, S; Yilmaz, H; Asian, G; Algallad, DA; Cesur, S; El-Sokkary, R; Bekiroglu, N; Vahaboglu, H
    BACKGROUND CONTEXT: No direct comparison between brucellar spondylodiscitis (BSD) and tuberculous spondylodiscitis (TSD) exists in the literature. PURPOSE: This study aimed to compare directly the clinical features, laboratory and radiological aspects, treatment, and outcome data of patients diagnosed as BSD and TSD. STUDY DESIGN: A retrospective, multinational, and multicenter study was used. PATIENT SAMPLE: A total of 641 (TSD, 314 and BSD, 327) spondylodiscitis patients from 35 different centers in four countries (Turkey, Egypt, Albania, and Greece) were included. OUTCOME MEASURES: The pre- and peri- or post-treatment spinal deformity and neurologic deficit parameters, and mortality were carried out. METHODS: Brucellar spondylodiscitis and TSD groups were compared for demographics, clinical, laboratory, radiological, surgical interventions, treatment, and outcome data. The Student t test and Mann-Whitney U test were used for group comparisons. Significance was analyzed as two sided and inferred at 0.05 levels. RESULTS: The median baseline laboratory parameters including white blood cell count, C-reactive protein, and erythrocyte sedimentation rate were higher in TSD than BSD (p<.0001). Prevertebral, paravertebral, epidural, and psoas abscess formations along with loss of vertebral corpus height and calcification were significantly more frequent in TSD compared with BSD (p<.01). Surgical interventions and percutaneous sampling or abscess drainage were applied more frequently in TSD (p<.0001). Spinal complications including gibbus deformity, kyphosis, and scoliosis, and the number of spinal neurologic deficits, including loss of sensation, motor weakness, and paralysis were significantly higher in the TSD group (p<.05). Mortality rate was 2.22% (7 patients) in TSD, and it was 0.61% (2 patients) in the BSD group (p=.1). CONCLUSIONS: The results of this study show that TSD is a more suppurative disease with abscess formation requiring surgical intervention and characterized with spinal complications. We propose that using a constellation of constitutional symptoms (fever, back pain, and weight loss), pulmonary involvement, high inflammatory markers, and radiological findings will help to differentiate between TSD and BSD at an early stage before microbiological results are available. (C) 2015 Elsevier Inc. All rights reserved.