| Yazarlar |
Ayşe Batırel
|
|
İlker İnanç Ibalkan
|
|
Oğuz Karabay
Sakarya Üniversitesi, Türkiye |
|
Canan Ağalar
|
|
Şerife Akalın
Pamukkale Üniversitesi, Türkiye |
|
Özlem Alıcı
|
|
Emine Alp Meşe
Erciyes Üniversitesi, Türkiye |
|
Fatma Aybala Altay
|
|
N Altın
|
|
Ferhat Arslan
İstanbul Medipol Üniversitesi, Türkiye |
|
Turan Aslan
Bezm-İ Âlem Vakıf Üniversitesi, Türkiye |
|
Gülnaz Nural Bekiroğlu
Marmara Üniversitesi, Türkiye |
|
Salih Cesur
|
|
Aygül Çelik
Trakya Üniversitesi, Türkiye |
|
Mustafa Doğan
Namık Kemal Üniversitesi, Türkiye |
|
Bülent Durdu
Bezm-İ Âlem Vakıf Üniversitesi, Türkiye |
|
Fazilet Duygu
Gaziosmanpaşa Üniversitesi, Türkiye |
|
Aynur Engin
Cumhuriyet Üniversitesi, Türkiye |
|
Do Engin
|
|
İbak Gönen
Süleyman Demirel Üniversitesi, Türkiye |
|
Ertuğrul Güçlü
Sakarya Üniversitesi, Türkiye |
|
Tümer Güven
Yıldırım Beyazıt Üniversitesi, Türkiye |
|
Çiğdem Ataman Hatipoğlu
|
|
Salih Hoşoğlu
Fatih Üniversitesi, Türkiye |
Prof. Dr. Mustafa Kasım KARAHOCAGİL
Yüzüncü Yıl Üniversitesi, Türkiye |
|
Ayşegül Ulu Kılıç
Erciyes Üniversitesi, Türkiye |
|
Bahar Örmen
|
|
Davut Özdemir
Düzce Üniversitesi, Türkiye |
|
S Özer
|
|
Nefise Öztoprak
|
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N Sezak
|
|
Vedat Turhan
Gülhane Askeri Tıp Akademisi, Türkiye |
|
N Türker
|
|
H Yılmaz
|
| Özet |
| The purpose of this investigation was to compare the efficacy of colistin-based therapies in extremely drug-resistant Acinetobacter spp. bloodstream infections (XDR-ABSI). A retrospective study was conducted in 27 tertiary-care centers from January 2009 to August 2012. The primary end-point was 14-day survival, and the secondary end-points were clinical and microbiological outcomes. Thirty-six and 214 patients [102 (47.7 %): colistin-carbapenem (CC), 69 (32.2 %): colistin-sulbactam (CS), and 43 (20.1 %: tigecycline): colistin with other agent (CO)] received colistin monotherapy and colistin-based combinations, respectively. Rates of complete response/cure and 14-day survival were relatively higher, and microbiological eradication was significantly higher in the combination group. Also, the in-hospital mortality rate was significantly lower in the combination group. No significant difference was found in the clinical (p = 0.97) and microbiological (p = 0.92) outcomes and 14-day survival rates (p = 0.79) between the three combination groups. Neither the timing of initial effective treatment nor the presence of any concomitant infection was significant between the three groups (p > 0.05) and also for 14-day survival (p > 0.05). Higher Pitt bacteremia score (PBS), Acute Physiology and Chronic Health Evaluation II (APACHE II) score, Charlson comorbidity index (CCI), and prolonged hospital and intensive care unit (ICU) stay before XDR-ABSI were significant risk factors for 14-day mortality (p = 0.02, p = 0.0001, p = 0.0001, p = 0.02, and p = 0.01, respectively). In the multivariable analysis, PBS, age, and duration of ICU stay were independent risk factors for 14-day mortality (p < 0.0001, p < 0.0001, and p = 0.001, respectively). Colistin-based combination therapy resulted in significantly higher microbiological eradication rates, relatively higher cure and 14-day survival rates, and lower in-hospital mortality compared to colistin monotherapy. CC, CS, and CO combinations for XDR-ABSI did not reveal significant differences with respect to 14-day survival and clinical or microbiological outcome before and after propensity score matching (PSM). PBS, age, and length of ICU stay were independent risk factors for 14-day mortality. |
| Anahtar Kelimeler |
| Makale Türü | Özgün Makale |
| Makale Alt Türü | SSCI, AHCI, SCI, SCI-Exp dergilerinde yayımlanan tam makale |
| Dergi Adı | European Journal of Clinical Microbiology & Infectious Diseases |
| Dergi ISSN | 0934-9723 |
| Dergi Tarandığı Indeksler | SSCI |
| Makale Dili | İngilizce |
| Basım Tarihi | 08-2014 |
| Cilt No | 33 |
| Sayı | 8 |
| Sayfalar | 1311 / 1322 |
| Doi Numarası | 10.1007/s10096-014-2070-6 |
| Makale Linki | http://link.springer.com/10.1007/s10096-014-2070-6 |
| Atıf Sayıları | |
| WoS | 129 |
| SCOPUS | 150 |
| Google Scholar | 222 |
