Pseudomonas aeruginosa suşları özellikle yoğun bakım ünitelerinde yatan hasta örneklerinden sıklıkla izole edilmektedir. Bu suşlar morbidite ve mortaliteyi artırıp, antibiyotik direnci nedeniyle zor tedavi edilen enfeksiyonlara yol açmaktadır. Bu çalışmanın amacı, Malatya Eğitim ve Araştırma Hastanesi'nin yoğun bakım hastalarından izole edilen P. aeruginosa izolatlarının çeşitli antibiyotiklere direncinin belirlenmesidir. Çalışmaya Temmuz 2016-Temmuz 2019 tarihleri arasında Malatya Eğitim ve Araştırma Hastanesi'nin yoğun bakım ünitelerinde izlenmiş olan hastaların çeşitli klinik örneklerinden izole edilen P. aeruginosa suşları dâhil edilmiştir. Suşların identifikasyonu ve in-vitro antibiyotik duyarlılıkları Vitek 2 otomatize sistemi (bioMérieux, France) ile belirlenmiştir. Çalışmaya dâhil edilen 468 P. aeruginosa suşunun % 51,7'si solunum yolu örneklerinden izole edilirken bunu % 31,2 ile idrar ve %9 ile abse ve yara örnekleri izlemiştir. P. aeruginosa suşları için en etkili antibiyotikler kolistin ve norfloksasin olarak belirlenirken, çalışılan antibiyotikler arasında en düşük duyarlılık aztreonam için tespit edilmiştir. Duyarlılık oranları amikasine %76,

Objective: Escherichia coli is the most common cause of urinary tract infections. The increase and spread of resistance to antibiotics is a serious problem in our country as well as in the world. The aim of this study was to determine the antimicrobial susceptibility profiles of E. coli strains that cause urinary tract infection. Methods: The antibiotic susceptibilities of 1850 E. coli strains isolated from urine samples of patients who applied to Urology service and outpatient clinics of Malatya Education and Research Hospital, which is a tertiary care hospital in eastern part of Turkey, over the 3 years between July 2016 and July 2019, were evaluated retrospectively from computer records using the Vitek 2.0 Compact automated system (BioMérieux, France). Antibiogram results were classified as susceptible, moderately susceptible and resistant. Result: Of the total 1850 samples, 1300 (70.3%) were female and 550 (29.7%) were male, with a mean age of 52 (18-104) years. 73 (3.9%) of the patients were inpatients and 1777 were outpatients. All the isolated E. coli strains were found to be susceptible to ampicillin 39.2%, amoxicillin-clavulanic acid 67.9%, piperacillin-tazobactam 80.8%, cefuroxime 67.1%, cefotaxime 68.8%, cefixime 67.7%, ceftazidime 71.2%, cefepime 73.9%, ertapeneme 97.9%, imipeneme 99.5%, meropeneme 99.7%, amikacin 89.7%, gentamicin 78.4%, norfloxacine 65.8%, ciprofloxacine 65.9%, nitrofurantoin 94.2% and fosfomycin 96.5%. Resistance rates were higher in inpatients as compared to outpatients. Antibiotic susceptibilities were found to be decreased in different age ranges with increasing age. Conclusion:When selecting the antimicrobial treatment in community-acquired urinary tract infections, considering the antimicrobial resistance data in the region, the choice of cost-effective treatment with high patient compliance and low resistance rates will increase treatment success. It is thought that antibiotic treatment should be determined according to the results of culture antibiograms, especially in nosocomial infections due to high resistance rates.

No abstract

Objective: In this century, with the prolonged life expectancy, chronic diseases have become the most important cause of mortality and morbidity in the world and in our country. Frequent drug-drug interactions have made it necessary to update the doses of drugs in multiple drug use. In our study, we aimed to observe how the drugs that are frequently prescribed by physicians in the treatment of chronic and infectious diseases, together with standard bacteria and fungi strains in in vitro environment, change the effects of each other.Methods: By combining antibiotic discs and drugs that are commonly used in chronic diseases (acetylsalicylic acid, amlodipine, atorvastatin, warfarin, metoprolol and clopidogrel) in in vitro environment, we determined the drug interactions (synergy/antagonism) by Kirby Bauer disk diffusion method.Results: While most of the discs placed on the culture of Candida albicans through impregnation of drugs showed potentiation synergism with itraconazole and fluconazole, other microorganisms showed synergistic and sometimes antagonistic interactions with different drugs and antibiotics, whereas some of the drugs did not show any interaction with antibiotic discs.Conclusion: Due to the strong relationship between advanced age and the number of prescribed drugs and the frequency of possible drug-drug interactions, the elderly people especially are susceptible to this situation. Infections caused by resistant bacteria cause an increase in disease/death rates and treatment costs. With the awareness that the only difference between drug and poison is the dose, all health professionals especially doctors and pharmacists and patients have a responsibility towards the rational use of drugs.