Escherichia coli is the most frequently isolated microorganism from both community-acquired and nosocomial urinary tract infections in Turkey. A large number of studies concerning antibiotic susceptibility of E.coli have been published from different centers throughout the country. The aim of this study was to evaluate the antibiotic resistance patterns of E.coli strains isolated from urine cultures by a meta-analysis in published medical literature between the years of 1996-2012 in Turkey. The study was planned and conducted in accordance with the declaration of PRISMA and describes the methods of literature search, the determining criteria for inclusion and evaluation of articles, data collection and statistical analysis. To find the published series Google Scholar and PubMed international databases were used to access published manuscripts evaluated according to the determined criteria for acceptance and rejection. For each study, general data and antibiotic resistance rates were collected as a common unit. Publications considered as lacking in appropriate content was eliminated from the study. Statistical analysis of the data obtained were 95% confidence intervals, and p≤ 0.05 value was considered as significant difference. A total of 228 articles were found to be published during 1996-2012 period, while 101 of them were included in the meta-analysis according to the eligibility criteria. The analyses indicated that nitrofurantoin and piperacillin resistance rates have been decreased, whereas ciprofloxacin, cefepime, co-trimoxazole and extended-spectrum beta-lactamase (ESBL) positivity rates have been increased during the study period. The increases in the rates of ciprofloxacin and cefepime resistance and and ESBL production were statistically-significant (p< 0.05). A significant reduction in resistance rates for ampicilin, amoxicillin-clavulanate, and amikacin was noted in pediatric patients between 2002-2012. Ceftriaxone, imipenem, gentamicin and amikacin resistance were not homogenous between the geographical regions, and statistically significant differences were observed for amoxicillin-clavulanate, cefuroxime and ciprofloxacin resistance rates (p< 0.05). Antibiotic resistance rates, except for imipenem, in bacterial strains, isolated from hospitalized patients were found significantly higher in strains obtained from outpatients. The differences between those groups were significant in terms of ampicilin, amoxicillin-clavulanate, cefuroxime, ceftriaxone, trimethoprim-sulfamethoxazole, gentamicin, ciprofloxacin, amikacin and cefepime resistances (p< 0.05). It has been noted that antibiotic resistance patterns of E.coli strains isolated from urine cultures between 1996-2012 demonstrated significant variability, and many studies were based only on laboratory data. The results of this meta-analysis demonstrated that the resistance rates in commonly-used antibiotics for empirical therapy were high. In conclusion, information obtained by systematic evaluation of national data will be valuable for the determin...
Objectives:To evaluate the in vitro activity of doripenem in Acinetobacter baumannii (A. baumannii) clinical isolates that possess different OXA-type carbapenemases, and to evaluate the roles of these enzymes in the development of carbapenem resistance.Methods:This retrospective study was conducted with 25 A. baumannii isolates at Sakarya University Training and Research Hospital, Sakarya, Turkey from June to October 2014. Antibiotic susceptibility testing was carried out using the Vitek-2 automated system (bioMérieux, Marcy l’Etoile, France). Minimum inhibitory concentrations (MICs) were determined using Etest strips (bioMérieux, Marcy l’Etoile, France). Quantitative polymerase chain reaction was performed in a Fluorion Instrument (Iontek, Istanbul, Turkey).Results:Isolates were divided into 5 groups based on their susceptibility profiles and OXA-type carbapenemase positivity. Group 2 isolates whose MIC of both meropenem and doripenem are in the range of 4-32 µg/mL were negative for both blaOXA-23 and blaOXA-58. Group 3 isolates whose MIC of meropenem and doripenem is in the range of 4-32 µg/mL, blaOXA-23 is positive, and blaOXA-58 is negative. Group 5 isolates whose MIC of meropenem is >32 µg/mL, and that of doripenem is in the range of 16-32 µg/mL were positive for both blaOXA-23 and blaOXA-58.Conclusion:The blaOXA-23 and blaOXA-58 gene combinations may confer resistance with a much greater MIC of both meropenem and doripenem. However, the presence of blaOXA-58 alone was not correlated with doripenem resistance.
ÖZPseudomonas aeruginosa izolatların sahip oldukları direnç mekanizmalarının çeşitliliği ve artan direnç oranları tedavide ciddi sorunlara yol açmaktadır. Bakterinin antibiyotiklere direnci hastanın özelliğine ve antibiyotik kullanım politikalarına bağlı olarak ülkeye, bölgeye, hastaneye ve kliniğe göre değişebilmekte, hatta tedavi sırasında da değişiklik gösterebilmektedir. Bu meta-analiz çalışmasında, P.aeruginosa izolatların-da antibiyotik direnç değişiminin son 11 yıldaki durumunun değerlendirilmesi amaçlanmıştır. Meta-analiz çalışması, PRISMA bildirisine uygun olarak planlanmış ve uygulanmıştır. Buna göre çalışmamızda literatür tarama, kabul ve red kriterlerinin belirlenmesi, makale incelenmesi, veri toplanması ve istatistiksel analizler yapılmıştır. Literatür taramada iki ulusal (ULAKBİM ve Türk Medline) ve bir uluslararası (PubMed) veritabanı kullanılmıştır. Literatürler, dışlama kriterleri göz önünde tutularak incelenmiş, çalışma verileri toplanmış ve istatistiksel analiz gerçekleştirilmiştir. Literatürlerden elde edilen veriler ortak bir birim altında toplanarak değerlendirilmiştir. %95 güven aralığında yapılan hesaplamalarda p≤ 0.05 değeri istatistiksel olarak anlamlı kabul edilmiştir.
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