Objective: Urinary tract infections (UTIs) are among the most frequently seen community-acquired infections worldwide. E. coli causes 90% of urinary system infections. To guide the empirical therapy, the resistance pattern of E. coli responsible for community-acquired UTI was evaluated throughout a seven-year period in this study. Material and methods:The urine cultures of patients with urinary tract infections admitted to outpatient clinics between 1 st January 2008 and 31 st December 2014 were analyzed. Presence of ≥10 5 colony-forming units/mL in urine culture media was considered as significant for UTI. Isolated bacteria were identified by standard laboratory techniques or automated system VITEK2 (BioMerieux, France) and BD PhoenixTM 100 (BD, USA), as required. Antibiotic susceptibility testing was performed by Kirby-Bauer disk diffusion method using Clinical Laboratory Standard Institute (CLSI) criteria.Results: A total of 13281 uropathogens were isolated. Overall E. coli accounted for 8975 (67%) of all isolates. Resistance rates of E. coli to antimicrobial agents was demonstrated to be as follows: ampicillin 66.9%, cefazolin 30.9%, cefuroxime 30.9%, ceftazidime 14.9%, cefotaxime 28%, cefepime 12%, amoxicillin-clavulanic acid 36.9%, trimethoprim-sulfamethoxazole (TMP-SXT) 20%, ciprofloxacin 49.9%, amikacin 0.3%, gentamycin 24%, nitrofurantoin 0.9%, and fosfomycin 4.3%. There was no resistance to imipenem nor meropenem. The frequency of ESBL-producing E. coli strains was 24%. Conclusion:It is concluded that fosfomycin and nitrofurantoin are appropriate empirical therapy for community-acquired UTI empirical therapy, but the fluoroquinolones and the TMP-SXT shall not be used in the emprical treatment of UTI at this stage. In conclusion, as resistance rates show regional differences, it is necessary to regularly examine regional resistance rates to determine the appropriate empiric antibiotic treatment and national antibiotic usage policies must be reorganized according to data obtained from these studies.

Objectives:To determine the seroprevalence of Toxoplasma gondii (T. gondii), Rubella virus, and Cytomegalovirus (CMV) among pregnant women in Izmir, Turkey.Methods:Medical records of pregnant women attending Izmir Tepecik Training and Research Hospital, Izmir, Turkey between January 2014 and January 2016 were analyzed in this retrospective cross-sectional study. The 7513 T. gondii IgM/IgG results, 7189 Rubella IgM/IgG results, 906 CMV IgM/IgG results and 146 avidity test results were evaluated. Specific IgM and IgG antibodies were detected by an automated chemiluminescent enzyme immunoassay method. Immunoglobulin G avidity tests were performed using a multiparametric immunoassay system.Results:The rates of IgG positivity for T. gondii was 32.3%, Rubella virus 93.5%, and CMV 98.9%. Immunoglobulin M antibodies were found to be positive in 138 (1.9%) cases for T. gondii, 88 (1.2%) cases for Rubella, and 14 (1.5%) cases for CMV. Avidity tests were ordered from 146 of 218 patients who were found both IgM and IgG positive. Among 146 patients, 6 patients had a low avidity index (all for T. gondii), 11 patients showed borderline avidity, and 129 patients revealed high avidity.Conclusion:In our region, whereas the rates of IgG positivity for Rubella and CMV are high, most pregnant women were susceptible to T. gondii infections. In order to enhance the reliability of the serological diagnosis, avidity tests should be performed in all IgM positivities detected together with IgG positivity.

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Yoğun bakım ünitelerinden izole edilen Pseudomonas aeruginosa ve Acinetobacter baumannii suşlarında antibiyotik direnç profillerinin yıllar içindeki değişimi The change of antibiotic resistance profiles over the years in Pseudomonas aeruginosa and Acinetobacter baumannii strains isolated from intensive care units

Objective: In recent years, the incidence of invasive Candida infections have increased due to the increased use of broad-spectrum antibiotics, the number of patients with immunosuppressive therapy and in the intensive care unit with the impaired condition. Knowing the species distribution and antifungal susceptibilities in Candida infections are important in managing the treatment of these infections with high mortality and morbidity. In this study, it was aimed to determine the distribution and antifungal sensitivities of Candida species that isolated from blood cultures taken from patients hospitalized in various clinics in our hospital and evaluation of the antifungal treatment policy applied in our hospital according to these results. Method: Using gradient test strips (BioMérieux E test, France) of Candida spp. grown in blood cultures (BacT/Alert 3D, BioMérieux, France), and identified by conventional methods and automated identification systems [API ID 32C, (BioMérieux, France) and MaldiTOF MS, (Bruker Daltonik GmbH, Bremen, Germany)] between July 2017 and March 2019, and their susceptibilities to antifungal agents were determined). Results: Among the 175 Candida strains isolated, 84 (48%) were Candida parapsilosis, other identified strains were as follows; Candida albicans (n=57; (32.6%), Candida glabrata (n=15; 8.6%), Candida tropicalis (n=12; 6.9%), Candida kefyr (n=3; 1.7%), one Candida dubliniensis (n=1; 0.6%), Candida famata (n=1; 0.6%), Candida lusitaniae (n=1; 0.6%) and Candida spp. (n=1; 0.6%). Antimicrobial resistance rates of isolated C. parapsilosis strains against fluconazole (54.8%), voriconazole (44.1%), posaconazole (7.1%), itraconazole (25%) and anidulafungin (1.2%), and of C. albicans against fluconazole (8.8%), voriconazole (7%), itraconazole (15.8%) were determined as indicated. Conclusion: As a result, it is noteworthy that C. parapsilosis is the most frequently isolated infection agent in the blood cultures of patients hospitalized in our hospital and that especially C. parapsilosis species show high fluconazole resistance.