Karbapeneme dirençli, çoklu ilaç direnci fenotipi gösteren  Acinetobacter baumannii suşlarında polimiksin B, minosiklin, kolistin ve fosfomisin duyarlılıklarının belirlenmesi

Introduction: Multidrug-resistant bacterial infections such as pseudomonas aeruginosa, Acinetobacter baumannii, klebsiella pneumoniae are common in Intensive Care Units. Colistin is preferred today due to limited treatment options sensitive to these pathogens. However, colistin has a high potential for nephrotoxicity. Some classifications (KDIGO, RIFLE, AKIN) are used for the diagnosis of Acute Kidney Injury (AKI). The incidence of AKI varies according to these classifications. In our study, we aimed to evaluate and compare the development of Acute Kidney Injury according to KDIGO criteria and RIFLE classification in patients followed up in the intensive care unit and started colistin therapy. Materials and Method: The data of 145 patients who started colistin treatment in the Internal Medicine Intensive Care Unit between January 2016 and December 2019 were retrospectively reviewed. Patients were grouped as those with Acute Kidney Injury and those without. Acute Kidney Injury evaluation was made according to RIFLE classification and KDIGO criteria. Results: In patients who received colistin treatment, 75 patients were evaluated as AKI when KDIGO criteria were used for the AKI diagnosis, and 54 patients were evaluated as AKI when the RIFLE classification was used. While the number of KDIGO Stage 1 patients was 44, the number of patients in the RIFLE classification risk group was determined as 23. The mean SOFA score was calculated as 7.91±2.8 and the mean APACHE II score as 22.77±5.3. The duration of stay in the ICU was 22.60±9.04. The duration of stay in the ICU was shorter in the group who developed AKI. 44.8% of the patients included in the study died. 52% of patients who developed AKI and 37.1% of those who did not develop AKI died. 30-day mortality in patients with AKI was significantly higher than both KDIGO staging and RIFLE classification (p=0.03, p=0.005, respectively). Mortality rate increased 1.42 times in KDIGO Stage 1, 2.79 times in KDIGO Stage 2 and 2.10 times in KDIGO Stage 3. When evaluated by the RIFLE classification, the mortality rate increased 2.32 times in the Risk group, 3.12 times in the Injury group, 2.06 times in the Failure group and 2.15 times in the Loss group. Conclusion:We observed an increase in the frequency of AKI in patients using colistin in the ICU, both according to KDIGO criteria and the RIFLE classification. This situation also increases the 30-day mortality. We think that the KDIGO criteria are more sensitive to diagnose AKI in these patients.

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Evaluation of mortality and acute kidney injury by KDIGO and RIFLE in patients treated with colistin in the intensive care unit

Aydın

Keserci

Yılmaz

et al. 2021

Journal of Health Sciences and Medicine

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Shotgun Metagenomic Analysis for Mucilage in the Surface Waters of The Çanakkale Strait (Dardanelles): Metabolic Diversity, Microbial Community Structure and Antibiotic Resistance Genes

Yılmaz

YILMAZ

Çelik

et al. 2021

Journal of Anatolian Environmental and Animal Sciences

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In this study, we used shotgun metagenome sequencing to examine the metabolic diversity, microbial community structure and diverse antimicrobial resistance genes of mucilage in the surface waters of the Çanakkale Strait (Dardanelles). Mucilage samples were collected in April 2021 from the three different stations of the Dardanelles. The dominant microbial communities at the phylum level were Bacteroidetes (20.06%), Proteobacteria (13.68%), Verrucomicrobia (6.25%), Planctomycetes (3.02%) and Cyanobacteria (2.5%). Metabolic pathway analysis using KEGG (Kyoto Encyclopedia of Genes and Genomes) revealed that most of the genes of mucilage samples were involved in unclassified (73.86%) followed by metabolism (14.45%), genetic information processing (4.16%), environmental information processing (2.57%), cellular processing (1.88%), human diseases (1.61%), and organismal systems (1.47%). The dfrA3 gene was the most prevalent (20.36%) followed by CRP (18.17%), PmrE (14.92%), rpoB2 (11.17%), SoxR (7.49%), AbeS (6.83%), baeR (5.22%), PmrF (3.70%), dfrA22 (2.20%), dfrA26 (1.76%), dfrA20 (1.63%), golS (1.26%), CAT (1.03%), mtrA (1.01%), TMB-1 (0.64%), novA (0.64%), dfrK (0.59%), vanXB (0.48%), dfrG (0.39%), FosC2 (0.31%), and MexA (0.20%) genes. Antibiotic resistance gene (ARG) types mainly included the resistance genes of multidrug (40.19%), trimethoprim (26.93%), polymyxin (18.62%), rifamycin (11.17%), chloramphenicol (1.03%), aminocoumarin (0.64%), beta-lactamase (0.64%), fosfomycin (0.31%), and vancomycin (0.48%). Antibiotic-resistant bacteria in mucilage can adhere to human skin during swimming, fishing, water sports etc., enter the body through the nose and mouth, and transfer genetic information to the bacteria in contact areas in the human body. Therefore, this situation is risky in public health, and necessary precautions should be taken. In the light of these findings, it has been observed that there is a need for more detailed studies in the future.

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Evaluation of the in vitro efficacy of non-beta-lactam antibiotics in extended-spectrum beta-lactamase-producing and non-producing Klebsiella spp. and Escherichia coli strains

Toros

Timurkaynak

2021

Journal of Medicine and Palliative Care

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Karbapeneme dirençli, çoklu ilaç direnci fenotipi gösteren Acinetobacter baumannii suşlarında polimiksin B, minosiklin, kolistin ve fosfomisin duyarlılıklarının belirlenmesi

Cited by 3 publications

References 17 publications

Evaluation of mortality and acute kidney injury by KDIGO and RIFLE in patients treated with colistin in the intensive care unit

Evaluation of mortality and acute kidney injury by KDIGO and RIFLE in patients treated with colistin in the intensive care unit

Shotgun Metagenomic Analysis for Mucilage in the Surface Waters of The Çanakkale Strait (Dardanelles): Metabolic Diversity, Microbial Community Structure and Antibiotic Resistance Genes

Evaluation of the in vitro efficacy of non-beta-lactam antibiotics in extended-spectrum beta-lactamase-producing and non-producing Klebsiella spp. and Escherichia coli strains

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