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Articles by Meltem ISIKGOZ TASBAKAN
Total Records ( 3 ) for Meltem ISIKGOZ TASBAKAN
  Husnu PULLUKCU , Sohret AYDEMIR , Meltem ISIKGOZ TASBAKAN , Feriha CILLI , Alper TUNGER and Sercan ULUSOY

Aim: Urinary tract infections (UTIs) caused in particular by extended-spectrum beta-lactamase (ESBL)-producing Escherichia coli strains are related with high morbidity and mortality, and treatment is quite difficult. These infections generally are treated by carbapenems, and their costs are high. We aimed in this study to investigate the susceptibilities of ESBL-producing E. coli strains isolated from urine cultures to fosfomycin, ciprofloxacin, amikacin and trimethoprim-sulfamethoxazole and to determine the general resistance profile in our region of these strains isolated from UTIs.

Materials and Methods: Between January 2005-December 2005, ESBL-producing E. coli strains isolated from urine samples sent from various outpatient and inpatient clinics to the Bacteriology Laboratory of the Department of Microbiology and Clinical Microbiology were included prospectively in the study. ESBL production was detected using the double disk synergy test. Antibiotic susceptibility testing was performed for ESBL-producing isolates by disk diffusion test according to Clinical and Laboratory Standards Institute (CLSI) criteria. Escherichia coli ATCC 35218 and ATCC 25922 were used as control strains. The diagnosis of nosocomial UTIs was established according to the Centers for Disease Control and Prevention criteria. The data were assessed using the SPSS 11.0 packet program.

Results: A total of 344 ESBL-producing E. coli isolates (241 nosocomial isolates; 103 outpatient isolates) were included in the study. The rates of resistance were 3.5% for fosfomycin, 76.5% for ciprofloxacin, 11% for amikacin, and 74.4% for trimethoprim-sulfamethoxazole. While resistance rates of nosocomial strains were 4.1%, 81.3%, 11.2%, and 71%, respectively, resistance rates of the strains isolated from outpatients were 1.9%, 65%, 10.7%, and 82.5%, respectively. There were statistically significant differences between the two groups for ciprofloxacin and trimethoprim-sulfamethoxazole.

Conclusions: Because of the high antibiotic resistance rates in our country, we think that fosfomycin and amikacin may have priority in the treatment of non-complicated UTIs caused by ESBL-producing E. coli strains due to ease of use and high concentration in the urine.


Aim: The aim of this study was to evaluate patients attending a sexually transmitted infection (STI) outpatient clinic with a presumptive or definitive diagnosis of syphilis with regard to demographic characteristics, clinical findings, diagnostic criteria, treatment regimens and follow-up data over a 10-year period.

Materials and Methods: The records of patients who had a presumptive/definitive diagnosis of syphilis [according to Centers for Disease Control (CDC) criteria] and who were referred to the ?zmir State Venereal Diseases Outpatient Clinic or who were diagnosed in the clinic between 1994 and 2004 were reviewed retrospectively.

Results: A total of 689 patients were included for evaluation; 378 (54.7%) were males and 311 (45.3%) were females. The ages of these patients ranged between 13-77 years, with a mean of 35.2±11.2. One hundred and fifty-three of the cases were sex workers. At the time of admission, 12.3% were considered to be in the primary stage, 17.4% in the secondary stage and 70.3% in the latent stage. The most common clinical findings in symptomatic patients were chancre (12%) and rash (9.2%). Human immunodeficiency virus (HIV) serology was screened in only 19.6% of the patients and two were positive. The most preferred treatment regimen was three doses of 2.4 million units benzathine penicillin (at one-week intervals).

Conclusions: Our results indicate that syphilis is still present in the Turkish population and standard approaches in the treatment and follow-up of patients are lacking.

  Meltem ISIKGOZ TASBAKAN , Husnu PULLUKCU , Oguz Resat SIPAHI , Tansu YAMAZHAN , Bilgin ARDA and Sercan ULUSOY
  Aim: To compare the resistance patterns of Escherichia coli strains reported to be isolated from urine cultures in published medical literature from Turkey in 1997-2001 and 2002-September 2007.
Materials and methods:
To find the published series, 3 national databases (Ulakbim Turkish Medical Literature database,,, and 2 international databases (Pubmed and Science Citation Index (SCI)) were searched.
Data for 25,577 E. coli strains were obtained from 53 articles (28 articles from 1997-2001, 25 from 2002-2007). Of these strains 18,106 were isolated from outpatients, whereas 7471 were from inpatients. When the strains isolated from outpatients were evaluated, there was a significant increase in the ciprofloxacin resistance, whereas there was a significant decrease in amikacin, netilmicin, and co-trimoxazole resistance (P < 0.05). When the data of hospitalized patients were analyzed, there was significant decrease in amikacin, gentamicin, netilmicin, co-trimoxazole, and amoxicillin/clavulanate resistance, whereas a significant increase was observed in nitrofurantoin resistance (P < 0.05). The ESBL rate increased in both the inpatients and outpatients (P < 0.05).
When looked at from Turkey's perspective, our data suggest that aminoglycosides and third-generation cephalosporins may be good choices in the treatment of inpatients. Fosfomycin/tromethamine, nitrofurantoin, and oral third-generation cephalosporins may be reasonable alternatives in the empirical treatment of uncomplicated outpatient cases. Policies to constrain resistance in both the community, and hospitals, such as antibiotic stewardship or restriction programs, should be implemented immediately.
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