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Öğe The distribution according to the species of Gram-negative bacteria isolated from hospitalized patients's urine specimens and their antimicrobial susceptibility(2012) Dal T.; Tekin A.; Tekin R.; Deveci O.; Can S.; Özekinci T.; Dayan S.Objective: In this retrospective study, we aimed to determine the distribution according to the species of Gram-negative bacteria in isolates obtained from urine cultures of hospitalized patients with urinary tract infections and to detect their antimicrobial susceptibility pattern for contribute to empirical treatment approach to urinary tract infections in our hospital. Methods: Between the dates of January 2006 and September 2011, a total of 3,548 Gram-negative isolates obtained from urine cultures of hospitalized patients with urinary tract infection were identified by conventional methods and the BD PhoenixTM 100 (Becton Dickinson, MD, USA) fully automated microbiology system. Antimicrobial susceptibility testing of isolates was performed by Kirby- Bauer's disk diffusion method according to the Clinical and Laboratory Standarts Institute (CLSI) criteria. In addition, extended-spectrum beta-lactamase (ESBL) production of predominant urinary pathogenic bacteria was detected by the double-disk synergy method. Results: In this study, a significantly higher incidence of urinary tract infection was observed in females compared with males; 2,245 (63.3%) and 1,303 (36.7%), respectively. Escherichia coli was the predominant pathogenic bacterium and accounted for 2,341 (65.8%) of 3,548 hospitalized patients with urinary tract infections. In addition, Klebsiella pneumoniae accounted for 679 (19.1%), Acinetobacter spp. for 177 (5%), Enterobacter spp. for 176 (5%), Pseudomonas aeruginosa for 142 (4%), and other Gram-negative bacteria for 38 (1.1%). Antimicrobial susceptibility rates of Gram-negative bacteria isolated from urine cultures for ceftazidime, trimethoprim-sulfamethoxazole, ciprofloxacin, piperacillin-tazobactam, cefoperazonesulbactam, amikacin, imipenem, meropenem were detected as 34.5%, 38%, 42%, 50%, 70%, 87%, 90%, and 92%, respectively. In addition, the rates of ESBLproducing Escherichia coli and Klebsiella pneumoniae were detected as 38% and 36%, respectively. Conclusion: The present study and the other studies show that in the near future it is possible our therapeutic options may become more limited than ever due to the development of high-level resistance against broad-spectrum antibiotics such as cephalosporins, carbapenems and fluoroquinolones. Due to the highlevel resistance to ceftazidime, ciprofloxacin and trimethoprim-sulfamethoxazole, we recommend that these antibiotics should not be used for the empirical treatment of urinary tract infections.Öğe Is chryseobacterium indologenes a shunt-lover bacterium? a case report and review of the literature(2013) Ozcan N.; Dal T.; Tekin A.; Kelekci S.; Can S.; Ezin O.; Kandemir I.Chryseobacterium indologenes is a non-fermentative Gram-negative bacillus formerly belonging to the Flavobacterium genus. It is widely found in water and soil, also on wet surfaces of the hospital environment. It rarely causes infections and is usually associated with altered immune status or indwelling devices. We present a case of ventriculoperitoneal shunt infection caused by C. indologenes in a premature pediatric patient. A sixmonth-old male infant with congenital hydrocephalus and ventriculoperitoneal shunt was admitted with complaints of irritability, high fever and projectile vomiting. He was diagnosed as suffering from meningitis based on the clinical symptoms and laboratory findings of cerebrospinal fluid. The ventriculoperitoneal shunt was externalized and cerebrospinal fluid samples were sent for bacterial cultures. The isolated bacterium was identified as C. indologenes by conventional methods and the BD Phoenix™ 100 (Becton Dickinson, MD, USA) fully automated microbiology system. Antimicrobial susceptibility testing was performed by the microdilution method and Kirby-Bauer's disk diffusion method according to the Clinical and Laboratory Standards Institute guidelines. The isolate was found susceptible to ciprofloxacin, levofloxacin, cefoperazone and trimethoprim-sulfamethoxazole, while it was resistant to amikacin, aztreonam, cefepime, ceftazidime, gentamicin, imipenem and ticarcillinclavulanic acid. The treatment was started with trimethoprim-sulfamethoxazole and cefoperazone-sulbactam The ventriculoperitoneal shunt was then removed. The patient was fully healed after two weeks and discharged. Central nervous system infection is a rare form of C. indologenes infections. The case presented herein may make a useful contribution to the existing literature.