Publications by authors named "Serkan Surme"

8 Publications

  • Page 1 of 1

National Early Warning Score 2 and laboratory predictors correlate with clinical deterioration in hospitalized patients with COVID-19.

Biomark Med 2021 Aug 21;15(11):807-820. Epub 2021 Jul 21.

Department of Infectious Diseases & Clinical Microbiology, Haseki Training & Research Hospital, Istanbul, Turkey.

We aimed to determine the prognostic values of the National Early Warning Score 2 (NEWS2) and laboratory parameters during the first week of COVID-19. All adult patients who were hospitalized for confirmed COVID-19 between 11 March and 11 May 2020 were retrospectively included. Overall, 611 patients were included. Our results showed that NEWS2, procalcitonin, neutrophil/lymphocyte ratio and albumin at D0, D3, D5 and D7 were the best predictors for clinical deterioration defined as a composite of ICU admission during hospitalization or in-hospital death. Procalcitonin had the highest odds ratio for clinical deterioration on all days. This study provides a list of several laboratory parameters correlated with NEWS2 and potential predictors for clinical deterioration in patients with COVID-19.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.2217/bmm-2021-0061DOI Listing
August 2021

The Effects of Antimicrobial Resistance and the Compatibility of Initial Antibiotic Treatment on Clinical Outcomes in Patients With Diabetic Foot Infection.

Int J Low Extrem Wounds 2021 Apr 15:15347346211004141. Epub 2021 Apr 15.

University of Health Sciences, Ankara Education and Research Hospital, Ankara, Turkey.

We aimed to determine pathogen microorganisms, their antimicrobial resistance patterns, and the effect of initial treatment on clinical outcomes in patients with diabetic foot infection (DFI). Patients with DFI from 5 centers were included in this multicenter observational prospective study between June 2018 and June 2019. Multivariate analysis was performed for the predictors of reinfection/death and major amputation. A total of 284 patients were recorded. Of whom, 193 (68%) were male and the median age was 59.9 ± 11.3 years. One hundred nineteen (41.9%) patients had amputations, as the minor (n = 83, 29.2%) or major (n = 36, 12.7%). The mortality rate was 1.7% with 4 deaths. A total of 247 microorganisms were isolated from 200 patients. The most common microorganisms were (n = 36, 14.6%) and (n = 32, 13.0%). Methicillin resistance rates were 19.4% and 69.6% in and coagulase-negative spp., respectively. Multidrug-resistant was detected in 4 of 22 (18.2%) isolates. Extended-spectrum beta-lactamase-producing Gram-negative bacteria were detected in 20 (38.5%) isolates of (14 of 32) and spp. (6 of 20). When the initial treatment was inappropriate, spp. related reinfection within 1 to 3 months was observed more frequently. Polymicrobial infection ( = .043) and vancomycin treatment ( = .007) were independent predictors of reinfection/death. Multivariate analysis revealed vascular insufficiency ( = .004), hospital readmission ( = .009), C-reactive protein > 130 mg/dL ( = .007), and receiving carbapenems ( = .005) as independent predictors of major amputation. Our results justify the importance of using appropriate narrow-spectrum empirical antimicrobials because higher rates of reinfection and major amputation were found even in the use of broad-spectrum antimicrobials.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1177/15347346211004141DOI Listing
April 2021

Predictors of Intensive Care Unit Admission or Death in Patients with Coronavirus Disease 2019 Pneumonia in Istanbul, Turkey.

Jpn J Infect Dis 2021 Feb 26. Epub 2021 Feb 26.

Department of Infectious Diseases and Clinical Microbiology, Haseki Training and Research Hospital, Turkey.

We aimed to determine the predictors of intensive care unit (ICU) admission or death in patients with Coronavirus Disease 2019 (COVID-19) pneumonia. This retrospective and single-center study includes patients aged ≥18 years who were diagnosed with COVID-19 pneumonia (laboratory and radiologically confirmed) between March 9 and April 8, 2020. Our composite endpoint was ICU admission or in-hospital death. To evaluate the factors in the composite endpoint, univariate and multivariate logistic regression analyses were performed. A total of 336 patients with COVID-19 pneumonia were recorded. The median age was 54 years [interquartile range (IQR): 21] and 187 (55.7%) were male. Fifty-one (15.2%) patients were admitted to the ICU. In-hospital death occurred in 33 (9.8%) patients. In univariate analysis, 17 parameters were associated with the composite endpoint and procalcitonin had the highest ODDs ratio (OR=36.568 CI=5.145-259.915). Our results revealed that body temperature (OR=1.489 CI=1.023-2.167, p=0.037), peripheral capillary oxygen saturation (SpO2) (OR=0.835 CI=0.773-0.901, p<0.001), and consolidation (>25%) in chest computed tomography (OR=3.170 CI=1.218-8.252, p=0.018) at admission were independent predictors. As a result, increased body temperature, decreased SpO2, a high level of procalcitonin, and degree of consolidation in chest computed tomography may predict a poor prognosis and have utility in the management of patients.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.7883/yoken.JJID.2020.1065DOI Listing
February 2021

Swab Samples in Diabetic Foot Infections: Easy to Obtain but Difficult to Interpret.

Surg Infect (Larchmt) 2021 Jun 18;22(5):587. Epub 2020 Nov 18.

Department of Infectious Diseases and Clinical Microbiology, Cerrahpasa Medical Faculty, Istanbul University-Cerrahpasa, Istanbul, Turkey.

View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1089/sur.2020.395DOI Listing
June 2021

An eleven-year cohort of bloodstream infections in 552 febrile neutropenic patients: resistance profiles of Gram-negative bacteria as a predictor of mortality.

Ann Hematol 2020 Aug 20;99(8):1925-1932. Epub 2020 Jun 20.

Department of Infectious Diseases and Clinical Microbiology, Istanbul University-Cerrahpasa, Cerrahpasa Medical Faculty, 34098, Istanbul, Turkey.

Antimicrobial stewardship is of major importance in patients with febrile neutropenia (FN). In this study, we aimed to investigate the trends in resistance and the relationship with mortality rates in patients with FN. The single-center surveillance data of inpatients with FN and diagnosed as microbiologically confirmed bloodstream infections (BSIs) between 2006 and 2016 were reviewed retrospectively. A total of 950 episodes in 552 patients with BSIs were analyzed. Of whom, 55.9% were male, the median age was 43 years, and 35.6% had acute myeloid leukemia. In total, 1016 microorganisms were isolated from blood cultures. Gram-negatives accounted for 42.4% (n = 403) of the episodes. Among Gram-negatives, Enterobacteriaceae accounted for 346 (86%) (E. coli, n = 197; 34% extended-spectrum β-lactamases (ESBL) producers, and Klebsiella spp., n = 120; 48.3% ESBL producers). Also, 24 (20.0%) of Klebsiella spp. had carbapenemase activity. There were 6 (5.0%) colistin-resistant Klebsiella spp. Thirteen (26.5%) of Pseudomonas spp. and 17 (60.7%) of Acinetobacter spp. had carbapenemase activity. There were 2 (5.6%) colistin-resistant Acinetobacter spp. The 30-day mortality rates were 12.0%, 21.5%, 34.6%, and 29.0% in BSIs due to Gram-positive, Gram-negative bacterial, fungal, and polymicrobial etiology respectively (p = 0.001). BSIs with ESBL-producing (p = 0.001) isolates, carbapenem (p < 0.001), and colistin-resistant isolates (p < 0.001) were associated with increased mortality risk. The tremendous rise in resistance rates among Gram-negatives is dreadfully related to increasing mortality and leads to sharp shifts toward extreme restrictions of unnecessary antibiotic uses. Antimicrobial stewardship in patients with FN requires vigilance and tailoring of treatment upon local surveillance data.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1007/s00277-020-04144-wDOI Listing
August 2020

Reducing blood culture contaminations by use of hair nets and face masks.

Diagn Microbiol Infect Dis 2020 03 21;96(3):114947. Epub 2019 Nov 21.

Department of Infectious Diseases and Clinical Microbiology, Istanbul University-Cerrahpasa, Cerrahpasa Medical Faculty, 34098 Istanbul, Turkey.

We have read the article by Sanders et al. with great interest. We appreciate the authors for their stewardship to decrease blood culture contamination rate. We would like to address the etiological distribution before and after the addition of hair nets and masks in the study. We would expect oral streptococci to decrease proportionally by using masks, but this rate did not decrease (4.7% versus 6.3%). We think that if a control group was formed in which face masks and hair nets were not used during the intervention 2 and 3 phase, similar low contamination rates would have been obtained. Strict hand hygiene, proper use of gloves, proper skin antisepsis, and nonpalpation of the disinfected area are crucial to prevent contamination. In conclusion, skin contamination constitutes a significant proportion of false culture positivity rates and is still a major problem.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1016/j.diagmicrobio.2019.114947DOI Listing
March 2020

Influence of multidrug resistant organisms on the outcome of diabetic foot infection.

Int J Infect Dis 2018 May 21;70:10-14. Epub 2018 Feb 21.

Okmeydanı Education and Research Hospital, Infectious Diseases and Clinical Microbiology, Istanbul, Turkey.

Objectives: We described the clinical outcomes of the diabetic patients who had foot infections with multidrug resistant organisms.

Methods: We included the patients with diabetic foot infections (DFI) from 19 centers, between May 2011 and December 2015. Infection was defined according to IDSA DFI guidelines. Patients with severe infection, complicated moderate infection were hospitalized. The patients were followed-up for 6 months after discharge.

Results: In total, 791 patients with DFI were included, 531(67%) were male, median age was 62 (19-90). Severe infection was diagnosed in 85 (11%) patients. Osteomyelitis was diagnosed in 291(36.8%) patients. 536 microorganisms were isolated, the most common microorganisms were S. aureus (20%), P. aeruginosa (19%) and E. coli (12%). Methicillin resistance (MR) rate among Staphylococcus aureus isolates was 31%. Multidrug resistant bacteria were detected in 21% of P. aeruginosa isolates. ESBL (+) Gram negative bacteria (GNB) was detected in 38% of E. coli and Klebsiella isolates. Sixty three patients (8%) were re-hospitalized. Of the 791 patiens, 127 (16%) had major amputation, and 24 (3%) patients died. In multivariate analysis, significant predictors for fatality were; dialysis (OR: 8.3, CI: 1.82-38.15, p=0.006), isolation of Klebsiella spp. (OR:7.7, CI: 1.24-47.96, p=0.028), and chronic heart failure (OR: 3, CI: 1.01-9.04, p=0.05). MR Staphylococcus was detected in 21% of the rehospitalized patients, as the most common microorganism (p<0.001).

Conclusion: Among rehospitalized patients, methicillin resistant Staphylococcus infections was detected as the most common agent, and Klebsiella spp. infections were found to be significantly associated with fatality.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1016/j.ijid.2018.02.013DOI Listing
May 2018

Association between biofilm and multi/extensive drug resistance in diabetic foot infection.

Int J Clin Pract 2018 Mar 30;72(3):e13060. Epub 2018 Jan 30.

Cerrahpasa Medical Faculty, Istanbul University, Istanbul, Turkey.

Purpose: We aimed to determine significant risk factors for biofilm production and to investigate the association between antimicrobial resistance profile and biofilm formation in the bacterial isolates obtained from patients with diabetic foot infection (DFI).

Methods: Demographic, clinical, laboratory and outcome data of 165 patients, prospectively recorded and followed between January 2008 and December 2015 by a multidisciplinary committee, were analysed. Standard microbiological methods were adopted. Risk factors associated with biofilm were determined by univariate and multivariate analyses.

Results: The overall rate of biofilm production among 339 wound isolates was 34%. The biofilm production rate was significantly higher in Gram-negative micro-organisms (39%) in comparison with Gram positives (21%) (P = .01). A. baumannii presented the highest biofilm production (62%), followed by P. aeruginosa (52%) and Klebsiella spp. (40%). On univariate analysis, significant factors associated with biofilm were antibiotic use within last 3 months (OR:2.94, CI: 1.5-5.75, P = .002), recurrent DFI within last 6 months (OR:2.35, CI: 1.23-4.53, P = .01), hospitalisation within last 3 months due to ipsilateral recurrent DFI (OR:2.44, CI: 1.06-5.58, P = .03), presence of amputation history (OR: 2.20, CI: 1.14-4.24, P = .01), multidrug-resistant (MDR) micro-organism (OR: 7.76, CI: 4.53-13.35, P<.001) and extensively drug-resistant (XDR) micro-organism (OR:11.33, CI:4.97-26.55, P<.001). Multivariate regression analysis revealed two variables to be significant factors associated with biofilm: MDR micro-organism (OR: 3.63, CI: 1.58-8.33, P = .002) and XDR micro-organism (OR:4.06, CI: 1.25-13.1, P = .01).

Conclusions: Multi/extensive drug resistance and previous recurrent DFIs were significantly associated with biofilm formation in patients with diabetic foot.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1111/ijcp.13060DOI Listing
March 2018
-->