The aim of this study was to evaluate the efficacy of tigecycline in multidrug-resistant (MDR) Acinetobacter baumannii pneumonia. We retrospectively evaluated the outcome of adult patients with culture proven MDR A. baumannii pneumonia treated with tigecycline between January 2009 and March 2011. The study comprised a total of 72 MDR A. baumannii pneumonia cases (44 men, mean age 65.9±15.0). Tigecycline was used for a mean duration of 10.7±4.8 days. Microbiological eradication was observed in 47 cases (65.3%). Overall mortality was 55.5% and was lower in cases with microbiological eradication vs others (15/47 32% vs 25/25 100%, p<0.0001). Mortality and microbiological eradication rates were not different with monotherapy vs combination therapy (p>0.05). Patients who died had lower albumin levels, higher APACHE-II scores and CRP levels. The microbiological eradication rate of tigecycline in MDR A. baumannii was considerable. However, eradication of A. baumannii did not result in favorable clinical outcomes in those patients with low albumin, higher APACHE-II scores and CRP levels.

Objective: Candida species are often isolated from respiratory specimens of patients with a history of long duration of hospitalization, immunosuppression, diabetes, alcoholism, history of wide spectrum antibiotic or corticosteroid usage. The aim of this retrospective study is to investigate the effect of isolation of Candida species from respiratory specimens on prognosis. Material and Method:Patients in the Department of Chest Disease in whom Candida species had been grown in ≥2 respiratory specimens obtained at the same or at different time periods within the last two years were enrolled in the study. Demographic features of the patients, risk factors for fungal infection, and the effect of this infection on prognosis were evaluated.Results: Out of 47 cases (mean age 67.6±14.6 yrs, 33 males) enrolled in the study, 29 were diagnosed as pneumonia at admission. The most frequent species isolated was C. albicans (68.1%). Fifty bacterial agents were isolated from respiratory specimens of 29 patients (61.7%) initially or on follow-up along with Candida species. Immunosuppression was detected in 28 patients (59.6%). Mean duration of hospitalization was 22.3±15.2 days and 26 patients (55.3%) died. Radiologically, multiple-zone involvement, C. tropicalis isolation, high APACHE II score, co-existing bacterial infection, low PaO 2 /FiO 2 ratio, and low albumin levels were found to be associated with mortality. Conclusion:This study showed that Candida species could also be isolated in respiratory specimens of non-immunosuppressed patients and mortality was high. It was concluded that bacterial co-infection and C. tropicalis isolation affected the prognosis negatively. (Tur Toraks Der 2011; 12: 153-7) ÖZET Amaç: Uzun süreli hastanede yatış, bağışıklığın baskılanması, diyabet, alkolizm, kortikosteroid ve geniş spektrumlu antibiyotik kullanımı öyküsü olan olguların solunum örneklerinden, sıklıkla Candida türleri izole edilmektedir. Bu retrospektif çalışmanın amacı, solunum örneklerinden Candida türleri izole edilmesinin prognoza etkisinin araştırılmasıdır. Gereç ve Yöntem: Çalışmaya; son iki yılda Göğüs HastalıklarıKliniğinde, aynı ya da farklı zamanlarda alınan en az iki farklı solunum örneğinde "Candida türleri" üreyen olgular alınmıştır. Olguların demografik özellikleri, mantar enfeksiyonu için risk faktörleri ile bu enfeksiyonun prognoza etkisi değerlendirilmiştir.Bulgular: Çalışmaya alınan 47 olgunun (yaş ort. 67.6±14.6, 33'ü erkek) 29'unda (%61.7), hastaneye yatış tanısının pnömoni olduğu görülmüştür. En sık izole edilen tür C. albicans (%68.1) olmuştur. Candida türlerinin izolasyonu anında veya izlemde; 29 olgunun (%61.7) solunum örneğinde, 50 bakteriyel etken izole edilmiştir. Olguların 28'inde (%59.6) immunsüpresyon saptanmıştır. Olgular ortalama 22.3±16.2 gün hastanede izlenmiş ve 26'sı (%55.3) eksitus olmuştur. Radyolojik olarak multi-zon tutulumu, C. tropicalis izolasyonu, APACHE II skoru yüksekliği, eşlik eden bakteriyel enfeksiyon, PaO 2 /FiO 2 oranı ve albümin düzeyi düşüklüğü mortalite ile ilişkili bulunmuşt...