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    EVALUATION OF INFECTION AGENT AND ANTIBIOTIC RESISTANCE DISTRIBUTION IN PALLIATIVE CARE PATIENTS WITH PRESSURE ULCERS
    (2022) Öztürk, Reyhan; Yıldırım, Filiz; Yıldırım, Zuhal; Şimşek, Asiye Ç.; Karageçili, Hasan
    Objectives: In our study, it was aimed to examine the distribution of infectious microorganisms, and antibiotic\rresistance status in palliative care patients with pressure ulcers followed in Ankara Polatlı Duatepe State\rHospital Palliative Care Service in 2019- 2020.\rMaterials and Methods: The sex, age, and detected diseases of a total of 178 palliative care patients included\rin our study were analyzed retrospectively. For determining the causative agents of pressure ulcer infections\rin these patients, Gram staining was performed on the bacterial cultures that developed in the wound samples,\rand the Vitek-2 (bioMérieux, France) automatic test device was used to identify these cultures and determine\rtheir antibiotic susceptibility.\rResults: It was observed that the single-agent microorganism grew in 26 of the cultures. When the 26 active\rmicroorganisms we detected in the wound culture growths were examined; it was observed that Escherichia\rcoli (n=9, 34.62%) and Proteus mirabilis (n=3, 11.54%) grew more frequently in enteric bacteria and\rPseudomonas aeruginosa (n=3, 11.54%) in non-fermentative bacteria. In our study, the absence of antibiotic\rresistance in Pseudomonas aeruginosa isolates was considered remarkable. In our study, 100% resistance was\rfound to antibiotics such as Ampicillin, Cefepime, Ceftriaxone, Ciprofloxacin, Amoxicillin-clavulanate, and\rGentamicin in gram (+) bacteria, while 100% resistance was found against antibiotics such as Ceftriaxone,\rCiprofloxacin, and Trimethoprim/sulfamethoxazole in gram (-) bacteria.\rConclusion: In the treatment of infection pressure ulcers, starting antibiotic therapy at the appropriate time\rand choosing the right antibiotic is one of the most important factors that determine the success of treatment.
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    The role of Diabetes mellitus in the progression and prognosis of COVID-19
    (2022) Yıldırım, Filiz; Karageçili, Hasan; Öztürk, Reyhan; Yıldırım, Zuhal
    Objective: The COVID-19 pandemic, caused by SARS-CoV-2 of Coronaviruses types, is a highly infectious disease caused by SARS-CoV-2, which first appeared in China. The presence of comorbid diseases, especially diabetes, and advanced age are determinants of the mortality and morbidity of the disease. In this study, it was aimed to examine the possible role of Diabetes mellitus (DM) in the course of the novel coronavirus disease (COVID-19). Methods: In this study, the data of 81 patients who applied to Ankara Polatlı Duatepe State Hospital between January 01 and May 05, 2021 and were confirmed to have COVID-19 and were hospitalized in the COVID-19 service for 5 to 20 days were analyzed. 39 female and 42 male patients were included in the study and the patients were divided into three groups. COVID-19 group (n=26; 10 female, 16 male), COVID-19+DM group (n=28; 13 female, 15 male), and COVID-19+hypertension (HT) group (n=27; 16 female, 11 male). Demographic, clinical, radiological and laboratory records of the patients were reviewed retrospectively. Results: There was a statistically significant difference between the groups when they matched for age and gender (p<0.05). The mean age of the COVID-19+DM and COVID-19+HT groups was higher than the COVID-19 group (p<0.05). COVID-19 group 55.96±15.545 years, COVID-19+DM 68.29±12.849 years, COVID-19+HT 71.48±11.416 years. Only 32 patients had positive PCR tests, and the rate was 39.5%. The number of patients with CT is 69, and the rate is 85.2%. The number of CT-positive patients is 56 and the positivity rate is 81%. The PCR test positivity rate is lower than the CT positivity rate. The serum fasting blood glucose (FBG) and C-reactive protein (CRP) levels were significantly higher in the COVID-19+DM group when compared to the COVID-19 group and COVID-19+HT group (p<0.05). The serum sodium (Na) and chlorine (Cl) levels were significantly lower in the COVID-19+DM group when compared to the COVID-19 group and COVID-19+HT group (p<0.05). The serum creatinine and phosphorus (P) levels were significantly higher in the COVID-19+DM group when compared to the COVID-19 group (p<0.05).The serum hemoglobin (HGB) and hematocrit (HCT) levels were considerably higher in the COVID-19 group compared to the COVID-19+DM group (p<0.05). Conclusion: When all the data we obtained in our study are evaluated; we determined that the comorbidity effect of DM is important in the clinical course of patients infected with the SARS-CoV-2 virus. We think that SARS-CoV-2 pneumonia patients with diabetes may be more severe than those without diabetes in terms of organ damage, and inflammatory variables, and are more likely to evolve to a worse prognosis, regardless of whether the additional comorbidities were present or not.