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KÜÇÜKDEMİRCİ KAYA, PINAR

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KÜÇÜKDEMİRCİ KAYA

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PINAR

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    Publication
    Oxa-48 dominance meets ceftazidime-avibactam: A battle against life-threatening carbapenem-resistant klebsiella pneumoniae infections in the intensive care unit
    (Springernature, 2023-10-10) Önal, Uğur; Tüzemen, Ülkü; Kaya, Pınar K.; İşçimen, Remzi; Girgin, Nermin Küçükdemirci; Özakın, Cüneyt; Kahveci, Ferda; Akalın, Halis; ÖNAL, UĞUR; TÜZEMEN, NAZMİYE ÜLKÜ; KÜÇÜKDEMİRCİ KAYA, PINAR; ÖZAKIN, CÜNEYT; KAHVECİ, FERDA ŞÖHRET; İŞÇİMEN, REMZİ; Girgin, Nermin Küçükdemirci; AKALIN, EMİN HALİS; Bursa Uludağ Üniversitesi/Tıp Fakültesi/Enfeksiyon Hastalıkları; Bursa Uludağ Üniversitesi/Tıp Fakültesi/Mikrobiyoloji Bölümü; Bursa Uludağ Üniversitesi/Tıp Fakültesi/Anesteziyoloji ve Yoğun Bakım; Bursa Uludağ Üniversitesi/Tıp Fakültesi/Yoğun Bakım Ünitesi; Bursa Uludağ Üniversitesi/Tıp Fakültesi/Tıbbi Mikrobiyoloji; 0000-0001-6194-3254; 0000-0002-8428-8245; JCO-3678-2023; JCO-2264-2023; JNY-9122-2023; JMU-3479-2023; DTU-3148-2022; JNH-9929-2023; CYR-2043-2022; CYR-2043-2022; AAU-8952-2020
    ObjectiveIn this study, we aimed to describe the outcomes in ICU patients with bloodstream infection (BSI) or ventilatory-associated pneumonia (VAP) due to carbapenem-resistant Klebsiella pneumoniae (CRKP) who received ceftazidime-avibactam treatment at a tertiary care university hospital.MethodsPatients aged 18 years or older who were admitted to the Anesthesiology and Reanimation ICU at Bursa Uludag University Faculty of Medicine Hospital between June 13, 2021, and July 16, 2023, and diagnosed with BSI or VAP due to CRKP were included in this study.ResultsA total of 42 patients treated with ceftazidimeavibactam were included. Total crude mortality rates were 33.3% on day 14 and 54.8% on day 30. Mortality rates on the 14th and 30th days were 37.5% and 62.5% in patients with BSI and 27.8% and 44.4% in patients with VAP, respectively. There was no statistically significant difference between monotherapy and combination therapy in terms of mortality rates on days 14 and 30, respectively (3/11 vs. 11/31, p=0.620; 5/11 vs. 18/31, p=0.470). Immunosuppression (10/11 vs. 13/31, p=0.005), the Sequential Organ Failure Assessment (SOFA) score >= 8 (at the initiation of treatment; 19/25 vs. 4/17, p<0.001), INCREMENT-CPE score >= 10 (12/16 vs. 3/10, p=0.024) and longer duration (in days) from culture collection to treatment initiation (5.0 +/- 0.61 vs. 3.11 +/- 0.48, p=0.024) were found to have a statistically significant effect on 30-day mortality. In multivariate analysis, a SOFA score >= 8 at the initiation of treatment (p=0.037, OR: 17.442, 95% CI: 1.187-256.280) was found to be a significant risk factor affecting mortality (30-day).ConclusionThe mortality rates of patients with CRKP infection who were followed up in the ICU were found to be high, and it was observed that whether ceftazidime-avibactam treatment was given as a combination or monotherapy did not affect mortality. Further multicentre studies with a larger number of patients are needed to gain a comprehensive understanding of the topic, given that this treatment is typically reserved for documented infections.
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    Publication
    The impact of the COVID-19 pandemic on tracheostomy applications in the COVID and non-COVID intensive care units: A single-center experience
    (Galenos Yayıncılık, 2023-06-01) Çalışkan, Gülbahar; Topal, Serra; Kaya, Pınar Küçükdemirci; Tüzemen, Gökhan; Ulutaş, Elifgül; Girgin, Nermin Kelebek; KÜÇÜKDEMİRCİ KAYA, PINAR; ULUTAŞ, ELİFGÜL; Bursa Uludağ Üniversitesi/Tıp Fakültesi/Anesteziyoloji ve Reanimasyon Anabilim Dalı.; 0000-0002-8428-8245; JCO-2264-2023; JOJ-0316-2023
    Objective: In the early stages of the pandemic, there were reservations about early tracheostomy due to the high risk of infection transmission. We reported the clinical characteristics and outcomes of patients who underwent an elective tracheostomy during the pandemic.Materials and Methods: The data from patients who underwent the elective tracheostomy between March 20, 2020, and January 01, 2021, were evaluated retrospectively. Medical records were analyzed for age, gender, comorbidities, complications, and outcomes. The duration from intubation to tracheostomy and the length of intensive care unit (ICU) and hospital stay were calculated. The data of coronavirus disease-2019 (COVID-19) patients (group I) and non-COVID-19 patients (group II) were compared. Additionally, early tracheostomy (<= 14 days) and late tracheostomy (>14 days) groups were compared in terms of clinical outcomes.Results: A total of 144 patients, 70 of whom were diagnosed with COVID-19, were included. Tracheostomy was performed on the median 19th day in both groups (p=0.85). Percutaneous tracheostomy (68.6%) was performed more frequently in COVID-19 patients. The time of tracheostomy application had no positive effect on mortality in either groups. Bleeding occurred less frequently in group I.Conclusion: Percutaneous tracheostomy was performed more frequently in COVID-19 patients. Percutaneous tracheostomy is feasible to be conducted by the ICU team at the bedside with few complications.