Mermer, Sinan

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https://hdl.handle.net/20.500.14365/7670
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Email Address
sinan.mermer@ieu.edu.tr
Main Affiliation
09.02. Internal Sciences
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Current Staff
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0000-0001-9937-6267
Scopus Author ID
56039759700
Turkish CoHE Profile ID
72DA238756C607C6
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N-nhXp8AAAAJ
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FMY-7158-2022

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  • Thumbnail Image
    Article
    Cefixime-Clavulanic Acid in ESBL-Producing E. coli Lower Urinary Tract Infections: A 13-Patient Case Series
    (BMC, 2025) Mermer, Sinan; Akyol, Deniz; Ozkara, Mehmet Bugra; Aydemir, Sabire Sohret; Sipahi, Oguz Resat
    BackgroundUrinary tract infections (UTIs) represent a substantial proportion of community-acquired infections. The increasing prevalence of Escherichia coli strains that produce extended spectrum beta-lactamases (ESBL) poses a significant obstacle to effective infection treatment. Although carbapenems remain highly effective against ESBL-producing isolates, their use in lower UTIs is limited by the need for intravenous or intramuscular administration, hospitalization, high cost, and the risk of collateral damage due to their broad-spectrum activity. Therefore, there is a growing need for effective oral alternatives.MethodsThis retrospective study evaluated the clinical and microbiological outcomes of 13 patients diagnosed with lower UTIs caused by ESBL-producing E. coli (ESBL-PE), treated with oral cefixime-clavulanic acid (400/125 mg every 12 hours for 14 days). Follow-up urine cultures were obtained on days 3-5 and/or at the end of treatment (days 11-14).ResultsOn days 3-5 of treatment, microbiological and clinical success rates were 53.8% (7/13) and 61.5% (8/13) respectively. At the end of the treatment, urine culture results could be evaluated in 10 cases, microbiological success was 80% (8/10). Clinical success was 84.6% (11/13). Re-infection and relapse rates on day 30 post-treatment were 7.7% (1/13) and 30.8% (4/13), respectively.ConclusionsCefixime-clavulanic acid may be considered an alternative to older antibiotics such as fosfomycin and nitrofurantoin in the treatment of uncomplicated urinary tract infections, and may also contribute to the prevention of carbapenem resistance development. However, these findings should be interpreted with caution due to important limitations, including the small sample size, retrospective design, absence of standardized minimum inhibitor concentration (MIC) testing, and lack of a control group. Larger prospective studies are needed to confirm these results.
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    Article
    Prevalence, Clinical Characteristics, and Antibiotic Resistance of Carbapenem-Resistant Klebsiella Pneumoniae in a Tertiary Hospital in Türkiye (2023–2025)
    (BioMed Central Ltd, 2026) Mermer, S.; Çağlayan, E.
    Background: Carbapenem-resistant Klebsiella pneumoniae (CRKP) represents a growing public health threat due to limited treatment options, high morbidity and mortality rates. This study aimed to investigate the prevalence, clinical characteristics, and antibiotic resistance profiles of CRKP isolates identified in a tertiary hospital in Türkiye between 2023 and 2025. Methods: A retrospective observational study was conducted using microbiological and clinical data collected from patients diagnosed with CRKP infections between January 2023 and April 2025. A total of 1588 CRKP isolates were retrospectively analyzed and compared with patient clinical data. Bacterial identification and antimicrobial susceptibility testing were performed using the BD Phoenix 100 M50 automated system (Becton Dickinson Company, USA), and results were interpreted in accordance with the European Committee on Antimicrobial Susceptibility Testing (EUCAST) guidelines. Results: Among 2376 K. pneumoniae isolates, the overall CRKP prevalence was 66.8%. The annual carbapenem resistance rates were 64.9% in 2023, 69.4% in 2024, and 61.0% in 2025, respectively. Resistance rates among CRKP isolates were as follows: tigecycline 14.7%, colistin 23.0%, fosfomycin 47.6%, ceftazidime-avibactam 50.9%, and amikacin 66.8%. The prevalence of CRKP was significantly higher among inpatients (83.8%) compared to outpatients (26.8%). Of the CRKP-positive samples, 62.5% were collected from patients in intensive care units (ICUs), 12.2% from hematology, and 5.1% from oncology departments. Tracheal aspirates accounted for 43.5% of isolates, followed by urine samples at 25.8%. Conclusions: The study revealed a notably high prevalence of CRKP with substantial resistance to most commonly used antibiotics. Among the tested antibiotics, tigecycline showed the lowest resistance rate, consistent with its limited usage profile. These findings underscore the urgent need for strengthened infection control measures and may guide more effective empirical treatment strategies for CRKP infections in the region. © The Author(s) 2026.