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2. Abnormal 99mTc-MDP uptake in radiation nephritis: A Case Report

Author

Kekilli E, Bati F, Koksal I, Koroglu R, Aluclu MA, and Subasi V

Subjects
radiation nephritis, bone, scintigraphy, Medicine
Abstract

The radiation nephritis is a long-term degenerative injury involving nephron and mesangium after radiation exposure. 51 year-old male patient who underwent gastric surgery due to adenocarcinoma 18 months ago and had postoperative chemo-radiotherapy using FUFA Mayo Clinic regimen after surgical resection of gastric cancer. After one year from end of the radiation therapy, bone scan showed markedly increased 99mTc-MDP uptake in the upper pole of the left kidney. [Med-Science 2012; 1(2.000): 125-130]

Published
2012
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4. Effectiveness of a multidimensional approach for prevention of ventilator-associated pneumonia in 11 adult intensive care units from 10 cities of Turkey: findings of the International Nosocomial Infection Control Consortium (INICC)

Author

Leblebicioglu, H., Yalcin, A. N., Rosenthal, V. D., Koksal, I., Sirmatel, F., Unal, S., Turgut, H., Ozdemir, D., Ersoz, G., Uzun, C., Ulusoy, S., Esen, S., Ulger, F., Dilek, A., Yilmaz, H., Turhan, O., Gunay, N., Gumus, E., Dursun, O., Yýlmaz, G., Kaya, S., Ulusoy, H., Cengiz, M., Yilmaz, L., Yildirim, G., Topeli, A., Sacar, S., Sungurtekin, H., Uğurcan, D., Geyik, M. F., Şahin, A., Erdogan, S., Kaya, A., Kuyucu, N., Arda, B., and Bacakoglu, F.

Published
2013
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13. liver fibrosis in chronic hepatitis C infection: A multicenter

Author

Koksal, I, Yilmaz, G, Parlak, M, Demirdal, T, Kinikli, S, Candan, M, Kaya, A, Akhan, S, Aydogdu, O, Turgut, H, Gurbuz, Y, Dagli, O, Gokal, AA, Guner, R, Kuruuzum, Z, Tarakci, H, Beslen, N, Erdogan, S, and Ozdener, F

Subjects
Chronic hepatitis C infection, liver fibrosis, FibroTest, APRI, Forns, index, Fib-4, non-invasive serum biomarkers
Abstract

Background/Aims: The hepatitis C virus (HCV) infection is important cause of chronic hepatitis. Liver biopsy is considered the gold standard for assessment of fibrosis but this procedure is an invasive procedure. We aimed to evaluate the diagnostic efficiency of non-invasive serum biomarkers, separately and in combinations, on liver fibrosis in treatment-naive chronic hepatitis C (CHC) patients. Materials and Methods: Two hundred and sixteen treatment-naive CHC patients were enrolled from 32 locations across Turkey in this open-labelled, non-interventional prospective observational study. FibroTest (R), aspartate aminotransferase-to-platelet ratio index(A-PRI), aspartate aminotransferase and alanine aminotransferase ratio (AAR), fibrosis index based on four factors (FIB-4), Age-platelet(AP) index and Forns index were measured and compared with Metavir scores got from liver biopsies. Results: Data from 182 patients with baseline liver biopsy were suitable for analysis. One hundred and twenty patients (65.9%) had F0-F1 fibrosis and 62 patients (34.1%) had F2-F4 fibrosis. APRI 0.732 area under the curve(AUC) indicated advanced fibrosis with 69% sensitivity and 77% specificity. FIB-4 0.732 AUC and FibroTest 0.715 AUC indicated advanced fibrosis with 69% and 78.4% sensitivity, and 75% and 71.4% specificity, respectively. The combined use of tests also led to an increase in AUC and specificity. Combinations of FibroTest with APRI and/or FIB-4, and FIB-4 with APRI were optimal for the evaluation of liver fibrosis. Conclusion: Fibrotest, FIB-4, APRI, AP index and Forns index exhibit good diagnostic performance for determining liver fibrosis in CHC patients, and the use of at least two tests together will increase their diagnostic value still further.

Published
2018

14. Surgical site infection rates in 16 cities in Turkey: findings of the International Nosocomial Infection Control Consortium (INICC)

Author

Leblebicioglu H, Erben N, Rosenthal VD, Sener A, Uzun C, Senol G, Ersoz G, Demirdal T, Duygu F, Willke A, Sirmatel F, Oztoprak N, Koksal I, Oncul O, Gurbuz Y, Güçlü E, Turgut H, Yalcin AN, Ozdemir D, Kendirli T, Aslan T, Esen S, Ulger F, Dilek A, Yilmaz H, Sunbul M, Ozgunes I, Usluer G, Otkun M, Kaya A, Kuyucu N, Kaya Z, Meric M, Azak E, Yýlmaz G, Kaya S, Ulusoy H, Haznedaroglu T, Gorenek L, Acar A, Tutuncu E, Karabay O, Kaya G, Sacar S, Sungurtekin H, Uğurcan D, Turhan O, Gumus E, and Dursu

Subjects
Cities, Cohort Studies, Hospitals, Humans, Prevalence, Prospective Studies, Surgical Wound Infection/*epidemiology, Turkey/epidemiology
Abstract

BACKGROUND: Surgical site infections (SSIs) are a threat to patient safety; however, there were no available data on SSI rates stratified by surgical procedure (SP) in Turkey. METHODS: Between January 2005 and December 2011, a cohort prospective surveillance study on SSIs was conducted by the International Nosocomial Infection Control Consortium (INICC) in 20 hospitals in 16 Turkish cities. Data from hospitalized patients were registered using the Centers for Disease Control and Prevention (CDC) National Healthcare Safety Network (NHSN) methods and definitions for SSIs. Surgical procedures (SPs) were classified into 22 types according to International Classification of Diseases, Ninth Revision criteria. RESULTS: We recorded 1879 SSIs, associated with 41,563 SPs (4.3%; 95% confidence interval, 4.3-4.7). Among the results, the SSI rate per type of SP compared with rates reported by the INICC and CDC NHSN were 11.9% for ventricular shunt (vs 12.9% vs 5.6%); 5.3% for craniotomy (vs 4.4% vs 2.6%); 4.9% for coronary bypass with chest and donor incision (vs 4.5 vs 2.9); 3.5% for hip prosthesis (vs 2.6% vs 1.3%), and 3.0% for cesarean section (vs 0.7% vs 1.8%). CONCLUSIONS: In most of the 22 types of SP analyzed, our SSI rates were higher than the CDC NHSN rates and similar to the INICC rates. This study advances the knowledge of SSI epidemiology in Turkey, allowing the implementation of targeted interventions.

Published
2015

15. International Nosocomial Infection Control Consortium (INICC)

Author

Leblebicioglu, H, Erben, N, Rosenthal, VD, Sener, A, Uzun, C, Senol, G, Ersoz, G, Demirdal, T, Duygu, F, Willke, A, Sirmatel, F, Oztoprak, N, Koksal, I, Oncul, O, Gurbuz, Y, Guclu, E, Turgut, H, Yalcin, AN, Ozdemir, D, Kendirli, T, Aslan, T, Esen, S, Ulger, F, Dilek, A, Yilmaz, H, Sunbul, M, Ozgunes, I, Usluer, G, Otkun, M, Kaya, A, Kuyucu, N, Kaya, Z, Meric, M, Azak, E, Yylmaz, G, Kaya, S, Ulusoy, H, Haznedaroglu, T, Gorenek, L, Acar, A, Tutuncu, E, Karabay, O, Kaya, G, Sacar, S, Sungurtekin, H, Ugurcan, D, Turhan, O, Gumus, E, Dursun, O, Geyik, MF, Sahin, A, Erdogan, S, Ince, E, Karbuz, A, Ciftci, E, Tasyapar, N, and Gunes, M

Subjects
infection, Surgical wound infection, Developing countries, Hospital infection, Nosocomial infection, Health care-associated
Abstract

Background: Surgical site infections (SSIs) are a threat to patient safety; however, there were no available data on SSI rates stratified by surgical procedure (SP) in Turkey. Methods: Between January 2005 and December 2011, a cohort prospective surveillance study on SSIs was conducted by the International Nosocomial Infection Control Consortium (INICC) in 20 hospitals in 16 Turkish cities. Data from hospitalized patients were registered using the Centers for Disease Control and Prevention (CDC) National Healthcare Safety Network (NHSN) methods and definitions for SSIs. Surgical procedures (SPs) were classified into 22 types according to International Classification of Diseases, Ninth Revision criteria. Results: We recorded 1879 SSIs, associated with 41,563 SPs (4.3%; 95% confidence interval, 4.3-4.7). Among the results, the SSI rate per type of SP compared with rates reported by the INICC and CDC NHSN were 11.9% for ventricular shunt (vs 12.9% vs 5.6%); 5.3% for craniotomy (vs 4.4% vs 2.6%); 4.9% for coronary bypass with chest and donor incision (vs 4.5 vs 2.9); 3.5% for hip prosthesis (vs 2.6% vs 1.3%), and 3.0% for cesarean section (vs 0.7% vs 1.8%). Conclusions: In most of the 22 types of SP analyzed, our SSI rates were higher than the CDC NHSN rates and similar to the INICC rates. This study advances the knowledge of SSI epidemiology in Turkey, allowing the implementation of targeted interventions. Copyright (C) 2015 by the Association for Professionals in Infection Control and Epidemiology, Inc. Published by Elsevier Inc. All rights reserved.

Published
2015

16. Surgical site infection rates in 16 cities in Turkey: findings of the International Nosocomial Infection Control Consortium (INICC)

Author

Leblebicioglu, H., Erben, N., Rosenthal, V.D., Sener, A., Uzun, C., Senol, G., Ersoz, G., Demirdal, T., Duygu, F., Willke, A., Sirmatel, F., Oztoprak, N., Koksal, I., Oncul, O., Gurbuz, Y., Güçlü, E., Turgut, H., Yalcin, A.N., Ozdemir, D., Kendirli, T., Aslan, T., Esen, S., Ulger, F., Dilek, A., Yilmaz, H., Sunbul, M., Ozgunes, I., Usluer, G., Otkun, M., Kaya, A., Kuyucu, N., Kaya, Z., Meric, M., Azak, E., Yýlmaz, G., Kaya, S., Ulusoy, H., Haznedaroglu, T., Gorenek, L., Acar, A., Tutuncu, E., Karabay, O., Kaya, G., Sacar, S., Sungurtekin, H., Uğurcan, Doğaç, Turhan, O., Gumus, E., Dursun, O., Geyik, M.F., Şahin, A., Erdogan, S., Ince, E., Karbuz, A., Çiftçi, E., Taşyapar, N., and Güneş, M.

Subjects
Turkey, Surgical wound infection, Health careeassociated infection, prevalence, infection rate, surgical infection, Article, Turkey (republic), Developing countries, Cohort Studies, hip prosthesis, Nosocomial infection, coronary artery bypass graft, Humans, Hospital infection, human, Prospective Studies, hospital, Cities, cesarean section, craniotomy, clinical trial, cohort analysis, shunting, Hospitals, hospital patient, multicenter study, city, prospective study
Abstract

Background: Surgical site infections (SSIs) are a threat to patient safety; however, there were no available data on SSI rates stratified by surgical procedure (SP) in Turkey. Methods: Between January 2005 and December 2011, a cohort prospective surveillance study on SSIs was conducted by the International Nosocomial Infection Control Consortium (INICC) in 20 hospitals in 16 Turkish cities. Data from hospitalized patients were registered using the Centers for Disease Control and Prevention (CDC) National Healthcare Safety Network (NHSN) methods and definitions for SSIs. Surgical procedures (SPs) were classified into 22 types according to International Classification of Diseases, Ninth Revision criteria. Results: We recorded 1879 SSIs, associated with 41,563 SPs (4.3%; 95% confidence interval, 4.3-4.7). Among the results, the SSI rate per type of SP compared with rates reported by the INICC and CDC NHSN were 11.9% for ventricular shunt (vs 12.9% vs 5.6%); 5.3% for craniotomy (vs 4.4% vs 2.6%); 4.9% for coronary bypass with chest and donor incision (vs 4.5 vs 2.9); 3.5% for hip prosthesis (vs 2.6% vs 1.3%), and 3.0% for cesarean section (vs 0.7% vs 1.8%). Conclusions: In most of the 22 types of SP analyzed, our SSI rates were higher than the CDC NHSN rates and similar to the INICC rates. This study advances the knowledge of SSI epidemiology in Turkey, allowing the implementation of targeted interventions. Copyright © 2015 by the Association for Professionals in Infection Control and Epidemiology, Inc. Published by Elsevier Inc. All rights reserved.

Published
2015

17. The characteristics of patients with chronic hepatitis B in Turkey

Author

Kemal Celen, M., Tekin Koruk, S., Aygen, B., Dal, T., Karabay, O., Tosun, S., and Koksal, I.

Subjects
adefovir, antivirus agent, Adult, Male, Blood donor, Turkey, alanine aminotransferase, prevalence, Antiviral Agents, Turkey (republic), Hepatitis B, Chronic, aspartate aminotransferase, Humans, liver function test, human, infection risk, radioimmunoassay, article, interferon, infection control, major clinical study, enzyme linked immunosorbent assay, female, gamma glutamyltransferase, Hepadnaviridae infections, lamivudine, hepatitis B, alkaline phosphatase, entecavir
Abstract

Aim To evaluate the characteristics of patients with hepatitis B virus (HBV) infection and summarize the treatment modalities. Methods By September 30, 2011 the data of 7871 HBsAg (+) patients were complied and analysed according to demographic and medical records (age, sex, laboratory tests, treatment with antiviral agents) in thirty centres of Turkey. Results Of the 7871 patients 3078 (39.1%) were females; mean (standard deviation) age was 35 (14) years, 3180 (40.4%) were HBsAg positive (+) after admission to a hospital, 1488 (18.9%) after blood donation and 967 (11.9%) were found during routine screening. The HBV prevalence among relatives of HBsAg (+) patients was 1764 (22.4%), and most frequently infected family members were siblings and mothers, 4961 (63.0%) and 2149 (27.3%), respectively). Anti-HDV was negative in 7407 94.1% of patients. Three-fourths of the patients 6383 (81.1%) were HBeAg negative (-). Mean (SD) ALT was 85.8 (266.4) U/L. Majority of patients, 5588 (71.0%) were chronic hepatitis-B patients under treatment, while 2283 (29.0%) were asymptomatic carriers without treatment and only 165 (2.1%) of patients were cirrhotic and 6612 (84.0%) of those were compensated. One-third of the patients 2983 (37.9%) were under a combined treatment, while others were under monotherapy. Lamivudine, entecavir and adefovir were the most frequently used oral therapies, used for 2583 (32.8%), 11.6% and 787 (10.0%) of patients, respectively), while 2975 (37.8%) of patients were under interferon treatment. Conclusion Hepatitis B is still a problem in our country. First task of the physicians and our state should be to prevent the development and spread of the disease with education and vaccination programs, safe blood transfusions, and control of barbers.

Published
2014

18. report on device-associated infection rates in 19 cities of Turkey, data

Author

Leblebicioglu, H, Erben, N, Rosenthal, VD, Atasay, B, Erbay, A, Unal, S, Senol, G, Willke, A, Ozgultekin, A, Altin, N, Bakir, M, Oncul, O, Ersoz, G, Ozdemir, D, Yalcin, AN, Ozdemir, H, Yildizdas, D, Koksal, I, Aygun, C, Sirmatel, F, Sener, A, Tuna, N, Akan, OA, Turgut, H, Demiroz, AP, Kendirli, T, Alp, E, Uzun, C, Ulusoy, S, Arman, D, Ozgunes, I, Usluer, G, Kilic, A, Arsan, S, Cabadak, H, Sen, S, Gelebek, Y, Zengin, H, Topeli, A, Alper, Y, Meric, M, Azak, E, Inan, A, Turan, G, Haznedaroglu, T, Gorenek, L, Acar, A, Cesur, S, Engin, A, Kaya, A, Kuyucu, N, Geyik, MF, Aydin, OC, Erdogan, NS, Turhan, O, Gunay, N, Gumus, E, Dursun, O, Esen, S, Ulger, F, Dilek, A, Yilmaz, H, Sunbul, M, Gokmen, Z, Ozdemir, SI, Horoz, OO, Yylmaz, G, Kaya, S, Ulusoy, H, Kucukoduk, S, Ustun, C, Baysal, AI, Otkun, M, Tulunay, M, Oral, M, Unal, N, Cengiz, M, Yilmaz, L, Sacar, S, Sungurtekin, H, Ugurcan, D, Yetkin, MA, Bulut, C, Erdinc, FS, Hatipoglu, CA, Ince, E, Ciftci, E, Odek, C, Yaman, A, Karbuz, A, Aldemir, B, Kilic, AU, Arda, B, Bacakoglu, F, and Hizel, K

Subjects
infection, Urinary tract infection, Network, Ventilator-associated pneumonia, Catheter-associated urinary tract, health care facilities, manpower, and services, Central line-associated bloodstream infections, Bloodstream, VELOPING-COUNTRIES, MULTIDIMENSIONAL APPROACH, STRATEGY, IMPACT, INICC, International Nosocomial Infection Consortium, Turkey, Device-associated infection, Antibiotic resistance, Hospital infection, Nosocomial infection, Healthcare-associated
Abstract

Background: Device-associated healthcare-acquired infections (DA-HAI) pose a threat to patient safety, particularly in the intensive care unit (ICU). We report the results of the International Infection Control Consortium (INICC) study conducted in Turkey from August 2003 through October 2012. Methods: A DA-HAI surveillance study in 63 adult, paediatric ICUs and neonatal ICUs (NICUs) from 29 hospitals, in 19 cities using the methods and definitions of the U.S. NHSN and INICC methods. Results: We collected prospective data from 94,498 ICU patients for 647,316 bed days. Pooled DA-HAI rates for adult and paediatric ICUs were 11.1 central line-associated bloodstream infections (CLABSIs) per 1000 central line (CL)-days, 21.4 ventilator-associated pneumonias (VAPs) per 1000 mechanical ventilator (MV)-days and 7.5 catheter-associated urinary tract infections (CAUTIs) per 1000 urinary catheter-days. Pooled DA-HAI rates for NICUs were 30 CLABSIs per 1000 CL-days, and 15.8 VAPs per 1000 MV-days. Extra length of stay (LOS) in adult and paediatric ICUs was 19.4 for CLABSI, 8.7 for VAP and 10.1 for CAUTI. Extra LOS in NICUs was 13.1 for patients with CLABSI and 16.2 for patients with VAP. Extra crude mortality was 12% for CLABSI, 19.4% for VAP and 10.5% for CAUTI in ICUs, and 15.4% for CLABSI and 10.5% for VAP in NICUs. Pooled device use (DU) ratios for adult and paediatric ICUs were 0.54 for MV, 0.65 for CL and 0.88 for UC, and 0.12 for MV, and 0.09 for CL in NICUs. The CLABSI rate was 8.5 per 1,000 CL days in the Medical Surgical ICUs included in this study, which is higher than the INICC report rate of 4.9, and more than eight times higher than the NHSN rate of 0.9. Similarly, the VAP and CAUTI rates were higher compared with U. S. NHSN (22.3 vs. 1.1 for VAP; 7.9 vs. 1.2 for CAUTI) and with the INICC report (22.3 vs. 16.5 in VAP; 7.9 vs. 5.3 in CAUTI). Conclusions: DA-HAI rates and DU ratios in our ICUs were higher than those reported in the INICC global report and in the US NHSN report.

Published
2014

19. International Nosocomial Infection Control Consortium (INICC) national report on device-associated infection rates in 19 cities of Turkey, data summary for 2003-2012

Author

Leblebicioglu, H., Erben, N., Rosenthal, V.D., Atasay, B., Erbay, A., Unal, S., Senol, G., Willke, A., Özgültekin, A., Altin, N., Bakir, M., Oncul, O., Ersöz, G., Ozdemir, D., Yalcin, A.N., Özdemir, H., Yıldızdaş, D., Koksal, I., Aygun, C., Sirmatel, F., Sener, A., Tuna, N., Akan, Ö.A., Turgut, H., Demiroz, A.P., Kendirli, T., Alp, E., Uzun, C., Ulusoy, S., Arman, D., Ozgunes, I., Usluer, G., Kiliç, A., Arsan, S., Cabadak, H., Sen, S., Gelebek, Y., Zengin, H., Topeli, A., Alper, Y., Meric, M., Azak, E., İnan, A., Turan, G., Haznedaroglu, T., Gorenek, L., Acar, A., Cesur, S., Engin, A., Kaya, A., Kuyucu, N., Geyik, M.F., Aydın, Ö.Ç., Erdogan, N.S., Turhan, O., Gunay, N., Gumus, E., Dursun, O., Esen, S., Ulger, F., Dilek, A., Yilmaz, H., Sunbul, M., Gökmen, Z., Özdemir, S.İ., Horoz, O.O., Yýlmaz, G., Kaya, S., Ulusoy, H., Küçüködük, S., Ustun, C., Otkun, M., Tulunay, M., Oral, M., Ünal, N., Cengiz, M., Yilmaz, L., Sacar, S., Sungurtekin, H., Uğurcan, D., Yetkin, M.A., Bulut, C., Erdinc, F.S., Hatipoglu, C.A., İnce, E., Çiftçi, E., Ödek, Ç., Yaman, A., Karbuz, A., Aldemir, B., Kılıc, A.U., Arda, B., Bacakoglu, F., and Hizel, K.

Subjects
Male, Turkey, healthcare associated infection, Antibiotic resistance, health care facilities, manpower, and services, central venous catheter, Network, intensive care unit, preschool child, Turkey (republic), Cohort Studies, Nosocomial infection, newborn, device infection, Prevalence, Prospective Studies, Child, intensive care, catheter infection, Urinary tract infection, Cross Infection, adult, Pneumonia, Ventilator-Associated, INICC, cohort analysis, infection control, Device-associated infection, female, Equipment and Supplies, Child, Preschool, disease surveillance, devices, prospective study, Adolescent, Catheter-associated urinary tract infection, infection rate, Bloodstream infection, Article, critically ill patient, length of stay, Ventilator-associated pneumonia, Humans, Hospital infection, human, Healthcare-associated infection, urinary catheter, Infant, Newborn, Infant, International Nosocomial Infection Consortium, mechanical ventilator, major clinical study, mortality, Catheter-Related Infections, ventilator associated pneumonia, Central line-associated bloodstream infections
Abstract

Background: Device-associated healthcare-acquired infections (DA-HAI) pose a threat to patient safety, particularly in the intensive care unit (ICU). We report the results of the International Infection Control Consortium (INICC) study conducted in Turkey from August 2003 through October 2012. Methods: A DA-HAI surveillance study in 63 adult, paediatric ICUs and neonatal ICUs (NICUs) from 29 hospitals, in 19 cities using the methods and definitions of the U.S. NHSN and INICC methods. Results: We collected prospective data from 94,498 ICU patients for 647,316 bed days. Pooled DA-HAI rates for adult and paediatric ICUs were 11.1 central line-associated bloodstream infections (CLABSIs) per 1000 central line (CL)-days, 21.4 ventilator-associated pneumonias (VAPs) per 1000 mechanical ventilator (MV)-days and 7.5 catheter-associated urinary tract infections (CAUTIs) per 1000 urinary catheter-days. Pooled DA-HAI rates for NICUs were 30 CLABSIs per 1000 CL-days, and 15.8 VAPs per 1000 MV-days. Extra length of stay (LOS) in adult and paediatric ICUs was 19.4 for CLABSI, 8.7 for VAP and 10.1 for CAUTI. Extra LOS in NICUs was 13.1 for patients with CLABSI and 16.2 for patients with VAP. Extra crude mortality was 12% for CLABSI, 19.4% for VAP and 10.5% for CAUTI in ICUs, and 15.4% for CLABSI and 10.5% for VAP in NICUs. Pooled device use (DU) ratios for adult and paediatric ICUs were 0.54 for MV, 0.65 for CL and 0.88 for UC, and 0.12 for MV, and 0.09 for CL in NICUs. The CLABSI rate was 8.5 per 1,000 CL days in the Medical Surgical ICUs included in this study, which is higher than the INICC report rate of 4.9, and more than eight times higher than the NHSN rate of 0.9. Similarly, the VAP and CAUTI rates were higher compared with U.S. NHSN (22.3 vs. 1.1 for VAP; 7.9 vs. 1.2 for CAUTI) and with the INICC report (22.3 vs. 16.5 in VAP; 7.9 vs. 5.3 in CAUTI). Conclusions: DA-HAI rates and DU ratios in our ICUs were higher than those reported in the INICC global report and in the US NHSN report. © 2014 Leblebicioglu et al.

Published
2014

20. THU-381 - Recurrence and occurrence of hepatocellular carcinoma following ledipasvir and sofosbuvir treatment for chronic hepatitis C in patients with advanced liver disease: Turkish multicenter early access program

Author

Jdilman, R., Demir, M., Aladag, M., Kaymakoglu, S., Erol, C., Cavus, B., Iliaz, R., Akarca, U.S., Koklu, S., Cakaloglu, Y., Sahin, M., Koksal, I., Ozgenel, M., Toka, B., Karasu, Z., Ersoz, G., Kiyici, M., Akdogan, M., and Turkey, E.A.P.

Published
2018
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22. Relationship Between Liver Biopsy and Non-Invasive Biochemical Methods in Determination of Liver Fibrosis in Treatment-Naive Chronic Hepatitis C Patients; A Multicentre Study

Author

Koksal, I., Yilmaz, G., Parlak, M., Demirdal, T., Kinikli, S., Candan, M., Beslen, N., and Giresun Üniversitesi

Abstract

47th Annual Meeting of the European-Association-for-the-Study-of-the-Liver (EASL) -- APR 18-22, 2012 -- Barcelona, SPAIN demirdal, tuna/0000-0002-9046-5666 WOS: 000303241301407 … European Assoc Study Liver (EASL)

Published
2012

23. International nosocomial infection control consortium (INICC) report, data summary of 36 countries, for 2004-2009

Author

Rosenthal, V.D., Bijie, H., Maki, D.G., Mehta, Y., Apisarnthanarak, A., Medeiros, E.A., Leblebicioglu, H., Fisher, D., Álvarez-Moreno, C., Khader, I.A., Martínez, M.D.R.G., Cuellar, L.E., Navoa-Ng, J.A., Abouqal, R., Garcell, H.G., Mitrev, Z., García, M.C.P., Hamdi, A., Dueñas, L., Cancel, E., Gurskis, V., Rasslan, O., Ahmed, A., Kanj, S.S., Ugalde, O.C., Mapp, T., Raka, L., Meng, C.Y., Thu, L.T.A., Ghazal, S., Gikas, A., Narváez, L.P., Mejía, N., Hadjieva, N., Elanbya, M.O.G., Siritt, M.E.G., Jayatilleke, K., Frías, M.L., Churruarín, G., Sztokhamer, D., Flynn, L.P., Rausch, D., Spagnolo, A., Santero, B., Soroka, L.C., For-Ciniti, S., Blasco, M., Lezcano, C.B., Lastra, C.E., Bedoya, M.Á.F., Costamagna, A., Dheza, G.R., Ávalos, J., Álvarez, M., Bench-Etrit, G., Bonaventura, C., Caridi, M.Á., Messina, A., Ricci, B., Viegas, M., Di Núbila, B.M.A., Lan-Zetta, D., Fernández, L.J., Rossetti, M.A., Romani, A., Migazzi, C., Barolin, C., Martínez, E., Bernan, M.L., Bay, M.R., Diaz, F.R., Dominguez, C.B., Coria, G.E., Martinelli, M.E., Grinberg, G., Ferreira, I.B., Cechinel, R.B., Zanandrea, B.B., Rohnkohl, C., Regalin, M., Spessatto, J.L., Pasini, R.S., Ferla, S., Salomao, R., da Silva, M.Â.M., de Jesus Silva, C.H., Vilins, M., Blecher, S., Angelieri, D.B., Kuchenbecker, R.S., Pires, M.R., Santos, R.P., Kuplich, N.M., Siliprandi, E.M.O., Do-Amaral, A.P., Silva, C.P.R., Biancalana, M.L.N., Sánchez, T.E.G., Valente, R., Apolinário, D., Freitas, L.F.B., Dos Santos, M.C.I., Lopes, J.M.M., Valadares, P.C.P., Batista, J.P., Campos, M.A.-E.S., Moretti, M.L., Cardoso, L.G., Trabaos, A., Martins, I.S., Santos, P.T.D., Pinhejro, D.O.B.P., Abreu, J.S.D., Richtmann, R., Rodríguez, T., Baltieri, S.R., Moreira, M., Stadtlober, G.F., Cavaglieri, A.G., Karadimovm, D., Velinova, V., Qin, J.A., Juan, H., Fang, H.C., Gao, X., Lili, T., Yao, S., Hungmei, W., Bin, C., Ruisheng, L., Yang, Y., Yeguxiang, Ziqin, X., Mei, W.H., Chun, G.S., Yang, X., Gan, A., Zhang, A., Luo, J., Zhao, A., Li, F., Liu, B., Gao, M., Zhao, B., Wei, L., Wang, C., Fang, L., Yi, C., Xie, X., Ling, F., Wu, Y., Xu, F., Feng, F., Weng, F., Dong, G.-H., Ye, G., Yang, W., Yu, H., Yang, H.-I., Yan, H., Mao, A., Zhou, H., Chen, W., Gong, H., Tan, H., Liu, Y., Wu, H., Tang, D., Hao, J., Zhang, H., Wang, J., Qiu, Y., Yu, J., Gu, X., Jiang, J., Zhang, M., Miu, J., Zhao, W., Shi, J., Li, L., Duo, K., Cai, L., Liu, L., Hua, L., Shao, Q., An, Y., Lu, Q., Li, G., Sun, R., Zhang, W., Tao, Z., Wang, W., Shen, Y., Fan, W., Chen, H., Yao, X., Wen, H., Xiong, X., Xu, H., Liu, X., Huang, M., Wang, X., Shao, G., Yuan, Y., Cao, Y., Chen, Y., Chen, X., Gu, Y., Zhu, L., Huang, Y., Wang, M., Wang, Y., Mao, Y., Cheng, Y., Zhao, C., Sun, Y., Zhu, B., Cai, M., Zhang, Y., Xue, M., Zhou, Y., Zhang, R., Du, Y., Li, D., Ni, Y., Zhang, L., Zhong, Z., Zhu, G., Yu, Z., Cao, M., Song, Z., Xu, J., Tong, Z., Gu, P., Agudelo, J.G., Sussmann, O., Mojica, B.E., Rojas, C., Beltran, H., Paez, J., Gómez, W.V., Dajud, L., Mendoza, M., Arrieta, P., Osorio, L., Olarte, N., Valderrama, A., Muñoz, H.J., Guzmán, N.B., Ferrer, M.R., Villa, G.S., Guzmán, A.L., Linares, C., Cortés, L.M., Campo, L.F.R., Menco, A., Calderón, M.E.R., Parada, D.E.C., Fernandez, A.M.P., Martínez, I.F.P., Saleg, P.A.M., Vega, Y.L., Luengas, E.L., Ramos, C.R., Hernández, H.T., Gomez, D.Y., Gomez, B.M.V., Ruiz, M.G., Millán, J.C.T., López, M.U.T., Parada, E.C., Rochel, A.E.M., Hidalgo, R.F., Calzada, J.M.A., Muñoz, G., Argüello, A.R., Chinchilla, A.S., Fuentes, C.G., Pérez, C.M., Pino, O.R., González, O.D., González, D.F., de Wang, C.M.R., Severino, R., Tolari, G., Delgado, M., Vélez, J.W., Zapata, M.A.C., Valle, M.J., Guayasamín, S., Seliem, Z.S., El Kholy, A.A., Abdel-Aziz, D., Sabour, M.A.E., Kalil, M., Saeed, A., Gafarey, M.E., Fouad, L., Muhamed, T., Saeed, H., Casares, A.C.B., Machuca, L.J., Chaniotaki, K., Tsioutis, C., Bampalis, D., Gopinath, R., Ravindra, N., Karlekar, A., Sood, S., Verma, N., Sen, N., Subramani, K., Raj, J.P., Mathur, P., Kumar, S., Sahu, S., Govil, D., Jaggi, N., Bhatnagar, S., Myatra, S.N., Divatia, Kelkar, R., Biswas, S., Raut, S., Sampat, S., Kumar, R., Todi, S.K., Bhakta, A., Bhattacharjee, M., Ramachandran, B., Chakravarthy, M., Gokul, B.N., Sukanya, R., Pushparaj, L., Singh, S., Radhakrishnan, K., Udwadia, F.E., Ansari, R., Poojary, A., Koppikar, G., Bhandarkar, L., Jadhav, S., Dwivedy, A., Shetty, S., Binu, S., Pawar, M., Gupta, A., Saini, N., Kothari, V., Singhal, T., Shah, S., Rodrigues, C., Hegd, A., Kapadia, F., Mehta, P., Surase, P., Narayanan, S., Munshi, N., Padbidri, V., Dawhale, R., Jacobs, S.M., Khuri-Bulos, N., Mahafzah, A., Baftiu, N., Spahija, G., Zahreddine, N., Alamuddin, L., Kanafani, Z., Dagys, A., Kondratas, T., Kevalas, R., Anguseva, T., Ampova, V., Guroska, S.T.-C., Manikavasagam, J., Tan, L.H., Kaur, K., Assadian, O., Wolfram, R., Kaur, P., Oropeza, M.S., Ruiz, A.A., Campuzano, R., Brito, J.M., Serrato, I.P., López, M.S., Gómez, A.C., Morales, J.R., Rodríguez, J.E.V., Gallo, J.H.P., Almazán, F.A., Miramontes, G.I., Vázquez Olivas, M.D.R., Chávez, A.S., Espinoza, Y.A., Gallegos, L.A., González, D.J.S., Rochín, A.M., Félix, M.J.S., Peña, R.D., Gómez, A.B.Z., Gutiérrez, C.A.E., Novales, M.G.M., Herver, M.D.J., Gaytan, J.A., Olmeda, J.A.G., Martínez-Marroquín, M.Y., Hernández, A., García, E.O., Cervantes, R.V., Arteaga-Troncoso, G., Guerra Infante, F.M., Méndez, I.M., Burguete, M.C.C., Barkat, A., Bouazzaoui, N.L., Meryem, K., Madani, N., Zeggwagh, A.A., Abidi, K., Dendane, T., Khan, S.G., Ali, F., Hussain, Y., Butt, F., Fakir, A., Mahmood, S.F., Jamil, B., Memon, B.A., Bhutto, G.H., Alfaro, F.G., Alvarado, C., León, L.M.D., Navarro, R., Moreno, J.L., Cerrad, R., Sabogal, A.C., Goicochea, I.P., Sanchez, A.A., Alva, G.R., Ventura, J.G., Aguilar, M.R., Plasencia, N.S., Maldonado, E.F., Espichan, M.J.M., Echenique, L., Rosales, R., Bravo, L.I.C., Cáceres, M.L., Espinoza, T.A., López, F.S., Saldarriaga, M.E.C., Morvelí, E.U.V., Barriga, H., Villacorta, M.S., Barrios, S.C., Zegarra, S.L.T., Astete, N.S., Guevara, F.C., Mendoza, C.B., Ramírez, A.V., Pastrana, J.S., Wong, F.M.R., Ángeles, C.S., Tavera, Z.D., Ramirez, E., Vergara, C.E.L.H., Mendoza, L., Sosa, G.B., Chávez, C.M., Berba, R., Genuino, G.A.S., Consunji, R.J., Mantaring, J.B.V., III, Villanueva, V.D., Tolentino, M.C.V., Galapia, Y.A., Tambyah, P.A., Hakawi, A., Kaluarachchi, N.N., Samaraweera, G.A.-R., Sid Ahmed Ali, I.M., Satti, A.A., Jamulitrat, S., Thamlikitkul, V., Ben-Jaballah, N., Ammar, K., Öztürk, R., Dikmen, Y., Aygún, G., Ulusoy, S., Arda, B., Bacakoglu, F., Sardan, Y.C., Yildirim, G., Topeli, A., Akan, Ö.A., Tulunay, M., Oral, M., Ünal, N., Alp, E., Aygen, B., Sirmatel, F., Cengiz, M., Yilmaz, L., Özgültekin, A., Turan, G.-D., Akgün, N., Ozdemir, D., Guclu, E., Erdogan, S., Erben, N., Ozgunes, I., Usluer, G., Aygun, C., Küçüködük, S., Arman, D., Hizel, K., Uzun, C., Turgut, Hüseyin, Saçar, Suzan, Sungurtekin, Hülya, Uğurcan, Doğaç, Koksal, I., Yýlmaz, G., Kaya, S., Ulusoy, H., Ersoz, G., Kaya, A., Kuyucu, N., Esen, S., Ulger, F., Dilek, A., Yalcin, A.N., Turhan, O., Keskin, S., Gumus, E., Dursun, O., Kendirli, T., Ince, E., Cliftci, E., Özdemir, H., Demiroz, A.P., Yetkin, M.A., Bulut, C., Erdinc, F.S., Hatipoglu, C.A., Erbay, A., Willke, A., Meric, M., Azak, E., Oncul, O., Haznedaroglu, T., Gorenek, L., Acar, A., Silvera, E., Techera, S., Frachia, A., Algorta, G., Gil de Añez, Z.D., Bravo, L.M., Orozco, N., Mejías, E., Trang, D.T.V., Nga, T.T.K., and Zruong, P.H.

Subjects
meticillin, Staphylococcus aureus, Asia, Antibiotic resistance, Health care-associated infection, Catheter-associated urinary tract infection, Network, bloodstream infection, intensive care unit, Developing countries, South and Central America, Nosocomial infection, Escherichia coli, Ventilator-associated pneumonia, Hospital infection, human, ceftazidime, catheter infection, Urinary tract infection, nonhuman, bacterium isolate, article, developing country, infection control, mortality, Device-associated infection, Low-income countries, hospital bed, Europe, Klebsiella pneumoniae, Central line-associated bloodstream infection, Africa, Pseudomonas aeruginosa, Limited-resources countries, disease surveillance, ventilator associated pneumonia, hospitalization, prospective study
Abstract

The results of a surveillance study conducted by the International Nosocomial Infection Control Consortium (INICC) from January 2004 through December 2009 in 422 intensive care units (ICUs) of 36 countries in Latin America, Asia, Africa, and Europe are reported. During the 6-year study period, using Centers for Disease Control and Prevention (CDC) National Healthcare Safety Network (NHSN; formerly the National Nosocomial Infection Surveillance system [NNIS]) definitions for device-associated health care-associated infections, we gathered prospective data from 313,008 patients hospitalized in the consortium's ICUs for an aggregate of 2,194,897 ICU bed-days. Despite the fact that the use of devices in the developing countries' ICUs was remarkably similar to that reported in US ICUs in the CDC's NHSN, rates of device-associated nosocomial infection were significantly higher in the ICUs of the INICC hospitals; the pooled rate of central line-associated bloodstream infection in the INICC ICUs of 6.8 per 1,000 central line-days was more than 3-fold higher than the 2.0 per 1,000 central line-days reported in comparable US ICUs. The overall rate of ventilator-associated pneumonia also was far higher (15.8 vs 3.3 per 1,000 ventilator-days), as was the rate of catheter-associated urinary tract infection (6.3 vs. 3.3 per 1,000 catheter-days). Notably, the frequencies of resistance of Pseudomonas aeruginosa isolates to imipenem (47.2% vs 23.0%), Klebsiella pneumoniae isolates to ceftazidime (76.3% vs 27.1%), Escherichia coli isolates to ceftazidime (66.7% vs 8.1%), Staphylococcus aureus isolates to methicillin (84.4% vs 56.8%), were also higher in the consortium's ICUs, and the crude unadjusted excess mortalities of device-related infections ranged from 7.3% (for catheter-associated urinary tract infection) to 15.2% (for ventilator-associated pneumonia). Copyright © 2012 by the Association for Professionals in Infection Control and Epidemiology, Inc. Published by Elsevier Inc. All rights reserved.

Published
2012

25. Time-dependent analysis of extra length of stay and mortality due to

Author

Rosenthal, VD, Udwadia, FE, Munoz, HJ, Erben, N, Higuera, F, Abidi, K, Medeiros, EA, Maldonado, EF, Kanj, SS, Gikas, A, Barnett, AG, Graves, N, Guzman, S, Flynn, LP, Rausch, D, Spagnolo, A, Benchetrit, G, Bonaventura, C, Caridi, MD, Messina, A, Ricci, B, Frias, ML, Churruarin, G, Sztokhamer, D, Soroka, LC, Forciniti, S, Blasco, M, Lezcano, CB, Lastra, CE, Viegas, M, Di Nubila, BMA, Lanzetta, D, Fernandez, LJ, Rossetti, MA, Romani, A, Migazzi, C, Barolin, C, Martinez, E, Kobylarz, A, Grinberg, G, Ferreira, IB, Cechinel, RB, Angelieri, DB, Nouer, S, Vianna, R, Machado, AL, Gama, E, Blanquet, D, Zanandrea, BB, Rohnkohl, C, Regalin, M, Salomao, R, da Silva, MAM, Silva, CHD, Vilins, M, Blecher, S, Spessatto, JL, Pasini, RS, Ferla, S, Sussmann, O, Mojica, BE, Gomez, WV, Vergara, GR, Arrieta, P, Rojas, C, Beltran, H, Paez, J, Navarrete, MDT, Dajud, L, Mendoza, M, Moreno, CA, Linares, C, Osorio, L, Guzman, NB, Ferrer, MR, Villa, GS, Guzman, AL, Olarte, N, Valderrama, A, Agudelo, JG, Calderon, MER, Chaniotaki, K, Tsioutis, C, Bampalis, D, Todi, SK, Bhakta, A, Bhattacharjee, M, Kumar, RK, Radhakrishnan, K, Ansari, R, Poojary, A, Koppikar, G, Bhandarkar, L, Jadhav, S, Sen, N, Subramani, K, Karlekar, A, Rodrigues, C, Hegd, A, Kapadia, F, Sahu, S, Gopinath, R, Ravindra, N, Myatra, SN, Divatia, JV, Kelkar, R, Biswas, S, Raut, S, Sampat, S, Kumar, R, Chakravarthy, M, Gokul, BN, Sukanya, R, Pushparaj, L, Dwivedy, A, Shetty, S, Binu, S, Zahreddine, N, Sidani, N, Jurdi, LA, Kanafani, Z, Lopez, MS, Hernandez, HT, Gomez, AC, Morales, JR, Rodriguez, JEV, Oropeza, MS, Rangel-Frausto, MS, Soto, JM, Ruiz, AA, Campuzano, R, Brito, JM, Abouqal, R, Madani, N, Zeggwagh, AA, Dendane, T, Barkat, A, Bouazzaoui, NL, Meryem, K, Cuellar, L, Rosales, R, Bravo, LIC, Caceres, ML, Espinoza, T, Lopez, FS, Espichan, MJM, Echenique, L, Sabogal, AC, Goicochea, IP, Sanchez, AA, Alva, GR, Ventura, JG, Aguilar, MR, Plasencia, NS, Rodriguez, T, Yalcin, AN, Turhan, O, Keskin, S, Gumus, E, Dursun, O, Ozdemir, D, Guclu, E, Erdogan, S, Ulusoy, S, Arda, B, Bacakoglu, F, Alp, E, Aygen, B, Arman, D, Hizel, K, Ozdemir, K, Uzun, C, Sardan, YC, Yildirim, G, Topeli, A, Sirmatel, F, Cengiz, M, Yilmaz, L, Ozgultekin, A, Turan, G, Akgun, N, Ozturk, R, Dikmen, Y, Aygun, G, Akan, OA, Tulunay, M, Oral, M, Unal, N, Koksal, I, Yylmaz, G, Senel, AC, Sozen, EE, Ersoz, G, Kaya, A, Kandemir, O, Leblebicioglu, H, Esen, S, Ulger, F, Dilek, A, Aygun, C, Kucukoduk, S, Ozgunes, I, Usluer, G, Turgut, H, Sacar, Suzan, Sungurtekin, Hülya, and Ugurcan, D

Subjects
and hospital infections, pneumonia, surveillance, respiratory tract diseases, Bacterial infections, hospital-acquired (noscomial) infections, hygiene
Abstract

Ventilator-associated pneumonias (VAPs) are a worldwide problem that significantly increases patient morbidity, mortality, and length of stay (LoS), and their effects should be estimated to account for the timing of infection. The purpose of the study was to estimate extra LoS and mortality in an intensive-care unit (ICU) due to a VAP in a cohort of 69 248 admissions followed for 283 069 days in ICUs from 10 countries. Data were arranged according to the multi-state format. Extra LoS and increased risk of death were estimated independently in each country, and their results were combined using a random-effects meta-analysis. VAP prolonged LoS by an average of 2.03 days (95% CI 1.52-2.54 days), and increased the risk of death by 14% (95% CI 2-27). The increased risk of death due to VAP was explained by confounding with patient morbidity.

Published
2011

26. Impact of International Nosocomial Infection Control Consortium (INICC) strategy on central line-associated bloodstream infection rates in the intensive care units of 15 developing countries

Author

Rosenthal, V.D., Maki, D.G., Rodrigues, C., Álvarez-Moreno, C., Leblebicioglu, H., Sobreyra-Oropeza, M., Berba, R., Madani, N., Medeiros, E.A., Cuéllar, L.E., Mitrev, Z., Dueñas, L., Guanche-Garcell, H., Mapp, T., Kanj, S.S., Fernández-Hidalgo, R., Viegas, M., Di Núbila, B.M.A., Lanzetta, D., Fernández, L.J., Rossetti, M.A., Romani, A., Migazzi, C., Barolin, C., Martínez, E., Sztokhamer, D., Soroka, L.C., Flynn, L.P., Rausch, D., Spagnolo, A., Forciniti, S., Blasco, M., Lezcano, C.B., Lastra, C.E., Angelieri, D.B., Salomao, R., Da Silva, M.Â.M., Vilins, M., Da Silva, E.H., Blecher, S., Grinberg, G., Linares, C., Gómez, W.V., Vergara, G.R., Arrieta, P., Osorio, L., Guzmán, N.B., Ferrer, M.R., Villa, G.S., Guzmán, A.L., Sussmann, O., Mojica, B.E., Olarte, N., Valderrama, A., Dajud, L., Mendoza, M., Bernate, P.H.A., Calderón, M.E.R., Calzada, J.M.A., Muñoz, G., Argüello, A.R., Pérez, C.M., De Casares, A.C.B., De Machuca, L.J., Hegd, A., Kapadia, F., Todi, S.K., Chakraborty, P., Chatterjee, S., Chakravarthy, M., Jawali, V., Adhikary, R., Singh, S., Kumar, R.K., Radhakrishnan, K., Karlekar, A., Kapoor, P., Pawar, M., Udwadia, F.E., Ansari, R., Poojary, A., Koppikar, G., Bhandarkar, L., Sen, N., Subramani, K., Raj, J.P., Myatra, S.N., Divatia, J.V., Kelkar, R., Biswas, S., Singhal, H., Raut, S., Mahale, N., Dhakate, V., Sampat, S., Ramachandran, B., Zahreddine, N., Sidani, N., Jurdi, L.A., Kanafani, Z., Anguseva, T., Ampova, V., Guroska, S.T., Higuera, F., Hernández, H.T., Gómez, A.C., Morales, J.R., Rodríguez, J.E.V., Serrato, I.P., López, M.S., Ruiz, A.A., Campuzano, R., Brito, J.M., Abouqal, R., Zeggwagh, A.A., Abidi, K., Dendane, T., Alfaro, F.G., Alvarado, C., De León, L.M., Navarro, R., Moreno, J.L., Cerrud, R., Rosales, R., Bravo, L.I.C., Cáceres, M.L., Maldonado, E.F., Espichan, M.J.M., Echenique, L., Sabogal, A.C., Goicochea, I.P., Sanchez, A.A., Alva, G.R., Ventura, J.G., Aguilar, M.R., Plasencia, N.S., Rodríguez, T., Espinoza, T.A., López, F.S., Angelo, G., Genuino, S., Consunji, R.J., Mantaring III, J.B.V., Navoa-Ng, J.A., Villanueva, V.D., Tolentino, M.C.V., Yalcin, A.N., Turhan, O., Keskin, S., Özgültekin, A., Turan, G., Akgün, N., Koksal, I., Yýlmaz, G., Senel, A.C., Sözen, E.E., Akan, Ö.A., Tulunay, M., Oral, M., Ünal, N., Esen, S., Ulger, F., Dilek, A., Aygun, C., Küçüködük, S., Erben, N., Ozgunes, I., Usluer, G., Sardan, Y.C., Yildirim, G., Topeli, A., Ozdemir, D., Guclu, E., Erdogan, N.S., Sirmatel, F., Cengiz, M., Yilmaz, L., Alp, E., Aygen, B., Turgut, H., Sacar, S., Sungurtekin, H., and Uǧurcan, D.

Subjects
health care organization, treatment duration, antisepsis, adult, chlorhexidine, article, bloodstream infection, clinical trial, catheter, intensive care unit, major clinical study, health survey, International Nosocomial Infection Control Consortium, aged, female, multicenter study, male, incidence, health program, controlled study, hospital infection, human
Abstract

BACKGROUND. The International Nosocomial Infection Control Consortium (INICC) was established in 15 developing countries to reduce infection rates in resource-limited hospitals by focusing on education and feedback of outcome surveillance (infection rates) and process surveillance (adherence to infection control measures). We report a time-sequence analysis of the effectiveness of this approach in reducing rates of central line-associated bloodstream infection (CLABSI) and associated deaths in 86 intensive care units with a minimum of 6-month INICC membership. METHODS. Pooled CLABSI rates during the first 3 months (baseline) were compared with rates at 6-month intervals during the first 24 months in 53,719 patients (190,905 central line-days). Process surveillance results at baseline were compared with intervention period data. RESULTS. During the first 6 months, CLABSI incidence decreased by 33% (from 14.5 to 9.7 CLABSIs per 1,000 central line-days). Over the first 24 months there was a cumulative reduction from baseline of 54% (from 16.0 to 7.4 CLABSIs per 1,000 central line-days; relative risk, 0.46 [95% confidence interval, 0.33-0.63]; P < .001). The number of deaths in patients with CLABSI decreased by 58%. During the intervention period, hand hygiene adherence improved from 50% to 60% (P < .001); the percentage of intensive care units that used maximal sterile barriers at insertion increased from 45% to 85% (P < .001 ), that adopted chlorhexidine for antisepsis increased from 7% to 27% (P=.018 ), and that sought to remove unneeded catheters increased from 37% to 83% (P=.004); and the duration of central line placement decreased from 4.1 to 3.5 days (P < .001). CONCLUSIONS. Education, performance feedback, and outcome and process surveillance of CLABSI rates significantly improved infection control adherence, reducing the CLABSI incidence by 54% and the number of CLABSI-associated deaths by 58% in INICC hospitals during the first 2 years. © 2010 by The Society for Healthcare Epidemiology of America. All rights reserved.

Published
2010

27. Clinical importance of extended-spectrum beta-lactamase (PER-1-type)-producing Acinetobacter spp. and Pseudomonas aeruginosa strains

Author

Vahaboglu, H, Coskunkan, F, Tansel, O, Ozturk, R, Sahin, N, Koksal, I, Korten, V, and Ondokuz Mayıs Üniversitesi

Abstract

Leblebicioglu, Hakan/0000-0002-6033-8543; VAHABOGLU, Haluk/0000-0001-8217-1767; KORTEN, VOLKAN/0000-0002-9991-814X; Kocazeybek, Bekir S/0000-0003-1072-3846 WOS: 000169534300010 PubMed: 11444775 Recently, an extended-spectrum beta -lactamase (PER-I) was found to be disseminated among Acinetobacter spp, and Pseudomonas aeruginosa isolates in Turkey. A population-based cohort study was conducted to elucidate predictive mortality factors in patients with nosocomial infections caused by Acinetobacter spp. and P. aeruginosa, with particular reference to PER-1-type extended-spectrum beta -lactamase (ESBL) production. The study group comprised 16 and 21 non-survivors and 82 and 126 survivors in cohorts infected with Acinetobacter and E. aeruginosa, respectively. In the Acinetobacter-infected cohort, nosocomial pneumonia, hypotension and infection with a PER-positive isolate were independent predictors of mortality. In the P. aeruginosa-infected cohort, impaired consciousness, a PER-positive isolate, male sex and (with a negative relative risk) urinary tract infection were independent predictors of death. This study demonstrated the relationship of PER-1-type ESBL-producing Acinetobacter spp. and P. aeruginosa with poor clinical outcome.

Published
2001

28. Results from the Survey of Antibiotic Resistance (SOAR) 2002-09 in Turkey.

Author

Torumkuney, D., Gur, D., Soyletir, G., Gurler, N., Aktas, Z., Sener, B., Tunger, A., Bayramoglu, G., Koksal, I., Yalcin, A. N., Tanriver, Y., Morrissey, I., and Barker, K.

Subjects
RESPIRATORY infections, STREPTOCOCCUS pneumoniae, DRUG resistance in bacteria, ANTIBIOTICS, PUBLIC health, DRUG resistance in microorganisms, HAEMOPHILUS diseases, HAEMOPHILUS influenzae, MICROBIAL sensitivity tests, STREPTOCOCCAL diseases, STREPTOCOCCUS, COMMUNITY-acquired infections, PHARMACODYNAMICS
Abstract

Objectives: To investigate changes in antibiotic susceptibility of Streptococcus pneumoniae and Haemophilus influenzae from the Survey of Antibiotic Resistance (SOAR) in community-acquired respiratory tract infections (CA-RTIs) between 2002 and 2009 in Turkey.Methods: Previously published SOAR data were used for this analysis. MICs were determined using Etest(®) gradient strips or disc diffusion. Susceptibility against a range of antimicrobial agents was assessed using CLSI breakpoints.Results: A total of 900 S. pneumoniae isolates were analysed: 2002-03 (n = 75), 2004-05 (n = 301) and 2007-09 (n = 524). Four antibiotics were tested consistently throughout and three showed a statistically significant decrease in susceptibility (P < 0.0001): penicillin (74.7% susceptible in 2002-03; 67.8% in 2004-05; and 47.2% in 2007-09); cefaclor (85.3% in 2002-03; 78.7% in 2004-05; and 53.5% in 2007-09) and clarithromycin (85.3% in 2002-03; 82.7% in 2004-05; and 61.9% in 2007-09). Susceptibility to amoxicillin/clavulanic acid did not significantly change (100% in 2002-03; 98.7% in 2004-05; and 97.7% in 2007-09). A total of 930 H. influenzae isolates were analysed: 2002-03 (n = 133), 2004-05 (n = 379) and 2007-09 (n = 418). Four antibiotics were also consistently tested: ampicillin, amoxicillin/clavulanic acid, clarithromycin and cefaclor. All showed >90% susceptibility, but only cefaclor susceptibility significantly reduced (P < 0.0001) over time (99.2% in 2002-03; 96.3% in 2004-05; and 90.4% in 2007-09).Conclusions: In S. pneumoniae from Turkey, there has been a clear statistically significant reduction in susceptibility to key antibiotics since 2002, but not to amoxicillin/clavulanic acid (or amoxicillin). However, susceptibility in H. influenzae remained stable. Continued surveillance is required to monitor future changes in antibiotic susceptibility for CA-RTI bacteria. [ABSTRACT FROM AUTHOR]

Published
2016
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33. 848 RELATIONSHIP BETWEEN LIVER BIOPSY AND NON-INVASIVE BIOCHEMICAL METHODS IN DETERMINATION OF LIVER FIBROSIS IN TREATMENT-NAIVE CHRONIC HEPATITIS C PATIENTS; A MULTICENTRE STUDY

Author

Koksal, I., Yilmaz, G., Parlak, M., Demirdal, T., Kinikli, S., Candan, M., Kaya, A., Akhan, S., Aydogdu, O., Turgut, H., Gurbuz, Y., Dagli, O., Gokal, A.A., Guner, R., Kuruuzum, Z., Tarakci, H., Beslen, N., Duyar, E., Inan, D., Leblebicioglu, H., Sehmen, E., Yulugkural, Z., Namiduru, M., Kokoglu, O.F., Baykam, N., Ural, O., Bostanci, F., Kaya, S., Kilic, S., Onlen, Y., Ozdemir, D., Tabak, F., and Yamazhan, T.

Published
2012
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34. Varicocele-Induced Testicular Dysfunction May Be Associated with Disruption of Blood-Testis Barrier.

Author

Koksal, I. T., Ishak, Y., Usta, M., Danisman, A., Guntekin, E., Bassorgun, I. C., and Ciftcioglu, A.

Subjects
*VARICOCELE, *CADHERINS, *PATHOLOGICAL physiology, *SERTOLI cells, *EPITHELIAL cells
Abstract

The objective of this study was to examine E-cadherin and α-catenin expression at the junctions between adjacent Sertoli cells in testicular specimens from patients with varicocele in order to determine the presence of a possible link between blood-testis barrier and pathophysiology of varicocele. A total of 51 testicular biopsies were obtained from 28 infertile men with unilateral or bilateral varicocele. Twenty-three patients had bilateral and 5 had unilateral varicocele, Grade I varicocele was detected in 30 (59%), grade II in 15 (29%) and grade III in 6 (12%) patients. Abnormal expression of E-cadherin and α-catenin at the junctions between adjacent Sertoli cells was demonstrated in 100% and 90% of the patients with varicocele, respectively. In those with grade I-III varicocele, the mean E-cadherin and α-catenin expression were 7.6 ± 11.4 and 39 ± 36; 7.6 ± 0.0 and 49 ± 30; 8.3 ± 9.3 and 58 ± 33, respectively, but the difference was not significant. Reduced E-cadherin and α-catenin expression at the junctions between adjacent Sertoli cells may be associated with disruption of blood-testis barrier in varicocele. [ABSTRACT FROM AUTHOR]

Published
2007
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35. RELATIONSHIP BETWEEN MAST CELL AND INOS EXPRESSION IN TESTICULAR TISSUE ASSOCIATED WITH INFERTILITY.

Author

Sezer, C., Koksal, I. T., Usta, M. F., Gulkesen, K. H., Erdogru, T., Ciftcioglu, A., and Baykara, M.

Subjects
*TESTIS, *MALE infertility, *MAST cells, *NITRIC-oxide synthases, *IMMUNOHISTOCHEMISTRY, *LEYDIG cells
Abstract

The objective of this study was to investigate mast cells and iNOS expression in testis tissue, and to correlate these results with spermatogenetic disorders. A total of 136 testicular biopsies were obtained from the testes of 80 patients with infertility. Their age ranged from 21 to 45 years. The biopsy specimens were immunohistochemically stained with antihuman tryptase for mast cells. In each section, all interstitial fields were evaluated for the total number of mast cells as well as the total number of Leydig cells. The number of mast cells per Leydig cell was calculated and recorded as mast cell index. Immunohistochemical iNOS staining was evaluated semiquantitatively according to intensity and the proportion of the stained cells. There was a significant increase of the mast cell index in all groups with testicular disorder compared with normal sperm atogenesis group (p < 0.05). Increase of the index was in the order of hypospermatogenesis, maturation arrest and SCO, and index of SCO group was especially higher, i.e., more than twice than other groups. iNOS score was significantly higher in the SCO group than in the men with normal sperm atogenesis, hypospermatogenesis, and maturation arrest (p < 0.05). Finally, a significant statistical correlation was found between the iNOS score and mast cells index (r = 0,758, p = 0,001). Increase of mast cell index was observed in the groups of infertile testis, and high expression of iNOS in Leydig cells was associated with the highest mast cell index in SGO, the lesion with the most severe damage of the germ cell. [ABSTRACT FROM AUTHOR]

Published
2005
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42. Patient and partner satisfaction and long-term results after surgical treatment for Peyronie’s disease

Author

Usta, Mustafa F., Bivalacqua, Trinity J., Sanabria, Jose, Koksal, I. Turker, Moparty, Krishnarao, and Hellstrom, Wayne J. G.

Subjects
*PENILE induration, *PATIENT satisfaction
Abstract

: ObjectivesTo assess the long-term functional outcome, patient and partner satisfaction, and predictive factors for unfavorable results in men treated with a surgical approach for severe Peyronie’s disease.: MethodsSixty-one patients underwent surgical treatment for Peyronie’s disease between 1997 and 2001 and were retrospectively evaluated. All patients were assessed preoperatively with a detailed sexual and medical history, focused physical examination, and penile duplex ultrasonography. Nineteen patients underwent penile plaque excision/incision and grafting with Tutoplast cadaveric pericardial grafting material (group 1). Penile prosthesis implantation and manual modeling was performed in 31 patients (group 2a), and 11 men were treated with penile prosthesis implantation and pericardial grafting (group 2b).: ResultsThe mean follow-up of the patients was 21.9 ± 13.6 months (range 12 to 48). Complete penile straightening was achieved in 15 patients (78.9%) in the excision/incision and grafting group. In the 42 men who underwent reconstruction using penile prosthesis implantation (group 2a,b), penile curvature resolved completely in 37 patients (88%). Long-term postoperative residual curvatures greater than 30° occurred in 3 patients (15.7%) and 2 patients (4.8%) in groups 1 and 2a,b, respectively. One penile prosthesis (2.3%) was explanted in the second group for erosion. Patient responses to our questionnaire showed that overall 83.6% of the patients and 76.9% of the partners were satisfied with the surgical result.: ConclusionsAccording to the results of this long-term, retrospective study, pericardial grafting can be used successfully after plaque excision/incision procedures in men undergoing surgical treatment for severe Peyronie’s disease. In patients with Peyronie’s disease and erectile dysfunction, implantation of a penile prosthesis and correction of the curvature with a graft can provide an acceptable, functionally straight penis without any increased risk of complications compared with penile prosthesis implantation alone. [Copyright &y& Elsevier]

Published
2003
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43. Surgical site infection rates in 16 cities in Turkey: findings of the International Nosocomial Infection Control Consortium (INICC)

Author

Ahmet Şahin, Iftihar Koksal, Gaye Usluer, Hülya Sungurtekin, Tanıl Kendirli, Selçuk Kaya, Eylul Gumus, Gürdal Yýlmaz, Mehmet Faruk Geyik, Ertugrul Guclu, Nurettin Erben, Tuna Demirdal, Tuncer Haznedaroglu, Huseyin Turgut, Levent Gorenek, Erdal Ince, Melek Güneş, Hava Yilmaz, Necdet Kuyucu, Suzan Sacar, Alper Şener, Oguz Dursun, Nefise Oztoprak, Ahmet Dilek, Fatma Sirmatel, Ergin Çiftçi, Meliha Meric, Gulsume Kaya, Mustafa Sunbul, Metin Otkun, Emel Azak, Fatma Ülger, Gülden Ersöz, Yunus Gürbüz, Ayşe Willke, Sehnaz Kaya, Hakan Leblebicioglu, Oral Oncul, Davut Ozdemir, Nevin Taşyapar, Ali Acar, Ediz Tutuncu, Zeynep Kaya, Doğaç Uğurcan, Oguz Karabay, Victor D. Rosenthal, Fazilet Duygu, Saban Esen, Ali Kaya, Ata Nevzat Yalcin, Hülya Ulusoy, Gunes Senol, Adem Karbuz, Turan Aslan, Özge Turhan, Selvi Erdogan, Cengiz Uzun, Ilhan Ozgunes, Leblebicioglu, H, Erben, N, Rosenthal, VD, Sener, A, Uzun, C, Senol, G, Ersoz, G, Demirdal, T, Duygu, F, Willke, A, Sirmatel, F, Oztoprak, N, Koksal, I, Oncul, O, Gurbuz, Y, Guclu, E, Turgut, H, Yalcin, AN, Ozdemir, D, Kendirli, T, Aslan, T, Esen, S, Ulger, F, Dilek, A, Yilmaz, H, Sunbul, M, Ozgunes, I, Usluer, G, Otkun, M, Kaya, A, Kuyucu, N, Kaya, Z, Meric, M, Azak, E, Yylmaz, G, Kaya, S, Ulusoy, H, Haznedaroglu, T, Gorenek, L, Acar, A, Tutuncu, E, Karabay, O, Kaya, G, Sacar, S, Sungurtekin, H, Ugurcan, D, Turhan, O, Gumus, E, Dursun, O, Geyik, MF, Sahin, A, Erdogan, S, Ince, E, Karbuz, A, Ciftci, E, Tasyapar, N, Gunes, M, Sakarya Üniversitesi/Tıp Fakültesi/Dahili Tıp Bilimleri Bölümü, Güçlü, Ertuğrul, MERİÇ KOÇ, MELİHA, and Ondokuz Mayıs Üniversitesi

Subjects
Turkey, Epidemiology, Surgical wound infection, Health careeassociated infection, Turkey (republic), Cohort Studies, hip prosthesis, Nosocomial infection, Prospective Studies, hospital, Prospective cohort study, Health Policy, craniotomy, clinical trial, cohort analysis, Hospitals, hospital patient, Infectious Diseases, Cohort, Surgical site infection, Cohort study, prospective study, medicine.medical_specialty, Health care-associated infection, prevalence, education, infection rate, surgical infection, Article, Developing countries, coronary artery bypass graft, Internal medicine, medicine, Humans, Hospital infection, human, Cities, cesarean section, business.industry, Public Health, Environmental and Occupational Health, findings of the International Nosocomial Infection Control Consortium (INICC)-, AMERICAN JOURNAL OF INFECTION CONTROL, cilt.43, ss.48-52, 2015 [Leblebicioglu H., Erben N., ROSENTHAL V. D. , ŞENER A., UZUN C., SENOL G., Ersoz G., Demirdal T., DUYGU F., Willke A., et al., -Surgical site infection rates in 16 cities in Turkey], Nosocomial infection control, Confidence interval, shunting, Surgery, Clinical trial, multicenter study, city, business
Abstract

Yalcin, Ata Nevzat/0000-0002-7243-7354; dursun, oguz/0000-0001-5482-3780; Oncul, Oral/0000-0002-1681-1866; Leblebicioglu, Hakan/0000-0002-6033-8543; demirdal, tuna/0000-0002-9046-5666; Ciftci, Ergin/0000-0002-4955-160X; Erben, Nurettin/0000-0003-0373-0132; Kendirli, Tanil/0000-0001-9458-2803; Acar, Ali/0000-0003-2008-5112; Geyik, Mehmet Faruk/0000-0002-0906-0902; Dursun, Oguz/0000-0001-5482-3780; KAYA, ZEYNEP/0000-0002-8468-2103; KARABAY, OGUZ/0000-0003-1514-1685; Karabay, Oguz/0000-0003-0502-432X; Kaya, Sehnaz/0000-0003-0002-1517 WOS: 000347654600011 PubMed: 25564124 Background: Surgical site infections (SSIs) are a threat to patient safety; however, there were no available data on SSI rates stratified by surgical procedure (SP) in Turkey. Methods: Between January 2005 and December 2011, a cohort prospective surveillance study on SSIs was conducted by the International Nosocomial Infection Control Consortium (INICC) in 20 hospitals in 16 Turkish cities. Data from hospitalized patients were registered using the Centers for Disease Control and Prevention (CDC) National Healthcare Safety Network (NHSN) methods and definitions for SSIs. Surgical procedures (SPs) were classified into 22 types according to International Classification of Diseases, Ninth Revision criteria. Results: We recorded 1879 SSIs, associated with 41,563 SPs (4.3%; 95% confidence interval, 4.3-4.7). Among the results, the SSI rate per type of SP compared with rates reported by the INICC and CDC NHSN were 11.9% for ventricular shunt (vs 12.9% vs 5.6%); 5.3% for craniotomy (vs 4.4% vs 2.6%); 4.9% for coronary bypass with chest and donor incision (vs 4.5 vs 2.9); 3.5% for hip prosthesis (vs 2.6% vs 1.3%), and 3.0% for cesarean section (vs 0.7% vs 1.8%). Conclusions: In most of the 22 types of SP analyzed, our SSI rates were higher than the CDC NHSN rates and similar to the INICC rates. This study advances the knowledge of SSI epidemiology in Turkey, allowing the implementation of targeted interventions. Copyright (C) 2015 by the Association for Professionals in Infection Control and Epidemiology, Inc. Published by Elsevier Inc. All rights reserved.

Published
2015

44. EFFECTS OF NUTRITIONAL SUPPLEMENT USAGE ON MORTALITY IN COLORECTAL CANCER PATIENT WITH ABDOMINAL RESECTION SURGERY

Author

MN Dogukan, M Berktas, ES Tezcan, O Ozcan, S Gulkan, I Koksal, Gulkan, S, Berktas, M, Tezcan, ES, Dogukan, MN, Ozcan, O, Koksal, I, and Yeditepe Üniversitesi

Subjects
medicine.medical_specialty, Text mining, Colorectal cancer, business.industry, Health Policy, General surgery, Public Health, Environmental and Occupational Health, medicine, medicine.disease, business, Bioinformatics, Resection
Abstract

…

Published
2015

45. Withdrawal of Staphylococcus aureus from intensive care units in Turkey

Author

Saim Dayan, Nail Ozgunes, Hasan Ucmak, Turan Aslan, Begin Altun, Adem Albayrak, Nefise Oztoprak, Selçuk Kaya, Tuna Demirdal, Salman Shaheer Ahmed, Fehmi Tabak, Iftihar Koksal, Hanefi Cem Gul, Yasemin Ersoy, Yeşim Taşova, Oral Oncul, Mehmet Bitirgen, Ibak Gonen, Murat Dizbay, Selma Karabey, Hakan Erdem, Nazif Elaldi, Fatma Sirmatel, İbrahim Erayman, Oznur Ak, Oguz Karabay, Birsen Cetin, Emel Azak, Bilgin Arda, Ercan Yenilmez, Hakan Leblebicioglu, Tumer Guven, Ayşe Willke, Recep Tekin, Saban Esen, Asim Ulcay, Davut Ozdemir, Serhat Ünal, Asuman Inan, Zeliha Kocak Tufan, Ilker Inanc Balkan, Sukran Kose, Filiz Akata, Aygul Dogan-Celik, Fatma Nurhayat Bayazit, Ayhan Akbulut, Gulden Yilmaz, Ömer Karaşahin, Derya Ozturk-Engin, Gokay Gungor, Güven Çelebi, Serkan Oncu, Levent Gorenek, Halis Akalin, Aysegul Ulu-Kilic, Aslihan Candevir, Hale Turan, [Erdem, Hakan -- Oncul, Oral -- Yenilmez, Ercan -- Gorenek, Levent -- Ulcay, Asim] GATA Haydarpasa Training Hosp, Dept Infect Dis & Clin Microbiol, Istanbul, Turkey -- [Dizbay, Murat -- Karasahin, Omer] Gazi Univ, Sch Med, Dept Infect Dis & Clin Microbiol, Ankara, Turkey -- [Karabey, Selma] Istanbul Univ, Istanbul Sch Med, Dept Publ Hlth, Istanbul, Turkey -- [Kaya, Selcuk -- Koksal, Iftihar] Karadeniz Tech Univ, Sch Med, Dept Infect Dis & Clin Microbiol, Trabzon, Turkey -- [Demirdal, Tuna] Katip Celebi Univ, Sch Med, Dept Infect Dis & Clin Microbiol, Izmir, Turkey -- [Inan, Asuman -- Ozturk-Engin, Derya] Haydarpasa Numune Training & Res Hosp, Dept Infect Dis & Clin Microbiol, Istanbul, Turkey -- [Erayman, Ibrahim -- Bitirgen, Mehmet] Selcuk Univ, Meram Sch Med, Dept Infect Dis & Clin Microbiol, Konya, Turkey -- [Ak, Oznur] Lutfi Kirdar Kartal Training & Res Hosp, Dept Infect Dis & Clin Microbiol, Istanbul, Turkey -- [Ulu-Kilic, Aysegul -- Ahmed, Salman Shaheer] Erciyes Univ, Sch Med, Dept Infect Dis & Clin Microbiol, Kayseri, Turkey -- [Akbulut, Ayhan] Firat Univ, Sch Med, Dept Infect Dis & Clin Microbiol, TR-23169 Elazig, Turkey -- [Elaldi, Nazif] Cumhuriyet Univ, Sch Med, Dept Infect Dis & Clin Microbiol, Sivas, Turkey -- [Yilmaz, Gulden] Ankara Univ, Sch Med, Dept Infect Dis & Clin Microbiol, TR-06100 Ankara, Turkey -- [Candevir, Aslihan -- Tasova, Yesim] Cukurova Univ, Sch Med, Dept Infect Dis & Clin Microbiol, Adana, Turkey -- [Gul, Hanefi Cem] Gulhane Mil Med Acad, Dept Infect Dis & Clin Microbiol, Ankara, Turkey -- [Gonen, Ibak] Suleyman Demirel Univ, Sch Med, Dept Infect Dis & Clin Microbiol, TR-32200 Isparta, Turkey -- [Aslan, Turan] Bezmi Alem Univ, Sch Med, Dept Infect Dis & Clin Microbiol, Istanbul, Turkey -- [Azak, Emel -- Willke, Ayse] Kocaeli Univ, Sch Med, Dept Infect Dis & Clin Microbiol, Kocaeli, Turkey -- [Tekin, Recep -- Dayan, Saim] Dicle Univ, Sch Med, Dept Infect Dis & Clin Microbiol, Izmir, Turkey -- [Tufan, Zeliha Kocak] Ankara Numune Training & Res Hosp, Dept Infect Dis & Clin Microbiol, Ankara, Turkey -- [Arda, Bilgin] Ege Univ, Sch Med, Dept Infect Dis & Clin Microbiol, Izmir, Turkey -- [Gungor, Gokay] Sureyyapasa Chest Dis & Thorac Surg Educ & Res Ho, Resp Intens Care Unit, Istanbul, Turkey -- [Cetin, Birsen] Koc Univ, Sch Med, Dept Infect Dis & Clin Microbiol, Istanbul, Turkey -- [Kose, Sukran] Izmir Tepecik Training & Res Hosp, Dept Infect Dis & Clin Microbiol, Izmir, Turkey -- [Turan, Hale] Baskent Univ, Sch Med, Dept Infect Dis & Clin Microbiol, Konya, Turkey -- [Akalin, Halis] Uludag Univ, Sch Med, Dept Infect Dis & Clin Microbiol, Bursa, Turkey -- [Karabay, Oguz] Sakarya Univ, Sch Med, Dept Infect Dis & Clin Microbiol, Sakarya, Turkey -- [Dogan-Celik, Aygul -- Tabak, Fehmi] Trakya Univ, Sch Med, Dept Infect Dis & Clin Microbiol, Edirne, Turkey -- [Albayrak, Adem -- Esen, Saban -- Leblebicioglu, Hakan] Ondokuz Mayis Univ, Sch Med, Dept Infect Dis & Clin Microbiol, Samsun, Turkey -- [Guven, Tumer] Ataturk Training & Res Hosp, Dept Infect Dis & Clin Microbiol, Ankara, Turkey -- [Celebi, Guven] Bulent Ecevit Univ, Sch Med, Dept Infect Dis & Clin Microbiol, Zonguldak, Turkey -- [Ozgunes, Nail] Medeniyet Univ, Sch Med, Dept Infect Dis & Clin Microbiol, Istanbul, Turkey -- [Ersoy, Yasemin] Inonu Univ, Sch Med, Dept Infect Dis & Clin Microbiol, Malatya, Turkey -- [Sirmatel, Fatma] Abant Izzet Baysal Univ, Sch Med, Dept Infect Dis & Clin Microbiol, Bolu, Turkey -- [Oztoprak, Nefise] Antalya Training & Res Hosp, Dept Infect Dis & Clin Microbiol, Antalya, Turkey -- [Balkan, Ilker Inanc -- Tabak, Fehmi] Istanbul Univ, Cerrahpasa Med Sch, Dept Infect Dis & Clin Microbiol, Istanbul, Turkey -- [Bayazit, Fatma Nurhayat] Fatih Univ, Sch Med, Dept Infect Dis & Clin Microbiol, Ankara, Turkey -- [Ucmak, Hasan] Sutcu Imam Univ, Sch Med, Dept Infect Dis & Clin Microbiol, Kahramanmaras, Turkey -- [Oncu, Serkan] Adnan Menderes Univ, Sch Med, Dept Infect Dis & Clin Microbiol, Aydin, Turkey -- [Ozdemir, Davut] Duzce Univ, Sch Med, Dept Infect Dis & Clin Microbiol, Duzce, Turkey -- [Altun, Begin -- Unal, Serhat] Hacettepe Univ Ankara, Fac Med, Dept Med, Infect Dis Unit, Ankara, Turkey, Leblebicioglu, Hakan -- 0000-0002-6033-8543, UNAL, SERHAT -- 0000-0003-1184-4711, Candevir, Aslihan -- 0000-0001-9340-516X, Tufan, Zeliha Kocak -- 0000-0002-3294-014X, Gungor, Gokay -- 0000-0003-2294-489X, Elaldi, Nazif -- 0000-0002-9515-770X, Karabay, Oguz -- 0000-0003-0502-432X, Ersoy, Yasemin -- 0000-0001-5730-6682, Dizbay, Murat -- 0000-0003-4120-0781, Erdem, H, Dizbay, M, Karabey, S, Kaya, S, Demirdal, T, Koksal, I, Inan, A, Erayman, I, Ak, O, Ulu-Kilic, A, Karasahin, O, Akbulut, A, Elaldi, N, Yilmaz, G, Candevir, A, Gul, HC, Gonen, I, Oncul, O, Aslan, T, Azak, E, Tekin, R, Tufan, ZK, Yenilmez, E, Arda, Sakarya Üniversitesi/Tıp Fakültesi/Dahili Tıp Bilimleri Bölümü, Karabay, Oğuz, Akbulut Uludağ, Ahsen, Zonguldak Bülent Ecevit Üniversitesi, Ondokuz Mayıs Üniversitesi, Arda, B, Gungor, G, Cetin, B, Kose, S, Turan, H, Akalin, H, Karabay, O, Dogan-Celik, A, Albayrak, A, Guven, T, Celebi, G, Ozgunes, N, Ersoy, Y, Sirmatel, F, Oztoprak, N, Balkan, II, Bayazit, FN, Ucmak, H, Oncu, S, Ozdemir, D, Ozturk-Engin, D, Bitirgen, M, Tabak, F, Akata, F, Willke, A, Gorenek, L, Ahmed, SS, Tasova, Y, Ulcay, A, Dayan, S, Esen, S, Leblebicioglu, H, Altun, B, Unal, S, and Çukurova Üniversitesi

Subjects
Staphylococcus aureus, medicine.medical_specialty, Pediatrics, Turkey, Epidemiology, health care facilities, manpower, and services, Staphylococcus, education, Staphylococcal infections, medicine.disease_cause, Tertiary Care Centers, Intensive care, health services administration, medicine, Humans, Retrospective Studies, Cross Infection, biology, business.industry, Health Policy, Incidence (epidemiology), Incidence, Public Health, Environmental and Occupational Health, Retrospective cohort study, Staphylococcal Infections, Acinetobacter, medicine.disease, biology.organism_classification, Critical, Intensive Care Units, Infectious Diseases, Emergency medicine, Staphylococcus aureus infections, business
Abstract

WOS: 000326241700021, PubMed ID: 23663858, Background: In the past, Staphylococcus aureus infections have displayed various patterns of epidemiologic curves in hospitals, particularly in intensive care units (ICUs). This study aimed to characterize the current trend in a nationwide survey of ICUs in Turkey. Methods: A total of 88 ICUs from 36 Turkish tertiary hospitals were included in this retrospective study, which was performed during the first 3 months of both 2008 (period [P] 1) and 2011 (P2). A P value

Published
2013

46. Examining the impact of a 9-component bundle and the INICC multidimensional approach on catheter-associated urinary tract infection rates in 32 countries across Asia, Eastern Europe, Latin America, and the Middle East.

Author

Rosenthal VD, Yin R, Jin Z, Perez V, Kis MA, Abdulaziz-Alkhawaja S, Valderrama-Beltran SL, Gomez K, Rodas CMH, El-Sisi A, Sahu S, Kharbanda M, Rodrigues C, Myatra SN, Chawla R, Sandhu K, Mehta Y, Rajhans P, Arjun R, Tai CW, Bhakta A, Mat Nor MB, Aguirre-Avalos G, Sassoe-Gonzalez A, Bat-Erdene I, Acharya SP, Aguilar-de-Moros D, Carreazo NY, Duszynska W, Hlinkova S, Yildizdas D, Kılıc EK, Dursun O, Odek C, Deniz SSO, Guclu E, Koksal I, Medeiros EA, Petrov MM, Tao L, Salgado E, Dueñas L, Daboor MA, Raka L, Omar AA, Ikram A, Horhat-Florin G, Memish ZA, and Brown EC

Subjects
Humans, Asia epidemiology, Latin America epidemiology, Middle East epidemiology, Male, Female, Europe, Eastern epidemiology, Infection Control methods, Middle Aged, Cross Infection prevention & control, Cross Infection epidemiology, Aged, Catheter-Related Infections epidemiology, Catheter-Related Infections prevention & control, Urinary Tract Infections epidemiology, Urinary Tract Infections prevention & control, Intensive Care Units
Abstract

Background: Catheter-Associated Urinary Tract Infections (CAUTIs) frequently occur in the intensive care unit (ICU) and are correlated with a significant burden., Methods: We implemented a strategy involving a 9-element bundle, education, surveillance of CAUTI rates and clinical outcomes, monitoring compliance with bundle components, feedback of CAUTI rates and performance feedback. This was executed in 299 ICUs across 32 low- and middle-income countries. The dependent variable was CAUTI per 1,000 UC days, assessed at baseline and throughout the intervention, in the second month, third month, 4 to 15 months, 16 to 27 months, and 28 to 39 months. Comparisons were made using a 2-sample t test, and the exposure-outcome relationship was explored using a generalized linear mixed model with a Poisson distribution., Results: Over the course of 978,364 patient days, 150,258 patients utilized 652,053 UC-days. The rates of CAUTI per 1,000 UC days were measured. The rates decreased from 14.89 during the baseline period to 5.51 in the second month (risk ratio [RR] = 0.37; 95% confidence interval [CI] = 0.34-0.39; P < .001), 3.79 in the third month (RR = 0.25; 95% CI = 0.23-0.28; P < .001), 2.98 in the 4 to 15 months (RR = 0.21; 95% CI = 0.18-0.22; P < .001), 1.86 in the 16 to 27 months (RR = 0.12; 95% CI = 0.11-0.14; P < .001), and 1.71 in the 28 to 39 months (RR = 0.11; 95% CI = 0.09-0.13; P < .001)., Conclusions: Our intervention, without substantial costs or additional staffing, achieved an 89% reduction in CAUTI incidence in ICUs across 32 countries, demonstrating feasibility in ICUs of low- and middle-income countries., (Copyright © 2024 Association for Professionals in Infection Control and Epidemiology, Inc. Published by Elsevier Inc. All rights reserved.)

Published
2024
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47. Incidence and risk factors for catheter-associated urinary tract infection in 623 intensive care units throughout 37 Asian, African, Eastern European, Latin American, and Middle Eastern nations: A multinational prospective research of INICC.

Author

Rosenthal VD, Yin R, Brown EC, Lee BH, Rodrigues C, Myatra SN, Kharbanda M, Rajhans P, Mehta Y, Todi SK, Basu S, Sahu S, Mishra SB, Chawla R, Nair PK, Arjun R, Singla D, Sandhu K, Palaniswamy V, Bhakta A, Nor MM, Chian-Wern T, Bat-Erdene I, Acharya SP, Ikram A, Tumu N, Tao L, Alvarez GA, Valderrama-Beltran SL, Jiménez-Alvarez LF, Henao-Rodas CM, Gomez K, Aguilar-Moreno LA, Cano-Medina YA, Zuniga-Chavarria MA, Aguirre-Avalos G, Sassoe-Gonzalez A, Aleman-Bocanegra MC, Hernandez-Chena BE, Villegas-Mota MI, Aguilar-de-Moros D, Castañeda-Sabogal A, Medeiros EA, Dueñas L, Carreazo NY, Salgado E, Abdulaziz-Alkhawaja S, Agha HM, El-Kholy AA, Daboor MA, Guclu E, Dursun O, Koksal I, Havan M, Ozturk-Deniz SS, Yildizdas D, Okulu E, Omar AA, Memish ZA, Janc J, Hlinkova S, Duszynska W, Horhat-Florin G, Raka L, Petrov MM, and Jin Z

Subjects
Humans, Catheters, Hospitals, Public, Incidence, Intensive Care Units, Prospective Studies, Catheter-Related Infections epidemiology, Cross Infection prevention & control, Urinary Tract Infections epidemiology
Abstract

Objective: To identify urinary catheter (UC)-associated urinary tract infection (CAUTI) incidence and risk factors., Design: A prospective cohort study., Setting: The study was conducted across 623 ICUs of 224 hospitals in 114 cities in 37 African, Asian, Eastern European, Latin American, and Middle Eastern countries., Participants: The study included 169,036 patients, hospitalized for 1,166,593 patient days., Methods: Data collection took place from January 1, 2014, to February 12, 2022. We identified CAUTI rates per 1,000 UC days and UC device utilization (DU) ratios stratified by country, by ICU type, by facility ownership type, by World Bank country classification by income level, and by UC type. To estimate CAUTI risk factors, we analyzed 11 variables using multiple logistic regression., Results: Participant patients acquired 2,010 CAUTIs. The pooled CAUTI rate was 2.83 per 1,000 UC days. The highest CAUTI rate was associated with the use of suprapubic catheters (3.93 CAUTIs per 1,000 UC days); with patients hospitalized in Eastern Europe (14.03) and in Asia (6.28); with patients hospitalized in trauma (7.97), neurologic (6.28), and neurosurgical ICUs (4.95); with patients hospitalized in lower-middle-income countries (3.05); and with patients in public hospitals (5.89).The following variables were independently associated with CAUTI: Age (adjusted odds ratio [aOR], 1.01; P < .0001), female sex (aOR, 1.39; P < .0001), length of stay (LOS) before CAUTI-acquisition (aOR, 1.05; P < .0001), UC DU ratio (aOR, 1.09; P < .0001), public facilities (aOR, 2.24; P < .0001), and neurologic ICUs (aOR, 11.49; P < .0001)., Conclusions: CAUTI rates are higher in patients with suprapubic catheters, in middle-income countries, in public hospitals, in trauma and neurologic ICUs, and in Eastern European and Asian facilities.Based on findings regarding risk factors for CAUTI, focus on reducing LOS and UC utilization is warranted, as well as implementing evidence-based CAUTI-prevention recommendations.

Published
2024
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48. Adult vaccination in three Eastern Mediterranean countries: current status, challenges and the way forward.

Author

Koksal I, Al Awaidy S, Assiri AM, Ozudogru O, Khalaf M, Yeşiloğlu C, and Badur S

Subjects
Humans, Aged, Vaccination Coverage statistics & numerical data, Pneumococcal Vaccines administration & dosage, Vaccination Hesitancy statistics & numerical data, Saudi Arabia epidemiology, United Arab Emirates, Adult, Vaccine-Preventable Diseases prevention & control, Vaccine-Preventable Diseases epidemiology, Herpes Zoster Vaccine administration & dosage, Herpes Zoster Vaccine immunology, Influenza, Human prevention & control, Vaccination statistics & numerical data, Vaccination trends, Influenza Vaccines administration & dosage
Abstract

Introduction: Changing population demographics places a premium on optimizing older adult health. Vaccine-preventable diseases represent a substantial clinical and economic burden in older adults (≥65 years)., Areas Covered: This narrative review summarizes the adult immunization landscape in three countries; Saudi Arabia, the United Arab Emirates and Türkiye, informed by literature searches; PubMed (23-27 September 2023) supplemented by citation tracking via Google Scholar). Existing vaccination recommendations and published data were reviewed to evaluate vaccine uptake, chiefly focusing on core adult vaccines (seasonal influenza, pneumococcal, and herpes zoster). Barriers to vaccine access and uptake were reviewed, and initiatives to improve recommended vaccine uptake in older (≥65 years) or otherwise high-risk adults are described., Expert Opinion: Uptake of recommended adult vaccines is low in all three countries. Receipt of annual seasonal influenza vaccine is typically below 50% in both older and at-risk younger adults; pneumococcal vaccination rates are even lower in eligible adults (<15% and often far lower), as is herpes zoster vaccine uptake (typically <5%). Low coverage is driven chiefly by low awareness of vaccine benefits, inconsistent recommendations, and vaccine hesitancy, together with often complex adult vaccine access pathways. Initiatives and remedies aimed at augmenting adult vaccination rates are warranted.

Published
2024
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49. Prospective Cohort Study of Incidence and Risk Factors for Catheter-associated Urinary Tract Infections in 212 Intensive Care Units of Nine Middle Eastern Countries.

Author

Jin Z, Yin R, Brown EC, Shukla B, Lee BH, Abdulaziz-Alkhawaja S, Magray TA, Agha HM, El-Sisi A, Ali El-Kholy A, Bayani V, Daboor MA, Ruzzieh MAA, Guclu E, Olmez-Gazioglu E, Dursun O, Kara TT, Koksal I, Eroglu A, Havan M, Kendirli T, Ozturk Deniz SS, Aktas G, Yildizdas D, Horoz OO, Okulu E, Kostekci YE, Omar AA, Memish ZA, and Rosenthal VD

Abstract

Objectives: To identify urinary catheter (UC)-associated urinary tract infections (CAUTI) incidence and risk factors (RF) in nine Middle Eastern countries., Methods: We conducted a prospective cohort study between 1 January 2014 and 2 December 2022 in 212 intensive care units (ICUs) of 67 hospitals in 38 cities in nine Middle Eastern countries (Bahrain, Egypt, Jordan, Kuwait, Lebanon, Morocco, Saudi Arabia, Turkey, and the UAE). To estimate CAUTI incidence, we used the number of UC days as denominator and the number of CAUTIs as numerator. To estimate CAUTI RFs, we analyzed the following 10 variables using multiple logistic regression: patient sex, age, length of stay (LOS) before CAUTI acquisition, UC-days before CAUTI acquisition, UC-device utilization (DU) ratio, hospitalization type, ICU type, facility-ownership, country income level classified by World Bank, and time period., Results: Among 50 637 patients hospitalized for 434 523 patient days, there were 580 cases of acquired CAUTIs. The pooled CAUTI rate per 1000 UC days was 1.84. The following variables were independently associated with CAUTI: age, rising risk 1.0% yearly (adjusted odds ratio [aOR] = 1.01, 95% CI: 1.01-1.02; p < 0.0001); female sex (aOR = 1.31, 95% CI: 1.09-1.56; p < 0.0001); LOS before CAUTI acquisition, rising risk 6.0% daily (aOR = 1.06, 95% CI: 1.05-1.06; p < 0.0001); and UC/DU ratio (aOR = 1.11, 95% CI: 1.06-1.14; p < 0.0001). Patients from lower-middle-income countries (aOR = 4.11, 95% CI: 2.49-6.76; p < 0.0001) had a similar CAUTI risk to the upper-middle countries (aOR = 3.75, 95% CI: 1.83-7.68; p < 0.0001). The type of ICU with the highest risk for CAUTI was neurologic ICU (aOR = 27.35, 95% CI: 23.03-33.12; p < 0.0001), followed by medical ICU (aOR = 6.18, 95% CI: 2.07-18.53; p < 0.0001) when compared to cardiothoracic ICU. The periods 2014-2016 (aOR = 7.36, 95% CI: 5.48-23.96; p < 0.001) and 2017-2019 (aOR = 1.15, 95% CI: 3.46-15.61; p < 0.001) had a similar risk to each other, but a higher risk compared to 2020-2022., Conclusions: The following CAUTI RFs are unlikely to change: age, sex, ICU type, and country income level. Based on these findings, it is suggested to focus on reducing LOS, UC/DU ratio, and implementing evidence-based CAUTI prevention recommendations., (Copyright © 2023, Oman Medical Journal.)

Published
2023
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50. Structural characterization of protective non-neutralizing antibodies targeting Crimean-Congo hemorrhagic fever virus.

Author

Durie IA, Tehrani ZR, Karaaslan E, Sorvillo TE, McGuire J, Golden JW, Welch SR, Kainulainen MH, Harmon JR, Mousa JJ, Gonzalez D, Enos S, Koksal I, Yilmaz G, Karakoc HN, Hamidi S, Albay C, Spengler JR, Spiropoulou CF, Garrison AR, Sajadi MM, Bergeron É, and Pegan SD

Subjects
Mice, Humans, Animals, Antibodies, Neutralizing, Antibodies, Viral, Epitopes, Antibodies, Monoclonal, Hemorrhagic Fever Virus, Crimean-Congo chemistry, Hemorrhagic Fever, Crimean prevention & control
Abstract

Crimean-Congo Hemorrhagic Fever Virus (CCHFV) causes a life-threatening disease with up to a 40% mortality rate. With no approved medical countermeasures, CCHFV is considered a public health priority agent. The non-neutralizing mouse monoclonal antibody (mAb) 13G8 targets CCHFV glycoprotein GP38 and protects mice from lethal CCHFV challenge when administered prophylactically or therapeutically. Here, we reveal the structures of GP38 bound with a human chimeric 13G8 mAb and a newly isolated CC5-17 mAb from a human survivor. These mAbs bind overlapping epitopes with a shifted angle. The broad-spectrum potential of c13G8 and CC5-17 and the practicality of using them against Aigai virus, a closely related nairovirus were examined. Binding studies demonstrate that the presence of non-conserved amino acids in Aigai virus corresponding region prevent CCHFV mAbs from binding Aigai virus GP38. This information, coupled with in vivo efficacy, paves the way for future mAb therapeutics effective against a wide swath of CCHFV strains., (© 2022. The Author(s).)

Published
2022
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