Search

Aims: Catheter-related bloodstream infections are important causes of mortality and morbidity. In this study, it was aimed to retrospectively determine the distribution of bacterial factors isolated from intra-catheter blood culture and antibiotic susceptibility rates of patients diagnosed with catheter infection in the intensive care unit of XXXXXXX Training and Research Hospital, Cardiovascular Surgery and Neurosurgery. Methods: In the intensive care unit of XXXXXXX Training and Research Hospital, Cardiovascular Surgery, and Neurosurgery, 79 bacteria isolated from intra-catheter blood cultures of patients diagnosed with catheter infection between January 1, 2021, and December 31, 2022, were included in the study.Antibiotic susceptibility of the factors reproducing in catheter blood culture was obtained from the hospital information system. Antibiotic susceptibilities of bacteria isolated from intra-catheter culture were determined by the disc diffusion method or VITEK-2 automated system. Results: The frequency of factors reproducing from intra-catheter blood culture of patients hospitalized in the intensive care unit of cardiovascular surgery and neurosurgery were Enterococcus spp., Klebsiella pneumoniae, Staphylococcus epidermidis, and Escherichia. coli retrospectively. Klebsiella pneumoniae isolates from intra-catheter blood cultures were resistant to ceftriaxone 75%, piperacillin-tazobactam 25%, amikacin 6.25%, but not to imipenem and meropenem. Antibiotic resistance rates of Staphylococcus aureus isolates isolated from intra-catheter blood cultures were as follows: 100% with penicillin, no resistance to vancomycin. In Escherichia coliisolate isolated from intra-catheter blood cultures, resistance to ceftriaxone was 6.3%, to piperacillin-tazobactam, 12.5%, to imipenem and meropenem, 16.6%, but not to amikacin. Acinetobacter baumanniiisolates isolated from intra-catheter blood culture showed 100% resistance to ceftriaxone, 100% to piperacillin-tazobactam, 85.7% to imipenem, 83.3% to meropenem, and no resistance to amikacin. In the Stenotrophomonas maltophilia isolatesisolated from intra-catheter blood culture, resistance to ceftriaxone, piperacillin-tazobactam, imipenem and meropenem was 100% and levofloxacin was 25%, while no resistance to trimethoprim/sulfamethoxazole was detected. Conclusion: Determining the antibiotic susceptibility of bacteria isolated from catheter culture will contribute to the determination of the appropriate treatment option in the empirical treatment of catheter infections in our hospital and contribute to decreasing in mortality and morbidity rates due to catheter infections.

Introduction: Corynebacterium striatum (C. striatum) is one of the most frequently reported nosocomial infection agents among patients hospitalized in intensive care units following the COVID-19 pandemic. It may cause various opportunistic infections, such as ventilator-associated pneumonia and catheter-associated bloodstream infections, in such patients. The present study attempted to investigate the antibiotic susceptibility of 14 nosocomial infection agent C. striatum strains, isolated from deep tracheal aspirate and blood culture samples of hospitalized patients, for seven different antibiotics (benzylpenicillin, ciprofloxacin, clindamycin, rifampicin, linezolid, tetracycline, and vancomycin). Material and Method: Antibiotic susceptibility of the strains for the mentioned antibiotics was determined utilizing a disk diffusion test in line with the recommendations of the European Antibiotic Susceptibility Committee (EUCAST).Results: While all the isolated C. striatum strains (100%) were resistant to benzylpenicillin, tetracycline, rifampicin, ciprofloxacin, and clindamycin, we found none of them to be resistant to vancomycin and linezolid.Conclusion: Overall, uncovering the antibiotic susceptibility of C. striatum strains isolated from clinical specimens would guide clinicians in deciding on the empirical treatment of hospital-acquired infections led by this agent.

Aim: In this study, it was aimed to determine the reproducing agents and the antibiotic susceptibility of the agents in a total of 89 urine samples cultured in Ankara Training and Research Hospital, Infectious Diseases and Clinical Microbiology laboratory during the 6-month period between 2021-2022. Material and Method: While growth was detected in urine culture in 68 (76%) of 89 urine samples taken in the study, no growth was found in 21 (24%) of them. Antibiotic susceptibility was studied on Mueller-Hinton agar by the disc diffusion method in isolates with growth in urine culture. Results: Reproducing factors are in order of frequency; 25 E. coli, 17 extended-spectrum beta-lactamase (ESBL) positive E. coli, 10 Klebsiella pneumoniae, 3 Pseudomonas aeruginosa, 3 Proteus mirabilis, 3 Enterococcus faecalis, 1 Enterobacter cloacae, 1 Candida krusei, 1 Staphylococcus aureus, 1 patient E. coli and Proteus species were determined. Resistance rates in E. coli strains isolated from urine culture; 20% (4/20) for ciprofloxacin, 5% (1/19) for nitrofurantoin, 9.5% (2/21) for trimethoprim/ sulfamethoxazole (TMP/SMZ). No resistance was found to fosfomycin 0% (0/19) and to carbapenems (imipenem, meropenem, and ertapenem) (0/21). The resistance rates in ESBL positive E. coli strains are; 100% (13/13) for ciprofloxacin, 7% (1/14) for nitrofurantoin, 12.5% (1/8) for fosfomycin, 26.6% (4/15) for TMP-SMZ. No resistance was found to carbapenems (imipenem, meropenem and ertapenem). Conclusion: In our study, it was determined that the most common infectious agent causing urinary tract infection was E. coli. In our study, it was determined that the resistance rates for ciprofloxacin and TMP-SMZ, which are used in empirical treatment, are high, and the resistance rates for fosfomycin and nitrofurantoin are low in E. coli strains that cause urinary system infection. Due to the low rates of resistance in the empirical treatment of urinary system infections, it would be a suitable approach to prefer oral treatment options such as fosfomycin and nitrofurantoin in outpatients.

Background CoronaVac, an inactivated whole-virion SARS-CoV-2 vaccine, has been shown to be well tolerated with a good safety profile in individuals aged 18 years and older in phase 1/2 trials, and provided a good humoral response against SARS-CoV-2. We present the interim efficacy and safety results of a phase 3 clinical trial of CoronaVac in Turkey. Methods This was a double-blind, randomised, placebo-controlled phase 3 trial. Volunteers aged 18-59 years with no history of COVID-19 and with negative PCR and antibody test results for SARS-CoV-2 were enrolled at 24 centres in Turkey. Exclusion criteria included (but were not limited to) immunosuppressive therapy (including steroids) within the past 6 months, bleeding disorders, asplenia, and receipt of any blood products or immunoglobulins within the past 3 months. The K1 cohort consisted of health-care workers (randomised in a 1:1 ratio), and individuals other than health-care workers were also recruited into the K2 cohort (randomised in a 2:1 ratio) using an interactive web response system. The study vaccine was 3 mu g inactivated SARS-CoV-2 virion adsorbed to aluminium hydroxide in a 0.5 mL aqueous suspension. Participants received either vaccine or placebo (consisting of all vaccine components except inactivated virus) intramuscularly on days 0 and 14. The primary efficacy outcome was the prevention of PCR-confirmed symptomatic COVID-19 at least 14 days after the second dose in the per protocol population. Safety analyses were done in the intention-to-treat population. This study is registered with ClinicalTrials.gov (NCT04582344) and is active but no longer recruiting. Findings Among 11 303 volunteers screened between Sept 14, 2020, and Jan 5, 2021, 10 218 were randomly allocated. After exclusion of four participants from the vaccine group because of protocol deviations, the intention-to-treat group consisted of 10 214 participants (6646 [65.1%] in the vaccine group and 3568 [34.9%] in the placebo group) and the per protocol group consisted of 10 029 participants (6559 [65.4%] and 3470 [34.6%]) who received two doses of vaccine or placebo. During a median follow-up period of 43 days (IQR 36-48), nine cases of PCR-confirmed symptomatic COVID-19 were reported in the vaccine group (31.7 cases [14.6-59.3] per 1000 person-years) and 32 cases were reported in the placebo group (192.3 cases [135.7-261.1] per 1000 person-years) 14 days or more after the second dose, yielding a vaccine efficacy of 83.5% (95% CI 65.4-92.1; p, TUSEB, We are grateful to all participants who volunteered to be part of this study and to all members of the clinical research teams of the participating sites. We thank TUSEB for funding the study and Omega-CRO for the statistical analyses and production of figures, and providing the study protocol. We also thank the members of the data and safety monitoring board for their contributions in the safe execution of this study.

Here, we present a case of bicipital fasciitis after intraarticular injection of the shoulder joint. Bicipital fasciitis was diagnosed using real-time ultrasonography. The infection was probably due to non-compliance with aseptic conditions. Therefore, we also want to emphasise the importance of using an aseptic technique.

Background: A crucial balance exists between oxidant and antioxidant mechanisms in the functional immune system. We aimed to evaluate the contributions of balance between these systems to coronavirus disease 2019 (COVID-19), a devastating pandemic caused by viral infection. Method: We analyzed serum oxidant and antioxidant stress parameters according to the clinical and demographic characteristics of children and adults with COVID-19 and compared them against the values of healthy controls. Serum native thiol (NT), total thiol (TT), disulfide, total antioxidant status, total oxidant status, and ischemia-modified albumin levels were evaluated and compared between groups. Results: A total of 79 children and 74 adults were evaluated in the present study, including 46 children and 40 adults with COVID-19, 33 healthy children, and 34 healthy adults. TT, NT, and disulfide levels were significantly lower in the adult COVID-19 group than in all other groups (p = 0.001, p = 0.001, and p = 0.005, respectively). Additionally, TT and NT levels were significantly lower in both pediatric and adult COVID-19 cases with severe disease course than mild/moderate course. TT and NT levels were identified as predictors for the diagnosis of the adult COVID-19 cases and as independent predictors for disease severity in both children and adults with COVID-19. Conclusion: Parameters that reveal the oxidant and antioxidant capacity, including TT and NT, appear to be good candidates for the accurate prediction of the clinical course among patients with COVID-19.

Eriskinlerde bakteriyel menenjitin en sik nedeni, Meningokok enfeksiyonuna bagli salginlar haric, S. pneumoniae’dir . S. pneumoniae’ye bagli menenjitler, sinuzit veya otit odagindan direkt yayilim veya bakteriyemiye bagli olarak gelisir. Burada, immunkompremize bir hastada, otitis media zemininden gelisen 67 yasinda erkek hastada pnomokok menenjiti sunulmustur.

Hepatitis B virus (HBV) infection is a well recognized occupational risk for the health care workers (HCWs). The aim of this study was to vaccinate our HCWs and to find out the facts that affect the compliance to the vaccination shedule. A total of 508 HCWs who were working in Ankara Teaching and Research Hospital during January 2002- April 2003 were enrolled into the study. Among 508 HCWs, 154 seronegative HCWs were included in the vaccination program; fourty-one (26.6%) were vaccinated with three-dose regimen, 113 (73.4%) with four-dose regimen. One hundred (64.9%) of the 154 HCWs completed the vaccination schedule successfully and 35.1% were noncompliant with the program. Being 30 years old or younger and working at jobs other than doctors or nurses were found significant factors that increase the compliance to vaccination program (p= 0.029 and p= 0.003 respectively). Working at jobs other than doctors or nurses was found significant too, by logistic regression analysis (p= 0.012). On the other hand, gender, vaccination dose number and the type of the department which they worked were not found assignificant factors influencing the compliance to the schedule (p> 0.05).

Peritonitis is a common clinical problem that occurs in patients with end stage renal disease treated by peritoneal dialysis. The aims of this study were to assess demographic aspects, rates of peritonitis, causative organisms, clinical outcomes and treatment approach for continuous ambulatory peritoneal dialysis (CAPD) -related peritonitis of patients undergoing CAPD. Seventy cases of peritonitis occurred in 55 patients treated in Infectious Diseases and Clinical Microbiology Department of Ankara Training and Research Hospital between May 2003 and April 2004 were enrolled into this study. Cloudiness of the peritoneal dialysis fluid and/or abdominal pain were considered suggestive of peritonitis and were confirmed by cell count and culture. The overall incidence of peritonitis was 2.46 ± 2.52 episodes/patient-year. Age, gender, education and profession of the patients have not been found as a risk factor in peritonitis attacks. The most common presentations of peritonitis included abdominal pain, cloudiness of the peritoneal dialysis fluid, nausea and vomiting. Peritoneal dialysate fluid white blood cell count was 1773 ± 1224/mm3 in 70 episodes. Cultures were positive in 51 (%72.9) peritonitis episodes; coagulase-negative staphylococci was the most common organism (%22.8), followed by Staphylococcus aureus (%21.4), 19 episodes (%27.2) had negative culture results. At the end of the study, 61 episodes of peritonitis in 55 patients were treated with intraperitoneal cefazolin and gentamicin protocol. Seven of the patients did not respond to initial therapy and the therapy was converted to intravenous protocol. Nine episodes were treated with IV antibiotics on admission for medical reasons (systemic infection and/or concurrent exit-side or tunnel infection). There were two deaths. Two catheters were removed and the patients were transferred to haemodialysis programme. Despite all technical improvements during recent decades, peritonitis and exit-side infections are still the major complication of CAPD. For the optimizing complication rates in individual centers, causative organisms and their antimicrobial susceptibilities must be known.

The automated Cepheid GeneXpert system provides rapid PCR results and can be used for the identification of VRE. We aimed to evaluate the use of the Cepheid Xpert vanA/vanB real-time PCR assay for the detection of VRE from rectal swabs of patients newly admitted to intensive care units in a hospital setting. Materials and methods: Rectal swab samples of patients newly admitted to 6 intensive care units from March 2011 to February 2012 were obtained. The specimens were analyzed by the GeneXpert system. The results were reported for both vanA and vanB as negative or positive. Results: Comparing the number of inpatients, most of the samples were delivered from the neurosurgery (48.3%), pediatrics (33.3%), and neonatology (20.6%) intensive care units. The positive samples according to GeneXpert vanA/vanB method were 33 (7.3%) among 454 rectal samples. Of these positive samples 22 (4.9%) were vanA, 10 (2.2%) were vanB, and 1 sample (0.2%) was vanA and vanB-harboring, by PCR. Conclusion: As a rapid, easy to use, and labor-saving method GeneXpert vanA/vanB can detect VRE-positive patients, particularly in risk groups, as soon as they are admitted to hospital so that infection control policies can be applied immediately.