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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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11. Antimicrobial de-escalation in the critically ill patient and assessment of clinical cure: the DIANA study

Author

De Bus, L., Depuydt, P., Steen, J., Dhaese, S., De Smet, K., Tabah, A., Akova, M., Cotta, M. O., De Pascale, Gennaro, Dimopoulos, G., Fujitani, S., Garnacho-Montero, J., Leone, M., Lipman, J., Ostermann, M., Paiva, J. -A., Schouten, J., Sjovall, F., Timsit, J. -F., Roberts, J. A., Zahar, J. -R., Zand, F., Zirpe, K., De Waele, J. J., Rios, F., Vazquez, A. R., Vidal, M. G., Zakalik, G., Attokaran, A. G., Banakh, I., Dey-Chatterjee, S., Ewan, J., Ferrier, J., Forbes, L., Fourie, C., Leditschke, A., Murray, L., Eller, P., Biston, P., Bracke, S., De Crop, L., De Schryver, N., Frans, E., Spapen, H., Van Malderen, C., Vansteelandt, S., Vermeiren, D., Arevalo, E. P., Crespo, M., Flores, R. Z., Piza, P., Tutillo, D. M., Elme, A., Kallaste, A., Starkopf, J., Bourenne, J., Calypso, M., Cohen, Y., Dahyot-Fizelier, C., Depret, F., Guillot, M., Imzi, N., Jochmans, S., Kouatchet, A., Lepape, A., Martin, O., Heim, M., Schaller, S. J., Arvaniti, K., Bekridelis, A., Ioannidis, P., Mitrakos, C., Papanikolaou, M. N., Pouriki, S., Vemvetsou, A., Abraham, B., Bhattacharya, P. K., Budugu, A., Dixit, S., Gurav, S., Kandanuri, P., Prabhu, D. A., Rathod, D., Savaru, K., Udupa, A. N., Varghese, S. B., Bakhodaei, H. H., Dabiri, G., Fallahi, M. J., Feiz, F., Firoozifar, M., Khaloo, V., Maghsudi, B., Masjedi, M., Nikandish, R., Sabetian, G., Marsh, B., Martin-Loeches, I., Steiner, J., Barbagallo, M., Caricato, Anselmo, Cortegiani, A., D'Andrea, R., Deana, C., Donati, A., Girardis, M., Mandala, G., Panarello, G., Pasero, D., Pelagalli, L., Soave, Paolo Maurizio, Spadaro, S., Fujita, Y., Fujiwara, S., Hara, Y., Hashi, H., Hashimoto, S., Hashimoto, H., Hayakawa, K., Inoue, M., Isokawa, S., Kameda, S., Kamohara, H., Kanamoto, M., Katayama, S., Kawagishi, T., Kawano, Y., Kida, Y., Kita, M., Kobayashi, A., Kuriyama, A., Naito, T., Nashiki, H., Nishiyama, K., Shindo, S., Suzuki, T., Takaba, A., Tanaka, C., Tetsuya, K., Tomioka, Y., Yanagawa, Y., Yoshida, H., Adnan, S., Hasan, M. S., Sulaiman, H., Gasca Lopez, G. A., Hernandez-Cardenas, C. M., Namendys-Silva, S. A., Bethlehem, C., de Lange, D., Hunfeld, N., Numan, S., van Leeuwen, H., Owens, D., Almeida, M., Fragoso, E., Leonor, T., Pereira, J. -M., Filipescu, D., Grigoras, I., Popescu, M., Tomescu, D., Alshahrani, M. S., Alvarez-Gonzalez, M., Barrero-Garcia, I., Blasco-Navalpotro, M. A., Claverias, L., Estella, A., Espina, L. F., Garmendia, J. L. G., Prieto, E. G., Gomez-Prieto, G., Conde, C. J., Sagasti, F. M., Cantero, A. M., Orejas-Gallego, A., Papiol, E., Perez-Civantos, D., Laderas, J. C. P., Alvarez, J. T., Vera-Artazcoz, P., Cortes, P. V., Oldner, A., Spangfors, M., Alp, E., Koksal, I., Korten, V., Ozveren, A., Hall, A., Hatton, K. W., Laudanski, K., De Pascale G. (ORCID:0000-0002-8255-0676), Caricato A. (ORCID:0000-0001-5929-120X), Soave P. M., De Bus, L., Depuydt, P., Steen, J., Dhaese, S., De Smet, K., Tabah, A., Akova, M., Cotta, M. O., De Pascale, Gennaro, Dimopoulos, G., Fujitani, S., Garnacho-Montero, J., Leone, M., Lipman, J., Ostermann, M., Paiva, J. -A., Schouten, J., Sjovall, F., Timsit, J. -F., Roberts, J. A., Zahar, J. -R., Zand, F., Zirpe, K., De Waele, J. J., Rios, F., Vazquez, A. R., Vidal, M. G., Zakalik, G., Attokaran, A. G., Banakh, I., Dey-Chatterjee, S., Ewan, J., Ferrier, J., Forbes, L., Fourie, C., Leditschke, A., Murray, L., Eller, P., Biston, P., Bracke, S., De Crop, L., De Schryver, N., Frans, E., Spapen, H., Van Malderen, C., Vansteelandt, S., Vermeiren, D., Arevalo, E. P., Crespo, M., Flores, R. Z., Piza, P., Tutillo, D. M., Elme, A., Kallaste, A., Starkopf, J., Bourenne, J., Calypso, M., Cohen, Y., Dahyot-Fizelier, C., Depret, F., Guillot, M., Imzi, N., Jochmans, S., Kouatchet, A., Lepape, A., Martin, O., Heim, M., Schaller, S. J., Arvaniti, K., Bekridelis, A., Ioannidis, P., Mitrakos, C., Papanikolaou, M. N., Pouriki, S., Vemvetsou, A., Abraham, B., Bhattacharya, P. K., Budugu, A., Dixit, S., Gurav, S., Kandanuri, P., Prabhu, D. A., Rathod, D., Savaru, K., Udupa, A. N., Varghese, S. B., Bakhodaei, H. H., Dabiri, G., Fallahi, M. J., Feiz, F., Firoozifar, M., Khaloo, V., Maghsudi, B., Masjedi, M., Nikandish, R., Sabetian, G., Marsh, B., Martin-Loeches, I., Steiner, J., Barbagallo, M., Caricato, Anselmo, Cortegiani, A., D'Andrea, R., Deana, C., Donati, A., Girardis, M., Mandala, G., Panarello, G., Pasero, D., Pelagalli, L., Soave, Paolo Maurizio, Spadaro, S., Fujita, Y., Fujiwara, S., Hara, Y., Hashi, H., Hashimoto, S., Hashimoto, H., Hayakawa, K., Inoue, M., Isokawa, S., Kameda, S., Kamohara, H., Kanamoto, M., Katayama, S., Kawagishi, T., Kawano, Y., Kida, Y., Kita, M., Kobayashi, A., Kuriyama, A., Naito, T., Nashiki, H., Nishiyama, K., Shindo, S., Suzuki, T., Takaba, A., Tanaka, C., Tetsuya, K., Tomioka, Y., Yanagawa, Y., Yoshida, H., Adnan, S., Hasan, M. S., Sulaiman, H., Gasca Lopez, G. A., Hernandez-Cardenas, C. M., Namendys-Silva, S. A., Bethlehem, C., de Lange, D., Hunfeld, N., Numan, S., van Leeuwen, H., Owens, D., Almeida, M., Fragoso, E., Leonor, T., Pereira, J. -M., Filipescu, D., Grigoras, I., Popescu, M., Tomescu, D., Alshahrani, M. S., Alvarez-Gonzalez, M., Barrero-Garcia, I., Blasco-Navalpotro, M. A., Claverias, L., Estella, A., Espina, L. F., Garmendia, J. L. G., Prieto, E. G., Gomez-Prieto, G., Conde, C. J., Sagasti, F. M., Cantero, A. M., Orejas-Gallego, A., Papiol, E., Perez-Civantos, D., Laderas, J. C. P., Alvarez, J. T., Vera-Artazcoz, P., Cortes, P. V., Oldner, A., Spangfors, M., Alp, E., Koksal, I., Korten, V., Ozveren, A., Hall, A., Hatton, K. W., Laudanski, K., De Pascale G. (ORCID:0000-0002-8255-0676), Caricato A. (ORCID:0000-0001-5929-120X), and Soave P. M.

Abstract

Purpose: The DIANA study aimed to evaluate how often antimicrobial de-escalation (ADE) of empirical treatment is performed in the intensive care unit (ICU) and to estimate the effect of ADE on clinical cure on day 7 following treatment initiation. Methods: Adult ICU patients receiving empirical antimicrobial therapy for bacterial infection were studied in a prospective observational study from October 2016 until May 2018. ADE was defined as (1) discontinuation of an antimicrobial in case of empirical combination therapy or (2) replacement of an antimicrobial with the intention to narrow the antimicrobial spectrum, within the first 3 days of therapy. Inverse probability (IP) weighting was used to account for time-varying confounding when estimating the effect of ADE on clinical cure. Results: Overall, 1495 patients from 152 ICUs in 28 countries were studied. Combination therapy was prescribed in 50%, and carbapenems were prescribed in 26% of patients. Empirical therapy underwent ADE, no change and change other than ADE within the first 3 days in 16%, 63% and 22%, respectively. Unadjusted mortality at day 28 was 15.8% in the ADE cohort and 19.4% in patients with no change [p = 0.27; RR 0.83 (95% CI 0.60–1.14)]. The IP-weighted relative risk estimate for clinical cure comparing ADE with no-ADE patients (no change or change other than ADE) was 1.37 (95% CI 1.14–1.64). Conclusion: ADE was infrequently applied in critically ill-infected patients. The observational effect estimate on clinical cure suggested no deleterious impact of ADE compared to no-ADE. However, residual confounding is likely.

Published
2020

14. 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

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

Published
2018
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16. Acute hepatitis B virus infection in Turkey: epidemiology and genotype distribution

Author

Tasova, Y, Kilic, D, Kaygusuz, S, Leblebicioglu, H, Eroglu, C, Aribas, E, Sirmatel, F, Ayaz, C, Ozsoy, MF, Cavuslu, S, Turkyilmaz, R, Tutuncu, E, Sunbul, M, Esen, S, Turan, D, Akbulut, A, Cihangiroglu, M, Aygen, B, Usluer, G, Kartal, ED, Irmak, H, Evirgen, O, Tulek, N, Yetkin, MA, Dokmetas, I, Bakir, M, Yildiz, ORHAN, Sencan, I, Yamazhan, T, Ulusoy, S, Akcam, Z, Yayli, G, Ersoz, G, Kaya, A, Saltoglu, N, Ersoy, Y, Ozgenc, O, Parlak, M, Parlak, E, Koksal, I, Caylan, R, and OMÜ

Subjects
Adult, Male, Microbiology (medical), Hepatitis B virus, HBsAg, Genotype, Turkey, genotype, viral hepatitis, medicine.disease_cause, Polymerase Chain Reaction, Orthohepadnavirus, Prevalence, medicine, Humans, Hepatitis B e Antigens, Fulminant hepatitis, biology, business.industry, Acute infection, General Medicine, hepatitis D virus, Middle Aged, Hepatitis B, medicine.disease, biology.organism_classification, Virology, Infectious Diseases, Acute Disease, DNA, Viral, Female, Hepatitis D virus, business, Viral hepatitis, acute infection, hepatitis B virus, Polymorphism, Restriction Fragment Length
Abstract

42nd Interscience Conference on Antimicrobial Agents and Chemotherapy -- SEP 26-30, 2002 -- SAN DIEGO, CA Saltoglu, Nese/0000-0003-4239-9585; Leblebicioglu, Hakan/0000-0002-6033-8543; dokmetas, ilyas/0000-0003-3523-3923; Ersoy, Yasemin/0000-0001-5730-6682 WOS: 000221932100007 PubMed: 15191382 The aim of this study was to investigate the prevalence of hepatitis B virus (HBV) genotypes in Turkey. Epidemiological and clinical data for 158 patients with acute HBV infection from 22 medical centres in the period February 2001 to February 2002 were collected prospectively. HBV genotyping was based on analysis of restriction fragment length polymorphisms and nested PCR. There were 59 female and 99 male patients, with a mean age of 34.2 +/- 15.6 years. The most common probable transmission route was blood contact in 63 (41.1%) cases, but was unknown in 78 (49.4%) cases. The mean alanine aminotransferase level was 1718 +/- 1089 IU/L. Four of the 158 patients (2.5%) died because of fulminant hepatitis. One year after discharge, 11 (10.6%) of 103 cases were positive for hepatitis B surface antigen (HBsAg) and 80 (77.7%) were positive for anti-HBsAg. Genotype determination was unsuccessful in 11 cases because of a negative PCR; genotype D was found in the remaining 147 cases. The results suggested that acute HBV infection constitutes a significant health problem in Turkey and that genotype D is predominant.

Published
2004
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17. 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

18. 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

19. 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

21. 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

22. 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

23. 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

24. 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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26. 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

27. 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

29. 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

34. The Demographic Aspects of Turkish Chronic Hepatitis C Patients And The Treatment Initiation From A Physician’s & Patient’s Point of View. First Interim Analysis of Turkish Data From Mosaic Study (An International Multicenter Prospective Observational Study To Evaluate The Epidemiology, Humanistic And Economic Outcomes Oftreatment for Chronic Hepatitis C Virus)

Author

Koksal, I, primary, Aladag, M, additional, Koklu, S, additional, and Sezgin, O, additional

Published
2015
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36. 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

38. 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

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