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Aim: The purpose of this study is to evaluate risk factors for, and the relationship between, lower urinary tract symptoms (LUTS) and double J stent (DJS) colonization. Material and Methods: One hundred and thirty five patients aged 18 to 77 were included in this prospective study conducted at Urology Clinic in our university hospital between July 2012 and December 2013. Patients were followed clinically; we recorded any bothersome symptoms after treatment. Stents were removed under aseptic conditions. Their distal ends were removed and placed in a culture medium for evaluation. The relationship between colonization and LUTS was evaluated. Results: Bacteriuria and stent colonization were found in 10 (7.4%) and 35 (26%) patients, respectively. In the colonized stents, Candida spp. was the most commonly observed pathogen (40%). Mean indwelling times were different for the colonized (68.6 days) and non-colonized (46.2 days) groups. Similarly, the encrustation rate was significantly higher in colonized patients (42.8%) than in non-colonized cases (27%). In the colonized group, rates were significantly higher for irritative voiding symptoms such as polyuria (57.1% vs. 31%), nocturia (71.4% vs. 57%), and urgency (54.2% vs. 33%). Conclusions: LUTS, especially irritative voiding symptoms including polyuria and nocturia, are more frequent in patients with stent colonization. Patients at risk of stent colonization should be followed up for the development of infections, and prophylactic treatment should be administered. In addition, indwelling time may be shortened to prevent colonization. [ABSTRACT FROM AUTHOR]

Background: Although the World Health Organization (WHO) classifies Turkey as a country with a moderate-high prevalence of hepatitis B virus (HBV) infection, there is little data on HBV transmission in this country. Objectives: To identify risk factors for HBV infection, we performed a retrospective case-control study between January 2007 and December 2009. Patients and Methods: Acute HBV patients and population controls were selected, and data from these groups were analyzed by logistic regression method. Results: The study included 129 patients with acute HBV infection and 219 controls. Hemodialysis (OR:8.2, 95% CI: 4.17-16.61, p < 0.05), having an HBsAg (+) spouse (OR: 4.3, 95% CI:2.17-8.53, p < 0.05), living with an HBsAg (+) parent(s) (OR: 3.25, 95% CI:1.73-6.12, p < 0.05), and being male (OR: 1.34, 95% CI: 0.82-2.21, p < 0.05) were independent risk factors that were potentially associated with HBV infection. More than one-third of female patients had a significantly higher risk (34.5% vs. 13.5%, p < 0.05) of acquiring HBV from their sexual partners. Hemodialysis was the most frequent risk factor (46.9% vs. 20%, x² = 10.45, p < 0.05) for patients aged over 31 years, and living with HBsAg (+) parents was a significantly higher risk factor (28.8% vs. 10.2%, x² = 6.15, p < 0.05) that is more likely to lead to HBVin patients aged under 30 years. Conclusions: This study suggests that persons in Turkey who undergo hemodialysis are at high risk for acquiring HBV. Having an HBsAg (+) spouse (sexual transmission) or living with HBsAg (+) parents (household transmission) are significant risk factors for HBV transmission. Vaccination appears to be better preventive method against the spread of HBV. [ABSTRACT FROM AUTHOR]

Colistin resistance causes substantial problems in the treatment of serious infections with carbapenem-resistant (CR) gram-negative bacteria. In this study, we report a fatal hospital outbreak from the spread of a pandrug-resistant Klebsiella pneumoniae clone. An outbreak investigation was conducted after consecutive isolation of nine CR-K. pneumoniae (CR-Kp) strains from eight patients in two intensive care units of a university hospital within 2 weeks. Carbapenem and colistin resistance genes were investigated with PCR, clonal relationships of isolates were studied with pulse-field gel electrophoresis, and multilocus sequence types were determined. The outcomes of the affected patients were analyzed. Genotyping showed a predominant CR-Kp clone consisting of seven strains from six patients. These strains were in ST11 type, an international high-risk clone. They were resistant to all antimicrobials, including colistin, and positive for NDM-1 and OXA-48 carbapenemases, but negative for plasmid-borne colistin resistance genes. One patient had colonization and the remaining five died due to the infection within mean 12 days. No environmental or staff links could be established, and the outbreak was stopped by augmenting infection-control measures. Colistin-resistant K. pneumoniae could clonally expand in the hospital setting, and this spread might be associated with high mortality due to the lack of an appropriate treatment option. Immediate implementation of infection-control measures may be the best way to limit fatal consequences of the spread of such incurable pathogens. [ABSTRACT FROM AUTHOR]

A cross-sectional study was conducted to determine bacterial colonization on the mobile phones (MPs) used by patients, patients' companions, visitors, and health care workers (HCWs). Significantly higher rates of pathogens (39.6% vs 20.6%, respectively; P = .02) were found in MPs of patients' (n = 48) versus the HCWs' (n = 12). There were also more multidrug pathogens in the patents' MPs including methicillin-resistant Staphylococcus aureus, extended-spectrum β-lactamase-producing Escherichia coli, and Klebsiella spp, high-level aminoglycoside-resistant Enterococcus spp, and carabepenem-resistant Acinetobacter baumanii. Our findings suggest that mobile phones of patients, patients' companions, and visitors represent higher risk for nosocomial pathogen colonization than those of HCWs. Specific infection control measures may be required for this threat., (Copyright © 2011 Association for Professionals in Infection Control and Epidemiology, Inc. Published by Mosby, Inc. All rights reserved.)

We characterized an outbreak of acute diarrheal disease caused by group A rotavirus that occurred during the Autumn of 2005 in Malatya City, Turkey. A total 9907 patients between 0 to 91 years old (mean age: 25.05�19.67) were included in the epidemic. The patients� data were prospectively collected and statistically analyzed. Microbiologic analyses were performed to determine the etiologic agent. Rapid onset diarrhea (98.36%), abdominal cramps (69%), fever (44.4%) and vomiting (69.6%) were the most common symptoms observed in patients. Rotavirus antigen was detected in 52.7% of the studied patients. RT-PCR analysis led to identification of Group A rotavirus as the causative agent of this epidemic. Simultaneous measurements of the drinking water samples yielded very low chlorine levels; as low as 0 to 0.05 mg/L. The outbreak investigation team indicated possible contamination of a large water depository from a water well, which supplies drinking water to two major districts of the city. Effective chlorination and blockage of the passage between the well and the water depository stopped the outbreak. This outbreak shows the high epidemic potency of rotavirus in large human populations, including all age groups, and underlines the importance of water safety in pipeline systems.