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Azak E, Sertcelik A, Ersoz G, Celebi G, Eser F, Batirel A, Cag Y, Ture Z, Ozturk Engin D, Yetkin MA, Kaygusuz S, Candevir A, Tartari E, Rello J, Alp E. Evaluation of the implementation of WHO infection prevention and control core components in Turkish health care facilities: results from a WHO infection prevention and control assessment framework (IPCAF)-based survey. Antimicrob Resist Infect Control 2023; 12:11. [PMID: 36782267 PMCID: PMC9923650 DOI: 10.1186/s13756-023-01208-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2022] [Accepted: 01/21/2023] [Indexed: 02/15/2023] Open
Abstract
BACKGROUND The core components (CCs) of infection prevention and control (IPC) from World Health Organization (WHO) are crucial for the safety and quality of health care. Our objective was to examine the level of implementation of WHO infection prevention and control core components (IPC CC) in a developing country. We also aimed to evaluate health care-associated infections (HAIs) and antimicrobial resistance (AMR) in intensive care units (ICUs) in association with implemented IPC CCs. METHODS Members of the Turkish Infectious Diseases and Clinical Microbiology Specialization Association (EKMUD) were invited to the study via e-mail. Volunteer members of any healt care facilities (HCFs) participated in the study. The investigating doctor of each HCF filled out a questionnaire to collect data on IPC implementations, including the Infection Prevention and Control Assessment Framework (IPCAF) and HAIs/AMR in ICUs in 2021. RESULTS A total of 68 HCFs from seven regions in Türkiye and the Turkish Republic of Northern Cyprus participated while 85% of these were tertiary care hospitals. Fifty (73.5%) HCFs had advanced IPC level, whereas 16 (23.5%) of the 68 hospitals had intermediate IPC levels. The hospitals' median (IQR) IPCAF score was 668.8 (125.0) points. Workload, staffing and occupancy (CC7; median 70 points) and multimodal strategies (CC5; median 75 points) had the lowest scores. The limited number of nurses were the most important problems. Hospitals with a bed capacity of > 1000 beds had higher rates of HAIs. Certified IPC specialists, frequent feedback, and enough nurses reduced HAIs. The most common HAIs were central line-associated blood stream infections. Most HAIs were caused by gram negative bacteria, which have a high AMR. CONCLUSIONS Most HCFs had an advanced level of IPC implementation, for which staffing was an important driver. To further improve care quality and ensure everyone has access to safe care, it is a key element to have enough staff, the availability of certified IPC specialists, and frequent feedback. Although there is a significant decrease in HAI rates compared to previous years, HAI rates are still high and AMR is an important problem. Increasing nurses and reducing workload can prevent HAIs and AMR. Nationwide "Antibiotic Stewardship Programme" should be initiated.
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Affiliation(s)
- Emel Azak
- grid.411105.00000 0001 0691 9040Department of Infectious Diseases and Clinical Microbiology, Faculty of Medicine, Kocaeli University, Kocaeli, Türkiye
| | - Ahmet Sertcelik
- grid.14442.370000 0001 2342 7339Division of Epidemiology, Department of Public Health, Faculty of Medicine, Hacettepe University, Ankara, Türkiye
| | - Gulden Ersoz
- grid.411691.a0000 0001 0694 8546Department of Infectious Diseases and Clinical Microbiology, Faculty of Medicine, Mersin University, Mersin, Türkiye
| | - Guven Celebi
- grid.411822.c0000 0001 2033 6079Department of Infectious Diseases and Clinical Microbiology, Zonguldak Bulent Ecevit University Faculty of Medicine, Zonguldak, Türkiye
| | - Fatma Eser
- grid.449874.20000 0004 0454 9762Department of Infectious Diseases and Clinical Microbiology, Ankara Yildirim Beyazit University, Ankara, Türkiye
| | - Ayse Batirel
- grid.488643.50000 0004 5894 3909Department of Infectious Diseases and Clinical Microbiology, University of Health Sciences, Kartal Dr. Lutfi Kirdar City Hospital, Istanbul, Türkiye
| | - Yasemin Cag
- grid.411776.20000 0004 0454 921XDepartment of Infectious Diseases and Clinical Microbiology, Istanbul Medeniyet University Faculty of Medicine, Istanbul, Türkiye
| | - Zeynep Ture
- grid.411739.90000 0001 2331 2603Department of Infectious Diseases and Clinical Microbiology, Erciyes University Faculty of Medicine, Kayseri, Türkiye
| | - Derya Ozturk Engin
- grid.414850.c0000 0004 0642 8921Department of Infectious Diseases and Clinical Microbiology, Sancaktepe Sehit Prof. Dr. Ilhan Varank Training and Research Hospital, Istanbul, Türkiye
| | - Meltem Arzu Yetkin
- grid.411709.a0000 0004 0399 3319Department of Infectious Diseases and Clinical Microbiology, Giresun University Faculty of Medicine, Giresun, Türkiye
| | - Sedat Kaygusuz
- grid.411047.70000 0004 0595 9528Department of Infectious Diseases and Clinical Microbiology, Kirikkale University Faculty of Medicine, Kirikkale, Türkiye
| | - Aslıhan Candevir
- grid.98622.370000 0001 2271 3229Department of Infectious Diseases and Clinical Microbiology, Cukurova University Faculty of Medicine, Adana, Türkiye
| | - Ermira Tartari
- grid.4462.40000 0001 2176 9482Faculty of Health Sciences, University of Malta, Msida, Malta
| | - Jordi Rello
- grid.410675.10000 0001 2325 3084Catedràtic de Medicina, Universitat Internacional de Catalunya, Barcelona, Spain
| | - Emine Alp
- Department of Infectious Diseases and Clinical Microbiology, Ankara Yildirim Beyazit University, Ankara, Türkiye.
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Tabah A, Buetti N, Staiquly Q, Ruckly S, Akova M, Aslan AT, Leone M, Conway Morris A, Bassetti M, Arvaniti K, Lipman J, Ferrer R, Qiu H, Paiva JA, Povoa P, De Bus L, De Waele J, Zand F, Gurjar M, Alsisi A, Abidi K, Bracht H, Hayashi Y, Jeon K, Elhadi M, Barbier F, Timsit JF, Pollock H, Margetts B, Young M, Bhadange N, Tyler S, Ledtischke A, Finnis M, Ledtischke A, Finnis M, Dwivedi J, Saxena M, Biradar V, Soar N, Sarode V, Brewster D, Regli A, Weeda E, Ahmed S, Fourie C, Laupland K, Ramanan M, Walsham J, Meyer J, Litton E, Palermo AM, Yap T, Eroglu E, Attokaran AG, Jaramillo C, Nafees KMK, Rashid NAHA, Walid HAMI, Mon T, Moorthi PD, Sudhirchandra S, Sridharan DD, Haibo Q, Jianfeng X, Wei-Hua L, Zhen W, Qian C, Luo J, Chen X, Wang H, Zhao P, Zhao J, Wusi Q, Mingmin C, Xu L, Yin C, Wang R, Wang J, Yin Y, Zhang M, Ye J, Hu C, Zhou S, Huang M, Yan J, Wang Y, Qin B, Ye L, Weifeng X, Peije L, Geng N, Hayashi Y, Karumai T, Yamasaki M, Hashimoto S, Hosokawa K, Makino J, Matsuyoshi T, Kuriyama A, Shigemitsu H, Mishima Y, Nagashima M, Yoshida H, Fujitani S, Omori K, Rinka H, Saito H, Atobe K, Kato H, Takaki S, Hasan MS, Jamaluddin MFH, Pheng LS, Visvalingam S, Liew MT, Wong SLD, Fong KK, Rahman HBA, Noor ZM, Tong LK, Azman AH, Mazlan MZ, Ali S, Jeon K, Lee SM, Park S, Park SY, Lim SY, Goh QY, Ng SY, Lie SA, Kwa ALH, Goh KJ, Li AY, Ong CYM, Lim JY, Quah JL, Ng K, Ng LXL, Yeh YC, Chou NK, Cia CT, Hu TY, Kuo LK, Ku SC, Wongsurakiat P, Apichatbutr Y, Chiewroongroj S, Nadeem R, Houfi AE, Alsisi A, Elhadidy A, Barsoum M, Osman N, Mostafa T, Elbahnasawy M, Saber A, Aldhalia A, Elmandouh O, Elsayed A, Elbadawy MA, Awad AK, Hemead HM, Zand F, Ouhadian M, Borsi SH, Mehraban Z, Kashipazha D, Ahmadi F, Savaie M, Soltani F, Rashidi M, Baghbanian R, Javaherforoosh F, Amiri F, Kiani A, Zargar MA, Mahmoodpoor A, Aalinezhad F, Dabiri G, Sabetian G, Sarshad H, Masjedi M, Tajvidi R, Tabatabaei SMN, Ahmed AK, Singer P, Kagan I, Rigler M, Belman D, Levin P, Harara B, Diab A, Abilama F, Ibrahim R, Fares A, Buimsaedah A, Gamra M, Aqeelah A, AliAli AM, Homaidan AGS, Almiqlash B, Bilkhayr H, Bouhuwaish A, Taher AS, Abdulwahed E, Abousnina FA, Hdada AK, Jobran R, Hasan HB, Hasan RSB, Serghini I, Seddiki R, Boukatta B, Kanjaa N, Mouhssine D, Wajdi MA, Dendane T, Zeggwagh AA, Housni B, Younes O, Hachimi A, Ghannam A, Belkhadir Z, Amro S, Jayyab MA, Hssain AA, Elbuzidi A, Karic E, Lance M, Nissar S, Sallam H, Elrabi O, Almekhlafi GA, Awad M, Aljabbary A, Chaaban MK, Abu-Sayf N, Al-Jadaan M, Bakr L, Bouaziz M, Turki O, Sellami W, Centeno P, Morvillo LN, Acevedo JO, Lopez PM, Fernández R, Segura M, Aparicio DM, Alonzo MI, Nuccetelli Y, Montefiore P, Reyes LF, Reyes LF, Ñamendys-Silva SA, Romero-Gonzalez JP, Hermosillo M, Castillo RA, Leal JNP, Aguilar CG, Herrera MOG, Villafuerte MVE, Lomeli-Teran M, Dominguez-Cherit JG, Davalos-Alvarez A, Ñamendys-Silva SA, Sánchez-Hurtado L, Tejeda-Huezo B, Perez-Nieto OR, Tomas ED, De Bus L, De Waele J, Hollevoet I, Denys W, Bourgeois M, Vanderhaeghen SFM, Mesland JB, Henin P, Haentjens L, Biston P, Noel C, Layos N, Misset B, De Schryver N, Serck N, Wittebole X, De Waele E, Opdenacker G, Kovacevic P, Zlojutro B, Custovic A, Filipovic-Grcic I, Radonic R, Brajkovic AV, Persec J, Sakan S, Nikolic M, Lasic H, Leone M, Arbelot C, Timsit JF, Patrier J, Zappela N, Montravers P, Dulac T, Castanera J, Auchabie J, Le Meur A, Marchalot A, Beuzelin M, Massri A, Guesdon C, Escudier E, Mateu P, Rosman J, Leroy O, Alfandari S, Nica A, Souweine B, Coupez E, Duburcq T, Kipnis E, Bortolotti P, Le Souhaitier M, Mira JP, Garcon P, Duprey M, Thyrault M, Paulet R, Philippart F, Tran M, Bruel C, Weiss E, Janny S, Foucrier A, Perrigault PF, Djanikian F, Barbier F, Gainnier M, Bourenne J, Louis G, Smonig R, Argaud L, Baudry T, Dessap AM, Razazi K, Kalfon P, Badre G, Larcher R, Lefrant JY, Roger C, Sarton B, Silva S, Demeret S, Le Guennec L, Siami S, Aparicio C, Voiriot G, Fartoukh M, Dahyot-Fizelier C, Imzi N, Klouche K, Bracht H, Hoheisen S, Bloos F, 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Cotoia A, Rizzo AC, Mikstacki A, Tamowicz B, Komorowska IK, Szczesniak A, Bojko J, Kotkowska A, Walczak-Wieteska P, Wasowska D, Nowakowski T, Broda H, Peichota M, Pietraszek-Grzywaczewska I, Martin-Loeches I, Bisanti A, Cartoze N, Pereira T, Guimarães N, Alves M, Marques AJP, Pinto AR, Krystopchuk A, Teresa A, de Figueiredo AMP, Botelho I, Duarte T, Costa V, Cunha RP, Molinos E, da Costa T, Ledo S, Queiró J, Pascoalinho D, Nunes C, Moura JP, Pereira É, Mendes AC, Valeanu L, Bubenek-Turconi S, Grintescu IM, Cobilinschi C, Filipescu DC, Predoi CE, Tomescu D, Popescu M, Marcu A, Grigoras I, Lungu O, Gritsan A, Anderzhanova A, Meleshkina Y, Magomedov M, Zubareva N, Tribulev M, Gaigolnik D, Eremenko A, Vistovskaya N, Chukina M, Belskiy V, Furman M, Rocca RF, Martinez M, Casares V, Vera P, Flores M, Amerigo JA, Arnillas MPG, Bermudez RM, Armestar F, Catalan B, Roig R, Raguer L, Quesada MD, Santos ED, Gomà G, Ubeda A, Salgado DM, Espina LF, Prieto EG, Asensio DM, Rodriguez DM, Maseda E, De La Rica AS, Ayestaran JI, Novo M, Blasco-Navalpotro MA, Gallego AO, Sjövall F, Spahic D, Svensson CJ, Haney M, Edin A, Åkerlund J, De Geer L, Prazak J, Jakob S, Pagani J, Abed-Maillard S, Akova M, Aslan AT, Timuroglu A, Kocagoz S, Kusoglu H, Mehtap S, Ceyhun S, Altintas ND, Talan L, Kayaaslan B, Kalem AK, Kurt I, Telli M, Ozturk B, Erol Ç, Demiray EKD, Çolak S, Akbas T, Gundogan K, Sari A, Agalar C, Çolak O, Baykam NN, Akdogan OO, Yilmaz M, Tunay B, Cakmak R, Saltoglu N, Karaali R, Koksal I, Aksoy F, Eroglu A, Saracoglu KT, Bilir Y, Guzeldag S, Ersoz G, Evik G, Sungurtekin H, Ozgen C, Erdoğan C, Gürbüz Y, Altin N, Bayindir Y, Ersoy Y, Goksu S, Akyol A, Batirel A, Aktas SC, Morris AC, Routledge M, Morris AC, Ercole A, Antcliffe D, Rojo R, Tizard K, Faulkner M, Cowton A, Kent M, Raj A, Zormpa A, Tinaslanidis G, Khade R, Torlinski T, Mulhi R, Goyal S, Bajaj M, Soltan M, Yonan A, Dolan R, Johnson A, Macfie C, Lennard J, Templeton M, Arias SS, Franke U, Hugill K, Angell H, Parcell BJ, Cobb K, Cole S, Smith T, Graham C, Cerman J, Keegan A, Ritzema J, Sanderson A, Roshdy A, Szakmany T, Baumer T, Longbottom R, Hall D, Tatham K, Loftus S, Husain A, Black E, Jhanji S, Baikady RR, Mcguigan P, Mckee R, Kannan S, Antrolikar S, Marsden N, Torre VD, Banach D, Zaki A, Jackson M, Chikungwa M, Attwood B, Patel J, Tilley RE, Humphreys MSK, Renaud PJ, Sokhan A, Burma Y, Sligl W, Baig N, McCoshen L, Kutsogiannis DJ, Sligl W, Thompson P, Hewer T, Rabbani R, Huq SMR, Hasan R, Islam MM, Gurjar M, Baronia A, Kothari N, Sharma A, Karmakar S, Sharma P, Nimbolkar J, Samdani P, Vaidyanathan R, Rubina NA, Jain N, Pahuja M, Singh R, Shekhar S, Muzaffar SN, Ozair A, Siddiqui SS, Bose P, Datta A, Rathod D, Patel M, Renuka MK, Baby SK, Dsilva C, Chandran J, Ghosh P, Mukherjee S, Sheshala K, Misra KC, Yakubu SY, Ugwu EM, Olatosi JO, Desalu I, Asiyanbi G, Oladimeji M, Idowu O, Adeola F, Mc Cree M, Karar AAA, Saidahmed E, Hamid HKS. Epidemiology and outcomes of hospital-acquired bloodstream infections in intensive care unit patients: the EUROBACT-2 international cohort study. Intensive Care Med 2023; 49:178-190. [PMID: 36764959 PMCID: PMC9916499 DOI: 10.1007/s00134-022-06944-2] [Citation(s) in RCA: 30] [Impact Index Per Article: 30.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2022] [Accepted: 11/23/2022] [Indexed: 02/12/2023]
Abstract
PURPOSE In the critically ill, hospital-acquired bloodstream infections (HA-BSI) are associated with significant mortality. Granular data are required for optimizing management, and developing guidelines and clinical trials. METHODS We carried out a prospective international cohort study of adult patients (≥ 18 years of age) with HA-BSI treated in intensive care units (ICUs) between June 2019 and February 2021. RESULTS 2600 patients from 333 ICUs in 52 countries were included. 78% HA-BSI were ICU-acquired. Median Sequential Organ Failure Assessment (SOFA) score was 8 [IQR 5; 11] at HA-BSI diagnosis. Most frequent sources of infection included pneumonia (26.7%) and intravascular catheters (26.4%). Most frequent pathogens were Gram-negative bacteria (59.0%), predominantly Klebsiella spp. (27.9%), Acinetobacter spp. (20.3%), Escherichia coli (15.8%), and Pseudomonas spp. (14.3%). Carbapenem resistance was present in 37.8%, 84.6%, 7.4%, and 33.2%, respectively. Difficult-to-treat resistance (DTR) was present in 23.5% and pan-drug resistance in 1.5%. Antimicrobial therapy was deemed adequate within 24 h for 51.5%. Antimicrobial resistance was associated with longer delays to adequate antimicrobial therapy. Source control was needed in 52.5% but not achieved in 18.2%. Mortality was 37.1%, and only 16.1% had been discharged alive from hospital by day-28. CONCLUSIONS HA-BSI was frequently caused by Gram-negative, carbapenem-resistant and DTR pathogens. Antimicrobial resistance led to delays in adequate antimicrobial therapy. Mortality was high, and at day-28 only a minority of the patients were discharged alive from the hospital. Prevention of antimicrobial resistance and focusing on adequate antimicrobial therapy and source control are important to optimize patient management and outcomes.
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Affiliation(s)
- Alexis Tabah
- Intensive Care Unit, Redcliffe Hospital, Brisbane, Australia. .,Queensland Critical Care Research Network (QCCRN), Brisbane, QLD, Australia. .,Queensland University of Technology, Brisbane, QLD, Australia. .,Faculty of Medicine, The University of Queensland, Brisbane, QLD, Australia.
| | - Niccolò Buetti
- Infection Control Program and WHO Collaborating Centre on Patient Safety, Geneva University Hospitals and Faculty of Medicine, Geneva, Switzerland.,Université de Paris, INSERM, IAME UMR 1137, 75018, Paris, France
| | | | - Stéphane Ruckly
- Université de Paris, INSERM, IAME UMR 1137, 75018, Paris, France.,ICUREsearch, Biometry, 38600, Fontaine, France
| | - Murat Akova
- Department of Infectious Diseases, Hacettepe University School of Medicine, Ankara, Turkey
| | - Abdullah Tarik Aslan
- Department of Internal Medicine, Hacettepe University School of Medicine, Ankara, Turkey
| | - Marc Leone
- Department of Anesthesiology and Intensive Care Unit, Hospital Nord, Aix Marseille University, Assistance Publique Hôpitaux Universitaires de Marseille, Marseille, France
| | - Andrew Conway Morris
- Division of Anaesthesia, Department of Medicine, University of Cambridge, Addenbrooke's Hospital, Hills Road, Cambridge, CB2 0QQ, UK.,Division of Immunology, Department of Pathology, University of Cambridge, Tennis Court Road, Cambridge, Cb2 1QP, UK.,JVF Intensive Care Unit, Addenbrooke's Hospital, Cambridge, Hills Road, Cambridge, CB2 0QQ, UK
| | - Matteo Bassetti
- Infectious Diseases Clinic, Department of Health Sciences, University of Genoa and Ospedale Policlinico San Martino, Genoa, Italy
| | - Kostoula Arvaniti
- Intensive Care Unit, Papageorgiou University Affiliated Hospital, Thessaloníki, Greece
| | - Jeffrey Lipman
- Faculty of Medicine, The University of Queensland, Brisbane, QLD, Australia.,Nimes University Hospital, University of Montpellier, Nimes, France.,Jamieson Trauma Institute, Royal Brisbane and Women's Hospital, Herston, Australia
| | - Ricard Ferrer
- Intensive Care Department, SODIR-VHIR Research Group, Vall d'Hebron University Hospital, Barcelona, Spain
| | - Haibo Qiu
- Jiangsu Provincial Key Laboratory of Critical Care Medicine, Department of Critical Care Medicine, Nanjing Zhongda Hospital, Southeast University, Nanjing, 210009, China
| | - José-Artur Paiva
- Intensive Care Medicine Department, Centro Hospitalar Universitário Sao Joao, Porto, Portugal.,Department of Medicine, Faculty of Medicine, University of Porto, Porto, Portugal.,Infection and Sepsis ID Group, Porto, Portugal
| | - Pedro Povoa
- NOVA Medical School, New University of Lisbon, Lisbon, Portugal.,Center for Clinical Epidemiology and Research Unit of Clinical Epidemiology, OUH Odense University Hospital, Odense, Denmark.,Polyvalent Intensive Care Unit, Hospital de São Francisco Xavier, CHLO, Lisbon, Portugal
| | - Liesbet De Bus
- Department of Critical Care Medicine, Ghent University Hospital, Ghent, Belgium
| | - Jan De Waele
- Department of Internal Medicine and Pediatrics, Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium.,Department of Intensive Care Medicine, Ghent University Hospital, Ghent, Belgium
| | - Farid Zand
- Anesthesiology and Critical Care Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Mohan Gurjar
- Department of Critical Care Medicine, Sanjay Gandhi Post Graduate Institute of Medical Sciences (SGPGIMS), Lucknow, India
| | - Adel Alsisi
- ICU Department, Prime Hospital, Dubai, United Arab Emirates.,Critical Care Department, Faculty of Medicine, Cairo University, Cairo, Egypt
| | - Khalid Abidi
- Medical ICU, Ibn Sina University Hospital, Faculty of Medicine and Pharmacy, Mohammed V University, Rabat, Morocco
| | - Hendrik Bracht
- Central Interdisciplinary Emergency Medicine, University Hospital Ulm, Ulm, Germany
| | - Yoshiro Hayashi
- Department of Intensive Care Medicine, Kameda General Hospital, Kamogawa, Japan
| | - Kyeongman Jeon
- Division of Pulmonary and Critical Care Medicine, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea
| | | | - François Barbier
- Service de Médecine Intensive-Réanimation, Centre Hospitalier Régional d'Orléans, 14, avenue de L'Hôpital, 45100, Orléans, France
| | - Jean-François Timsit
- Université Paris-Cité, INSERM, IAME UMR 1137, 75018, Paris, France.,Medical and Infectious Diseases Intensive Care Unit, AP-HP, Bichat-Claude Bernard University Hospital, 46 Omdurman maternity hospitalrue Henri Huchard, 75877, Paris Cedex, France
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Rosenthal VD, Bat-Erdene I, Gupta D, Belkebir S, Rajhans P, Zand F, Myatra SN, Afeef M, Tanzi VL, Muralidharan S, Gurskis V, Al-Abdely HM, El-Kholy A, AlKhawaja SAA, Sen S, Mehta Y, Rai V, Hung NV, Sayed AF, Guerrero-Toapanta FM, Elahi N, Morfin-Otero MDR, Somabutr S, De-Carvalho BM, Magdarao MS, Velinova VA, Quesada-Mora AM, Anguseva T, Ikram A, Aguilar-de-Moros D, Duszynska W, Mejia N, Horhat FG, Belskiy V, Mioljevic V, Di-Silvestre G, Furova K, Gamar-Elanbya MO, Gupta U, Abidi K, Raka L, Guo X, Luque-Torres MT, Jayatilleke K, Ben-Jaballah N, Gikas A, Sandoval-Castillo HR, Trotter A, Valderrama-Beltrán SL, Leblebicioglu H, Riera F, López M, Maurizi D, Desse J, Pérez I, Silva G, Chaparro G, Golschmid D, Cabrera R, Montanini A, Bianchi A, Vimercati J, Rodríguez-del-Valle M, Domínguez C, Saul P, Chediack V, Piastrelini M, Cardena L, Ramasco L, Olivieri M, Gallardo P, Juarez P, Brito M, Botta P, Alvarez G, Benchetrit G, Caridi M, Stagnaro J, Bourlot I, García M, Arregui N, Saeed N, Abdul-Aziz S, ALSayegh S, Humood M, Mohamed-Ali K, Swar S, Magray T, Aguiar-Portela T, Sugette-de-Aguiar T, Serpa-Maia F, Fernandes-Alves-de-Lima L, Teixeira-Josino L, Sampaio-Bezerra M, Furtado-Maia R, Romário-Mendes A, Alves-De-Oliveira A, Vasconcelos-Carneiro A, Anjos-Lima JD, Pinto-Coelho K, Maciel-Canuto M, Rocha-Batista M, Moreira T, Rodrigues-Amarilo N, Lima-de-Barros T, Guimarães KA, Batista C, Santos C, de-Lima-Silva F, Santos-Mota E, Karla L, Ferreira-de-Souza M, Luzia N, de-Oliveira S, Takeda C, Azevedo-Ferreira-Lima D, Faheina J, Coelho-Oliveira L, do-Nascimento S, Machado-Silva V, Bento-Ferreira, Olszewski J, Tenorio M, Silva-Lemos A, Ramos-Feijó C, Cardoso D, Correa-Barbosa M, Assunção-Ponte G, Faheina J, da-Silva-Escudero D, Servolo-Medeiros E, Andrade-Oliveira-Reis M, Kostadinov E, Dicheva V, Petrov M, Guo C, Yu H, Liu T, Song G, Wang C, Cañas-Giraldo L, Marin-Tobar D, Trujillo-Ramirez E, Andrea-Rios P, Álvarez-Moreno C, Linares C, González-Rubio P, Ariza-Ayala B, Gamba-Moreno L, Gualtero-Trujill S, Segura-Sarmiento S, Rodriguez-Pena J, Ortega R, Olarte N, Pardo-Lopez Y, Luis Marino Otela-Baicue A, Vargas-Garcia A, Roncancio E, Gomez-Nieto K, Espinosa-Valencia M, Barahona-Guzman N, Avila-Acosta C, Raigoza-Martinez W, Villamil-Gomez W, Chapeta-Parada E, Mindiola-Rochel A, Corchuelo-Martinez A, Martinez A, Lagares-Guzman A, Rodriguez-Ferrer M, Yepes-Gomez D, Muñoz-Gutierrez G, Arguello-Ruiz A, Zuniga-Chavarria M, Maroto-Vargas L, Valverde-Hernández M, Solano-Chinchilla A, Calvo-Hernandez I, Chavarria-Ugalde O, Tolari G, Rojas-Fermin R, Diaz-Rodriguez C, Huascar S, Ortiz M, Bovera M, Alquinga N, Santacruz G, Jara E, Delgado V, Salgado-Yepez E, Valencia F, Pelaez C, Gonzalez-Flores H, Coello-Gordon E, Picoita F, Arboleda M, Garcia M, Velez J, Valle M, Unigarro L, Figueroa V, Marin K, Caballero-Narvaez H, Bayani V, Ahmed S, Alansary A, Hassan A, Abdel-Halim M, El-Fattah M, Abdelaziz-Yousef R, Hala A, Abdelhady K, Ahmed-Fouad H, Mounir-Agha H, Hamza H, Salah Z, Abdel-Aziz D, Ibrahim S, Helal A, AbdelMassih A, Mahmoud AR, Elawady B, El-sherif R, Fattah-Radwan Y, Abdel-Mawla T, Kamal-Elden N, Kartsonaki M, Rivera D, Mandal S, Mukherjee S, Navaneet P, Padmini B, Sorabjee J, Sakle A, Potdar M, Mane D, Sale H, Abdul-Gaffar M, Kazi M, Chabukswar S, Anju M, Gaikwad D, Harshe A, Blessymole S, Nair P, Khanna D, Chacko F, Rajalakshmi A, Mubarak A, Kharbanda M, Kumar S, Mathur P, Saranya S, Abubakar F, Sampat S, Raut V, Biswas S, Kelkar R, Divatia J, Chakravarthy M, Gokul B, Sukanya R, Pushparaj L, Thejasvini A, Rangaswamy S, Saini N, Bhattacharya C, Das S, Sanyal S, Chaudhury B, Rodrigues C, Khanna G, Dwivedy A, Binu S, Shetty S, Eappen J, Valsa T, Sriram A, Todi S, Bhattacharyya M, Bhakta A, Ramachandran B, Krupanandan R, Sahoo P, Mohanty N, Sahu S, Misra S, Ray B, Pattnaik S, Pillai H, Warrier A, Ranganathan L, Mani A, Rajagopal S, Abraham B, Venkatraman R, Ramakrishnan N, Devaprasad D, Siva K, Divekar D, Satish Kavathekar M, Suryawanshi M, Poojary A, Sheeba J, Patil P, Kukreja S, Varma K, Narayanan S, Sohanlal T, Agarwal A, Agarwal M, Nadimpalli G, Bhamare S, Thorat S, Sarda O, Nadimpalli P, Nirkhiwale S, Gehlot G, Bhattacharya S, Pandya N, Raphel A, Zala D, Mishra S, Patel M, Aggarwal D, Jawadwal B, Pawar N, Kardekar S, Manked A, Tamboli A, Manked A, Khety Z, Singhal T, Shah S, Kothari V, Naik R, Narain R, Sengupta S, Karmakar A, Mishra S, Pati B, Kantroo V, Kansal S, Modi N, Chawla R, Chawla A, Roy I, Mukherjee S, Bej M, Mukherjee P, Baidya S, Durell A, Vadi S, Saseedharan S, Anant P, Edwin J, Sen N, Sandhu K, Pandya N, Sharma S, Sengupta S, Palaniswamy V, Sharma P, Selvaraj M, Saurabh L, Agarwal M, Punia D, Soni D, Misra R, Harsvardhan R, Azim A, Kambam C, Garg A, Ekta S, Lakhe M, Sharma C, Singh G, Kaur A, Singhal S, Chhabra K, Ramakrishnan G, Kamboj H, Pillai S, Rani P, Singla D, Sanaei A, Maghsudi B, Sabetian G, Masjedi M, Shafiee E, Nikandish R, Paydar S, Khalili H, Moradi A, Sadeghi P, Bolandparvaz S, Mubarak S, Makhlouf M, Awwad M, Ayyad O, Shaweesh A, Khader M, Alghazawi A, Hussien N, Alruzzieh M, Mohamed Y, ALazhary M, Abdul Aziz O, Alazmi M, Mendoza J, De Vera P, Rillorta A, de Guzman M, Girvan M, Torres M, Alzahrani N, Alfaraj S, Gopal U, Manuel M, Alshehri R, Lessing L, Alzoman H, Abdrahiem J, Adballah H, Thankachan J, Gomaa H, Asad T, AL-Alawi M, Al-Abdullah N, Demaisip N, Laungayan-Cortez E, Cabato A, Gonzales J, Al Raey M, Al-Darani S, Aziz M, Al-Manea B, Samy E, AlDalaton M, Alaliany M, Alabdely H, Helali N, Sindayen G, Malificio A, Al-Dossari H, Kelany A, Algethami A, Mohamed D, Yanne L, Tan A, Babu S, Abduljabbar S, Al-Zaydani M, Ahmed H, Al Jarie A, Al-Qathani A, Al-Alkami H, AlDalaton M, Alih S, Alaliany M, Gasmin-Aromin R, Balon-Ubalde E, Diab H, Kader N, Hassan-Assiry I, Kelany A, Albeladi E, Aboushoushah S, Qushmaq N, Fernandez J, Hussain W, Rajavel R, Bukhari S, Rushdi H, Turkistani A, Mushtaq J, Bohlega E, Simon S, Damlig E, Elsherbini S, Abraham S, Kaid E, Al-Attas A, Hawsawi G, Hussein B, Esam B, Caminade Y, Santos A, Abdulwahab M, Aldossary A, Al-Suliman S, AlTalib A, Albaghly N, HaqlreMia M, Kaid E, Altowerqi R, Ghalilah K, Alradady M, Al-Qatri A, Chaouali M, Shyrine E, Philipose J, Raees M, AbdulKhalik N, Madco M, Acostan C, Safwat R, Halwani M, Abdul-Aal N, Thomas A, Abdulatif S, Ali-Karrar M, Al-Gosn N, Al-Hindi A, Jaha R, AlQahtani S, Ayugat E, Al-Hussain M, Aldossary A, Al-Suliman S, Al-Talib A, Albaghly N, Haqlre-Mia M, Briones S, Krishnan R, Tabassum K, Alharbi L, Madani A, Al-Hindi A, Al-Gethamy M, Alamri D, Spahija G, Gashi A, Kurian A, George S, Mohamed A, Ramapurath R, Varghese S, Abdo N, Foda-Salama M, Al-Mousa H, Omar A, Salama M, Toleb M, Khamis S, Kanj S, Zahreddine N, Kanafani Z, Kardas T, Ahmadieh R, Hammoud Z, Zeid I, Al-Souheil A, Ayash H, Mahfouz T, Kondratas T, Grinkeviciute D, Kevalas R, Dagys A, Mitrev Z, Bogoevska-Miteva Z, Jankovska K, Guroska S, Petrovska M, Popovska K, Ng C, Hoon Y, Hasan YM, Othman-Jailani M, Hadi-Jamaluddin M, Othman A, Zainol H, Wan-Yusoff W, Gan C, Lum L, Ling C, Aziz F, Zhazali R, Abud-Wahab M, Cheng T, Elghuwael I, Wan-Mat W, Abd-Rahman R, Perez-Gomez H, Kasten-Monges M, Esparza-Ahumada S, Rodriguez-Noriega E, Gonzalez-Diaz E, Mayoral-Pardo D, Cerero-Gudino A, Altuzar-Figueroa M, Perez-Cruz J, Escobar-Vazquez M, Aragon D, Coronado-Magana H, Mijangos-Mendez J, Corona-Jimenez F, Aguirre-Avalos G, Lopez-Mateos A, Martinez-Marroquin M, Montell-Garcia M, Martinez-Martinez A, Leon-Sanchez E, Gomez-Flores G, Ramirez M, Gomez M, Lozano M, Mercado V, Zamudio-Lugo I, Gomez-Gonzalez C, Miranda-Novales M, Villegas-Mota I, Reyes-Garcia C, Ramirez-Morales M, Sanchez-Rivas M, Cureno-Diaz M, Matias-Tellez B, Gonzalez-Martinez J, Juarez-Vargas R, Pastor-Salinas O, Gutierrez-Munoz V, Conde-Mercado J, Bruno-Carrasco G, Manrique M, Monroy-Colin V, Cruz-Rivera Z, Rodriguez-Pacheco J, Cruz N, Hernandez-Chena B, Guido-Ramirez O, Arteaga-Troncoso G, Guerra-Infante F, Lopez-Hurtado M, Caleco JD, Leyva-Medellin E, Salamanca-Meneses A, Cosio-Moran C, Ruiz-Rendon R, Aguilar-Angel L, Sanchez-Vargas M, Mares-Morales R, Fernandez-Alvarez L, Castillo-Cruz B, Gonzalez-Ma M, Zavala-Ramír M, Rivera-Reyna L, del-Moral-Rossete L, Lopez-Rubio C, Valadez-de-Alba M, Bat-Erdene A, Chuluunchimeg K, Baatar O, Batkhuu B, Ariyasuren Z, Bayasgalan G, Baigalmaa S, Uyanga T, Suvderdene P, Enkhtsetseg D, Suvd-Erdene D, Chimedtseye E, Bilguun G, Tuvshinbayar M, Dorj M, Khajidmaa T, Batjargal G, Naranpurev M, Bat-Erdene A, Bolormaa T, Battsetseg T, Batsuren C, Batsaikhan N, Tsolmon B, Saranbaatar A, Natsagnyam P, Nyamdawa O, Madani N, Abouqal R, Zeggwagh A, Berechid K, Dendane T, Koirala A, Giri R, Sainju S, Acharya S, Paul N, Parveen A, Raza A, Nizamuddin S, Sultan F, Imran X, Sajjad R, Khan M, Sana F, Tayyab N, Ahmed A, Zaman G, Khan I, Khurram F, Hussain A, Zahra F, Imtiaz A, Daud N, Sarwar M, Roop Z, Yusuf S, Hanif F, Shumaila X, Zeb J, Ali S, Demas S, Ariff S, Riaz A, Hussain A, Kanaan A, Jeetawi R, Castaño E, Moreno-Castillo L, García-Mayorca E, Prudencio-Leon W, Vivas-Pardo A, Changano-Rodriguez M, Castillo-Bravo L, Aibar-Yaranga K, Marquez-Mondalgo V, Mueras-Quevedo J, Meza-Borja C, Flor J, Fernandez-Camacho Y, Banda-Flores C, Pichilingue-Chagray J, Castaneda-Sabogal A, Caoili J, Mariano M, Maglente R, Santos S, de-Guzman G, Mendoza M, Javellana O, Tajanlangit A, Tapang A, Sg-Buenaflor M, Labro E, Carma R, Dy A, Fortin J, Navoa-Ng J, Cesar J, Bonifacio B, Llames M, Gata H, Tamayo A, Calupit H, Catcho V, Bergosa L, Abuy M, Barteczko-Grajek B, Rojek S, Szczesny A, Domanska M, Lipinska G, Jaroslaw J, Wieczoreka A, Szczykutowicza A, Gawor M, Piwoda M, Rydz-Lutrzykowska J, Grudzinska M, Kolat-Brodecka P, Smiechowicz K, Tamowicz B, Mikstacki A, Grams A, Sobczynski P, Nowicka M, Kretov V, Shalapuda V, Molkov A, Puzanov S, Utkin I, Tchekulaev A, Tulupova V, Vasiljevic S, Nikolic L, Ristic G, Eremija J, Kojovic J, Lekic D, Simic A, Hlinkova S, Lesnakova A, Kadankunnel S, Abdo-Ali M, Pimathai R, Wanitanukool S, Supa N, Prasan P, Luxsuwong M, Khuenkaew Y, Lamngamsupha J, Siriyakorn N, Prasanthai V, Apisarnthanarak A, Borgi A, Bouziri A, Cabadak H, Tuncer G, Bulut C, Hatipoglu C, Sebnem F, Demiroz A, Kaya A, Ersoz G, Kuyucu N, Karacorlu S, Oncul O, Gorenek L, Erdem H, Yildizdas D, Horoz O, Guclu E, Kaya G, Karabay O, Altindis M, Oztoprak N, Sahip Y, Uzun C, Erben N, Usluer G, Ozgunes I, Ozcelik M, Ceyda B, Oral M, Unal N, Cigdem Y, Bayar M, Bermede O, Saygili S, Yesiler I, Memikoglu O, Tekin R, Oncul A, Gunduz A, Ozdemir D, Geyik M, Erdogan S, Aygun C, Dilek A, Esen S, Turgut H, Sungurtekin H, Ugurcan D, Yarar V, Bilir Y, Bayram N, Devrim I, Agin H, Ceylan G, Yasar N, Oruc Y, Ramazanoglu A, Turhan O, Cengiz M, Yalcin A, Dursun O, Gunasan P, Kaya S, Senol G, Kocagoz A, Al-Rahma H, Annamma P, El-Houfi A, Vidal H, Perez F, D-Empaire G, Ruiz Y, Hernandez D, Aponte D, Salinas E, Vidal H, Navarrete N, Vargas R, Sanchez E, Ngo Quy C, Thu T, Nguyet L, Hang P, Hang T, Hanh T, Anh D. International Nosocomial Infection Control Consortium (INICC) report, data summary of 45 countries for 2012-2017: Device-associated module. Am J Infect Control 2020; 48:423-432. [PMID: 31676155 DOI: 10.1016/j.ajic.2019.08.023] [Citation(s) in RCA: 61] [Impact Index Per Article: 15.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2019] [Revised: 08/20/2019] [Accepted: 08/21/2019] [Indexed: 12/18/2022]
Abstract
BACKGROUND We report the results of International Nosocomial Infection Control Consortium (INICC) surveillance study from January 2012 to December 2017 in 523 intensive care units (ICUs) in 45 countries from Latin America, Europe, Eastern Mediterranean, Southeast Asia, and Western Pacific. METHODS During the 6-year study period, prospective data from 532,483 ICU patients hospitalized in 242 hospitals, for an aggregate of 2,197,304 patient days, were collected through the INICC Surveillance Online System (ISOS). The Centers for Disease Control and Prevention-National Healthcare Safety Network (CDC-NHSN) definitions for device-associated health care-associated infection (DA-HAI) were applied. RESULTS Although device use in INICC ICUs was similar to that reported from CDC-NHSN ICUs, DA-HAI rates were higher in the INICC ICUs: in the medical-surgical ICUs, the pooled central line-associated bloodstream infection rate was higher (5.05 vs 0.8 per 1,000 central line-days); the ventilator-associated pneumonia rate was also higher (14.1 vs 0.9 per 1,000 ventilator-days,), as well as the rate of catheter-associated urinary tract infection (5.1 vs 1.7 per 1,000 catheter-days). From blood cultures samples, frequencies of resistance, such as of Pseudomonas aeruginosa to piperacillin-tazobactam (33.0% vs 18.3%), were also higher. CONCLUSIONS Despite a significant trend toward the reduction in INICC ICUs, DA-HAI rates are still much higher compared with CDC-NHSN's ICUs representing the developed world. It is INICC's main goal to provide basic and cost-effective resources, through the INICC Surveillance Online System to tackle the burden of DA-HAIs effectively.
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Erdem H, Puca E, Ruch Y, Santos L, Ghanem-Zoubi N, Argemi X, Hansmann Y, Guner R, Tonziello G, Mazzucotelli JP, Como N, Kose S, Batirel A, Inan A, Tulek N, Pekok AU, Khan EA, Iyisoy A, Meric-Koc M, Kaya-Kalem A, Martins PP, Hasanoglu I, Silva-Pinto A, Oztoprak N, Duro R, Almajid F, Dogan M, Dauby N, Gunst JD, Tekin R, Konopnicki D, Petrosillo N, Bozkurt I, Wadi J, Popescu C, Balkan II, Ozer-Balin S, Zupanc TL, Cascio A, Dumitru IM, Erdem A, Ersoz G, Tasbakan M, Ajamieh OA, Sirmatel F, Florescu S, Gulsun S, Ozkaya HD, Sari S, Tosun S, Avci M, Cag Y, Celebi G, Sagmak-Tartar A, Karakus S, Sener A, Dedej A, Oncu S, Del Vecchio RF, Ozturk-Engin D, Agalar C. Portraying infective endocarditis: results of multinational ID-IRI study. Eur J Clin Microbiol Infect Dis 2019; 38:1753-1763. [PMID: 31187307 DOI: 10.1007/s10096-019-03607-x] [Citation(s) in RCA: 25] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2019] [Accepted: 05/29/2019] [Indexed: 01/18/2023]
Abstract
Infective endocarditis is a growing problem with many shifts due to ever-increasing comorbid illnesses, invasive procedures, and increase in the elderly. We performed this multinational study to depict definite infective endocarditis. Adult patients with definite endocarditis hospitalized between January 1, 2015, and October 1, 2018, were included from 41 hospitals in 13 countries. We included microbiological features, types and severity of the disease, complications, but excluded therapeutic parameters. A total of 867 patients were included. A total of 631 (72.8%) patients had native valve endocarditis (NVE), 214 (24.7%) patients had prosthetic valve endocarditis (PVE), 21 (2.4%) patients had pacemaker lead endocarditis, and 1 patient had catheter port endocarditis. Eighteen percent of NVE patients were hospital-acquired. PVE patients were classified as early-onset in 24.9%. A total of 385 (44.4%) patients had major embolic events, most frequently to the brain (n = 227, 26.3%). Blood cultures yielded pathogens in 766 (88.4%). In 101 (11.6%) patients, blood cultures were negative. Molecular testing of vegetations disclosed pathogens in 65 cases. Overall, 795 (91.7%) endocarditis patients had any identified pathogen. Leading pathogens (Staphylococcus aureus (n = 267, 33.6%), Streptococcus viridans (n = 149, 18.7%), enterococci (n = 128, 16.1%), coagulase-negative staphylococci (n = 92, 11.6%)) displayed substantial resistance profiles. A total of 132 (15.2%) patients had cardiac abscesses; 693 (79.9%) patients had left-sided endocarditis. Aortic (n = 394, 45.4%) and mitral valves (n = 369, 42.5%) were most frequently involved. Mortality was more common in PVE than NVE (NVE (n = 101, 16%), PVE (n = 49, 22.9%), p = 0.042).
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Affiliation(s)
| | - Edmond Puca
- Department of Infectious Diseases, University Hospital Center "Mother Teresa", Tirana, Albania
| | - Yvon Ruch
- Department of Infectious Diseases, Strasbourg University Hospital, Nouvel Hôpital Civil, Strasbourg, France
| | - Lurdes Santos
- Infectious Diseases Department, Centro Hospitalar São João and Faculdade de Medicina da Universidade do Porto, Porto, Portugal
| | | | - Xavier Argemi
- Department of Infectious Diseases, Strasbourg University Hospital, Nouvel Hôpital Civil, Strasbourg, France
| | - Yves Hansmann
- Department of Infectious Diseases, Strasbourg University Hospital, Nouvel Hôpital Civil, Strasbourg, France
| | - Rahmet Guner
- Ataturk Training and Research Hospital, Department of Infectious Diseases and Clinical Microbiology, Yildirim Beyazit University, Ankara, Turkey
| | - Gilda Tonziello
- Clinical & Research Department for Infectious Diseases, National Institute for Infectious Diseases "Lazzaro Spallanzani", IRCCS,, Via Portuense, 292, 00149, Rome, Italy
| | - Jean-Philippe Mazzucotelli
- Department of Cardiovascular Surgery, Strasbourg University Hospital, Nouvel Hôpital Civil, Strasbourg, France
| | - Najada Como
- Service of Infectious Disease, UHC, Tirana, Albania
| | - Sukran Kose
- Department of Infectious Diseases and Clinical Microbiology, Tepecik Training and Research Hospital, Izmir, Turkey
| | - Ayse Batirel
- Department of Infectious Diseases and Clinical Microbiology, Dr. Lutfi Kirdar Training and Research Hospital, Health Sciences University, Istanbul, Turkey
| | - Asuman Inan
- Department of Infectious Diseases and Clinical Microbiology, Haydarpasa Numune Training and Research Hospital, Istanbul, Turkey
| | - Necla Tulek
- Department of Microbiology, Atilim University, School of Medicine, Ankara, Turkey
| | - Abdullah Umut Pekok
- Department of Infectious Diseases and Clinical Microbiology, Pendik Medical Park Hospital, Istanbul, Turkey
| | - Ejaz Ahmed Khan
- Shifa International Hospital and Shifa Tameer-e-Millat University, Islamabad, Pakistan
| | - Atilla Iyisoy
- Department of Cardiology, Gulhane Training and Research Hospital, Health Sciences University, Ankara, Turkey
| | - Meliha Meric-Koc
- Department of Infectious Diseases and Clinical Microbiology, Bezmialem Vakıf University School of Medicine, Istanbul, Turkey
| | - Ayse Kaya-Kalem
- Ataturk Training and Research Hospital, Department of Infectious Diseases and Clinical Microbiology, Yildirim Beyazit University, Ankara, Turkey
| | - Pedro Palma Martins
- Infectious Diseases Department, Centro Hospitalar São João and Faculdade de Medicina da Universidade do Porto, Porto, Portugal
| | - Imran Hasanoglu
- Ataturk Training and Research Hospital, Department of Infectious Diseases and Clinical Microbiology, Yildirim Beyazit University, Ankara, Turkey
| | - André Silva-Pinto
- Infectious Diseases Department, Centro Hospitalar São João and Faculdade de Medicina da Universidade do Porto, Porto, Portugal
| | - Nefise Oztoprak
- Department of Infectious Diseases and Clinical Microbiology, Antalya Training and Research Hospital, Health Sciences University, Antalya, Turkey
| | - Raquel Duro
- Infectious Diseases Department, Centro Hospitalar São João and Faculdade de Medicina da Universidade do Porto, Porto, Portugal
| | - Fahad Almajid
- Department of Medicine, Infectious Diseases Division, King Saud University Hospital, Riyadh, Saudi Arabia
| | - Mustafa Dogan
- Department of Infectious Diseases and Clinical Microbiology, Corlu State Hospital, Tekirdag, Antalya, Turkey
| | - Nicolas Dauby
- Department of Infectious Diseases, Centre Hospitalier Universitaire Saint-Pierre, Université libre de Bruxelles (ULB), 322 rue Haute, 1000, Brussels, Belgium
| | | | - Recep Tekin
- Department of Infectious Diseases and Clinical Microbiology, Dicle University Faculty of Medicine, Diyarbakır, Turkey
| | - Deborah Konopnicki
- Department of Infectious Diseases, Centre Hospitalier Universitaire Saint-Pierre, Université libre de Bruxelles (ULB), 322 rue Haute, 1000, Brussels, Belgium
| | - Nicola Petrosillo
- Clinical & Research Department for Infectious Diseases, National Institute for Infectious Diseases "Lazzaro Spallanzani", IRCCS,, Via Portuense, 292, 00149, Rome, Italy
| | - Ilkay Bozkurt
- Department of Infectious Diseases and Clinical Microbiology, Ondokuz Mayis University School of Medicine, Samsun, Turkey
| | - Jamal Wadi
- Department of Infectious Diseases, School of Medicine, The University of Jordan, Amman, Jordan
| | - Corneliu Popescu
- Dr Victor Babes Clinical Hospital of Infectious and Tropical Disease, Bucharest, Romania
| | - Ilker Inanc Balkan
- Department of Infectious Diseases and Clinical Microbiology, Cerrahpasa Medical Faculty, Istanbul University, Istanbul, Turkey
| | - Safak Ozer-Balin
- Department of Infectious Diseases and Clinical Microbiology, Faculty of Medicine, Firat University, Elazig, Turkey
| | | | - Antonio Cascio
- Department of Health Promotion Sciences and Mother and Child Care "G. D'Alessandro", University of Palermo, Palermo, Italy
| | | | - Aysegul Erdem
- Department of Pathology, Kecioren Training and Research Hospital, Ankara, Turkey
| | - Gulden Ersoz
- Department of Infectious Diseases and Clinical Microbiology, Mersin University School of Medicine, Mersin, Turkey
| | - Meltem Tasbakan
- Department of Infectious Diseases and Clinical Microbiology, Ege University Faculty of Medicine, Izmir, Turkey
| | - Oday Abu Ajamieh
- Department of Infectious Diseases, School of Medicine, The University of Jordan, Amman, Jordan
| | - Fatma Sirmatel
- Department of Infectious Disease and Clinical Microbiology, Izzet Baysal University School of Medicine, Bolu, Turkey
| | - Simin Florescu
- Dr Victor Babes Clinical Hospital of Infectious and Tropical Disease, Bucharest, Romania
| | - Serda Gulsun
- Department of Infectious Diseases and Clinical Microbiology, Diyarbakir Training and Research Hospital, Diyarbakir, Turkey
| | - Hacer Deniz Ozkaya
- Department of Infectious Diseases and Clinical Microbiology, Cigli Regional Education Hospital, Izmir, Turkey
| | - Sema Sari
- Department of Intensive Care Unit, Turkey Advanced Specialty Education and Research Hospital, Ankara, Turkey
| | - Selma Tosun
- Department of Infectious Diseases and Clinical Microbiology, Izmir Bozyaka Training and Research Hospital, Izmir, Turkey
| | - Meltem Avci
- Department of Infectious Disease and Clinical Microbiology, Usak University School of Medicine, Usak, Turkey
| | - Yasemin Cag
- Department of Infectious Diseases and Clinical Microbiology, Medeniyet University, Goztepe Training and Research Hospital, Istanbul, Turkey
| | - Guven Celebi
- Department of Infectious Diseases and Clinical Microbiology, Faculty of Medicine, Bulent Ecevit University, Zonguldak, Turkey
| | - Ayse Sagmak-Tartar
- Department of Infectious Diseases and Clinical Microbiology, Faculty of Medicine, Firat University, Elazig, Turkey
| | - Sumeyra Karakus
- Department of Infectious Diseases and Clinical Microbiology, Medeniyet University, Goztepe Training and Research Hospital, Istanbul, Turkey
| | - Alper Sener
- Department of Infectious Diseases and Clinical Microbiology, Onsekiz Mart University School of Medicine, Canakkale, Turkey
| | - Arjeta Dedej
- Department of Nephrology, American Hospital, Tirana, Albania
| | - Serkan Oncu
- Department of Infectious Diseases and Clinical Microbiology, Adnan Menderes University School of Medicine, Aydin, Turkey
| | - Rosa Fontana Del Vecchio
- Department of Clinical and Molecular Biomedicine, Section of Infectious Diseases, University of Catania, Catania, Italy
| | - Derya Ozturk-Engin
- Department of Infectious Diseases and Clinical Microbiology, Fatih Sultan Mehmet Training and Research Hospital, Istanbul, Turkey
| | - Canan Agalar
- Department of Infectious Diseases and Clinical Microbiology, Fatih Sultan Mehmet Training and Research Hospital, Istanbul, Turkey
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5
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Erdem H, Inan A, Guven E, Hargreaves S, Larsen L, Shehata G, Pernicova E, Khan E, Bastakova L, Namani S, Harxhi A, Roganovic T, Lakatos B, Uysal S, Sipahi OR, Crisan A, Miftode E, Stebel R, Jegorovic B, Fehér Z, Jekkel C, Pandak N, Moravveji A, Yilmaz H, Khalifa A, Musabak U, Yilmaz S, Jouhar A, Oztoprak N, Argemi X, Baldeyrou M, Bellaud G, Moroti RV, Hasbun R, Salazar L, Tekin R, Canestri A, Čalkić L, Praticò L, Yilmaz-Karadag F, Santos L, Pinto A, Kaptan F, Bossi P, Aron J, Duissenova A, Shopayeva G, Utaganov B, Grgic S, Ersoz G, Wu AKL, Lung KC, Bruzsa A, Radic LB, Kahraman H, Momen-Heravi M, Kulzhanova S, Rigo F, Konkayeva M, Smagulova Z, Tang T, Chan P, Ahmetagic S, Porobic-Jahic H, Moradi F, Kaya S, Cag Y, Bohr A, Artuk C, Celik I, Amsilli M, Gul HC, Cascio A, Lanzafame M, Nassar M. The burden and epidemiology of community-acquired central nervous system infections: a multinational study. Eur J Clin Microbiol Infect Dis 2017; 36:1595-1611. [PMID: 28397100 DOI: 10.1007/s10096-017-2973-0] [Citation(s) in RCA: 37] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2017] [Accepted: 03/22/2017] [Indexed: 12/11/2022]
Abstract
Risk assessment of central nervous system (CNS) infection patients is of key importance in predicting likely pathogens. However, data are lacking on the epidemiology globally. We performed a multicenter study to understand the burden of community-acquired CNS (CA-CNS) infections between 2012 and 2014. A total of 2583 patients with CA-CNS infections were included from 37 referral centers in 20 countries. Of these, 477 (18.5%) patients survived with sequelae and 227 (8.8%) died, and 1879 (72.7%) patients were discharged with complete cure. The most frequent infecting pathogens in this study were Streptococcus pneumoniae (n = 206, 8%) and Mycobacterium tuberculosis (n = 152, 5.9%). Varicella zoster virus and Listeria were other common pathogens in the elderly. Although staphylococci and Listeria resulted in frequent infections in immunocompromised patients, cryptococci were leading pathogens in human immunodeficiency virus (HIV)-positive individuals. Among the patients with any proven etiology, 96 (8.9%) patients presented with clinical features of a chronic CNS disease. Neurosyphilis, neurobrucellosis, neuroborreliosis, and CNS tuberculosis had a predilection to present chronic courses. Listeria monocytogenes, Staphylococcus aureus, M. tuberculosis, and S. pneumoniae were the most fatal forms, while sequelae were significantly higher for herpes simplex virus type 1 (p < 0.05 for all). Tackling the high burden of CNS infections globally can only be achieved with effective pneumococcal immunization and strategies to eliminate tuberculosis, and more must be done to improve diagnostic capacity.
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Affiliation(s)
- H Erdem
- Principal Coordinator of ID-IRI, Ankara, Turkey.
- Department of Infectious Diseases and Clinical Microbiology, Gulhane Medical Academy, 06010, Etlik, Ankara, Turkey.
| | - A Inan
- Department of Infectious Diseases and Clinical Microbiology, Haydarpasa Numune Training and Research Hospital, Istanbul, Turkey
| | - E Guven
- Beytepe Murat Erdi Eker State Hospital, Ankara, Turkey
| | - S Hargreaves
- International Health Unit, Section of Infectious Diseases and Immunity, Commonwealth Building, Hammersmith Campus, Imperial College London, London, UK
| | - L Larsen
- Department of Infectious Diseases Q, Odense University Hospital, Odense, Denmark
| | - G Shehata
- Department of Neurology and Psychiatry, Assiut University Hospital, Assiut, Egypt
| | - E Pernicova
- Avenier, Centres for Vaccination and Travel Medicine, Prague, Czech Republic
- Faculty Hospital Brno, Department of Infectious Diseases, Brno, Czech Republic
| | - E Khan
- Shifa International Hospital, Islamabad, Pakistan
| | - L Bastakova
- Faculty Hospital Brno, Department of Infectious Diseases and Masaryk University Faculty of Medicine, Brno, Czech Republic
| | - S Namani
- Infectious Diseases Clinic, University Clinical Center of Kosovo, Prishtina, Kosovo
| | - A Harxhi
- Service of Infectious Disease, University Hospital Center of Tirana, Tirana, Albania
| | - T Roganovic
- Infectious Diseases Clinic, University Hospital Clinical Center Banja Luka, Banja Luka, Bosnia and Herzegovina
| | - B Lakatos
- Department of Infectious Diseases, Saint Laszlo Hospital, Budapest, Hungary
| | - S Uysal
- Department of Infectious Diseases and Clinical Microbiology, Seyfi Demirsoy State Hospital, Buca, İzmir, Turkey
| | - O R Sipahi
- Department of Infectious Diseases and Clinical Microbiology, Ege University School of Medicine, Izmir, Turkey
| | - A Crisan
- Department of Infectious Diseases, Victor Babes University of Medicine and Pharmacy, Timisoara, Romania
| | - E Miftode
- Hospital of Infectious Diseases, Gr. T. Popa University of Medicine and Pharmacy, Iasi, Romania
| | - R Stebel
- Faculty Hospital Brno, Department of Infectious Diseases and Masaryk University Faculty of Medicine, Brno, Czech Republic
| | - B Jegorovic
- Clinic for Infectious and Tropical Diseases, Clinical Centre of Serbia, Faculty of Medicine, University of Belgrade, Belgrade, Serbia
| | - Z Fehér
- Department of Infectious Diseases, Markusovszky University Teaching Hospital, Szombathely, Hungary
| | - C Jekkel
- Department of Infectious Diseases, Saint Laszlo Hospital, Budapest, Hungary
| | - N Pandak
- General Hospital Slavonski Brod, Department for Infectious Diseases, School of Medicine, University of Split, Split, Croatia
| | - A Moravveji
- Social Determinants of Health Research Center, Department of Community Medicine, Kashan University of Medical Sciences, Kashan, Iran
| | - H Yilmaz
- Department of Infectious Diseases and Clinical Microbiology, Ondokuz Mayis University School of Medicine, Samsun, Turkey
| | - A Khalifa
- Department of Neurology, Damascus Hospital, Damascus, Syria
| | - U Musabak
- Department of Immunology and Allergy, Losante Hospital, Ankara, Turkey
| | - S Yilmaz
- Gulhane Medical Academy, Blood Bank, Clinical Microbiology Division, Ankara, Turkey
| | - A Jouhar
- Department of Neurology, Damascus Hospital, Damascus, Syria
| | - N Oztoprak
- Antalya Education and Research Hospital, Antalya, Turkey
| | - X Argemi
- Infectious Diseases Department, Nouvel Hôpital Civil, Strasbourg, France
| | - M Baldeyrou
- Infectious Diseases Department, Nouvel Hôpital Civil, Strasbourg, France
| | - G Bellaud
- Department of Infectious Diseases, Tenon University Hospital, Paris, France
| | - R V Moroti
- Carol Davila University of Medicine and Pharmacy and Matei Bals National Institute for Infectious Diseases, Bucharest, Romania
| | - R Hasbun
- Medical School, Department of Infectious Diseases, The University of Texas Health Science Center at Houston, Houston, TX, USA
| | - L Salazar
- Medical School, Department of Infectious Diseases, The University of Texas Health Science Center at Houston, Houston, TX, USA
| | - R Tekin
- Department of Infectious Diseases and Clinical Microbiology, Dicle University School of Medicine, Diyarbakir, Turkey
| | - A Canestri
- Department of Infectious Diseases, Tenon University Hospital, Paris, France
| | - L Čalkić
- Department of Infectious Diseases, Zenica Cantonal Hospital, Zenica, Bosnia and Herzegovina
| | - L Praticò
- University Division of Infectious and Tropical Diseases, Piazza Spedali Civili, 25123, Brescia, Italy
| | - F Yilmaz-Karadag
- Goztepe Training and Research Hospital, Department of Infectious Diseases and Clinical Microbiology, Medeniyet University, Istanbul, Turkey
| | - L Santos
- Infectious Diseases Service, Centro Hospitalar São João and Faculty of Medicine, University of Porto, Porto, Portugal
| | - A Pinto
- Infectious Diseases Service, Centro Hospitalar São João and Faculty of Medicine, University of Porto, Porto, Portugal
| | - F Kaptan
- Department of Infectious Diseases and Clinical Microbiology, Katip Celebi University School of Medicine, Izmir, Turkey
| | - P Bossi
- Department Maladies Infectieuses, Institut Pasteur de Paris-HPA, Paris, France
| | - J Aron
- Department Maladies Infectieuses, Institut Pasteur de Paris-HPA, Paris, France
| | - A Duissenova
- Department of Infectious and Tropical Diseases, Asfendiyarov Kazakh National Medical University, Almaty, Kazakhstan
| | - G Shopayeva
- Department of Infectious and Tropical Diseases, Asfendiyarov Kazakh National Medical University, Almaty, Kazakhstan
| | - B Utaganov
- Department of Infectious and Tropical Diseases, Asfendiyarov Kazakh National Medical University, Almaty, Kazakhstan
| | - S Grgic
- Clinic for Infectious Diseases, University Hospital of Mostar, Mostar, Bosnia and Herzegovina
| | - G Ersoz
- Department of Infectious Diseases and Clinical Microbiology, Mersin University School of Medicine, Mersin, Turkey
| | - A K L Wu
- Department of Clinical Pathology, Pamela Youde Nethersole Eastern Hospital, Hong Kong SAR, China
| | - K C Lung
- Department of Clinical Pathology, Pamela Youde Nethersole Eastern Hospital, Hong Kong SAR, China
| | - A Bruzsa
- Department of Infectious Diseases, Saint Laszlo Hospital, Budapest, Hungary
| | - L B Radic
- Department of Infectious Diseases, General Hospital Dubrovnik, Dubrovnik, Croatia
| | - H Kahraman
- Department of Infectious Diseases and Clinical Microbiology, Ege University School of Medicine, Izmir, Turkey
| | - M Momen-Heravi
- Department of Infectious Diseases, Social Determinants of Health Research Center, Kashan University of Medical Sciences, Kashan, Iran
| | - S Kulzhanova
- Department of Infectious Diseases, Astana Medical University, Astana, Kazakhstan
| | - F Rigo
- Unit of Infectious Diseases, Azienda Ospedaliera Universitaria Integrata, Verona, Italy
| | - M Konkayeva
- Department of Infectious Diseases, Astana Medical University, Astana, Kazakhstan
| | - Z Smagulova
- Department of Infectious Diseases, Astana Medical University, Astana, Kazakhstan
| | - T Tang
- Infectious Diseases Team, Department of Medicine, Queen Elizabeth Hospital, Hong Kong, China
| | - P Chan
- Neurology Team, Department of Medicine, Queen Elizabeth Hospital, Hong Kong, China
| | - S Ahmetagic
- University Clinical Center Tuzla, Tuzla, Bosnia and Herzegovina
| | - H Porobic-Jahic
- University Clinical Center Tuzla, Tuzla, Bosnia and Herzegovina
| | - F Moradi
- Infectious and Tropical Diseases Research Center, Hormozgan University of Medical Sciences, Bandar Abbas, Iran
| | - S Kaya
- Department of Infectious Diseases and Clinical Microbiology, Karadeniz Technical University School of Medicine, Trabzon, Turkey
| | - Y Cag
- School of Medicine, Department of Infectious Diseases and Clinical Microbiology, Medeniyet University, Istanbul, Turkey
| | - A Bohr
- Institute of Inflammation Research, Department of Infectious Diseases and Rheumatology, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark
| | - C Artuk
- Department of Infectious Diseases and Clinical Microbiology, Gulhane Training and Research Hospital, Ankara, Turkey
| | - I Celik
- Department of Infectious Diseases and Clinical Microbiology, Kayseri Training and Research Hospital, Kayseri, Turkey
| | - M Amsilli
- Infectious Diseases Unit, CHU Bicètre, Paris, France
| | - H C Gul
- Department of Infectious Diseases and Clinical Microbiology, Gulhane Training and Research Hospital, Ankara, Turkey
| | - A Cascio
- Department of Health Promotion Sciences and Mother and Child Care "G. D'Alessandro", University of Palermo, Palermo, Italy
| | - M Lanzafame
- Unit of Infectious Diseases, Azienda Ospedaliera Universitaria Integrata, Verona, Italy
| | - M Nassar
- Infection Control Department, Saudi German Hospital Group, Jeddah, Saudi Arabia
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6
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Hasanoglu I, Guner R, Atalay HV, Sahin S, Parmaksiz E, Karadag FY, Ecder SA, Gulen TA, Ucar ZA, Karabay O, Sipahi S, Yapar D, Dogan I, Baran I, Kilic EK, Duranay M, Ersoz G, Turkmen G, Kiykim AA. Surveillance of Hemodialysis Events: A Prospective Multicenter Study, First Report from Turkey. Open Forum Infect Dis 2017. [DOI: 10.1093/ofid/ofx163.332] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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7
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Rosenthal VD, Al-Abdely HM, El-Kholy AA, AlKhawaja SAA, Leblebicioglu H, Mehta Y, Rai V, Hung NV, Kanj SS, Salama MF, Salgado-Yepez E, Elahi N, Morfin Otero R, Apisarnthanarak A, De Carvalho BM, Ider BE, Fisher D, Buenaflor MCS, Petrov MM, Quesada-Mora AM, Zand F, Gurskis V, Anguseva T, Ikram A, Aguilar de Moros D, Duszynska W, Mejia N, Horhat FG, Belskiy V, Mioljevic V, Di Silvestre G, Furova K, Ramos-Ortiz GY, Gamar Elanbya MO, Satari HI, Gupta U, Dendane T, Raka L, Guanche-Garcell H, Hu B, Padgett D, Jayatilleke K, Ben Jaballah N, Apostolopoulou E, Prudencio Leon WE, Sepulveda-Chavez A, Telechea HM, Trotter A, Alvarez-Moreno C, Kushner-Davalos L, Desse J, Maurizi D, Montanini A, Chaparro G, Stagnaro J, Romani A, Bianchi A, Álvarez G, Palaoro A, Bernan M, Cabrera-Montesino R, Domínguez C, Rodríguez C, Silva C, Bogdanowicz E, Riera F, Benchetrit G, Perez I, Vimercati J, Marcos L, Ramasco L, Caridi M, Oyola M, Rodríguez M, Spadaro M, Olivieri M, Saul P, Juarez P, Pérez R, Botta P, Quintana D, Ríos A, Stagnaro J, Chediack V, Chilon W, Alsayegh AI, Yaseen FH, Hani LF, Sowar SF, Magray TA, Medeiros E, Alves De Oliveira A, Romario-Mendes A, Fernandes-Valente C, Santos C, Escudeiro D, Azevedo-Ferreira Lima D, Azevedo-Pereira D, Onzi-Siliprandi E, Serpa-Maia F, Aguiar-Leitao F, Assuncao-Ponte G, Dos Anjos-Lima J, Olszewski J, Harten Pinto Coelho K, Alves De Lima L, Mendonca M, Maciel-Canuto Amaral M, Tenorio M, Gerah S, Andrade-Oliveira-Reis M, Moreira M, Ximenes-Rocha Batista M, Campos-Uchoa R, Rocha-Vasconcelos Carneiro R, Amaral De Moraes R, Do Nascimento S, Moreira-Matos T, Lima-De Barros Araujo T, De Jesus Pinheiro-Bandeira T, Machado-Silva V, Santos Monteiro W, Hristozova E, Kostadinov E, Angelova K, Velinova V, Dicheva V, Guo X, Ye G, Li R, Song L, Liu K, Liu T, Song G, Wang C, Yang X, Yu H, Yang Y, Martínez A, Vargas-García A, Lagares-Guzmán A, González A, Linares C, Ávila-Acosta C, Santofimio D, Yepes-Gomez D, Marin-Tobar D, Mazo-Elorza D, Chapeta-Parada E, Camacho-Moreno G, Roncancio-Vill G, Valderrama-Marquez I, Ruiz-Gallardo J, Ospina-Martínez J, Osorio J, Marín-Uribe J, López J, Gualtero S, Rojas J, Gomez-Nieto K, Rincon L, Meneses-Ovallos L, Canas-Giraldo L, Burgos-Florez L, Amaral-Almeida Costa M, Rodriguez M, Barahona-Guzmán N, Mancera-Paez O, Rios-Arana P, Ortega R, Romero-Torres S, Pulido-Leon S, Valderrama S, Moreno-Mejia V, Raigoza-Martinez W, Villamil-Gomez W, Pardo-Lopez Y, Argüello-Ruiz A, Solano-Chinchilla A, Muñoz-Gutierrez G, Calvo-Hernández I, Maroto-Vargas L, Zuniga M, Valverde-Hernandez M, Chavarria-Ugalde O, Herrera B, Díaz C, Bovera M, Cevallos C, Pelaez C, Jara E, Delgado V, Coello-Gordon E, Picoita F, Guerrero-Toapant F, Valencia F, Santacruz G, Gonzalez H, Pazmino L, Garcia M, Arboleda M, Lascano M, Alquinga N, Ramírez V, Yousef RH, Moustafa AEM, Ahmed A, Elansary A, Ali AM, Hasanin A, Messih AA, Ramadan A, El Awady B, Hassan D, Abd El Aziz D, Hamza H, Agha HM, Ghazi IA, ElKholy J, Fattah MA, Elanany M, Mansour M, Haleim M, Fouda R, El-Sherif RH, Bekeit S, Bayani V, Elkholy Y, Abdelhamid Y, Salah Z, Rivera D, Chawla A, Manked A, Azim A, Mubarak A, Thakur A, Dharan A, Patil A, Sasidharan A, Bilolikar AK, Anirban Karmakar A, Mathew A, Kulkarni A, Agarwal A, Sriram A, Dwivedy A, Dasgupta A, Bhakta A, Suganya AR, Poojary A, Mani AK, Sakle A, Abraham BK, Padmini B, Ramachandran B, Ray B, Pati BK, Chaudhury BN, Mishra BM, Biswas S, Saibala MB, Jawadwala BQ, Rodrigues C, Modi C, Patel C, Khanna D, Devaprasad D, Divekar D, Aggarwal DG, Divatia J, Zala D, Pathrose E, Abubakar F, Chacko F, Gehlot G, Khanna G, Sale H, Roy I, Shelgaonkar J, Sorabjee J, Eappen J, Mathew J, Pal J, Varma K, Joshi KL, Sandhu K, Kelkar R, Ranganathan L, Pushparaj L, Lavate M, Latha M, Suryawanshi M, Bhattacharyya M, Kavathekar M, Agarwal MK, Patel M, Shah M, Sivakumar M, Kharbanda M, Bej M, Potdar M, Chakravarthy M, Karpagam M, Myatra S, Gita N, Rao N, Sen N, Ramakrishnan N, Jaggi N, Saini N, Pawar N, Modi N, Pandya N, Mohanty N, Thakkar P, Joshi P, Sahoo PK, Nair PK, Kumar PS, Patil P, Mukherjee P, Mathur P, Shah P, Sukanya R, Arjun R, Chawla R, Gopalakrishnan R, Venkataraman R, Raut S, Krupanandan R, Tejam R, Misra R, Debroy R, Saranya S, Narayanan S, Mishra S, Saseedharan S, Sengupta S, Patnaik S, Sinha S, Blessymole S, Rohra S, Rajagopal S, Mukherjee S, Sengupta S, John S, Bhattacharya S, Sijo, Bhattacharyya S, Singh S, Sohanlal T, Vadi S, Dalal S, Todi S, Kumar S, Kansal S, Misra S, Bhattacharyya S, Nirkhiwale S, Purkayastha SK, Mukherjee S, Singh S, Sahu S, Sharma S, Kumar S, Basu S, Shetty S, Shah S, Singhal T, Francis T, Anand T, Venkateshwar V, Thomas V, Kothari V, Velupandi, Kantroo V, Sitohang G, Kadarsih R, Sanaei A, Maghsudi B, Sabetian G, Masjedi M, Alebouyeh M, Sherafat SJ, Mohamed YK, Al Khamis A, Alsaadi AS, Al-Jarie AA, Mutwalli AH, Rillorta A, Thomas A, Kelany A, Manao A, Alamri DM, Santiago E, Cruzpero E, Sawan FA, Al Qasmah FA, Alabdaly H, Al-Dossary HA, Ahmed H, Roshdi H, Al-Alkami HY, Hanafi H, Ammari HE, Hani HMA, Asiri IAA, Mendoza JA, Philipose J, Selga JO, Kehkashan, Ghalilah KM, Redito LS, Josph L, Al-Alawi M, Al-Gethamy MM, Madco M, Manuel M, Girvan M, Aldalaton M, De Guzman M, Alkhamaly M, Masfar M, Karrar MAA, Al Azmi MM, Quisai ML, Torres MM, Al-Abdullah N, Tawfic NA, Elsayed N, Abdulkhalik NS, Bugis NA, Ariola NC, Gad N, Alghosn N, Tashkandi N, Zharani NA, De Vera P, Krishnan R, Al Shehri RH, Jaha RNA, Thomas R, Cresencia RL, Penuliar R, Lozada R, Al Qahtani S, Twfik S, Al Faraj SH, El-Sherbiny S, Alih SJB, Briones S, Bukhari SZ, Alotaibi TSA, Gopal U, Nair U, Abdulatif WA, Hussain WM, Demotica WM, Spahija G, Baftiu N, Gashi A, Omar AA, Mohamed A, Rebello F, Almousa HH, Abdo NM, George S, Khamis S, Thomas S, Ahmad Zaatari A, Anwar Al Souheil A, Ayash H, Zeid I, Tannous J, Zahreddine N, Ahmadieh R, Mahfouz T, Kardas T, Tanzi V, Kanafani Z, Hammoud Z, Dagys A, Grinkeviciute D, Kevalas R, Kondratas T, Petrovska M, Popovska K, Mitrev Z, Miteva ZB, Jankovska K, Guroska ST, Gan CS, Othman AA, Yusof AM, Abidin ASZ, Aziz FA, Weng FK, Zainol H, Bakar KBA, Lum LCS, Mansor M, Zaman MK, Jamaluddin MFH, Hasan MS, Rahman RA, Zaini RHM, Zhazali R, Sri Ponnampala SSL, Chuah SL, Shukeri WFWM, Hassan WNW, Yusoff WNW, Mat WRW, Cureno-Diaz M, Aguirre-Avalos G, Flores-Alvarado A, Cerero-Gudino A, Zamores-Pedroza A, Cano-Munoz B, Hernandez-Chena B, Carreon-Martinez C, Coronado-Magana H, Corona-Jimenez F, Rodriguez-Noriega E, Alcala-Martinez E, Gonzalez-Diaz E, Guerra-Infante F, Arteaga-Troncoso G, Martinez-Falcon G, Leon-Garnica G, Delgado-Aguirre H, Perez-Gomez H, Sosa-Gonzalez I, Galindo-Olmeda J, Ayala-Gaytan J, Rodriguez-Pacheco J, Zamorano-Flores L, Lopez-Pulgarin J, Miranda-Novales M, Ramírez M, Lopez-Hurtado M, Lozano M, Gomez M, Sanchez-Castuera M, Kasten-Monges M, Gonzalez-Martinez M, Sanchez-Vargas M, Culebro-Burguet M, Altuzar-Figueroa M, Mijangos-Mendez J, Ramires O, Espinosa O, De Leon-Escobedo R, Salas-Flores R, Ruiz-Rendon R, Petersen-Morfin S, Aguirre-Diaz S, Esparza-Ahumada S, Vega-Gonzalez S, Gaona-Flores V, Monroy-Colin V, Cruz-Rivera Z, Bat-Erdene A, Narankhuu B, Choijamts B, Tuvdennyam B, Batkhuu B, Chuluunchimeg K, Enkhtsetseg D, Batjargal G, Bayasgalan G, Dorj M, Mendsaikhan N, Baatar O, Suvderdene P, Baigalmaa S, Khajidmaa T, Begzjav T, Tsuyanga, Ariyasuren Z, Zeggwagh A, Berechid K, Abidi K, Madani N, Abouqal R, Koirala A, Giri R, Sainju S, Acharya SP, Ahmed A, Raza A, Parveen A, Sultan F, Khan M, Paul N, Daud N, Yusuf S, Nizamuddin S, Garcia-Mayorca E, Castaño E, Moreno-Castillo J, Ballinas-Aquino J, Lara L, Vargas M, Rojas-Bonilla M, Ramos S, Mapp T, De Iturrado V, La Hoz Vergara C, Linares-Calderon C, Moreno D, Ramirez E, Ramírez Wong F, Montenegro-Orrego G, Sandoval-Castillo H, Pichilingue-Chagray J, Mueras-Quevedo J, Aibar-Yaranga K, Castillo-Bravo L, Santivanez-Monge L, Mayorga-Espichan M, Rosario-Tueros M, Changano-Rodriguez M, Salazar-Ramirez N, Marquez-Mondalgo V, Tajanlangit ALN, Tamayo AS, Llames CMJP, Labro E, Dy AP, Fortin J, Bergosa L, Salvio L, Bermudez V, Sg-Buenaflor M, Trajano M, Mendoza M, Javellana O, Maglente R, Arreza-Galapia Y, Navoa-Ng J, Kubler A, Barteczko-Grajek B, Dragan B, Zurawska M, Mikaszewska-Sokolewicz M, Zielinska M, Ramos-Ortiz G, Florin-Rogobete A, Vlad CD, Muntean D, Sandesc D, Papurica M, Licker M, Bedreag OH, Popescu R, Grecu S, Dumitrascu V, Molkov A, Galishevskiy D, Furman M, Simic A, Lekic D, Ristic G, Eremija J, Kojovic J, Nikolic L, Bjelovic M, Lesnakova A, Hlinkova S, Gamar-Elanbya M, Supa N, Prasan P, Pimathai R, Wanitanukool S, Somabutr S, Ben-Jaballah N, Borgi A, Bouziri A, Dilek A, Oncul A, Kaya A, Demiroz AP, Gunduz A, Ozgultekin A, Inan A, Yalcin A, Ramazanoglu A, Engin A, Willke A, Meco BC, Aygun C, Bulut C, Uzun C, Becerik C, Hatipoglu CA, Guclu CY, Ozdemir D, Yildizdas D, Ugurcan D, Azak E, Guclu E, Yilmaz EM, Sebnem-Erdinc F, Sirmatel F, Ulger F, Sari F, Kizilates F, Usluer G, Ceylan G, Ersoz G, Kaya G, Ertem GT, Senol G, Agin H, Cabadak H, Yilmaz H, Sungurtekin H, Zengin H, Turgut H, Ozgunes I, Devrim I, Erdem I, Işcanlı IGE, Bakir MM, Geyik M, Oral M, Meric M, Cengiz M, Ozcelik M, Altindis M, Sunbul M, Elaldi N, Kuyucu N, Unal N, Oztoprak N, Yasar N, Erben N, Bayram N, Dursun O, Karabay O, Coskun O, Horoz OO, Turhan O, Sandal OS, Tekin R, Esen S, Erdogan SY, Unal S, Karacorlu S, Sen S, Sen S, Sacar S, Yarar V, Oruc Y, Sahip Y, Kaya Z, Philip A, Elhoufi A, Alrahma H, Sachez E, Perez F, Empaire G, Vidal H, Montes-Bravo L, Guzman Siritt M, Orozco N, Navarrete N, Ruiz Y, De Anez ZDG, Van Trang DT, Minh DQ, Co DX, Anh DPP, Thu LTA, Tuyet LTD, Nguyet LTT, Chau NU, Binh NG, Tien NP, Anh NQ, Hang PT, Hanh TTM, Hang TTT, Thu TA, Thoa VTH. International Nosocomial Infection Control Consortium report, data summary of 50 countries for 2010-2015: Device-associated module. Am J Infect Control 2016; 44:1495-1504. [PMID: 27742143 DOI: 10.1016/j.ajic.2016.08.007] [Citation(s) in RCA: 217] [Impact Index Per Article: 27.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2016] [Accepted: 08/29/2016] [Indexed: 02/07/2023]
Abstract
BACKGROUND We report the results of International Nosocomial Infection Control Consortium (INICC) surveillance study from January 2010-December 2015 in 703 intensive care units (ICUs) in Latin America, Europe, Eastern Mediterranean, Southeast Asia, and Western Pacific. METHODS During the 6-year study period, using Centers for Disease Control and Prevention National Healthcare Safety Network (CDC-NHSN) definitions for device-associated health care-associated infection (DA-HAI), we collected prospective data from 861,284 patients hospitalized in INICC hospital ICUs for an aggregate of 3,506,562 days. RESULTS Although device use in INICC ICUs was similar to that reported from CDC-NHSN ICUs, DA-HAI rates were higher in the INICC ICUs: in the INICC medical-surgical ICUs, the pooled rate of central line-associated bloodstream infection, 4.1 per 1,000 central line-days, was nearly 5-fold higher than the 0.8 per 1,000 central line-days reported from comparable US ICUs, the overall rate of ventilator-associated pneumonia was also higher, 13.1 versus 0.9 per 1,000 ventilator-days, as was the rate of catheter-associated urinary tract infection, 5.07 versus 1.7 per 1,000 catheter-days. From blood cultures samples, frequencies of resistance of Pseudomonas isolates to amikacin (29.87% vs 10%) and to imipenem (44.3% vs 26.1%), and of Klebsiella pneumoniae isolates to ceftazidime (73.2% vs 28.8%) and to imipenem (43.27% vs 12.8%) were also higher in the INICC ICUs compared with CDC-NHSN ICUs. CONCLUSIONS Although DA-HAIs in INICC ICU patients continue to be higher than the rates reported in CDC-NSHN ICUs representing the developed world, we have observed a significant trend toward the reduction of DA-HAI rates in INICC ICUs as shown in each international report. It is INICC's main goal to continue facilitating education, training, and basic and cost-effective tools and resources, such as standardized forms and an online platform, to tackle this problem effectively and systematically.
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Karacaer Z, Cakir B, Erdem H, Ugurlu K, Durmus G, Ince NK, Ozturk C, Hasbun R, Batirel A, Yilmaz EM, Bozkurt I, Sunbul M, Aynioglu A, Atilla A, Erbay A, Inci A, Kader C, Tigen ET, Karaahmetoglu G, Coskuner SA, Dik E, Tarakci H, Tosun S, Korkmaz F, Kolgelier S, Karadag FY, Erol S, Turker K, Necan C, Sahin AM, Ergen P, Iskender G, Korkmaz P, Eroglu EG, Durdu Y, Ulug M, Deniz SS, Koc F, Alpat SN, Oztoprak N, Evirgen O, Sozen H, Dogan M, Kaya S, Kaya S, Altindis M, Aslan E, Tekin R, Sezer BE, Ozdemir K, Ersoz G, Sahin A, Celik I, Aydin E, Bastug A, Harman R, Ozkaya HD, Parlak E, Yavuz I, Sacar S, Comoglu S, Yenilmez E, Sirmatel F, Balkan II, Alpay Y, Hatipoglu M, Denk A, Senol G, Bitirgen M, Geyik MF, Guner R, Kadanali A, Karakas A, Namiduru M, Udurgucu H, Boluktas RP, Karagoz E, Ormeci N. Quality of life and related factors among chronic hepatitis B-infected patients: a multi-center study, Turkey. Health Qual Life Outcomes 2016; 14:153. [PMID: 27809934 PMCID: PMC5095975 DOI: 10.1186/s12955-016-0557-9] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2016] [Accepted: 10/21/2016] [Indexed: 12/16/2022] Open
Abstract
BACKGROUND The aim of this study was to assess health-related quality of life (HRQOL) among chronic hepatitis B (CHB) patients in Turkey and to study related factors. METHODS This multicenter study was carried out between January 01 and April 15, 2015 in Turkey in 57 centers. Adults were enrolled and studied in three groups. Group 1: Inactive HBsAg carriers, Group 2: CHB patients receiving antiviral therapy, Group 3: CHB patients who were neither receiving antiviral therapy nor were inactive HBsAg carriers. Study data was collected by face-to-face interviews using a standardized questionnaire, Short Form-36 (SF-36) and Hepatitis B Quality of Life (HBQOL). Values equivalent to p < 0.05 in analyses were accepted as statistically significant. RESULTS Four thousand two hundred fifty-seven patients with CHB were included in the study. Two thousand five hundred fifty-nine (60.1 %) of the patients were males. Groups 1, 2 and 3, consisted of 1529 (35.9 %), 1721 (40.4 %) and 1007 (23.7 %) patients, respectively. The highest value of HRQOL was found in inactive HBsAg carriers. We found that total HBQOL score increased when antiviral treatment was used. However, HRQOL of CHB patients varied according to their socio-demographic properties. Regarding total HBQOL score, a higher significant level of HRQOL was determined in inactive HBV patients when matched controls with the associated factors were provided. CONCLUSIONS The HRQOL score of CHB patients was higher than expected and it can be worsen when the disease becomes active. Use of an antiviral therapy can contribute to increasing HRQOL of patients.
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Affiliation(s)
- Zehra Karacaer
- Department of Infectious Diseases and Clinical Microbiology, Etimesgut Military Hospital, Ankara, Turkey.
| | - Banu Cakir
- Institute of Public Health, Hacettepe University Faculty of Medicine, Ankara, Turkey
| | - Hakan Erdem
- Department of Infectious Diseases and Clinical Microbiology, Gulhane Military Medical Academy, Ankara, Turkey
| | - Kenan Ugurlu
- Department of Infectious Diseases and Clinical Microbiology, 25 Aralık State Hospital, Gaziantep, Turkey
| | - Gul Durmus
- Department of Infectious Diseases and Clinical Microbiology, Sevket Yilmaz Training and Research Hospital, Bursa, Turkey
| | - Nevin Koc Ince
- Department of Infectious Diseases and Clinical Microbiology, Duzce University School of Medicine, Duzce, Turkey
| | - Cinar Ozturk
- Department of Infectious Diseases and Clinical Microbiology, Recep Tayyip Erdogan University School of Medicine, Rize, Turkey
| | - Rodrigo Hasbun
- Department of Infectious Diseases, The University of Texas Health Science Center at Houston, Medical School, Houston, TX, USA
| | - Ayse Batirel
- Department of Infectious Diseases and Clinical Microbiology, Kartal Dr. Lutfi Kirdar Education and Research Hospital, Istanbul, Turkey
| | - Esmeray Mutlu Yilmaz
- Department of Infectious Diseases and Clinical Microbiology, Samsun Training and Research Hospital, Samsun, Turkey
| | - Ilkay Bozkurt
- Department of Infectious Diseases and Clinical Microbiology, Ondokuz Mayis University School of Medicine, Samsun, Turkey
| | - Mustafa Sunbul
- Department of Infectious Diseases and Clinical Microbiology, Ondokuz Mayis University School of Medicine, Samsun, Turkey
| | - Aynur Aynioglu
- Department of Infectious Diseases and Clinical Microbiology, Ataturk State Hospital, Zonguldak, Turkey
| | - Aynur Atilla
- Department of Infectious Diseases and Clinical Microbiology, Samsun Training and Research Hospital, Samsun, Turkey
| | - Ayse Erbay
- Department of Infectious Diseases and Clinical Microbiology, Bozok University School of Medicine, Yozgat, Turkey
| | - Ayse Inci
- Department of Infectious Diseases and Clinical Microbiology, Kanuni Sultan Suleyman Training and Research Hospital, Istanbul, Turkey
| | - Cigdem Kader
- Department of Infectious Diseases and Clinical Microbiology, Bozok University School of Medicine, Yozgat, Turkey
| | - Elif Tukenmez Tigen
- Department of Infectious Diseases and Clinical Microbiology, Marmara University Pendik Training and Research Hospital, Istanbul, Turkey
| | - Gokhan Karaahmetoglu
- Department of Infectious Diseases and Clinical Microbiology, Gulhane Military Medical Academy Haydarpasa Training and Research Hospital, Istanbul, Turkey
| | - Seher Ayten Coskuner
- Department of Infectious Diseases and Clinical Microbiology, Bozyaka Training and Research Hospital, Izmir, Turkey
| | - Ebru Dik
- Department of Infectious Diseases and Clinical Microbiology, Bozyaka Training and Research Hospital, Izmir, Turkey
| | - Huseyin Tarakci
- Department of Infectious Diseases and Clinical Microbiology, Izmir Metropolitan Municipalities Esrefpasa Hospital, Izmir, Turkey
| | - Selma Tosun
- Department of Infectious Diseases and Clinical Microbiology, Bozyaka Training and Research Hospital, Izmir, Turkey
| | - Fatime Korkmaz
- Department of Infectious Diseases and Clinical Microbiology, Konya Training and Research Hospital, Konya, Turkey
| | - Servet Kolgelier
- Department of Infectious Diseases and Clinical Microbiology, Yildirim Beyazit University Ankara Ataturk Training and Research Hospital, Ankara, Turkey
| | - Fatma Yilmaz Karadag
- Department of Infectious Diseases and Clinical Microbiology, Medeniyet University, Goztepe Training and Research Hospital, Istanbul, Turkey
| | - Serpil Erol
- Department of Infectious Diseases and Clinical Microbiology, Haydarpasa Numune Training and Research Hospital, Istanbul, Turkey
| | - Kamuran Turker
- Department of Infectious Diseases and Clinical Microbiology, Bagcilar Training and Research Hospital, Istanbul, Turkey
| | - Ceyda Necan
- Department of Infectious Diseases and Clinical Microbiology, Pamukkale University School of Medicine, Denizli, Turkey
| | - Ahmet Melih Sahin
- Department of Infectious Diseases and Clinical Microbiology, Giresun State Hospital, Giresun, Turkey
| | - Pinar Ergen
- Department of Infectious Diseases and Clinical Microbiology, Medeniyet University, Goztepe Training and Research Hospital, Istanbul, Turkey
| | - Gulsen Iskender
- Department of Infectious Diseases and Clinical Microbiology, Ankara Oncology Training and Research Hospital, Ankara, Turkey
| | - Pinar Korkmaz
- Department of Infectious Diseases and Clinical Microbiology, Dumlupinar University Evliya Celebi Training and Research Hospital, Kutahya, Turkey
| | - Esma Gulesen Eroglu
- Department of Infectious Diseases and Clinical Microbiology, Necmettin Erbakan University, Meram School of Medicine, Konya, Turkey
| | - Yasemin Durdu
- Department of Infectious Diseases and Clinical Microbiology, Eyup State Hospital, Istanbul, Turkey
| | - Mehmet Ulug
- Department of Infectious Diseases and Clinical Microbiology, Umit Hospital, Eskisehir, Turkey
| | - Suna Secil Deniz
- Department of Infectious Diseases and Clinical Microbiology, Kecioren Training and Research Hospital, Ankara, Turkey
| | - Filiz Koc
- Department of Infectious Diseases and Clinical Microbiology, Kecioren Training and Research Hospital, Ankara, Turkey
| | - Saygın Nayman Alpat
- Department of Infectious Diseases and Clinical Microbiology, Osmangazi University School of Medicine, Eskisehir, Turkey
| | - Nefise Oztoprak
- Department of Infectious Diseases and Clinical Microbiology, Antalya Training and Research Hospital, Antalya, Turkey
| | - Omer Evirgen
- Department of Infectious Diseases and Clinical Microbiology, Mustafa Kemal University School of Medicine, Hatay, Turkey
| | - Hamdi Sozen
- Department of Infectious Diseases and Clinical Microbiology, Sitki Kocman University School of Medicine, Mugla, Turkey
| | - Mustafa Dogan
- Department of Infectious Diseases and Clinical Microbiology, Corlu State Hospital, Tekirdag, Turkey
| | - Selcuk Kaya
- Department of Infectious Diseases and Clinical Microbiology, Karadeniz Technical University School of Medicine, Trabzon, Turkey
| | - Safak Kaya
- Department of Infectious Diseases and Clinical Microbiology, Gazi Yasargil Training and Research Hospital, Diyarbakir, Turkey
| | - Mustafa Altindis
- Department of Clinical Microbiology, Sakarya University School of Medicine, Sakarya, Turkey
| | - Emel Aslan
- Department of Infectious Diseases and Clinical Microbiology, Dicle University School of Medicine, Diyarbakir, Turkey
| | - Recep Tekin
- Department of Infectious Diseases and Clinical Microbiology, Dicle University School of Medicine, Diyarbakir, Turkey
| | - Busra Ergut Sezer
- Department of Infectious Diseases and Clinical Microbiology, Corlu State Hospital, Tekirdag, Turkey
| | - Kevser Ozdemir
- Department of Infectious Diseases and Clinical Microbiology, Denizli State Hospital, Denizli, Turkey
| | - Gulden Ersoz
- Department of Infectious Diseases and Clinical Microbiology, Mersin University School of Medicine, Mersin, Turkey
| | - Ahmet Sahin
- Department of Infectious Diseases and Clinical Microbiology, Gaziantep University School of Medicine, Gaziantep, Turkey
| | - Ilhami Celik
- Department of Infectious Diseases and Clinical Microbiology, Kayseri Training and Research Hospital, Kayseri, Turkey
| | - Emsal Aydin
- Department of Infectious Diseases and Clinical Microbiology, Kafkas University School of Medicine, Kars, Turkey
| | - Aliye Bastug
- Department of Infectious Diseases and Clinical Microbiology, Ankara Numune Training and Research Hospital, Ankara, Turkey
| | - Rezan Harman
- Department of Infectious Diseases and Clinical Microbiology, Sani Konukoglu Hospital, Gaziantep, Turkey
| | - Hacer Deniz Ozkaya
- Department of Infectious Diseases and Clinical Microbiology, Karsıkaya State Hospital, Izmir, Turkey
| | - Emine Parlak
- Department of Infectious Diseases and Clinical Microbiology, Ataturk University School of Medicine, Erzurum, Turkey
| | - Ilknur Yavuz
- Department of Infectious Diseases and Clinical Microbiology, Trabzon Kanuni Training and Research Hospital, Trabzon, Turkey
| | - Suzan Sacar
- Department of Infectious Diseases and Clinical Microbiology, Onsekiz Mart University School of Medicine, Canakkale, Turkey
| | - Senol Comoglu
- Department of Infectious Diseases and Clinical Microbiology, Umraniye Training and Research Hospital, Istanbul, Turkey
| | - Ercan Yenilmez
- Department of Infectious Diseases and Clinical Microbiology, Kasimpasa Military Hospital, Istanbul, Turkey
| | - Fatma Sirmatel
- Department of Infectious Diseases and Clinical Microbiology, Abant Izzet Baysal University School of Medicine, Bolu, Turkey
| | - Ilker Inanc Balkan
- Department of Infectious Diseases and Clinical Microbiology, Istanbul University Cerrahpasa School of Medicine, Istanbul, Turkey
| | - Yesim Alpay
- Department of Infectious Diseases and Clinical Microbiology, Balikesir University School of Medicine, Balikesir, Turkey
| | - Mustafa Hatipoglu
- Department of Infectious Diseases and Clinical Microbiology, Canakkale Military Hospital, Canakkale, Turkey
| | - Affan Denk
- Department of Infectious Diseases and Clinical Microbiology, Firat University School of Medicine, Elazig, Turkey
| | - Gunes Senol
- Department of Infectious Diseases and Clinical Microbiology, Izmir Dr. Suat Seren Pulmonology and Pulmonary Surgery Training and Research Hospital, Izmir, Turkey
| | - Mehmet Bitirgen
- Department of Infectious Diseases and Clinical Microbiology, Necmettin Erbakan University, Meram School of Medicine, Konya, Turkey
| | - Mehmet Faruk Geyik
- Department of Infectious Diseases and Clinical Microbiology, Duzce University School of Medicine, Duzce, Turkey
| | - Rahmet Guner
- Department of Infectious Diseases and Clinical Microbiology, Yildirim Beyazit University Ankara Ataturk Training and Research Hospital, Ankara, Turkey
| | - Ayten Kadanali
- Department of Infectious Diseases and Clinical Microbiology, Umraniye Training and Research Hospital, Istanbul, Turkey
| | - Ahmet Karakas
- Department of Infectious Diseases and Clinical Microbiology, Gulhane Military Medical Academy, Ankara, Turkey
| | - Mustafa Namiduru
- Department of Infectious Diseases and Clinical Microbiology, Gaziantep University School of Medicine, Gaziantep, Turkey
| | - Hatice Udurgucu
- Department of Infectious Diseases and Clinical Microbiology, Firat University School of Medicine, Elazig, Turkey
| | - Rukiye Pinar Boluktas
- Faculty of Health Sciences, Department of Nursing, Selahaddin Eyyubi University, Diyarbakir, Turkey
| | - Ergenekon Karagoz
- Department of Infectious Diseases and Clinical Microbiology, Van Military Hospital, Van, Turkey
| | - Necati Ormeci
- Department of Gastroenterology, Ankara University School of Medicine, Ankara, Turkey
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Ersoz G, Tekin F, Bozkaya H, Parildar M, Turan I, Ozutemiz O, Teksein O. Magnetic compression anastomosis for post-traumatic disconnected bile duct. Acta Gastroenterol Belg 2016; 79:60-61. [PMID: 27295727] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
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Ayaz C, Yardimci C, Candir N, Ersoz G, Sanlidag T, Tigli A, Turken M. Management of Chronic Hepatitis D Virus Infection: A Consensus Report of the Study Group for Viral Hepatitis of the Turkish Society of Clinical Microbiology and Infectious Diseases. Klimik Dergisi 2015. [DOI: 10.5152/kd.2014.28] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
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Rosenthal VD, Ramachandran B, Dueñas L, Álvarez-Moreno C, Navoa-Ng JA, Armas-Ruiz A, Ersoz G, Matta-Cortés L, Pawar M, Nevzat-Yalcin A, Rodriguez-Ferrer M, de Casares ACB, Linares C, Villanueva VD, Campuzano R, Kaya A, Rendon-Campo LF, Gupta A, Turhan O, Barahona-Guzmán N, de Jesús-Machuca L, Tolentino MCV, Mena-Brito J, Kuyucu N, Astudillo Y, Saini N, Gunay N, Sarmiento-Villa G, Gumus E, Lagares-Guzmán A, Dursun O. Findings of the International Nosocomial Infection Control Consortium (INICC), Part I: Effectiveness of a Multidimensional Infection Control Approach on Catheter-Associated Urinary Tract Infection Rates in Pediatric Intensive Care Units of 6 Developing Countries. Infect Control Hosp Epidemiol 2015; 33:696-703. [DOI: 10.1086/666341] [Citation(s) in RCA: 46] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
Design.A before-after prospective surveillance study to assess the impact of a multidimensional infection control approach for the reduction of catheter-associated urinary tract infection (CAUTI) rates.Setting.Pediatric intensive care units (PICUs) of hospital members of the International Nosocomial Infection Control Consortium (INICC) from 10 cities of the following 6 developing countries: Colombia, El Salvador, India, Mexico, Philippines, and Turkey.Patients.PICU inpatients.Methods.We performed a prospective active surveillance to determine rates of CAUTI among 3,877 patients hospitalized in 10 PICUs for a total of 27,345 bed-days. The study was divided into a baseline period (phase 1) and an intervention period (phase 2). In phase 1, surveillance was performed without the implementation of the multidimensional approach. In phase 2, we implemented a multidimensional infection control approach that included outcome surveillance, process surveillance, feedback on CAUTI rates, feedback on performance, education, and a bundle of preventive measures. The rates of CAUTI obtained in phase 1 were compared with the rates obtained in phase 2, after interventions were implemented.Results.During the study period, we recorded 8,513 urinary catheter (UC) days, including 1,513 UC-days in phase 1 and 7,000 UC-days in phase 2. In phase 1, the CAUTI rate was 5.9 cases per 1,000 UC-days, and in phase 2, after implementing the multidimensional infection control approach for CAUTI prevention, the rate of CAUTI decreased to 2.6 cases per 1,000 UC-days (relative risk, 0.43 [95% confidence interval, 0.21–1.0]), indicating a rate reduction of 57%.Conclusions.Our findings demonstrated that implementing a multidimensional infection control approach is associated with a significant reduction in the CAUTI rate of PICUs in developing countries.
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Rosenthal VD, Maki DG, Mehta Y, Leblebicioglu H, Memish ZA, Al-Mousa HH, Balkhy H, Hu B, Alvarez-Moreno C, Medeiros EA, Apisarnthanarak A, Raka L, Cuellar LE, Ahmed A, Navoa-Ng JA, El-Kholy AA, Kanj SS, Bat-Erdene I, Duszynska W, Van Truong N, Pazmino LN, See-Lum LC, Fernández-Hidalgo R, Di-Silvestre G, Zand F, Hlinkova S, Belskiy V, Al-Rahma H, Luque-Torres MT, Bayraktar N, Mitrev Z, Gurskis V, Fisher D, Abu-Khader IB, Berechid K, Rodríguez-Sánchez A, Horhat FG, Requejo-Pino O, Hadjieva N, Ben-Jaballah N, García-Mayorca E, Kushner-Dávalos L, Pasic S, Pedrozo-Ortiz LE, Apostolopoulou E, Mejía N, Gamar-Elanbya MO, Jayatilleke K, de Lourdes-Dueñas M, Aguirre-Avalos G, Maurizi DM, Montanini A, Spadaro ML, Marcos LS, Botta P, Jerez FM, Chavez MC, Ramasco L, Colqui MI, Olivieri MS, Rearte AS, Correa GE, Juarez PD, Gallardo PF, Brito MP, Mendez GH, Valdez JR, Cardena LP, Harystoy JM, Chaparro GJ, Rodriguez CG, Toomey R, Caridi M, Viegas M, Bernan ML, Romani A, Dominguez CB, Davalos LK, Richtmann R, Silva CA, Rodrigues TT, Filho AM, Seerig Palme ED, Besen A, Lazzarini C, Cardoso CB, Azevedo FK, Pinheiro APF, Camacho A, De Carvalho BM, De Assis MJM, Carneiro APV, Canuto MLM, Pinto Coelho KH, Moreira T, Oliveira AA, Sousa Colares MM, De Paula Bessa MM, Gomes Bandeira TDJP, De Moraes RA, Campos DA, De Barros Araújo TML, Freitas Tenório MT, Amorim S, Amaral M, Da Luz Lima J, Pino Da Silva Neta L, Batista C, De Lima Silva FJ, Ferreira De Souza MC, Arruda Guimaraes K, Marcia Maluf Lopes J, Nogueira Napoles KM, Neto Avelar LLS, Vieira LA, Gustavo De Oliveira Cardo L, Takeda CF, Ponte GA, Eduardo Aguiar Leitão F, De Souza Kuchenbecker R, Pires Dos Santos R, Maria Onzi Siliprandi E, Fernando Baqueiro Freitas L, Martins IS, Casi D, Maretti Da Silva MA, Blecher S, Villins M, Salomao R, Oliveira Castro SR, Da Silva Escudero DV, Andrade Oliveira Reis M, Mendonca M, Furlan V, Claudio do Amaral Baruzzi A, Sanchez TE, Moreira M, Vasconcelos de Freitas W, Passos de Souza L, Velinova VA, Hadjieva N, Petrov MM, Karadimov DG, Kostadinov ED, Dicheva VJ, Wang C, Guo X, Geng X, Wang S, Zhang J, Zhu L, Zhuo S, Guo C, Lili T, Ruisheng L, Kun L, Yang X, Yimin L, Pu M, Changan L, Shumei Y, Kangxiong W, Meiyi L, Ye G, Ziqin X, Yao S, Liqiang S, Marino Cañas Giraldo L, Margarita Trujillo Ramirez E, Rios PA, Carlos Torres Millan J, Giovanny Chapeta Parada E, Eduardo Mindiola Rochel A, Corchuelo Martinez AH, Marãa Perez Fernandez A, Guzman NB, Guzman AL, Ferrer MR, Vega YL, Munoz HJ, Moreno GC, Romero Torres SL, Hernandez HT, Valderrama MarquezClaudia Linares IA, Valencia ME, Corrales LS, Bonilla SM, Ivan Marin Uribe J, Gomez DY, Martinez JO, Dary Burgos Florez L, Osorio J, Santofimio D, Cortes LM, Villamil-Gomez W, Gutierrez GM, Ruiz AA, Fuentes CG, Chinchilla AS, Hernandez IC, Ugalde OC, Garcell HG, Perez CM, Bardak S, Ozkan S, Mejia N, Puello Guerrero Glenny Mirabal AM, Delgado M, Severino R, Lacerda E, Tolari G, Bovera MM, Pinto DB, González PF, Santacruz G, Alquinga N, Zaruma C, Remache N, Morocho D, Arboleda M, Zapata MC, Garcia MF, Picoita F, Velez J, Valle M, Yepez ES, Tutillo DM, Mora RA, Padilla AP, Chango M, Cabezas K, Tenorio López S, Lucía Bonilla Escudero A, Sánchez GT, Alberto Gonzalez Flores H, Garcia MF, Ghazi IA, Hassan M, Ismail GA, Hamed R, Abdel-Halim MM, El-Fattah MA, Abdel-Aziz D, Seliem ZS, Elsherif RH, Dewdar RA, Mohmed AA, Abdel-Fatteh Ahmed L, De Jesus Machuca L, Bran De Casares C, Kithreotis P, Daganou M, Veldekis D, Kartsonaki M, Gikas A, Luque Torres MT, Padgett D, Rivera DM, Jaggi N, Rodrigues C, Shah B, Parikh K, Patel J, Thakkar R, Chakravarthy M, Gokul B, Sukanya R, Pushparaj L, Vini T, Rangaswamy S, Patnaik SK, Venkateshwar V, John B, Dalal S, Sahu S, Sahu S, Ray B, Misra S, Mohanty N, Mishra BM, Sahoo P, Parmar N, Mishra S, Pati BK, Singh S, Pati BS, Panda A, Banergee S, Padhihari D, Samal S, Sahu S, Varma K, Suresh Kumar VP, Gopalakrishnan R, Ramakrishnan N, Abraham BK, Rajagopal S, Venkatraman R, Mani AK, Devaprasad D, Ranganathan L, Francis T, Cherain KM, Ramachandran B, Krupanandan R, Muralidharan S, Karpagam M, Padmini B, Saranya S, Kumar S, Pandya N, Kakkar R, Zompa T, Saini N, Samavedam S, Jagathkar G, Nirkhiwale S, Gehlot G, Bhattacharya S, Sood S, Singh S, Singh S, Todi SK, Bhattacharyya M, Bhakta A, Basu S, Agarwal A, Agarwal M, Kharbanda M, Sengupta S, Karmakar A, Gupta D, Sarkar AK, Dey R, Bhattacharya C, Chandy M, Ramanan V, Mahajan A, Roy M, Bhattacharya S, Sinha S, Roy I, Gupta U, Mukherjee S, Bej M, Mukherjee P, Baidya S, Azim A, Sakle AS, Sorabjee JS, Potdar MS, Subhedar VR, Udwadia F, Francis H, Dwivedy A, Binu S, Shetty S, Nair PK, Khanna DK, Chacko F, Blessymole S, Mehta PR, Singhal T, Shah S, Kothari V, Naik R, Patel MH, Aggarwal DG, Jawadwala BQ, Pawar NK, Kardekar SN, Manked AN, Myatra S, Divatia J, Kelkar R, Biswas S, Raut V, Sampat S, Thool A, Karlekar A, Nandwani S, Gupta S, Singhal S, Gupta M, Mathur P, Kumar S, Sandhu K, Dasgupta A, Raha A, Raman P, Wadhera A, Badyal B, Juneja S, Mishra B, Sharma S, Mehrotra M, Shelgaonkar J, Padbidri V, Dhawale R, Sibin SM, Mane D, Sale HK, Mukhit Abdul Gaffar Kazi M, Chabukswar S, Mathew A, Gaikwad D, Harshe A, Nadimpalli G, Bhamare S, Thorat S, Sarda O, Nadimpalli P, Mendonca A, Malik S, Kamble A, Kumari N, Arora S, Munshi N, Divekar DG, Kavathekar MS, Kulkarni AK, Kavathekar MS, Suryawanshi MV, Bommala ML, Bilolikar A, Joshi KL, Pamnani C, Wasan H, Khamkar S, Steephen L, Rajalakshmi A, Thair A, Mubarak A, Sathish S, Kumar S, Sunil H, Sujith S, Dinesh, Sen N, Thool A, Shinde N, Alebouyeh M, Jahani-Sherafat S, Zali MR, Sarbazi MR, Mansouri N, Tajeddin E, Razaghi M, Seyedjavadi S, Tajeddin E, Rashidan M, Razaghi M, Masjedi M, Maghsudi B, Sabetian G, Sanaei A, Yousefipour A, Alebouyeh M, Assiri AM, Furukawa-Cinquini EM, Alshehri AD, Giani AF, Demaisip NL, Cortez EL, Cabato AF, Gonzales Celiz JM, Al-Zaydani Asiri IA, Mohammed YK, Abdullah Al Raey M, Omer Abdul Aziz A, Ali Al Darani S, Aziz MR, Basri RH, Al-Awadi DK, Bukhari SZ, Aromin RG, Ubalde EB, Molano AM, Abdullah Al Enizy H, Baldonado CF, Al Adwani FM, Marie Casuyon Pahilanga A, Tan AM, Joseph S, Nair DS, Al-Abdullah NA, Sindayen G, Malificio AA, Mohammed DA, Mesfer Al Ghamdi H, Silo AC, Valisto MBV, Foteinakis N, Ghazal SS, Joseph MV, Hakawi A, Hasani A, Jusufi I, Spahija G, Baftiu N, Gecaj-Gashi A, Aly NY, El-Dossoky Noweir M, Varghese ST, Ramapurath RJ, Mohamed AM, George SM, Kurian A, Sayed AF, Salama MF, Omar AA, Rebello FM, Narciso DM, Zahreddine NK, Kanafani Z, Kardas T, Molaeb B, Jurdi L, Al Souheil A, Ftouni M, Ayash H, Mahfouz T, Kondratas T, Grinkeviciute D, Kevalas R, Gailiene G, Dagys A, Petrovska M, Popovska K, Bogoevska-Miteva Z, Jankovska K, Guroska ST, Anguseva T, Wan Yusoff WN, Shiham Zainal Abidin A, Gan CS, Zainol H, Rai V, Kwong WK, Hasan MS, Sri La Sri Ponnampala S, Veerakumaran J, Assadian O, Phuong DM, Binh NG, Kaur K, Lim J, Tan LH, Manikavasagam J, Cheong YM, Magaña HC, Cesar Mijangos Méndez J, Jiménez FC, Esparza-Ahumada S, Morfin-Otero R, Rodriguez-Noriega E, Gutierrez-Martinez S, Perez-Gomez HR, León-Garnica G, Mendoza-Mujica C, Cecilia Culebro Burguet M, Portillo-Gallo JH, Almazán FA, Miramontes GI, Olivas MDRV, Aguilar Angel LA, Vargas MS, Orlando Flores Alvarado A, Carlos Mares Morales R, Carlos Fernandez Alvarez L, Armando Rincon Leon H, Navarro Fuentes KR, Mariela Perez Hernandez Y, Falcon GM, Vargas AG, Trujillo Juarez MA, Mulia AM, Alma Ulloa Camacho P, Martinez-Marroquin MY, Garcia MM, Martinez AM, Sanchez EL, Flores GG, Martínez MDRG, Alfonso Galindo Olmeda J, Olivarez G, Rodriguez EB, Magdalena Gutierrez Castillo M, Guadalupe Villa González M, Beatriz Sauceda Castañeda I, Rodriguez JM, Baatar O, Batkhuu B, Meryem K, Amina B, Abouqal R, Zeggwagh AA, Dendane T, Abidi K, Madani N, Mahmood SF, Memon BA, Bhutto GH, Paul N, Parveen A, Raza A, Mahboob A, Nizamuddin S, Sultan F, Nazeer H, Khan AA, Hafeez A, Lara L, Mapp T, Alvarez B, Rojas-Bonilla MI, Castano E, De Moros DA, Atarama RE, Calisto Pazos ME, Paucar A, Ramos MT, Jurado J, Moreno D, Cruz Saldarriaga ME, Ramirez E, La Hoz Vergara CE, Enrique Prudencio Leon W, Isidro Castillo Bravo L, Fernanda Aibar Yaranga K, Pichilingue Chagray JE, Marquez Mondalgo VA, Zegarra ST, Astete NS, Guevara FC, Pastrana JS, Enrique Prudencio Leon W, Linares Calderon CF, Jesus Mayorga Espichan M, Martin Santivanez Monge L, Changano Rodriguez MV, Rosa Diaz Tavera Z, Martin Ramirez Wong F, Chavez SM, Rosa Diaz Tavera Z, Martin Ramirez Wong F, Atencio-Espinoza T, Villanueva VD, Blanco-Abuy MT, Tamayo AS, Bergosa LD, Llames CMJP, Trajano MF, Bunsay SA, Amor JC, Berba R, Sg Buenaflor MC, Labro E, Mendoza MT, Javellana OP, Salvio LG, Rayco RG, Bermudez V, Kubler A, Zielinska M, Kosmider-Zurawska M, Barteczko-Grajek B, Szewczyk E, Dragan B, Mikaszewska-Sokolewicz MA, Lazowski T, Cancel E, Licker MS, Dragomirescu LA, Dumitrascu V, Sandesc D, Bedreag O, Papurica M, Muntean D, Kotkov I, Kretov V, Shalapuda V, Molkov A, Puzanov S, Utkin I, Tchekulaev A, Tulupova V, Nikolic L, Ristic G, Eremija J, Kojovic J, Lekic D, Vasiljevic S, Lesnakova A, Marcekova A, Furova K, Gamar Elanbya MO, Ali MA, Kadankunnel SK, Somabutr S, Pimathai R, Wanitanukool S, Luxsuwong M, Supa N, Prasan P, Thamlikitkul V, Jamulitrat S, Suwalak N, Phainuphong P, Asma B, Aida B, Sarra BH, Ammar K, Ertem GT, Bulut C, Hatipoglu CA, Erdinc FS, Demiroz AP, Ozcelik M, Meco BC, Oral M, Unal N, Guclu CY, Kendirli T, İnce E, Çiftçi E, Yaman A, Ödek Ç, Karbuz A, Kocabaş BA, Altın N, Cesur S, Atasay B, Erdeve O, Akduman H, Kahvecioglu D, Cakir U, Yildiz D, Kilic A, Arsan S, Arman D, Unal S, Gelebek Y, Zengin H, Sen S, Cabadak H, Erbay A, Yalcin AN, Turhan O, Cengiz M, Dursun O, Gunasan P, Kaya S, Ramazanoglu A, Ustun C, Yasayacak A, Akdeniz H, Sirmatel F, Otkun AM, Sacar S, Sener A, Turgut H, Sungurtekin H, Ugurcan D, Necan C, Yilmaz C, Ozdemir D, Geyik MF, Ince N, Danis A, Erdogan SY, Erben N, Usluer G, Ozgunes I, Uzun C, Oncul O, Gorenek L, Erdem H, Baylan O, Ozgultekin A, Inan A, Bolukcu S, Senol G, Ozdemir H, Gokmen Z, Ozdemir SI, Kaya A, Ersoz G, Kuyucu N, Karacorlu S, Kaya Z, Guclu E, Kaya G, Karabay O, Esen S, Aygun C, Ulger F, Dilek A, Yilmaz H, Sunbul M, Engin A, Bakir M, Elaldi N, Koksal I, Yildizdas D, Horoz OO, Willke A, Koç MM, Azak E, Elahi N, Annamma P, El Houfi A, Pirez Garcia MC, Vidal H, Perez F, Empaire GD, Ruiz Y, Hernandez D, Aponte D, Salinas E, Diaz C, Guzmán Siritt ME, Gil De Añez ZD, Bravo LM, Orozco N, Mejías E, Hung NV, Anh NQ, Chau NQ, Thu TA, Phuong DM, Binh NG, Thi Diem Tuyet L, Thi Van Trang D, Hong Thoa VT, Tien NP, Anh Thu LT, Hang PT, My Hanh TT, Thuy Hang TT, Phuong Anh DP. International Nosocomial Infection Control Consortium (INICC) report, data summary of 43 countries for 2007-2012. Device-associated module. Am J Infect Control 2014; 42:942-56. [PMID: 25179325 DOI: 10.1016/j.ajic.2014.05.029] [Citation(s) in RCA: 172] [Impact Index Per Article: 17.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2014] [Revised: 05/07/2014] [Accepted: 05/07/2014] [Indexed: 12/14/2022]
Abstract
We report the results of an International Nosocomial Infection Control Consortium (INICC) surveillance study from January 2007-December 2012 in 503 intensive care units (ICUs) in Latin America, Asia, Africa, and Europe. During the 6-year study using the Centers for Disease Control and Prevention's (CDC) U.S. National Healthcare Safety Network (NHSN) definitions for device-associated health care-associated infection (DA-HAI), we collected prospective data from 605,310 patients hospitalized in the INICC's ICUs for an aggregate of 3,338,396 days. Although device utilization in the INICC's ICUs was similar to that reported from ICUs in the U.S. in the CDC's NHSN, rates of device-associated nosocomial infection were higher in the ICUs of the INICC hospitals: the pooled rate of central line-associated bloodstream infection in the INICC's ICUs, 4.9 per 1,000 central line days, is nearly 5-fold higher than the 0.9 per 1,000 central line days reported from comparable U.S. ICUs. The overall rate of ventilator-associated pneumonia was also higher (16.8 vs 1.1 per 1,000 ventilator days) as was the rate of catheter-associated urinary tract infection (5.5 vs 1.3 per 1,000 catheter days). Frequencies of resistance of Pseudomonas isolates to amikacin (42.8% vs 10%) and imipenem (42.4% vs 26.1%) and Klebsiella pneumoniae isolates to ceftazidime (71.2% vs 28.8%) and imipenem (19.6% vs 12.8%) were also higher in the INICC's ICUs compared with the ICUs of the CDC's NHSN.
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Ersoz G, Uguz M, Aslan G, Horasan E, Kaya A. Outbreak of meningitis due to Serratia marcescens after spinal anaesthesia. J Hosp Infect 2014; 87:122-5. [DOI: 10.1016/j.jhin.2014.03.004] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2013] [Accepted: 03/07/2014] [Indexed: 11/26/2022]
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Dag A, Akca T, Ersoz G, Cinel L. Aspergillosis of thyroid gland managed by thyroidectomy. Surgical Practice 2013. [DOI: 10.1111/j.1744-1633.2012.00636.x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Affiliation(s)
- Ahmet Dag
- Department of General Surgery; Mersin University; Mersin; Turkey
| | - Tamer Akca
- Department of General Surgery; Mersin University; Mersin; Turkey
| | - Gulden Ersoz
- Department of Infectious Disease; Mersin University; Mersin; Turkey
| | - Leyla Cinel
- Department of Pathology; Mersin University; Mersin; Turkey
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Dag A, Akca T, Ersoz G, Cinel L. Aspergillosis of Thyroid Gland Managed by Thyroidectomy. Surgical Practice 2013. [DOI: 10.1111/1744-1633.12025] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Affiliation(s)
- Ahmet Dag
- Departments of General Surgery Medical Faculty of Mersin University, Mersin; TURKEY
| | - Tamer Akca
- Departments of General Surgery Medical Faculty of Mersin University, Mersin; TURKEY
| | - Gulden Ersoz
- Departments of Infectious Disease Medical Faculty of Mersin University, Mersin; TURKEY
| | - Leyla Cinel
- Departments of Pathology Medical Faculty of Mersin University, Mersin; TURKEY
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Aytacoglu BN, Ersoz G, Sucu N, Tamer L, Coskun B, Oguz I, Bayindir I, Kose N, Ozeren M, Dikmengil M. Combined Therapy of Teicoplanin and Caffeic Acid Phenethyl Ester (CAPE) in the Treatment of Experimental Mediastinitis in the Rat. J Chemother 2013; 18:268-77. [PMID: 17129837 DOI: 10.1179/joc.2006.18.3.268] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022]
Abstract
Post-sternotomy mediastinitis affects 1-3% of patients undergoing cardiac surgery and is lethal in 10-47% of these patients. We investigated the effect of an antioxidant/anti-inflammatory agent, caffeic acid phenethyl ester (CAPE), in the attenuation of inflammatory response induced by methicillin-resistant Staphylococcus aureus (MRSA) infection in a rat experimental mediastinitis model. Rats, divided into six equal groups, received MRSA precolonized stainless steel wire pieces implanted into their mediastinal spaces. Control group and CAPE control group received saline and CAPE 10 micromol/kg.day(-1 )respectively, where Group A received a single dose of teicoplanin 24 mg/kg i.m. for the first day and then 12 mg/kg.day(-1) . Group B received teicoplanin as in Group A plus CAPE 10 micromol/kg. day(-1 )intra-peritoneally. Group C received teicoplanin 60 mg/kg i.m. for the first day and then 30 mg/kg.day(-1 )and Group D received teicoplanin as in Group C plus CAPE 10 micromol/kg.day(-1) . By the end of 14 days rats were sacrificed and serum malondialdehyde (MDA), myeloperoxidase (MPO), nitric oxide (NO), urea and creatinine levels were evaluated. Mediastinal organ tissues were collected for histopathological analysis. Infection rates in all the drug-treated groups were lower than the control groups ( P=0.002) but statistical significance was attained only between the groups A and D ( P=0.018). In connective tissues and the peribronchial area polymorphonuclear leukocytic (PNL) infiltration in the treatment groups, although becoming very close, did not reach statistical significance (P =0.053, P=0.075, respectively). PNL infiltration especially in the peribronchial tissues of the Group B animals was found to be significantly less than the Control and CAPE Control groups with P values of 0.013 and 0.010, respectively. MDA and MPO levels were significantly lower in the treatment groups ( P<0.001 and P<0.001 respectively). Levels of the degradation products of NO were lower in treatment groups compared to two control groups (P=0.003, P= 0.005). NO levels in Group D were lowest among all treatment groups ( P=0.001). It has been demonstrated that although bacterial colonization can be controlled in mediastinitis, the inflammatory response persists. The combination of an antioxidant / anti-inflammatory agent, CAPE, added to standard antibiotic therapy might be effective in the treatment of post-sternotomy mediastinitis due to MRSA.
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Affiliation(s)
- B N Aytacoglu
- Department of Cardiovascular Surgery, Mersin University, School of Medicine, Mersin, Turkey
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Leblebicioglu H, Öztürk R, Rosenthal VD, Akan ÖA, Sirmatel F, Ozdemir D, Uzun C, Turgut H, Ersoz G, Koksal I, Özgültekin A, Esen S, Ulger F, Dilek A, Yilmaz H, Dikmen Y, Aygún G, Tulunay M, Oral M, Ünal N, Cengiz M, Yilmaz L, Geyik MF, Şahin A, Erdogan S, Sacar S, Sungurtekin H, Uğurcan D, Kaya A, Kuyucu N, Yýlmaz G, Kaya S, Ulusoy H, İnan A. Impact of a multidimensional infection control approach on central line-associated bloodstream infections rates in adult intensive care units of 8 cities of Turkey: findings of the International Nosocomial Infection Control Consortium (INICC). Ann Clin Microbiol Antimicrob 2013; 12:10. [PMID: 23641950 PMCID: PMC3674978 DOI: 10.1186/1476-0711-12-10] [Citation(s) in RCA: 46] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2013] [Accepted: 02/23/2013] [Indexed: 02/07/2023] Open
Abstract
Background Central line-associated bloodstream infections (CLABs) have long been associated with excess lengths of stay, increased hospital costs and mortality attributable to them. Different studies from developed countries have shown that practice bundles reduce the incidence of CLAB in intensive care units. However, the impact of the bundle strategy has not been systematically analyzed in the adult intensive care unit (ICU) setting in developing countries, such as Turkey. The aim of this study is to analyze the impact of the International Nosocomial Infection Control Consortium (INICC) multidimensional infection control approach to reduce the rates of CLAB in 13 ICUs of 13 INICC member hospitals from 8 cities of Turkey. Methods We conducted active, prospective surveillance before-after study to determine CLAB rates in a cohort of 4,017 adults hospitalized in ICUs. We applied the definitions of the CDC/NHSN and INICC surveillance methods. The study was divided into baseline and intervention periods. During baseline, active outcome surveillance of CLAB rates was performed. During intervention, the INICC multidimensional approach for CLAB reduction was implemented and included the following measures: 1- bundle of infection control interventions, 2- education, 3- outcome surveillance, 4- process surveillance, 5- feedback of CLAB rates, and 6- performance feedback on infection control practices. CLAB rates obtained in baseline were compared with CLAB rates obtained during intervention. Results During baseline, 3,129 central line (CL) days were recorded, and during intervention, we recorded 23,463 CL-days. We used random effects Poisson regression to account for clustering of CLAB rates within hospital across time periods. The baseline CLAB rate was 22.7 per 1000 CL days, which was decreased during the intervention period to 12.0 CLABs per 1000 CL days (IRR 0.613; 95% CI 0.43 – 0.87; P 0.007). This amounted to a 39% reduction in the incidence rate of CLAB. Conclusions The implementation of multidimensional infection control approach was associated with a significant reduction in the CLAB rates in adult ICUs of Turkey, and thus should be widely implemented.
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Abstract
BACKGROUND Implant-related infections with bacteria resistant to multiple antibiotics represent one of the major problems in orthopaedic surgery. It was our hypothesis that local application of bacteriophages, which are bacteria-destroying viruses, would be effective against biofilm-forming bacteria. METHODS An implant-related infection model was created using methicillin-resistant Staphylococcus aureus (MRSA) in forty-eight rats and Pseudomonas aeruginosa in another forty-eight rats. Each group was divided into four subgroups; one subgroup received a bacterium-specific bacteriophage (Sb-1 in the MRSA group and PAT14 in the Pseudomonas aeruginosa group), one received antibiotic for fourteen days (20 mg/kg/day teicoplanin in the MRSA group, and 120 mg/kg/day imipenem + cilastatin and 25 mg/kg/day amikacin in the Pseudomonas group), one received antibiotic and bacteriophage, and one received no treatment. Animals receiving bacteriophage therapy were injected locally with 107 bacteriophages in a 0.1-mL suspension on three consecutive days. All animals were killed on the fifteenth day after initiation of treatment, and the tibia was excised. Results were assessed with use of microbiology, light microscopy, and electron microscopy. RESULTS In the MRSA group, the antibiotic administration significantly decreased the number of colony-forming units per subject in quantitative cultures (control subgroup, 50,586; bacteriophage, 30,788; antibiotic, 17,165; antibiotic + bacteriophage, 5000; p = 0.004 for the comparison of the latter group with the control). Biofilm was absent only in the antibiotic + bacteriophage subgroup. In the Pseudomonas group, the number of colony-forming units per subject in quantitative cultures was significantly lower in each treatment subgroup compared with the control subgroup (control subgroup, 14,749; bacteriophage, 6484 [p = 0.016]; antibiotic, 2619 [p = 0.01]; antibiotic + bacteriophage, 1705 [p < 0.001]). The value in the antibiotic + bacteriophage subgroup was also significantly lower than the values in the other subgroups (p = 0.006). Biofilm thickness did not differ significantly among the subgroups in the Pseudomonas group. CONCLUSIONS The addition of bacteriophage treatment to an appropriate antibiotic regimen helped to dissolve the biofilm of both types of bacteria studied. This effect on MRSA was more pronounced than that on Pseudomonas aeruginosa.
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Affiliation(s)
- Cengiz Yilmaz
- Department of Orthopedics and Traumatology, Mersin University Medical School, Zeytinlibahce cd, Mersin, Turkey.
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Rosenthal VD, Álvarez-Moreno C, Villamil-Gómez W, Singh S, Ramachandran B, Navoa-Ng JA, Dueñas L, Yalcin AN, Ersoz G, Menco A, Arrieta P, Bran-de Casares AC, de Jesus Machuca L, Radhakrishnan K, Villanueva VD, Tolentino MC, Turhan O, Keskin S, Gumus E, Dursun O, Kaya A, Kuyucu N. Effectiveness of a multidimensional approach to reduce ventilator-associated pneumonia in pediatric intensive care units of 5 developing countries: International Nosocomial Infection Control Consortium findings. Am J Infect Control 2012; 40:497-501. [PMID: 22054689 DOI: 10.1016/j.ajic.2011.08.005] [Citation(s) in RCA: 59] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2011] [Revised: 07/29/2011] [Accepted: 08/01/2011] [Indexed: 01/13/2023]
Abstract
BACKGROUND Ventilator-associated pneumonia (VAP) is one of the most common health care-associated infections in pediatric intensive care units (PICUs). Practice bundles have been shown to reduce VAP rates in PICUs in developed countries; however, the impact of a multidimensional approach, including a bundle, has not been analyzed in PICUs from developing countries. METHODS This was a before-after study to determine rates of VAP during a period of active surveillance without the implementation of the multidimensional infection control program (phase 1) to be compared with rates of VAP after implementing such a program, which included the following: bundle of infection control interventions, education, outcome surveillance, process surveillance, feedback on VAP rates, and performance feedback on infection control practices (phase 2). This study was conducted by infection control professionals applying the National Health Safety Network's definitions of health care-associated infections and the International Nosocomial Infection Control Consortium's surveillance methodology. RESULTS During the baseline period, we recorded a total of 5,212 mechanical ventilator (MV)-days, and during implementation of the intervention bundle, we recorded 9,894 MV-days. The VAP rate was 11.7 per 1,000 MV-days during the baseline period and 8.1 per 1,000 MV-days during the intervention period (relative risk, 0.69; 95% confidence interval, 0.5-0.96; P = .02), demonstrating a 31% reduction in VAP rate. CONCLUSIONS Our results show that implementation of the International Nosocomial Infection Control Consortium's multidimensional program was associated with a significant reduction in VAP rate in PICUs of developing countries.
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Rosenthal VD, Todi SK, Álvarez-Moreno C, Pawar M, Karlekar A, Zeggwagh AA, Mitrev Z, Udwadia FE, Navoa-Ng JA, Chakravarthy M, Salomao R, Sahu S, Dilek A, Kanj SS, Guanche-Garcell H, Cuéllar LE, Ersoz G, Nevzat-Yalcin A, Jaggi N, Medeiros EA, Ye G, Akan ÖA, Mapp T, Castañeda-Sabogal A, Matta-Cortés L, Sirmatel F, Olarte N, Torres-Hernández H, Barahona-Guzmán N, Fernández-Hidalgo R, Villamil-Gómez W, Sztokhamer D, Forciniti S, Berba R, Turgut H, Bin C, Yang Y, Pérez-Serrato I, Lastra CE, Singh S, Ozdemir D, Ulusoy S. Impact of a multidimensional infection control strategy on catheter-associated urinary tract infection rates in the adult intensive care units of 15 developing countries: findings of the International Nosocomial Infection Control Consortium (INICC). Infection 2012; 40:517-26. [DOI: 10.1007/s15010-012-0278-x] [Citation(s) in RCA: 69] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2011] [Accepted: 05/25/2012] [Indexed: 11/24/2022]
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Rosenthal VD, Rodríguez-Calderón ME, Rodríguez-Ferrer M, Singhal T, Pawar M, Sobreyra-Oropeza M, Barkat A, Atencio-Espinoza T, Berba R, Navoa-Ng JA, Dueñas L, Ben-Jaballah N, Ozdemir D, Ersoz G, Aygun C. Findings of the International Nosocomial Infection Control Consortium (INICC), Part II: Impact of a multidimensional strategy to reduce ventilator-associated pneumonia in neonatal intensive care units in 10 developing countries. Infect Control Hosp Epidemiol 2012; 33:704-10. [PMID: 22669232 DOI: 10.1086/666342] [Citation(s) in RCA: 75] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
Design. Before-after prospective surveillance study to assess the efficacy of the International Nosocomial Infection Control Consortium (INICC) multidimensional infection control program to reduce the rate of occurrence of ventilator-associated pneumonia (VAP). Setting. Neonatal intensive care units (NICUs) of INICC member hospitals from 15 cities in the following 10 developing countries: Argentina, Colombia, El Salvador, India, Mexico, Morocco, Peru, Philippines, Tunisia, and Turkey. Patients. NICU inpatients. Methods. VAP rates were determined during a first period of active surveillance without the implementation of the multidimensional approach (phase 1) to be then compared with VAP rates after implementation of the INICC multidimensional infection control program (phase 2), which included the following practices: a bundle of infection control interventions, education, outcome surveillance, process surveillance, feedback on VAP rates, and performance feedback on infection control practices. This study was conducted by infection control professionals who applied National Health Safety Network (NHSN) definitions for healthcare-associated infections and INICC surveillance methodology. Results. During phase 1, we recorded 3,153 mechanical ventilation (MV)-days, and during phase 2, after the implementation of the bundle of interventions, we recorded 15,981 MV-days. The VAP rate was 17.8 cases per 1,000 MV-days during phase 1 and 12.0 cases per 1,000 MV-days during phase 2 (relative risk, 0.67 [95% confidence interval, 0.50-0.91]; [Formula: see text]), indicating a 33% reduction in VAP rate. Conclusions. Our results demonstrate that an implementation of the INICC multidimensional infection control program was associated with a significant reduction in VAP rate in NICUs in developing countries.
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Affiliation(s)
- Victor D Rosenthal
- International Nosocomial Infection Control Consortium, Avenue Corrientes4580,Buenos Aires, Argentina.
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Horasan ES, Ersoz G, Tombak A, Tiftik N, Kaya A. Bloodstream infections and mortality-related factors in febrile neutropenic cancer patients. Med Sci Monit 2011; 17:CR304-9. [PMID: 21525814 PMCID: PMC3539578 DOI: 10.12659/msm.881773] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
Background We performed a prospective observational cohort study to evaluate the causative bacteria and to identify risk factors for mortality in febrile neutropenic (FN) patients with blood stream infection (BSI). Material/Methods We conducted a prospective data collection on all patients with bacteremia or fungemia. The patients were assigned into low-risk and high-risk groups in accordance with the Multinational Association for Supportive Care in Cancer (MASCC) Risk Index. Results Throughout the study period, the patients developed 420 FN episodes. Out of 420 episodes, only 90 (21.4%) were found to have bloodstream infection. The mean age of the patients was 45.6±18.4 years and 55.6% of the patients were male. A total of 98 isolates were recovered from the cases of BSI. Coagulase-negative Staphylococcus spp (CoNS) were the most common isolates overall (33.7%). There was a significant increase in the rate of gram-negative bacteria throughout the study period (p=0.028). Overall mortality was 33%. Multivariate analyses showed that MASCC risk scores (p=0.0001, OR=15.1, CI%95 4.5–50.7), ICU wards (p=0.0002, OR= 8.6, Cl%95 1.101–68,157) and CoNS (p=0.004, OR=12.12, CI%95 2.3–64.7) were independent risk factors associated with mortality. BSI due to CoNS was associated with lower mortality; however, MASCC high risk score and ICU stay were associated with higher mortality. Conclusions The MASCC risk-index score and emergence of CoNS in positive blood cultures are valuable tools in the management of FN.
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Affiliation(s)
- Elif Sahin Horasan
- Department of Clinical Microbiology and Infectious Diseases, Mersin University, Faculty of Medicine, Mersin, Turkey.
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Turgutalp K, Kiykim A, Ersoz G, Kaya A. Fatal catheter-related bacteremia due to Alcaligenes (Achromobacter) xylosoxidans in a hemodialysis patient. Int Urol Nephrol 2011; 44:1281-3. [PMID: 21637989 DOI: 10.1007/s11255-011-0003-1] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2011] [Accepted: 05/18/2011] [Indexed: 10/18/2022]
Affiliation(s)
- K Turgutalp
- Division of Nephrology, Department of Internal Medicine, Faculty of Medicine, Mersin Üniversitesi Tıp Fakültesi, İç Hastalıkları Anabilim Dalı, Nefroloji B.D, 33079 Mersin, Turkey.
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Horasan ES, Ersoz G, Horoz M, Göksu M, Karacorlu S, Kaya A. Risk factors for infections caused by multidrug-resistant bacteria in patients with solid tumours. ACTA ACUST UNITED AC 2010; 43:107-11. [PMID: 21080767 DOI: 10.3109/00365548.2010.534500] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
OBJECTIVES We aimed to determine the risk factors for healthcare-associated infections (HCAI) caused by multidrug-resistant (MDR) bacteria in patients with solid tumours. METHODS This retrospective study was performed in the Department of Clinical Microbiology and Infectious Diseases, Mersin Teaching and Research Medical Centre, between January 2004 and December 2008. SPSS version 11.5 program package was used for the statistical analyses. RESULTS A total of 145 patients who had an HCAI were analyzed; 62% of the patients were male and their median age was 57.7 ± 16 y and median Charlson co-morbidity score was 4.94 ± 1.2. During the study period, 83 MDR bacteria were isolated from HCAIs that developed in 70 (48.3%) patients. In multiple binary logistic regression analysis, duration of hospital stay (odds ratio (OR) 1.041, 95% confidence interval (CI) 1.007-1.077; p = 0.019), surgery (OR 3.115, 95% CI 1.288-7.535; p = 0.012), use of glycopeptides (OR 5.394, 95% CI 1.960-14.850; p = 0.001), and use of third-generation cephalosporins (OR 5.521, 95% CI 2.017-15.110; p = 0.001) were found to be independent risk factors for the development of an MDR infection. CONCLUSIONS Among hospitalized patients with a solid tumour, HCAIs caused by MDR bacteria occurred more frequently in patients undergoing surgery, receiving third-generation cephalosporins and glycopeptide antibiotics, and having a prolonged hospital stay.
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Affiliation(s)
- Elif Sahin Horasan
- Department of Clinical Microbiology and Infectious Diseases, Faculty of Medicine, Mersin University, 33079 Mersin, Turkey.
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Basterzi Y, Ersoz G, Sarac G, Sari A, Demirkan F. In-vitro Comparison of Antimicrobial Efficacy of Various Wound Dressing Materials. Wounds 2010; 22:165-170. [PMID: 25901495] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
UNLABELLED Many new antimicrobial dressings have been used for the treatment of or protection against wound infection since the early 1980s. There are many different wound dressings such as silver, povidone iodine, and chlorhexidine impregnated materials on the market today. Various manufacturers assert that their dressings are the most effective and therefore should be preferentially employed. However, it is difficult to find a study that clearly identifies the most effective antimicrobial wound dressing. METHODS Eight different commercially available wound dressing materials were compared in terms of their antimicrobial effectiveness on 18 different microorganisms via disk diffusion test (Kirby-Bauer Method) on Mueller-Hinton (MH) agar. Among the 16 bacterial and 2 yeast species grown on MH agar plates, Contreet was the most effective antimicrobial dressing tested (P <0.001). RESULTS A statistical difference was not found concerning efficacy against gram-positive and -negative bacteria among any of the materials except for Aquacel Ag and Inadine, the activity of which were found to be higher on gram-positive bacteria compared to gram-negative bacteria (P = 0.029, P = 0.030). In-vitro data suggest that Contreet is the most effective for topical treatment of contaminated wounds. CONCLUSION Further methods of assessment, including the use of infected animal models and clinical studies, will be necessary to better understand the antimicrobial efficacy of these dressings .
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Karasu Z, Akay S, Yilmaz F, Akarca U, Ersoz G, Gunsar F, Kilic M. A pilot study: longer duration of posttransplant hepatitis C virus therapy may increase the sustained response rate. Transplant Proc 2010; 41:3806-9. [PMID: 19917392 DOI: 10.1016/j.transproceed.2009.06.212] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2009] [Revised: 04/01/2009] [Accepted: 06/01/2009] [Indexed: 11/30/2022]
Abstract
BACKGROUND Although end of treatment virological responses are similar in posttransplant patients with recurrent chronic hepatitis C virus infection and nontransplant patients, the sustained virological response rate is lower in the posttransplant setting. We investigated the efficacy of a longer duration (3 years) of therapy. METHODS Thirteen patients with biopsy-proven recurrent hepatitis C were included in the study. In the first year of therapy, all patients were treated with a standard regimen of interferon alpha 2b 3MU 3 times in a week plus ribavirin (800 to 1000 mg/d). After the availability of pegylated interferon, patients were converted to pegylated interferon (1.5 microg/kg body weight). Hepatitis C virus RNA was evaluated at months 3, 6, 9, 12, 24, 36, and 42. If hepatitis C virus RNA was negative at month 12, the patients continued treatment for 36 months. RESULTS Hepatitis C virus RNA was negative in six patients at 12 months, including two who became hepatitis C virus RNA negative after 3 months; two, after 6 months; and two, after 12 months of therapy. Those six continued treatment completing 3 years of treatment with a sustained virological response. Four of those six patients with sustained virological response required colony-stimulating factors during treatment. CONCLUSION Although the hepatitis C virus RNA status of patients at 12 weeks is a good marker to predict a sustained virological response in the nontransplant setting, it is not valid in posttransplant patients. A prolonged duration of therapy for patients who are viral responders at 12 months may prevent recurrence and increase the sustained virological response rate.
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Affiliation(s)
- Z Karasu
- Department of Gastroenterology, Ege University, Izmir, Turkey
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Affiliation(s)
- F Tekin
- Department of Gastroenterology, Ege University Medical School, Izmir, Turkey.
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Tekin F, Gunsar F, Karasu Z, Akarca U, Ersoz G. Safety, tolerability, and efficacy of pegylated-interferon alfa-2a plus ribavirin in HCV-related decompensated cirrhotics. Aliment Pharmacol Ther 2008; 27:1081-5. [PMID: 18346186 DOI: 10.1111/j.1365-2036.2008.03680.x] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
BACKGROUND Pretransplantation clearance of hepatitis C virus (HCV)-RNA reduces the risk of HCV recurrence after transplantation. Furthermore, a sustained virological response could reduce disease progression and slow clinical deterioration in nontransplanted patients. AIM To evaluate the safety, tolerability and efficacy of pegylated-interferon (PEG-IFN) alfa-2a plus ribavirin therapy in HCV-related decompensated cirrhotics. METHODS Twenty HCV-related decompensated cirrhotics (44-67 years, 12 males, six Child-Pugh score A, 14 Child-Pugh score B, all with genotype 1b) were enrolled into the study. Treatment with PEG-IFN alfa-2a (135 microg, once a week) plus ribavirin (1000-1200 mg/day) was commenced. A 48-week treatment was planned in patients who had early virological response. RESULTS Treatment was stopped in 8 (40%) patients. The remaining 12 (60%) patients completed 48 weeks of therapy; nine (45%) of them obtained end-of-therapy virological response and six (30%) of them obtained sustained virological response. Living donor liver transplantation was performed in three (15%) patients. Eight (40%) and six (30%) patients needed to reduce PEG-IFN alfa-2a and ribavirin dosages, respectively. No patient died during the follow-up period. CONCLUSION PEG-IFN alfa-2a plus ribavirin therapy is safe, tolerable and efficacious in selected HCV-related decompensated cirrhotics.
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Affiliation(s)
- F Tekin
- Department of Gastroenterology, Ege University Medical School, Izmir, Turkey.
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Affiliation(s)
- Mehmet Colak
- Department of Orthopedics and Traumatology, University of Mersin, School of Medicine, Mersin, Turkey
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Celebi Kobak A, Karasu Z, Kilic M, Ozacar T, Tekin F, Gunsar F, Ersoz G, Yuzer Y, Tokat Y. Living donor liver transplantation from hepatitis B core antibody positive donors. Transplant Proc 2007; 39:1488-90. [PMID: 17580169 DOI: 10.1016/j.transproceed.2006.11.015] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2006] [Accepted: 11/02/2006] [Indexed: 01/10/2023]
Abstract
UNLABELLED Liver allografts from donors previously exposed to hepatitis B virus (HBV) carry the risk of transmission of HBV infection to immunosuppressed recipients. However, exclusion of donor candidates with the serologic evidence of resolved hepatitis B-HBV surface antigen (HbsAg) negative and HBV core antibody (anti-HBc) positive-is not feasible in countries endemic for HBV. AIM Our aim was to assess the safety of living donor liver transplantation from anti-HBc positive donors. MATERIALS AND METHODS In our institution, 152 transplants were performed between June 1999 and April 2004. Fifty-six (37%) of the living donors were anti-HBc positive. Twenty of these liver grafts were transplanted to HbsAg-negative recipients. We excluded four HBsAg negative recipients who died because of early complications after transplantation. Lamivudine (100 mg/day) was given for prophylaxis of de novo HBV infection. RESULTS The mean follow-up time for 16 HBsAg-negative recipients was 21.7 (7-48) months. None of them experienced de novo HBV infection. CONCLUSION The use of liver allografts from anti-HBc-positive living donors is reasonably safe in HBsAg-negative recipients under lamivudine prophylaxis.
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Affiliation(s)
- A Celebi Kobak
- Department of Gastroenterology, General Surgery, and Microbiology, Ege University Faculty of Medicine, Izmir, Turkey.
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Affiliation(s)
- G Ersoz
- Department of Gastroenterology, Ege University Medical School, Izmir, Turkey
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Affiliation(s)
- O Ozutemiz
- Department of Gastroenterology, Ege University Medical School, Izmir, Turkey
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Abstract
BACKGROUND/PURPOSE The study investigates the effect of airway instrumentation on the histopathology of the intestine, contribution of bacterial translocation, and whether oxygen supplementation may counteract the possible detrimental effects of this procedure. METHODS Fifty-five Wistar rats were assigned to 3 groups. Group 1 served as control. Groups 2 and 3 underwent airway instrumentation. In addition, group 3 received oxygen supplementation during the procedure. Arterial blood gases were measured after the procedure. Samples of mesenteric lymph nodes ileum, cecum, spleen, liver, and blood were harvested for determination of bacterial growth after 24 hours. Ileum was evaluated histologically. RESULTS In group 2, the rats presented a decrease in oxygen saturation (90% +/- 0.3%, P < .0001), hypoxemia (PaO2, 73 +/- 1.5 mm Hg; P < .0001), and respiratory acidosis (pH 7.27 +/- 0.01; PaCO2, 48 +/- 1.5 mm Hg; P < .0001) after airway instrumentation. These rats also showed evidence of intestinal injury (P < .0001) and bacterial translocation to mesenteric lymph nodes in 10 of 20 rats compared with 0 of 15 in the controls (P = .004). In group 3, oxygen supplementation provided normal arterial blood gas parameters, and led to minimal histologic changes and bacterial translocation in only 1 of 20 rats, compared with group 2 (P < .0001 and P = .005, respectively). CONCLUSIONS The study suggests that oxygen supplementation during airway instrumentation prevents hypoxemia, intestinal damage, and bacterial translocation.
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Affiliation(s)
- Ali Nayci
- Department of Pediatric Surgery, Mersin University, School of Medicine, Mersin, Turkey.
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Ersoz G, Aytacoglu BN, Sucu N, Tamer L, Bayindir I, Kose N, Kaya A, Dikmengil M. Comparison and evaluation of experimental mediastinitis models: precolonized foreign body implants and bacterial suspension inoculation seems promising. BMC Infect Dis 2006; 6:76. [PMID: 16638144 PMCID: PMC1479828 DOI: 10.1186/1471-2334-6-76] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2005] [Accepted: 04/25/2006] [Indexed: 11/10/2022] Open
Abstract
Background Post-sternotomy mediastinitis (PSM) is a devastating surgical complication affecting 1–3% of patients that undergo cardiac surgery. Staphylococcus aureus is one of the most commonly encountered bacterial pathogen cultured from mediastinal samples obtained from patients with PSM. A component of the membrane of the gram positive bacteria, lipoteichoic acid, stimulates the blood monocytes and macrophages to secrete cytokines, radicals and nitrogen species leading to oxido-inflammatory damage. This seems to be responsible for the high mortality rate in PSM. For the evaluation of the pathogenesis of infection or for the investigation of alternative treatment models in infection, no standard model of mediastinitis seems to be available. In this study, we evaluated four mediastinitis models in rats. Methods The rats were divided into four groups to form different infection models. Group A: A suspension of 1 × 107 colony-forming units Staphylococcus aureus in 0,5 mL was inoculated from the right second intercostal space into the mediastinum. Group B: A hole was created in the right second intercostal space and a piece of stainless-steel implant with a length of 0.5 cm was inserted into the mediastinum and a suspension of 1 × 107 cfu bacteria in 0,5 mL was administered via the tail vein. Group C: Precolonized stainless-steel implant was inserted into the mediastinum. Group D: Precolonized stainless-steel implant was inserted into the mediastinum and the bacteria suspension was also injected into the mediastinum. On the 10th day, rats were sacrificed and the extension of infection in the mediastenae was evaluated by quantitative cultures. Myeloperoxidase activity (MPO) and malondialdehyde (MDA) levels were determined in the sera to evaluate the neutrophil activation and assess the inflammatory oxidation. Results The degree of infection in group C and D were 83.3% and 100% respectively (P < 0.001). MDA levels were significantly higher in these two groups than the others (P < 0.001). Conclusion Infected implants and high bacterial concentration administration were the two important components that played a significant role in the outcome of a successful infection in mediastinum in a rat model.
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Affiliation(s)
- Gulden Ersoz
- Department of Clinical Microbiology and Infectious Diseases, Mersin University, School of Medicine, Mersin, Turkey
| | - Barlas Naim Aytacoglu
- Department of Cardiovascular Surgery, Mersin University, School of Medicine, Mersin, Turkey
| | - Nehir Sucu
- Department of Cardiovascular Surgery, Mersin University, School of Medicine, Mersin, Turkey
| | - Lulufer Tamer
- Department of Biochemistry, Mersin University, School of Medicine, Mersin, Turkey
| | - Ismet Bayindir
- Department of Clinical Microbiology and Infectious Diseases, Mersin University, School of Medicine, Mersin, Turkey
| | - Necmi Kose
- Department of Cardiovascular Surgery, Mersin University, School of Medicine, Mersin, Turkey
| | - Ali Kaya
- Department of Clinical Microbiology and Infectious Diseases, Mersin University, School of Medicine, Mersin, Turkey
| | - Murat Dikmengil
- Department of Cardiovascular Surgery, Mersin University, School of Medicine, Mersin, Turkey
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Ficicilar H, Zergeroglu AM, Ersoz G, Erdogan A, Ozdemir S, Tekin D. The effects of short-term training on platelet functions and total antioxidant capacity in rats. Physiol Res 2006; 55:151-156. [PMID: 15910176 DOI: 10.33549/physiolres.930756] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
The purpose of the present study was to investigate the effect of short-term endurance training on plasma total antioxidant status (TAS) and on in vitro platelet aggregation and ATP release. Blood samples were collected from the abdominal aorta of rats following short-term treadmill exercise (25 m/min, 0 % grade, 30 min) for three consecutive days, as well as in non-exercised control group. Platelet aggregation and platelet ATP release were evaluated by impedance and bioluminescence techniques, respectively. Plasma TAS was measured spectrophotometrically. Plasma TAS was higher and ADP-induced platelet ATP release was lower in the short-term training group with respect to the control group (p<0.001). Significant negative correlation (r = -0.56, p<0.05) was found between plasma TAS and ADP-induced platelet ATP release. Neither ADP- and collagen-induced maximum aggregation rate nor collagen-induced platelet ATP release were significantly different between the groups. According to these results, short-term training caused an alteration in platelet functions limited to the secretion response, which may be related to the oxidant/antioxidant balance changes favoring the antioxidants. The improved plasma total antioxidant capacity was possibly sufficient to prevent exercise-induced oxidative damage, and the adaptive response of platelets might be associated with enhanced antioxidant status.
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Affiliation(s)
- H Ficicilar
- Department of Physiology, Ankara University, School of Medicine, Ankara, Turkey
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Akyildiz M, Karasu Z, Arikan C, Kilic M, Zeytunlu M, Gunsar F, Ersoz G, Akarca U, Batur Y, Tokat Y. Impact of pretransplant MELD score on posttransplant outcome in living donor liver transplantation. Transplant Proc 2005; 36:1442-4. [PMID: 15251354 DOI: 10.1016/j.transproceed.2004.05.004] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
It is not clear whether pretransplantation MELD (model for End-Stage Liver Disease) score can foresee posttransplant outcome. We retrospectively evaluated 80 adult patients (55 men, 25 women) who underwent living donor liver transplantation between September 1998 and March 2003. Five other patients with fulminant hepatitis were excluded. The UNOS-modified MELD scores were calculated to stratify patients into three groups: group 1) MELD score less than 15 (n = 13); group 2) MELD score 15 to 24 (n = 36); and group 3) MELD score 25 and higher (n = 26). The patients were predominantly men (n = 52, 69.3%) with overall mean age of 43.9 years (range, 17-62 years). The mean follow-up was 15.7 months (range, 1-47; median = 14 months). The mean MELD score was 22.7 (range, 9-50; median = 21). The overall 1- and 2-year patient survivals were 87% and 78.7%, respectively. The 1-year patient survivals for groups 1, 2, and 3 were 100%, 87%, and 79%; respectively. 2-year survivals, 100%, 79%, and 61%, respectively. Survivals stratified by MELD showed no statistically remarkable differences in 1-year and 2-year patient survival (P = .08). In contrast, 1-year and 2-year patient survival rates for UNOS status 2A, 2B, and 3 were 73%-50%, 95%-91%, and 91%-91%, statistically significant difference (P = .002). Finally, to date preoperative MELD score showed no significant impact on 1- and 2-year posttransplant outcomes in adult-to-adult living donor liver transplantation recipients, but we await longer-term follow-up with greater numbers of patients.
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Affiliation(s)
- M Akyildiz
- Edge University Medical School, Izmir, Turkey.
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Karasu Z, Ozacar T, Akarca U, Ersoz G, Erensoy S, Gunsar F, Kobat A, Tokat Y, Batur Y. HBV vaccination in liver transplant recipients: not an effective strategy in the prophylaxis of HBV recurrence. J Viral Hepat 2005; 12:212-5. [PMID: 15720538 DOI: 10.1111/j.1365-2893.2005.00585.x] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
Anti-HBs immunoglobulins (HBIG) and lamivudine are main options to prevent hepatitis B virus (HBV) reinfection after liver transplantation. Although they are very effective, development of mutant viruses and high cost of treatment are main limitations for their application. Additionally there is an uncertainity for the duration of that prophylaxis regimen and its mostly applied indefinitely. Recently, post-transplant HBV vaccination is reported to be a cheaper alternative prophylaksis strategy, that enables discontinuation of HBIG. To investigate the efficacy of HBV vaccination in patients transplanted for HBV cirrhosis, we administered double course of double dose recombinant HBV vaccine (Genhavac B; containing HBV pre-S1, pre-S2, and S gene products). Vaccination has been started 1 month after HBIg discontinuation, and lamivudine (100 mg/day) was given throughout the study. The first cycle consisted of 0, 1- and 6-month schedule, and, in nonresponders, second cycle 0, 1-, 2-month schedule. Fourteen patients included into the study. Only one patient seroconverted (an anti-HBs titre of 37 IU/L) after the first cycle. No other patient responded to second cycle. HBV vaccination in the post-transplantation setting does not seems like an effective strategy in the prophylaxis of HBV recurrence.
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Affiliation(s)
- Z Karasu
- Department of Gastroenterology, Ege University Medical School, Izmir, Turkey.
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Ersoz G, Otag F, Erturan Z, Aslan G, Kaya A, Emekdas G, Sugita T. An outbreak of Dipodascus capitatus infection in the ICU: three case reports and review of the literature. Jpn J Infect Dis 2004; 57:248-52. [PMID: 15623948] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/01/2023]
Abstract
A mini epidemic of Dipodascus capitatus (teleomorph of Geotrichum capitatum) involving three cases is reported. The index case was pulmonary infection and a fulminant course of fungal infection, which resulted in the patient's death with acute myelocytic leukemia. In the other cases, the patients were simultaneously hospitalized, the first in the intensive care unit. In all cases, D. capitatus was identified in different samples (sputum, deep tracheal aspiration, blood, and urine) from each of the patients. Growing evidence indicates that D. capitatus should be added to the lengthening list of opportunistic fungal pathogens that can cause infection in people of all ages and particularly in those who are immunocompromised. Further, the danger of cross-contamination and potential "outbreak" should be kept in mind during hospital management.
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Affiliation(s)
- Gulden Ersoz
- Department of Clinical Microbiology and Infectious Diseases, Mersin University School of Medicine, Mersin, Turkey.
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Ersoz G, Oztuna V, Coskun B, Eskandari MM, Bayarslan C, Kaya A. Addition of fusidic acid impregnated bone cement to systemic teicoplanin therapy in the treatment of rat osteomyelitis. J Chemother 2004; 16:51-5. [PMID: 15077999 DOI: 10.1179/joc.2004.16.1.51] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022]
Abstract
We compared the efficacy of the combination of fusidic acid impregnated bone cement and systemic teicoplanin to systemic teicoplanin alone in implant-related osteomyelitis model in the rats. Foreign bodies were implanted into the medullary channels of 30 rat tibias after intramedullary inoculation of methicillin-resistant Staphylococcus aureus. Following proof of induction of osteomyelitis in the rats on the 21st day, a bone cement rod including 1/40 ratio of fusidic acid was inserted into the medullary channel of the tibias in the study group. Teicoplanin was administered i.m. at 20 mg/kg/day for 14 days to both the study and control groups. At the end of the treatment, the tibias were examined macroscopically, microbiologically and histopathologically. The elimination rate with the teicoplanin+fusidic acid combination was 81.8%, while with teicoplanin alone was 55.6% (p=0.33). Although the difference between the two groups was not statistically significant, the combination treatment had a positive effect in eliminating the microorganism.
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Affiliation(s)
- G Ersoz
- Department of Clinical Microbiology and Infectious Diseases, Mersin University School of Medicine, Mersin, Turkey.
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Colak T, Ersoz G, Akca T, Kanik A, Aydin S. Efficacy and safety of reuse of disposable laparoscopic instruments in laparoscopic cholecystectomy: a prospective randomized study. Surg Endosc 2004; 18:727-31. [PMID: 15026911 DOI: 10.1007/s00464-004-8112-x] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2003] [Accepted: 11/07/2003] [Indexed: 10/26/2022]
Abstract
BACKGROUND The aim of this prospective randomized study was to investigate the efficacy and safety of the reuse of disposable laparoscopic instruments (DLI) in laparoscopic cholecystectomy. METHODS A total of 125 consecutive patients with symptomatic cholelithiasis were randomly assigned to undergo laparoscopic cholecystectomy with single-use DLI (group 1, n = 62) or DLI that were reused (group 2, n = 63) after high-level disinfection by alkalinized 2% glutaraldehyde. Operative and postoperative outcomes were investigated. RESULTS There was no significant difference between group 1 and group 2 in mean operating time, linear analogue pain scale score, duration and amount of analgesic administration, or hospital stay. Total incidence of complications (3.2% vs 4.8%, p = 0.50) and infection rates (1.6% vs 3.2%, p = 0.57) were also similar when group 1 was compared to group 2. CONCLUSION This study showed that reusing DLI did not change the operative and postoperative outcomes or the infection rate for laparoscopic cholecystectomy when strict rules for disinfection were followed.
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Affiliation(s)
- T Colak
- Department of General Surgery, Medical Faculty of Mersin University, Tip Fakultesi Hastanesi, Zeytinlibahce C., 33079, Mersin, Turkey.
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Nayci A, Atis S, Ersoz G, Polat A. Gut Decontamination Prevents Bronchoscopy-Induced Bacterial Translocation. Respiration 2004; 71:66-71. [PMID: 14872113 DOI: 10.1159/000075651] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2003] [Accepted: 08/16/2003] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Selective gut decontamination is suggested to suppress the gram-negative bacterial overgrowth in the intestine and consequently to reduce bacterial translocation. OBJECTIVE The purpose of the present study is to examine the effects of gut decontamination on bronchoscopy-induced bacterial translocation, and intestinal mucosal injury. METHODS Forty-five rats were assigned into three groups. Group 1 served as control (n=15). Group 2 (n=15) and group 3 (n=15) underwent bronchoscopy. In addition, group 3 underwent gut decontamination. Gut decontamination was performed two days prior to bronchoscopy with erythromycin and neomycin. Twenty-four hours after bronchoscopy, blood, mesenteric lymph nodes, spleen, liver, ileum and cecum were harvested for bacterial determination. The ileum was also assessed and graded histologically according to Chiu's injury scale. RESULTS In the bronchoscopy group, bacterial translocation to the mesenteric lymph nodes was found in 7/15 rats (46.7%), compared to none of the controls (p=0.01). These rats also showed significant evidence of intestinal injury, compared to the controls (mean ranks, 32.7 or 8.5, p<0.0001). On the other hand, gut decontamination prevented bacterial translocation, compared to the bronchoscopy group (p=0.011). However, gut decontamination provided no beneficial effect on the intestinal mucosal injury, compared to the bronchoscopy group. These animals also revealed significant intestinal injury, compared to the controls (mean ranks, 27.8 or 8.5, p<0.0001). CONCLUSIONS Our data shows that despite no amelioration in bronchoscopy-induced intestinal mucosal injury, gut decontamination has a preventive role for bronchoscopy-induced bacterial translocation.
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Affiliation(s)
- Ali Nayci
- Department of Pediatric Surgery, Mersin University School of Medicine, Mersin, Turkey.
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Comlekci A, Akpinar H, Yesil S, Okan I, Ellidokuz E, Okan A, Ersoz G, Tankurt E, Batur Y. Serum leptin levels in patients with liver cirrhosis and chronic viral hepatitis. Scand J Gastroenterol 2003; 38:779-86. [PMID: 12889566 DOI: 10.1080/00365520310003877] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
BACKGROUND The aim of the present study was to investigate serum leptin levels in relation to anthropometric features in patients with liver cirrhosis (LC) and chronic viral hepatitis (CVH), and to determine the effect of the severity and aetiology of the LC on serum leptin levels. METHODS Forty-nine patients with LC, 32 patients with CVH and 69 control subjects were age, body mass index (BMI) and sex-matched and included in the study. Plasma glucose, serum leptin and insulin levels were determined. Insulin resistance was assessed using homoeostasis model assessment (HOMA). Body composition was estimated by skinfold thickness. RESULTS Female patients with Child-A LC had higher levels of leptin, and female and male patients with Child-A LC had higher absolute leptin (leptin/BFM) levels compared to patients with Child-C LC and control subjects. Serum leptin levels of the patients with alcohol LC were higher than the control subjects, but the absolute leptin levels were comparable. When alcoholic and post-viral hepatitis cirrhotic patients were compared with each other on an aetiologic basis, there was no significant difference between them in leptin and absolute leptin levels. There were significant correlations between leptin and BMI, body fat percentage (BFP), BFM (body fat mass) in all three groups in both sexes. CONCLUSIONS These data suggest that the physiologic correlations among serum leptin level, sex, BMI and BFM were well preserved in patients with chronic liver disease. Patients with alcohol LC had higher leptin levels. In early stages of liver disease, leptin levels and absolute leptin levels are higher than in normal subjects. However, in advanced stages of the disease the significant decline in leptin levels and similar levels of leptin expressed in relation to BFM compared to control subjects predominantly represent the expression of fat mass.
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Affiliation(s)
- A Comlekci
- Dokuz Eylül University Medical School, Dept. of Internal Medicine, Division of Endocrinology, Inciralti, Turkey.
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Abstract
The aim of this study was to investigate the impact of acute exercise on portal blood flow in liver transplant recipients compared to healthy subjects since it is known that transplantation produces a denervated liver and intrahepatic vascular tube. Twelve liver transplantation recipients and 12 age-gender-matched subjects were included in the study. All patients were at least 6 months posttransplant and in stable condition with normal liver biochemistry values. Measurements of portal vein blood flow were performed before starting exercise and immediately after its completion. The exercise program consisted of 40 minutes of treadmill running or walking with at least 20 minutes at 75% of maximal heart rate. The portal vein flow in the controls decreased by 74% after 40 minutes of exercise (absolute flow, 730 +/- 160 to 190 +/- 35 mL x min). Among the liver transplant group, following exercise the portal vein cross-sectional area also decreased to a lesser degree. However, statistical significance was only reached for blood flow. In this group the absolute flow was 940 +/- 165 mL x min at rest and 460 +/- 135 mL x min at 40 minutes (P <.01 by ANOVA). This flow pattern was more resistant to exercise, thereby protecting the liver from an exercise-induced low-flow state. Exercise and physical conditioning should be recommended without hesitation for liver transplant recipients.
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Affiliation(s)
- G Ersoz
- Department of Exercise Physiology, School of Physical Education and Sports, Medical School, Ankara University, Ankara, Turkey.
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Abstract
Bronchoscopy has the potential to propagate infections. Bacterial translocation was hypothesised to be the cause of infections observed following bronchoscopy and this study was designed to assess the risk of bacterial translocation following rigid bronchoscopy in rats. A total of 30 rats were evaluated. The study group (n=15) underwent rigid bronchoscopy. Arterial blood gas analysis was performed in all rats. Blood and tissue cultures from the ileum, caecum, mesenteric lymph nodes, liver, spleen, mediastinal lymph nodes and lung were obtained 24 h following bronchoscopy. Bacterial translocation to the mesenteric lymph nodes was found in seven of 15 rats (46.7%) that underwent bronchoscopy, compared with none of the controls. Of the seven positives, three rats (42.8%) also demonstrated other organ involvement, such as the liver and spleen. Escherichia coli, Salmonella typhymirium, S. enteritidis and Pseudomonas spp. were found as translocating bacteria. In the study group, pH and arterial oxygen tension were significantly lower and arterial carbon dioxide tension was higher, compared with controls. This study shows that rigid bronchoscopy may induce bacterial translocation in rats. Further investigations aimed at understanding the clinical consequences of this phenomenon are warranted.
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Affiliation(s)
- A Nayci
- Dept of Paediatric Surgery, Mersin University School of Medicine, Mersin, Turkey.
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Affiliation(s)
- O Surgit
- Ankara University Medical School, Ankara, Turkey
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Abstract
Drug-induced chronic hepatitis is a rare pathological condition. There is no reported case with chronic hepatitis secondary to nitroimidazole use. We report a patient who developed nitroimidazole-induced chronic hepatitis following acute exacerbation of hepatitis three times after nitroimidazole use.
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Affiliation(s)
- G Ersoz
- Ege University Medical School, Department of Gastroenterology, Izmir, Turkey
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Abstract
Toxic hepatitis secondary to amoxycillin-clavulanic acid is an infrequent clinical picture. Most of the cases are reported to have a benign course. We report two cases of severe hepatic failure following amoxycillin-clavulanic acid use. One of the cases had cholestatic features primarily, and the other had hepatocellular injury prominently. The first case had also findings of trombotic trombositic purpura and had a fatal course.
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Affiliation(s)
- G Ersoz
- Department of Gastroenterology, Ege University Medical School, Bornova, 35100 Izmir, Turkey
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Ersoz G, Karasu Z, Vardar R, Akarca US, Batur Y. Resolution of chronic hepatitis-C following tuberculous infection. Am J Gastroenterol 2000; 95:3680-2. [PMID: 11151940 DOI: 10.1111/j.1572-0241.2000.03420.x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
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Abstract
STUDY DESIGN Collagen-induced platelet aggregation and platelet count of ten paraplegic patients (four females, six males, aged 16 - 42 years) with traumatic spinal cord injury (SCI) (posttraumatic 12 - 48 weeks) and of ten age-matched healthy volunteers (control group; five females, five males, aged 18 - 37 years) were investigated. OBJECTIVES Investigation of platelet aggregation in the whole blood of the patients with SCI. SETTING Ankara/Turkey. METHODS Platelet aggregation was evaluated by impedance technique using Chrono Log Model 560 WB aggregometer in whole blood. Platelet count was determined by Medonic Cell Analyser 610. RESULTS Maximal intensity of collagen-induced platelet aggregation of the patients was 18.50+/-8.28 ohm (mean+/-SD) and of the controls was 7.60+/-4.25 ohm. Maximal rate of collagen-induced aggregation of platelets from the patients was 3.98+/-1.59 ohm/min, maximal rate of aggregation of platelets from the controls was 1.57+/-1.01 ohm/min. Platelet counts of the patients and controls were 290 500+/-50 357/mm3 and 273 000+/-48 343/mm3 respectively. It was determined that both maximal rate (P<0.001) and maximal intensity (P<0.01) of collagen-induced platelet aggregation of the patients were significantly higher than those of the controls. There was no significant difference between the two groups in respect to platelet counts. CONCLUSION Collagen-induced platelet aggregation of patients with traumatic SCI 12 - 48 weeks after the trauma was significantly higher than that of the controls. Our results indicate that increased tendency of platelet aggregation, which is probably induced by free radicals, may have a great impact on the late thromboembolic complications reported in patients with traumatic SCI.
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Affiliation(s)
- G Ersoz
- Ankara University Medical School, Department of Physiology, Sihhiye, Ankara 06100, Türkiye
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