Long-term sustainability of zero central-line associated bloodstream infections is possible with high compliance with care bundle elements

Central-line-associated bloodstream infection (CLABSI) is one of the most important problems in intensive care units (ICUs) worldwide. A bundle of CLABSI care measures was introduced at a 13-bed medical/surgical ICU in Kocaeli, Turkey in January 2010. Compliance rates with the bundle were measured at the beginning of the third quarter of 2010 until June 2013 and compared with CLABSI rates. During the post-intervention period, of 2196 ICU patients, 732 lines placed for 4366 line-days were monitored. Feedback to staff reinforced a culture of patient safety in the ICU. Infection rates remained zero for 38 months after the implementation. There was a strong negative correlation between bundle compliance rate and CLABSI rates. With the implementation of the central-line bundle of care, together with emphasis on high compliance with all its components and a culture of patient safety, it was possible to achieve and maintain a zero rate of CLABSI in this ICU.

KPC-producing Klebsiella pneumoniae, finally targeting Turkey

We report here the first identification of the worldwide spread of Klebsiella pneumoniae carbapenemase-2-producing and carbapenem-resistant K. pneumoniae clone ST258 in Turkey, a country where the distantly-related carbapenemase OXA-48 is known to be endemic. Worryingly, this isolate was also resistant to colistin, now considered to be the last-resort antibiotic for carbapenem-resistant isolates.

Analysis of cerebral toxoplasmosis in a series of 170 allogeneic hematopoietic stem cell transplant patients

INTRODUCTION

Cerebral toxoplasmosis is a rare but fatal complication in hematopoietic stem cell transplant patients, which mostly is caused by reactivation of latent disease.

METHODS

In this study, we report an analysis of cerebral toxoplasmosis in a series of 170 allogeneic stem cell transplant patients during a 30-month period at our institution.

RESULTS

Among these allogeneic stem cell transplant patients, 5 were diagnosed with cerebral toxoplasmosis by brain magnetic resonance imaging and polymerase chain reaction of Toxoplasma gondii DNA. The incidence of cerebral toxoplasmosis was found to be 2.94%.

CONCLUSION

Mortality rate is known to be very high in cerebral toxoplasmosis; therefore, it is life saving to diagnose the disease in the early stages and start treatment promptly, especially in high-endemic countries like Turkey.