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Objectives: Percutaneous injuries (PCIs) remain a common incident among healthcare workers (HCWs) despite the introductionof safety programs. The aim of this study was to assess the PCIs, required precautions, and applications after the injuries among healthcare workers in a small general hospital.Materials and methods: We assessed the occurrence of PCIs at a General Hospital (EGH) from January 2007 to November2010. During this period, all injury cases among HCWs were reported to the Infection Control Committee (ICC) using percutaneous injury notification form. The injury notification forms were evaluated retrospectively.Results: Totally 275 health personnel were working in our hospital, 36 healthy workers have been exposed to PCIs during this period. The incidence of PCIs was 2,9/10000 in 2007, 3,1/10000 in 2008, 3,8/10000 in 2009 and 3,9/10000 patient-days in 2010. Injured staff were recorded as, 16 nurses (44%), 12 cleaning staffs (34%), and eight (22%) doctors. The device leading to damage was most frequently the needle-channel. Ten sources (27%) were detected positive for hepatitis B virus (HBV), four (11%) for hepatitis C virus (HCV), and two (5%) for Crimean-Congo hemorrhagic fever virus (CCHFV). No case of seroconversion has been recognized for any of the above mentioned infections.Conclusions: Percutaneous injuries remain to occur among HCWs. Since some the sources were infected, the health personnel are endangered for infections due to PCIs. The health personnel should presume that all patients are infected,and thus should work following universal precautions to avoid complications about the PCIs. J Microbiol Infect Dis 2011;1(1):26-30.

Objectives: The aim of this study was to evaluate clinical and laboratory features of CCHF cases on admission to the emergency department.Materials and methods: Clinical and laboratory features of CCHF cases which applied to the emergency department of a district general hospital (Erbaa, Tokat Province) between the period of 2008 and 2010 were retrospectively assessed.Results: Totally 15 cases were included in the study. Most of the patients applied with non-specific symptoms, some of them admitted with atypical symptoms such as abdominal pain and hematemesis. In three patients, all laboratory findingsat admission were within normal limits.Conclusions: Although, CCHF patients apply to hospital with nonspecific symptoms, some may have atypical symptoms like severe abdominal pain and hematemesis. Moreover, some may have normal leukocyte and platelet counts on admission.Therefore, for early diagnosis, physicians should have knowledge about the various clinical symptomatology of CCHF. J Microbiol Infect Dis 2011;1(1):1-4.

Meningitis and intracranial abscess due to Proteus mirabilis is seen especially in the neonatalperiod and among the patients with immune deficiency. It was learned that 35 years old malepatient who applied to the emergency room with ongoing fever, nausea and vomiting for threedays have had their upper left jaw tooth out 10 days ago. As clinical and laboratory to patientswith acute bacterial meningitis empirical ceftriaxone 2x2 gr/day parenteral was started. Thecranial MR of the patient, that has P. mirabilis producing in their blood and cerebrospinal fluid(CSF) culture, was taken at the seventh day of hospitalization as his complaints started again.In the MR, abscess was detected in the left temporal brain of the patient and a surgical treatmentwas applied. Complete healing was seen eight week treatment with antibiotics after surgery.During application it was though that meningitis has occurred due to the dental surgery, howeverafter the temporal BT, mastoiditis was detected. It was thought that meningitis and brain abscessdeveloped on the patient was caused by mastoiditis. Even with sensitive antibiotics if norecovery is observed in patients with meningitis, intracranial abscess should be considered, alsoit should not be forgotten that in adults and patients with no immune deficiency meningitis dueto P. mirabilis may develop.

Aim: Resistance to gram negative bacilli is increasing all over the world. In this study, theresistance of gram negative bacilli, which were isolated from inpatients, was evaluated forselected antibiotics. The aim of this study was to acquire the significant results for empirictherapy.Material and Method: Eight hundered ninety eight strains which were isolated from inpatientswere investigated between May 2003 and April 2005 from clinical speciments at DicleUniversity Hospital, Diyarbakir. The microdiluation test was used to determine for antibioticsresistance.Findings: Escherichia coli (n=282), Enterobacter spp. (n=215), Pseudomonas aeruginosa(n=101), Klebsiella spp. (n=95), Stenotrophomanas maltophilia (n=69) and Acinetobacter spp.(n=52) were the most frequent isolates. The resistance ratio among whole isolates againstceftriaxone was 73%, cefotaxime 68%, ceftazidime 63%, trimetoprim/sulfamethoxazole 60%,ciprofloksasin 51%, amikasin 20%, imipenem 3% and meropenem 2%. The resistance to thethird generation cephalosporins, trimetoprim/sulfamethoxazole and ciprofloxacin was foundhigher than other antibiotics in this study.Results: In conclusion, antimicrobial resistance must be monitored for each hospital for areasonable empirical antibiotic therapy. Surveillance studies might be useful for empiricaltreatment approach.

Aim: The aim of this study is to evaluate the epidemiologic data of nosocomial infection (NI)occurring in the General Surgery Unit (GSU).Method: This study was performed between January 1997 and December 2006. The surveillancemethod was active, prospective, and based on laboratory and patient. NIs were defined accordingto Centers for Diseases Control and Prevention criteria (CDC).Results: During the ten-year period, 305 NI episodes were detected in 290 patients. The overallincidence rates and incidence densities of NIs were 2.0% and 2.3/1,000 patient-day respectively.The most common NIs by primary site were surgical site infections, urinary tract infections,and pneumonia. The most prevalent microorganisms were Escherichia coli (36.8%),Staphylococcus aureus (17.7%) and Pseudomonas aeruginosa (10.5%). Meticillin resistanceamong S. aureus isolates was 76%. Meropenem and amikacin were the most effective agentsagainst to Gram-negative bacteria. Conclusion: In order to detect of the variation and trends of NIs, the data of surveillanceactivities must be evaluated decisively and regularly with collaboration among infection controlteam, Infectious Disease clinic, and GSU.

WOS: 000386954300001, PubMed: 27809934, 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.

EASL International Liver Congress -- APR 13-17, 2016 -- -- Barcelona, SPAIN, WOS: 000398711700582, …, EASL

Aims: To evaluate the effectiveness of the International Nosocomial Infection Control Consortium (INICC) Multidimensional Hand Hygiene Approach in Turkey and analyse predictors of poor hand hygiene compliance. Design: An observational, prospective, interventional, before-and-after study was conducted from August 2003 to August 2011 in 12 intensive care units (ICU) of 12 hospitals in 11 cities. The study was divided into a baseline and a follow-up period and included random 30-minute observations for hand hygiene compliance in ICU. The hand hygiene approach included administrative support, supplies availability, education and training, reminders in the workplace, process surveillance, and performance feedback. Results: We observed 21,145 opportunities for hand hygiene. Overall hand hygiene compliance increased from 28.8% to 91% (95% CI 87.6–93.0, p 0.0001). Multivariate and univariate analyses showed that several variables were significantly associated with poor hand hygiene compliance: males vs. females (39% vs. 48%; 95% CI 0.79–0.84, p 0.0001), ancillary staff vs. physicians (35% vs. 46%, 95% CI 0.73–0.78, p 0.0001), and adult vs. pediatric ICUs (42% vs. 74%, 95% CI 0.54–0.60, p 0.0001). Conclusions: Adherence to hand hygiene was significantly increased with the INICC Hand Hygiene Approach. Specific programmes should be directed to improve hand hygiene in variables found to be predictors of poor hand hygiene compliance.

The objective consumption rate of antibiotics at our hospital has been measured using “antibiotic consumption index (ACI)” described by World Health Organization. In our hospital, ACI was found 90.7 DDDs/100-Bed Day (BD). In the first level of study, antimicrobial consumption was measured. In the second level, an educational intervention program was started for four of the departments (the study departments). The incidence of hospital infections was monitored during the first and second six-month periods. The index was 128 to 83 in burn unit, 109.8 to 84 in department of nephrology, 102.7 to 90 in thoracic and cardiac surgery (TCS) and 71.5 to 64 in neurosurgery. There was no remarkable change in control departments that 62.7 to 60.7 in gastroenterology and 103 to 106.5 DDDs/100-BD in haematology. Approximately 80.000 dollar were saved from antibiotic budget in the four study departments during the second semester. In the study departments, nosocomial infection rate was found 8.3% in the first semester and 4.9% in the second semester. As a conclusion, educational programs for rational antibiotic consumption and consultations from infectious diseases department are thought to be effective to prevent irrational antibiotic consumption and our new antibiotic policy did not resulted in an increase in nosocomial infection in our hospital.

Yalcin, Ata Nevzat/0000-0002-7243-7354; dursun, oguz/0000-0001-5482-3780; Oncul, Oral/0000-0002-1681-1866; Leblebicioglu, Hakan/0000-0002-6033-8543; demirdal, tuna/0000-0002-9046-5666; Ciftci, Ergin/0000-0002-4955-160X; Erben, Nurettin/0000-0003-0373-0132; Kendirli, Tanil/0000-0001-9458-2803; Acar, Ali/0000-0003-2008-5112; Geyik, Mehmet Faruk/0000-0002-0906-0902; Dursun, Oguz/0000-0001-5482-3780; KAYA, ZEYNEP/0000-0002-8468-2103; KARABAY, OGUZ/0000-0003-1514-1685; Karabay, Oguz/0000-0003-0502-432X; Kaya, Sehnaz/0000-0003-0002-1517 WOS: 000347654600011 PubMed: 25564124 Background: Surgical site infections (SSIs) are a threat to patient safety; however, there were no available data on SSI rates stratified by surgical procedure (SP) in Turkey. Methods: Between January 2005 and December 2011, a cohort prospective surveillance study on SSIs was conducted by the International Nosocomial Infection Control Consortium (INICC) in 20 hospitals in 16 Turkish cities. Data from hospitalized patients were registered using the Centers for Disease Control and Prevention (CDC) National Healthcare Safety Network (NHSN) methods and definitions for SSIs. Surgical procedures (SPs) were classified into 22 types according to International Classification of Diseases, Ninth Revision criteria. Results: We recorded 1879 SSIs, associated with 41,563 SPs (4.3%; 95% confidence interval, 4.3-4.7). Among the results, the SSI rate per type of SP compared with rates reported by the INICC and CDC NHSN were 11.9% for ventricular shunt (vs 12.9% vs 5.6%); 5.3% for craniotomy (vs 4.4% vs 2.6%); 4.9% for coronary bypass with chest and donor incision (vs 4.5 vs 2.9); 3.5% for hip prosthesis (vs 2.6% vs 1.3%), and 3.0% for cesarean section (vs 0.7% vs 1.8%). Conclusions: In most of the 22 types of SP analyzed, our SSI rates were higher than the CDC NHSN rates and similar to the INICC rates. This study advances the knowledge of SSI epidemiology in Turkey, allowing the implementation of targeted interventions. Copyright (C) 2015 by the Association for Professionals in Infection Control and Epidemiology, Inc. Published by Elsevier Inc. All rights reserved.

Geyik, Mehmet Faruk/0000-0002-0906-0902; demirdal, tuna/0000-0002-9046-5666; KARABAY, OGUZ/0000-0003-1514-1685; Karabay, Oguz/0000-0003-0502-432X; Gunduz, Alper/0000-0001-9154-844X WOS: 000352106600012 PubMed: 25500658 Introduction: Although pegylated interferons (pegIFNs) alpha-2a and alpha-2b have been used in chronic hepatitis B (CHB) treatment for many years, there are few studies concerning predictors of sustained virologic response (SVR) to pegIFN therapy. In this study, we aimed to investigate the predictors of response to pegIFN treatment in cases with HBeAg-negative CHB infection. Methodology: Seventeen tertiary care hospitals in Turkey were included in this study. Data from consecutively treated HBeAg-negative CHB patients, who received either pegIFN alpha-2a or alpha-2b, were collected retrospectively. SVR is defined as an HBV DNA concentration of less than 2,000 IU/mL six months after the completion of therapy Results: SVR was achieved in 40 (25%) of the 160 HBeAg-negative CHB patients. Viral loads in patients with SVR were lower compared to those with no SVR, beginning in the third month of treatment (p < 0.05). The number of cases with a decline of 1 log(10) IU/mL in viral load after the first month of treatment and with a serum HBV DNA level under 2,000 IU/mL after the third month of treatment was higher in cases with SVR (p < 0.05). The number of patients who had undetectable HBV DNA levels at week 48 among responders was significantly greater than among post-treatment virological relapsers (p < 0.05). Conclusions: Detection of a 1 log(10) decline in serum HBV DNA level at the first month of treatment and a serum HBV DNA level < 2000 IU/mL at the third month of therapy may be predictors of SVR.

Objectives: Percutaneous injuries (PCIs) remain a common incident among healthcare workers (HCWs) despite the introduction of safety programs. The aim of this study was to assess the PCIs, required precautions, and applications after the injuries among healthcare workers in a small general hospital. Materials and methods: We assessed the occurrence of PCIs at a General Hospital (EGH) from January 2007 to November 2010. During this period, all injury cases among HCWs were reported to the Infection Control Committee (ICC) using percutaneous injury notification form. The injury notification forms were evaluated retrospectively. Results: Totally 275 health personnel were working in our hospital, 36 healthy workers have been exposed to PCIs during this period. The incidence of PCIs was 2,9/10000 in 2007, 3,1/10000 in 2008, 3,8/10000 in 2009 and 3,9/10000 patient-days in 2010. Injured staff were recorded as, 16 nurses (44%), 12 cleaning staffs (34%), and eight (22%) doctors. The device leading to damage was most frequently the needle-channel. Ten sources (27%) were detected positive for hepatitis B virus (HBV), four (11%) for hepatitis C virus (HCV), and two (5%) for Crimean-Congo hemorrhagic fever virus (CCHFV). No case of seroconversion has been recognized for any of the above mentioned infections. Conclusions: Percutaneous injuries remain to occur among HCWs. Since some the sources were infected, the health personnel are endangered for infections due to PCIs. The health personnel should presume that all patients are infected, and thus should work following universal precautions to avoid complications about the PCIs.

Geyik, Mehmet Faruk/0000-0002-0906-0902 WOS: 000343068800019 PubMed: 25539553 Background/aim: Chronic hepatitis due to hepatitis B and hepatitis C virus infections is the most common cause of chronic liver disease. In this study we aimed to find out seroprevalences and associated risk factors of hepatitis B and C in adults in Duzce. Materials and methods: The sample of study was determined with a cluster-type sampling method. The study included 1321 people, consisting of 667 women and 654 men who were 18 years or older. A questionnaire about demographic information and risk factors was applied. Results: Seroprevalences of HBsAg, anti-HBs, and anti-HCV were 4.8%, 9.4%, and 0.7%, respectively. HBsAg seroprevalences were found to be statistically higher in the dental visit group (8.9% versus 4.0%, P = 0.002) and in people living within the same house with hepatitis B carriers (11.5% versus 4.6%, P = 0.036). Living in Duzce during the 1999 earthquake and staying in prefabricated houses after the earthquake were not risk factors of HBsAg carriage. Conclusion: HBsAg and anti-HCV seroprevalences in Duzce were in parallel with the previous data from Turkey and a low ratio of anti-HBs appeared. Identifying risk groups with large epidemiological screening studies and vaccination of nonimmune people are essential.

Yalcin, Ata Nevzat/0000-0002-7243-7354; dursun, oguz/0000-0001-5482-3780; Geyik, Mehmet Faruk/0000-0002-0906-0902; Dursun, Oguz/0000-0001-5482-3780; Leblebicioglu, Hakan/0000-0002-6033-8543; Unal, Necmettin/0000-0002-9440-7893 WOS: 000325254600011 PubMed: 23623158 Background: We evaluate the effectiveness of a multidimensional infection control approach for the reduction of catheter-associated urinary tract infections (CAUTIs) in 13 intensive care units (ICUs) in 10 hospital members of the International Nosocomial Infection Control Consortium (INICC) from 10 cities of Turkey. Methods: A before-after prospective active surveillance study was used to determine rates of CAUTI. The study was divided into baseline (phase 1) and intervention (phase 2). In phase 1, surveillance was performed applying the definitions of the Centers for Disease Control and Prevention/National Healthcare Safety Network. In phase 2, we implemented a multidimensional approach that included bundle of infection control interventions, education, surveillance and feedback on CAUTI rates, process surveillance, and performance feedback. We used random effects Poisson regression to account for clustering of CAUTI rates across time periods. Results: The study included 4,231 patients, hospitalized in 13 ICUs, in 10 hospitals, in 10 cities, during 49,644 patient-days. We recorded a total of 41,871 urinary catheter (UC)-days: 5,080 in phase 1 and 36,791 in phase 2. During phase 1, the rate of CAUTI was 10.63 per 1,000 UC-days and was significantly decreased by 47% in phase 2 to 5.65 per 1,000 UC-days (relative risk, 0.53; 95% confidence interval: 0.4-0.7; P value = .0001). Conclusion: Our multidimensional approach was associated with a significant reduction in the rates of CAUTI in Turkey. Copyright (C) 2013 by the Association for Professionals in Infection Control and Epidemiology, Inc. Published by Elsevier Inc. All rights reserved. Foundation to Fight against Nosocomial Infections Funding for the activities carried out at INICC headquarters were provided by the corresponding author, Victor D. Rosenthal, and the Foundation to Fight against Nosocomial Infections.

UNAL, SERHAT/0000-0003-1184-4711; Yalcin, Ata Nevzat/0000-0002-7243-7354; Dursun, Oguz/0000-0001-5482-3780; Geyik, Mehmet Faruk/0000-0002-0906-0902; Leblebicioglu, Hakan/0000-0002-6033-8543; dursun, oguz/0000-0001-5482-3780; Topeli, Arzu/0000-0002-5874-9087 WOS: 000316641000020 PubMed: 23355330 Purpose To evaluate the impact of the International Nosocomial Infection Control Consortium (INICC) multidimensional approach on the reduction of ventilator-associated pneumonia (VAP) in adult patients hospitalized in 11 intensive care units (ICUs), from 10 hospitals, members of the INICC, in 10 cities of Turkey. Methods A prospective active before-after surveillance study was conducted to determine the effect of the INICC multidimensional approach in the VAP rate. The study was divided into two phases. In phase 1, active prospective surveillance of VAP was conducted using the definitions of the Centers for Disease Control and Prevention National Health Safety Network, and the INICC methods. In phase 2, we implemented the multidimensional approach for VAP. The INICC multidimensional approach included the following measures: (1) bundle of infection control interventions, (2) education, (3) outcome surveillance, (4) process surveillance, (5) feedback of VAP rates, and (6) performance feedback of infection control practices. We compared the rates of VAP obtained in each phase. A time series analysis was performed to assess the impact of our approach. Results In phase 1, we recorded 2,376 mechanical ventilator (MV)-days, and in phase 2, after implementing the multidimensional approach, we recorded 28,181 MV-days. The rate of VAP was 31.14 per 1,000 MV-days during phase 1, and 16.82 per 1,000 MV-days during phase 2, amounting to a 46 % VAP rate reduction (RR, 0.54; 95 % CI, 0.42-0.7; P value, 0.0001.) Conclusions The INICC multidimensional approach was associated with a significant reduction in the VAP rate in these adult ICUs of Turkey. Foundation to Fight against Nosocomial Infections The authors thank the many health care professionals at each member hospital who assisted with the conduct of surveillance in their hospital, including the surveillance nurses, clinical microbiology laboratory personnel, and the physicians and nurses providing care for the patients during the study; without their cooperation and generous assistance this INICC would not be possible; Mariano Vilar, Debora Lopez Burgardt, Santiago Suarez, Cecilia Cappelini, Denise Brito, Eugenia Manfredi, Luciana Soken, Dario Pizzuto, Yuan Ding, Katie Saunders, and Isaac Kelmeszes who work at INICC headquarters in Buenos Aires, for their hard work and commitment to achieve INICC goals; the INICC country coordinators (Altaf Ahmed, Carlos A. Alvarez Moreno, Anucha Apisarnthanarak, Luis E. Cuellar, Bijie Hu, Hakan Leblebicioglu, Eduardo A. Medeiros, Yatin Mehta, Lul Raka, Namita Jaggi, and Toshihiro Mitsuda); the INICC Advisory Board (Carla J. Alvarado, Gary L. French, Nicholas Graves, William R. Jarvis, Patricia Lynch, Dennis Maki, Russell N. Olmsted, Didier Pittet, Wing Hong Seto, Syed Sattar, and William Rutala), who have so generously supported this unique international infection control network; and specially to Patricia Lynch, who inspired and supported us to follow our dreams despite obstacles. The funding for the activities carried out at INICC head quarters were provided by the corresponding author, Victor D. Rosenthal, and Foundation to Fight against Nosocomial Infections.

Background: The Widal test is the most common, specific and quick diagnostic method available in the world for diagnosis of typhoid fever; however, false negativity is one of the obstructive features of the test. The aim of this study was to evaluate the associated factors with Widal test negativity in an endemic area., Methods: Widal test negativity was retrospectively analyzed among culture-proven typhoid fever cases. The potential features including age, gender, previous antibiotic usage, duration of symptoms, leucopoenia, hematocrit value, and erythrocyte sedimentation rate (ESR) were evaluated for association with Widal test negativity., Results: A total of 166 culture-proven typhoid fever cases (93 or 56.0% males) were included in the study. The mean age +/- SD was 23.3 +/- 10.6 years. Mean time of interval between first symptom and test performance time was 10.6 +/- 7.8 days. The Widal test (STO and/or STH) was found positive in 75 cases (45.2%). The statistical analyses revealed that none of these variables were significant for false negativity of the Widal test. Age was found to be a possible factor for a false negative Widal test (p=0.06)., Conclusion: Of existing compatible clinical findings, age should be considered in cases of Widal test negativity.

The aim of this study was to present a unique case of intramedullary brucellar granuloma (IBG) and to discuss the diagnosis and management. To our knowledge, only one case of thoracic IBG has been reported previously, and our case is the first in cervical spine. A 35-year-old female patient was admitted with headache, pain and weakness in her four extremities. She had no gastrointestinal symptoms and fever. She had been diagnosed with Brucella meningitis 3 months ago and a triple therapy of doxycyclin, rifampicin and trimetoprim/sulfametoxazol (TMP/SMZ) had been started. Medical history revealed that she had ingested raw cheese and taken her medication improperly. Loss of strength was detected in her four extremities, which led us to assume the formation of a mass lesion at cervical level. Therefore, we performed a magnetic resonance imaging scan and found enhancement of an intramedullary mass lesion at cervical 1–2 level. Diagnosis of neurobrucellosis was confirmed by titer of >1/160 Brucella antibodies both in blood and cerebrospinal fluid. Based on these findings, brucellar granuloma of cervical spine was diagnosed and a combination therapy of doxycyclin, TMP/SMZ and rifampicin was administered for additional 6 months. At the ninth month of treatment, the patient recovered both radiologically and clinically. Our case is unique, in terms of cervical IBG formation. The excellent response to antimicrobial therapy in our patient suggests that, a trial of medical treatment for 6 months may be effective in such cases.

INTRODUCTION The aim of this study was to investigate the effect of Saccharomyces boulardii treatment on preventing bacterial translocation in an obstructive jaundice animal model. MATERIALS AND METHODS Sixty adult rats were divided into five groups: group 1 – the sham-operated group; group 2 – the common bile duct ligation group; group 3 – the S. boulardii group; group 4 – the ampicillin-sulbaktam group; and group 5 – the S. boulardii plus ampicillin-sulbaktam group. The saline, antibiotics and S. boulardii were given, respectively, for a 7-day period as a single dose per day via temporary orogastric intubation. Seven days following the obstructive jaundice, the animal had laparatomy under sterile conditions. Segments of ileum were removed for histopathological examination. Blood, liver, spleen and mesenteric lymph nodes were taken for microbiological culture. RESULTS Bacterial translocation rates were 0% in the sham-operated group, 83% in group 2, 42% in group 3, 42% in group 4 and 33% in group 5. Bacterial translocation significantly increased in group 2 compared to groups 3, 4 and 5 (P = 0.001). The bacterial counts (CFU/g) of group 2 were significantly higher than those of groups 3, 4 and 5 (P = 0.001). Histopathological examination of ileum specimens revealed a significant decrease in the heights of villi in groups 2–5 compared to the sham-operated group (P = 0.001). The mean villus height in groups 3 and 5 was significantly higher than that of group 4 (P = 0.001). CONCLUSIONS S. boulardii was found to be effective in the successful control of translocation and improvement of intestinal barrier function.

WOS: 000184460300022, PubMed ID: 12925117, Informed consultation between physicians is an important part of medical practice. The aim of the study was to evaluate the nature and frequency of such consultations in infectious diseases and clinical microbiology practice. This study was done in five university hospitals. Twenty-one infectious diseases and clinical microbiology specialists participated in informal ('curbside') consultations. In a written questionnaire, physicians were asked to report the number and nature of the informal consultations (ICs) they were asked to provide. A total three hundred and sixty-two such consultations were carried out during a three-month period. The ICs occurred most frequently in the hospital (82.3%). Most of the ICs from outside the hospital were by telephone. Most of the ICs (54.4%) were requested by fellows of specialists. 78.7% of the ICs were requested during working hours. 58.8% of consultations took less than 5 min, 18.8% took 6-10 min, 15.2% took 11-20 min, and 7.2% took over 20 min. The four most common reasons for obtaining ICs were to: help to select an appropriate treatment plan (41.4%), help to select an appropriate prophylaxis (19.3%), interpret laboratory data (10.2%), and provide information about antibiotics (10.2%). 30.1% of ICs resulted in subsequent formal consultation and only four patients (1.1%) were transferred to the consultants' clinics. Informal consultations are a frequent occurrence in the practice of infectious diseases and clinical microbiology (ID&CM). Physicians use this sort of consultation to select an appropriate treatment plan and obtain medical information. This study confirms the importance of the ID&CM specialists as a resource for medical personnel.

WOS: 000182584000009, PubMed ID: 12803374, A retrospective study was performed to assess the epidemiology, diagnosis, clinic, and laboratory of the patients with tuberculous meningitis (TBM) in a multicentral study. The medical records of adult cases with TBM treated at 12 university hospitals throughout Turkey, between 1985 and 1998 were reviewed using a standardized protocol. The diagnosis of TMB was established with the clinical and laboratory findings and/or microbiological confirmation in cerebrospinal fluid (CSF). The non-microbiologically confirmed cases were diagnosed with five diagnostic sub-criteria which CSF findings, radiological findings, extra-neural tuberculosis, epidemiological findings and response to antituberculous therapy. A total of 469 patients were included in this study. Majority of the patients were from Southeast Anatolia (164 patients, 35.0%) and (108 patients, 23.0%) from East Anatolia regions. There was a close contact with a tuberculous patient in 88 of 341 patients (25.8%) and with a tuberculous family member in 53 of 288 patients (18.4%). BCG scar was positive in 161 of 392 patients (41.1%). Tuberculin skin test was done in 233 patients and was found to be negative in 75. Totally 115 patients died (24.5%) of whom 23 died in 24 hour after admittance. The diagnosis was confirmed with clinical findings and CSF culture and/or Ziehl-Nelson staining in 88 patients (18.8%). Besides clinical criteria, there were three or more diagnostic sub-criteria in 252 cases (53.7%), two diagnostic sub-criteria in 99 cases (21.1%), and any diagnostic sub-criteria in 30 patients (6.4%). Since TBM is a very critical disease, early diagnosis and treatment may reduce fatal outcome and morbidity.

The objective of this study was to determine the molecular epidemiology of Salmonella typhi isolates from patients with typhoid fever in southeast Turkey and to determine the relationship between the clinical strains and environmental subtypes. Both demographic and clinical data were obtained by chart review and compared to the molecular subtyping results.

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.