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Aim:We aimed to evaluate the effects of the application of the electronic blood tracking system and transfusion nursing on the transfusion process.Methods:Blood transfusion tracking forms were included in the hospital information Management System (HIMS) in July 2015 and the users were able to electronically record all data, including order, approval, transfusion tracking, and destruction and reaction notification. The transfusion nurse in the blood center followed the processes and gave feedback. Nurses were periodically trained on transfusion, unintended events and reaction reporting. The effects of this application were evaluated based on 36 months of pooled data.Results:With the electronic registration application, the location of the blood products could be tracked via the HIMS. During this 36-month period, 401 in-house and in-clinic trainings were conducted in our hospital; there was a statistically significant increase in the feedback rates in 2016 (p=0.006), and this increase continued in 2017 (p=0.049); the increase in the first period was more prominent (p=0.010). It was observed that the number of inappropriate cases decreased. There was a decrease blood product transfer time in 2017 compared to 2016 (p=0.036).Results:Electronic recording of all transfusion processes in hospitals, in which a large number of blood transfusions are performed, can increase the safety of transfusion and transfusion feedback.

Aim: This study analyzed diabetic foot infections (DFI) in patients who were followed up in our clinic. Methods: We retrospectively evaluated demographic characteristics and clinical and laboratory findings in 27 patients (12 female, 15 male) with DFI who were followed up in our clinic between June 2013 and January 2014. The foot ulcerations in the patients were classified according to Wagner’s classification. Results: The mean age of the patients was 59 years. Erythrocyte sedimentation rate (ESR), C-reactive protein (CRP) and white blood cell levels were found to be high in 89%, 78% and only 22% of patients, respectively. 78% of patients had grade 2 and lower grade ulcerations. Growth of methicillin-resistant Staphylococcus aureus, Enterobacter cloacae and Enterococcus spp. was encountered in five (28%) of 18 patients in whom deep tissue culture test could be performed. Conclusion: Appropriate diagnosis and treatment planning can be achieved by guiding classifications performed by regarding clinical, neurological and vascular conditions as well as ulcer depth. In follow-up of cases, ESR and CRP tests are very useful in diagnosis and treatment of the complications such as osteomyelitis, which may lead to amputation. Treatment should be conducted with a multidisciplinary approach in tertiary healthcare facilities.

Aim: In this study, we retrospectively evaluated the demographic features and the results of human immunodeficiency virus (HIV) RNA testing in 65 cases with HIV infection. Methods: We analyzed HIV RNA values in patients investigated using real time polymerase chain reaction (RT-PCR) between June and September 2010. HIV RNA levels of less than 500 copies/ml in patients receiving highly active antiretroviral therapy (HAART) were considered virological response. Results: Of 65 patients aged between 23-80 years old (median: 42±12), 55 were male; and six of them were diagnosed over one year and followed up in different medical centers. In fifteen patients (25%), who were aged between 23 and 69 years and were newly diagnosed with HIV, HIV RNA levels were found to be between 481 and 1.497.088 copies/ml (median 215.554 copies/ml). Of 44 patients followed up in our clinic, 39 (89%) were receiving HAART and their HIV RNA levels ranged between 0 and 680.842 copies/ml, and viral load was

Objective: Using proper antibiotics in diabetic foot infections can save an extremity. The goal of this study was to determine the antibiotic susceptibility of the most frequent isolates from diabetic foot infections, to compare these results with those for species obtained from both intensive care unit and community-acquired infections, and to re-evaluate the empirical antimicrobial therapy in diabetic foot infections. Material and Methods: Antibiotic susceptibility testing was performed on bacteria from diabetic foot cultures, ICU and community-acquired infections. Skin and soft tissue samples of a total of 181 patients have been studied. Sensitivity to ampicillin/ sulbactam (SAM), ciprofloxacin (CIP), piperacillin/tazobactam (TZP), cefoperazone/sulbactam (SCF), amikacin (AN), meropenem (MEM) and cefepime (FEP) has been investigated. Results: Among the samples, reproduction was detected in 154 (85%), 132 of which (79.5%) contained gram-negative bacteria (46 Enterobacter spp, 36 Pseudomonas spp, 30 Acinetobacter spp, 20 others). Resistance of bacteria isolated from diabetic foot cultures was less than the one of bacteria isolated from ICU and more than the one from community-acquired infections. However, an increased resistance was detected to ciprofloxacin, frequently used in urinary infections, in agents from community-acquired infections. Conclusion: In conclusion, due to the risk of possible loss of tissue/extremity and possible antibiotic resistance, treatment should be started empirically and continued considering the culture results. (The Me di cal Bul le tin of Ha se ki 2011; 49: 137-40)

Aim: Safe transfusion is one of the important steps in blood transfusion. This survey study evaluates the level of education and awareness of our nurses about safe blood transfusion. Method: 192 nurses working in our hospital were surveyed. Results: Only 16% of the participants were 40 years old or older, 18% worked for more than 20 years, 20% were high school graduates, and 25% of them never received training on blood transfusion (BT). All participants have been acquired awareness on cross match and record control. However, 20% were hesitant about the necessity of patient consent. It was observed that there was information confusion about premedication, and 25% were misinformed about blood transfusion procedures. For BTrelated reactions, 67% and 40% could exactly identify the symptoms and the findings, respectively. Of the participants, 15% were misinformed about the necessity of emergency kit and 50% were aware of what to be performed in case of a BT reaction. Discussion: Since increasing the safety in BT process is highly related to the level of knowledge and awareness of the transfusion nurses, it is important to establish inservice training programs and safety control systems. (The Me di cal Bul le tin of Ha se ki 2011; 49: 145-9

Objective: We retrospectively evaluated the culture results of patients hospitalized in the Pediatric Intensive Care Unit (PICU) and Neonatal Intensive Care Unit (NICU) at our hospital during 2008. Material and methods: In this study, the cultures results of the patients were analyzed. Identification of bacteria was performed by conventional methods and antibiotic susceptibility tests were done using disc diffusion method according to the Clinical and Laboratory Standards Institute (CLSI) guidelines. Results: 222 materials sent from 5-bed PICU and 5-bed NICU consisted of 135 (61%) tracheal aspirates, 46 (21%) blood cultures, 21 (10%) urine cultures, 6 (3%) catheter tip cultures, 6 (3%) eye secretion cultures, and 8 (4%) other materials. Pseudomonas spp. were the most frequently isolated bacteria (33%). Carbapenem resistance was not detected for Enterobacteriaceae species and was very low for nonfermentative bacteria. Ciprofloxacin resistance was low and cephoperazone-sulbactam resistance was not detected for Acinetobacter species. Conclusion: Our ICUs are new and patient circulation is low due to long hospitalization period caused by underlying conditions of patients. The well-trained staff and effective infection consultation, along with the previously mentioned facts, resulted in low antibiotic resistance rates and absence of panresistant bacteria. (The Medical Bulletin of Haseki 2011;49: 73-6)

Aim: The aim of this study was to determine the incidence of macrolide-lincosamide-streptogramin B (MLSB) resistance in staphylococcal isolates from various clinical samples. Methods: In this study, we included a total of 100 staphylococcal isolates, 35 Staphylococcus aureus and 65 coagulase-negative staphylococci (CNS), from specimens obtained from patients followed up in our hospital between 2009 and 2010. Methicillin resistance of these isolates was determined using cefoxitin disc diffusion method. MLSB resistance was investigated by D-test method using erythromycin and clindamycin disks. Results: Of 35 S. aureus isolates, 14 were methicillin-resistant (MRSA) and 21 were methicillin-sensitive (MSSA). Of 65 CNS isolates, 41 were methicillin-resistant (MRCNS) and 24 were methicillin-sensitive (MSCNS). In 79 strains, there was at least one MLSB resistance phenotype. The most frequent resistance phenotypes were inducible (35%) and constitutive (30%) among all isolates, while the constitutive one was more common in S. aureus strains (62%). Conclusion: Since the resistant community- and hospitalacquired staphylococcal infections have become a therapeutic problem, it is very important to detect MLSB resistance routinely in microbiology laboratories. D-test is a cheap and reliable diagnostic method which can be performed in every laboratory. In order to prevent treatment failure, D-test should be routinely used and the results should be reported to the clinician before starting a therapy with MLSB group of antibiotics. (The Me di cal Bul le tin of Ha se ki 2011; 49: 102-4)