Search

We aimed to assess the 24-week virological and immunological success of the treatment of treatment-naive and treatment-experienced patients included in the Action against HIV in Istanbul (ACTHIV-IST) database. The ACTHIV-IST database was screened retrospectively from January 2012 to January 2014. The data for these patients such as age, sex, treatment-naive or treatment-experienced status, date of diagnosis, date of commencing antiretroviral therapy, antiretroviral therapy regimen, CD4+ cell count, and viral load before and after therapy were analyzed. In the 24th week of antiretroviral therapy, there were 40 (17.9%) and 29 (14.1%) virological and immunological failures, respectively. Virological failure (VF) was associated with a baseline viral load > 100,000 copies (p = 0.004). A CD4+ cell count lower than 200 cells/μl was not found to be associated with VF (p = 0.843). Immunological failure was substantially rare in patients with a baseline CD4+ cell count > 200 cells/μl (p = 0.005). Although an HIV-RNA ≤ 100,000 copies/ml was protective against VF in the 24th week, in individuals with an HIV-RNA > 100,000 copies/ml, VF was 3.2 times more likely to occur. Baseline VF was the most predictive parameter to estimate 24th week virological success and VF. VF is an important prognostic parameter resulting in CD4+ cell depletion, AIDS-related events, and increased mortality.

In the present study, we aimed to assess the rate and effect of device-associated nosocomial infections (DANIs), as well as the rate of antibiotic resistance, in the medical-surgical intensive care unit (ICU) of a research and training hospital in Turkey, and to compare our results with those reported by the National Nosocomial Infections Surveillance (NNIS) system and International Nosocomial Infection Control Consortium (INICC). A total of 509 patients were followed up within a 1-year period from 1 November 2007 to 1 November 2008. The total patient days were 4,087, the number of DANIs was 181. The ventilator-associated pneumonia rate in 1,000 ventilator days was 27.1, the rate of central venous catheter (CVC)-associated blood circulation infections in 1,000 CVC days was 11.8, and the rate of urinary catheter-associated urinary tract infections in 1,000 urinary catheter days was 9.6. The most frequently isolated microorganisms were Pseudomonas aeruginosa and Acinetobacter spp. Of the infections caused by Staphylococcus aureus, 81.2% were due to methicillin-resistant strains. Of the Enterobacteriaceae isolates, 53.5% were found to be resistant to ceftriaxone, while 29% of the P. aeruginosa isolates were found to be resistant to ciprofloxacin. The rates of use of devices such as ventilators, CVCs, and urinary catheters were 0.87, 0.93, and 0.98, respectively, which are higher than the rates reported by NNIS and INICC. On the other hand, the present DANI rate was higher than that reported by NNIS, but close to that reported by INICC. We conclude that the indications for and duration of device use should be reviewed.