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1. Factors Affecting Inadequate Empirical Antimicrobial Therapy and the Clinical Course of Upper Urinary Tract Infections in Elderly Patients: A Multicenter Study

Author

Pınar KORKMAZ, Behice KURTARAN, Şule ÖZDEMİR ARMAĞAN, Hale TURAN ÖZDEN, Fatma KAÇAR, Selma ATEŞ, Gül DURMUŞ, Fulya BAYINDIR BİLMAN, Yeşim UYGUN KIZMAZ, Aziz Ahmad HAMİDİ, Burcu ÖZDEMİR, Aslıhan BURCU YIKILGAN, Pınar FIRAT, Asuman İNAN, Gülay OKAY, Mehmet Emirhan IŞIK, Ayşe BUT, Kenan UĞURLU, Rezan HARMAN, Büşra ERGÜT SEZER, Elif DOYUK KARTAL, Ferit KUŞÇU, Alper ŞENER, Duru MISTANOĞLU ÖZATAĞ, Elif TÜKENMEZ TİGEN, Özgür DAĞLI, Funda KOÇAK, Hülya KUŞOĞLU, Buket ERTÜRK ŞENGEL, Aslıhan DEMİREL, Hasan NAZ, Canan AĞALAR, Derya ÖZTÜRK ENGİN, İlyas DÖKMETAŞ, Nur CANCAN GÜRSUL, Fatma YILMAZ KARADAĞ, Mehmet Umut ÇAYIRÖZ, Yeşim KÜREKÇİ, Ayten KADANALI, Zeynep Şule ÇAKAR, Ümit SAVAŞÇI, İlknur ERDEM, and Sabahat ÇAĞAN AKTAŞ

Subjects
urinary tract infection, empirical, antibiotherapy, mortality, Medicine, Infectious and parasitic diseases, RC109-216
Abstract

Introduction: In this study, we aimed to determine the risk factors associated with inadequate empirical antibiotherapy (IEAT) and hospital-related mortality in elderly patients being treated for upper urinary tract infections (UTI). Materials and Methods: This study included individuals aged 65 years and over who were hospitalized after being diagnosed of communityacquired UTI or community-onset healthcare-associated UTI and followed-up in clinics and/or intensive care units (ICU) of 33 hospitals between March and September 2017. Results: A total of 525 patients (48% males; mean age: 76.46±7.93 years) were included in the study. Overall, 68.2% of the patients were hospitalized through the emergency department and 73.9% of patients were followed-up for pyelonephritis. Gram-negative, Gram-positive, and Gram-negative and positive mix growths were determined in 88%, 9.3%, and 2.7% of urine cultures, respectively. Fifty-six (10.7%) of the patients died. In multivariate analysis, the presence of chronic obstructive pulmonary disease [Odds ratio (OR): 2.278], age 85 years and over (OR: 2.816), admission to the ICU (OR: 14.831), and IEAT (OR: 2.364) were independent factors that significantly affected mortality. The presence of a urinary catheter, being followed-up in the ICU, benign prostate hypertrophy, use of antibiotics other than piperacillin-tazobactam and carbapenem were determined as independent factors that significantly affected IEAT (p

Published
2020
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2. Are Soap, Paper Towel and Alcohol-based Disinfectants Easily Accessible in Intensive Care Units in Turkey?: Results of the Phokai Study

Author

Ayşe UYAN, Gül DURMUŞ, Nurbanu SEZAK, Burcu ÖZDEMİR, Türkkan KAYGUSUZ, Nefise ÖZTOPRAK, Kevser ÖZDEMİR, Firdevs AKSOY, Asu ÖZGÜLTEKİN, Meliha Meriç KOÇ, Ahsen ÖNCÜL, Sabahat ÇAĞAN AKTAŞ, Burcu IŞIK, Güven ÇELEBİ, Güliz EVİK, Selçuk ÖZGER, Rezan HARMAN, Emine Kübra DİNDAR DEMİRAY, Şebnem ÖZKÖREN ÇALIK, Sevil ALKAN ÇEVİKER, İlknur Esen YILDIZ, Mehmet Emirhan IŞIK, Güneş ŞENOL, Sema SARI, Mustafa DOĞAN, Kenan UĞURLU, Mustafa ARSLAN, Fethiye AKGÜL, Filiz KOÇ, Yeşim KÜREKÇİ, Derya ÇAĞLAYAN, Mehmet UÇAR, Ramazan GÖZÜKÜÇÜK, Habibe Tülin ELMASLAR MERT, Handan ALAY, Haluk ERDOĞAN, Aslıhan DEMİREL, Nilgün DOĞAN, Funda KOÇAK, Emre GÜVEN, Güleser ÜNSAL, Hilal SİPAHİ, Tansu YAMAZHAN, Bilgin ARDA, Sercan ULUSOY, and Oğuz Reşat SİPAHİ

Subjects
Soap, paper towel, alcohol based disinfectants, intensive care units, nosocomial infections, Medicine, Infectious and parasitic diseases, RC109-216
Abstract

Introduction: Hand hygiene is one of the most effective infection control measures to prevent the spread of healthcare-associated infections (HCAI). Water, soap, paper towel and hand disinfectant must be available and adequate in terms of effective hand hygiene. The adequacy of hand hygiene products or keeping water-soap and paper towel is still a problem for many developing countries like Turkey. In this multicenter study, we analyzed the adequacy in number and availability of hand hygiene products. Materials and Methods: This study was performed in all intensive care units (ICUs) of 41 hospitals (27 tertiary-care educational, 10 state and four private hospitals) from 22 cities located in seven geographical regions of Turkey. We analyzed water, soap, paper towel and alcohol-based hand disinfectant adequacy on four different days, two of which were in summer during the vacation time (August, 27th and 31st 2016) and two in autumn (October, 12th and 15th 2016). Results: The total number of ICUs and intensive care beds in 41 participating centers were 214 and 2357, respectively. Overall, there was no soap in 3-11% of sinks and no paper towel in 10-18% of sinks while there was no alcohol-based hand disinfectant in 1-4.7% of hand disinfectant units on the observation days. When we compared the number of sinks with soap and/or paper towel on weekdays vs. weekends, there was no significant difference in summer. However, on autumn weekdays, the number of sinks with soap and paper towel was significantly lower on weekend days (p

Published
2018
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3. Is Nurse Workforce Sufficient in Intensive Care Units in Turkey? Results of the Multicenter Karia Study

Author

Ayşe UYAN, Gül DURMUŞ, Nurbanu SEZAK, Fatmanur PEPE, Türkkan KAYGUSUZ, Nefise ÖZTOPRAK, Kevser ÖZDEMİR, Firdevs AKSOY, Serpil EROL, Meliha Meriç KOÇ, Ahsen ÖNCÜL, Sabahat ÇAĞAN AKTAŞ, Hülya ÇAŞKURLU, Güven ÇELEBİ, Özlem KANDEMİR, Selçuk ÖZGER, Rezan HARMAN, Kübra DEMİRAY, Alpay ARI, Sevil ALKAN ÇEVİKER, İlknur ESEN YILDIZ, Şirin MENEKŞE, Güneş ŞENOL, Sema SARI, Mustafa DOĞAN, Kenan UĞURLU, Mustafa ARSLAN, İrem AKDEMİR, Pınar FIRAT, Yeşim KÜREKÇİ, Derya ÇAĞLAYAN, Mehmet UÇAR, Ramazan GÖZÜKÜÇÜK, Habibe Tülin ELMASLAR MERT, Handan ALAY, Haluk ERDOĞAN, Aslıhan DEMİREL, Nilgün DOĞAN, Funda KOÇAK, Emre GÜVEN, Güleser ÜNSAL, Hilal SİPAHİ, Meltem IŞIKGÖZ TAŞBAKAN, Bilgin ARDA, Sercan ULUSOY, and Oğuz Reşat SİPAHİ

Subjects
Infection control, infection, healthcare-associated infections, intensive care infections, infection control practitioner, Medicine, Infectious and parasitic diseases, RC109-216
Abstract

Introduction: In this multicenter study, we analysed the magnitude of healthcare worker (HCW) [infection control practitioner (ICP), nurses and others] workforce in hospitals participated in the study. Materials and Methods: This study was performed in 41 hospitals (with intensive care units-ICU) located in 22 cities from seven regions of Turkey. We analysed the ICP workforce, nursing and auxiliary HCW (AHCW) workforce in ICUs, number of ICU beds and occupied beds in four different days [two of which were in summer during the vacation time (August 27 and 31, 2016) and two others in autumn (October 12 and 15, 2016)]. The Turkish Ministry of Health (TMOH) requires two patients per nurse in level 3 ICUs, three patients per nurse in level 2 ICUs and five patients per nurse in level 1 ICUs. There is no standardization for the number of AHCW in ICUs. Finally, one ICP per 150 hospital beds is required by TMOH. Results: The total number of ICUs, ICU beds and ICPs were 214, 2377 and 111, respectively in he 41 participated centers. The number ICPs was adequate only in 12 hospitals. The percentage of nurses whose working experience was 2. The number of patients per other HCW was minimum 3.75 and maximum 4.89 on weekdays and on day shift while it was minimum 5.02 and maximum 7.7 on weekends or on night shift. When we compared the number of level 1, 2 and 3 ICUs with adequate nursing workforce vs inadequate nursing workforce, the p value was

Published
2017
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4. A snapshot of geriatric infections in Turkey: ratio of geriatric inpatients in hospitals and evaluation of their infectious diseases: A multicenter point prevalence study

Author

Ramazan Gözüküçük, Ilyas Dokmetas, Yeşim Taşova, Umit Savasci, Hale Turan Özden, Selma Ateş, Esra Kaya Kılıç, Serhat Birengel, Ali Acar, M Emirhan Işık, Şaban Esen, Fatma Yılmaz Karadağ, Kader Arslan, Rezan Harman, Ahmet Hamidi, Emine Sehmen, Asli Haykir Solay, Ayşe Sağmak Tartar, Sedat Kaygusuz, Funda Kocak, Esmeray Mutlu Yilmaz, Filiz Koc, Ozgur Dagli, Hande Aslaner, Şule Özdemir Armağan, Isil Deniz Aliravci, Serpil Erol, Duru Mıstanoğlu Özatağ, Behice Kurtaran, Canan Agalar, Ilknur Esen Yildiz, Mustafa Dogan, Merve Sefa Sayar, Yeşim Kürekçi, Rıdvan Kara Ali, Ilknur Erdem, Zehra Demirbaş, Yasemin Balkan, Fatime Korkmaz, Funda Bilman, Yesim Uygun Kizmaz, Nur Cancan Gürsul, Hüseyin Şahintürk, Emine Fırat Göktaş, Nefise Oztoprak, Pinar Korkmaz, Hande Aydemir, Aynur Atilla, A İrfan Baran, Nevin Ince, Hülya Kuşoğlu, Sabahat Çağan Aktaş, Ilknur Yavuz, Nilsun Altunal, Abdulkadir Daldal, Ferit Kuşcu, Aslıhan Demirel, Serhat Uysal, Mehmet Ulug, Buket Erturk Sengel, Güliz Evik, Dilara Inan, Gülay Okay, Aslihan Ulu, Nurettin Erben, Selçuk Nazik, A Altunçekiç Yıldırım, Sema Turan, M Reşat Ceylan, Haluk Erdoğan, Hatice Ürgüdücü, Hasan Naz, Kevser Ozdemir, Nirgül Kılıçaslan, Elif Tukenmez Tigen, Süheyla Kömür, Gül Durmuş, Uğur Kostakoğlu, Ayten Kadanali, B Ergüt Sezer, Habibe Tülin Elmaslar Mert, Emel Aslan, Ergenekon Karagoz, Alper Şener, Burcu Ozdemir, Emel Azak, Mevliye Yetik, Kenan Ugurlu, Sema Sarı, A Seza Inal, and OKAY, GÜLAY

Subjects
Male, 0301 basic medicine, Turkey, healthcare associated infection, very elderly, Antibiotics, Psychological intervention, Prevalence, Turkey (republic), 0302 clinical medicine, Health care, antibiotic therapy, antibiotic agent, 030212 general & internal medicine, Aged, 80 and over, Geriatrics, education.field_of_study, inappropriate prescribing, General Medicine, Hospitals, Hospitalization, aged, hospital patient, Infectious Diseases, female, multicenter study (topic), Female, Infection, Microbiology (medical), medicine.medical_specialty, medicine.drug_class, Urinary system, 030106 microbiology, Population, prevalence, Infections, Communicable Diseases, Article, lcsh:Infectious and parasitic diseases, 03 medical and health sciences, length of stay, male, medicine, Humans, pneumonia, lcsh:RC109-216, human, education, Aged, Preventive healthcare, Inpatients, business.industry, Antibiotic, Length of Stay, major clinical study, infection, Emergency medicine, geriatric disorder, business
Abstract

Introduction The human population is aging at an astonishing rate. The aim of this study is to capture a situation snapshot revealing the proportion of individuals aged 65 years and over among inpatients in healthcare institutions in Turkey and the prevalence and type of infections in this patient group in order to draw a road map. Materials and Methods Hospitalized patients over 65 years at any of the 62 hospitals in 29 cities across Turkey on February 9, 2017 were included in the study. Web-based SurveyMonkey was used for data recording and evaluation system. Results Of 17,351 patients 5871 (33.8%) were ≥65 years old. The mean age was 75.1 ± 7.2 years; 3075 (52.4%) patients were male. Infection was reason for admission for 1556 (26.5%) patients. Pneumonia was the most common infection. The median length of hospital stay was 5 days (IQR: 2–11 days). The Antibiotic therapy was initiated for 2917 (49.7%) patients at the time of admission, and 23% of the antibiotics prescribed were inappropriate. Healthcare-associated infections developed in 1059 (18%) patients. Urinary catheters were placed in 2388 (40.7%) patients with 7.5% invalid indication. Conclusion This study used real data to reveal the proportion of elderly patients in hospital admissions. The interventions done, infections developed during hospitalization, length of hospital stay, and excessive drug load emphasize the significant impact on health costs and illustrate the importance of preventive medicine in this group of patients.

Published
2020

5. The factors affecting inadequate empirical antimicrobial therapy and clinical course in upper urinary tract infections of the elderly patients

Author

Derya Ozturk Engin, Pinar Korkmaz, Rezan Harman, Behice Kurtaran, Asuman Inan, Kenan Uğurlu, Mehmet Umut Çayiröz, Umit Savasci, Aslıhan Demirel, Hale Turan Özden, Aslıhan Burcu Yikilgan, Yeşim Kürekçi, Yesim Uygun Kizmaz, Ayten Kadanali, Zeynep Sule Cakar, Alper Şener, Pınar Firat, Fulya Bayindir Bilman, Burcu Ozdemir, Şule Özdemir Armağan, Buket Erturk Sengel, Nur Cancan Gürsul, Gülay Okay, Mehmet Emirhan Işık, Sabahat Çağan Aktaş, Duru Mistanoğlu Özatağ, Canan Ağalar, Fatma Kaçar, Hülya Kuşoğlu, Ayşe But, Ilknur Erdem, Hasan Naz, Özgür Dağli, Gül Durmuş, Fatma Yilmaz Karadağ, Büşra Ergüt Sezer, Ferit Kuşcu, Selma Ateş, Elif Tukenmez Tigen, Ilyas Dokmetas, Elif Doyuk Kartal, Aziz Ahmad Hamidi, and Funda Kocak

Subjects
Microbiology (medical), medicine.medical_specialty, Infectious Diseases, General Immunology and Microbiology, Multicenter study, business.industry, Internal medicine, medicine, Clinical course, Antimicrobial, business, Upper urinary tract
Published
2020

6. Türkiye’deki yoğun bakım ünitelerinde hemşire işgücü yeterli mi? Çok merkezli karia çalışmasının sonuçları

Author

Alpay Ari, Yeşim Kürekçi, Fatmanur Pepe, Handan Alay, Funda Kocak, Mehmet Uçar, Selçuk Özger, Türkkan Öztürk Kaygusuz, Serpil Erol, Rezan Harman, Ramazan Gözüküçük, Güleser Ünsal, Oğuz Reşat Sipahi, Sema Sarı, Ilknur Esen Yildiz, Gül Durmuş, Meliha Meriç Koç, Nefise Oztoprak, Kenan Uğurlu, Aslıhan Demirel, Sevil Alkan Çeviker, Şirin Menekşe, Güven Çelebi, Nilgün Doğan, Ayşe Uyan, Meltem Taşbakan, Firdevs Aksoy, Nurbanu Sezak, Mustafa Doğan, Hilal Sipahi, Pınar Firat, Kevser Ozdemir, Gunes Senol, Sercan Ulusoy, Bilgin Arda, Kübra Demiray, Derya Çağlayan, İrem Akdemir, Sabahat Çağan Aktaş, Ahsen Oncul, Mustafa Arslan, Haluk Erdoğan, Hulya Caskurlu, Özlem Kandemir, Habibe Tülin Elmaslar Mert, Emre Güven, Ege Üniversitesi, RTEÜ, Tıp Fakültesi, Dahili Tıp Bilimleri Bölümü, Yıldız, İlknur Esen, Zonguldak Bülent Ecevit Üniversitesi, and MERİÇ KOÇ, MELİHA

Subjects
Microbiology (medical), Healthcare associated infections, Infection control, infection, healthcare-associated infections, intensive care infections, health care facilities, manpower, and services, education, lcsh:Medicine, Healthcare-associated infections, lcsh:Infectious and parasitic diseases, Nursing, Infection control practitioner, Intensive care, Medicine, lcsh:RC109-216, Intensive care infections, integumentary system, General Immunology and Microbiology, business.industry, lcsh:R, infection control practitioner, Infectious Diseases, Workforce, Uyan A., Durmus G., Sezak N., Pepe F., Kaygusuz T., Oztoprak N., Ozdemir K., AKSOY F., Erol S., Koc M., et al., -Is Nurse Workforce Sufficient in Intensive Care Units in Turkey. Results of the Multicenter Karia Study-, MEDITERRANEAN JOURNAL OF INFECTION MICROBES AND ANTIMICROBIALS, cilt.6, 2017, business, Infection
Abstract

Introduction: In this multicenter study, we analysed the magnitude of healthcare worker (HCW) [infection control practitioner (ICP), nurses and others] workforce in hospitals participated in the study., Materials and Methods: This study was performed in 41 hospitals (with intensive care units-ICU) located in 22 cities from seven regions of Turkey. We analysed the ICP workforce, nursing and auxiliary HCW (AHCW) workforce in ICUs, number of ICU beds and occupied beds in four different days [two of which were in summer during the vacation time (August 27 and 31, 2016) and two others in autumn (October 12 and 15, 2016)]. The Turkish Ministry of Health (TMOH) requires two patients per nurse in level 3 ICUs, three patients per nurse in level 2 ICUs and five patients per nurse in level 1 ICUs. There is no standardization for the number of AHCW in ICUs. Finally, one ICP per 150 hospital beds is required by TMOH., Results: The total number of ICUs, ICU beds and ICPs were 214, 2377 and 111, respectively in he 41 participated centers. The number ICPs was adequate only in 12 hospitals. The percentage of nurses whose working experience was 2. The number of patients per other HCW was minimum 3.75 and maximum 4.89 on weekdays and on day shift while it was minimum 5.02 and maximum 7.7 on weekends or on night shift. When we compared the number of level 1, 2 and 3 ICUs with adequate nursing workforce vs inadequate nursing workforce, the p value was, Conclusion: Our data suggest that ICP workforce is inadequate in Turkey. Besides, HCW workforce is inadequate and almost 1/4 of nurses are relatively inexperienced especially in level 3 ICUs. Turkish healthcare system should promptly make necessary arrangements for adequate HCW staffing.

Published
2017

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