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In this study, the blood culture results of patients aged >65 years who were admitted to the cardiology intensive care unit in a training and research hospital and who had positive blood cultures within the first 48 hours were evaluated. This was a retrospective, observational and nonrandomized study. Patient data at the time of the blood culture were included in the study. Sex, age, length of hospital stay, mortality, Acute Physiology Chronic Health Evaluation II score, laboratory values, and microorganisms grown in blood culture included in the study. Two hundred forty-seven patients, 43.3% of whom were female (n = 107), were included in the study. The median age of the patients was 75 (range 70-83). The mean hospital stay was 5 days (range 3-8). All patients had a median Acute Physiology Chronic Health Evaluation II score of 21 (range 19-23). The overall mortality rate 48.2% (n = 119). The results showed that 49.8% of those died and 50.2% of survivors had positive blood culture results. The most common gram-positive cocci in those died were Staphylococcus hominis (15.6%), Staphylococcus epidermis (14.8%), Enterococcus faecium (9.6%). The most common gram-negative cocci were Escherichia coli (9.6%), Klebsiella pneumoniae (9.6%), Acinetobacter baummanii (1.6%). With an increase in the elderly population, infection management in elderly patients hospitalized in cardiology intensive care units has become increasingly critical., Competing Interests: The authors have no funding and conflicts of interest to disclose., (Copyright © 2024 the Author(s). Published by Wolters Kluwer Health, Inc.)

Background: This improvement report presents a hospital blood-management programme, a hospital-specific model that differs from patient blood managment and was aimed at improving operational standards of transfusion. We identified the challenges of the transfusion process and suggest practical strategies for improving them. The aim of this article was to investigate the effect of the programme on the transfusion of blood components., Methods: In January 2019, the programme was started to improve the transfusion process. The data before and after the start of the programme were compared. Frequency distribution was obtained for each variable for statistical analysis and the chi-squared test with continuity correction was used to compare these variables for the years 2018 and 2019., Results: Transfusion of total blood components decreased by 23.2%, fresh whole blood by 46.7%, fresh frozen plasma by 38.4%, pooled platelets by 14.0% and red blood cells by 9.66%. Autologous transfusion increased 11.7-fold. The emergency department (76.0%) and intensive care unit transfusion rate (9.26%) decreased significantly., Conclusion: This programme is an example for hospitals where patient blood management cannot be applied. The programme can be considered the first step for blood management and may be applied to blood management in institutions worldwide. The difficulty of blood supply and increased cost will increase the importance of hospital blood-management programmes in the coming years.

We explored the self-reported antibiotic stewardship (AS), and infection prevention and control (IPC) activities in intensive care units (ICUs) of different income settings. A cross-sectional study was conducted using an online questionnaire to collect data about IPC and AS measures in participating ICUs. The study participants were Infectious Diseases-International Research Initiative (IDI-IR) members, committed as per their institutional agreement form. We analyzed responses from 57 ICUs in 24 countries (Lower-middle income (LMI), n = 13; Upper-middle income (UMI), n = 33; High-income (HI), n = 11). This represented (~5%) of centers represented in the ID-IRI. Surveillance programs were implemented in (76.9%-90.9%) of ICUs with fewer contact precaution measures in LMI ones (p = 0.02); (LMI:69.2%, UMI:97%, HI:100%). Participation in regional antimicrobial resistance programs was more significantly applied in HI (p = 0.02) (LMI:38.4%,UMI:81.8%,HI:72.2%). AS programs are implemented in 77.2% of institutions with AS champions in 66.7%. Infectious diseases physicians and microbiologists are members of many AS teams (59%&50%) respectively. Unqualified healthcare professionals(42.1%), and deficient incentives(28.1%) are the main barriers to implementing AS. We underscore the existing differences in IPC and AS programs' implementation, team composition, and faced barriers. Continuous collaboration and sharing best practices on APM is needed. The role of regional and international organizations should be encouraged. Global support for capacity building of healthcare practitioners is warranted., (Copyright © 2022. Published by Elsevier Ltd.)

Background: Isolated pulmonary valve endocarditis is extremely rare, accounting for <2% of cases. Major predisposing factors are intravenous drug use, implanted cardiac devices, congenital heart diseases, and central venous catheters. Most patients respond well to appropriate antibiotherapy., Aim: We report a case with an isolated native pulmonary valve endocarditis due to methicillin-resistant staphylococcus-aureus infection which developed after a tooth abscess in a previously healthy non-drug user young male. After one week antibiotherapy, surgery was required due to acute severe pulmonary insufficiency and right heart-failure. After the operation, he had a multi-organ failure despite veno-arterial extracorporeal membrane oxygenation, antibiotherapy, and other supportive treatments, therefore the case concluded with mortality., Discusion and Conclusion: Our case showed that pulmonary valve endocarditis may occur in patients without risk factors in case of portal of entry for bacteremia and it may carry worse prognosis than previously known. Virulence of the microorganism and vegetation size are the major predictors of prognosis. Pulmonary valve endocarditis should be kept in mind even in patients without any known risk factors., (© 2022 Wiley Periodicals LLC.)

Background/objective: Lung transplantation is a well-established treatment in patients who have bronchiectasis with diffuse involvement, and with a progressive decline in respiratory function despite maximal medical therapy. We have aimed to present pre-transplantation factors and our results of lung transplantation for non-cystic fibrosis bronchiectasis., Methods: Patients who underwent lung transplantation for non-cystic fibrosis bronchiectasis between the dates of December 2016 and July 2019 were included. The patients' clinical parameters, pulmonary function tests, microbiological results, cardiac parameters, intraoperative data, and lung transplant outcomes were assessed retrospectively., Results: Bilateral lung transplantation for bronchiectasis were performed in eleven patients. The mean age was 36.5 years (range 22-57 years). There were 4 (36.4%) female patients and 7 (63.6%) male patients. All patients had a high score as per the bronchiectasis severity index (BSI). The FACED score was moderate in six patients and severe in five patients. Preoperative colonization with Pseudomonas aeruginosa was observed in five patients. Hospital mortality was 18.2% (2/11). The 1-year mortality was 27.2% (3/11). Eight patients were alive. The mean follow-up period of patients with survival was 28.2 months (range 13-42 months). One patient was diagnosed with chronic lung allograft dysfunction (CLAD). The 3-year survival rates were 73%., Conclusion: Lung transplantation for bronchiectasis with end-stage lung disease can improve the quality of life and increase survival in selected patients. Further studies are needed to identify the optimal time for lung transplantation referral due to the availability of limited data., Competing Interests: Declaration of competing interest None., (Copyright © 2021. Published by Elsevier Taiwan LLC.)