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2. Effectiveness of a multidimensional approach for prevention of ventilator-associated pneumonia in 11 adult intensive care units from 10 cities of Turkey: findings of the International Nosocomial Infection Control Consortium (INICC)

Author

Leblebicioglu, H., Yalcin, A. N., Rosenthal, V. D., Koksal, I., Sirmatel, F., Unal, S., Turgut, H., Ozdemir, D., Ersoz, G., Uzun, C., Ulusoy, S., Esen, S., Ulger, F., Dilek, A., Yilmaz, H., Turhan, O., Gunay, N., Gumus, E., Dursun, O., Yýlmaz, G., Kaya, S., Ulusoy, H., Cengiz, M., Yilmaz, L., Yildirim, G., Topeli, A., Sacar, S., Sungurtekin, H., Uğurcan, D., Geyik, M. F., Şahin, A., Erdogan, S., Kaya, A., Kuyucu, N., Arda, B., and Bacakoglu, F.

Published
2013
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21. ACKNOWLEDGEMENT OF REVIEWERS

Author

Adams, NG, Adekambi, T, Afeltra, J, Aguado, J, Aires de Sousa, M, Akiyoshi, K, Al Hasan, M, Ala-Kokko, T, Albert, M, Alfandari, S, Allen, D, Allerberger, F, Almyroudis, N, Alp, E, Amin, R, Anderson-Berry, A, Andes, DR, Andremont, A, Andreu, A, Angelakis, M, Antachopoulos, C, Antoniadou, A, Arabatzis, M, Arlet, G, Arnez, M, Arnold, C, Asensio, A, Asseray, N, Ausiello, C, Avni, T, Ayling, R, Baddour, L, Baguelin, M, Bányai, K, Barbour, A, Basco, LK, Bauer, D, Bayston, R, Beall, B, Becker, K, Behr, M, Bejon, P, Belliot, G, Benito-Fernandez, J, Benjamin, D, Benschop, K, Berencsi, G, Bergeron, MG, Bernard, K, Berner, R, Beyersmann, J, Bille, J, Bizzini, A, Bjarnsholt, T, Blanc, D, Blanco, J, Blot, S, Bohnert, J, Boillat, N, Bonomo, R, Bonten, M, Bordon, JM, Borel, N, Boschiroli, ML, Bosilkovski, M, Bosso, JA, Botelho-Nevers, E, Bou, G, Bretagne, S, Brouqui, P, Brun-Buisson, C, Brunetto, M, Bucher, H, Buchheidt, D, Buckling, A, Bulpa, P, Cambau, E, Canducci, F, Cantón, R, Capobianchi, M, Carattoli, A, Carcopino, X, Cardona-Castro, N, Carling, PC, Carrat, F, Castilla, J, Castilletti, C, Cavaco, L, Cavallo, R, Ceccherini-Silberstein, F, Centrón, D, Chappuis, F, Charrel, R, Chen, M, Chevaliez, S, Chezzi, C, Chomel, B, Chowers, M, Chryssanthou, E, Ciammaruconi, A, Ciccozzi, M, Cid, J, Ciofu, O, Cisneros, D, Ciufolini, MG, Clark, C, Clarke, SC, Clayton, R, Clementi, M, Clemons, K, Cloeckaert, Ael, Cloud, J, Coenye, T, Cohen Bacri, S, Cohen, R, Coia, J, Colombo, A, Colson, P, Concerse, P, Cordonnier, C, Cormican, M, Cornaglia, G, Cornely, O, Costa, S, Cots, F, Craxi, A, Creti, R, Crnich, C, Cuenca Estrella, M, Cusi, MG, d'Ettorre, G, da Cruz Lamas, C, Daikos, G, Dannaoui, E, De Barbeyrac, B, De Grazia, S, de Jager, C, de Lamballerie, X, de Marco, F, del Palacio, A, Delpeyroux, F, Denamur, E, Denis, O, Depaquit, J, Deplano, A, Desenclos, J-C, Desjeux, P, Deutch, S, Di Luca, D, Dianzani, F, Diep, B, Diestra, K, Dignani, C, Dimopoulos, G, Divizia, M, Doi, Y, Dornbusch, HJ, Dotis, J, Drancourt, M, Drevinek, P, Dromer, F, Dryden, M, Dubreuil, L, Dubus, J-C, Dumitrescu, O, Dumke, R, DuPont, H, Edelstein, M, Eggimann, P, Eis-Huebinger, A-M, El Atrouni, WI, Entenza, J, Ergonul, O, Espinel-Ingroff, A, Esteban, J, Etienne, J, Fan, X-G, Fenollar, F, Ferrante, P, Ferrieri, P, Ferry, T, Feuchtinger, T, Finegold, S, Fingerle, V, Fitch, M, Fitzgerald, R, Flori, P, Fluit, A, Fontana, R, Fournier, PE, François, M, Francois, P, Freedman, DO, Friedrich, A, Gallego, L, Gallinella, G, Gangneux, J-P, Gannon, V, Garbarg-Chenon, A, Garbino, J, Garnacho-Montero, J, Gatermann, Soeren, Gautret, P, Gentile, G, Gerlich, W, Ghannoum, M, Ghebremedhin, B, Ghigo, E, Giamarellos-Bourboulis, E, Girgis, R, Giske, C, Glupczynski, Y, Gnarpe, J, Gomez-Barrena, E, Gorwitz, RJ, Gosselin, R, Goubau, P, Gould, E, Gradel, K, Gray, J, Gregson, D, Greub, G, Grijalva, CG, Groll, A, Groschup, M, Gutiérrez, J, Hackam, DG, Hall, WA, Hallett, R, Hansen, S, Harbarth, S, Harf-Monteil, C, Hasanjani, Roushan MR, Hasler, P, Hatchette, T, Hauser, P, He, Q, Hedges, A, Helbig, J, Hennequin, C, Herrmann, B, Hezode, C, Higgins, P, Hoesli, I, Hoiby, N, Hope, W, Houvinen, P, Hsu, LY, Huard, R, Humphreys, H, Icardi, M, Imoehl, M, Ivanova, K, Iwamoto, T, Izopet, J, Jackson, Y, Jacobsen, K, Jang, TN, Jasir, A, Jaulhac, B, Jaureguy, F, Jefferies, JM, Jehl, F, Johnstone, J, Joly-Guillou, M-L, Jonas, M, Jones, M, Joukhadar, C, Kahl, B, Kaier, K, Kaiser, L, Kato, H, Katragkou, A, Kearns, A, Kern, W, Kerr, K, Kessin, R, Kibbler, C, Kimberlin, D, Kittang, B, Klaassen, C, Kluytmans, J, Ko, W-C, Koh, W-J, Kostrzewa, M, Kourbeti, I, Krause, R, Krcmery, V, Krizova, P, Kuijper, E, Kullberg, B-J, Kumar, G, Kunin, CM, La Scola, B, Lagging, M, Lagrou, K, Lamagni, T, Landini, P, Landman, D, Larsen, A, Lass-Floerl, C, Laupland, K, Lavigne, JP, Leblebicioglu, H, Lee, B, Lee, CH, Leggat, P, Lehours, P, Leibovici, Lonard, Leon, L, Leonard, N, Leone, M, Lescure, X, Lesprit, P, Levy, PY, Lew, D, Lexau, CA, Li, S-Y, Li, W, Lieberman, D, Lina, B, Lina, G, Lindsay, JA, Livermore, D, Lorente, L, Lortholary, O, Lucet, J-C, Lund, B, Lütticken, R, MacLeod, C, Madhi, S, Maertens, J, Maggi, F, Maiden, M, Maillard, J-Y, Maira-Litran, T, Maltezou, H, Manian, FA, Mantadakis, E, Maragakis, L, Marcelin, A-G, Marchaim, D, Marchetti, O, Marcos, M, Markotic, A, Martina, B, Martínez, J, Martinez, J-L, Marty, F, Maurin, M, McGee, L, Mediannikov, O, Meersseman, W, Megraud, F, Meletiadis, J, Mellmann, A, Meyer, E, Meyer, W, Meylan, P, Michalopoulos, A, Micol, R, Midulla, F, Mikami, Y, Miller, RF, Miragaia, M, Miriagou, V, Mitchell, TJ, Miyakis, S, Mokrousov, I, Monecke, S, Mönkemüller, K, Monno, L, Monod, M, Morales, G, Moriarty, F, Morosini, I, Mortensen, E, Mubarak, K, Mueller, B, Mühlemann, K, Muñoz Bellido, JL, Murray, P, Muscillo, M, Mylotte, J, Naessens, A, Nagy, E, Nahm, MH, Nassif, X, Navarro, D, Navarro, F, Neofytos, D, Nes, I, Ní Eidhin, D, Nicolle, L, Niederman, MS, Nigro, G, Nimmo, G, Nordmann, P, Nougairède, A, Novais, A, Nygard, K, Oliveira, D, Orth, D, Ortiz, JR, Osherov, N, Österblad, M, Ostrosky-Zeichner, L, Pagano, L, Palamara, AT, Pallares, R, Panagopoulou, P, Pandey, P, Panepinto, J, Pappas, G, Parkins, M, Parola, P, Pasqualotto, A, Pasteran, F, Paul, M, Pawlotsky, J-M, Peeters, M, Peixe, L, Pepin, J, Peralta, G, Pereyre, S, Perfect, JR, Petinaki, E, Petric, M, Pettigrew, M, Pfaller, M, Philipp, M, Phillips, G, Pichichero, M, Pierangeli, A, Pierard, D, Pigrau, C, Pilishvili, T, Pinto, F, Pistello, M, Pitout, J, Poirel, L, Poli, G, Poppert, S, Posfay-Barbe, K, Pothier, P, Poxton, I, Poyart, C, Pozzetto, B, Pujol, M, Pulcini, C, Punyadeera, C, Ramirez, M, Ranque, S, Raoult, D, Rasigade, J-P, Re, MC, Reilly, JS, Reinert, R, Renaud, B, Rice, L, Rich, S, Richet, H, Rigouts, L, Riva, E, Rizzo, C, Robotham, J, Rodicio, MR, Rodriguez, J, Rodriguez-Bano, J, Rogier, C, Roilides, E, Rolain, J-M, Rooijakkers, S, Rooney, P, Rossi, F, Rotimi, V, Rottman, M, Roux, V, Ruhe, J, Russo, G, Sadowy, E, Sagel, U, Said, SI, Saijo, M, Sak, B, Sa-Leao, R, Sanders, EAM, Sanguinetti, M, Sarrazin, C, Savelkoul, P, Scheifele, D, Schmidt, W-P, Schønheyder, H, Schönrich, G, Schrenzel, J, Schubert, S, Schwarz, K, Schwarz, S, Sefton, A, Segondy, M, Seifert, H, Seng, P, Senneville, E, Sexton, D, Shafer, RW, Shalit, I, Shankar, N, Shata, TM, Shields, J, Sibley, C, Sicinschi, L, Siljander, T, Simitsopoulou, M, Simoons-Smit, AM, Sissoko, D, Sjögren, J, Skiada, A, Skoczynska, A, Skov, R, Slack, M, Sogaard, M, Sola, C, Soriano, A, Sotto, A, Sougakoff, W, Souli, M, Spelberg, B, Spelman, D, Spiliopoulou, I, Springer, B, Stefani, S, Stein, A, Steinbach, WJ, Steinbakk, M, Strakova, L, Strenger, V, Sturm, P, Sullivan, P, Sutton, D, Symmons, D, Tacconelli, E, Tamalet, C, Tang, JW, Tang, Y-W, Tattevin, P, Thibault, V, Thomsen, RW, Thuny, F, Tong, S, Torres, C, Townsend, R, Tristan, A, Trouillet, J-L, Tsai, H-C, Tsitsopoulos, P, Tuerlinckx, D, Tulkens, P, Tumbarello, M, Tureen, J, Turnidge, JD, Turriziani, O, Tutuian, R, Uçkay, I, Upton, M, Vabret, A, Vamvakas, EC, van den Boom, D, Van Eldere, J, van Leeuwen, W, van Strijp, J, Van Veen, S, Vandamme, P, Vandenesch, F, Vayssier, M, Velin, D, Venditti, M, Venter, M, Venuti, A, Vergnaud, G, Verheij, T, Verhofstede, C, Viscoli, C, Vizza, CD, Vogel, U, Waller, A, Wang, YF, Warn, P, Warris, A, Wauters, G, Weidmann, M, Weill, F-X, Weinberger, M, Welch, D, Wellinghausen, N, Wheat, J, Widmer, A, Wild, F, Willems, R, Willinger, B, Winstanley, C, Witte, W, Wolff, M, Wong, F, Wootton, M, Wyllie, D, Xu, W, Yamamoto, S, Yaron, S, Yildirim, I, Zaoutis, T, Zazzi, M, Zbinden, R, Zehender, Gianguglielmo G, Zemlickova, H, Zerbini, ML, Zhang, L, Zhang, Y, Zhao, Y-D, Zhu, Z, and Zimmerli, W

Published
2011
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22. Central nervous system infections in the absence of cerebrospinal fluid pleocytosis

Author

Erdem, H., Ozturk-Engin, D., Cag, Y., Senbayrak, S., Inan, A., Kazak, E., Savasci, U., Elaldi, N., Vahaboglu, H., Hasbun, R., Nechifor, M., Tireli, H., Kilicoglu, G., Defres, S., Gulsun, S., Ceran, N., Crisan, A., Johansen, I.S., Namiduru, M., Dayan, S., Kayabas, U., Parlak, E., Khalifa, A., Kursun, E., Sipahi, O.R., Yemisen, M., Akbulut, A., Bitirgen, M., Popovic, N., Kandemir, B., Luca, C., Parlak, M., Stahl, J.P., Pehlivanoglu, F., Simeon, S., Ulu-Kilic, A., Yasar, K., Yilmaz, G., Yilmaz, E., Beovic, B., Catroux, M., Lakatos, B., Sunbul, M., Oncul, O., Alabay, S., Sahin-Horasan, E., Kose, S., Shehata, G., Andre, K., Dragovac, G., Gul, H.C., Karakas, A., Chadapaud, S., Hansmann, Y., Harxhi, A., Kirova, V., Masse-Chabredier, I., Oncu, S., Sener, A., Tekin, R., Deveci, O., Ozkaya, H.D., Karabay, O., Agalar, C., Gencer, S., Karahocagil, M.K., Karsen, H., Kaya, S., Pekok, A.U., Celen, M.K., Deniz, S., Ulug, M., Demirdal, T., Guven, T., Bolukcu, S., Avci, M., Nayman-Alpat, S., Yaşar, K., Pehlivanoʇlu, F., Ates-Guler, S., Mutlu-Yilmaz, E., Tosun, S., Sirmatel, F., Batirel, A., Öztoprak, N., Kadanali, A., Turgut, H., Baran, A.I., Karaahmetoglu, G., Sunnetcioglu, M., Haykir-Solay, A., Denk, A., Ayaz, C., Gorenek, L., Larsen, L., Poljak, M., Barsic, B., Argemi, X., Sørensen, S.M., Bohr, A.L., Tattevin, P., Gunst, J.D., Baštáková, L., Jereb, M., Chehri, M., Beraud, G., Del Vecchio, R.F., Maresca, M., Yilmaz, H., Sharif-Yakan, A., Kanj, S.S., Korkmaz, F., Komur, S., Coskuner, S.A., Ince, N., Akkoyunlu, Y., Halac, G., Nemli, S.A., Ak, O., Gunduz, A., Gozel, M.G., Hatipoglu, M., Cicek-Senturk, G., Akcam, F.Z., Inkaya, A.C., Sagmak-Tartar, A., Ersoy, Y., Tuncer-Ertem, G., Balkan, I.I., Cetin, B., Ersoz, G., Ozgunes, N., Yesilkaya, A., Erturk, A., Gundes, S., Turhan, V., Yalci, A., Aydin, E., Diktas, H., Ulcay, A., Seyman, D., and Leblebicioglu, H.

Subjects
protein cerebrospinal fluid level, Male, pleocytosis, Meningitis, Pneumococcal, Leukocytosis, herpes simplex encephalitis, CSF, Leukocyte, brucella meningitis, Article, cerebrospinal fluid, clinical feature, female, Central Nervous System Infections, tuberculous meningitis, Tuberculosis, Meningeal, central nervous system infection, middle aged, neurosyphilis, Encephalitis, Humans, pathology, Meningitis, human, pneumococcal meningitis
Abstract

Previous multicenter/multinational studies were evaluated to determine the frequency of the absence of cerebrospinal fluid pleocytosis in patients with central nervous system infections, as well as the clinical impact of this condition. It was found that 18% of neurosyphilis, 7.9% of herpetic meningoencephalitis, 3% of tuberculous meningitis, 1.7% of Brucella meningitis, and 0.2% of pneumococcal meningitis cases did not display cerebrospinal fluid pleocytosis. Most patients were not immunosuppressed. Patients without pleocytosis had a high rate of unfavorable outcomes and thus this condition should not be underestimated. © 2017 The Author(s)

Published
2017

23. Surgical Site Infections, International Nosocomial Infection Control Consortium (INICC) Report, Data Summary of 30 Countries, 2005–2010

Author

Rosenthal, V. D., Richtmann, R., Singh, S., Apisarnthanarak, A., Kubler, A., Viet-Hung, N., Ramirez-Wong, F. M., Portillo-Gallo, J. H., Toscani, J., Gikas, A., Duenas, L., El-Kholy, A., Ghazal, S., Fisher, D., Mitrev, Z., Gamar-Elanbya, M. O., Kanj, S. S., Arreza-Galapia, Y., Leblebicioglu, H., Hlinkova, S., Memon, B. A., Guanche-Garcell, H., Gurskis, V., Carlos Arturo Alvarez-Moreno, Barkat, A., Mejia, N., Rojas-Bonilla, M., Ristic, G., Raka, L., Yuet-Meng, C., Int Nosocomial Infection, Control, and Ondokuz Mayıs Üniversitesi

Subjects
Microbiology (medical), medicine.medical_specialty, Asia, Epidemiology, Arthroplasty, Replacement, Hip, Hysterectomy, Ventriculoperitoneal Shunt, Internal medicine, Abdomen, Surgical site, medicine, Humans, Surgical Wound Infection, Prospective Studies, Coronary Artery Bypass, Prospective cohort study, Abdominal hysterectomy, Cross Infection, business.industry, Surgical wound, South America, Nosocomial infection control, Confidence interval, Surgery, Europe, Infectious Diseases, Population Surveillance, Relative risk, Africa, business, Abdominal surgery
Abstract

Objective.To report the results of a surveillance study on surgical site infections (SSIs) conducted by the International Nosocomial Infection Control Consortium (INICC).Design.Cohort prospective multinational multicenter surveillance study.Setting.Eighty-two hospitals of 66 cities in 30 countries (Argentina, Brazil, Colombia, Cuba, Dominican Republic, Egypt, Greece, India, Kosovo, Lebanon, Lithuania, Macedonia, Malaysia, Mexico, Morocco, Pakistan, Panama, Peru, Philippines, Poland, Salvador, Saudi Arabia, Serbia, Singapore, Slovakia, Sudan, Thailand, Turkey, Uruguay, and Vietnam) from 4 continents (America, Asia, Africa, and Europe).Patients.Patients undergoing surgical procedures (SPs) from January 2005 to December 2010.Methods.Data were gathered and recorded from patients hospitalized in INICC member hospitals by using the methods and definitions of the Centers for Disease Control and Prevention National Healthcare Safety Network (CDC-NHSN) for SSI. SPs were classified into 31 types according toInternational Classification of Diseases, Ninth Revision, criteria.Results.We gathered data from 7,523 SSIs associated with 260,973 SPs. SSI rates were significantly higher for most SPs in INICC hospitals compared with CDC-NHSN data, including the rates of SSI after hip prosthesis (2.6% vs 1.3%; relative risk [RR], 2.06 [95% confidence interval (CI), 1.8–2.4];PPPPPConclusions.SSI rates were higher for most SPs in INICC hospitals compared with CDC-NHSN data.

Published
2013

24. Current knowledge and future perspectives on acute hepatitis C

Author

Hullegie, SJ, Arends, JE, Rijnders, BJ, Irving, WL, Salmon, D, Prins, M, Wensing, AM, Klenerman, P, Leblebicioglu, H, Boesecke, C, Rockstroh, JK, and Hoepelman, AI

Abstract

Acute hepatitis C virus (AHCV) infections are frequently seen worldwide in certain risk groups with an annual incidence rate varying between 0.08% and 66%. Although this incidence is substantial, a delayed diagnosis during chronic infection is most often made in the absence of clinical symptoms in the acute phase of the infection. Current used methods to diagnose AHCV are IgG antibody seroconversion and repeated HCV RNA measurements though no definite diagnostic test is currently available. Progress in the field of adaptive and innate immune responses has aided to both advancements in the field of HCV vaccine development and a more basic understanding of viral persistence. The rapid changes in the treatment of chronic HCV will affect therapeutic regimens in AHCV in the coming years leading to shorter treatment courses and pegylated interferon-free modalities. This review gives an overview of the current knowledge and uncertainties together with some future perspectives on acute HCV epidemiology, virology, immunology and treatment.

Published
2016

25. Management of infections in critically ill returning travellers in the intensive care unit-II: clinical syndromes and special considerations in immunocompromised patients

Author

Rello, J., Manuel, O., Eggimann, P., Richards, G., Wejse, C., Petersen, J.E., Zacharowski, K., Leblebicioglu, H., and ESGCIP and ESGITM

Subjects
Critical Illness, Dengue/therapy, Humans, Immunocompromised Host, Infection/etiology, Infection/therapy, Influenza, Human/therapy, Intensive Care Units, Malaria/therapy, Mycoses/therapy, Travel
Abstract

This position paper is the second ESCMID Consensus Document on this subject and aims to provide intensivists, infectious disease specialists, and emergency physicians with a standardized approach to the management of serious travel-related infections in the intensive care unit (ICU) or the emergency department. This document is a cooperative effort between members of two European Society of Clinical Microbiology and Infectious Diseases (ESCMID) study groups and was coordinated by Hakan Leblebicioglu and Jordi Rello for ESGITM (ESCMID Study Group for Infections in Travellers and Migrants) and ESGCIP (ESCMID Study Group for Infections in Critically Ill Patients), respectively. A relevant expert on the subject of each section prepared the first draft which was then edited and approved by additional members from both ESCMID study groups. This article summarizes considerations regarding clinical syndromes requiring ICU admission in travellers, covering immunocompromised patients.

Published
2016

26. To the editor

Author

Ozaras R., Leblebicioglu H., and Ondokuz Mayıs Üniversitesi

Abstract

PubMed: 27732816 [No abstract available]

Published
2016

27. Healthcare-associated Crimean-Congo haemorrhagic fever in Turkey, 2002-2014: a multicentre retrospective cross-sectional study

Author

Leblebicioglu, H., Sunbul, M., Guner, R., Bodur, H., Bulut, C., Duygu, F., Elaldi, N., and OMÜ

Subjects
healthcare associated, ribavirin, infection prevention and control, Crimean-Congo haemorrhagic fever, viral haemorrhagic fever
Abstract

Leblebicioglu, Hakan/0000-0002-6033-8543; Fletcher, Tom/0000-0002-3712-415X; Beeching, Nicholas/0000-0002-7019-8791 WOS: 000375399900025 PubMed: 26806137 Healthcare-related transmission of Crimean-Congo haemorrhagic fever (CCHF) is a well-recognized hazard. We report a multicentre retrospective cross-sectional study undertaken in Turkey in 2014 in nine hospitals, regional reference centres for CCHF, covering the years 2002 to 2014 inclusive. Data were systematically extracted from charts of all personnel with a reported health care injury/accident related to CCHF. Blood samples were tested for CCHF IgM/IgG by enzyme-linked immunosorbent assay and/or viral nucleic acid detection by PCR after the injury. Fifty-one healthcare-related exposures were identified. Twenty-five (49%) of 51 resulted in laboratory-confirmed infection, with a 16% (4/25) overall mortality. The main route of exposure was needlestick injury in 32/51 (62.7%). A potential benefit of post-exposure prophylaxis with ribavirin was identified. (C) 2016 European Society of Clinical Microbiology and Infectious Diseases. Published by Elsevier Ltd. All rights reserved. Wellcome TrustWellcome Trust; UK Ministry of Defence; National Institute for Health Research Health Protection Research Unit (NIHRHPRU) in Emerging and Zoonotic Infections Financial support was received from Wellcome Trust and the UK Ministry of Defence (to TF) and the National Institute for Health Research Health Protection Research Unit (NIHRHPRU) in Emerging and Zoonotic Infections, a partnership between the University of Liverpool, Liverpool School of Tropical Medicine and Public Health England (PHE) (to NJB). The views expressed are those of the authors and not necessarily those of the Turkish Ministry of Health, the NHS, the NIHR, the Department of Health or Public Health England. All authors report no conflicts of interest relevant to this article.

Published
2016

28. International Nosocomial Infection Control Consortium (INICC)

Author

Leblebicioglu, H, Erben, N, Rosenthal, VD, Sener, A, Uzun, C, Senol, G, Ersoz, G, Demirdal, T, Duygu, F, Willke, A, Sirmatel, F, Oztoprak, N, Koksal, I, Oncul, O, Gurbuz, Y, Guclu, E, Turgut, H, Yalcin, AN, Ozdemir, D, Kendirli, T, Aslan, T, Esen, S, Ulger, F, Dilek, A, Yilmaz, H, Sunbul, M, Ozgunes, I, Usluer, G, Otkun, M, Kaya, A, Kuyucu, N, Kaya, Z, Meric, M, Azak, E, Yylmaz, G, Kaya, S, Ulusoy, H, Haznedaroglu, T, Gorenek, L, Acar, A, Tutuncu, E, Karabay, O, Kaya, G, Sacar, S, Sungurtekin, H, Ugurcan, D, Turhan, O, Gumus, E, Dursun, O, Geyik, MF, Sahin, A, Erdogan, S, Ince, E, Karbuz, A, Ciftci, E, Tasyapar, N, and Gunes, M

Subjects
infection, Surgical wound infection, Developing countries, Hospital infection, Nosocomial infection, Health care-associated
Abstract

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.

Published
2015

29. Surgical site infection rates in 16 cities in Turkey: findings of the International Nosocomial Infection Control Consortium (INICC)

Author

Leblebicioglu, H., Erben, N., Rosenthal, V.D., Sener, A., Uzun, C., Senol, G., Ersoz, G., Demirdal, T., Duygu, F., Willke, A., Sirmatel, F., Oztoprak, N., Koksal, I., Oncul, O., Gurbuz, Y., Güçlü, E., Turgut, H., Yalcin, A.N., Ozdemir, D., Kendirli, T., Aslan, T., Esen, S., Ulger, F., Dilek, A., Yilmaz, H., Sunbul, M., Ozgunes, I., Usluer, G., Otkun, M., Kaya, A., Kuyucu, N., Kaya, Z., Meric, M., Azak, E., Yýlmaz, G., Kaya, S., Ulusoy, H., Haznedaroglu, T., Gorenek, L., Acar, A., Tutuncu, E., Karabay, O., Kaya, G., Sacar, S., Sungurtekin, H., Uğurcan, Doğaç, Turhan, O., Gumus, E., Dursun, O., Geyik, M.F., Şahin, A., Erdogan, S., Ince, E., Karbuz, A., Çiftçi, E., Taşyapar, N., and Güneş, M.

Subjects
Turkey, Surgical wound infection, Health careeassociated infection, prevalence, infection rate, surgical infection, Article, Turkey (republic), Developing countries, Cohort Studies, hip prosthesis, Nosocomial infection, coronary artery bypass graft, Humans, Hospital infection, human, Prospective Studies, hospital, Cities, cesarean section, craniotomy, clinical trial, cohort analysis, shunting, Hospitals, hospital patient, multicenter study, city, prospective study
Abstract

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 © 2015 by the Association for Professionals in Infection Control and Epidemiology, Inc. Published by Elsevier Inc. All rights reserved.

Published
2015

30. Surgical site infection rates in 16 cities in Turkey: findings of the International Nosocomial Infection Control Consortium (INICC)

Author

Leblebicioglu H, Erben N, Rosenthal VD, Sener A, Uzun C, Senol G, Ersoz G, Demirdal T, Duygu F, Willke A, Sirmatel F, Oztoprak N, Koksal I, Oncul O, Gurbuz Y, Güçlü E, Turgut H, Yalcin AN, Ozdemir D, Kendirli T, Aslan T, Esen S, Ulger F, Dilek A, Yilmaz H, Sunbul M, Ozgunes I, Usluer G, Otkun M, Kaya A, Kuyucu N, Kaya Z, Meric M, Azak E, Yýlmaz G, Kaya S, Ulusoy H, Haznedaroglu T, Gorenek L, Acar A, Tutuncu E, Karabay O, Kaya G, Sacar S, Sungurtekin H, Uğurcan D, Turhan O, Gumus E, and Dursu

Subjects
Cities, Cohort Studies, Hospitals, Humans, Prevalence, Prospective Studies, Surgical Wound Infection/*epidemiology, Turkey/epidemiology
Abstract

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.

Published
2015

31. Acute hepatitis B virus infection in Turkey: epidemiology and genotype distribution

Author

Tasova, Y, Kilic, D, Kaygusuz, S, Leblebicioglu, H, Eroglu, C, Aribas, E, Sirmatel, F, Ayaz, C, Ozsoy, MF, Cavuslu, S, Turkyilmaz, R, Tutuncu, E, Sunbul, M, Esen, S, Turan, D, Akbulut, A, Cihangiroglu, M, Aygen, B, Usluer, G, Kartal, ED, Irmak, H, Evirgen, O, Tulek, N, Yetkin, MA, Dokmetas, I, Bakir, M, Yildiz, ORHAN, Sencan, I, Yamazhan, T, Ulusoy, S, Akcam, Z, Yayli, G, Ersoz, G, Kaya, A, Saltoglu, N, Ersoy, Y, Ozgenc, O, Parlak, M, Parlak, E, Koksal, I, Caylan, R, and OMÜ

Subjects
Adult, Male, Microbiology (medical), Hepatitis B virus, HBsAg, Genotype, Turkey, genotype, viral hepatitis, medicine.disease_cause, Polymerase Chain Reaction, Orthohepadnavirus, Prevalence, medicine, Humans, Hepatitis B e Antigens, Fulminant hepatitis, biology, business.industry, Acute infection, General Medicine, hepatitis D virus, Middle Aged, Hepatitis B, medicine.disease, biology.organism_classification, Virology, Infectious Diseases, Acute Disease, DNA, Viral, Female, Hepatitis D virus, business, Viral hepatitis, acute infection, hepatitis B virus, Polymorphism, Restriction Fragment Length
Abstract

42nd Interscience Conference on Antimicrobial Agents and Chemotherapy -- SEP 26-30, 2002 -- SAN DIEGO, CA Saltoglu, Nese/0000-0003-4239-9585; Leblebicioglu, Hakan/0000-0002-6033-8543; dokmetas, ilyas/0000-0003-3523-3923; Ersoy, Yasemin/0000-0001-5730-6682 WOS: 000221932100007 PubMed: 15191382 The aim of this study was to investigate the prevalence of hepatitis B virus (HBV) genotypes in Turkey. Epidemiological and clinical data for 158 patients with acute HBV infection from 22 medical centres in the period February 2001 to February 2002 were collected prospectively. HBV genotyping was based on analysis of restriction fragment length polymorphisms and nested PCR. There were 59 female and 99 male patients, with a mean age of 34.2 +/- 15.6 years. The most common probable transmission route was blood contact in 63 (41.1%) cases, but was unknown in 78 (49.4%) cases. The mean alanine aminotransferase level was 1718 +/- 1089 IU/L. Four of the 158 patients (2.5%) died because of fulminant hepatitis. One year after discharge, 11 (10.6%) of 103 cases were positive for hepatitis B surface antigen (HBsAg) and 80 (77.7%) were positive for anti-HBsAg. Genotype determination was unsuccessful in 11 cases because of a negative PCR; genotype D was found in the remaining 147 cases. The results suggested that acute HBV infection constitutes a significant health problem in Turkey and that genotype D is predominant.

Published
2004

32. report on device-associated infection rates in 19 cities of Turkey, data

Author

Leblebicioglu, H, Erben, N, Rosenthal, VD, Atasay, B, Erbay, A, Unal, S, Senol, G, Willke, A, Ozgultekin, A, Altin, N, Bakir, M, Oncul, O, Ersoz, G, Ozdemir, D, Yalcin, AN, Ozdemir, H, Yildizdas, D, Koksal, I, Aygun, C, Sirmatel, F, Sener, A, Tuna, N, Akan, OA, Turgut, H, Demiroz, AP, Kendirli, T, Alp, E, Uzun, C, Ulusoy, S, Arman, D, Ozgunes, I, Usluer, G, Kilic, A, Arsan, S, Cabadak, H, Sen, S, Gelebek, Y, Zengin, H, Topeli, A, Alper, Y, Meric, M, Azak, E, Inan, A, Turan, G, Haznedaroglu, T, Gorenek, L, Acar, A, Cesur, S, Engin, A, Kaya, A, Kuyucu, N, Geyik, MF, Aydin, OC, Erdogan, NS, Turhan, O, Gunay, N, Gumus, E, Dursun, O, Esen, S, Ulger, F, Dilek, A, Yilmaz, H, Sunbul, M, Gokmen, Z, Ozdemir, SI, Horoz, OO, Yylmaz, G, Kaya, S, Ulusoy, H, Kucukoduk, S, Ustun, C, Baysal, AI, Otkun, M, Tulunay, M, Oral, M, Unal, N, Cengiz, M, Yilmaz, L, Sacar, S, Sungurtekin, H, Ugurcan, D, Yetkin, MA, Bulut, C, Erdinc, FS, Hatipoglu, CA, Ince, E, Ciftci, E, Odek, C, Yaman, A, Karbuz, A, Aldemir, B, Kilic, AU, Arda, B, Bacakoglu, F, and Hizel, K

Subjects
infection, Urinary tract infection, Network, Ventilator-associated pneumonia, Catheter-associated urinary tract, health care facilities, manpower, and services, Central line-associated bloodstream infections, Bloodstream, VELOPING-COUNTRIES, MULTIDIMENSIONAL APPROACH, STRATEGY, IMPACT, INICC, International Nosocomial Infection Consortium, Turkey, Device-associated infection, Antibiotic resistance, Hospital infection, Nosocomial infection, Healthcare-associated
Abstract

Background: Device-associated healthcare-acquired infections (DA-HAI) pose a threat to patient safety, particularly in the intensive care unit (ICU). We report the results of the International Infection Control Consortium (INICC) study conducted in Turkey from August 2003 through October 2012. Methods: A DA-HAI surveillance study in 63 adult, paediatric ICUs and neonatal ICUs (NICUs) from 29 hospitals, in 19 cities using the methods and definitions of the U.S. NHSN and INICC methods. Results: We collected prospective data from 94,498 ICU patients for 647,316 bed days. Pooled DA-HAI rates for adult and paediatric ICUs were 11.1 central line-associated bloodstream infections (CLABSIs) per 1000 central line (CL)-days, 21.4 ventilator-associated pneumonias (VAPs) per 1000 mechanical ventilator (MV)-days and 7.5 catheter-associated urinary tract infections (CAUTIs) per 1000 urinary catheter-days. Pooled DA-HAI rates for NICUs were 30 CLABSIs per 1000 CL-days, and 15.8 VAPs per 1000 MV-days. Extra length of stay (LOS) in adult and paediatric ICUs was 19.4 for CLABSI, 8.7 for VAP and 10.1 for CAUTI. Extra LOS in NICUs was 13.1 for patients with CLABSI and 16.2 for patients with VAP. Extra crude mortality was 12% for CLABSI, 19.4% for VAP and 10.5% for CAUTI in ICUs, and 15.4% for CLABSI and 10.5% for VAP in NICUs. Pooled device use (DU) ratios for adult and paediatric ICUs were 0.54 for MV, 0.65 for CL and 0.88 for UC, and 0.12 for MV, and 0.09 for CL in NICUs. The CLABSI rate was 8.5 per 1,000 CL days in the Medical Surgical ICUs included in this study, which is higher than the INICC report rate of 4.9, and more than eight times higher than the NHSN rate of 0.9. Similarly, the VAP and CAUTI rates were higher compared with U. S. NHSN (22.3 vs. 1.1 for VAP; 7.9 vs. 1.2 for CAUTI) and with the INICC report (22.3 vs. 16.5 in VAP; 7.9 vs. 5.3 in CAUTI). Conclusions: DA-HAI rates and DU ratios in our ICUs were higher than those reported in the INICC global report and in the US NHSN report.

Published
2014

33. International Nosocomial Infection Control Consortium (INICC) national report on device-associated infection rates in 19 cities of Turkey, data summary for 2003-2012

Author

Leblebicioglu, H., Erben, N., Rosenthal, V.D., Atasay, B., Erbay, A., Unal, S., Senol, G., Willke, A., Özgültekin, A., Altin, N., Bakir, M., Oncul, O., Ersöz, G., Ozdemir, D., Yalcin, A.N., Özdemir, H., Yıldızdaş, D., Koksal, I., Aygun, C., Sirmatel, F., Sener, A., Tuna, N., Akan, Ö.A., Turgut, H., Demiroz, A.P., Kendirli, T., Alp, E., Uzun, C., Ulusoy, S., Arman, D., Ozgunes, I., Usluer, G., Kiliç, A., Arsan, S., Cabadak, H., Sen, S., Gelebek, Y., Zengin, H., Topeli, A., Alper, Y., Meric, M., Azak, E., İnan, A., Turan, G., Haznedaroglu, T., Gorenek, L., Acar, A., Cesur, S., Engin, A., Kaya, A., Kuyucu, N., Geyik, M.F., Aydın, Ö.Ç., Erdogan, N.S., Turhan, O., Gunay, N., Gumus, E., Dursun, O., Esen, S., Ulger, F., Dilek, A., Yilmaz, H., Sunbul, M., Gökmen, Z., Özdemir, S.İ., Horoz, O.O., Yýlmaz, G., Kaya, S., Ulusoy, H., Küçüködük, S., Ustun, C., Otkun, M., Tulunay, M., Oral, M., Ünal, N., Cengiz, M., Yilmaz, L., Sacar, S., Sungurtekin, H., Uğurcan, D., Yetkin, M.A., Bulut, C., Erdinc, F.S., Hatipoglu, C.A., İnce, E., Çiftçi, E., Ödek, Ç., Yaman, A., Karbuz, A., Aldemir, B., Kılıc, A.U., Arda, B., Bacakoglu, F., and Hizel, K.

Subjects
Male, Turkey, healthcare associated infection, Antibiotic resistance, health care facilities, manpower, and services, central venous catheter, Network, intensive care unit, preschool child, Turkey (republic), Cohort Studies, Nosocomial infection, newborn, device infection, Prevalence, Prospective Studies, Child, intensive care, catheter infection, Urinary tract infection, Cross Infection, adult, Pneumonia, Ventilator-Associated, INICC, cohort analysis, infection control, Device-associated infection, female, Equipment and Supplies, Child, Preschool, disease surveillance, devices, prospective study, Adolescent, Catheter-associated urinary tract infection, infection rate, Bloodstream infection, Article, critically ill patient, length of stay, Ventilator-associated pneumonia, Humans, Hospital infection, human, Healthcare-associated infection, urinary catheter, Infant, Newborn, Infant, International Nosocomial Infection Consortium, mechanical ventilator, major clinical study, mortality, Catheter-Related Infections, ventilator associated pneumonia, Central line-associated bloodstream infections
Abstract

Background: Device-associated healthcare-acquired infections (DA-HAI) pose a threat to patient safety, particularly in the intensive care unit (ICU). We report the results of the International Infection Control Consortium (INICC) study conducted in Turkey from August 2003 through October 2012. Methods: A DA-HAI surveillance study in 63 adult, paediatric ICUs and neonatal ICUs (NICUs) from 29 hospitals, in 19 cities using the methods and definitions of the U.S. NHSN and INICC methods. Results: We collected prospective data from 94,498 ICU patients for 647,316 bed days. Pooled DA-HAI rates for adult and paediatric ICUs were 11.1 central line-associated bloodstream infections (CLABSIs) per 1000 central line (CL)-days, 21.4 ventilator-associated pneumonias (VAPs) per 1000 mechanical ventilator (MV)-days and 7.5 catheter-associated urinary tract infections (CAUTIs) per 1000 urinary catheter-days. Pooled DA-HAI rates for NICUs were 30 CLABSIs per 1000 CL-days, and 15.8 VAPs per 1000 MV-days. Extra length of stay (LOS) in adult and paediatric ICUs was 19.4 for CLABSI, 8.7 for VAP and 10.1 for CAUTI. Extra LOS in NICUs was 13.1 for patients with CLABSI and 16.2 for patients with VAP. Extra crude mortality was 12% for CLABSI, 19.4% for VAP and 10.5% for CAUTI in ICUs, and 15.4% for CLABSI and 10.5% for VAP in NICUs. Pooled device use (DU) ratios for adult and paediatric ICUs were 0.54 for MV, 0.65 for CL and 0.88 for UC, and 0.12 for MV, and 0.09 for CL in NICUs. The CLABSI rate was 8.5 per 1,000 CL days in the Medical Surgical ICUs included in this study, which is higher than the INICC report rate of 4.9, and more than eight times higher than the NHSN rate of 0.9. Similarly, the VAP and CAUTI rates were higher compared with U.S. NHSN (22.3 vs. 1.1 for VAP; 7.9 vs. 1.2 for CAUTI) and with the INICC report (22.3 vs. 16.5 in VAP; 7.9 vs. 5.3 in CAUTI). Conclusions: DA-HAI rates and DU ratios in our ICUs were higher than those reported in the INICC global report and in the US NHSN report. © 2014 Leblebicioglu et al.

Published
2014

36. Differences in the availability of diagnostics and treatment modalities for chronic hepatitis B across Europe

Author

Ozaras, R, Corti, G, Ruta, S, Lacombe, K, Mondelli, M, Irwing, W, Puoti, M, Khalighi, A, Santos, M, Harxhi, A, Lazarevic, I, Soriano, V, Gervain, J, Leblebicioglu, H, Salmon, D, Arends, J, Mondelli, MU, Irwing, WL, Santos, ML, Arends, JE, Ozaras, R, Corti, G, Ruta, S, Lacombe, K, Mondelli, M, Irwing, W, Puoti, M, Khalighi, A, Santos, M, Harxhi, A, Lazarevic, I, Soriano, V, Gervain, J, Leblebicioglu, H, Salmon, D, Arends, J, Mondelli, MU, Irwing, WL, Santos, ML, and Arends, JE

Abstract

The prevalence and management of chronic hepatitis B virus (HBV) infection differ among European countries. The availability and reimbursement of diagnostics and drugs may also vary, determining distinct treatment outcomes. Herein, we analyse differences in medical facilities for the care of patients with chronic HBV infection across Europe. A survey was sent to the members of the ESCMID Study Group for Viral Hepatitis, all of whom are experts in chronic HBV infection management. The comprehensive survey asked questions regarding hepatitis B surface antigen (HBsAg) prevalence, the availability of diagnostics and drugs marketed, and distinct clinical practice behaviours in the management of chronic HBV infection. World Bank data were used to assess the economic status of the countries. With 16 expert physicians responding (69%), the HBsAg prevalence rates were <1% in France, Hungary, Italy, The Netherlands, Portugal, Spain, and the UK, intermediate (1-5%) in Turkey, Romania, and Serbia, and high (>5%) in Albania and Iran. Regarding the availability and reimbursement of HBV diagnostics (HBV DNA and liver stiffness measurement), HBV drugs (interferon, lamivudine, tenofovir, and entecavir), HBV prophylaxis, and duration of HBeAg-positive and HBeAg-negative HBV infection, the majority of high-income and middle-income countries had no restrictions; Albania, Iran and Serbia had several restrictions in diagnostics and HBV drugs. The countries in the high-income group were also the ones with no restrictions in medical facilities, whereas the upper-middle-income countries had some restrictions. The prevalence of chronic HBV infection is much higher in southern and eastern than in western European countries. Despite the availability of European guidelines, policies for diagnostics and treatment vary significantly across European countries.

Published
2015

37. Current knowledge and future perspectives on acute hepatitis C infection

Author

Hullegie, S. J., Arends, J. E., Rijnders, B. J A, Irving, W. L., Salmon, D., Prins, M., Wensing, A. M., Klenerman, P., Leblebicioglu, H., Boesecke, C., Rockstroh, J. K., Hoepelman, A. I M, Hullegie, S. J., Arends, J. E., Rijnders, B. J A, Irving, W. L., Salmon, D., Prins, M., Wensing, A. M., Klenerman, P., Leblebicioglu, H., Boesecke, C., Rockstroh, J. K., and Hoepelman, A. I M

Published
2015

38. Current knowledge and future perspectives on acute hepatitis C infection

Author

MS Infectieziekten, Infection & Immunity, MICU, MMB Medische Staf, Hullegie, S. J., Arends, J. E., Rijnders, B. J A, Irving, W. L., Salmon, D., Prins, M., Wensing, A. M., Klenerman, P., Leblebicioglu, H., Boesecke, C., Rockstroh, J. K., Hoepelman, A. I M, MS Infectieziekten, Infection & Immunity, MICU, MMB Medische Staf, Hullegie, S. J., Arends, J. E., Rijnders, B. J A, Irving, W. L., Salmon, D., Prins, M., Wensing, A. M., Klenerman, P., Leblebicioglu, H., Boesecke, C., Rockstroh, J. K., and Hoepelman, A. I M

Published
2015

39. Control Consortium findings (INICC)

Author

Leblebicioglu, H, Ersoz, G, Rosenthal, VD, Nevzat-Yalcin, A, Akan, OA, Sirmatel, F, Turgut, H, Ozdemir, D, Alp, E, Uzun, C, Ulusoy, S, Esen, S, Ulger, F, Dilek, A, Yilmaz, H, Kaya, A, Kuyucu, N, Turhan, O, Gunay, N, Gumus, E, Dursun, O, Tulunay, M, Oral, M, Unal, N, Cengiz, M, Yilmaz, L, Sacar, S, Sungurtekin, H, Ugurcan, D, Geyik, MF, Sahin, A, Erdogan, S, Aygen, B, Arda, B, and Bacakoglu, F

Subjects
infections, Urinary catheter, Developing countries, Limited resources, Hospital infection, Nosocomial infection, Health care-acquired, Critical care, Incidence density, Bundle, Hand hygiene, Handwashing, infection, Device-associated infection, Catheter-related urinary tract, countries, Low-income countries, Emerging countries, Surveillance
Abstract

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.

Published
2013

41. Neurobrucellosis: Results of the Istanbul Study

Author

Erdem, H, Ulu-Kilic, A, Kilic, S, Karahocagil, M, Shehata, G, Eren-Tulek, N, Yetkin, F, Celen, MK, Ceran, N, Gul, HC, Mert, G, Tekin-Koruk, S, Dizbay, M, Inal, AS, Nayman-Alpat, S, Bosilkovski, M, Inan, D, Saltoglu, N, Abdel-Baky, L, Adeva-Bartolome, MT, Ceylan, B, Sacar, S, Turhan, V, Yilmaz, E, Elaldi, N, Kocak-Tufan, Z, Ugurlu, K, Dokuzoguz, B, Yilmaz, H, Gundes, S, Guner, R, Ozgunes, N, Ulcay, A, Unal, S, Dayan, S, Gorenek, L, Karakas, A, Tasova, Y, Usluer, G, Bayindir, Y, Kurtaran, B, Sipahi, OR, and Leblebicioglu, H

Abstract

No data on whether brucellar meningitis or meningoencephalitis can be treated with oral antibiotics or whether an intravenous extended-spectrum cephalosporin, namely, ceftriaxone, which does not accumulate in phagocytes, should be added to the regimen exist in the literature. The aim of a study conducted in Istanbul, Turkey, was to compare the efficacy and tolerability of ceftriaxone-based antibiotic treatment regimens with those of an oral treatment protocol in patients with these conditions. This retrospective study enrolled 215 adult patients in 28 health care institutions from four different countries. The first protocol (P1) comprised ceftriaxone, rifampin, and doxycycline. The second protocol (P2) consisted of trimethoprim-sulfamethoxazole, rifampin, and doxycycline. In the third protocol (P3), the patients started with P1 and transferred to P2 when ceftriaxone was stopped. The treatment period was shorter with the regimens which included ceftriaxone (4.40 +/- 2.47 months in P1, 6.52 +/- 4.15 months in P2, and 5.18 +/- 2.27 months in P3) (P = 0.002). In seven patients, therapy was modified due to antibiotic side effects. When these cases were excluded, therapeutic failure did not differ significantly between ceftriaxone-based regimens (n = 5/166, 3.0%) and the oral therapy (n = 4/42, 9.5%) (P = 0.084). The efficacy of the ceftriaxone-based regimens was found to be better (n = 6/166 [3.6%] versus n = 6/42 [14.3%]; P = 0.017) when a composite negative outcome (CNO; relapse plus therapeutic failure) was considered. Accordingly, CNO was greatest in P2 (14.3%, n = 6/42) compared to P1 (2.6%, n = 3/ 117) and P3 (6.1%, n = 3/ 49) (P = 0.020). Seemingly, ceftriaxone-based regimens are more successful and require shorter therapy than the oral treatment protocol.

Published
2012

43. International nosocomial infection control consortium (INICC) report, data summary of 36 countries, for 2004-2009

Author

Rosenthal, V.D., Bijie, H., Maki, D.G., Mehta, Y., Apisarnthanarak, A., Medeiros, E.A., Leblebicioglu, H., Fisher, D., Álvarez-Moreno, C., Khader, I.A., Martínez, M.D.R.G., Cuellar, L.E., Navoa-Ng, J.A., Abouqal, R., Garcell, H.G., Mitrev, Z., García, M.C.P., Hamdi, A., Dueñas, L., Cancel, E., Gurskis, V., Rasslan, O., Ahmed, A., Kanj, S.S., Ugalde, O.C., Mapp, T., Raka, L., Meng, C.Y., Thu, L.T.A., Ghazal, S., Gikas, A., Narváez, L.P., Mejía, N., Hadjieva, N., Elanbya, M.O.G., Siritt, M.E.G., Jayatilleke, K., Frías, M.L., Churruarín, G., Sztokhamer, D., Flynn, L.P., Rausch, D., Spagnolo, A., Santero, B., Soroka, L.C., For-Ciniti, S., Blasco, M., Lezcano, C.B., Lastra, C.E., Bedoya, M.Á.F., Costamagna, A., Dheza, G.R., Ávalos, J., Álvarez, M., Bench-Etrit, G., Bonaventura, C., Caridi, M.Á., Messina, A., Ricci, B., Viegas, M., Di Núbila, B.M.A., Lan-Zetta, D., Fernández, L.J., Rossetti, M.A., Romani, A., Migazzi, C., Barolin, C., Martínez, E., Bernan, M.L., Bay, M.R., Diaz, F.R., Dominguez, C.B., Coria, G.E., Martinelli, M.E., Grinberg, G., Ferreira, I.B., Cechinel, R.B., Zanandrea, B.B., Rohnkohl, C., Regalin, M., Spessatto, J.L., Pasini, R.S., Ferla, S., Salomao, R., da Silva, M.Â.M., de Jesus Silva, C.H., Vilins, M., Blecher, S., Angelieri, D.B., Kuchenbecker, R.S., Pires, M.R., Santos, R.P., Kuplich, N.M., Siliprandi, E.M.O., Do-Amaral, A.P., Silva, C.P.R., Biancalana, M.L.N., Sánchez, T.E.G., Valente, R., Apolinário, D., Freitas, L.F.B., Dos Santos, M.C.I., Lopes, J.M.M., Valadares, P.C.P., Batista, J.P., Campos, M.A.-E.S., Moretti, M.L., Cardoso, L.G., Trabaos, A., Martins, I.S., Santos, P.T.D., Pinhejro, D.O.B.P., Abreu, J.S.D., Richtmann, R., Rodríguez, T., Baltieri, S.R., Moreira, M., Stadtlober, G.F., Cavaglieri, A.G., Karadimovm, D., Velinova, V., Qin, J.A., Juan, H., Fang, H.C., Gao, X., Lili, T., Yao, S., Hungmei, W., Bin, C., Ruisheng, L., Yang, Y., Yeguxiang, Ziqin, X., Mei, W.H., Chun, G.S., Yang, X., Gan, A., Zhang, A., Luo, J., Zhao, A., Li, F., Liu, B., Gao, M., Zhao, B., Wei, L., Wang, C., Fang, L., Yi, C., Xie, X., Ling, F., Wu, Y., Xu, F., Feng, F., Weng, F., Dong, G.-H., Ye, G., Yang, W., Yu, H., Yang, H.-I., Yan, H., Mao, A., Zhou, H., Chen, W., Gong, H., Tan, H., Liu, Y., Wu, H., Tang, D., Hao, J., Zhang, H., Wang, J., Qiu, Y., Yu, J., Gu, X., Jiang, J., Zhang, M., Miu, J., Zhao, W., Shi, J., Li, L., Duo, K., Cai, L., Liu, L., Hua, L., Shao, Q., An, Y., Lu, Q., Li, G., Sun, R., Zhang, W., Tao, Z., Wang, W., Shen, Y., Fan, W., Chen, H., Yao, X., Wen, H., Xiong, X., Xu, H., Liu, X., Huang, M., Wang, X., Shao, G., Yuan, Y., Cao, Y., Chen, Y., Chen, X., Gu, Y., Zhu, L., Huang, Y., Wang, M., Wang, Y., Mao, Y., Cheng, Y., Zhao, C., Sun, Y., Zhu, B., Cai, M., Zhang, Y., Xue, M., Zhou, Y., Zhang, R., Du, Y., Li, D., Ni, Y., Zhang, L., Zhong, Z., Zhu, G., Yu, Z., Cao, M., Song, Z., Xu, J., Tong, Z., Gu, P., Agudelo, J.G., Sussmann, O., Mojica, B.E., Rojas, C., Beltran, H., Paez, J., Gómez, W.V., Dajud, L., Mendoza, M., Arrieta, P., Osorio, L., Olarte, N., Valderrama, A., Muñoz, H.J., Guzmán, N.B., Ferrer, M.R., Villa, G.S., Guzmán, A.L., Linares, C., Cortés, L.M., Campo, L.F.R., Menco, A., Calderón, M.E.R., Parada, D.E.C., Fernandez, A.M.P., Martínez, I.F.P., Saleg, P.A.M., Vega, Y.L., Luengas, E.L., Ramos, C.R., Hernández, H.T., Gomez, D.Y., Gomez, B.M.V., Ruiz, M.G., Millán, J.C.T., López, M.U.T., Parada, E.C., Rochel, A.E.M., Hidalgo, R.F., Calzada, J.M.A., Muñoz, G., Argüello, A.R., Chinchilla, A.S., Fuentes, C.G., Pérez, C.M., Pino, O.R., González, O.D., González, D.F., de Wang, C.M.R., Severino, R., Tolari, G., Delgado, M., Vélez, J.W., Zapata, M.A.C., Valle, M.J., Guayasamín, S., Seliem, Z.S., El Kholy, A.A., Abdel-Aziz, D., Sabour, M.A.E., Kalil, M., Saeed, A., Gafarey, M.E., Fouad, L., Muhamed, T., Saeed, H., Casares, A.C.B., Machuca, L.J., Chaniotaki, K., Tsioutis, C., Bampalis, D., Gopinath, R., Ravindra, N., Karlekar, A., Sood, S., Verma, N., Sen, N., Subramani, K., Raj, J.P., Mathur, P., Kumar, S., Sahu, S., Govil, D., Jaggi, N., Bhatnagar, S., Myatra, S.N., Divatia, Kelkar, R., Biswas, S., Raut, S., Sampat, S., Kumar, R., Todi, S.K., Bhakta, A., Bhattacharjee, M., Ramachandran, B., Chakravarthy, M., Gokul, B.N., Sukanya, R., Pushparaj, L., Singh, S., Radhakrishnan, K., Udwadia, F.E., Ansari, R., Poojary, A., Koppikar, G., Bhandarkar, L., Jadhav, S., Dwivedy, A., Shetty, S., Binu, S., Pawar, M., Gupta, A., Saini, N., Kothari, V., Singhal, T., Shah, S., Rodrigues, C., Hegd, A., Kapadia, F., Mehta, P., Surase, P., Narayanan, S., Munshi, N., Padbidri, V., Dawhale, R., Jacobs, S.M., Khuri-Bulos, N., Mahafzah, A., Baftiu, N., Spahija, G., Zahreddine, N., Alamuddin, L., Kanafani, Z., Dagys, A., Kondratas, T., Kevalas, R., Anguseva, T., Ampova, V., Guroska, S.T.-C., Manikavasagam, J., Tan, L.H., Kaur, K., Assadian, O., Wolfram, R., Kaur, P., Oropeza, M.S., Ruiz, A.A., Campuzano, R., Brito, J.M., Serrato, I.P., López, M.S., Gómez, A.C., Morales, J.R., Rodríguez, J.E.V., Gallo, J.H.P., Almazán, F.A., Miramontes, G.I., Vázquez Olivas, M.D.R., Chávez, A.S., Espinoza, Y.A., Gallegos, L.A., González, D.J.S., Rochín, A.M., Félix, M.J.S., Peña, R.D., Gómez, A.B.Z., Gutiérrez, C.A.E., Novales, M.G.M., Herver, M.D.J., Gaytan, J.A., Olmeda, J.A.G., Martínez-Marroquín, M.Y., Hernández, A., García, E.O., Cervantes, R.V., Arteaga-Troncoso, G., Guerra Infante, F.M., Méndez, I.M., Burguete, M.C.C., Barkat, A., Bouazzaoui, N.L., Meryem, K., Madani, N., Zeggwagh, A.A., Abidi, K., Dendane, T., Khan, S.G., Ali, F., Hussain, Y., Butt, F., Fakir, A., Mahmood, S.F., Jamil, B., Memon, B.A., Bhutto, G.H., Alfaro, F.G., Alvarado, C., León, L.M.D., Navarro, R., Moreno, J.L., Cerrad, R., Sabogal, A.C., Goicochea, I.P., Sanchez, A.A., Alva, G.R., Ventura, J.G., Aguilar, M.R., Plasencia, N.S., Maldonado, E.F., Espichan, M.J.M., Echenique, L., Rosales, R., Bravo, L.I.C., Cáceres, M.L., Espinoza, T.A., López, F.S., Saldarriaga, M.E.C., Morvelí, E.U.V., Barriga, H., Villacorta, M.S., Barrios, S.C., Zegarra, S.L.T., Astete, N.S., Guevara, F.C., Mendoza, C.B., Ramírez, A.V., Pastrana, J.S., Wong, F.M.R., Ángeles, C.S., Tavera, Z.D., Ramirez, E., Vergara, C.E.L.H., Mendoza, L., Sosa, G.B., Chávez, C.M., Berba, R., Genuino, G.A.S., Consunji, R.J., Mantaring, J.B.V., III, Villanueva, V.D., Tolentino, M.C.V., Galapia, Y.A., Tambyah, P.A., Hakawi, A., Kaluarachchi, N.N., Samaraweera, G.A.-R., Sid Ahmed Ali, I.M., Satti, A.A., Jamulitrat, S., Thamlikitkul, V., Ben-Jaballah, N., Ammar, K., Öztürk, R., Dikmen, Y., Aygún, G., Ulusoy, S., Arda, B., Bacakoglu, F., Sardan, Y.C., Yildirim, G., Topeli, A., Akan, Ö.A., Tulunay, M., Oral, M., Ünal, N., Alp, E., Aygen, B., Sirmatel, F., Cengiz, M., Yilmaz, L., Özgültekin, A., Turan, G.-D., Akgün, N., Ozdemir, D., Guclu, E., Erdogan, S., Erben, N., Ozgunes, I., Usluer, G., Aygun, C., Küçüködük, S., Arman, D., Hizel, K., Uzun, C., Turgut, Hüseyin, Saçar, Suzan, Sungurtekin, Hülya, Uğurcan, Doğaç, Koksal, I., Yýlmaz, G., Kaya, S., Ulusoy, H., Ersoz, G., Kaya, A., Kuyucu, N., Esen, S., Ulger, F., Dilek, A., Yalcin, A.N., Turhan, O., Keskin, S., Gumus, E., Dursun, O., Kendirli, T., Ince, E., Cliftci, E., Özdemir, H., Demiroz, A.P., Yetkin, M.A., Bulut, C., Erdinc, F.S., Hatipoglu, C.A., Erbay, A., Willke, A., Meric, M., Azak, E., Oncul, O., Haznedaroglu, T., Gorenek, L., Acar, A., Silvera, E., Techera, S., Frachia, A., Algorta, G., Gil de Añez, Z.D., Bravo, L.M., Orozco, N., Mejías, E., Trang, D.T.V., Nga, T.T.K., and Zruong, P.H.

Subjects
meticillin, Staphylococcus aureus, Asia, Antibiotic resistance, Health care-associated infection, Catheter-associated urinary tract infection, Network, bloodstream infection, intensive care unit, Developing countries, South and Central America, Nosocomial infection, Escherichia coli, Ventilator-associated pneumonia, Hospital infection, human, ceftazidime, catheter infection, Urinary tract infection, nonhuman, bacterium isolate, article, developing country, infection control, mortality, Device-associated infection, Low-income countries, hospital bed, Europe, Klebsiella pneumoniae, Central line-associated bloodstream infection, Africa, Pseudomonas aeruginosa, Limited-resources countries, disease surveillance, ventilator associated pneumonia, hospitalization, prospective study
Abstract

The results of a surveillance study conducted by the International Nosocomial Infection Control Consortium (INICC) from January 2004 through December 2009 in 422 intensive care units (ICUs) of 36 countries in Latin America, Asia, Africa, and Europe are reported. During the 6-year study period, using Centers for Disease Control and Prevention (CDC) National Healthcare Safety Network (NHSN; formerly the National Nosocomial Infection Surveillance system [NNIS]) definitions for device-associated health care-associated infections, we gathered prospective data from 313,008 patients hospitalized in the consortium's ICUs for an aggregate of 2,194,897 ICU bed-days. Despite the fact that the use of devices in the developing countries' ICUs was remarkably similar to that reported in US ICUs in the CDC's NHSN, rates of device-associated nosocomial infection were significantly higher in the ICUs of the INICC hospitals; the pooled rate of central line-associated bloodstream infection in the INICC ICUs of 6.8 per 1,000 central line-days was more than 3-fold higher than the 2.0 per 1,000 central line-days reported in comparable US ICUs. The overall rate of ventilator-associated pneumonia also was far higher (15.8 vs 3.3 per 1,000 ventilator-days), as was the rate of catheter-associated urinary tract infection (6.3 vs. 3.3 per 1,000 catheter-days). Notably, the frequencies of resistance of Pseudomonas aeruginosa isolates to imipenem (47.2% vs 23.0%), Klebsiella pneumoniae isolates to ceftazidime (76.3% vs 27.1%), Escherichia coli isolates to ceftazidime (66.7% vs 8.1%), Staphylococcus aureus isolates to methicillin (84.4% vs 56.8%), were also higher in the consortium's ICUs, and the crude unadjusted excess mortalities of device-related infections ranged from 7.3% (for catheter-associated urinary tract infection) to 15.2% (for ventilator-associated pneumonia). Copyright © 2012 by the Association for Professionals in Infection Control and Epidemiology, Inc. Published by Elsevier Inc. All rights reserved.

Published
2012

44. training under the pressure of consultation needs

Author

Erdem, H, Tekin-Koruk, S, Koruk, I, Tozlu-Keten, D, Ulu-Kilic, A, Oncul, O, Guner, R, Birengel, S, Mert, G, Nayman-Alpat, S, Eren-Tulek, N, Demirdal, T, Elaldi, N, Ataman-Hatipoglu, C, Yilmaz, E, Mete, B, Kurtaran, B, Ceran, N, Karabay, O, Inan, D, Cengiz, M, Sacar, S, Yucesoy-Dede, B, Yilmaz, S, Agalar, C, Bayindir, Y, Alpay, Y, Tosun, S, Yilmaz, H, Bodur, H, Erdem, HA, Dikici, N, Dizbay, M, Oncu, S, Sezak, N, Sari, T, Sipahi, OR, Uysal, S, Yeniiz, E, Kaya, S, Ulcay, A, Kurt, H, Besirbellioglu, BA, Vahaboglu, H, Tasova, Y, Usluer, G, Arman, D, Diktas, H, Ulusoy, S, and Leblebicioglu, H

Subjects
Infectious disease, clinical microbiology, training, consultation
Abstract

Background: Training of infectious disease (ID) specialists is structured on classical clinical microbiology training in Turkey and ID specialists work as clinical microbiologists at the same time. Hence, this study aimed to determine the clinical skills and knowledge required by clinical microbiologists. Methods: A cross-sectional study was carried out between June 1, 2010 and September 15, 2010 in 32 ID departments in Turkey. Only patients hospitalized and followed up in the ID departments between January-June 2010 who required consultation with other disciplines were included. Results: A total of 605 patients undergoing 1343 consultations were included, with pulmonology, neurology, cardiology, gastroenterology, nephrology, dermatology, haematology, and endocrinology being the most frequent consultation specialties. The consultation patterns were quite similar and were not affected by either the nature of infections or the critical clinical status of ID patients. Conclusions: The results of our study show that certain internal medicine subdisciplines such as pulmonology, neurology and dermatology appear to be the principal clinical requisites in the training of ID specialists, rather than internal medicine as a whole.

Published
2011

45. Time-dependent analysis of extra length of stay and mortality due to

Author

Rosenthal, VD, Udwadia, FE, Munoz, HJ, Erben, N, Higuera, F, Abidi, K, Medeiros, EA, Maldonado, EF, Kanj, SS, Gikas, A, Barnett, AG, Graves, N, Guzman, S, Flynn, LP, Rausch, D, Spagnolo, A, Benchetrit, G, Bonaventura, C, Caridi, MD, Messina, A, Ricci, B, Frias, ML, Churruarin, G, Sztokhamer, D, Soroka, LC, Forciniti, S, Blasco, M, Lezcano, CB, Lastra, CE, Viegas, M, Di Nubila, BMA, Lanzetta, D, Fernandez, LJ, Rossetti, MA, Romani, A, Migazzi, C, Barolin, C, Martinez, E, Kobylarz, A, Grinberg, G, Ferreira, IB, Cechinel, RB, Angelieri, DB, Nouer, S, Vianna, R, Machado, AL, Gama, E, Blanquet, D, Zanandrea, BB, Rohnkohl, C, Regalin, M, Salomao, R, da Silva, MAM, Silva, CHD, Vilins, M, Blecher, S, Spessatto, JL, Pasini, RS, Ferla, S, Sussmann, O, Mojica, BE, Gomez, WV, Vergara, GR, Arrieta, P, Rojas, C, Beltran, H, Paez, J, Navarrete, MDT, Dajud, L, Mendoza, M, Moreno, CA, Linares, C, Osorio, L, Guzman, NB, Ferrer, MR, Villa, GS, Guzman, AL, Olarte, N, Valderrama, A, Agudelo, JG, Calderon, MER, Chaniotaki, K, Tsioutis, C, Bampalis, D, Todi, SK, Bhakta, A, Bhattacharjee, M, Kumar, RK, Radhakrishnan, K, Ansari, R, Poojary, A, Koppikar, G, Bhandarkar, L, Jadhav, S, Sen, N, Subramani, K, Karlekar, A, Rodrigues, C, Hegd, A, Kapadia, F, Sahu, S, Gopinath, R, Ravindra, N, Myatra, SN, Divatia, JV, Kelkar, R, Biswas, S, Raut, S, Sampat, S, Kumar, R, Chakravarthy, M, Gokul, BN, Sukanya, R, Pushparaj, L, Dwivedy, A, Shetty, S, Binu, S, Zahreddine, N, Sidani, N, Jurdi, LA, Kanafani, Z, Lopez, MS, Hernandez, HT, Gomez, AC, Morales, JR, Rodriguez, JEV, Oropeza, MS, Rangel-Frausto, MS, Soto, JM, Ruiz, AA, Campuzano, R, Brito, JM, Abouqal, R, Madani, N, Zeggwagh, AA, Dendane, T, Barkat, A, Bouazzaoui, NL, Meryem, K, Cuellar, L, Rosales, R, Bravo, LIC, Caceres, ML, Espinoza, T, Lopez, FS, Espichan, MJM, Echenique, L, Sabogal, AC, Goicochea, IP, Sanchez, AA, Alva, GR, Ventura, JG, Aguilar, MR, Plasencia, NS, Rodriguez, T, Yalcin, AN, Turhan, O, Keskin, S, Gumus, E, Dursun, O, Ozdemir, D, Guclu, E, Erdogan, S, Ulusoy, S, Arda, B, Bacakoglu, F, Alp, E, Aygen, B, Arman, D, Hizel, K, Ozdemir, K, Uzun, C, Sardan, YC, Yildirim, G, Topeli, A, Sirmatel, F, Cengiz, M, Yilmaz, L, Ozgultekin, A, Turan, G, Akgun, N, Ozturk, R, Dikmen, Y, Aygun, G, Akan, OA, Tulunay, M, Oral, M, Unal, N, Koksal, I, Yylmaz, G, Senel, AC, Sozen, EE, Ersoz, G, Kaya, A, Kandemir, O, Leblebicioglu, H, Esen, S, Ulger, F, Dilek, A, Aygun, C, Kucukoduk, S, Ozgunes, I, Usluer, G, Turgut, H, Sacar, Suzan, Sungurtekin, Hülya, and Ugurcan, D

Subjects
and hospital infections, pneumonia, surveillance, respiratory tract diseases, Bacterial infections, hospital-acquired (noscomial) infections, hygiene
Abstract

Ventilator-associated pneumonias (VAPs) are a worldwide problem that significantly increases patient morbidity, mortality, and length of stay (LoS), and their effects should be estimated to account for the timing of infection. The purpose of the study was to estimate extra LoS and mortality in an intensive-care unit (ICU) due to a VAP in a cohort of 69 248 admissions followed for 283 069 days in ICUs from 10 countries. Data were arranged according to the multi-state format. Extra LoS and increased risk of death were estimated independently in each country, and their results were combined using a random-effects meta-analysis. VAP prolonged LoS by an average of 2.03 days (95% CI 1.52-2.54 days), and increased the risk of death by 14% (95% CI 2-27). The increased risk of death due to VAP was explained by confounding with patient morbidity.

Published
2011

46. Impact of International Nosocomial Infection Control Consortium (INICC) strategy on central line-associated bloodstream infection rates in the intensive care units of 15 developing countries

Author

Rosenthal, V.D., Maki, D.G., Rodrigues, C., Álvarez-Moreno, C., Leblebicioglu, H., Sobreyra-Oropeza, M., Berba, R., Madani, N., Medeiros, E.A., Cuéllar, L.E., Mitrev, Z., Dueñas, L., Guanche-Garcell, H., Mapp, T., Kanj, S.S., Fernández-Hidalgo, R., Viegas, M., Di Núbila, B.M.A., Lanzetta, D., Fernández, L.J., Rossetti, M.A., Romani, A., Migazzi, C., Barolin, C., Martínez, E., Sztokhamer, D., Soroka, L.C., Flynn, L.P., Rausch, D., Spagnolo, A., Forciniti, S., Blasco, M., Lezcano, C.B., Lastra, C.E., Angelieri, D.B., Salomao, R., Da Silva, M.Â.M., Vilins, M., Da Silva, E.H., Blecher, S., Grinberg, G., Linares, C., Gómez, W.V., Vergara, G.R., Arrieta, P., Osorio, L., Guzmán, N.B., Ferrer, M.R., Villa, G.S., Guzmán, A.L., Sussmann, O., Mojica, B.E., Olarte, N., Valderrama, A., Dajud, L., Mendoza, M., Bernate, P.H.A., Calderón, M.E.R., Calzada, J.M.A., Muñoz, G., Argüello, A.R., Pérez, C.M., De Casares, A.C.B., De Machuca, L.J., Hegd, A., Kapadia, F., Todi, S.K., Chakraborty, P., Chatterjee, S., Chakravarthy, M., Jawali, V., Adhikary, R., Singh, S., Kumar, R.K., Radhakrishnan, K., Karlekar, A., Kapoor, P., Pawar, M., Udwadia, F.E., Ansari, R., Poojary, A., Koppikar, G., Bhandarkar, L., Sen, N., Subramani, K., Raj, J.P., Myatra, S.N., Divatia, J.V., Kelkar, R., Biswas, S., Singhal, H., Raut, S., Mahale, N., Dhakate, V., Sampat, S., Ramachandran, B., Zahreddine, N., Sidani, N., Jurdi, L.A., Kanafani, Z., Anguseva, T., Ampova, V., Guroska, S.T., Higuera, F., Hernández, H.T., Gómez, A.C., Morales, J.R., Rodríguez, J.E.V., Serrato, I.P., López, M.S., Ruiz, A.A., Campuzano, R., Brito, J.M., Abouqal, R., Zeggwagh, A.A., Abidi, K., Dendane, T., Alfaro, F.G., Alvarado, C., De León, L.M., Navarro, R., Moreno, J.L., Cerrud, R., Rosales, R., Bravo, L.I.C., Cáceres, M.L., Maldonado, E.F., Espichan, M.J.M., Echenique, L., Sabogal, A.C., Goicochea, I.P., Sanchez, A.A., Alva, G.R., Ventura, J.G., Aguilar, M.R., Plasencia, N.S., Rodríguez, T., Espinoza, T.A., López, F.S., Angelo, G., Genuino, S., Consunji, R.J., Mantaring III, J.B.V., Navoa-Ng, J.A., Villanueva, V.D., Tolentino, M.C.V., Yalcin, A.N., Turhan, O., Keskin, S., Özgültekin, A., Turan, G., Akgün, N., Koksal, I., Yýlmaz, G., Senel, A.C., Sözen, E.E., Akan, Ö.A., Tulunay, M., Oral, M., Ünal, N., Esen, S., Ulger, F., Dilek, A., Aygun, C., Küçüködük, S., Erben, N., Ozgunes, I., Usluer, G., Sardan, Y.C., Yildirim, G., Topeli, A., Ozdemir, D., Guclu, E., Erdogan, N.S., Sirmatel, F., Cengiz, M., Yilmaz, L., Alp, E., Aygen, B., Turgut, H., Sacar, S., Sungurtekin, H., and Uǧurcan, D.

Subjects
health care organization, treatment duration, antisepsis, adult, chlorhexidine, article, bloodstream infection, clinical trial, catheter, intensive care unit, major clinical study, health survey, International Nosocomial Infection Control Consortium, aged, female, multicenter study, male, incidence, health program, controlled study, hospital infection, human
Abstract

BACKGROUND. The International Nosocomial Infection Control Consortium (INICC) was established in 15 developing countries to reduce infection rates in resource-limited hospitals by focusing on education and feedback of outcome surveillance (infection rates) and process surveillance (adherence to infection control measures). We report a time-sequence analysis of the effectiveness of this approach in reducing rates of central line-associated bloodstream infection (CLABSI) and associated deaths in 86 intensive care units with a minimum of 6-month INICC membership. METHODS. Pooled CLABSI rates during the first 3 months (baseline) were compared with rates at 6-month intervals during the first 24 months in 53,719 patients (190,905 central line-days). Process surveillance results at baseline were compared with intervention period data. RESULTS. During the first 6 months, CLABSI incidence decreased by 33% (from 14.5 to 9.7 CLABSIs per 1,000 central line-days). Over the first 24 months there was a cumulative reduction from baseline of 54% (from 16.0 to 7.4 CLABSIs per 1,000 central line-days; relative risk, 0.46 [95% confidence interval, 0.33-0.63]; P < .001). The number of deaths in patients with CLABSI decreased by 58%. During the intervention period, hand hygiene adherence improved from 50% to 60% (P < .001); the percentage of intensive care units that used maximal sterile barriers at insertion increased from 45% to 85% (P < .001 ), that adopted chlorhexidine for antisepsis increased from 7% to 27% (P=.018 ), and that sought to remove unneeded catheters increased from 37% to 83% (P=.004); and the duration of central line placement decreased from 4.1 to 3.5 days (P < .001). CONCLUSIONS. Education, performance feedback, and outcome and process surveillance of CLABSI rates significantly improved infection control adherence, reducing the CLABSI incidence by 54% and the number of CLABSI-associated deaths by 58% in INICC hospitals during the first 2 years. © 2010 by The Society for Healthcare Epidemiology of America. All rights reserved.

Published
2010

47. A multicenter point-prevalence study: antimicrobial prescription frequencies in hospitalized patients in turkey

Author

Usluer G., Ozgunes I., Leblebicioglu H., Akalin H., Ayaz C., Caylan R., Yamazhan T., and OMÜ

Subjects
Microbiology (medical), medicine.medical_specialty, Cost, Appropriate antimicrobial use, lcsh:QR1-502, Prevalence, Drug resistance, lcsh:Microbiology, Drug Costs, lcsh:Infectious and parasitic diseases, Anti-Infective Agents, Internal medicine, Intensive care, cost, medicine, Humans, lcsh:RC109-216, Prospective Studies, Antibiotic prophylaxis, Elective surgery, Medical prescription, Intensive care medicine, appropriate antimicrobial use, business.industry, Research, lcsh:RM1-950, General Medicine, Antibiotic Prophylaxis, Antimicrobial, medicine.disease, antimicrobial use, Drug Utilization, Hospitalization, Antimicrobial use, lcsh:Therapeutics. Pharmacology, Infectious Diseases, Drug Therapy, Combination, business, Febrile neutropenia
Abstract

Background Accurate information about prescribing patterns in hospitals is valuable in improving the quality of antimicrobial prescriptions. Methods Data on the use of antimicrobial agents in eighteen tertiary care hospitals were collected on March 20th 2002. Results One or more antimicrobials were ordered in 2900 (30.6 %)of 9471 hospitalized patients. The reasons of hospitalization of the patients receiving antimicrobials were medical treatment (42.5 %), elective surgery (39.6 %), treatment of infectious disease (17.1 %) and emergent surgical procedures (10.4 %). The highest consumption frequencies were found in surgical (81.6 %) and medical (55.2 %) intensive care units. The 48.8 % of antimicrobials were given for treatment and 44.2 % for prophylactic use. The most common reasons for treatment were found as lower respiratory tract, urinary tract, surgical wound infections and febrile neutropenia. Antimicrobials were ordered empirically in 78.4 % of patients. The proven infection ratio was found as 30.7 %. The 56.4 % and 13.4 % of orders were evaluated as clinically and microbiologically appropriate respectively. Conclusion These results suggest that antimicrobial prescription and empirical treatment ratios were high and inappropriate at inpatient groups.

Published
2005

50. Treatment of acute hepatitis C virus infection with interferon-? 2b and ribavirin: Case report and review of the literature

Author

Leblebicioglu H., Bayirli D., Esen S., Sunbul M., Eroglu C., and OMÜ

Subjects
virus diseases, digestive system diseases
Abstract

PubMed: 12437778 Hepatitis C virus (HCV) infection becomes chronic in about 85 % of individuals as demonstrated by the persistence of HCV. It is necesseray to treat acute hepatitis C infection. Interferon-?is generally used for the treatment of acute HCV infection. Case presentation: A 55-year-old woman with a history of fatique and icter was diagnosed as acute hepatitis C virus infection. She was treated with interferon-? 2b 3 million unite sc three times in a week and ribavirin 1000 mg daily for 6 months. Within 2 weeks of therapy, the alanine aminotransferase (ALT) had became normal. At the end of the 3 months of therapy, HCV RNA was negative and remained negative 6 months after the end of interferon treatment (sustained response). Conclusion: This report suggests that interferon-? 2b and ribavirin may have a role in treatment of acute hepatitis C virus infection. © 2002 Leblebicioglu et al; licensee BioMed Central Ltd.

Published
2002

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