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Aim: Positive results have been reported regarding the early use of favipiravir,a RNA-dependent RNA polymerase inhibitor,in the COVID-19 pandemic. In our study, we aimed to understand the potential role of favipiravir in controlling COVID-19 pneumonia and sepsis by comparing the early use of favipiravir with the late using. Material and Method: Treatments are carried out in line with the guidelines constantly updated by the Ministry of Health in Turkey. Following the guide published on April 14,2020,we examined 18 patients who received favipiravir as the last treatment option in the late period and 17 patients who received favipiravir in the early period in two different groups.We recorded the demographic characteristics,comorbidities,APACHE-II scores,consecutive SOFA scores and mortality status of the patients in both groups. Results: The difference between groups in terms of gender and age was not statistically significant.The difference between groups in terms of APACHE-II score was statistically significant.(p=0.018)The late group also had higher APACHE-II scores.The difference between groups in terms of exitus was not statistically significant but lower in the group using favipiravir early. Conclusion: In studies with a limited number of patients, favipiravir has been shown to have a significant advantage over lopinavir/ritonavir in viral clearance as well as a significant reduction in viral load when used in the early period.Similarly,in our study,patients who used favipiravir in the late period came to us more seriously and the mortality rate was higher. We think that favipiravir had a significant effect even in studies with a small number of patients, and larger studies are needed in this area.

Background: The European Confederation of Medical Mycology (ECMM) collected data on epidemiology, risk factors, treatment, and outcomes of patients with culture-proven candidaemia across Europe to assess how adherence to guideline recommendations is associated with outcomes. Methods: In this observational cohort study, 64 participating hospitals located in 20 European countries, with the number of eligible hospitals per country determined by population size, included the first ten consecutive adults with culture-proven candidaemia after July 1, 2018, and entered data into the ECMM Candida Registry (FungiScope CandiReg). We assessed ECMM Quality of Clinical Candidaemia Management (EQUAL Candida) scores reflecting adherence to recommendations of the European Society of Clinical Microbiology and Infectious Diseases and the Infectious Diseases Society of America guidelines. Findings: 632 patients with candidaemia were included from 64 institutions. Overall 90-day mortality was 43% (265/617), and increasing age, intensive care unit admission, point increases in the Charlson comorbidity index score, and Candida tropicalis as causative pathogen were independent baseline predictors of mortality in Cox regression analysis. EQUAL Candida score remained an independent predictor of mortality in the multivariable Cox regression analyses after adjusting for the baseline predictors, even after restricting the analysis to patients who survived for more than 7 days after diagnosis (adjusted hazard ratio 1·08 [95% CI 1·04–1·11; p

Background We report the results of INICC surveillance study from 2013 to 2018, in 664 intensive care units (ICUs) in 133 cities, of 45 countries, from Latin-America, Europe, Africa, Eastern-Mediterranean, Southeast-Asia, and Western-Pacific. Methods Prospective data from patients hospitalized in ICUs were collected through INICC Surveillance Online System. CDC-NHSN definitions for device-associated healthcare-associated infection (DA-HAI) were applied. Results We collected data from 428,847 patients, for an aggregate of 2,815,402 bed-days, 1,468,216 central line (CL)-days, 1,053,330 mechanical ventilator (MV)-days, 1,740,776 urinary catheter (UC)-days. We found 7,785 CL-associated bloodstream infections (CLAB), 12,085 ventilator-associated events (VAE), and 5,509 UC-associated urinary tract infections (CAUTI). Pooled DA-HAI rates were 5.91% and 9.01 DA-HAIs/1,000 bed-days. Pooled CLAB rate was 5.30/1,000 CL-days; VAE rate was 11.47/1,000 MV-days, and CAUTI rate was 3.16/1,000 UC-days. P aeruginosa was non-susceptible (NS) to imipenem in 52.72% of cases; to colistin in 10.38%; to ceftazidime in 50%; to ciprofloxacin in 40.28%; and to amikacin in 34.05%. Klebsiella spp was NS to imipenem in 49.16%; to ceftazidime in 78.01%; to ciprofloxacin in 66.26%; and to amikacin in 42.45%. coagulase-negative Staphylococci and S aureus were NS to oxacillin in 91.44% and 56.03%, respectively. Enterococcus spp was NS to vancomycin in 42.31% of the cases. Conclusions DA-HAI rates and bacterial resistance are high and continuous efforts are needed to reduce them.

Simple Summary Patients with simultaneous diagnosis of haematological malignancies (HM) and COVID-19 are an even greater challenge for hematologists. To better clarify their outcome, we describe the clinical features and outcome of a cohort of 450 patients with simultaneous diagnosis of HM and COVID-19 registered in the EPICOVIDEHA registry between March 2020 to February 2022. Overall, 343 (76.2%) patients received treatment for HM, and an overall response rate was observed in 140 (40.8%) patients after the first line of treatment. Thirty-day mortality was significantly higher in patients not receiving HM treatment (42.1%) than in those receiving treatment (27.4%, p = 0.004). Statistical analysis showed that, together with age, severe/critical COVID-19, >= 2 comorbidities, lack of HM treatment was an independent risk factors for mortality. These observations suggest the importance of HM treatment in these patients; therefore, it should be delivered as soon as possible for patients requiring immediate therapy. Background: The outcome of patients with simultaneous diagnosis of haematological malignancies (HM) and COVID-19 is unknown and there are no specific treatment guidelines. Methods: We describe the clinical features and outcome of a cohort of 450 patients with simultaneous diagnosis of HM and COVID-19 registered in the EPICOVIDEHA registry between March 2020 to February 2022. Results: Acute leukaemia and lymphoma were the most frequent HM (35.8% and 35.1%, respectively). Overall, 343 (76.2%) patients received treatment for HM, which was delayed for longer than one month since diagnosis in 57 (16.6%). An overall response rate was observed in 140 (40.8%) patients after the first line of treatment. After a median follow-up of 35 days, overall mortality was 177/450 (39.3%); 30-day mortality was significantly higher in patients not receiving HM treatment (42.1%) than in those receiving treatment (27.4%, p = 0.004), either before and/or after COVID-19, or compared to patients receiving HM treatment at least after COVID-19 (15.2%, p < 0.001). Age, severe/critical COVID-19, >= 2 comorbidities, and lack of HM treatment were independent risk factors for mortality, whereas a lymphocyte count >500/mcl at COVID-19 onset was protective. Conclusions: HM treatment should be delivered as soon as possible for patients with simultaneous diagnosis of COVID-19 and HM requiring immediate therapy.

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.

Introduction: People who inject drugs (PWID) should be treated in order to eliminate hepatitis C virus (HCV) in the world. Aims: The aim of this study was to compare direct acting antivirals (DAAs) treatment of HCV for PWID and non-PWID in real life setting. Materials and methods: We performed a prospective, non-randomized, observational multi-center cohort study in 37 centers. All patients treated with DAAs therapy between April 1, 2017 to February 28, 2019 were included. In total, 2,713 patients were included in the study among which 250 were PWID and 2,463 were non-PWID. Besides patient characteristics, treatment response, follow-up and side effects of treatment were also analyzed. Results: Genotype 1a and 3 were more prevalent in PWID infected patients (20.4% vs 9.9% and 46.8% vs 5.3%). The number of naïve patients was higher in PWID (90.7% vs 60.0%), while the number of patients with cirrhosis was higher in non-PWID (14.1% vs 3.7%). The loss of follow up was higher in PWID (29.6% vs 13.6%). There was no difference in the sustained virologic response at 12 weeks after treatment (98.3% vs 98.4%), but the end of treatment response was lower in PWID (96.2% vs 99.0%). In addition, the rate of treatment completion was lower in PWID (74% vs 94.4%). Conclusion: DAAs were safe and effective in PWID. Primary measures should be taken to prevent the loss of follow-up and poor adherence in PWID patients in order to achieve World Health Organization’s objective of eliminating viral hepatitis.

Gunal, Ozgur/0000-0002-7744-4123; KARABAY, OGUZ/0000-0003-1514-1685 WOS: 000490537600009 PubMed: 31580558 Objective: Treponema pallidum and HIV are transmitted frequently through sexual contact, these agents with epidemiological similarities co-infect the same host. The current number of HIV-infected cases in Turkey is increasing. For this reason, we aimed to reveal the characteristics of syphilis in HIV/AIDS cases. Methods: A retrospective longitudinal cohort study was performed, patients were followed up at 24 clinics in 16 cities from all seven regions of Turkey between January 2010 to April 2018. We examined the socio-demographic characteristics, laboratory parameters and neurosyphilis association in HIV/AIDS-syphilis co-infected cases. Results: Among 3,641 patients with HIV-1 infection, 291 (8%) patients were diagnosed with syphilis co-infection. Most patients were older than 25 years (92%), 96% were males, 74% were working, 23% unemployed, and 3% were students. The three highest prevalence of syphilis were in Black Sea (10.3%), Mediterranean (8.4%) and Marmara Regions (7.4%). As for sexual orientation, 46% were heterosexuals, 42% men who have sex with men (MSM), and no data available for 12%. Patients with the number of CD4+

Hasan, M. Shahnaz/0000-0002-7493-7416; Abouqal, Redouane/0000-0002-6117-4341; Altindis, Mustafa/0000-0003-0411-9669; Masjedi, Mansoor/0000-0001-6175-9289; Popescu, Roxana/0000-0002-9387-1141; Mikaszewska-Sokolewicz, Malgorzata A/0000-0002-1148-7817; Meco, Basak Ceyda/0000-0003-2951-9634; Kumar, Perikala Vijayananda/0000-0001-8315-7000; Zand, Farid/0000-0003-3489-3372; Maghsoudi, Behzad/0000-0002-1279-8799; KAMARUL ZAMAN, MAZUIN/0000-0002-7920-6399; Gan, Chin Seng/0000-0002-6758-4798; Horoz, Ozden Ozgur/0000-0001-7590-650X; Medeiros, Eduardo A/0000-0002-6205-259X; Sabetian, Golnar/0000-0001-8764-2150; UNAL, SERHAT/0000-0003-1184-4711; Gan, Chin Seng/0000-0002-6758-4798; Delia, Muntean/0000-0001-9100-4530; Yalcin, Ata Nevzat/0000-0002-7243-7354; Leblebicioglu, Hakan/0000-0002-6033-8543; Horhat, Florin George/0000-0001-6133-0204; Yousef, Reham H. A./0000-0003-4004-3008; Delgado Aguirre, Hector Alberto/0000-0001-5448-7975; El Kholy, Amani/0000-0002-0645-7664; Rodriguez Ferrer, Marena Luz/0000-0002-8053-8454; Sanaei Dashti, Anahita/0000-0002-2827-3575; KARABAY, OGUZ/0000-0003-1514-1685; Barahona G., Nayide/0000-0003-3559-6900; Stagnaro, Juan Pablo/0000-0003-3836-9957; Alexandru Florin, Rogobete/0000-0003-1286-4431; KAYA, ZEYNEP/0000-0002-8468-2103; Dragan, Barbara/0000-0003-3108-4211; alvarez Moreno, carlos Arturo/0000-0001-5419-4494; Gonzalez Martinez, Marisela del Rocio/0000-0003-1474-736X; Jayatilleke, Kushlani/0000-0002-3931-6630; Unal, Necmettin/0000-0002-9440-7893; Duszynska, Wieslawa/0000-0002-5880-4904; Ngo, Quy Chau/0000-0002-6787-2757; Elmanakhly, Arwa/0000-0001-8557-0536; yildizdas, dincer/0000-0003-0739-5108; Kanj, Souha/0000-0001-6413-3396; Gupta, Umesh/0000-0001-7717-1404 WOS: 000392626300014 PubMed: 27742143 Background: We report the results of International Nosocomial Infection Control Consortium (INICC) surveillance study from January 2010-December 2015 in 703 intensive care units (ICUs) in Latin America, Europe, Eastern Mediterranean, Southeast Asia, and Western Pacific. Methods: During the 6-year study period, using Centers for Disease Control and Prevention National Healthcare Safety Network (CDC-NHSN) definitions for device-associated health care-associated infection (DAHAI), we collected prospective data from861,284 patients hospitalized in INICC hospital ICUs for an aggregate of 3,506,562 days. Results: Although device use in INICC ICUs was similar to that reported from CDC-NHSN ICUs, DA-HAI rates were higher in the INICC ICUs: in the INICC medical-surgical ICUs, the pooled rate of central lineassociated bloodstream infection, 4.1 per 1,000 central line-days, was nearly 5-fold higher than the 0.8 per 1,000 central line-days reported from comparable US ICUs, the overall rate of ventilator-associated pneumonia was also higher, 13.1 versus 0.9 per 1,000 ventilator-days, as was the rate of catheterassociated urinary tract infection, 5.07 versus 1.7 per 1,000 catheter-days. From blood cultures samples, frequencies of resistance of Pseudomonas isolates to amikacin (29.87% vs 10%) and to imipenem (44.3% vs 26.1%), and of Klebsiella pneumoniae isolates to ceftazidime (73.2% vs 28.8%) and to imipenem (43.27% vs 12.8%) were also higher in the INICC ICUs compared with CDC-NHSN ICUs. Conclusions: Although DA-HAIs in INICC ICU patients continue to be higher than the rates reported in CDC-NSHN ICUs representing the developed world, we have observed a significant trend toward the reduction of DA-HAI rates in INICC ICUs as shown in each international report. It is INICC's main goal to continue facilitating education, training, and basic and cost-effective tools and resources, such as standardized forms and an online platform, to tackle this problem effectively and systematically. (C) 2016 Association for Professionals in Infection Control and Epidemiology, Inc. Published by Elsevier Inc. All rights reserved. VDR; Foundation to Fight against Nosocomial Infections The funding for design, development, maintenance, technical support, data validation, and report generation of the Surveillance Online System, and the activities carried out at International Nosocomial Infection Control Consortium headquarters, were provided by VDR and the Foundation to Fight against Nosocomial Infections.

Objective In this study, we aimed to evaluate the efficacy of pegylated interferon alpha 2a and adefovir dipivoxil treatment in chronic hepatitis B patients. Methods This study was performed on patients treated for chronic hepatitis B in the Infectious Disease Clinic of Eskisehir Osmangazi University between 01.09.2005 and 31.03.2008. A total of 30 patients aged between 18 and 65 years constituted the study group. One of patient groups received (10 HBeAg negative, 4 HBeAg positive) PEG-IFN alpha 2a at a dose of 180 μg/once a week, whereas the other group (11 HBeAg negative, 5 HBeAg positive) received daily oral doses of 10 mg ADV. Treatment responses were evaluated at week 48. Results Reductions in serum HBV DNA levels at the end of 48 weeks were 4.8 log10 copy/ml and 4.2 log10 copy/ml in HBeAg negative patients who received ADV or PEG-IFN alpha 2a, respectively. Biochemical response rates were 60% and 91% in PEG-IFN alpha 2a and ADV groups, respectively. Among HBeAg positive patients, reductions in serum HBV DNA levels were 3. 2 log10 copy/ml and 4 log10 copy/ml in ADV and PEG-IFN alpha 2a groups, at week 48, respectively. Biochemical response rates were 50% and 40% in PEG-IFN alpha 2a and ADV groups, respectively. No significant difference was determined in biochemical and virological responses in HBeAg positive and negative patients between PEG-IFN alpha 2a and ADV groups, at week 48. When both treatment groups were evaluated for side effects, it was observed that side effects were significantly common in PEG-IFN alpha 2a group. Conclusion When we compared PEG-IFN alpha 2a and ADV treatment in both HBeAg positive and negative patients, biochemical and virological response rates at 48 weeks were similar.

Tularemia is a zoonosis caused by Francisella tularensis. Oropharyngeal tularemia is due to bacteria penetrating the oral mucosa during intake of contaminated water and food and is the common form seen in our country. A case of oropharyngeal tularemia associated with erythema multiforme is reported herein. Physicians should recognize the cutaneous lesions of tularemia and consider tularemia in patients with eruptions having an epidemiological history.

Background/aim: Broad-spectrum antibiotics have become available for use only with the approval of infectious disease specialists (IDSs) since 2003 in Turkey. This study aimed to analyze the tendencies of doctors who are not disease specialists (non-IDSs) towards the restriction of antibiotics., Materials and methods: A questionnaire form was prepared, which included a total of 22 questions about the impact of antibiotic restriction (AR) policy, the role of IDSs in the restriction, and the perception of this change in antibiotic consumption. The questionnaire was completed by each participating physician., Results: A total of 1906 specialists from 20 cities in Turkey participated in the study. Of those who participated, 1271 (67.5%) had 5 years of occupational experience in their branch expressed that they followed the antibiotic guidelines more strictly than the JSs (P < 0.05) and 755 of physicians (88%) and 720 of surgeons (84.6%) thought that the AR policy was necessary and useful (P < 0.05)., Conclusion: This study indicated that the AR policy was supported by most of the specialists. Physicians supported this restriction policy more so than surgeons did.

Introduction: This study was planned to determine the rate of surgical site infection and to evaluate related risk factors and the effect on cost following surgical procedures in the Departments of Surgery and Orthopedics and Traumatology. Materials and Methods: Six hundred and twenty nine patients who underwent surgery were enrolled into the study. Incidence rates of clean, clean-contaminated, contaminated, and dirty-infected wounds were 3.2%, 16.4%, 32.7%, and 40.9%, respectively. Results: Older age, wound classification, malignancy, diabetes mellitus, cardiovascular system disease, bleeding from wound, preoperative antibiotic usage, urgent surgery, secondary surgical operation, number and duration of drainage catheters, and shaving with blade prior to operation were risk factors significantly related with the occurrence of surgical site infection. Duration of hospitalization (28.6 ± 20.1 days) was significantly longer in patients with surgical site infection compared to the non-surgical site infection group (11.4 ± 8.1 days) (p< 0.001). The mortality rate was 12.7%, and it was higher in patients with surgical site infection compared to the non-surgical site infection group (1.3%) (p< 0.001). The mean cost was 5038 ± 4237 American dollars and 1305 ± 1249 American dollars for the groups with and without a history of surgical site infection, respectively (p< 0.001). Conclusion: To minimize the incidence of surgical site infection, possible risk factors related with the patient should be considered.

Objective: We investigated whether determination IL-6, IL-8, IL-1beta and TNF-alpha at baseline, total protein C (PC) levels at time of admission and 48 hours after initiation could complement the Acute Physiology and Chronic Health Evaluation (APACHE) II scoring system to identify patients with sepsis, severe sepsis or septic shock for clinical outcome. Material and Methods: The study was carried out prospectively. 60 consecutive patients with sepsis, severe sepsis or septic shock were included. Blood samples were obtained at baseline and 48 hours after initiation. Cytokines and PC levels in plasma were measured with an enzyme-linked immunoabsorbent assay (ELISA). APACHE II score was calculated on admission. Results: Baseline IL-6 levels and PC levels 48 hours after initiation were predictive of increased mortality (p=0.016, p=0.044 respectively). Baseline IL-6, IL-8 and TNF-alpha baseline levels correlate with the severity of physiologic insult, as determined by the APACHE II score. However, our multiple logistic regression analysis of these did not reveal any predictive value in combination with the APACHE II score. Conclusion: Determination of baseline IL-6 and PC 48 hours after initiation were of predictive value for prognostic evaluation of septic patients, but did not significantly increase predictive power of the APACHE scoring system to identify patients with sepsis for fatal clinical outcome.

Objective. 2009 H1N1 virus is a new virus that was firstly detected in April 2009. This virus spreads from human to human and causes a worldwide disease. This paper aimed to review the clinical and epidemiological properties of patients with 2009 H1N1 influenza who were hospitalized and monitored at Eskisehir Osmangazi University Faculty of Medicine Hospital. Setting. A 1000-bed teaching hospital in Eskisehir, Turkey. Patients-Methods. Between 05 November 2009–01 February 2010, 106 patients with 2009 H1N1 influenza, who were hospitalized, were prospectively evaluated. Results. Out of 106 patients who were hospitalized and monitored, 99 (93.4%) had fever, 86 (81.1%) had cough, 48 (45.3%) had shortness of breath, 47 (44.3%) had sore throat, 38 (35.8%) had body pain, 30 (28.3%) had rhinorrhea, 17 (16%) had vomiting, 15 (14.2%) had headache, and 14 (13.2%) had diarrhea. When the patients were examined in terms of risk factors for severe disease, 83 (78.3%) patients had at least one risk factor. During clinical monitoring, pneumonia was the most frequent complication with a rate of 66%. While 47.2% of the patients were monitored in intensive care unit, 34% of them required mechanical ventilation support. Conclusion. Patients with 2009 H1N1 influenza, who were hospitalized and monitored, should be carefully monitored and treated.

Dikmen, Yalim/0000-0002-3122-5099; Erben, Nurettin/0000-0003-0373-0132; Tsioutis, Constantinos/0000-0002-7865-8529; Barnett, Adrian/0000-0001-6339-0374; Abouqal, Redouane/0000-0002-6117-4341; Medeiros, Eduardo A/0000-0002-6205-259X; Leblebicioglu, Hakan/0000-0002-6033-8543; Gikas, Achilleas/0000-0002-8455-9631; Unal, Necmettin/0000-0002-9440-7893; Kanj, Souha/0000-0001-6413-3396; Graves, Nicholas/0000-0002-5559-3267; Barahona G., Nayide/0000-0003-3559-6900 WOS: 000296428300015 PubMed: 21320374 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.

Introduction: Fever of unknown origin is first defined in 1961 as a temperature higher than 38.3°C lasting longer than 3 weeks, with a diagnosis that remains uncertain after 1 week of investigation. In this study, it’s aimed to evaluate etiology of fever of unknown origin cases hospitalized in department of infectious diseases and clinical microbiology. Patients and Methods: Fifty three fever of unknown origin cases hospitalized at our department between January 2002-August 2007 were evaluated retrospectively. Fever of unknown origin was diagnosed according to the criteria described by Petersdorf and Beeson. Patients with a history of immunosuppressive disease and nosocomial fever were excluded. Results: Median days with fever was 15.8 days (20-160 days), median days for diagnosis was 4.8 days (3-120 days). Seventeen (32.1%), 10 (18.9%) and 5 (9.4%) of the 53 cases were diagnosed as infection, collagen vascular disease and malignancy respectively. Eight (15.1%) of all cases were diagnosed as other diseases such as thyroiditis, pheochromocytoma, ulcerative collitis, and familial mediterrenean fever. Origins of the fever was not defined for 13 (24.5%) of the patients. Fever decreased spontaneously in 61.5% of undiagnosed patients at follow up. Invasive procedures were performed at 20.8% of whole cases. Conclusion: As a result infectious diseases are the leading causes of fever of unknown origin. For diagnosis routine tests should be performed first and then if necessary, more complicated or invasive tests may be performed. Endemic, regional infectious diseases should be considered primarily.

Medical students are exposed to the risk of occupational infections due to accidental exposures such as needlestick injuries, sharps injuries and mucosal exposure of contaminated blood or body fluids. A questionnaire was devised to determine occupational exposures (OEs) they had experienced, behaviours following OE, their knowledge and compliance on universal precautions. One hundred and fourteen medical students filled out the questionnaire. 31.6% were in 3rd, 22.8% in 4th, 35.1% in 5th, and 10.5% in 6th class. 61.4% of students had history of occupational injuries at least once. Rate of sharps injuries, needlestick injuries and mucosal exposure were 30%, 82.9%, 35.7% respectively. Rate of OEs was higher and statistically significant in 5th, 6th classes compared to 3rd, 4th.The most common way for exposure was recapping the needle. Rate of underreporting was 74.2%. 53.5% of the participants were vaccinated with complete dose of hepatitis B virus vaccine. 28.9% declared they always wore gloves prior to any percutaneus procedures. Medical students should be educated for the risk and encouraged to report OEs for their own safety.

Health care workers (HCWs) are exposed to the risk of occupational infections due to accidental exposures such as needlestick injuries, sharp injuries and mucosal exposure of contaminated blood or body fluids. A questionnaire was devised to determine occupational exposures (OEs) they had experienced, behaviours following OE, condition of hepatitis B virus immunization, their knowledge and compliance on universal precautions. One hundred and thirty HCWs filled out the questionnaire. One hundred and three (79.2%) of participants determined at least one or more occupational exposure during last one year. Eighteen (17.5%) of participants exposed to accidental exposure during last one year reported these exposures. One hundred and nine (83.8%) of participants had history of hepatitis B virus vaccination. Results showed that only 30 (23.1%) followed universal precautions completely.

Infective endocarditis is a life threatening disease of endocardium of the heart. Viridans streptococci are the most common reported isolates among patients with infective endocarditis. Abiotrophia and Granulicatella species form part of the normal flora of the oral cavity. They are infrequently isolated in patients with infective endocarditis. We report a case of native valve endocarditis attributed to Granulicatella elegans. We isolated G. elegans in two blood samples of the patient. Patient was successfully treated with ceftriaxone and gentamycin.

This retrospective study was performed in two university hospitals between January 2002 and 2006. Ninety-nine brucellosis patients were included in the study. These patients were classified as acute (91), chronic (4) and relapse (4) according to their clinical presentations and serological tests. Brucella bacteria were isolated in the blood of 17 (17.2%) cases. The most frequent symptom and clinical sign was fever. The osteoarticular complications were found in 17 patients (17.2%). Four of them were complicated with epidural abscess the same time. Two (2.2%) had meningitis, two (2.2%) had epididymoorchitis, three (3.3%) had skin rashes and one (1.1%) had hepatitis. Three of the acute brucellosis patients were pregnant. Rifampin and doxycycline combination therapy had been administered to most of the patients with acute and relapse brucellosis. However, complicated and chronic brucellosis cases were given different treatment combinations. This study reviews brucellosis therapy choices.

Aims: To evaluate the effectiveness of the International Nosocomial Infection Control Consortium (INICC) Multidimensional Hand Hygiene Approach in Turkey and analyse predictors of poor hand hygiene compliance. Design: An observational, prospective, interventional, before-and-after study was conducted from August 2003 to August 2011 in 12 intensive care units (ICU) of 12 hospitals in 11 cities. The study was divided into a baseline and a follow-up period and included random 30-minute observations for hand hygiene compliance in ICU. The hand hygiene approach included administrative support, supplies availability, education and training, reminders in the workplace, process surveillance, and performance feedback. Results: We observed 21,145 opportunities for hand hygiene. Overall hand hygiene compliance increased from 28.8% to 91% (95% CI 87.6–93.0, p 0.0001). Multivariate and univariate analyses showed that several variables were significantly associated with poor hand hygiene compliance: males vs. females (39% vs. 48%; 95% CI 0.79–0.84, p 0.0001), ancillary staff vs. physicians (35% vs. 46%, 95% CI 0.73–0.78, p 0.0001), and adult vs. pediatric ICUs (42% vs. 74%, 95% CI 0.54–0.60, p 0.0001). Conclusions: Adherence to hand hygiene was significantly increased with the INICC Hand Hygiene Approach. Specific programmes should be directed to improve hand hygiene in variables found to be predictors of poor hand hygiene compliance.

Yalcin, Ata Nevzat/0000-0002-7243-7354; dursun, oguz/0000-0001-5482-3780; Oncul, Oral/0000-0002-1681-1866; Leblebicioglu, Hakan/0000-0002-6033-8543; demirdal, tuna/0000-0002-9046-5666; Ciftci, Ergin/0000-0002-4955-160X; Erben, Nurettin/0000-0003-0373-0132; Kendirli, Tanil/0000-0001-9458-2803; Acar, Ali/0000-0003-2008-5112; Geyik, Mehmet Faruk/0000-0002-0906-0902; Dursun, Oguz/0000-0001-5482-3780; KAYA, ZEYNEP/0000-0002-8468-2103; KARABAY, OGUZ/0000-0003-1514-1685; Karabay, Oguz/0000-0003-0502-432X; Kaya, Sehnaz/0000-0003-0002-1517 WOS: 000347654600011 PubMed: 25564124 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.

Kikuchi-Fujimoto disease, also known as histiocytic necrotizing lympadenitis, is an uncommon clinical and patological autolimited feature of bening prognosis that may mimic many other diseases diagnosed chiefly in young adults. It is clinically significant because of possible misdiagnosis of other diseses such as malignant lymphoma or tuberculosis. Thus, an early biopsy is instrumental in making definite diagnosis and preventing unnecessary investigation. We described a case of Kikuchi-Fujimoto disease in a 22-year-old woman who presented with swollen lymph nodes and a fever. A rapid clinical improvement after lymph nodes excisional biopsy was remarkable. No treatment was given, and a full recovery was achived within six weeks. In this case had emphasized the clinical, histologic features, and outcome of Kikuchi-Fujimoto disease.

Ocular toxoplasmosis is one of the causes of severe visual loss in young people. We reviewed the records of 15 patients with ocular toxoplasmosis who were examined between 2003 and 2005. The diagnosis of ocular toxoplasmosis was established by detecting morphologically characteristic toxoplasmic fundus lesions in either eye by ophthalmologist. A positive serologic test for toxoplasmosis was used to support the diagnosis. All patients were treated. Our treatment protocol included the combination of primethamine and trimethoprim-sulfamethoxazol (TMP-SMX) or clindamicin and TMP-SMX or spiramycin and TMP-SMX with corticosteroid. Duration of treatment was average of four-six weeks. There were active lesions in 11 of the patients. There was also inflammation accompanied with chorioretinitis scars in four patients. Macular involvement were seen in three patients. Fourteen patients had unilateral and one had bilateral involvement. Retinochroidal lesions of 12 patient showed full regression. Relaps was seen in four patients. In conclusion, ocular toxoplasmosis seriously impairs vision acuity. Patients who have active choroidoretinitis of T. gondii should be treated and followed to avoid late compllications.

In this article, a patient in whom cochlear implant was administered following hearing loss associated with acute bacterial meningitis is presented. The 57-year-old male patient presented due to fever, ear pain and hearing loss for the past three days. On physical examination, the patient was conscious, had a moderate general condition, and fever of 37.7°C. There was total hearing loss and aphasia. Neck stiffness was positive during neurological examination. During non-stained microscopic examination of the cerebrospinal fluid, 1900 cells/mm3 (89% PMNL, 11% lymphocyte) were detected. During gram staining, gram-positive diplococcus was seen. Ceftriaxone was started with the diagnosis of acute bacterial meningitis. On day 2 of the treatment, his fever decreased, but hearing loss and speech and balance disorder continued. On day 4 of the treatment, vancomycin was added due to newly developed fever. Response to fever was achieved on day 2 of the combination treatment. During audiological examination of the patient with ongoing hearing loss, very severe bilateral sensorineural hearing loss was detected. 1 mg/kg prednisolone was started for the patien,t and cochlear implant was planned by the otorhinolaryngology department. Cochlear implant was performed as the patient’s complaint did not regress after one month of prednisolone treatment. Monitoring of the patient is ongoing. In conclusion, hearing loss developing in acute bacterial meningitis should be detected promptly, and rehabilitated as required.

Maghsoudi, Behzad/0000-0002-1279-8799; Kritsotakis, Evangelos/0000-0002-9526-3852; Yalcin, Ata Nevzat/0000-0002-7243-7354; Mikaszewska-Sokolewicz, Malgorzata A/0000-0002-1148-7817; ALDEMIR KOCABAS, Bilge/0000-0002-6396-5243; Masjedi, Mohammad Reza/0000-0002-6871-382X; Masjedi, Mansoor/0000-0001-6175-9289; Gan, Chin Seng/0000-0002-6758-4798; Oncul, Oral/0000-0002-1681-1866; Sabetian, Golnar/0000-0001-8764-2150; YAMAN, Ayhan/0000-0002-5651-1286; Ozdemir, Halil/0000-0002-7318-1688; Leon, Hector Armando Rincon/0000-0003-0715-200X; Delia, Muntean/0000-0001-9100-4530; Atasay, Fatma Begum/0000-0002-9114-5293; Zand, Farid/0000-0003-3489-3372; Kuchenbecker, Ricardo/0000-0002-4707-3683; Medeiros, Eduardo A/0000-0002-6205-259X; ROMERO LOPEZ-ALBERCA, CRISTINA/0000-0001-5856-8668; Salomao, Reinaldo/0000-0003-1149-4598; ozdemir, sonay incesoy/0000-0003-2863-901X; Meco, Basak Ceyda/0000-0003-2951-9634; Horoz, Ozden Ozgur/0000-0001-7590-650X; Horhat, Florin George/0000-0001-6133-0204; Kazi, Mohammad Mukhit/0000-0003-3824-5540; Ciftci, Ergin/0000-0002-4955-160X; Abouqal, Redouane/0000-0002-6117-4341; Leblebicioglu, Hakan/0000-0002-6033-8543; Garcell, Humberto Guanche/0000-0001-7279-0062; Kendirli, Tanil/0000-0001-9458-2803; de Souza, Maria Cecilia B V/0000-0003-0318-3087; Sanaei Dashti, Anahita/0000-0002-2827-3575; UNAL, SERHAT/0000-0003-1184-4711; alvarez Moreno, carlos Arturo/0000-0001-5419-4494; Barahona G., Nayide/0000-0003-3559-6900; Rodriguez Ferrer, Marena Luz/0000-0002-8053-8454; Karabay, Oguz/0000-0003-0502-432X; Kaya, Sehnaz/0000-0003-0002-1517; ERDEVE, OMER/0000-0002-3193-0812; Gonzalez Martinez, Marisela del Rocio/0000-0003-1474-736X; Gikas, Achilleas/0000-0002-8455-9631; Baylan, Orhan/0000-0002-6529-7824; Mitrev, Zan/0000-0001-7859-8821; yildizdas, dincer/0000-0003-0739-5108; Ngo, Quy Chau/0000-0002-6787-2757; Duszynska, Wieslawa/0000-0002-5880-4904; KAYA, ZEYNEP/0000-0002-8468-2103; Dragan, Barbara/0000-0003-3108-4211; Gupta, Umesh/0000-0001-7717-1404; Navarro Fuentes, Karla Reyna/0000-0002-6894-8872; zali, Mohammadreza/0000-0002-9027-4560; Morocho Tutillo, Diego Rolando/0000-0002-4974-7856; El Kholy, Amani/0000-0002-0645-7664; Kanj, Souha/0000-0001-6413-3396; Assiri, Abdullah/0000-0002-5605-2876; Unal, Necmettin/0000-0002-9440-7893; Jayatilleke, Kushlani/0000-0002-3931-6630; KARABAY, OGUZ/0000-0003-1514-1685 WOS: 000341307100001 PubMed: 25179325 We report the results of an International Nosocomial Infection Control Consortium (INICC) surveillance study from January 2007-December 2012 in 503 intensive care units (ICUs) in Latin America, Asia, Africa, and Europe. During the 6-year study using the Centers for Disease Control and Prevention's (CDC) U.S. National Healthcare Safety Network (NHSN) definitions for device-associated health care-associated infection (DA-HAI), we collected prospective data from 605,310 patients hospitalized in the INICC's ICUs for an aggregate of 3,338,396 days. Although device utilization in the INICC's ICUs was similar to that reported from ICUs in the U.S. in the CDC's NHSN, rates of device-associated nosocomial infection were higher in the ICUs of the INICC hospitals: the pooled rate of central line-associated bloodstream infection in the INICC's ICUs, 4.9 per 1,000 central line days, is nearly 5-fold higher than the 0.9 per 1,000 central line days reported from comparable U. S. ICUs. The overall rate of ventilator-associated pneumonia was also higher (16.8 vs 1.1 per 1,000 ventilator days) as was the rate of catheter-associated urinary tract infection (5.5 vs 1.3 per 1,000 catheter days). Frequencies of resistance of Pseudomonas isolates to amikacin (42.8% vs 10%) and imipenem (42.4% vs 26.1%) and Klebsiella pneumoniae isolates to ceftazidime (71.2% vs 28.8%) and imipenem (19.6% vs 12.8%) were also higher in the INICC's ICUs compared with the ICUs of the CDC's NHSN. Copyright (C) 2014 by the Association for Professionals in Infection Control and Epidemiology, Inc. Published by Elsevier Inc. All rights reserved.

The H5N1 infection was diagnosed in 12 patients in Turkey and confirmed by the WHO. Of these 12 patients so far, 8 have been published. In this case, we are presenting a case of pneumonia that developed following avian influenza infection in Eskisehir. Our case is one of the 4 patients who were not reported previously.

Brucellosis is a zoonosis, and transmitted by direct or indirect exposure. Direct invasion of the central nervous system occurs in fewer than 5% of cases. Neurobrucellosis includes meningitis, encephalitis, myelitisradiculoneuronitis, brain abscess, intra-medullary spinal cord abscess, epidural abscess, granuloma, and demyelinating and meningovascular syndromes. We report a case of meningitis caused by Brucella melitensis in a patient with ventriculoperitoneal shunt.

Diabetes mellitus (DM) is one of the most common diseases worldwide, and is a significant risk factor for healthcare-associated infections (HAIs). Our aim in this study was to compare the distributions of HAIs and the causative pathogens between diabetic and non-diabetic patients. In this study, 716 HAIs in 465 diabetic patients and 761 HAIs in 465 non-diabetic patients were evaluated. HAIs in patients with DM were most frequently urinary tract infections (UTIs) [266 infections (37.2 %)], followed by blood stream infections (BSIs) [161 infections (22.5 %)], surgical site infections (SSIs) [127 infections (17.7 %)], pneumonia [107 infections (14.9 %)] and any other infections [161 infections (22.5 %)]. The rates of UTIs, BSIs, SSIs, pneumonia and any other infections were similar between diabetic and non-diabetic patients. In terms of the causative pathogens, Staphylococcus aureus more frequently caused SSIs and Candida spp more frequently caused UTIs in diabetic patients compared with non-diabetic patients. We found no differences in the distribution of HAIs between patients without and with DM. However, S. aureus and Candida spp were more common causative pathogens of SSIs and URTIs, respectively, in diabetic patients than in non-diabetic patients.

Urinary system infections are usually bacterial, however, fungal etiology, particularly Candida spp. are encountered in about 10% of these infections. C.albicans is still the most frequently isolated species in candiduria. This study was aimed to identify the risk factors of candiduria and to determine species distribution of Candida which cause candiduria in hospitalized patients. The study was carried out in a total of 93 hospitalized patients (68 female, 25 male; age range: 17-84 yrs, mean age: 59.5 ± 1.7 yrs) of which 50 presented with candiduria (case group) and 43 with bacteriuria (control group), between January 2009 to December 2009. The most frequently isolated species was C.albicans (n= 32; 64%), followed by C.glabrata (n= 13; 26%), C.tropicalis (n= 4; 8%) and C.krusei (n= 1; 2%). All of the isolates except one, were found susceptible to fluconazole and voriconazole by E-test (AB Biodisk, Sweden), however, C.krusei isolate was resistant to fluconazole and susceptible to voriconazole. The mean hospitalization period and the period of stay in intensive care unit (ICU) of the case group (9.56 ± 9.09 and 4.12 ± 7.05 days, respectively) were found statistically significant compared to control group (4.42 ± 3.71 and 0.53 ± 1.78, respectively) (p0.005). Nosocomial origin of infection was higher in control group (n= 45, 90%) than the case group (n= 30, 69.8%), (p= 0.014). The rate of antibiotic use prior to candiduria in the case group was detected significantly higher (n= 43; 86%) than the controls (n= 14; 32.6%) (p= 0.000). The most frequently used antibiotic prior to candiduria/bacteriuria was the quinolone group of agents both in case and control groups (42% and 21%, respectively). The other risk factors for candiduria found to be higher in the case group than the controls were as follows; presence of urinary system intervention (32% and 0, respectively; p= 0.000), catheter use (76% and 46.5%, respectively; p= 0.003) and immunosuppression history (24% and 9.3%, respectively; p= 0.041). However, there was no significant relationship between candiduria and history of surgical intervention, diabetes mellitus and renal failure (p0.05). In conclusion, rate of candiduria might be reduced by judicious antibiotic use, by implementation of guidelines for urinary catheter use, care and maintenance, and shortening the duration of ICU and hospital stay.

Yalcin, Ata Nevzat/0000-0002-7243-7354; alvarez Moreno, carlos Arturo/0000-0001-5419-4494; Abouqal, Redouane/0000-0002-6117-4341; Salomao, Reinaldo/0000-0003-1149-4598; Leblebicioglu, Hakan/0000-0002-6033-8543; Medeiros, Eduardo A/0000-0002-6205-259X; Barahona G., Nayide/0000-0003-3559-6900; Consunji, Rafael/0000-0002-9854-3585; Rodriguez Ferrer, Marena Luz/0000-0002-8053-8454; Chatterjee, Sharmila/0000-0001-5905-1089; Kanj, Souha/0000-0001-6413-3396; Chatterjee, Sharmila/0000-0002-3890-8386; Mitrev, Zan/0000-0001-7859-8821; Unal, Necmettin/0000-0002-9440-7893 WOS: 000283842300009 PubMed: 21029008 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.

Nosocomial urinary tract infections (NUTI) which are usually in the first rank in health care associated infections, significantly influence mortality, morbidity, hospitalization period and cost. In this retrospective study, it was aimed to analyze the risk factors in NUTI and also to investigate the effect of urinary catheter application on the distribution of pathogens in patients with NUTI. The study included 1236 NUTI episodes in 1103 patients (age range: 18-95 years; 641 female, 462 male) between January 2000-December 2006. Diagnosis of NUTI was agreed according to CDC criteria. Asymptomatic UTI (urinary tract infection) and other UTIs were excluded and only symptomatic UTI was evaluated. Of NUTIs, 87.9% (1086/1236) were found to be associated with urinary catheter use. No statistically significant difference by means of age, gender and mean interval between admission date and date of determination of infection was determined between the two patient groups, with and without urinary catheter (p0.05). However, catheter associated NUTI development was statistically significantly higher in intensive care unit patients than patients in other wards (p0.001). Respiratory failure, unconsciousness, multiple trauma, surgery, central vascular catheter, tracheostomy, mechanical ventilation and peritoneal dialysis were observed more frequently in patients who developed catheter-associated NUTIs (p0.001). Escherichia coil was isolated in 23.6%, Candida albicans in 18% and non-albicans Candida spp. in 11% of the NUTI episodes. When all Candida species were taken into consideration, they were the most frequent causative agents of NUTI. C. albicans was the most frequent agent in catheter-associated NUTI and E. coli in non-catheter-associated NUTI, their isolation rates being statistically significant (p=0.007 and p=0.005, respectively). No statistically significant difference was detected in the distribution of the other organisms in the two study groups. These data revealed that in urinary tract infections Candida species have replaced the first rank which was occupied by E. coli previously.

To evaluate the in vitro effect of ertapenem, imipenem and meropenem in clinical isolates of extended-spectrum beta-lactamase (ESBL)-producing strains of Escherichia coli and Klebsiella pneumoniae.We studied 82 consecutive clinical isolates of ESBL-producing E. coli (n = 49) and K. pneumonia (n = 33) between February 2006 and September 2007. The minimum inhibitory concentration for each carbapenem was determined using the agar dilution method.Eighty two consecutive microorganisms from sterile sites were evaluated. A total of 48.8% of patients had a history of surgical intervention, 78.0% needed urinary catheterization, 57.3% required vascular access and 40.3% mechanical ventilation; and 70.7% had a history of ICU stay. High resistance rates were shown for both E. coli and K. pneumoniae against cefepime (81.7%), ciprofloxacin (50.9%), tetracycline (75.0%), co-trimoxazole (47.4%), and gentamicin (48.7%). In addition, most K. pneumoniae and E. coli isolates were susceptible to amikacin (78.3%) and piperacilline-tazobactam (91.5%). Meropenem and imipenem showed activity against 100% of the isolates. Ertapenem showed activity against 100% of K. pneumoniae isolates, against 95.9% of E. coli isolates and against 97.5% of the 82 ESBL-producing microorganisms. Two E. coli isolates showed ertapenem resistance.In recent literature, carbapenems were the most active antimicrobial agents against ESBL-producing Enterobacteriaceae, as in our study. This is the first study on the in vitro activity of ertapenem against ESBL-producing E. coli and K. pneumoniae conducted in Turkey. In view of the serious infections caused by ESBL-producing microorganisms, therapeutic interventions are still problematic in serious clinical conditions. Ertapenem may be a good choice for treatment, with the additional advantage of being a once a day regimen.

Health-related quality of life (HRQoL) during therapy was found to be improved in patients treated with peginterferon alpha-2a compared to patients receiving interferon alpha-2a. This study aimed to assess the effect of different pegylated interferon therapies used in the treatment of patients with chronic hepatitis C on HRQoL. Forty chronic hepatitis C patients were enrolled. 22 patients were given a combination of peginterferon alpha-2a plus ribavirin and 18 patients received a combination of peginterferon alpha-2b plus ribavirin for 48 weeks. Patients completed a Short Form-36 (SF-36) questionnaire at the start of treatment and at week 12, week 24 and week 48 of treatment and week 24 posttreatment to evaluate HRQoL. In conclusion, the effect of both combination treatments on quality of life was similar.

To determine the prevalence of extended-spectrum beta-lactamase (ESBL) producing Klebsiella pneumoniae (K. pneumoniae) and Escherichia coli (E. coli), risk factors of ESBL-producing strains and antimicrobial susceptibility pattern of ESBL-producing and non producing strains.The study took place at the Faculty of Medicine, Osmangazi University, Eskisehir, Turkey from March to November 2002. We evaluated 100 K. pneumoniae and 100 E. coli strains isolated from various clinical specimens, as well as the patients from whom these strains were isolated. The double-disk synergy test was performed on the isolates for the detection of ESBL. We visited the patients with a growth of E. coli or K. pneumoniae or both from their clinical specimens in their wards if they were hospitalized, while the outpatients with a growth of these microorganisms were evaluated from their hospital records.The prevalence of ESBL-producing K. pneumoniae was 47% and E. coli was found as 12%. The ESBL-producing isolate rates were 50% (14/28) in intensive care units, 36.1% (35/97) in wards and 13.3% (10/75) in outpatients. Foley catheter (p0.001), intravenous catheter (p0.001), central venous catheter (p=0.002), intubation (p0.001), surgery (p0.001) and mechanical ventilation (p=0.002) were found as the risk factors for the acquisition of E. coli and K. pneumoniae with ESBLs.In our study, the prevalence of ESBL-producing isolates was high. The results of the study suggest that an antimicrobial policy and early removal of interventional apparatus be of importance for the control of ESBL-producing K. pneumoniae and E. coli.