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Abstract Background Herein, we analyzed the efficacy of main antibiotic therapy regimens in the treatment of healthcare-associated meningitis (HCAM). Materials/methods This retrospective cohort study was conducted in 18 tertiary-care academic hospitals Turkey, India, Egypt and Romania. We extracted data and outcomes of all patients with post-neurosurgical meningitis cases fulfilling the study inclusion criteria and treated with empirical therapy between December 2006-September 2018. Results Twenty patients in the cefepime + vancomycin-(CV) group, 31 patients in the ceftazidime + vancomycin-(CFV) group, and 119 patients in the meropenem + vancomycin-(MV) group met the inclusion criteria. The MV subgroup had a significantly higher mean Glasgow Coma Score, a higher rate of admission to the intensive care unit within the previous month, and a higher rate of antibiot herapy within the previous month before the meningitis episode (p 0.05) among the three cohorts. No regimen was effective against carbapenem-resistant bacteria, and vancomycin resulted in an EOT clinical success rate of 60.6% in the methicillin-resistant staphylococci or ampicillin-resistant enterococci subgroup (n = 34). Conclusions Our study showed no significant difference in terms of clinical success and mortality among the three treatment options. All regimens were ineffective against carbapenem-resistant bacteria. Vancomycin was unsuccessful in approximately 40% of cases involving methicillin-resistant staphylococci or ampicillin-resistant enterococci.

İşitsel peyzaj kavramı; mimari tasarım sürecinde, stüdyo tasarım sürecinin yapı sökümüyle yapılan deneyler ve yenilikçi tasarım çözümleri için yeni olanaklar yaratabilir. Algı önceliklerini değiştirmek (ses algısını görsel algıya tercih etmek) tasarım hakkında yeni düşünme ve bağ kurma biçimlerinin oluşması için yeni olasılıklar sağlayabilir. 2015 güz dönemi Anadolu Üniversitesi, Mimarlık Bölümü'nde, Mimari Tasarım Stüdyosu V dersimizde bu yaklaşım ve süreç deneyi gerçekleştirilmiştir. Yirmi üç kişilik öğrenci grubuna, önceden belirlenmiş kentsel alanların altı farklı, on beş dakikalık, binaural ses kayıtları, tek ve temel tasarım verisi olarak dağıtılmıştır. Öğrencilerden bu kayıtları dikkatli bir şekilde ve tekrar tekrar dinlemeleri; topoğrafya, yapı yoğunluğu, iklim koşulları, kullanıcıların demografik ve sosyo-ekonomik strüktürünü belirlemeleri, ve zaman alanına ait çıkarımlarda bulunmaları beklenilmiştir. Sonrasında, sadece duydukları ardından yarattıkları bu kendi kentsel alanlarına ait, ana tasarım problemini belirlemek üzere çalışmışlardır. Bu mimari tasarım stüdyo eğitimi denemesini önererek biz, temel maddesiz mimari elemanlardan olan sesin, yeni stüdyo ve tasarım süreçlerindeki etki ve olanaklarını araştırmaktayız.

Introduction: Carbapenem-resistant (CR) Klebsiella pneumoniae is one of the most common CR Enterobacteriaceae species and is resistant to many antibiotics. Generally, combined use of antibiotics is preferred during infections of these microorganisms. This study aimed to demonstrate the in vitro synergy between meropenem (MEM), fosfomycin (FOS), colistin (CS), and tigecycline (TGC) in CR-K. pneumoniae (Kp) strains. Materials and Methods: A total of 52 CR-Kp strains were included. MicroScan WalkAway (Beckman Culture) plus system were used to identify strains. Antibiotic susceptibilities of the isolates were detected in the MicroScan WalkAway device (Beckman Culture) using MicroScan Gram-negative panel type 44 (Beckman Culture), and the minimal inhibitory concentrations (MIC) of antibiotics and extended-spectrum beta-lactamases (ESBL) formation were detected. Synergy studies were performed by the microdilution checkerboard method. A fractional inhibitory concentration index was used to interpret the results. Results: Of 52 strains, 11 had only carbapenem (MEM) resistance. Twenty-three of strains were also resistant to FOS, 27 to CS, and eight to TGC. When antibiotic combinations were compared, MEM + FOS, MEM + CS, and CS + TGC showed the best synergy in our strains. By contrast, the lowest synergy was observed with MEM + TGC, and the difference was significant (p50% synergistic effect in these strains. Conclusion: This study showed that high FOS and CS resistance was also present in our CR-Kp strains. However, even in case of resistance to one or more of the antibiotics mentioned in this study, the results showed that, in combination with these antibiotics, especially MEM + FOS, MEM + CS, and CS + TGC, a significant amount of in vitro synergy can be achieved.

Recent advances in our knowledge of hepatitis C virus (HCV) molecular biology have enabled improvements in the efficacy and tolerability of HCV treatment, and in this regard many direct-acting antiviral (DAA) agents have been developed. These drugs target specific stages in the HCV life cycle. Phase 3 clinical trials have demonstrated treatment success rates of 90% with these drugs and their combinations, while real world data indicate a rate of 80-90%. In this review, the use of DAA drugs in the treatment of chronic HCV infection is reviewed in detail.

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