ABSTRACT
Background@#Fungal pneumonia is a common infectious complication of hematological cancer (HC) patients. In this retrospective study, the objective was set to identify the risk factors and outcome of fungal pneumonia in adult HC patients. @*Materials and Methods@#This retrospective study was conducted with adult (>16 years) HC patients from January 2017 and December 2018. @*Results@#During the study period, of 181 patients included 76 were diagnosed with fungal pneumonia. The most common HC was identified as acute myeloid leukaemia (40%). Of the participating patients, 52 (29%) were hematopoietic stem cell transplant (HSCT) recipients.The median age of patients with fungal pneumonia was significantly greater: 57 vs. 48 (odds ratio [OR]: 1.08) and they had longer hospitalization durations (OR: 1.14). Overall, 37 patients (20%) died, and 28-day mortality was significantly greater among patients with fungal pneumonia than without fungal pneumonia (33% vs. 11%). The most significant risk factors for mortality in fungal pneumonia were identified as need of intensive care unit (ICU) (OR: 191.2, P <0.001) and the need of vasopressor support (OR:81.6, P <0.012). ICU-mortality was (88%). @*Conclusion@#Fungal pneumonia is a lethal complication in HC patients. Intensive care need is the most important predictive factor for mortality.
ABSTRACT
Background@#Fungal pneumonia is a common infectious complication of hematological cancer (HC) patients. In this retrospective study, the objective was set to identify the risk factors and outcome of fungal pneumonia in adult HC patients. @*Materials and Methods@#This retrospective study was conducted with adult (>16 years) HC patients from January 2017 and December 2018. @*Results@#During the study period, of 181 patients included 76 were diagnosed with fungal pneumonia. The most common HC was identified as acute myeloid leukaemia (40%). Of the participating patients, 52 (29%) were hematopoietic stem cell transplant (HSCT) recipients.The median age of patients with fungal pneumonia was significantly greater: 57 vs. 48 (odds ratio [OR]: 1.08) and they had longer hospitalization durations (OR: 1.14). Overall, 37 patients (20%) died, and 28-day mortality was significantly greater among patients with fungal pneumonia than without fungal pneumonia (33% vs. 11%). The most significant risk factors for mortality in fungal pneumonia were identified as need of intensive care unit (ICU) (OR: 191.2, P <0.001) and the need of vasopressor support (OR:81.6, P <0.012). ICU-mortality was (88%). @*Conclusion@#Fungal pneumonia is a lethal complication in HC patients. Intensive care need is the most important predictive factor for mortality.
ABSTRACT
In this study, we aimed to evaluate the incidence and economic burden of prosthetic joint infections [PJIs] in a university hospital in a middle-income country. Surveillance data between April 2011 and April 2013 in the Orthopedic Surgery Department was evaluated. Patients [>16 years old] who had primary arthroplasty in Erciyes University were included in the study, and patients with preoperative infection were excluded. Patients were followed up during their stay in the hospital and during readmission to the hospital for PJI by a trained Infection Control Nurse. During the study period, 670 patients were followed up. There were 420 patients [62.7%] with total hip arthroplasty [THA], 241 [36.0%] with total knee arthroplasty [TKA] and 9 [1.3%] with shoulder arthroplasty [SA]. The median age was 64, and 70.6% were female. The incidence of PJI was 1.2% [5/420] in THA, 4.6% [11/241] in TKA and 0% [0/9] in SA. PJI was significantly more prevalent in TKA [p = 0.029]. All of the PJIs showed early infection, and the median time for the development of PJI was 23.5 days [range 7-120 days]. The median total length of the hospital stay was seven times higher in PJI patients than patients without PJI [49 vs. 7 days, p = 0.001, retrospectively]. All hospital costs were 2- to 24-fold higher in patients with PJI than in those without PJI [p = 0.001]. In conclusion, the incidence and economic burden of PJI was high. Implementing a national surveillance system and infection control protocols in hospitals is essential for the prevention of PJI and a cost-effective solution for the healthcare system in low-middle-income countries
ABSTRACT
The aim of this study is to determine the risk factors for percutaneous and mucocutaneous exposures in healthcare workers [HCW] in one of the largest centers of a middle income country, Turkey. This study has a retrospective design. HCWs who presented between August 2011 and June 2013, with Occupational Exposures [OEs] [cases] and those without [controls] were included. Demographic information was collected from infection control committee documents. A questionnaire was used to ask the HCWs about their awareness of preventive measures. HCWs who work with intensive work loads such as those found in emergency departments or intensive care units have a higher risk of OEs. Having heavy workloads and hours increases the risk of percutaneous and mucocutaneous exposures. For that reason the most common occupation groups are nurses and cleaning staff who are at risk of OEs. Increasing work experience has reduced the frequency of OEs
ABSTRACT
A structured questionnaire was administered to health-care workers [HCWs]. The HCWs were also screened for measles, rubella, mumps, and varicella [MMRV] using serological methods. One thousand two hundred and fifty-five HCWs were tested. Of the HCWs examined, 94% were immune to measles, 97% to rubella, 90% to mumps and 98% to varicella. The positive predictive values of histories of measles, mumps, rubella and varicella were 96%, 93%, 100% and 98%, respectively. The negative predictive values of histories of measles, mumps, rubella and varicella were 13%, 17%, 5% and 2%, respectively. The cost of vaccination without screening was significantly more expensive [cost difference: 24,385] for varicella, although vaccination without screening was cheap [cost difference: 5693] for MMR. Although the use of cheaper vaccines supports the implementation of vaccination programs without screening, the cost of vaccination should not be calculated based only on the direct costs. The indirect costs associated with lost work time due to vaccination and its side effects and the direct costs of potential side effects should be considered. However, if prescreening is not conducted, some HCWs [2-7%] would be unprotected against these contagious illnesses because of the unreliability of their MMRV history. In conclusion, the screening of HCWs before vaccination continues to be advisable