Device-associated infection rates and bacterial resistance in the intensive care units of a Turkish referral hospital

To determine device-associated infection [DAT] rates, and the microbiological and antibiotic resistance profiles of infecting pathogens in our hospital. Prospective surveillance of healthcare-associated infections was performed from January 2007 to March 2010 in 4 different intensive care units [ICUs] of SB Diskapi Yildirim Beyazit Training and Research Hospital, Ankara, Turkey. During the study period, 6,005 patients were followed-up in ICUs for a total of 46,355 patient-days. The total number of DATs was 969. Catheter-associated urinary tract infection [CAUTI] was the most common DAI [55.3% of DAIs; 11.9 cases per 1000 catheter-days], followed by ventilator-associated pneumonia [VAP] [38.9% of DAIs; 21.2 cases per 1000 ventilator-days], and central line-associated blood stream infection [CLABSI] [5.8% of DAIs; 2.8 cases per 1000 central line-days]. The most frequently isolated pathogens in patients with VAP were Acinetobacter species [24.5%] and Escherichia coli in CAUTI [24.2%]. Coagulase negative Staphylococci and Candida species were the leading pathogens in patients with CLABSI. We observed considerably high rates of VAP and CAUTI and a high rate of CLABSI in our ICUs when compared with the National Healthcare Safety Network data. These findings emphasize the need to improve infection control practices and management of invasive device use in our hospital

Clinical characteristics of 74 pandemic HlNl influenza patients from Turkey. Risk factors for fatality

To evaluate the clinical characteristics and certain risk factors that may be associated with fatal outcome in patients with HlNl influenza. This retrospective study was conducted between October and December 2009 in the Department of Infectious Diseases and Clinical Microbiology, SB Diskapi Yildirim Beyazit Training and Research Hospital, Ankara, Turkey. Data regarding the epidemiological and clinical characteristics of 74 hospitalized cases of confirmed pandemic HlNl influenza were reviewed. The median age was 49 [18-83] years, and 34 [46%] were males. The most common symptom and signs on admission were cough [91.9%] and fever >38°C [71.7%]. More than two-thirds of patients [68.9%] had at least one underlying condition; most frequently chronic respiratory disease, including asthma and diabetes. Seventy-seven percent had evidence of pneumonia on their chest x-rays at presentation. Of the 74 cases, 16 [21.6%] were followed up in the Intensive Care Unit, and 10 [13.5%] died. Obesity and oxygen saturation below 92% at the time of admission were found to be significantly related with fatal outcome. In addition, fatal patients had significantly higher levels of alanine aminotransferase [ALT], aspartate aminotransferase [AST], lactate dehydrogenase [LDH], urea, creatinine, d-dimer on admission and prothrombin time [PT], activated partial thromboplastin time, and the international normalized ratio [INR] was longer. Timely identification and management of patients with higher risk for fatality may improve outcomes

long-term hunger [Ramadan model] a risk factor for acute appendicitis?

To investigate whether long-term hunger and the changes in nutritional routines during Ramadan constitute risk factors in acute appendicitis on the model of Ramadan fasting in this study. This retrospective study was carried out in 2 different hospitals [Istanbul Haydarpasa Numune Training and Research Hospital and Kars State Hospital, Kars, Turkey] between January 2004 and December 2007. The data obtained from the patients were classified according to age, gender, age group, and pathological characteristics of the appendix. The data obtained during the Ramadan fasting period was compared with the periods before and after. Nine hundred and ninety-two of the 4288 patients who received a diagnosis of acute appendicitis during the 4 years received their diagnosis during the 3 periods. Three hundred sixty-eight [37.1%] patients underwent surgery before Ramadan, 318 [32.1%] during, and 306 [30.8%] after. No significant difference was observed in terms of perforated and non-perforated AA frequency, age, age group, and gender [p>0.05]. There are changes in the nutritional routines during the Ramadan fasting period due to long-term hunger; and limitations were seen in the fluid and food intake. We detected that these changes did not constitute risk factors for acute appendicitis formation as a result of our study

rare case of distal one-third of the transverse colon supplied by a branch from splenic artery

We observed a rare variation of splenic artery during the routine dissection in the Laboratory of the Anatomy Department. It arose from the splenic artery toward the distal part of transverse colon which typically supplied by the inferior mesenteric artery. Embryologically distal part of the transverse colon is a segment of hindgut In this case splenic artery which an artery of foregut supplies an area of hindgut. The knowledge of splenic artery variations has significant importance during surgery of the organs of the upper abdominal region. In this study, we discussed clinical significance and embryological aspects of this anomalous artery