Ventilator-associated pneumonia in surgical emergency intensive care unit

To investigate the incidence, risk factors and the etiology of ventilator-associated pneumonia [VAP] in surgical emergency intensive care unit [ICU] patients. We conducted this prospective cohort study in the surgical emergency ICU of Istanbul Medical Faculty between December 1999 and May 2001. We included 100 mechanically ventilated patients in this study. We diagnosed VAP according to the current diagnostic criteria. We identified the etiology of VAP cases by both quantitative cultures of endotracheal aspiration and blood cultures. To analyze the predisposing factors for the development of VAP, we recorded the following variables: age, gender, acute physiology and chronic health evaluation [APACHE] II score, Glasgow coma scale [GCS], sequential organ failure assessment [SOFA] score, serum albumin level, duration of mechanical ventilation [MV] prior to the development of VAP, and underlying diseases. We determined the VAP incidence rate as 28%. We found the APACHE II score and the duration of MV to be statistically significant variables for the development of VAP. There were no significant differences regarding age, gender, GCS, SOFA score, albumin level, or underlying diseases for the development of VAP. The isolated bacteria among VAP cases were as follows: Staphylococcus aureus [n=12, 43%], Acinetobacter spp. [n=6, 21%], coagulase-negative Staphylococci [n=4, 15%], Pseudomonas aeruginosa [n=3, 10.7%] and Klebsiella pneumoniae [n=3, 10.7%]. Ventilator-associated pneumonia is a common infection, and certain interventions might affect the incidence of VAP. The ICU clinicians should be aware of the risk factors for VAP, which could prove useful in identifying patients at high risk for VAP, and modifying patient care to minimize the risk of VAP

Effect of preventive applications on prevalence of hepatitis B virus and hepatitis C virus infections in West Turkey

Hepatitis B virus [HBV] and hepatitis C virus [HCV] infections are community health problems in developing countries and the most common causative agents of chronic hepatitis, cirrhosis and hepatocellular carcinoma. This study investigates the prevalence and the effect of preventive applications on prevalence of HBV and HCV infections in blood donors. Blood donors enrolled to the University and State Hospital Blood Banks in Aydin region of Turkey through the years 1993 to 2002 were retrospectively analyzed. Blood donors were investigated in 2 groups, Group I [1993-1997] and Group II [1998-2002] to compare the prevalence difference in 10-years period. Serum hepatitis B antigen [HbsAg] and anti-HCV were tested by commercially available enzyme-linked immunosorbent assay kits and anti-HCV positive results were confirmed by recombinant immune blot assays HCV test. The prevalence of HBV and HCV infections was determined as 1.5% and 0.19% over the period 1993-2002. Although, the prevalence of HBV infection declined significantly in Group II [1.17%] in comparison with Group I [2.27%] [p<0.0001], there was no significant difference in both groups regarding HCV infection [p=0.238]. Preventive applications against blood transfusion related diseases succeed to decrease HBV infection significantly in West Turkey. Vaccination seems to be the most effective method to prevent hepatitis infection