The association between Acinetobacter baumannii infections and the COVID-19 pandemic in an intensive care unit.

We aimed to describe the increased rate of Acinetobacter baumannii infections during the COVID-19 pandemic and define its significance within the last five years. This study was performed in a tertiary hospital with 280 beds and included all patients infected with A. baumannii in the intensive care unit between January 1, 2018, and June 30, 2022. A. baumannii-infected patients in the intensive care unit 27 months before the pandemic and 27 months during the pandemic were included. Pulsed-field gel electrophoresis was performed to assess clonal relatedness. The infection control measures were specified based on the findings and targeted elimination. In total, 5718 patients were admitted to the intensive care unit from January 1st, 2018, to June 30th, 2022. A. baumannii infection was detected in 81 patients. Compared to the pre-pandemic era, the rate of A. baumannii infection during the pandemic was 1.90 times higher (OR: 1.90, 95% CI: [1.197, 3.033]). Clonality assessment of multidrug-resistant A. baumannii samples revealed eight clusters with one main cluster comprising 14/27 isolates between 2021 and 2022. The case fatality rate of the pre-pandemic and pandemic era was not different statistically (83.33% vs. 81.48%, p = 0.835). Univariate analysis revealed the association of mechanical ventilation (p = 0.002) and bacterial growth in tracheal aspirate (p = 0.001) with fatality. During the COVID-19 pandemic, potential deficits in infection control measures may lead to persistent nosocomial outbreaks. In this study, the introduction of enhanced and customized infection control measures has resulted in the containment of an A. baumannii outbreak.

Evaluation of Factors That Affect COVID-19 Infection in Turkish Society.

AIM: The study aims to determine the risk factors that affect coronavirus-2019 infection in Turkey. METHOD: This descriptive study was performed between October 18, 2020, and November 18, 2020. The online link of the form created on Google forms was sent to the participants' phones. Totally 1104 individuals from different regions of Turkey participated. Logistic regression analysis was performed to detect risk factors of coronavirus-2019 infection. RESULTS: Most of the participants were women and university graduates. All participants except one wore masks, 96.8% paid attention to social distance, and 57.8% did not use public transportation. Of the participants, 9.8% (n = 108) were diagnosed with coronavirus-2019 and 41.5% (n = 458) had a coronavirus-2019-positive relative. The infection risk was higher for those who lived in the Marmara region, who went to work daily (odds ratio = 2.18; 95% CI: 1.18-4.04), who had a coronavirus-2019-positive patient where they lived (odds ratio = 3.44; 95% CI: 1.95-6.05), and who shared items with a coronavirus-2019-positive patient (odds ratio = 4.76; 95% CI: 2.64-8.58). CONCLUSION: Sharing items with a coronavirus-2019-positive patient, living in crowded regions, and going to work daily were the main risk factors of coronavirus-2019 infection in Turkish society.

Intensive and Critical Care Nursing of a COVID-19 Patient in Turkey: A Case Study.

BACKGROUND: A multidisciplinary approach is required to provide holistic care and treatment in the fight against the COVID-19 pandemic. Being in the center of the multidisciplinary approach, nurses provide therapeutic, primary, and psychosocial care for the patients. OBJECTIVES: This study was conducted to diagnose according to the North American Nursing Diagnosis Associations by determining the care needs of a case who was diagnosed with COVID-19, planning interventions, and observing the results. METHODS: This descriptive case study included a patient who applied to a university hospital located in Istanbul/Turkey between March and April 2020 because of COVID-19. As the inclusion criteria, only a positive result from a polymerase chain reaction test was accepted. The details of the patient presented in the study were obtained through face-to-face interviews and electronic medical records. DISCUSSION: Specified care plans enable defining problems in practice for all needs of the individual and developing solution recommendations. It was observed that there were improvements and a decrease in symptom severity after the interventions were applied for the symptoms developing in the case. The execution of the treatment and care practices under quality and effective nursing care such as giving proper ventilatory support at the right time, giving prone position for a long time, and providing sufficient fluid resuscitation and an early and balanced diet contributed to the patient's discharge from the intensive care unit successfully without having any organ dysfunction. This presentation is expected to be a source for collaborative nursing care for other cases diagnosed with COVID-19 and intensive care indications. CONCLUSIONS: Nursing care interventions were applied for gas exchange, risk of decreased tissue perfusion, excess fluid volume, and constipation nursing diagnosis. It was observed that there were improvements and a decrease in symptom severity after the interventions were applied for the symptoms developing in the case. This presentation is expected to be a source for collaborative nursing care for other cases diagnosed with COVID-19 and intensive care indications.

Evaluation of the caregiving roles and attitudes of nurses during the COVID-19 pandemic.

BACKGROUND: Nurses play a critical role in providing care to patients, in particular, they work in the frontlines in caring for patients with complicated COVID-19 requiring hospitalization. Evaluation of the caregiving roles and attitudes of nurses is critical in the current crisis. Therefore, this study aimed to determine the caregiving roles and attitudes of nurses during the COVID-19 pandemic. METHODS: A quantitative descriptive study was performed with 130 nurses in Turkey. The attitude scale for the caregiving roles of nurses (ASCRNs) was used to collect data. We conducted an online survey between May and November 2020. RESULTS: The mean total score of the participants on the ASCRN was 62.20 ± 18.42. All nurses stated that they were affected by the COVID-19 pandemic. The ASCRN scores of nurses who received training about the COVID-19 pandemic and who thought that the personal protective equipment they used was sufficient had statistically higher scores on the ASCRN (p < .05). CONCLUSION: The results of this study suggested that the COVID-19 pandemic had a negative effect on the caregiving roles and attitudes of the nurses.

Risk Groups for SARS-CoV-2 Infection among Healthcare Workers: Community Versus Hospital Transmission.

BACKGROUND: We aimed to detect the risk factors for SARS-CoV-2 infection among healthcare workers (HCWs) in 2020 before the vaccination era. METHODS: We surveyed SARS-CoV-2 infection among the HCWs in a hospital through screening for antibody levels and the detection of viral RNA by RT-PCR between May 2020 and December 2020. Occupational and non-occupational potential predictors of disease were surveyed for the HCWs included in this study. RESULTS: Among 1925 personnel in the hospital, 1732 were included to the study with a response rate of 90%. The overall infection rate of HCWs was 16.3% at the end of 2020, before vaccinations started. In the multivariate analysis, being janitorial staff (OR: 2.24, CI: 1.21-4.14, p = 0.011), being a medical secretary (OR: 4.17, CI: 2.12-8.18, p < 0.001), having at least one household member with a COVID-19 diagnosis (OR: 8.98, CI: 6.64-12.15, p < 0.001), and number of household members > 3 (OR: 1.67, CI: 1.26-2.22, p < 0.001) were found to be significantly associated with SARS-CoV-2 infection. CONCLUSIONS: Medical secretaries and janitorial staff were under increased risk of SARS-CoV-2 infection. The community-hospital gradient can explain the mode of transmission for infection among HCWs. In the setting of this study, community measures were less strict, whereas hospital infection control was adequate and provided necessary personal protective equipment. Increasing risk in larger households and households with diagnosed COVID-19 patient indicates the community-acquired transmission of the infection.