ABSTRACT
Introduction: Healthcare-associated infections have increased during the Coronavirus disease-2019 (COVID-19) pandemic because of inadequate adherence to infection control measures. Central line-associated bloodstream infections (CLBSI) are one of the infections with an increased incidence. In this study, CLBSI standardized infection ratio (SIRs) in three periods were compared, and the effect of the COVID-19 pandemic on CLBSI observed in intensive care units (ICUs) was evaluated. The hand hygiene compliance rates were also examined for the same period.Materials and Methods: The 3-year (2019, 2020, and 2021) SIR, standardized utilization ratio (SUR), and SIR change rates between years in 12 adult ICUs were compared. Calculations were made using the SIR and SUR calculation tool prepared by the General Directorate of Public Health of Turkey. The formula [(SIR/SUR of year Y-SIR/SUR of year X) / SIR/SUR x 100 of year X] was used when calculating the SIR/SUR change rates between periods.Results: In 2019 and 2020, SIR was detected as >1 only in the Burn ICU. Anesthesiology and Reanimation 1 and 2 and Internal Medicine 3 were the ICUs with the highest SIR increase rate in 2020. In 2021, the SIR was <1 in all units. In Anesthesiology and Reanimation 2, Internal Medicine 1 and 3, and Cardiovascular Surgery ICUs, the SUR was >1 in all periods. When the mean SIR values of ICUs between 2019, 2020, and 2021 were compared, the rate was significantly higher in 2020 (p<0.05). A significant increase was found in hand hygiene compliance in 2021 compared with previous years (p<0.05).Conclusion: With the COVID-19 pandemic, an increase in CLBSI-SIR was observed in 2020. In 2021, a decrease in CLBSI-SIR and an increase in hand hygiene compliance were achieved by gaining experience in the follow-up and treatment of patients with COVID-19, implementing infection control programs, and conducting on-site training and inspections.
ABSTRACT
Objective: The aim of this study was to investigate the impact of sex-specific genetic factors in the pathogenesis and prog-nosis of severe acute respiratory syndrome coronavirus 2 (SARS-CoV2)-induced macrophage activation syndrome (MAS), independent of age and comorbidity presence. Material(s) and Method(s): Patients aged 18-50 years who had been diagnosed with coronavirus 2019 (COVID-19), the disease caused by the SARS-CoV2 virus, were enrolled in a prospective, case-control, multi-center study. Genetic alterations and messenger RNA (m-RNA) expression levels of the TLR7, TLR8, ACE2, CD40L, CXCR3, and TASL genes were determined using DNA sequencing analysis, and gene expression was determined using quantitative reverse transcriptase polymerase chain reaction testing. PolyPhen-2 (Polymorphism Phenotyping v2;Adzhubei et al., 2010) and SNAP2 (Rostlab, Munich, Germany) genetic analysis tools were used to define the pathogenic effects of detected mutations by sequencing the selected genes in hotspot regions. Result(s): The study group consisted of 80 patients diagnosed with COVID-19 and was divided into groups based on sex and MAS status. Twenty-nine mutations were detected in 6 genes. Among the alterations, 15 were identified in this study for the first time and 9 were pathogenic. Pathogenic missense mutations in the TLR7, TLR8, ACE2, and TASL genes were detected in the MAS (+) group. In males, decreased TLR7, TLR8, and CXCR3 expression was statistically significant in the MAS (+) group (p<0.050). CXCR3 expression was lower in the female and male MAS (+) groups compared with the MAS (-) groups (p<0.050). Conclusion(s): In the absence of major risk factors for COVID-19, the TLR7/8, ACE2, and CXCR3 variants and decreased m-RNA expression levels associated with genetic susceptibility may be independent prognostic risk factors for COVID-19. Copyright © 2022 by Erciyes University Faculty of Medicine.