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

OBJECTIVE: To determine device-associated infection (DAI) rates, and the microbiological and antibiotic resistance profiles of infecting pathogens in our hospital. METHODS: 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. RESULTS: During the study period, 6,005 patients were followed-up in ICUs for a total of 46,355 patient-days. The total number of DAIs 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. CONCLUSION: 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 H1N1 influenza patients from Turkey. Risk factors for fatality.

OBJECTIVE: To evaluate the clinical characteristics and certain risk factors that may be associated with fatal outcome in patients with H1N1 influenza. METHODS: 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 H1N1 influenza were reviewed. RESULTS: 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 more than 38 degrees Centigrade (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. CONCLUSION: Timely identification and management of patients with higher risk for fatality may improve outcomes.