The intensity of antibiotic usage in the university hospital and the investigation of an inappropriate use of antibiotics.

AIMS: In the present study, we intended to investigate the intensity of antibiotic administration in our hospital and the ratio of an inappropriate antibiotic usage. MATERIAL AND METHOD: Related data was collected during 3 consecutive days between 1-3 July 2009 at the Mustafa Kemal University, Faculty of Medicine Hospital. The antimicrobial usage was calculated as defined daily doses (DDDs) per 100 bed-days (BD) according to 2009 ATC-DDD index. RESULTS: Antibiotics were administered to 74 patients (61.5%) out of 121 who were hospitalized in our hospital. Antibiotic usage in the internal clinics was intended for therapeutical reasons in 18 patients (94.7%) and for prophylactic reasons in 35 patients (77.8%) in the surgical clinics. The use of antibiotics in 44 patients (59.7%) out of 74 was appropriate. However, an inappropriate antibiotic use was detected in 30 patients (40.5%). The inappropriate antibiotics were administered to 21 patients (70%) who were hospitalized in the surgical clinics. A three days total antimicrobial consumption index value in the hospital was 81,19 DDD/100 BD, while this value was found 25,45 DDD/100 BD for the internal clinics and 38,39 DDD/100 BD for the surgical clinics. A positive correlation was observed among the inappropriate antibiotic usage and the antibiotic consumption (p<0.001). DISCUSSION: Consequently, the ratio of an inappropriate antibiotic usage in our hospital is high and parallel to this, the antibiotic consumption ratio is excessive. It is necessary to share microbiological data and provide an adequate education to reduce the antibiotic consumption and enable a better and rational antibiotic consumption (Tab. 2, Fig. 2, Ref. 22).

Nosocomial urinary tract infections: micro-organisms, antibiotic sensitivities and risk factors.

OBJECTIVE: Although urinary tract infections (UTIs) are the most common hospital-acquired infections, the epidemiology of these UTIs is not well defined in Turkey. The aim of this surveillance study was to determine micro-organisms responsible for UTI, their antibiotic sensitivities and to describe the incidence and risk factors of nosocomial urinary tract infections (NUTI). SUBJECTS AND METHODS: This was a prospective surveillance study including cases of NUTI in intensive care units and various inpatient clinics. This study was carried out between November 2000 and January 2002. The following information was recorded: patients' age, gender, type of infection (hospital-acquired), presence of urinary catheter, intensive care unit admission, duration of hospital stay, type of organisms isolated and their antimicrobial susceptibility. The diagnosis of NUTI was based on criteria established by the Centers for Disease Control, Atlanta. Mini Api and conventional culture methods were used to determine the causative agents. The agents were isolated on eosin methylene blue agar and 5% sheep blood agar Statistical analyses of data were by chi-square test and logistic regression. RESULTS: In this study, 618 (2.1%) nosocomial infections (NIs) were determined in 29,778 patients, and 178 of these infections were NUTI (28.8%, 178/618). The mean age of NUTI patients was 61.0 +/- 19.4 years (0-91 years) and 82 NUTI patients (46.1%) were male and 96 (53.9%) were female. The most frequently isolated micro-organism was Escherichia coli (31.4%) followed by Candida spp (21.3%), Klebsiella spp (10.6%) and Enterococcus spp (6.9%). Compared to the rate of other NIs, the rate of NUTI increased by 1.011 times per year of age, by 2.052 times in females and by 3.83 times in patients with urinary catheters (p < 0.05). The most effective antibiotics against Gram-negative bacteria were found to be imipenem and meropenem. CONCLUSIONS: Important factors to prevent NUTI are to avoid unnecessary urethral catheterization, to choose narrow spectrum antibiotics according to antibiotic sensitivities, to investigate regularly the causative micro-organisms and their resistance patterns and to update the treatment protocols.

Full recovered meningoencephalomyelitis caused by mumps virus.

Meningitis is the most common central nervous system complication of mumps virus, whereas encephalitis, cranial nerve palsies, poliradiculoneuritis are less common and myelitis caused by mumps virus is very rare [Nussinovitch et al., Acta Pediatrica (1992) 81, 183]. Lesions in young age as a result of severe acute transverse myelitis [shown on a magnetic resonance imaging (MRI) procedure] often has a viral cause. The case of a young male afflicted by meningoencephalomyelitis because of mumps virus is discussed.

Nosocomial urinary tract infections: micro-organisms, antibiotic sensitivities and risk factors / Infecciones nosocomiales del tracto urinario: microorganismos, sensibilidades antibióticas y factores de riesgo

OBJECTIVE: Although urinary tract infections (UTIs) are the most common hospital-acquired infections, the epidemiology of these UTIs is not well defined in Turkey. The aim of this surveillance study was to determine micro-organisms responsible for UTI, their antibiotic sensitivities and to describe the incidence and risk factors of nosocomial urinary tract infections (NUTI). SUBJECTS AND METHODS: This was a prospective surveillance study including cases of NUTI in intensive care units and various inpatient clinics. This study was carried out between November 2000 and January 2002. The following information was recorded: patients' age, gender, type of infection (hospital-acquired), presence of urinary catheter, intensive care unit admission, duration of hospital stay, type of organisms isolated and their antimicrobial susceptibility. The diagnosis of NUTI was based on criteria established by the Centers for Disease Control, Atlanta. Mini Api and conventional culture methods were used to determine the causative agents. The agents were isolated on eosin methylene blue agar and 5sheep blood agar Statistical analyses of data were by chi-square test and logistic regression. RESULTS: In this study, 618 (2.1) nosocomial infections (NIs) were determined in 29,778 patients, and 178 of these infections were NUTI (28.8, 178/618). The mean age of NUTI patients was 61.0 +/- 19.4 years (0-91 years) and 82 NUTI patients (46.1) were male and 96 (53.9) were female. The most frequently isolated micro-organism was Escherichia coli (31.4) followed by Candida spp (21.3), Klebsiella spp (10.6) and Enterococcus spp (6.9). Compared to the rate of other NIs, the rate of NUTI increased by 1.011 times per year of age, by 2.052 times in females and by 3.83 times in patients with urinary catheters (p < 0.05). The most effective antibiotics against Gram-negative bacteria were found to be imipenem and meropenem. CONCLUSIONS: Important factors to prevent NUTI are to avoid unneces...

OBJETIVO: Aunque las infecciones del tracto urinario (ITU) son las que con mayor frecuencia se adquieren en los hospitales, su epidemiología no se halla bien definida en Turquía. El objetivo de este estudio de vigilancia fue determinar los microorganismos responsables de la ITU, sus sensibilidades antibióticas, y describir la incidencia y los factores de riesgo de las infecciones del tracto urinario nosocomiales (ITUN). SUJEITOS Y MÉTODOS: Este fue un estudio prospectivo de vigilancia que incluyó casos de ITUN en unidades de cuidados intensivos y en varias clínicas de ingreso. El estudio se llevó a cabo entre noviembre de 2000 y enero de 2002. Se registró la siguiente información: edad del paciente, sexo, tipo de infección (adquirida en el hospital), presencia de catéter urinario, ingreso a la unidad de cuidados intensivos, duración de la estadía hospitalaria, y el tipo de organismo aislado así como su susceptibilidad antimicrobiana. El diagnóstico de ITUN se basó en criterios establecidos por los Centros de Control de Enfermedades, Atlanta. El sistema Mini Api y métodos de cultivo convencionales fueron usados con el propósito de determinar los agentes causantes. Los agentes causantes fueron aislados sobre agar-eosina-azul de metileno y agar sangre de oveja a 5%. El análisis estadístico de los datos se realizó usando la prueba de chi-cuadrado y regresión logística. RESULTS: En este estudio, se determinaron 618 (2.1%) infecciones nosocomiales (IN) en 29 778 pacien-tes, y 178 de estas infecciones resultaron ser INTU (28.8%, 178/618). La edad media de los pacientes de INTU fue 61.0 B1 19.4 años (0–91 años) y 82 pacientes de INTU (46.1%) fueron varones y 96 (53.9%) fueron hembras. El micro-organismo más frecuentemente aislado fue Escherichia coli (31.4%), seguido por Candida spp (21.3%), Klebsiella spp (10.6%) y Enterococcus spp (6.9%). En comparación con la tasa de otras IN, la tasa de INTU aumentó 1.011 veces por año de edad, 2.052 veces en las...