A prospective, multi-center study: factors related to the management of diabetic foot infections.

The Turkish Association of Clinical Microbiology and Infectious Diseases, Diabetic Foot Infections Working Group conducted a prospective study to determine the factors affecting the outcomes of diabetic foot infections. A total of 96 patients were enrolled in the study. Microbiological assessment was performed in 86 patients. A total of 115 causative bacteria were isolated from 71 patients. The most frequently isolated bacterial species was Pseudomonas aeruginosa (n = 21, 18.3%). Among cases with bacterial growth, 37 patients (43%) were infected with 38 (33%) antibiotic-resistant bacteria. The mean (±SD) antibiotics cost was 2,220.42 (±994.59) USD in cases infected with resistant bacteria, while it was 1,206.60 (±1,160.6) USD in patients infected with susceptible bacteria (p < 0.001). According to the logistic regression analysis, the risk factors related to the growth of resistant bacteria were previous amputation (p = 0.018, OR = 7.229) and antibiotics administration within the last 30 days (p = 0.032, OR = 3.796); that related to the development of osteomyelitis was wound size >4.5 cm(2) (p = 0.041, OR = 2.8); and that related to the failure of the treatment was the growth of resistant bacteria (p = 0.016, OR = 5.333). Diabetic foot osteomyelitis is usually a chronic infection and requires surgical therapy. Amputation is the accepted form of treatment for osteomyelitis. Limited limb-saving surgery and prolonged antibiotic therapy directed toward the definitive causative bacteria are most appropriate. This may decrease limb loss through amputations. As a result the infections caused by resistant bacteria may lead to a high cost of antibiotherapy, prolonged hospitalization duration, and failure of the treatment.

Food-borne tonsillopharyngitis outbreak in a hospital cafeteria.

OBJECTIVE: A food-borne tonsillopharyngitis outbreak was reported between 9th and 13th of February, 2008, in Söke State Hospital, Aydin, Turkey. METHODS: This descriptive cohort study was carried out immediately after the outbreak. In order to determine the probable origin, a questionnaire involving demographical features, clinical features, and possible risk factors was distributed to 403 persons. The participants of the questionnaire (n = 403) were divided into two groups: the study group (n = 252); those with any two of the following three complaints; sore throat, fever, and dizziness, and the control group (n = 151); those without these complaints. RESULTS: This investigation revealed that 252 people were affected by this outbreak. Group A ß-hemolytic streptococci were isolated from the throat cultures of 63 affected individuals (25%) and an employee working in the patisserie that made desserts served for lunch. Since the number of people who ate the milky dessert was statistically higher compared to the non-eaters, the milky dessert was thought to be the origin of the outbreak. CONCLUSIONS: We suggest that throat infections among employees working in food production may cause outbreaks of upper respiratory tract infections.