An evaluation of a Stenotrophomonas maltophilia outbreak due to commercial arterial blood gas collection kit.

BACKGROUND: Stenotrophomonas maltophilia is a gram-negative bacterium that can cause hospital infections and outbreaks within hospitals. This study aimed to evaluate an outbreak of Stenotrophomonas maltophilia, caused by ready-to-use commercial syringes containing liquid lithium and heparin for arterial blood gas collection in a university hospital. METHODS: Upon detecting an increase in Stenotrophomonas maltophilia growth in blood cultures between 15.09.2021 and 19.11.2021, an outbreak analysis and a case-control study (52 patients for the case group, 56 patients for the control group) were performed considering risk factors for bacteremia. Samples from possible foci for bacteremia were also cultured. Growing bacteria were identified by matrix-assisted laser desorption ionization time-of-flight mass spectrometry. The genetic linkage and clonal relationship isolates were investigated with pulsed-field gel electrophoresis (PFGE) in the reference laboratory. RESULTS: In the case-control study, the odds ratio for the central venous catheter [3.38 (95% confidence interval [CI]: 1.444, 8.705 ; p = 0.006)], for surgery [3.387 (95% confidence interval [CI]: 1.370, 8.373 ; p = 0.008)] and for arterial blood gas collection history [18.584 (95% confidence interval [CI]:4.086, 84.197; p < 0.001)] were identified as significant risk factors. Stenotrophomonas maltophilia growth was found in ready-to-use commercial syringes used for arterial blood gas collection. Molecular analysis showed that the growths in the samples taken from commercial syringes and the growths from blood cultures were the same. It was decided that the epidemic occurred because the method for sterilization of heparinized liquid preparations were not suitable. After discontinuing the use of the kits with this lot number, the outbreak was brought under control. CONCLUSIONS: According to our results, disposable or sterile medical equipment should be included as a risk factor in outbreak analyses. The method by which injectors containing liquids, such as heparin, are sterilized should be reviewed. Our study also revealed the importance of the cooperation of the infection control team with the microbiology laboratory.

Health status, health behaviours and healthcare access of lesbian, gay, bisexual and transgender populations in Turkey.

BACKGROUND: Lesbian, gay, bisexual and transgender (LGBT) individuals experience many barriers to healthcare access and health disparities because of societal stigma, discrimination and homophobia by the community and healthcare providers. Therefore, this sexual minority group poses a risk for poor health status. AIMS: To determine the health status, health behaviours and healthcare access among LGBT individuals in Turkey. METHODS: The study was conducted on 140 self-identified LGBT individuals in Turkey between 11 April and 15 July 2016 as a descriptive, electronical survey design. Data were collected by questionnaire form, developed based on the researchers' review of the literature. RESULTS: The results of this study revealed that 65% of LGBT participants self-reported that their mental health status was 'poor/fair' while 69% of participants reported that their physical health was 'good/excellent'. Most of them had smoking (60%), using alcohol (76.3%) and did unprotected sex (55.3%) and reported disclosing their LGBT status to the healthcare provider (90.6%); 48.6% of participants thought that disclosing their LGBT status would affect their treatment. Barriers to healthcare access included disclosing LGBT status, societal stigma, negative attitude of healthcare provider, dissatisfaction with healthcare, and lack of health insurance and financial resources. CONCLUSIONS: These results can assist healthcare providers, especially nurses as critical members of this group, to serve LGBT individuals satisfactorily. Besides, it is expected that these results will shed light on new research.