Evaluation of active microorganisms and antibiotic susceptibility in community-acquired intraabdominal infections in children.

BACKGROUND: In this study, we aimed to investigate the results of intraoperative culture and antibiogram in children who underwent surgery with the diagnosis of community-acquired intraabdominal infections (CA-IAIs) to determine the causative microorganisms and antibiotic susceptibility of the bacterial agents. METHODS: Antibiotic susceptibility of isolated bacteria was investigated with disk diffusion method according to EUCAST (European Committee on Antimicrobial Susceptibility Testing) suggestions directly from the patients' intraabdominal peritoneal fluid or tissues, aged <18 years. RESULTS: Bacterial growth was found in 17 (34%) of the blood cultures taken before the operation and 38 (76%) of the intraoperative abdominal cultures. According to the isolated strains; 44 (80%) were Gram-negative and 11 (20%) were Gram-positive, however, the most commonly isolated microorganisms were Escherichia coli (52.72%), Klebsiella pneumonia (14.54%), and Enterobacter cloacae (5.45%); extended-spectrum beta-lactamase (ESBL) resistance was detected in 12 of the Escherichia coli strains (41.38%) and the rates of ampicillin-sulbactam, ceftriaxone, and cefotaxime resistance were 43.2%, 40.9%, and 6.8%, respectively. CONCLUSION: In our study, ESBL-resistant gram-negative microorganisms in CA-IAIs presented as primary agents to be considered. Ampicillin-sulbactam, ceftriaxone and cefotaxime should not be preferred in the monotherapy of complicated CA-IAIs due to their high resistance rates, but they can be combined with aminoglycosides. Quinolones can be included in the treatment because of their low resistance rates. It is considered that routine intraoperative culture and evaluation of antibiotic susceptibility in complicated CA-IAIs will provide an insight into the outcomes of empirical treatment. KEY WORDS: Antimicrobial resistance, Intraabdominal infection, Surgery.

Evaluation of clinical and laboratory characteristics and factors affecting mortality in 500 hospitalized COVID-19 patients: A retrospective study.

OBJECTIVES: To evaluate the clinical and laboratory characteristics of COVID-19 patients admitted to Afyonkarahisar Health Sciences University, Afyonkarahisar, Turkey, and to determine the factors affecting mortality. METHODS: A total of 500 patients who were diagnosed with COVID-19 between 19th of March and 30th of September 2020 in Afyonkarahisar Health Sciences University, Faculty of Medicine, Pandemic Service, Afyonkarahisar, Turkey, were retrospectively investigated for this study. These individuals' prognoses, demographic, clinical, laboratory, and radiological information were examined and recorded retrospectively. Comparisons were carried out between the characteristics of patients with a prognosis of death and those who recovered. RESULTS: Of the 500 definite COVID-19 cases included in the study, 53.8% were male and the mean age was 57.6±15.1 (18-88 years). The most common comorbidities were hypertension and diabetes mellitus. A total of 45 (9%) patients developed mortality. Factors such as advanced age, male gender, shortness of breath, fever at admission, comorbid conditions such as hypertension, diabetes mellitus, cardiovascular diseases, lymphopenia, high C-reactive protein, high D-dimer, and high ferritin in the laboratory were found to be important risk factors for mortality. Treatments such as hydroxychloroquine, favipiravir, and lopinavir/ritonavir were not found to have lower mortality rates than one another. CONCLUSION: Considering these elements when assessing patients and adjusting the course of treatment according to the recommendations of the most recent guidelines may lower mortality.

Neurological symptoms and findings in COVID-19: a prospective clinical study.

OBJECTIVE: We sought to evaluate neurologic symptoms and findings in patients with COVID-19 infection hospitalized in a ward and intensive care unit (ICU). METHODS: This study was designed as a prospective study. Hospitalized COVID-19 rRt-PCR positive patients in the ward and ICU were included in the study. A 54-item questionnaire was used to evaluate the patients. Patients were examined within 3 hours of hospitalization. RESULTS: A total of 379 patients were included in the study. The mean age of the patients was 56.1 ± 17.8. 89 of the patients were in intensive care. At least one general symptom was recorded in 95.5% of patients. The most common neurologic symptoms were myalgia (48.5%), headache (39.6%), anosmia (34.8%), and dysgeusia (34%). Neurological symptoms in ICU patients were higher than in the ward. 53.6% of patients had comorbidities. DISCUSSION: This study indicated that the prevalence of neurological symptoms was very high in patients with COVID-19. The percentage of neurological symptoms and findings was higher in patients hospitalized in ICU.

[Evaluation of Healthcare Professionals in Contact with Patients Diagnosed with COVID-19 Detected Outside of the Pandemic Service in our Hospital]. / Hastanemizde Pandemi Servisi Disinda Saptanan COVID-19 Tanisi Alan Hastalarla Temasli Saglik Çalisanlarinin Degerlendirilmesi.

The "Coronavirus Disease 19 (COVID-19)" caused by "Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2)" is still active all over the world as a pandemia. It is reported that at least 7000 health care workers (HCW) had lost their lives due to COVID-19 from the beginning of the pandemia till September 2020 in the world. In our country between the dates, March 11, 2020 which the first case was reported, and September 1, 2020, the date which our study has been finalized, 7428 HCW were infected by SARS-CoV-2, and 52 of them were deceased. In this study, it was aimed to evaluate the contact and illness of healthcare workers working outside of the pandemic clinics in our hospital and to examine the possible transmission routes and disease prognoses. Healthcare workers who were working outside the pandemic service between March 11, 2020 and September 1, 2020 and who had a definite diagnosis of COVID-19 and all hospital staff who had contacted with these people, and HCW who had contact with patients diagnosed with COVID-19 while receiving inpatient treatment in services other than the pandemic service was evaluated and classified as low, medium and high risk according to the risk scoring defined in the published "Ministry of Health COVID-19 Guidelines". Healthcare workers who were evaluated as contacted were questioned in detail regarding the use of personal protective equipment (PPE) at the time of contact, especially suitability of the masks, contact time and shape and all the data were recorded. A total of 53 index cases (40 HCW and 13 inpatients diagnosed as COVID-19) were detected during the study period. The number of HCW contacted with these index cases was 672. In our study, we examined the data of 40 index cases and 672 contacted HCW (total of 712 HCW). Only 3 of 40 index cases (7.5%) had hospital-acquired COVID-19 infection, the other 37 cases were infected by community sources. COVID-19 was not detected in 94.2% of the contacted HCW during the follow-up while 5.8% of them had positive PCR test results. Considering the possible way of contamination among the contacted HCW who developed COVID-19 during the follow-up period, it was determined that 13.1% of the cases were a result of taken care of patients, 86.9% of the cases were a result of being in hospital social environments (drinking tea, smoking, eating, chatting in the same room without personal precautions) and in the days after the contact, it was in the form of contact with healthcare personnel diagnosed with COVID-19. When the contacted HCW were questioned about using proper masks at the time of contact, we determined that 93.3% of them used masks during patient caring procedures, however, only 48.9% used masks when they were in social areas (p<0.001). Healthcare workers face an unprecedented risk of occupational disease and death due to the COVID-19 pandemic. However, it is also observed that prolonged pandemia period caused health workers to disregard rigorous infection control precautions in social areas of hospitals which they follow inpatient care although this has shown to be the most common way of contamination. Commonly performed in-service training and causing awareness in all areas of the hospital about following infection control precautions and PPE usage and checking the process regularly are the most important ways to prevent HCW from being affected by COVID-19.

Evaluation of Patients with Cystic Echinococcosis.

OBJECTIVE: Cystic echinococcosis (CE) is a globally prevalent zoonotic disease. METHODS: Demographic, clinical, laboratory, and follow-up data of patients between May 2009 and 2015 were retrospectively analyzed by screening data from a hospital automation system. RESULTS: A total of 238 (females, n=139 and males, n=99) patients with a mean age of 40.6±20.58 years were included. Less than half (40.8%) of the patients were living in the countryside. Hepatic involvement of CE was most frequently (72.2%) seen. A majority (75.6%) of the patients were symptomatic, but abdominal pain was the most frequently seen symptom. For diagnosis, in all patients, imaging modalities were used, while in 66% of the patients, serological methods were also employed. The patients received both medical and surgical treatments (78.5%, n=187), only surgical treatment (10.5%, n=25), or only medical treatment (8.8%, n=21). Surgical treatment was performed for patients with hepatic (n=139/176, 80.6%), pulmonary (n=78/94, 82.9%), splenic (n=7/9; 77.7%), and mesenteric (n=6/7, 85.1%) cysts, and patients cases with brain, bone, muscle, omentum, bladder, and adrenal cysts had undergone surgical intervention. CONCLUSION: Publication of regional data is important in terms of epidemiological considerations and may aid in the formulation of standard treatment approaches.

Assessment of the Frequency of Autoantibodies in Chronic Viral Hepatitis.

OBJECTIVE: To examine the occurrence frequency of auto-antibodies and autoimmune diseases in patients with chronic hepatitis B or C. METHODS: A total of 67 patients diagnosed with chronic hepatitis B and 77 patients diagnosed with chronic hepatitis C infection based on HBs Ag, Anti HCV, HBe Ag, Anti HBe Ag, HBV DNA, HCV RNA, liver ultrasound, and liver biopsy results as well as 48 healthy individuals were included in this study. ANA, anti dsDNA, anti LKM, Anti-SMA, AMA, C-ANCA, P-ANCA, anti-SSA, anti-SSB, anti-Scl-70, anti Jo-1, anti-U1snRNP, anti-centromere, anti-Jo-1, anti tpo, and anti tg were studied in all individuals in each study group. RESULTS: ANA positivity was detected in 8 (12%), 15 (19%) and 2 (4%) individuals in HBV, HCV and control groups, respectively. The difference between the groups was significant (P=0.04). Similarly, anti Tg was positive in one subject in HBV group, in 6 subjects (7%) in HCV group, and in one subject among controls, the difference being significant (P=0.04). There were no significant differences between the study groups in the frequency of other auto-antibodies. CONCLUSION: Similar to studies involving patients who received interferon and/or antiviral agents, an increased frequency of auto-antibodies was also detected in our patient group consisting of interferon and anti-viral naive subjects. The increase in the frequency of auto-antibodies reached statistical significance among individuals with HCV infection. Thus, pre-treatment assessment of auto-antibodies in newly diagnosed cases of chronic hepatitis B or hepatitis C infection may provide beneficial information on the future occurrence of auto-immune responses in these patients.