Hepatitis A seroprevalence in children and young adults in Istanbul, Turkey: seroprevalence change and associated factors.

Hepatitis A is a widespread infectious disease. The prevalence of the disease is closely related to socioeconomic status (SES) and environmental factors. Understanding its prevalence is essential for instituting appropriate precautions. The aim of this study was to determine the prevalence of hepatitis A and evaluate the associated demographic features in children and young adults in Istanbul. In total, 630 individuals between the ages of 5-24 were included in the study. They were classified into four age groups (5-9, 10-14, 15-19 and 20-24 years). The seropositivity of hepatitis A in the whole study population was 40%. Age-specific prevalence was 11.4% in children 5-9 years old, 29% in those 10-14 years old, 49.7% in those 15-19 years old and 69% in those 20-25 years old. Seropositivity was associated with increasing age, low SES, large family size, low maternal educational level, use of unsafe drinking water and living in regions with poor infrastructure and incomplete urbanization. When we compared our results with previous seroprevalence studies performed in Istanbul, we found an epidemiological shift towards increasing age. Factors associated with changes in prevalence were urbanization and associated infrastructure improvement, knowledge of the disease by the population, use of good hygiene and use of vaccination in those at high risk.

Bloodstream infections in a medical-surgical intensive care unit: incidence, aetiology, antimicrobial resistance patterns of Gram-positive and Gram-negative bacteria.

In the present study, the incidence and antimicrobial resistance patterns of the microorganisms that caused bloodstream infections (BSIs) in a medical-surgical intensive care unit during the years 2005-2007 were determined. The mean BSI incidence density was 6.56 per 1000 patient-days. The incidence density increased linearly during the study period (from 3.57 to 9.60 per 1000 patient-days). Staphylococcus aureus was most frequently isolated (47.3%), followed by Enterococcus spp. (10.8%) and Candida spp. (10.1%). There was a high rate of resistance to several of the prescribed antimicrobials among the bacteria isolated from patients with BSIs.

Bacterial brain abscesses: prognostic value of an imaging severity index.

AIM: To assess the correlation between imaging findings [computed tomography (CT) or magnetic resonance imaging (MRI)] and neurological status before and after the treatment of bacterial brain abscesses. MATERIALS AND METHODS: CT and MRI images of 96 patients with brain abscesses were retrospectively evaluated in terms of the number, location and size of lesions, and the presence and extent of perilesional oedema and midline shift. An imaging severity index (ISI) based on these different radiological parameters was calculated. Initial Glasgow Coma Scale (GCS) scores and ISI were assessed and the prognostic value of these two indices was calculated. The Pearson correlation test, Mann-Whitney test, Chi-square test, receiver-operating characteristic (ROC) analysis, together with comparison of ROC analyses and Fisher's exact test were used. RESULTS: There was a negative correlation between ISI and the initial GCS values: ISI increased as the GCS score decreased, indicating an inverse relationship (r=-0.51, p<0.0001). There was a significant difference between the ISI and GCS scores of patients with an adverse event compared with patients with good recovery. Outcome was significantly worse in patients with initial ISI over the calculated cut-off values of 8 points or GCS scores under the cut-off value of 13 points. CONCLUSION: ISI is a useful prognostic indicator for bacterial brain abscess patients and correlates strongly with the patient outcome for all parameters studied. ISI score had a better prognostic value than GCS.

[Bacteriological examination of paper money]. / Kagit paralarin bakteriyolojik incelenmesi.

Bacteriological survey of one hundred twenty currency notes was done. Aerobic spore-forming bacilli (91%), Staphylococcus epidermidis (63.3%), Staphylococcus aureus (4.2%), Enterococcus (24.1%), alpha-hem. streptococcus (4.1%), Streptococcus pneumoniae (1.7%), Corynebacterium (7.5%), Lactobacilli (10.8%), Klebsiella pneumoniae (31.7%), Enterobacter (19.2%), E. coli (17.5%), Proteus (1.7%), Pseudomonas aeruginosa (0.8%), Shigella flexneri (0.8%) were isolated from paper money samples. Currency notes in general were bacteriologically contaminated especially with enteric pathogens and potentially pathogens, it was thought that some measures have to be taken to reduce these ill effects.

[The effectiveness of various disinfection methods on the surface of gloved hands]. / Eldivenli eller üzerine çesitli denzenfeksiyon yontemlerinin etkinligi.

The gloved hands were contaminated by using E.coli and Pseudomonas aeruginosa Brain Heart Infusion broth cultures and the efficacy of tap water, unmedicated bar soap, benzalkonium chloride 1% (Zefiran), Na-hypochloride 1% and 5%, alcohol 70%, hexachlorophene 3%, hexachlorophene 3% liquid soap (Solu-heks), chlorhexidine 1.5% liquid soap (Savlon), chlorhexidine 4% liquid soap (Hibiscrub), povidone-iodine 10% solution (Betadine and polyod), povidone-iodine 7.5% liquid soap (Betadine and Polyod) were compared onto the gloved hands. Disinfectants were applied for 30, 45 and 60 seconds. It was found that washing time of 30 seconds with chlorhexidine 4% (Hibiscrub) liquid soap or povidone-iodine 7.5% liquid soap (Betadine and Polyod) was required to eradicate all the organisms inoculated from both glove surfaces. Povidone-iodine and chlorhexidine were more effective washing agents than the other disinfectants. In underdeveloped or developing countries and areas where gloves can not easily supplied, it has been suggested that gloved hands could be washed between patient treatments and gloves re-used in dentistry, gynecology and like the other areas of medicine. Chlorhexidine 4% and povidone-iodine 7.5% liquid soaps are recommended as a hand-washing agents in these areas.