Tosun, Mustafa; Binay, Umut Devrim; Akyüz, Sumeyye; Ölmez, Hasan; Karakeçili, Faruk

Introduction: Intensive care units are units where healthcare associated infections (HAIs) are most common. Hand hygiene plays a critical role in preventing HAIs. We divided the patients hospitalized in Erzincan Binali yildirim University Faculty of Medicine, Chest Diseases Intensive Care Unit (ICU) into two groups as before and after COVID-19 pandemic. In our study, it was aimed to measure the effect of hand hygiene compliance, which increased in healthcare workers with the pandemic on culture results and to emphasize the importance of hand hygiene. Materials and Methods: Patients were examined in two groups in 4-month periods. The period between 15 November, 2019-15 March, 2020 was considered as before COVID-19 and between March 16, 2020 and 15 July, 2020 as after COV1D-19. The number of cultures taken from these patients and the agents isolated were determined, and according to the number of cultures taken, the change in growth rate, resistance rates, length of stay in intensive care unit, intubation days and mortality rates were compared. Results: There were 40 females (46.5%) and 46 males (53.5%) in the Pre-Pandemic (Prep) group, and mean age was 71.5 +/- 14.8 years. In the Post-Pandemic (PostP) group, there were 38 females (38.8%) and 60 males (61.2%) with a mean age of 72.6 +/- 14.8 years. The agent was reproduced in 128 (21%) of a total of 605 cultures taken from 86 patients in the PreP group, and in 31 (10.2%) of a total of 304 cultures from 98 patients in the PostP group. When the two groups were compared in terms of the number of cultures, the number of agent-isolated cultures and the percentage of growth according to the cultures, all parameters in the PreP group were found to be significantly higher than the PostP group (p< 0.001, p= 0.002, p= 0.001, respectively). Conclusion: As a result, for whatever reason, it is thought that the increase in hand hygiene compliance may have resulted in a decrease in active microorganisms in the cultures and indirectly in the decrease in HAls. For this reason, the first step to be taken in order to prevent multi-drug resistant (MDR) infections, especially in intensive care units, is to ensure hand hygiene compliance of healthcare workers.

Türken, Melda; Pamukçuoglu, Serap Sevim; Karakeçili, Faruk; Tunca, Berivan; Çelik, Didem; Köse, Sukran

Introduction: Brucellosis is a zoonotic infectious disease endemic in our country and affects all systems. We aimed to evaluate clinical, laboratory findings and treatment outcomes of uncomplicated brucellosis in our study. Materials and Methods: Patients with uncomplicated brucellosis and with no relapse were evaluated from four different cities. Demographic data, clinical, laboratory and radiological findings of follow-up and treatment of 101 patients were recorded in forms. Clinical response (healing, treatment failure, relapse, etc.), treatment side effects, compliance and treatment discontinuation were evaluated at one-year follow-up. Results: The most common risk factors for brucellosis were detected respectively as fresh cheese/dairy product consumption (82.2%), rural area life (71.3%), brucellosis in family and surroundings (42.6%), animal husbandry (27.7%), and brucellosis in animals (24.8%). 80.2% of the patients were evaluated as acute brucellosis. Clinically, fatigue, sweating, loss of appetite, fever, body aches, arthralgia; elevated erythrocyte sedimentation rate, elevated C-reactive protein, elevated liver function tests, anemia and thrombocytopenia were the most frequent findings in laboratory examinations, respectively. In patients with brucellosis, blood culture positivity was 68%, Rose Bengal slide agglutination test was 97.1%, and tube agglutinin test positivity was 96.8%. The most preferred treatment regimen (90%) was doxycycline and rifampicin for 45 days, and treatment response was 89%. In five of the patients, treatment was changed due to doxycycline-linked gastrointestinal side effects. Relapses were seen in 4.9% of all patients. Conclusion: In brucellosis, delay in diagnosis increases the incidence of complications and the tendency to become chronic. For this reason, brucellosis must be considered in patients referred to health institutions with complaints such as fever, sweating and joint pain. Since uncomplicated brucellosis was evaluated in this study, it was seen that the majority of the patients were acute onset and had a high response rate to treatment.

Sayar, Ilyas; Kavruk, Utku; Çelebi, Bekir; Kılıç, Selçuk

Lyme borreliyozu veya Lyme hastalığı, Borrelia burgdorferi'nin etken olduğu kene kaynaklı bir hastalıktır. B. burgdorferi sensu lato ile infeksiyon dermatolojik, nörolojik, kalp ve kas-iskelet tutulumlarını içeren multisistemik bir hastalığa neden olmaktadır. Lyme borreliyozu kuzey yarım kürede en sık görülen kene kaynaklı infeksiyondur. Ülkemizde ilk olguların 1990'lı yıllarda bildirilmesine ve kenelerden etkenin izole edilmesine rağmen, Lyme borreliyozunun epidemiyolojisi konusunda çok az veri bulunmaktadır ve çoğunlukla olgu sunumlarına dayanmaktadır. Bu raporda, ülkemizde ilk defa serolojik ve moleküler yöntemlerle tanı konulan erken Lyme borreliyozu olgusu sunulmuştur. Nisan 2011 tarihinde, 48 yaşında daha önceden sağlıklı kadın, ateş, miyalji, sağ kolda eritemli, ağrılı, kaşıntılı deri lezyonu ile kliniğimize başvurdu. Hastada kene veya atropod ısırığı öyküsü yoktu. Hastanın fizik muayenesinde, sağ kolunda eritema migransa benzemeyen kabuklu deri lezyonlarıyla epitroklear ve aksiller lenfadenopati saptandı. Laboratuvar incelemelerinde; C-reaktif protein yüksekliği dışında diğerleri normal olarak bulundu. Deri biyopsi örneğinin histopatolojik incelemesinde; Lyme borreliyozunu düşündüren belirgin periglandüler, perivasküler ve perinöral lenfoplazmositer infiltrasyon gözlendi. Lyme borreliyozu tanısı serum örneklerinin negatif olduğu dönemde deri biyopsi örneğindeki real time-PCR pozitifliği ile konuldu. Hastaya 21 gün süreli doksisiklin tedavisi başlandı ve tedavinin beşinci gününde ateşi düştü. Bilgilerimize göre, bu olgu ülkemizde polimeraz zincir reaksiyonu ile tanı konulmuş ilk Lyme borreliyozu olgusudur. Bu olgu, kırsal bölgede karakteristik lezyon (eritema migrans) ve kene teması öyküsü olmasa bile deri lezyonlarıyla başvuran hastada Lyme borreliyozuna dikkat çekmek amacıyla sunulmuştur.