Browsing by Author "Borand, H"

Now showing 1 - 5 of 5
  • No Thumbnail Available
    Item
    Rational antibiotic use
    Tunger, O; Karakaya, Y; Cetin, CB; Dinc, G; Borand, H
    Background: Development of resistance to antimicrobial agents and increase of cost as the result of unnecessary and inappropriate use of antibiotics has become a global health problem. Therefore many strategies, which are aimed at optimizing antibiotic therapy, have been developed until now. In Turkey, an antibiotic restriction policy as a governmental solution was applied to decrease the antibiotic use and especially costs by Ministry of Health in 2003. The aim of this study is to evaluate the rational antibiotic use and the impact of the implementation of new restriction policy, with their reinforcement by infectious disease specialist, on the hospital wide use of antibiotics. Methodology: The data of the inpatients received antibiotics (n=495) during January-June 2006 were compared with our previous study performed by the same methodology before the restriction policy in 1998. In both studies, prospective active daily surveillance of patients was performed by three infectious disease specialists. The appropriateness of antibiotic therapy was determined using the criteria described by Kunin and Jones. The data were analyzed by using SPSS for Windows. Results: While the rate of antibiotic use decreased from 16.6% to 11.3%, rational use increased after the restriction policy (p<0.001). Besides the specific antibiotic use increasing, prophylactic antibiotic use was found decreased (p<0.001). Mostly determined irrationality was the prophylactic uses in both studies. As expected, infectious disease specialist examinations resulted in an increase in the appropriate antibiotic use. Conclusions: The restriction policy was effective in decreasing the antibiotic consumption and increasing the rational antibiotic prescription in our hospital.
  • No Thumbnail Available
    Item
    Secondary brucellar psoas abscess
    Tünger, Ö; Arysoy, AS; Öbakkaloglu, B; Temiz, C; Borand, H
    Psoas abscesses are rarely seen and usually misdiagnosed infections of the musculoskeletal system. A case of secondary psoas abscess due to Brucella spp. that was successfully treated with percutaneous computed tomography-guided aspiration and antimicrobial therapy is presented. The reported cases, diagnostic and therapeutic recommendations are also reviewed.
  • No Thumbnail Available
    Item
    Investigation of Serological Markers for Hepatitis B Virus and Knowledge about Hepatitis B Infection in Hospital Staff
    Akgül, S; Gündüz, T; Borand, H; Ispir, B; Ötnü, AA
    Health care workers are in the high risk group for hepatitis B virus (HBV) infection. The aim of this study was to determine the knowledge levels about HBV infection and HBV sero-prevalance of the hospital staff in the Government Hospital. Totally 554 workers (377 health care workers, 177 assistant workers for cleaning) filled a questionnaire (including risk factors, methods of prevention, ways of prevention, etc..) and their blood samples were screened for HBsAg, anti-HBs, anti-HBc IgG. The screening results were as follows: HBsAg positive cases 2.2%, anti-HBs positive cases 23.8%, the naturally immunized cases 20.2%, sensitive cases for HBV 53.8% and only anti-HBc positive cases 1.9%. In the questionnaire, 164 (29.6%) did not fill or answered as I don't know the question Can you define hepatitis B?, while 390 (70.4%) answered as hepatitis is elevation of bilirubin levels in blood, jaundice and a kind of liver disease. The names of hepatitis viruses were asked, 164 (29.6%) had no idea and 390 (70.4%) answered as hepatitis A, hepatitis B, hepatitis C. Totally 440 (79.4%) knew that hepatitis is a contagious disease and were aware of the risk of their jobs. The question What do you do for prevention from HBV? was answered as nothing by 212 (38.3%), while 98 (17.7%) used gloves and mask, 112 (20.2%) were naturally immunized and 132 (23.8%) were vaccinated before. As the result, health care workers have risk of contamination with HBV and their knowledge about the infection is not enough. Routine serological screening and vaccination in the hospital staff should be performed as a significant prevention method.
  • No Thumbnail Available
    Item
    Clinical aspects and risk factors of nosocomial Stenotrophomonas maltophilia Bacteremia episodes in a Turkish intensive care unit
    Tunger, O; Vural, S; Cetin, CB; Keles, G; Borand, H; Gazi, H
    Stenotrophomonas maltophilia is an important nosocomial pathogen with increasing frequency in recent years, especially in immunocompromised and clinically debilitated patients. The aim of this study is to describe the characteristics of 35 episodes of S. maltophilia bacteremia at Celal Bayar University hospital in Turkey over a 3-year period from January 2003 to December 2005. Cases were identified with microbiology laboratory records and clinical data were collected from the medical record of each patient. The source of bacteremia was central venous catheter (CVC) in 65.7% (23) and respiratory tract infection in 2.9% (1) of episodes while the source of bacteremia was unknown in 11 (31.4%) episodes of bacteremia. Factors significantly associated with mortality were age of >= 65 years, APACHE score of >= 16, the presence of the total parenterall nutrition, anemia, low creatinine clearance level and shock. The most sensitive antibiotic was found as trimethoprim-sulfamethoxazole (91.4%) in antibiotic susceptibility testing of the isolates. Susceptibilities of piperacillin-tazobactam and netilmicin which frequently used antibiotics as an empirical therapy were 62.8% and 68.6%, respectively.
  • No Thumbnail Available
    Item
    Case of Lemierre's syndrome presenting with thyroid abscess
    Kara, E; Sakarya, A; Keles, C; Borand, H; Pekindil, G; Göktan, C
    Lemierre's syndrome is an uncommon condition characterized by post-anginal septicemia due to anaerobes. Reported here is a case of Lemierre's syndrome presenting with thyroid and liver abscesses. At presentation, the 70-year-old female patient complained of fever, jaundice and neck pain. Computed tomography (CT) and ultrasound confirmed the presence of a left-sided internal jugular vein thrombosis as well as abscesses in the left thyroid lobe and the right lobe of the liver with pleural effusion. The thyroid abscess was treated with a left lobectomy.