Browsing by Author "Dindar Demiray, EK"

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    Evaluation of Achromobacter xylosoxidans subsp. denitrificans Infections at an University Hospital
    Senol Akar, S; Dindar Demiray, EK; Alkan, S; Özer, D; Kurutepe, S
    Introduction: Infections due to Achromobacter xylosoxidans (AX) type bacteria are very rare. There are few case reports from our country but knowledge about practical therapeutical applications is scarce. In this study we aimed to report AX denitrificans infections and clinical approach at our hospital. Materials and Methods: This study comprised patients over 18 years old who were hospitalised at Manisa Celal Bayar University Hafsa Sultan Hospital and who were positive for AX. denitrificans between 01.01.2016-31.12.2019. Data about these patients were obtained retrospectively from hospital records. Demographic clinical and bacteriologic data were analysed by suitable methods. Results: AX. denitrificans was detected in 16 cultures of 10 patients. Growth was detected from wound biopsy cultures in 11 specimens (68.7%). Nine patients were male and the mean age was 51.3 +/- 17. Seven of the patients had been hospitalised in the same clinic at different time intervals. The most common diagnosis was surgical site infection. All of AX. denitrificans induced infections were health care associated infections (HAI). Risc factors were found as being hospitalised and/or operated at the plastic and reconstructive surgery ward, antibiotic consumption within the last month and history of collagen tissue disorders. At the time of diagnosis with AX. denitrificans infection, 10 patients were using ampirical antibiotic for vairous reasons. One patient passed away before culture result was obtained. The most common ampirical antibiotic was found as third generation cephalosporins. When culture results were identified in 50% of the patients were receiving appropriate antibiotherapy. All 16 culture growths revealed sensitivity towards piperacillin/tazobactam. Conclusion: Even though AX. denitrificans is a rare community and hospital derived infectious agent, it should be kept in mind in clinics that show clustering and suitable ampiric therapy should be applied to keep the infection under control.
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    Are Soap, Paper Towel and Alcohol-based Disinfectants Easily Accessible in Intensive Care Units in Turkey?: Results of the Phokai Study
    Uyan, A; Durmus, G; Sezak, N; Özdemir, B; Kaygusuz, T; Öztoprak, N; Özdemir, K; Aksoy, F; Özgültekin, A; Koç, MM; Öncül, A; Çagan Aktas, S; Isik, B; Çelebi, G; Evik, G; Özger, S; Harman, R; Dindar Demiray, EK; Özkören Çalik, S; Alkan Çeviker, S; Yildiz, IE; Isik, ME; Senol, G; Sari, S; Dogan, M; Ugurlu, K; Arslan, M; Akgül, F; Koç, F; Kürekçi, Y; Çaglayan, D; Uçar, M; Gözüküçük, R; Elmaslar Mert, HT; Alay, H; Erdogan, H; Demirel, A; Dogan, N; Koçak, F; Güven, E; Ünsal, G; Sipahi, H; Yamazhan, T; Arda, B; Ulusoy, S; Sipahi, OR
    Introduction: Hand hygiene is one of the most effective infection control measures to prevent the spread of healthcare-associated infections (HCAI). Water, soap, paper towel and hand disinfectant must be available and adequate in terms of effective hand hygiene. The adequacy of hand hygiene products or keeping water-soap and paper towel is still a problem for many developing countries like Turkey. In this multicenter study, we analyzed the adequacy in number and availability of hand hygiene products. Materials and Methods: This study was performed in all intensive care units (ICUs) of 41 hospitals (27 tertiary-care educational, 10 state and four private hospitals) from 22 cities located in seven geographical regions of Turkey. We analyzed water, soap, paper towel and alcohol-based hand disinfectant adequacy on four different days, two of which were in summer during the vacation time (August, 27th and 31st 2016) and two in autumn (October, 12th and 15th 2016). Results: The total number of ICUs and intensive care beds in 41 participating centers were 214 and 2357, respectively. Overall, there was no soap in 3-11% of sinks and no paper towel in 10-18% of sinks while there was no alcohol-based hand disinfectant in 1-4.7% of hand disinfectant units on the observation days. When we compared the number of sinks with soap and/or paper towel on weekdays vs. weekends, there was no significant difference in summer. However, on autumn weekdays, the number of sinks with soap and paper towel was significantly lower on weekend days (p<0.0001, p<0.0001) while the number of hand disinfectant units with alcohol-based disinfectant was significantly higher (p<0.0001). Conclusion: There should be adequate and accessible hand hygiene materials for effective hand hygiene. In this study, we found that soap and paper towels were inadequate on the observation days in 3-11% and 10-18% of units, respectively. Attention should be paid on soap and paper towel supply at weekends as well.