Browsing by Author "Erdem, HA"

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    Necrotising Fasciitis: Clinical Evaluation and Treatment Results of 18 Patients
    Öztürk, AM; Akyol, D; Süer, O; Erdem, HA; Simsir, IY; Akar, SS; Özkayin, N; Tasbakan, MI
    Introduction: Necrotizing fasciitis (NF) is a complicated and rapidly spreading soft tissue infection that affects the superficial fascia, skin, and subcutaneous tissue. In this study, we evaluated patients who were diagnosed with NF and treated in two tertiary-care educational university hospitals. Materials and Methods: Patients diagnosed with NF in three centers (Ege University Department of Orthopedics and Traumatology and Department of Infectious Diseases and Clinical Microbiology and Celal Bayar University Department of Infectious Diseases and Clinical Microbiology) between November 2016 and December 2018 were retrospectively analyzed. The patients' demographic characteristics, significant risk factors for infection, sites of infection, models of surgical treatment, department(s) that performed the surgery, causative infectious agents, empirical and agent-specific treatment regimens and their duration, length of hospital stay, need for intensive care, and one month survival were evaluated. Results: Eighteen patients (10 females, mean age 53.7 [19-86 years]) who were diagnosed with NF were included in the study. Diabetes mellitus, trauma/surgery history, and decubitus wound were the most common predisposing factors. The most common anatomic site was lower extremity (n=10, 55.5%). All patients underwent surgical debridement. The most commonly isolated microorganisms were Escherichio coli (n=4), Klebsiella pneumoniae, Proteus mirabilis, and Acinetobacter boumannii (each n=3). Empirical treatment was initiated with meropenem in eight patients (32%) and tigecycline in four patients (12.5%), and the antibiotic was changed in five patients based on culture results. The mean duration of antibiotic therapy was 35.5 (9-68) days. The average hospital stay was 55 (11-186) days. Six patients (33.3%) required intensive care during follow-up. The mortality rate was 16.6%. Conclusion: NF is a fulminant disease, and early diagnosis and effective multidisciplinary treatment are crucial for reducing mortality rates. When the diagnosis is suspected, early surgical debridement should be performed and empirical antibiotherapy should be started immediately.
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    Assessment of Compliance with Bundle Programs for the Prevention of Bloodstream Infections
    Kahraman, H; Erdem, HA; Mermer, S; Kivrak, EE; Çaglayan, D; Karakoç, E; Erben, N
    Introduction: Bloodstream infections are a significant public health problem in hospitals, leading to increased hospital stays, costs, mortality, and morbidity. This study aims to evaluate compliance with the National Healthcare -Associated Infections Prevention Bundle Guidelines, published in March 2021. Materials and Methods: This study was conducted as a multicenter research between August and September 2022, involving physicians and nurses providing services in adult, pediatric, and neonatal intensive care units. Surveys were administered to collect data on participants' demographic information, professional experiences, and practices related to catheter insertion and care. Results: The study included 156 nurses and 81 physicians from 24 different centers. Among the participating physicians, 41 were female, with an average age of 36.4 +/- 9.1 years. It was observed that physicians had a compliance rate of 95% for hand hygiene before catheter insertion and 100% for using sterile gloves. The utilization rates for masks, sterile gowns, and caps were found to be 95%, 72.8%, and 56%, respectively. It was noted that a sterile full -body drape was used in 81% of cases. For skin antisepsis, 75.3% of physicians used povidone-iodine, 13.6% used chlorhexidine, 9.9% used povidone-iodine/alcohol, and 1.2% used chlorhexidine/ alcohol. Additionally, 76.5% of physicians reported waiting for the antiseptic to dry, while 19.9% stated that they would continue with the procedure despite being warned about the inadequate maintenance of sterility during the process. In the study, 136 (87.2%) of the participating nurses were female, with an average age of 31.7 +/- 7.6 years. Hand hygiene compliance before catheter contact was 96.8%, while it was 99.4% after contact. 94.9% of the participants reported providing disinfection before touching the catheter, and 90.4% stated they performed disinfection after contact. The usage rate of checklists during catheter insertion was 87.2%, and during catheter care, it was 86.5%. 28 (34.6%) of the physicians and 74 (47.4%) of the nurses reported receiving training on bloodstream infection prevention bundles within the last year. Conclusion: The National Healthcare -Associated Infections Prevention Bundle Guidelines are an important step to reduce hospital infections in our country. Nevertheless, there is an observed lack of standardization across different hospitals in the implementation of these guidelines. It is believed that integrating bundle practices into routine applications and promoting behavioral changes can lead to improvements in infection rates in our country.
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    ABSTRACT Are Family Physicians and Medical Students Aware of Chronic Hepatitis C Infection?
    Nazli, A; Sertcelik, A; Kahraman, H; Erdem, HA; Mermer, S; Çaglayan, D; Kivrak, EE; Tasbakan, MI
    Introduction: Chronic hepatitis C is a public health problem that can result in cirrhosis, liver cancer, and death, which can be cured with current treatments. In our study, we evaluated the level of knowledge and awareness of medical school students and family physicians about chronic hepatitis C.Materials and Methods: Our study was carried out between 01.06.2022 and 01.08.2022, between the 1st and 6th grade medical students, family physicians (family medicine residents, family medicine specialists) using an online questionnaire.Results: In our study, 536 medical faculty students and 162 family physicians were recruited. Two hundred seventy one (50.6%) of the students were male and the median age was 23.0 (2.0) years. Of the family physicians, 84 (51.2%) were male, the median age was 30 (24-68) years and the median time in the profession was 14.5 (1-40) years. Students answered 69.2% of the questions correctly, and family physicians answered 73% correctly. While the students knew the transmission routes of hepatitis C mostly (97.2%), they got the less information about the testing (34.9%) and treatment (21.9%). Family physicians answered the questions about the transmission routes of hepatitis C with a high rate (99.4%), and the questions about the groups that should be tested (28%) and the questions about the treatment of hepatitis C less correctly (29.4%). In the multivariate analysis, the factors affecting the median knowledge score of the students were male gender (p= 0.019), the student's class (p= 0.002), having Infectious diseases and clinical microbiology committee (p= 0.005) and gastroenterology committee (p= 0.027). The only factor affecting the median knowledge score of family physicians was the use of online presentations by experts in their fields as a source of information (p= 0.003). 67% of the students and 87.2% of the family physicians answered the question How do you manage the person when the anti-HCV screening test is positive? as I will refer the patient to the infectious diseases and clinical microbiology or gastroenterology .Conclusion: In our study, it was found that awareness of screening and treatment was low in both groups. Considering that the main factors related to the level of knowledge of medical students are having committee of the gastroenterology and infectious diseases and clinical microbiology, and online presentations of experienced teachers in family physicians, preparing a special content for these groups may be useful in raising awareness and level of knowledge.