Aim: Sepsis is the most common life-threatening syndrome. Oxidative stress is one of the mechanisms that play a role in sepsis pathogenesis. Thiols are antioxidant buffers. Changes in thiol parameters refer to changes in oxidative balance. In this study; we aimed to investigate changes in thiol homeostasis in sepsis patients. Methods: In this study, we included 99 patients (53 patients and 46 controls). Sepsis patients were divided into two groups based on their diagnosis: sepsis and septic shock. Total thiol and native thiol levels were measured in the patients and controls. Disulfide levels were calculated. The thiol parameters were compared between the patient and control groups, sepsis and septic shock, mortality, and survivor groups. Results: The disulfide/native thiol and disulfide/total thiol rates were higher (p 0,00; 0,00) and the native thiol and total thiol levels were lower (p 0,00; 0,00) than controls in sepsis patients. Compared to the sepsis group, the disulfide level was higher (p 0,001), and native thiol and total thiol levels were lower (p 0,00; 0,009) in the septic shock patients. The results from patients who survived showed no statistical difference from the patients who died. Conclusion: The differences in thiol homeostasis parameters showed that sepsis patients had higher oxidative stress compared to the controls. The oxidative stress changes were parallel to the disease severity. The septic shock patients had higher oxidative stress compared to the sepsis patients. Diagnosis is still a problem despite the many new biomarkers in sepsis. Measuring thiol parameters and assessing them will contribute to sepsis diagnosis and follow-up.

Objective: The aim is to analyze the relation of psychosocial factors to COVID-19 contraction, vaccination, and preventive health behavior in and outside work. Methods: The questionnaire data from hospital-workers in Turkey is analyzed using independent-samples t-test, logistic regression, linear regression, and mediation analyses. We developed a questionnaire on mask-hygiene-distance measures and also used previously developed scales including the Big Five Personality Questionnaire, Young Schema Questionnaire Short Form 3, Schwartz's Basic Human Values Scale, Short Dark Triad. Results: The odds of being infected by COVID-19 increases by self-direction. The odds of being vaccinated increases by age and conformity, and decreases by emotional stability. Education predicts certain preventive behaviors at work negatively and outside work positively. Older age, being a woman, having chronic disease, the self-transcendence and conservation values, agreeableness, and conscientiousness predict more preventive behaviors. The self-enhancement and openness to change values, the Dark Triad, and early maladaptive schemas predict more risky behaviors. Conclusions: Designing prohealth policies requires further elaboration on the relation of psychosocial factors to preventive behaviors.

Candida auris spreads rapidly and causes outbreaks worldwide. Strict infection control is critical to control its spread; however, it is challenging and requires a special approach. This study aims to investigate the colonization and infection of C. auris in intensive care units (ICUs), analyses its susceptibility, and mortality rates, and contributes to an effective infection control.An infection control study was planned, and a C. auris infection control bundle and checklist were developed. During the study's pre-intervention, intervention, and post-intervention periods, C. auris candidemia cases and colonized patients were identified. Until the infection control intervention, all the candidemia cases, antifungal resistance, and mortality were investigated retrospectively. Clinical isolates were identified by phenotypic and genotypic characterization using MALDI-TOF MS Biotyper (Bruker Daltonics, Bremen, Germany) and sequencing.During the pre-intervention, intervention, and post-intervention periods, 26 C. auris cases were identified. Pan-resistant C. auris isolates were 3.84%, and the multidrug resistance was 65.38%. With the infection control intervention, the number of colonized patients decreased (pre-intervention 9.61‰, intervention 6.19‰, post-intervention 5.20‰). Candidemia incidence decreased from 4.09 to 2.3‰. No new cases of candidemia were observed at the end of the study.The risk of new cases is elevated in the rooms where multiple C. auris cases have been previously isolated. Mortality rate was high; namely, 76.92% of patients died, and 19.23% of strains were resistant to anidulofungin, one of the most commonly used antifungals. Despite the short implementation period, the infection control bundle and checklist have been demonstrated to be effective in controlling C. auris spread in the ICU.

Introduction: There has been a shift in the care of older patients from hospital settings to home healthcare. Older patients are more susceptible to infections, and infections associated with home healthcare are often understudied. This study aimed to investigate the changing trends in carbapenem resistance in these infections over time. Materials and Method: Microbiological data of home healthcare patients between 2018 and 2023 were analyzed using hospital records. Results: The rate of carbapenem resistance increased significantly from 4.17% to 19.53% between 2018 and 2023, particularly in Klebsiella spp. and Pseudomonas spp. Additionally, an increase in the number of respiratory and wound tissue samples was observed. Conclusion: Carbapenem resistance is a growing problem not only in hospitals but also in home healthcare settings. Effective infection prevention and control measures should be implemented, given the complexities of managing these infections, especially in geriatric populations. Keywords: Home Care Services; Carbapenem-Resistant Enterobacteriaceae; Pseudomonas Aeruginosa; Acinetobacter Baumannii.

Objective: Many healthcare workers (HCWs) hesitated or refused to receive the COVID-19 vaccines during the pandemic. The attitudes of HCWs toward vaccines have an impact on society and patients. In this study, we aimed to investigate the reasons for vaccine hesitancy and refusal among HCWs during the COVID pandemic. Materials and Methods: We planned a two-step descriptive survey study. In the first step, we surveyed the unvaccinated HCWs in our hospital face-to-face after the first vaccination program. After eight months, we conducted another survey with the unvaccinated HCWs over the phone. We investigated the changes in their attitudes between the two surveys and the relationship of vaccine hesitation with their occupation and COVID-19 history. Results: After the first vaccine program, 325 (21.2%) HCWs out of 1532 did not get vaccinated in our hospital. We found that there was a significant relationship between vaccine hesitancy and occupation. In our study, the group of “non-HCWs” had the highest vaccine hesitancy rate at the beginning. The most common reasons for vaccine hesitancy were breastfeeding and pregnancy (29.5%) and side effects, especially allergic reactions (18.0%). After eight months, in the second survey, vaccine hesitancy dropped to 5.6%. We found that 80.1% of the HCWs who stated they were planning to get vaccinated in the first survey were vaccinated, and 62.4% of those who were not planning it were vaccinated. In the second survey, 1.8% of HCWs were still planning the vaccination, but 3.8% of HCWs refused the COVID-19 vaccine. Not believing in the efficacy of the vaccine in the first survey was associated with vaccine refusal in the second survey (p=0.001). Conclusion: The overall rate of vaccine refusal was low among HCWs. Nevertheless, vaccine refusal among HCWs having more information about the vaccine and disease than the community may be related to cultural, psychological, and political reasons other than efficacy and safety. Future studies on the cultural, psychological, and political reasons for vaccine refusal will contribute to understanding vaccine refusal and increasing vaccine acceptance. Keywords: COVID-19 pandemic, COVID-19 vaccine, vaccine hesitancy, healthcare workers

Amaç: Yoğun bakım üniteleri ventilatör ilişkili pnömoni gibi ciddi enfeksiyonlar için yüksek riske sahip ünitelerdir. Ventilatör ilişkili pnömoni gelişiminin önlenmesi yoğun bakım ünitelerindeki en önemli enfeksiyon kontrol uygulamalarından biridir. Biz bu çalışmada ventilatör ilişkili pnömoni gelişimini önlemeye yönelik tedbirleri içeren kontrol listesi kullanımının ventilatör ilişkili pnömoni hızlarını azaltmadaki etkisini incelemeyi amaçladık. Gereç ve Yöntem: Bu çalışma Yenimahalle Eğitim ve Araştırma Hastanesi karma yoğun bakım ünitesinde, Ocak 2013 ve Eylül 2013 arasında gerçekleştirildi. İlk üç aylık dönemde rutin enfeksiyon kontrol önlemleri uygulandı. Sonunda hemşirelere ventilatör ilişkili pnömoni önleme paketi ve bu uygulamaların yapılıp yapılmadığına dair kontrol listesinin uygulanması ile ilgili eğitim verildi. İkinci üç aylık dönemde ise her hasta için hastanın hemşiresi tarafından günlük olarak kontrol listesi dolduruldu. Sonraki 3 aylık dönemde ise kontrol listesi uygulaması yapılmadı. Bu dönemlerdeki ventilatör ilişkili pnömoni oranları kaydedildi. Hemşirelere uygulama başlatılmadan önce ve sonra ventilatör ilişkili pnömoni önleme konusunda 20 soruluk test yapıldı. Bulgular: Ocak-Mart 2013 arasındaki birinci 3 aylık dönemde ventilatör ilişkili pnömoni hızı %38,2, ikinci 3 aylık dönemde ventilatör ilişkili pnömoni hızı %7,4 ve üçüncü 3 aylık dönemde ventilatör ilişkili pnömoni hızı %3,8 şeklinde bulunmuştur. Ön testte hemşirelerin aldığı ortalama puan 84,5, son testte ise 92,6 olarak bulunmuştur. İkinci testle birinci test arasındaki başarı farkı Wilcoxon testi ile (z-3,4; p=0,001) anlamlı olarak bulunmuştur. Sonuç: Bu çalışma sonucunda rutin uygulamada ve hasta popülasyonunda değişiklik olmamasına rağmen ventilatör ilişkili pnömoni gelişmesini önlemek amaçlı kontrol listesi kullanımının müdahale sırasında ve sonrasında ventilatör ilişkili pnömoni hızında belirgin düşme sağladığı görülmüştür. Ayrıca kontrol listesi uygulaması hemşirelerin ventilatör ilişkili pnömoni önleme bilgi düzeylerinde ve el hijyeni uyum oranlarında artışa neden olmuştur.