Health care workers (HCWs) and students are at increased risk for blood borne infections and vaccine preventable diseases (VPDs). The aim of this study was to determine the seroprevalence of antibodies against measles, rubella, mumps, varicella zoster virus (VZV), hepatitis A and B viruses among HCWs and students and to determine whether there are differences according to gender and age group. Information about characteristics of the 1053 participants, history of disease and vaccination status were collected using a structured questionnaire. Serum samples were tested for antibodies by commercial immunoenzymatic assays. Seropositivity rates were 57.1% for measles, 74% for mumps, 96.3% for rubella, 93.7% for VZV, 33.9% for hepatitis A virus and 92.2% for hepatitis B virus. Susceptibility rates among participants 18-26, 27-38 and >38 years of age were statistically significant for measles (46%, 18.6% and 0%; p < 0.001) and mumps (27.1%, 12.9% and 21.4%; p < 0.05), respectively. Low seropositivity rates for measles, mumps and HAV are important findings. For other diseases other than VZV, it is thought that vaccination without pre-screening is more appropriate. Healthcare institutions should have policies for screening and vaccination of their staff and students.

The aim of the current study is to investigate the relationship between mortality rate in geriatric patients undergoing surgery with preoperative serum levels of procalcitonin, C-reactive protein, and erythrocyte sedimentation rate. This was a single-center retrospective study, including three groups with 101 patients, who are older than 65 years of age. A retrospective investigation was carried out from the laboratory information system for all groups from January to December 2018. Group 1 included patients who had surgery and then mortality within 30 days after surgery. Group 2 included hospitalized patients who had surgery and no mortality within 30 days after surgery. Group 3 included outpatient patients, who had suspicion for a bacterial infection and then no surgery or no mortality within 30 days. When three group comparisons were made for procalcitonin, C-reactive protein, and erythrocyte sedimentation rate values, the p-value of one-way analysis of variance (ANOVA) was higher than 0.05 for procalcitonin and lower than 0.05 for C-reactive protein and erythrocyte sedimentation rate, suggesting that one or more groups were significantly different. When post-hoc multiple comparison methods were applied, there were statistically significant differences between Groups 1 and 3 for C-reactive protein and erythrocyte sedimentation rate. Procalcitonin levels do not predict mortality following surgery. C-reactive protein and erythrocyte sedimentation rate are more useful biomarkers predicting mortality in geriatric patients undergoing surgery.

Objective: The aim of this study is to evaluate nosocomial infections (NIs) in intensive care unit (ICU) in terms of site of infection, distribution of pathogens and risk factors for developing infection. Methods: 80 patients staying for more than 48 hours in the ICU were included in the study. Epidemiologic characteristics of the patients, invasive procedures and other risk factors were noted. Cultures, identification of isolates and antibiotic susceptibility tests were made by standard microbiologic methods. Results: Of 56 patients who have developed NIs, 26 (50%) had pneumonia, 15 (28.8%) had bloodstream infections and 6 (11.5%) had urinary tract infections. Klebsiella pneumoniae (23.5%), Pseudomonas aeruginosa (19.6%), and Acinetobacter spp. (15.6%) were the most frequently isolated microorganisms, respectively. For Klebsiella pneumoniae isolates, extended spectrum beta lactamase (ESBL) rate was 91.6%, carbapenem resistance rate was 15.6% and for Pseudomonas aeruginosa and Acinetobacter spp. carbapenem resistance rates were 60% and 100% respectively. Hemodialysis, enteral nutrition, total parenteral nutrition and prolonged hospitalization for more than 10 days were determined as independent risk factors for developing NI. Additionally Acute Physiology and Chronic Health Evaluation (APACHE) II score, length of ICU stay and lenght of hospital stay before ICU were found to be high in the NI group. Conclusion: Pneumonia is the most common NI and carbapenem resistance in Gram-negative bacilli was remarkably high in our ICU. It was considered that infection control measures must be applied carefully, invasive procedures should be used in correct indications and we should avoid long-term hospitalization if unnecessary. J Clin Exp Invest 2015; 6 (3): 233-239 Key words: Intensive care unit, nosocomial infections, carbapenem resistance

Introduction: Early diagnosis of HIV infection is essential for the reduction of morbidity/mortality rates, health expenditures and the prevention of infection spread. In this study we aimed to test the knowledge of physicians regarding HIV risk groups, AIDS indicator diseases and their current practices about screening. Methodology: A questionnaire was used to collect data from physicians working in a multidisciplinary 170-bed tertiary university hospital in Istanbul, Turkey. The questionnaire measured physician knowledge of the above-mentioned points. Results: Ninety-six physicians replied to the questionnaire. "Preoperative screening" was found to be the most common (65.6%) indication for HIV testing. A large portion of physicians (72.9%) felt comfortable with an HIV test and 71.9% of the physicians had no impeding condition for HIV testing. Physicians were mostly (67.7%) unaware of the current guidelines for HIV testing. Conclusions: Teaching programs are essential to increase knowledge of HIV screening for physicians as this is an essential part of early diagnosis and therefore important for decreasing morbidity and mortality.

Üriner sistem enfeksiyonu (ÜSİ) klinik pratikte en sık karşılaşılan enfeksiyonlardandır. Bu çalışmada, ÜSİ etkenlerinin ve antimikrobiyal duyarlılıklarının incelenmesi ve ampirik tedavide sıkça kullandığımız antibiyotikeri gözden geçirmek amaçlanmıştır. Ocak 2008-Aralık 2009 tarihlerinde, hastanemiz klinik mikrobiyoloji laboratuvarına ÜSİ ön tanısı ile gönderilen idrarlar incelendi. Üropatojenlerin identifikasyonu ve antibiyotik duyarlılıkları tam otomatize sistemle belirlendi. ÜSİ tanısı olan hastalardan izolen edilen 537 (%68,5 ayaktan ve %31,5 yatan hastalardan elde edilen) üropatojen arasında E.coli (%66,5) en sık etkendi. Gram-negatif bakterilerde genişlemiş spektrumlu beta-aktamaz (GSBL) üretimi %14,9 oranında saptandı. Antibiyotiklere duyarlılıkları incelendiğinde; siprofloksasin ve trimetoprim-sulfametoksazol için %40, sefuroksim için %50, gentamisin için %17, nitrofurantoin için %15 ve fosfomisin için %6 civarında direnç saptandı. Direnç oranları, yatarak tedavi gören hastalarda anlamlı olarak daha yüksekti. Üropatojenlerde direnç artışı tedavide önemli bir sorundur. Bölgesel antibiyotik duyarlılıklarının bilinmesi, akılcı antibiyotik kullanımı için önem arz eder. Tedavide kinolon kullanımından kaçınılmalıdır. Komplike olmayan üriner sistem enfeksiyonlarında nitrofurantion ve fosfomisin kullanımı güvenli olacaktır.

Background/Aim: Group A beta-hemolytic streptococci (GAS) are among the most common bacterial causes of pharyngitis. Throat culture is the reference diagnostic method, whereas rapid antigen tests offer faster results. This study aimed to evaluate the diagnostic performance of the RapidFor™ Strep A Rapid Antigen Test compared with throat culture in throat swab specimens. Methods: Throat culture and rapid antigen testing were performed on specimens from 322 patients aged 2 years or older who presented to Maltepe University Faculty of Medicine Hospital between March and May 2024 with suspected upper respiratory tract infection and for whom GAS testing was planned. A single throat swab was used sequentially for culture and rapid antigen testing. Demographic information was recorded, and sensitivity, specificity, and accuracy were calculated using throat culture as the reference method. Results: Among the 322 patients evaluated, 74.84% were younger than 18 years. GAS was detected by culture in 97 patients (30.12%). Both tests were positive in 94 patients, both tests were negative in 225 patients, and culture was positive but the rapid antigen test was negative in 3 patients. No false-positive results were observed. Sensitivity, specificity, and accuracy were 96.91%, 100%, and 99.07%, respectively. Conclusion: The RapidFor™ Strep A Rapid Antigen Test demonstrated high diagnostic performance relative to throat culture in this cohort and provided a rapid testing option.