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    The accuracy and validity of a weekly point-prevalence survey for evaluating the trend of hospital-acquired infections in a university hospital in Turkey
    (Elsevier Sci Ltd, 2011) Ustun, Cemal; Hosoglu, Salih; Geyik, Mehmet Faruk; Parlak, Zafer; Ayaz, Celal
    Objective: To evaluate the validity of a weekly point-prevalence survey (WPS) by comparing it with a prospective-active incidence survey (PIS). Methods: WPS and PIS were conducted at a tertiary referral hospital between January and December 2006. Each Wednesday, an infection control team reviewed all clinical records of patients with hospital-acquired infections (HAIs) by WPS. Routine PIS was conducted with daily visits by the same team. The Rhame and Sudderth formula was used for converting the data between WPS and PIS. Results: During the study period, 1287 HAIs were detected in 37 466 patients by WPS. The mean observed prevalence and calculated prevalence were 5.42% and 5.45%, respectively. The reanimation intensive care unit (ICU) (49.4%) and burns unit (27.6%) had the highest prevalence rates. Pneumonia (0.94%) and urinary tract infections (0.37%) were the most frequent infections. Overall 602 HAIs were detected in 545 patients by PIS. The mean observed incidence and calculated incidence were 2.42/1000-admissions and 2.41/1000-admissions, respectively. The Critical care ICU (37.0/1000-admissions) and burns unit (24.8/1000-admissions) had the highest incidences of HAI. Pneumonia (0.64/1000-admissions) and urinary tract infections (0.37/1000-admissions) were the most frequent infections. Conclusions: This study confirms a close relationship between prevalence and incidence data. WPS may be a useful method for following HAIs when PIS cannot be performed. (C) 2011 International Society for Infectious Diseases. Published by Elsevier Ltd. All rights reserved.
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    Acute hepatitis: a rare complication of Epstein-Barr virus (EBV) infection
    (J Infection Developing Countries, 2010) Ulug, Mehmet; Celen, Mustafa Kemal; Ayaz, Celal; Geyik, Mehmet Faruk; Hosoglu, Salih
    Infectious Mononucleosis (IM), a benign lymphoproliferative disease, is the best known clinical syndrome caused by Epstein-Barr Virus (EBV). It usually resolves over a period of weeks or months without sequelae but may occasionally be complicated by a wide variety of neurologic, hematologic, hepatic, respiratory, and psychological complications. In this report we describe a patient with acute hepatitis following EBV-IM in a previously healthy woman. A 26-year-old woman who presented with fever, generalized weakness, nausea, sore throat, yellowing of skin, and a generalized skin rash was admitted to our clinic. Tonsillar enlargement, pharyngeal erythema, palatal petechiae, lymphadenopathy, and jaundice were noted. Significant atypical lymphocytes (> 10%) were seen on the peripheral blood smear. Liver function tests such as ALT: 303 U/L, AST: 172 U/L, ALP: 193 U/L and total bilirubin: 7.3 mg/dl were elevated. Serological tests for EBV infection were consistent with acute infection (EBV virus capsid antigen was reactive with IgM and IgG antibodies). The Monospot test was also positive. On the seventh day, liver function tests and bilirubin had risen to peak level and platelets were decreased. The patient was managed supportively and her critical condition improved and was finally stabilized. Although the prognosis for IM is very favorable, a variety of acute complications may occur.
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    Aerobik bakteriemi etkenlerinin izolasyonunda bactec 9240 sisteminin değerlendirilmesi
    (1999) Hoşoğlu, Salih; Demirel, Mahmut; Geyik, Mehmet Faruk; Kökoğlu, Ömer Faruk; Ayaz, Celal
    BACTEC 9240 otomatik kan kültürü sistemi; aerop bakterileri izolasyondaki başarısı, duyarlılığı ve spesifikliği yönüyle değerlendirilmek amacıyla retrospektif olarak incelendi. İncelenen 1118 örnekten 428'inde (% 38.3) üreme sinyali vardı ve bunların aerobik subkültürlerinin 410'unda (% 36.7) üreme oldu. On sekiz örnekte (% 1.6) ise yalancı pozitiflik vardı. Sistemin negatif olarak bildirdiği hiçbir örnekte subkültürlerde üreme olmadı. Sistemin duyarlılığı % 100.0, özgüllüğü 96.0 idi. Bu mikroorganizmaların 58'i (% 5.2) kontaminasyon olarak kabul edildi. Patojen kabul edilen 352 mikroorganizmanın 235'i (% 66.8) Gram-negatif, 114'ü (% 32.4) Gram-pozitif bakterilerdi ve üç örnekten (% 0.8) mantar izole edildi. En fazla izole edilen bakteriler Salmonella typhi (56), Staphylococcus aureus (44), Klebsiella pneumoniae (39) ve Escherichia coli (31) idi. BACTEC 9240; kullanışlı, duyarlı ve güvenilir bir sistem olarak kabul edilmiştir.
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    Akut viral hepatit ve risk faktörleri
    (2004) Geyik, Mehmet Faruk; Kökoğlu, Ömer Faruk; Uçmak, Hasan; Akalın, Şerife; Hoşoğlu, Salih; Ayaz, Celal
    Amaç: Akut viral hepatitlerin bulaşmasındaki risk faktörlerinin araştırılmasını amaçladık. Gereç ve Yöntem: Dicle Üniversitesi Tıp Fakültesi Enfeksiyon Hastalıkları Kliniği'ne yatırılarak tedavi edilen 201 akut viral hepatit olgusu risk faktörleri yönünden prospektif olarak incelendi. Bulgular: Hepatit A 'da 12 (% 27), hepatit E olgularında ise bir (% 14) oranında aile içi temas öyküsü saptandı. B hepatitli olgularda bulaşma yolu olarak 23'ünde (% 19) diş çekimi veya tedavisi, 17'sindc (% 14) şüpheli cinsel ilişki, 15'inde (% 13) sağlık çalışanı olmak, 11 'inde (% 9) ameliyat olmak, onunda (% 8) aile içi temas, beşinde (% 4) doğum, dördünde (% 3) kan nakli, üçünde (% 3) endoskopik girişim tespit edildi. Kırk sekiz (% 40) olguda muhtemel bir bulaşma yolu saptanamadı. C hepatitli altı hastanın ikisinde (%33) ameliyat, birinde (%17) cinsel temas, birinde (%17) doğum tespit edilirken, (%33) olguda olası bir bulaşma yolu tespit edilemedi. Sonuç: Viral hepatitlere ait risk faktörleri ve bulaşma yollan aydınlatılması akut viral hepatitlcre karşı alınacak önlemlerin etkinliğini artıracaktır.
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    Antibiyotiklerin reçete edilmesine getirilen sınırlamanın antibiyotik tüketimine etkileri
    (Antibiyotik ve Kemoterapi Derneği, 2006) Çelen, Mustafa Kemal; Hoşoğlu, Salih; Eraydın, Hakan; Geyik, Mehmet Faruk; Ayaz, Celal
    Dicle Üniversitesi Hastanesinde Sağlık Bakanlığı’nın 2003 Nisan ayında uygulamaya koyduğu antibiyotik kısıtlama politikası öncesi ve sonrası ardışık üç günlük antibiyotik kullanım yoğunluğu, maliyeti ve infeksiyon hastalıkları konsültasyon hizmetinin etkisi değerlendirilmiştir. Dicle Üniversitesi Hastanesi 1050 yataklı bölgesel sağlık hizmeti veren bir referans hastanesidir. DSÖ’nün tanımlamalarına göre kısıtlama öncesi ve sonrasında karbapenem, glikopeptid, piperasilin-tazobaktam ve amfoterisinB’nin ardışık üçer günlük “Antibiyotik tüketim indeksi” (ATİ) değeri hesaplanmıştır. Uygulama öncesi bütün antibiyotikler için ATİ 76.7 Tanımlanmış Gün Dozu (TGD)/100-Yatış Günü (YG) ve sonrası 76.6 TGD/100-YG olarak bulunmuş, önemli bir düşüş saptanmamıştır. Buna karşılık kullanımı kısıtlanan antibiyotiklerin ATİ değerlerinde belirgin bir düşüş saptanmış, kısıtlama öncesi ve sonrası ATİ değerleri meropenem için 2.5 TGD/100- YG’den 1.6’ya, teikoplanin için 1.4’den 0.8’e, vankomisin için 1.9’dan 1.2’ye, piperasilin-tazobaktam için 1.6’dan 0.6’ya ve amfoterisin-B için 0.5’ten 0.2’ye inmiştir. Üç günlük kısıtlama sonrası kullanılan antibiyotiklerin maliyetinden 1315 Amerikan doları tasarruf elde edilirken hastane infeksiyonu gelişiminde de artış görülmemiştir. Antibiyotiklerin reçete edilmesine getirilen sınırlamanın, gereksiz geniş spektrumlu antibiyotik kullanımını sınırlandırdığı ve ekonomiye doğrudan katkı sağladığı sonucuna varılmıştır.
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    Are sinus-track cultures reliable for identifying the causative agent in chronic osteomyelitis?
    (Springer, 2009) Ulug, Mehmet; Ayaz, Celal; Celen, Mustafa Kemal; Geyik, Mehmet Faruk; Hosoglu, Salih; Necmioglu, Serdar
    The infection of bone that contains bone marrow called osteomyelitis, and is caused by different microorganisms. In this study, we aimed to determine the diagnostic value and accuracy of cultures of material from a sinus track compared with those of cultures of bone specimens that have been controversial. Prospective study was conducted at Hospital University of Dicle, a 1,090-bed university-based hospital located in DiyarbakA +/- r, Turkey. Between May 2005 and September 2006, sinus-track cultures were compared with those of bone cultures from 43 patients with chronic osteomyelitis. The patients' mean age was 30.6 +/- A 3.6 years, and 29 (67%) male and 14 (33%) female. Organisms isolated from bone cultures were Staphylococcus 69% (29/42), Escherichia coli 9.5% (4/42), Pseudomonas aeruginosa 9.5% (4/42), Proteus mirabilis 7% (3/42), respectively. Cultures of sinus track and bone specimens gave identical results in 38% of patients. The value of bone culture in the therapy of osteomyelitis must be emphasized; it is the only reliable means of determining the responsible agent, up on which the antibiotic therapy is based. The correlation between sinus track and bone cultures was 38%, i.e., failure in the treatment for 6 patients out of 10.
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    Barsak kanaması ile seyreden bir tifo olgusu
    (2004) Gedik, Ercan; Ayaz, Celal; Çelen, Mustafa Kemal; Geyik, Mehmet Faruk; Uluğ, Mehmet; Eraydın, Hakan
    Tifoda rektal kanama nadir fakat morbidite ve mortalitesi yüksek bir komplikasyondur. Hikayesinden iki hafta önce arkadaş toplantısında çiğköfte ve marul yiyen 22 yaşındaki erkek hasta; Ateş, baş ağrısı, kuru öksürük ve iştahsızlık şikayeti ile yatırıldı. Yattığı sırada hematokriti (Htc) % 39,6 olan hastada Salmonella typhi enfeksiyonu düşünülerek siprofloksasin 500 mg. tablet 2x1 başlandı. Kan kültüründe S. typhi üredi. Masif rektal kanama gelişen hastanın Htc değeri % 23,9'a düşünce hastaya üç ünite kan verildi. Kanaması durmayan hasta genel cerrahi yoğun bakımına (GCYB) transfer edildi. Hastanın hematokrit değeri % 19,4'e düşünce acil olarak operasyona alındı. Hastanın tedavisi 21 güne tamamlanarak taburcu edildi. Enterostomi için ikinci operasyon planlandı.
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    Bel fıtığını taklit eden spinal epidural abse
    (2007) Şentürk, Senem; Güzel, Aslan; Geyik, Mehmet Faruk; Ceviz, Adnan
    Brusellozise bağlı spinal epidurel abse (SEA) oldukça nadir görülmekte olup bulguları bel fıtığını taklit edebilir. Bu olgularda en uygun tedavinin ne olduğu hala tartışmalıdır. Öncelikle konservatif tıbbi tedavinin tercih edilmesi, cerrahi tedavinin tıbbi tedaviye yanıt alınamaması durumunda uygulanması önerilmektedir. Bu yazıda siyatalji yakınmaları ile başvuran ve lumbosakral spinal manyetik rezonans görüntüleme (MRG)'sinde spondilodiskitisle birlikte L5-S1 disk aralığı düzeyinde, sol Sİ sinir köküne bası yapan epidural abse saptanan 23 yaşında erkek hasta sunulmaktadır. Radyolojik bulguları ve brusella tüp aglütinasyon testi ile brusellar SEA tanısı alan hastada tıbbi tedavi ile klinik ve radyolojik olarak tam düzelme sağlanmıştır. Brusella SEA'sine bağlı siyatalji yakınmaları bulunan olgularda hafif nörolojik defisit bulguları varlığında dahi tıbbi tedavi öncelikle denenebilir.
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    Brucellar epididymo-orchitis in southeastern part of Turkey: an 8 year experience
    (Elsevier Brazil, 2010) Celen, Mustafa Kemal; Ulug, Mehmet; Ayaz, Celal; Geyik, Mehmet Faruk; Hosoglu, Salih
    Objective: the different clinical and laboratory features and response to treatment of patients with acute brucellar epididymo-orchitis (BEO) reporting to the reference hospital in Southeastern Anatolia of Turkey. Material and methods: in this study, 27 male patients with brucellosis, who presented with epididymitis or epididymo-orchitis (EO) at the university hospital in Diyarbakir from 1998 to 2006, were included. They were compared with the other male patients. Positive blood culture or high agglutination titers of >= 1/160 and positive clinical manifestations of brucellosis were the main criteria for diagnosing brucellosis. Results: fourteen patients had unilateral EO. Leukocytosis was present in 10 patients; all of them had initial agglutination titers of >= 1/160 and 10 patients had a positive blood culture. All patients received combined therapy with streptomycin for the first 21 days (or oral rifampicin for 6-8 weeks) with doxycycline or tetracycline for 6-8 weeks. All showed improvement, fever subsided in 3-7 days, and the scrotal enlargement and tenderness regressed. Only one patient had a relapse within one year. Conclusion: in brucellosis-endemic areas, clinicians encountering EO should consider the likelihood of brucellosis. In this study, young age was the most common risk factor, and leukocytosis and high CRP level were the most common laboratory findings. Most cases were unilateral. All patients responded to medical management very well. Conservative management with combination antibiotic therapy was adequate for managing BEO. Conclusively, brucellosis must be considered as a cause of orchitis, especially in endemic regions like Turkey.
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    A case of brucellar spondylodiscitis involving the cervical spine
    (Ios Press, 2009) Nas, Kemal; Bukte, Yasar; Ustun, Cemal; Cevik, Remzi; Geyik, Mehmet Faruk; Batmaz, Ibrahim
    We have presented a patient of 71-year-age with brucellar spondylodiscitis, involving the cervical spine, especially the C3-C4 segment. The patient had painful percussion of the cervical spine and passive mobilization of the neck, decreased range of motion, and cervical paravertebral tenderness; but no abnormalities observed on neurological examination. Wright agglutination test for brucella was positive at 1/320. Cervical localization for brucellar spondylodiscitis is an unusual case and should be detected and treated as early as possible. In endemic regions, spinal involvement of brucellosis should be considered in cases with fever, neck and low back pain.
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    A Case of Necrotizing Fasciitis due to Intramuscular Injection and Review of the Literature
    (Aves, 2009) Ulug, Mehmet; Celen, Mustafa Kemal; Geyik, Mehmet Faruk; Hosoglu, Salih; Ayaz, Celal
    Necrotizing fasciitis is a life-threatening soft-tissue infection characterized by progressive necrosis of the skin, subcutaneous tissue, and fascia. A twenty-three year-old female patient presented with erythema and pain in the left thigh; both had started 15 days previously. Physical examination revealed swelling, warmth in the left thigh and pain related to passive movement. During follow up, the area involved developed echymotic bullous lesions which shortly spread to the perineal region. Despite appropriate antibiotic therapy and supportive management, the lesions progressed and surgical debridement was carried out. Deep wound and blood cultures revealed Staphylococcus aureus. Clearly, the mortality and morbidity can be decreased with clinical awareness, early diagnosis, effective surgical debridement, and intensive supportive care. In this study, we present a rare case of necrotizing fasciitis in an adult who had no predisposing factor and discuss its clinical manifestations and the best therapeutic choice for this potential life threatening disease, together with a review of the literature.
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    Cervical intramedullary granuloma of Brucella: a case report and review of the literature
    (Springer, 2007) Nas, Kemal; Tasdemir, Nebahat; Cakmak, Erkan; Kemaloglu, Mustafa Serdar; Bukte, Yasar; Geyik, Mehmet Faruk
    The aim of this study was to present a unique case of intramedullary brucellar granuloma (IBG) and to discuss the diagnosis and management. To our knowledge, only one case of thoracic IBG has been reported previously, and our case is the first in cervical spine. A 35-year-old female patient was admitted with headache, pain and weakness in her four extremities. She had no gastrointestinal symptoms and fever. She had been diagnosed with Brucella meningitis 3 months ago and a triple therapy of doxycyclin, rifampicin and trimetoprim/sulfametoxazol (TMP/SMZ) had been started. Medical history revealed that she had ingested raw cheese and taken her medication improperly. Loss of strength was detected in her four extremities, which led us to assume the formation of a mass lesion at cervical level. Therefore, we performed a magnetic resonance imaging scan and found enhancement of an intramedullary mass lesion at cervical 1-2 level. Diagnosis of neurobrucellosis was confirmed by titer of > 1/160 Brucella antibodies both in blood and cerebrospinal fluid. Based on these findings, brucellar granuloma of cervical spine was diagnosed and a combination therapy of doxycyclin, TMP/SMZ and rifampicin was administered for additional 6 months. At the ninth month of treatment, the patient recovered both radiologically and clinically. Our case is unique, in terms of cervical IBG formation. The excellent response to antimicrobial therapy in our patient suggests that, a trial of medical treatment for 6 months may be effective in such cases.
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    Cervical intramedullary granuloma of Brucella: A case report and review of the literature (European Spine Journal DOI: 10.1007/s00586-006-0252-3)
    (2007) Nas, Kemal; Taşdemir, Nebahat; Çakmak, Erkan; Kemaloğulu, Mustafa Serdar; Bükte, Yaşar; Geyik, Mehmet Faruk; 0000-0002-0906-0902
    [No abstract available]
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    Çocuk cerrahisinde nozokomiyal infeksiyonların epidemiyolojisi ve kontrolü
    (2002) Önen, Abdurrahman; Otçu, Selçuk; Çiğdem, Murat Kemal; Dokucu, Ali İhsan; Öztürk, Hayrettin; Geyik, Mehmet Faruk
    Amaç: Çocuk cerrahisinde görülen nazokomiyal infeksiyoıılar (NKİ)'m epidemiyolojisini ve kontrol yöntemlerini araştırmak. Yöntem: Çocuk cerrahisi kliniğinde Ocak 1997Aralık - 2000 tarihleri arasında yatırılıp tedavi edilen 2844 olgu geriye dönük olarak değerlendirildi. NKİ tanımlamasında "Centers for Disease Control and Prevention (CDC)" kriterleri kullanıldı. Bu çalışmada, kliniğimizde görülen NKI'lerin sıklığı, yaş ile ilgisi, İnfeksiyon türleri ve etkenleri, uygulanan invaziv girişimler ve risk faktörleri arasındaki ilişki araştırıldı. Aynı dönem içerisinde NKİ gelişmeyen ancak yaşları ve cinsiyetleri NKİ geçirenler ile uyumlu olan ve hastalık türleri NKİ geçirenler ile aynı olan 78 hasta kontrol grubu olarak alındı. Bu iki grup mortalite ve hastanede yatış süreleri açısından karşılaştırıldı. Bulgular: 78 olguda NKİ tespit edildi. NKİ sıklığı % 2.74 C/997''de % 4.99, 1998'de % 3.89, 1999'da % 1.33 ve 2000'de % l.44) idi. NKİ grubunda yaş ortalaması 28 ay, kontrol grubunda ise 26 ay idi. En sık gelişen NKİ türü cerrahi yara infeksiyonu ve üriner sistem infeksiyonu idi. NKİ gelişen hastalarda en sık eşlik eden predispozan faktörler; üretral kateterizasyon (% 10.26), travma (% 9.25) ve parenteral nütrisyon (% 8.70) idi. 'Hastanede kalış süresi NKİ grubunda 16 gün (428 gün) iken kontrol grubunda 9 gün (222 gün) idi. NKİ ve kontrol grupları arasında mortalité ve hastanede yatış süresi açısından anlamlı fark vardı (sırasıyla p<0.05, p<0.001). Sonuç: Çocuk cerrahisinde en sık görülen NKİ türü cerrahi yara infeksiyonu idi. NKI'li olgularda en sık görülen risk faktörleri üretral kateterizasyon, travma ve parenteral nütrisyon idi. NKİ morialitede, hospitalizasyon süresinde ve tedavi maliyetinde önemli artışa neden oldu. İnfeksiyon hastalıkları birimi ile sıkı iş birliği, cerrahi personelin eğitimi, el yıkama ve dezenfeksiyon, izolasyon, antibiyotik kullanımının kısıtlanması, invazif girişim ve kateterizasyonların endikasyon ve sürelerinin minimuma indirilmesi, risk faktörleri açısından yakın takip ve erken enterai beslenme ile kliniğimizde son iki yılda NKİ hızı belirgin düzeyde azaldı.
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    Çoklu antibiyotik direnci olan bir enterokok meninjiti olgusu
    (1998) Hoşoğlu, Salih; Demirel, Mahmut; Boşnak, Vuslat; Geyik, Mehmet Faruk; Ayaz, Celal
    Enterokok kökenli bir akut bakteriye! menenjit olgusu tanımlandı. On beş yaşında bir erkek çocuğu baş ağrısı, ateş ve bilinç kaybıyla başvurdu. Nörolojik muayenesinde ense sertliği, Kerning ve Brudzynski belirtileri pozitifti. Beyin omurilik sıvısı (BOS)'nın incelemesinde 15.000 $mu$l lökosit (% 96 nötrofil) vardı. Hastanın tedavisine günde 20 milyon ünite penisilin G ile başlandı. Hasta yatışından on saat sonra kaybedildi. Başvuruda alınan BOS kültüründen enterokok izole edildi, izole edilen bakteri glikopeptit antibiyotiklere dirençliydi.
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    Complications of brucellosis in different age groups: A study of 283 cases in Southeastern Anatolia of Turkey
    (Yonsei University College of Medicine, 2003) Gür, Ali; Geyik, Mehmet Faruk; Dikici, Bünyamin; Nas, Kemal; Çevik, Remzi; Saraç, Jale; Hoşoğlu, Salih
    We carried out a retrospective analysis of 283 patients diagnosed with brucellosis in our hospital, which serves almost 5.5 million inhabitants in Southeastern Anatolia in Turkey. Our study focuses on the frequency of complications in cases with brucellosis across different age groups. Patients were classified into three groups according to age: less than 15 years old (group A), 15-45 years old (group B) and over 45 years old (group C). Of 283 patients, 138 (49%) were female and 145 (51%) male. Fifty-three (19%) were younger than 15 years old (group A), 178 (63%) were 15-45 (group B), and 52 (18%) were over 45 (group C). When the distribution of all cases was examined according to months of the year, an increase was seen in June. Osteoarticular complications were the most frequent, found in 195 (69%) cases, followed by cutaneous (17%), genitourinary (8%), nervous (7%), respiratory (5%) and hematological (4%) complications. Treatment failed in 15 patients (5%), owing to true relapse in ten and to non-compliance and drug side effects in the other five. Two hundred seventy-two patients received medical treatment alone and 11 required medical and surgical treatment as well (9 spondylitis and 2 carditis). Complications in brucellosis were frequent because 25% of all patients with brucellosis had more than one complication, more so in group C (38%) than in group A (28%) or B (20%). Cutaneous, hematological and respiratory complications in childhood; osteoarticular and cardiac complications in adults; and genitourinary, neurological and gastrointestinal complications in middle aged were more prominent. In conclusion, the frequency of brucella complications was variable in different age groups in Southeastern Anatolia of Turkey. Since brucellosis is a preventable disease, knowledge and early diagnosis of the complications are especially important. Therefore, population education and medical precautions are necessary to prevent the harmful effects of brucella and its complications. In addition, primary health care physicians should be alerted regarding the clinical and laboratory findings of brucella complications.
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    A continuing problem of tetanus in the southeast of Turkey
    (Blackwell Publishing Ltd, 1997) Hoşoǧlu, Salih; Ayaz, Celal; Geyik, Mehmet Faruk; Yaǧmur, Yusuf; Kökoǧlu, Ömer Faruk; 0000-0002-0906-0902
    Tetanus continues to represent a serious health problem in developing countries [1,2]. Although tetanus is a rare disease in the developed countries [3], it is still common enough to cause concern in Turkey. During the years 1992-3, 75 deaths caused by tetanus were reported from Turkey [4]. Clinical details of 88 adult patients with tetanus who received treatment at our hospital are summarized in this report.
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    Critical evaluation of antimicrobial use - A Turkish university hospital example
    (J Infection Developing Countries, 2013) Hosoglu, Salih; Parlak, Zafer; Geyik, Mehmet Faruk; Palanci, Yilmaz
    Introduction: Antimicrobials are being used unnecessarily for different reasons. The aims of this study were: assessment of the quality of antimicrobial use and determination of the factors related to correct use. Method: Antimicrobial practice at Dicle University Hospital (DUH) was evaluated with a point prevalence approach. Using a standardized data collection form, the patients' data (clinic, epidemiology, laboratory and antimicrobial use) was collected. Possible influential factors on antimicrobial use were examined. Results: In the surveillance study 1,350 inpatients were evaluated; 461 (34.1%) of them were using antimicrobials for treatment and 187 (13.9%) for prophylaxis. Antimicrobial indication was found in 355 of 461 patients (77.0%), and the number of antimicrobials was 1.8 per patient in the treatment group. The most common reason for antimicrobial use was community-acquired infection (57.9%). Pneumonia (20.4%), skin and soft tissue infections (9.11%) and urinary tract infections (7.9%) were the most common infectious diseases. Positive culture results were available for 39 patients (8.5.0%) when antimicrobial treatment started. All steps of antimicrobial use were found appropriate in 243 patients (52.7%). In multivariate analyses, clinical manifestation of infection at the beginning (p<0.001), presence of leukocyte counting (p<0.001) and prescription by an infectious disease specialist were found significantly positive factors for wholly appropriate antimicrobial use. Hospitalization with a diagnosis other than infection was found a significantly negative factor for appropriate antimicrobial use (p=0.001). Conclusion: The quality of antimicrobial use could be improved with better clinical and laboratory diagnosis and consultation with infectious diseases specialists
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    Dicle Üniversitesi Hastanesi çalışanları ve diyaliz hastalarında Staphylococcus aureus burun taşıyıcılığı ve antibiyotik duyarlığının araştırılması
    (Türk Mikrobiyoloji Cemiyeti, 2003) Kökoğlu, Ömer Faruk; Geyik, Mehmet Faruk; Ayaz, Celal; Uçmak, Hasan; Hoşoğlu, Salih
    Nasal carriage of Staphylococcus aureus among health-care workers (HCWs) is a significant risk factor for the epidemic staphylococcal infection in hospitals. With the purpose of determining the incidence of nasal carriage at Dicle University Hospital, 204 HCWs, 36 hemodialysis patients and 50 healthy controls were prospectively screened. Nasal carriage of S. aureus was found in 34 nurses (31.2%), 15 doctors (28.9%), and 17 other personnel (39.5%). In total; 66 HCWs (32.4%), 14 hemodialysis patients (38.9%), and 13 healthy controls (26.0%) were found positive. Twenty-six out of 66 HCW strains (39.4%), eight of out 14 hemodialysis (57.4%), and two of out 13 healthy controls’ (15.4%) methicillin-resistant S. aureus (MRSA) strains were determined. Susceptibility test was performed on 93 S. aureus strains using microdilution method. No strain of S. aureus was found resistant to vancomycin. The susceptibility rates to the antibiotics were as follows: to ofloxacin 74.2%, rifampicin 67.7%, gentamicin 63.4%, sulbactamampicillin 59.1%, tetracycline 54.8%, erythromycin 51.6%, co-trimoxazole 32.3%, cefazolin 26.9%, and clindamycin 21.5 %. All strains were resistant to penicillin G and ampicillin.
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    Dicle Üniversitesi Hastanesi'nde alet ilişkili hastane infeksiyonları
    (Antibiyotik ve Kemoterapi Derneği, 2007) Geyik, Mehmet Faruk; Üstün, Cemal; Hoşoğlu, Salih; Çelen, Mustafa Kemal; Ayaz, Celal
    Dicle Üniversitesi Hastanesi’nde alet kullan›m› ve alet iliflkili hastane infeksiyonlar› (A‹H‹) irdelenmifltir. A‹H‹’lerin tan›mlanmas›nda Centers for Diseases Control and Prevention kriterleri kullan›lm›flt›r. A‹H‹ h›zlar› 1000 alet-gün say›s›na göre hesaplanm›flt›r. Bir y›ll›k sürede 2006 y›l›nda hastanemizde 42843 hasta izlenmifltir. Bu sürede 545 hastada 602 hastane infeksiyonu saptanm›flt›r. Bu infeksiyonlar›n 174’ü A‹H‹ olarak tan›mlanm›flt›r. A‹H‹’n›n 78’i üriner sistem infeksiyonu, 66’s› ventilatör iliflkili pnömoni ve 30’u santral venöz kateter infeksiyonu olarak belirlenmifltir. Araflt›rma sonucunda, 1000 alet kullan›m gününe göre santral venöz kateter iliflkili bakteriyemi 2.7, üriner kateter iliflkili üriner sistem infeksiyonu 2.4 ve ventilatör iliflkili pnömoni 12.7 olarak bulunmufltur. ‹nvaziv giriflim endikasyonlar›n›n iyi konulmas›, kullan›lan ekipman›n mümkün oldu¤unca erken ç›kart›lmas› A‹H‹ h›z›n› azaltacakt›r.