BackgroundColistin-resistant Pseudomonas aeruginosa (P. aeruginosa) has been defined as pandrug-resistant (PDR) strain. Outbreaks of PDR P. aeruginosa especially in pulmonary tract infections due to contaminated bronchoscopes have rarely been reported. The emergence of pandrug-resistant strains in both CF (Cystic Fibrosis) and non-CF clinical isolates over recent years remains of a great concern. Hospital wards contaminated with PDR P. aeruginosa infection, must be shot down until their eradication. Health Authorities must be informed immediately and infection control strategies must be implemented.AimTo report such an outbreak and modify the infection control strategy in an academic hospital in Ankara Turkey.MethodsFrom October to December 2013, PDR-Pseudomonas aerogionsa were identified from bronchial cultures of 15 patients who had undergone bronchoscopy prior to the infection. Three batches of surveillance cultures were obtained from the environmental objects and healthcare workers related to the procedures. Pulsed-field gel electrophoresis (PFGE) was used for bacterial typing. Antimicrobial susceptibility was assessed by disc diffusion and E-test methods.FindingsA total of 70 specimens were obtained during the first surveillance operation. One Colistin-resistant P. aeroginosa was isolated from a bronchoscope. Although the disinfection protocols for bronchoscope were revised and implemented, seven additional bronchial cases were identified thereafter. The pathogen was identified from two subsequent surveillance cultures and was not eliminated until Ethylene oxide sterilization was added to the disinfection protocol. PFGE revealed that all 15 isolates from the patients and the three isolates from the bronchoscope shared a common pattern with minor variance. XbaI restriction enzyme turned out better than SpeI in interpreting bacterial pulse types with BioNumerics 6.0. The most suitable cut off value for SpeI was above 80% Dice similarity while for XbaI above 95%Dice similarity with BioNumerics 6.0.ConclusionThe outbreak of “Colistin” pan drug-resistant Pseudomonas aeroginosa was caused by a contaminated bronchoscope and was terminated by the implementation of a revised disinfection protocol for bronchoscope.
The purpose of this study is to perform the validity-reliability analysis of the three subtests of Basic School Skills Inventory 3 -Mathematics, Classroom Behavior and Daily Life skills -and do its adaptation for four to six year-old Turkish children. The sample of the study included 595 four to six year-old Turkish children attending public and private schools. The schools were selected from among the central towns of the province Konya based on random sampling method considering the social-economic conditions. For the reliability of the subtests of the Basic School Skills Inventory -that's Mathematics, Classroom Behavior and Daily Life and Skills -analyses were made to determine the internal consistency (Cronbach's Alpha), split-test reliability and test-retest reliability coefficient. The validity of the inventory was measured using construct, content and concurrent validity. The results showed that the Basic School Skills Inventory -Mathematics, Daily Life and Classroom Behavior Skills -was a reliable and valid instrument for Turkish children aged four to six years.
BackgroundThe optimal level of adherence necessary to achieve acceptable disease and quality-of-life outcomes for patients is not known. In order to identify these optimal levels, we need reliable and valid measures of adherence. Medication Adherence Scale in FMF (MASIF) is an instrument designed to measure adherence to treatment in children with FMF. We have developed this scale for children with FMF and found valid and reliable (1).ObjectivesIt was aimed to assess the validity and reliability of this adherence scale for medical treatment in adult FMF patients.MethodsThis study is multicentre and 14 centers participated to the study. Patients with FMF using medication at least for 6 months and accepted to participate constituted the sample of the study. Besides “Medication Adherence Scale in FMF Patients (MASIF)”, “Data collection forms about the sociodemographic and medical information (demographic, clinical and laboratory findings) of patients”, was used as data collection instruments. Morisky medication adherence scale was used as a gold standard in order to evaluate the criterion validity of MASIF. We assessed the validity of the adult version of the MASIF using the OMERACT filter.ResultsThe median age of the patients (n=133) was 28.60 years (min.18.12-max.71.34) and 52.6% of them were female. For internal consistency, Cronbach's alpha was 0,764 for MASIF adult version. Also, there was a positive and significant correlation between test and retest score (t=0.971; p=0.340). For the “criterion validity” the correlation with Morisky and MASIF was evaluated (r=0.530, p=0.000) and for the “structure” validity, factor analyzes and Kaiser-Meyer-Olkin tests were performed. After these tests, MASIF was found as a valid and reliable instrument. MASIF consists of 18 items and 4 sub-dimensions: knowledge about the medication, adherence to the treatment, barriers to drug use, factors that may increase compliance. The total score ranged from 18 to 90. A high score showed a good adherence to treatment. The cut-off point was determined as 55 points. A point over 55 was accepted as “good medication adherence” and a point less than 55 was considered as “bad medication adherence”ConclusionsApproximately 10-15% of patients with FMF are non-responders but it was claimed that in fact they are non-compliers that causes these patients receive unnecessary biologic agent treatment procedures, which are expensive and have some serious adverse effects. This scale will provide assessment and follow up of adherence to treatment patients and determine whether the patient is non-responders or non-compliers. It may help to determine the non-compliance and prevent unnecessary and expensive biologic agents.Disclosure of InterestNone declared
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