Objective:Urinary tract infections (UTI) are the second most common infection in geriatric population. This study investigated clinical findings, diagnostic approaches, complicating factors, prognosis, causative microorganisms and antimicrobial susceptibility in geriatric patients diagnosed with UTI.Methods:A total of 140 hospitalised patients with UTIs were evaluated within three years between January 2011-January 2015 at the Eskisehir Yunus Emre State Hospital. UTI diagnosed when there were systemic and urinary signs and symptoms and a positive dipstick test and urine culture result, leukocyte and CRP like serum parameters.Results:Among the studied patients, 41.4% had urological diseases, 20.7% had diabetes mellitus and 19.2% had neurological diseases. The most common symptoms and signs were fever, dysuria nausea/vomiting, general condition impairment, pyuria, haematuria. The laboratory values for CRP, ESR and leukocyte count were 84 mg/dL, 56 mm/s and 11.9 (10^3μL), with mean values being determined. Among patients having a urinary catheter (17.1%), 27.9% had a history of UTI, while 29.3% had been hospitalised. Escherichia coli and Klebsiella pneumoniae were the most commonly identified microorganisms. The mean duration for hospitalisation was 7.6 days, while a 5% mortality rate was observed over the course of the disease.Conclusion:Because of the potential for serious complications and mortality, elderly patients with urinary tract infection, should receive immediate empirical treatment based on anamnesis, clinical evaluation and urinalysis and should be re-examined using results from cultures and antibiograms upon follow-up.
ÖzetAmaç: Bu çalışmada, bir devlet hastanesindeki sağlık çalışanla-rında HBV, HAV, HCV ve HIV infeksiyonu seropozitifliğinin araş-tırılması amaçlandı. Yöntemler: 2012-2013 yılları arasında hastanemizde çalışan 586 sağlık personeline ait kayıtlar retrospektif olarak incelendi. Tarama amacıyla alınan kan örneklerinde HBsAg, anti-HBs, anti-HCV, anti-HAV ve anti-HIV kemilüminesans esasına dayanan "enzyme-linked immunosorbent assay" (ELISA) yönte-miyle çalışıldı. Bulgular: Personelimizin 208 (%35.5)'i erkek, 378 (%64.5)'i kadın olup, yaş ortalaması 35.78±8.76 (minimum 18, maksimum 64) yıldı. Çalışmaya katılan personelimizin 282 (%48.1)'si hemşire, 99 (%16.9)'u doktor, 102 (%17.4)'si temizlik personeli, 47 (%8)'si anestezi teknikeri, 56 (%9.6)'sı laboratuvar teknikeriydi. AbstractObjective: The aim of this study was to determine the seroprevalence of HAV, HBV, HCV and HIV infection among health personnel in a state hospital. Methods: Medical records of 586 health personnel who worked between 2012 and 2013 in our hospital were analyzed retrospectively. Serum samples were tested for HBsAg, anti-HBs, anti-HCV, anti-HAV, anti-HIV markers by "enzyme-linked immunosorbent assay" (ELISA) method based on the method of chemiluminescent immunoassay. Results: The staff comprised 208 (35.5%) male, and 378 (64.5%) women workers. The mean age was 35.78±8.76 (minimum 18, maximum 64) years. There were 282 (48.1%) nurses, 99 (16.9%) doctors, 102 (17.4%) cleaning staff, 47 (8%) anesthesia technicians and 56 (9.6%) laboratory technicians. The divisions of the workers were as follows: 125 (21.3%) were working at internal services, 204 (34.8%) at the operating room, 98 (16.7%) at intensive care units, 61 (10.4%) at emergency room and 28 (4.8%) at dialysis unit. While 504 personnel (86%) were positive for anti-HBs, only 5 (0.9%) were found positive for HBsAg. Only 1 (0.2%) cleaning staff was positive for anti-HCV. None was positive for anti-HIV. Anti-HAV has been studied in a total of 152 personnel, 109 (71.7%) of whom were positive. Anti-HBc IgG has been studied in a total of 250 personnel 7 (2.8%) of whom were positive. Conclusions: Healthcare personnel who are at high risk of HBV, HAV, HCV, and HIV infection should be screened for viral hepatitis and those who are not immunized should be vaccinated against HBV and HAV. It is important to follow standard infection control precautions in all patients to prevent diseases transmitted by blood and through contact. Klimik Dergisi 2013; 26(2): 64-7.
Viral Hepatitis Journal, pub lis hed by Ga le nos Pub lis hing. Dear Editor,In chronic renal failure (CRF), infections are important causes of morbidity and mortality. Impaired immune system, frequent blood transfusion because of anemia, vascular intervention for hemodialysis, and exposure to infected patient or equipment are the factors that increase the risk of viral hepatitis infection in hemodialysis (hD) patients (1,2). In a study evaluating viral hepatitis epidemiology in kidney disease (including patients who were on regular hemodialysis, and peritoneum dialysis and renal transplant recipients) performed in in 2010, it has been reported that the prevalence of hBsag positivity was 3.9% and anti-hCv positivity rate was 8.5% (3,4). In this study, we aimed to determine the seroprevalence of hBsag and hepatitis C virus (hCv) as well as antibody response against hepatitis B vaccination in hD patients due to CRF in our hospital.hBsag, anti-hBs and anti-hCv parameters of 64 patients, who underwent hD in 2013, were retrospectively evaluated from patient files. Serum samples were analyzed by a chemiluminescent immunoassay (elISa, liaison, Diasorin, Italy). Statistical analyses were performed by SPSS version 19 (Statistical Package for Social Sciences) package program. Twenty-nine (45.3%) patients were male, 35 (54.7%) were female. The mean age was 59.89±13.85 years. Duration of hD ranged between 12 and 252 months with a mean duration of 83.47±73.25 months. none of the patients was positive for hBsag. anti-hBs was positive in 56 (87.5%) patients and in 24 were positive for anti-hBs despite the absence of history of vaccination against hepatitis B. Fifteen patients (23.4%) were positive for anti-hCv. The anti-hCv positivity was confirmed by repeat testing in all anti-hCv positive patients. anti-hBs titer was lower than 10 mIu/ml in 4 (11.1%) of 36 patients who have completed hepatitis B vaccination schedule. Four patients had not hepatitis vaccination despite being recommended by their physicians.In a study from Turkey, the prevalence of hBsag positivity in hD patients was 5.5 % and anti-hCv positivity was 16% (5). In this study, hBsag positivity was not detected in our hD patients and anti-hCv positivity rate was found to be 23.4%. high anti-hCv positivity rates in our hD patients were attributed to the limited number of patients, the majority (86%) of patients' being at the age of 50 years and over, longer duration of dialysis, and the patients' history of undergoing dialysis in more than one center.Impaired immune response against hepatitis B vaccine is a problem in patients with end-stage renal failure including dialysis patients. In a study from Turkey, the rate of anti-hBs negativity following 3 doses of vaccination against hepatitis B has been reported to be 10.4% (6). our rate of anti-hBs negativity after vaccination against hepatitis B was 11.1%. We assume that this study will contribute to the epidemiological data on seroprevalence of hBv and hCv among hD patients in the eskişehir Province.Anahtar kelimeler...
ÖZObjective: The aim of the study was to evaluate the long-term results of treatment efficacy and safety in nucleos(t)ide analogue-naive (NA-naive) and NA-experienced chronic hepatitis B (CHB) patients receiving tenofovir disoproxil fumarate (TDF) therapy.
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