Objective Pseudomonas aeruginosa is the most important cause of lung infection among cystic fibrosis (CF) patients, and to reduce the severity of the infection, facility-specific cumulative antibiograms could help clinicians in empirical treatment. Methods Respiratory samples of CF patients between January 2015 and December 2018 were scanned through Laboratory Operating System retrospectively. Demographical data of patients, culture results, and antibiotic susceptibilities are recorded using Microsoft Excel 2010. Cumulative antibiogram data were obtained according to the CLSI M39A4 document. Results The number of registered patients has increased in 4 years from 154 to 253. The mean age of patients varied from 9 to 11.7 (range, 2–42). The ratio of patients with a positive culture for P. aeruginosa increased from 32 to 40%, and the mean patients' age decreased from 16.6 to 11.1 (p <0.05). A total number of 4,146 respiratory samples were analyzed. Sputum samples consisted of 42.5% (n: 1,767) of the samples with a 58.4% isolation rate of P. aeruginosa (n: 1,034). A notable increase of resistance was seen almost all antimicrobials tested by years. The ratio of multidrug-resistant (MDR) P. aeruginosa was 4.1, 10.2, 4.5, and 8.6% in 2015, 2016, 2017, and 2018. Conclusion Antimicrobial resistance is a challenging problem in CF patients, and surveillance should be done regularly.
Background: We aimed to determine hand hygiene (HH) compliance of the healthcare workers (HCW’s) and evaluate if there is an epidemiological relation between the microorganisms isolated from the hands of HCWs and patients clinical materials in the neonatal intensive care unit (NICU).Methods: HH compliance was observed in two unannounced phases in March and in August within the scope of 5 indications determined by WHO. Between two phases personnel was trained to improve HH by educational sessions and introduction of Semmelweis system hand in scan (HIS, Sysmex) in the unit. A total of 22 nurses, 11 physicians and 5 staff was working in the NICU. Hand samples taken from HCW by glove juice method were inoculated quantitatively in culture plates and colonies were identified by MALDI-TOF MS. Epidemiological relation between clinical isolates and hand samples was investigated with arbitrary primed PCR.Results: Although overall compliance remained only 50%, a significant increase in compliance was detected in August prior to aseptic procedures and after contact with patients and body fluids. Alcohol scrub was preferred as 60.4% in March and 75.2% in August. HH efficacy reached to 72% by implementing HIS. During this period, 10.7% of 607 patient’s samples revealed clinically significant growth. Potential pathogens were isolated in 5.2% of 144 hand samples, but any epidemiological correlation with patient isolates was detected.Conclusions: HH compliance observations should be done at regular intervals and current technology could be utilized in trainings to overcome hospital related infections.
Introduction and Objective: Microbiological surveillance guides the antibiotic therapy that plays an important role in maintaining the cystic fibrosis (CF) patients in stable clinical condition. Materials and Method: Respiratory samples (495 sputum, 711 deep pharyngeal swab) from 253 CF patients aged 0-43 were cultivated in conventional media and cumulative antibiogram was determined. A 24 questioned survey was applied to 119 patients for a 3 months period to measure demographic variabilities and knowledge about infection control. Results: The most common pathogen was Pseudomonas aeruginosa (45.7%), followed by Staphylococcus aureus (36%). P. aeruginosa was isolated from 60% of sputum samples and 28.5% of deep pharyngeal swab samples. High rate of resistance was detected to ceftazidime, amikacin and ciprofloxacin that are often preferred in treatment. Low monthly income, more than 9 visits to CF clinic in the last year, hospitalisation in the last year, spending more than 3 hours in CF clinic were significantly associated with P. aeruginosa colonisation. Health care providers was the main source of information (62.2% ).Vast majority of the patients (88.2%) knew that pathogens can be transmitted between the patients and infections could be reduced by using a mask, handwashing and by cleaning nebulizers as declared by 87.4% of participants clean the nebulizer after every usage and 93.3% of them dry it properly. Conclusion: Prevention of infections in CF patients is possible only if patients and their families are alert and have sufficient information about infection control that will provide great improvements in the prognosis.
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