Introduction: Bloodstream infection caused by extended-spectrum beta-lactamase (ESBL)-producing pathogens has become a serious concern worldwide. The purpose of this study was to identify risk factors for bacteremia due to ESBL-producing Escherichia coli in a Turkish hospital. Methodology: We retrospectively reviewed the medical records of patients with E. coli bacteremia in a tertiary care centre from January 2007 to October 2011. Data from patients such as demographic features, underlying conditions, and antibiotic exposure were analysed. Results: A total of 113 patients with bacteremia due to E. coli were included and data from patients with ESBL-producing E. coli (case patients) were compared to those with non-ESBL-producing E. coli (control patients). The frequency of ESBL producers was 38.9% (44/113). Exposure to fluoroquinolones and cephalosporins, history of intra-abdominal surgery intervention, and presence of central venous catheteter and urinary catheteter were more frequently detected among case patients (P < 0.05). Independent risk factors for bacteremia due to ESBL-producing E. coli were exposure to fluoroquinolones (OR 13.39, 95% CI 1.28-140.03) and cephalosporins (OR 3.48, 95% CI 1.03-11.74). Conclusions: Previous use of fluoroquinolone and cephalosporin in patients with bacteremia caused by E. coli increased the risk for ESBLproducing strains.

Background Before and throughout the COVID-19 pandemic, healthcare workers (HCWs) were victims of workplace violence (WPV). There are no reliable statistics on the occurrence and consequences of WPV against HCWs in Turkey throughout the pandemic period. Objective We investigated the rates of WPV against HCWs in Turkey in the pre-pandemic and pandemic periods, variables associated with WPV, and the relationship between these variables and job satisfaction and burnout. Methods A structured online questionnaire was disseminated through social media channels to HCWs in various healthcare settings. All the respondents also completed the Maslach Burnout Inventory (MBI) and Job Satisfaction Scale. Based on the data obtained, we determined the frequency, causes, and consequences of WPV against HCWs before and during the pandemic. Results There were 701 completed questionnaires. 68.2% of participants were female, and 65.6% of them were doctors. The rate of WPV was 54.1% and 24.3% before and during the pandemic, respectively. Verbal abuse was the most common kind of WPV. Female HCWs were more likely to be physically assaulted than their male counterparts, especially those working in COVID-19 units. The majority of HCWs who were exposed to the violence at least once did not report WPV. HCWs exposed to WPV during the pandemic reported more emotional exhaustion and depersonalization and a lower perceived level of personal achievement. Conclusion HCWs were exposed to significant levels of violence both before and during the pandemic. Preventing WPV against HCWs and removing barriers to reporting abuse is crucial.

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Ö ÖZ ZE ET T A Am ma aç ç: : Sağlık çalışanları kan yoluyla bulaşan enfeksiyonlar açısından önemli bir risk grubundadır. Perkütan ve mukozal yaralanma bu riskin artmasında en yaygın sebeptir. Bu çalışmada hastanemizdeki 4 yıl içerisinde görülen kesici delici alet yaralanmalarının epidemiyolojisi ve korunmaya yönelik önlemle-rin etkinliğini belirlemek amaçlandı. G Ge er re eç ç v ve e Y Yö ön nt te em ml le er r: : Ocak 2013-Aralık 2016 yılları arasında Erzurum Bölge Eğitim ve Araştırma Hastanesi'nde meydana gelen 177 delici kesici alet yaralanması retrospektif olarak değerlendirildi. B Bu ul lg gu ul la ar r: : Yaralanmalar perkütan yaralanma olup yüzeyel yaralanma oranı daha yüksekti. Dört yıl içerisinde yaralanma sayılarında düşme kaydedildi. Sağlık personellerinin %65'i kadın, %35'i erkekti. Meslek gruplarına bakıldığında %44,1'i hemşire, %27,1'i stajer hemşire idi. Klinik servisler, kan alma yaralanmaların en fazla yaşandığı alanlardı. Perkütan yaralanmaların %39,5'inin damar yolu açma esnasında ve en fazla sol el yaralanması olduğu kaydedildi. Yaralananların %19,8'inin koruyucu ekipman kullanmadığı, % 63.3'ünün tek kat eldiven, %13,6'sının çift kat eldiven kullandığı tespit edildi. 177 personelin 163'ünün Anti-HBs'si pozitif saptandı. Temasa maruz kalınan hastaların 23'ü HBsAg pozitif, 14'ü Anti-HCV pozitif, 1'i Anti-HIV pozitif, 2'si Kırım Kongo kanamalı ateş (KKKA) pozitif olarak saptandı. Bağışıklığı olmayan ve HBsAg pozitif kaynakla temas eden 3 personele hepatit B aşısı ve immünglobulin yapıldı. HIV pozitif kaynak kontaminasyonu olan 1 personele 1 ay antiretroviral profilaksi, 2 KKKA hastasının kanına maruz kalan personele 7 gün ribavirin profilaksisi verildi. HCV pozitif hastanın materyali ile teması olan personelin 6 ay süre ile laboratuvar sonuçları gözlendi. Sonuçta hiçbir personelde HCV serokonversiyonu izlenmedi. Hepatit C için tedavi uygulanmadı. S So on nu uç ç: : Kesici delici alet yaralanmalarının oranlarının ve zararlarının en aza indirilmesi için standart enfeksiyon kontrol önlemle-rinin uygulanması ve personelin yaralanmalar karşısında duyarlılığının artırılması gereklidir.A An na ah h t ta ar r K Ke e l li i m me e l le er r: : Yaralar, kesici alet; sağlık personeli; enfeksiyon A AB BS S T TR RA AC CT T O Ob bj je ec ct ti iv ve e: : Health workers are in the risk group of bloodborne infections. Percutaneous and mucosal injuries are leading cause of increasement of this risk. In this study we aim to determine the effectiveness of preventive precautions and epidemiology of sharp and needlestick object injuries encountered during 4 years period in our hospital. M Ma at te er ri ia al l a an nd d M Me et th ho od ds s: : 177 sharp and needlestick object injuries between january 2013 and december 2016 were evaluated retrospectively in Erzurum regional training and research hospital. R Re es su ul lt ts s: : Percutaneous superficial injury ratios were higher. Decrease in injury rate during 4 year period was recorded. 65% female and 35% male healthcare workers were exposed to sharp and needlest...

We report a case of infective endocarditis secondary to healthcare-associated bloodstream infection caused by an uncommon etiologic agent, multidrug-resistant Enterobacter cloacae. The patient was treated with a combination of antimicrobial therapy and surgery, but could not be saved. With this case, we discuss the prevalence, risk factors, treatment options, and outcomes of the rarely encountered Enterobacter cloacae-associated infective endocarditis.