Background/Aim: In recent years, the consumption of broad-spectrum antibiotics used in hospitals and the number of multidrug-resistant pathogens are increasing. Coronavirus disease 2019 (COVID-19) pandemic could also affect consumption of antibiotics used in the treatment of hospital-acquired infections and cause a difference antibiotic resistance rate. There is no study on whether there was a change in this trend during the COVID-19 pandemic in Turkey. Our study was conducted to determine antibiotic consumption, the distribution of bacterial agents in culture samples and changes in their antimicrobial resistance rates in our hospital during the COVID-19 pandemic. Methods: In this retrospective cohort study, January and February 2020 were defined as the pre-pandemic period (PPP), and March and April, as the pandemic period (PP). The bacterial agents isolated from blood, urine, and respiratory samples and the rates of antibiotic consumption during these periods were compared using statistical methods. Results: A total of 3,384 samples were analyzed during the PPP and 2,170 samples, during the PP. While the total bacterial agents isolated in PPP was 469, this number was 394 in PP. The isolation of Escherichia coli, Acinetobacter baumannii complex was significantly lower in the PP (P<0.001; P=0.008, respectively). Conversely, the isolation of Enterococcus spp. was higher during the PP (P<0.001). In the PP, the consumption of piperacillin-tazobactam, teicoplanin, meropenem and fluoroquinolones (ciprofloxacin, levofloxacin, and moxifloxacin) were significantly higher (P<0.001; P=0.016; P=0.016; P=0.02; P<0.001; P=0.018, respectively) while that of cefazolin was significantly lower (P<0.001). Total antibiotic consumptions during the PPP and PP were 725.8 DDD / 1000 and 811.4 DDD / 1000 inpatient days, respectively (P=0.002). Conclusions: Although bacterial agents isolated in PP were lower, antibiotics consumption was higher. The high positivity rate of Enterococcus spp. during the PP suggests that hand hygiene and contact isolation should be strictly observed, as this may be related to the inadequacy of hygiene practices.
Although Saccharomyces boulardii is usually a non-pathogenic fungus, in rare occasions it can cause invasive infection in children. We present the case of an 8-year-old patient in pediatric surgical intensive care unit who developed S. cerevisiae fungemia following probiotic treatment containing S. boulardii. Caspofungin was not effective in this case and he was treated with amphotericin B. We want to emphasize that physicians should be careful about probiotic usage in critically ill patients.
Raoultella planticola is rarely associated with clinical infection, and a limited number of pediatric cases have been reported. Herein we report a case of bacteremia presumptively secondary to bilateral conjunctivitis in an infant caused by R. planticola which was successfully treated with piperacillin-tazobactam. It should be kept in mind that R. planticola can be a pathogen in pediatric age groups.
Numerous vaccines have been generated to decrease the morbidity and mortality of COVID-19. This study aims to evaluate the immunogenicity of the heterologous boosts by BioNTech against homologous boosts by CoronaVac at three-month intervals in two health care worker (HCW) cohorts, with or without prior COVID-19, for one year post-vaccination. This is a prospective cohort study in which the humoral responses of 386 HCWs were followed-up longitudinally in six main groups according to their previous COVID-19 exposure and vaccination status. Anti-SARS-CoV-2 spike-RBD total antibody levels were measured and SARS-CoV-2 neutralization antibody (NAbs) responses against the ancestral Wuhan and the Omicron variant were evaluated comparatively using international standard serum for Wuhan and Omicron, as well as with the aid of a conversion tool. The anti-SARS-CoV-2 spike-RBD total Ab and Nab difference between with and without prior COVID-19, three months after two-dose primary vaccination with CoronaVac, was statistically significant (p = 0.001). In the subsequent follow-ups, this difference was not observed between the groups. Those previously infected (PI) and non-previously infected (NPI) groups receiving BioNTech as the third dose had higher anti-SARS-CoV-2 spike total Ab levels (14.2-fold and 17.4-fold, respectively, p = 0.001) and Nab responses (against Wuhan and Omicron) than those receiving CoronaVac. Ab responses after booster vaccination decreased significantly in all groups at the ninth-month follow-up (p < 0.05); however, Abs were still higher in all booster received groups than that in the primary vaccination. Abs were above the protective level at the twelfth-month measurement in the entire of the second BioNTech received group as the fourth dose of vaccination. In the one-year follow-up period, the increased incidence of COVID-19 in the groups vaccinated with two or three doses of CoronaVac compared with the groups vaccinated with BioNTech as a booster suggested that continuing the heterologous CoronaVac/BioNTech vaccination, revised according to current SARS-CoV-2 variants and with at least a six-month interval booster would be an effective and safe strategy for protection against COVID-19, particularly in health care workers.
Bu çalışmanın amacı Türkiye'de hemşirelik tarihi alanında yapılan lisansüstü tezlerin incelenmesidir.Yöntem: Betimsel bir çalışma olan bu araştırmada, Ulusal Tez Merkezine kayıtlı tezler Türkçe "hemşirelik tarihi", "hemşirelik", "hasta bakımı", "tıp tarihi", "hasta bakıcı" sözcükleri kullanılarak taranmıştır. Veri tabanına kayıtlı 1007 lisansüstü teze ulaşılmıştır. Dâhil edilme kriterlerine uyan sekiz tez, tezin türü, yöntemi, yılı, yapıldığı üniversite ve ana bilim dalı, danışman unvanı ve konusuna göre incelenmiştir.Bulgular: Ülkemizde hemşirelik tarihi ile ilgili yapılan lisansüstü tezlerden biri doktora, yedisi yüksek lisans tezidir. Bu alanda ilk çalışmanın 1998 yılında, en fazla çalışmanın beş tezle Sosyal Bilimler Enstitülerinde yapıldığı, Hemşirelik Ana Bilim Dalı tarafından sadece bir tez yapıldığı belirlenmiştir. Tezlerden dördü hemşirelik teşkilatı ve hemşirelik eğitimini, ikisi geçmiş hemşirelik uygulamalarını, biri ebelik tarihini, biri tarih bilgisinin mesleki tutumlara etkisini ele almıştır.Sonuç: Zengin bir tarihe sahip olan ve ülkemiz topraklarında modernleşen hemşirelik mesleğinin tarihi ile ilgili bu kadar az tez yapılmış olması üzücü ve düşündürücüdür. Arşivlerde hemşirelikle ilgili önemli belgeler ve bilgilerin günümüze gelebilmesi için araştırmacıları beklediği tartışmasız bir gerçektir. Bu nedenle hemşirelikte tarih araştırmalarına ve araştırmacılarına ihtiyaç bulunmaktadır.
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