TIP, Enfeksiyon Hastalıkları Anabilim Dalı, Makale Koleksiyonuhttp://hdl.handle.net/11616/117982024-03-29T06:08:19Z2024-03-29T06:08:19ZAssessment of the effectiveness of a ventilator associated pneumonia prevention bundle thatcontains endotracheal tube with subglottic drainage and cuff pressure monitorizationAkdogan, OzlemErsoy, YaseminKuzucu, CigdemGedik, EnderTogal, TurkanYetkin, Fundahttp://hdl.handle.net/11616/130792019-07-31T00:02:27Z2017-01-01T00:00:00ZAssessment of the effectiveness of a ventilator associated pneumonia prevention bundle thatcontains endotracheal tube with subglottic drainage and cuff pressure monitorization
Akdogan, Ozlem; Ersoy, Yasemin; Kuzucu, Cigdem; Gedik, Ender; Togal, Turkan; Yetkin, Funda
The effectiveness of prevention bundles on the occurrence and mortality of ventilator associated pneumonia (VAP) was evaluated in many studies. However, the effectiveness of endotracheal tube with subglottic secretion drainage (ETT-SD) and cuff pressure monitorization in VAP bundles have not been adequately assessed. In this study, we aimed to evaluate the effectiveness of VAP bundle containing ETT-SD and cuff pressure monitorization. This was a prospective, controlled study that was carried out between March 2011 and April 2012 including intubated patients. The study was conducted at the Anesthesiology Intensive Care Unit 1 and 2 (10 beds each) in a 898-bed university hospital. Occurrence of VAP and compliance with the parameters of the VAP prevention bundles were assessed daily. Patients intubated with the standard endotracheal tube were recruited as controls, mainly in the first six months of the study as ETT-SD and cuff pressure monometer had not yet been implemented. In the second term, patients intubated with ETT-SD were included as cases. Occurrence of VAP, mortality, and compliance with VAP prevention bundles were monitored. A total of 133 patients, 37 cases and 96 controls were recruited. VAP incidence declined from 40.82 to 22.16 per 1000 ventilator days among controls and cases, respectively (p < 005). On average, VAP occurred 17.33 +/- 21.09 days in the case group and 10.43 +/- 7.83 days in the control group (p = 0.04). However, mortality of cases and controls at the 14th and 30th days was not different. VAP prevention bundles including the utilization of ETT-SD, monitoring cuff pressure, and oral care with chlorhexidine were efficient in reducing the rate of VAP. (C) 2017 Sociedade Brasileira de Infectologia. Published by Elsevier Editora Ltda.
2017-01-01T00:00:00ZAn outbreak associated with multidrug-resistant pseudomonas aeruginosa contamination ofduodenoscopes and an automated endoscope reprocessorYetkin, FundaErsoy, YaseminKuzucu, CigdemOtlu, BarisParmaksiz, NalanSeckin, Yukselhttp://hdl.handle.net/11616/130412019-07-29T11:01:34Z2017-01-01T00:00:00ZAn outbreak associated with multidrug-resistant pseudomonas aeruginosa contamination ofduodenoscopes and an automated endoscope reprocessor
Yetkin, Funda; Ersoy, Yasemin; Kuzucu, Cigdem; Otlu, Baris; Parmaksiz, Nalan; Seckin, Yuksel
Background: Duodenoscopes are semi-critical devices used for endoscopic retrograde cholangiopancreatography (ERCP). Disinfection of these instruments is usually based on high-level disinfection procedures with a manual or automated endoscope reprocessor (AER). Duodenoscopes and AER are reported very rarely as a source of infection and outbreaks.
Aim: To investigate an outbreak caused by Pseudomonas aeruginosa in a Gastroenterology Department and ERCP unit in a university hospital and its underlying risk factors.
Method: Three patients in the gastroenterology unit were diagnosed as infected by multidrug-resistant P. aeruginosa and a case control study was conducted for detection of the risk factors. Our infection control team commenced active epidemiological surveillance to determine the cause of these infections. Clonal relationship of the strains was investigated by pulsed field gel electrophoresis (PFGE).
Results: Eight patients were affected in the gastroenterology unit during the period November 2007-February 2008. The case-control analysis confirmed that undergoing ERCP was significantly associated with isolation of P. aeruginosa (P=0.0001) in this unit. Six patients' isolates and seven environmental isolates had an indistinguishable PFGE profile, confirming cross-transmission. The healthcare worker implemented infection control measures to resolve the outbreak and no further cases occurred.
Conclusions: This outbreak resulted from failure of AER and inadequate high level disinfection procedures. AERs can cause contamination of duodenoscopes and can be related P. aeruginosa outbreaks. Reuse of ancillary materials of ERCP play a critical role in outbreak development.
2017-01-01T00:00:00ZPathogens of ıntensive care unit-acquired ınfections and their antimicrobial resistance: a 9-yearanalysis of data from a university hospitalYetkin, FundaYakupogullari, YusufKuzucu, CigdemErsoy, YaseminOtlu, BarisColak, CemilParmaksiz, Nalanhttp://hdl.handle.net/11616/127402019-07-19T00:00:45Z2018-01-01T00:00:00ZPathogens of ıntensive care unit-acquired ınfections and their antimicrobial resistance: a 9-yearanalysis of data from a university hospital
Yetkin, Funda; Yakupogullari, Yusuf; Kuzucu, Cigdem; Ersoy, Yasemin; Otlu, Baris; Colak, Cemil; Parmaksiz, Nalan
Background: Pathogens surveillance and antimicrobial resistance are essential for the prompt organization of therapeutic and preventive actions in healthcare settings.
Objectives: We investigated the causative agents of intensive care unit (ICU)-acquired infections and their antimicrobial resistance in a university hospital over a nine-year period.
Methods: An active, prospective surveillance was conducted in the ICUs of a tertiary care hospital between 2007 and 2015. The changing patterns in the frequency of pathogens and their antimicrobial resistance by the time were statistically evaluated with Mann-Whitney U test.
Results: A total of 3044 pathogens were isolated from 4272 healthcare-associated infections attacks in 3437 patients. The most frequently detected organisms were Acinetobacter spp. (n = 1060, 34.8%), Pseudomonas aeruginosa (n = 622, 20.4%), Escherichia coli (n = 340, 11.1%), Klebsiella pneumoniae (n = 331, 10.8%), and Candida spp. (n = 285, 9.3%). Carbapenem resistance among Acinetobacter spp., P. aeruginosa, E. coli, and K. pneumoniae was found as 82%, 30.7%, 2%, and 9.3%, respectively. The prevalence of extended-spectrum betalactamase (ESBL) among E. coli and K. pneumoniae was 49.7% and 41.3%, orderly, and methicillin resistance in Staphylococcus aureus was 81.8%. Substantial reductions occurred in the rates of E. coli (16.8% to 8.9%), S. aureus (11% to 3.2%), coagulase-negative staphylococci (7.9% to 0), and Stenotrophomonas maltophilia (4.2% to 0.3%) during the study period by the applied infection control measures while the rate of Acinetobacter spp. (9.7% to 51%) significantly increased. Furthermore, the increases in the carbapenem resistance among Acinetobacter spp. (52.5% to 91.4%), Pseudomonas spp. (25.7% to 51.6%), E. coli (0 to 12.7%), and K. pneumoniae (2.6% to 9%) and the decrease in the prevalence of ESBL-producing E. coli (57% to 27.2%) were statistically significant.
Conclusions: Despite the decreases in the frequencies of staphylococci and some Gram-negative bacteria, the current infection control measures have been unable to limit the spread of carbapenem-resistant Gram-negative bacteria in our facility. Additional precautions are required to control such pathogens in the intensive care units.
2018-01-01T00:00:00ZPatency of middle hepatic vein tributaries and right inferior hepatic vein reconstructed with differentsized ptfe vascular graft in right lobe living donor liver transplantationYonder, H.Akbulut, S.Isik, B.Yilmaz, S.http://hdl.handle.net/11616/127382019-07-18T10:19:09Z2018-01-01T00:00:00ZPatency of middle hepatic vein tributaries and right inferior hepatic vein reconstructed with differentsized ptfe vascular graft in right lobe living donor liver transplantation
Yonder, H.; Akbulut, S.; Isik, B.; Yilmaz, S.
2018-01-01T00:00:00Z