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    Does marking as sterile mean really sterile? Stenotrophomonas maltophilia outbreak caused by a blood-gas injector containing liquid heparin
    (Cambridge Univ Press, 2023) Dizman, Guelcin Telli; Metan, Gokhan; Karahan, Gizem; Tanriverdi, Elif Seren; Hazirolan, Gulsen; Otlu, Baris; Sonmezer, Meliha Cagla
    An outbreak investigation was initiated after detecting an increase in the number of patients with Stenotrophomonas maltophilia bloodstream infections (SM-BSIs) througout the hospital. S. maltophilia was isolated from the cultures of blood-gas injectors containing liquid heparin. The incidence density of SM-BSIs decreased significantly after prohibiting the use of those injectors.
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    Emergence of colistin and carbapenem-resistant Acinetobacter calcoaceticus-Acinetobacter baumannii (CCR-Acb) complex in a neurological intensive care unit followed by successful control of the outbreak
    (Elsevier Science London, 2020) Metan, Gokhan; Zarakolu, Pinar; Otlu, Baris; Tekin, Ilknur; Aytac, Hanife; Bolek, Ertugrul C.; Metin, Baki C.
    Background: Colistin and carbapenem-resistantAcinetobacter calcoaceticus-Acinetobacter baumannii complex (CCR-Acb complex) was isolated from two consecutive patients in the neurological intensive care unit (NICU). An urgent reaction to this desperate situation was required. Patients and methods: Screening cultures were taken from the other patients sharing the NICU with index patients and repeated periodically. NICU was closed for new admissions. Infection control precautions (ICP) such as hand hygiene, cohorting patients colonized with CCR-Acb complex, cohorting the staff caring for these patients, daily bathing with chlorhexidine gluconate impregnated clothes, using gowns when contacting with patients and patient care area, and sodium hypochlorite tablets for environmental cleaning were enforced. Results: Screening cultures revealed carbapenem-resistant Acb complex in 12 out of 32 patients and 8 of them were colonized with CCR-Acb complex. NICU was opened for new admissions one month later. No further new cases with CCR-Acb complex were detected by screening cultures after 6 weeks with enforcement of ICP. Moreover, the rate of nosocomial infections caused by other multi-drug resistant Gram-negative bacilli (MDR-GNB) decreased significantly when rates before and after closing the NICU were compared. Conclusion: ICP were effective not only to limit the spread of CCR-Acb complex but also decreased the incidence of other MDR-GNB infections when applied adequately. (C) 2019 The Author(s). Published by Elsevier Ltd on behalf of King Saud Bin Abdulaziz University for Health Sciences.
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    The impact of COVID-19 pandemic on nosocomial multidrug-resistant bacterial bloodstream infections and antibiotic consumption in a tertiary care hospital
    (German Medical Science-Gms, 2022) Metan, Gokhan; Cuha, Mervenur Demir; Hazirolan, Gulsen; Dizman, Gulcin Telli; Tanriverdi, Elif Seren; Otlu, Baris; Tas, Zahit
    We investigated the change in the epidemiology of nosocomial blood-stream infections (BSIs) caused by multidrug-resistant bacteria during Coronavirus Disease (COVID-19) and antibiotic consumption rates at a pandemic hospital and at the Oncology Hospital which operated as COVID-19-free on the same university campus. Significant increases in the infection density rate (IDRs) of BSIs caused by carbapenem-resistant Acinetobacter baumannii (CRAB) and ampicillin-resistant Enterococcus faecium (ARE) were detected at the pandemic hospital, whereas car-bapenem-resistant Klebsiella pneumoniae BSIs were increased at the non-pandemic Oncology Hospital. Pulsed field gel electrophoresis showed a polyclonal outbreak of CRAB in COVID-19 intensive care units. Antibiotic consumption rates were increased for almost all antibiotics, and was most significant for meropenem at both of the hospitals. In-creased IDRs of CRAB and ARE BSIs as well as an increased consump-tion rate of broad-spectrum antibiotics emphasize the importance of a multimodal infection prevention strategy combined with an active anti-biotic stewardship program.