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Effectiveness of Surgical Prophylaxis Where the Antibiotic Resistance is High 抗生素耐药性高的手术预防的有效性
Pub Date : 2020-12-31 DOI: 10.36519/10.36519/idcm.2020.0027
M. Aydın, Esra Nur Karadogan, A. Kadanalı
Objective: We aimed to investigate the risk factors for surgical site infections (SSI) and the effectiveness of prophylactic antibiotic use. Methods: The demographic characteristics, comorbidities, and microbiological examinations of patients diagnosed with SSI who had a cholecystectomy, vaginal hysterectomy, knee prosthesis, hip prosthesis, and gastric surgery between January the 1st, 2014 and December the 31st, 2019 were retrospectively analysed. The diagnosis of healthcare-associated infections and SSI was based on the Centers for Disease Control and Prevention criteria. Results: We detected Gram-negative bacteria in 30% of knee prosthesis infections (60% carbapenem-resistant), 60% of hip prosthesis infections (39% carbapenem-resistant), 36% of vaginal hysterectomy (no carbapenem resistance), 50% of cholecystectomy (no carbapenem resistance), and 20% of gastric surgery (no carbapenem resistance). Staphylococci were the causative agents in 30% of knee prosthesis infections (30% methicillin-resistant) and 20% of hip prosthesis infections (38% methicillin-resistant). Conclusion: We detected multidrug resistance in microorganisms isolated from knee and hip replacement infections. Antibiotic resistance is a big problem, and antibiotic prophylaxis is insufficient to prevent SSI. Doctors should follow up with the patient who underwent surgery closely and take microbiological samples to select appropriate antibiotics when SSI develops.
目的:探讨外科手术部位感染(SSI)的危险因素及预防性使用抗生素的效果。方法:回顾性分析2014年1月1日至2019年12月31日行胆囊切除术、阴道子宫切除术、膝关节假体、髋关节假体和胃手术的SSI患者的人口学特征、合并症和微生物学检查。医疗保健相关感染和SSI的诊断是基于疾病控制和预防中心的标准。结果:我们在30%的膝关节假体感染(60%碳青霉烯耐药)、60%的髋关节假体感染(39%碳青霉烯耐药)、36%的阴道子宫切除术(无碳青霉烯耐药)、50%的胆囊切除术(无碳青霉烯耐药)和20%的胃手术(无碳青霉烯耐药)中检测到革兰氏阴性菌。葡萄球菌是30%的膝关节假体感染(30%耐甲氧西林)和20%的髋关节假体感染(38%耐甲氧西林)的病原体。结论:我们检测到膝关节和髋关节置换术感染分离的微生物的多药耐药。抗生素耐药性是一个大问题,抗生素预防不足以预防SSI。当发生SSI时,医生应密切随访手术患者,并采集微生物样本,选择合适的抗生素。
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引用次数: 0
Relapse of Immune Thrombocytopenic Purpura in a Patient With COVID-19 COVID-19患者免疫性血小板减少性紫癜复发
Pub Date : 2020-12-31 DOI: 10.36519/idcm.2020.0026
G. Cengiz Seval, S. Bozdağ, İ. Akdemir Kalkan, S. Koçak Toprak, P. Topçuoğlu, A. Azap, O. Arslan
COVID-19, caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), has been declared as a global pandemic and worldwide confirmed cases are currently approaching 76 million. And so far, thrombocytopenia has been observed in 5% of hospitalized COVID-19 patients and 8% of those in intensive care unit (1,2). Although the decrease in platelet counts was mild, confirmation of immune etiology has to be confirmed in those with severe thrombocytopenia (<20 x 109/L) or a sudden decrease in the platelet count >50% over 24-48 hours (3). The role of viral infections in the exacerbation of immune thrombocytopenic thrombocytopenia (ITP) has been revealed previously. We hereby report a patient who had exacerbation of ITP and was subsequently found to be COVID-19 positive.
由严重急性呼吸综合征冠状病毒2 (SARS-CoV-2)引起的COVID-19已被宣布为全球大流行,目前全球确诊病例接近7600万例。到目前为止,在5%的住院COVID-19患者和8%的重症监护病房患者中观察到血小板减少(1,2)。虽然血小板计数的减少是轻微的,但在严重的血小板减少症(24-48小时内50%)中必须确认免疫病因(3)。病毒感染在免疫性血小板减少性血小板减少症(ITP)恶化中的作用先前已被揭示。我们在此报告一位ITP加重的患者,随后被发现为COVID-19阳性。
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引用次数: 0
Bacterial Contamination of Cellular Phones: Are Mobile Phones Safer than Smart Phones? 手机细菌污染:手机比智能手机更安全吗?
Pub Date : 2020-12-31 DOI: 10.36519/idcm.2020.0032
Duygu Ozkaya, Sevgi Bilen Ayhan, Çağla Yazar, Ozgen Nahya, Pınar Kılıcdagı, A. Azap
Objective: We aimed to describe pathogenic contamination on healthcare workers’ cellular phones, detect factors associated with contamination, and demonstrate whether there was a link between cell phone contamination and subsequent healthcare-associated infections. Methods: The study was conducted in a 2000-bed tertiary care university hospital in Ankara. A total of 631 healthcare workers (HCWs) from several departments willing to participate were included in the study. Bacterial cultures were taken from each cell phone via rotating a sterile swab moistened with sterile physiological saline solution over both sides of the phone surface and cover. Samples were taken to the bacteriology laboratory within one hour and streaked onto 5% sheep blood agar. Isolated microorganisms were identified with conventional methods. Results: All 631 cell phones investigated had positive cultures; forty-four (6.05%) were pathogenic microorganisms. Drug resistance was not detected among pathogenic bacteria. As determined by univariate analysis, using flip phone cover (P = 0.022), a professional experience of fewer than five years (P = 0.049), having cleaned the phone within the last 48 hours (P = 0.030), and working in a medical ward (P = 0.022) were significantly associated with pathogen contamination on the devices. Multivariate analysis with logistic regression revealed that using flip cover is the only factor associated with pathogen contamination on cell phones (P=0.035). Pathogen contamination on smartphones (7.7%) seemed to be higher than on mobile phones (5.2%) (P=0.263). Conclusion: Pathogen contamination on smartphones was higher than on mobile phones but did not reach statistical significance. Using flip cover covers on cellular phones increases contamination rates. We could not show any HAI occurred by the bacteria isolated from cell phones, but health care workers should pay attention to this issue.
目的:我们旨在描述卫生保健工作者手机上的致病性污染,检测与污染相关的因素,并证明手机污染与随后的卫生保健相关感染之间是否存在联系。方法:本研究在安卡拉一家拥有2000张床位的三级保健大学医院进行。来自多个科室的631名医护人员(HCWs)愿意参与本研究。通过在手机表面和盖子两侧旋转无菌生理盐水溶液湿润的无菌拭子,从每个手机上提取细菌培养物。在一小时内将样品送到细菌学实验室,并在5%羊血琼脂上划线。分离的微生物用常规方法鉴定。结果:631部手机全部培养阳性;病原微生物44种(6.05%)。病原菌中未检出耐药。单变量分析表明,使用翻盖手机壳(P = 0.022)、专业经验少于5年(P = 0.049)、在最近48小时内清洁过手机(P = 0.030)以及在医疗病房工作(P = 0.022)与设备上的病原体污染显著相关。多因素logistic回归分析显示,使用翻盖是唯一与手机病原体污染相关的因素(P=0.035)。智能手机(7.7%)的致病菌污染率高于手机(5.2%)(P=0.263)。结论:智能手机致病菌污染高于手机,但未达到统计学意义。在手机上使用翻盖会增加污染率。我们不能证明从手机中分离出的细菌会引起HAI,但卫生保健工作者应该注意这个问题。
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引用次数: 0
Contaminated Generic Non-approved Remdesivir Vials: New Risk in Treatment of COVID-19 受污染的非批准仿制瑞德西韦小瓶:治疗COVID-19的新风险
Pub Date : 2020-12-31 DOI: 10.36519/idcm.2020.0031
G. Aygun, O. Kayhan, Fatouma Moustapha Houssein, S. Urkmez, A. Kurt, B. Mete
The original trademark name of remdesivir with proven and approved efficacy developed by Gilead is Veklury®. Veklury® is licenced in over 50 countries around the world, including the United States, European Union, Japan, Canada, Australia. Veklury® has not yet been licenced by the Ministry of Health in Turkey. Gilead supplied 17 378 vials of Veklury® to the Health of Ministry of Turkey free of charge. However, Gilead announced that illegal products which are likely to contain remdesivir have been entered our country and sold on the black market (3).
由吉利德开发的经证实有效的瑞德西韦原商标名称为Veklury®。Veklury®在全球50多个国家获得许可,包括美国,欧盟,日本,加拿大,澳大利亚。Veklury®尚未获得土耳其卫生部的许可。吉利德向土耳其卫生部免费提供17 378瓶Veklury®。然而,吉利德宣布,可能含有remdesivir的非法产品已经进入我国并在黑市上销售(3)。
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引用次数: 0
Complete Pelvic Mass Regression Following Tuberculosis Treatment as Indicated by F18-FDG PET/CT F18-FDG PET/CT显示结核治疗后盆腔肿块完全消退
Pub Date : 2020-12-31 DOI: 10.36519/idcm.2020.0025
E. Akbulut, M. Tatoğlu, F. Arslan
This work is licensed under a Creative Commons Attribution-Non Commercial 4.0 International License. ABSTRACT A 19-year-old woman with a history of tuberculosis (TB) in her family presented to the infectious disease clinic of our hospital with right flank pain, nausea, vomiting, a 10kg weight loss, and decreased urine volume for the past two months. Empirical anti-TB treatment was initiated due to her family history of tuberculosis, a positive purified protein derivative skin test, and the presence of a nodule in the posterobasal segment of the lung upon F18-FDG PET/CT. We aimed to present the complete regression of a pelvic mass lesion after empirical tuberculosis treatment that was visualized on follow-up F18-FDG PET/CT imaging and discuss its contribution to the literature. F18-FDG PET/CT imaging followup may offer an invaluable resource for monitoring extrapulmonary involvement of TBinfected patients. The F18-FDG PET/CT imaging method may also contribute to the followup of granulomatous and inflammatory diseases.
本作品采用知识共享署名-非商业4.0国际许可协议。摘要一名19岁女性,家族史为结核(TB),因右侧腹痛、恶心、呕吐、体重减轻10kg、尿量减少2个月来我院传染病门诊就诊。由于其结核病家族史,纯化蛋白衍生物皮肤试验阳性,F18-FDG PET/CT显示肺后基底段存在结节,因此开始经验性抗结核治疗。我们的目的是在随访的F18-FDG PET/CT图像上显示经经验结核治疗后骨盆肿块病变的完全消退,并讨论其对文献的贡献。F18-FDG PET/CT成像随访可能为监测tb感染者肺外受累提供宝贵的资源。F18-FDG PET/CT成像方法也有助于肉芽肿和炎症性疾病的随访。
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引用次数: 0
Infectivity of Adult and Pediatric COVID-19 Patients 成人和儿童COVID-19患者的Infectivity
Pub Date : 2020-12-02 DOI: 10.21203/rs.3.rs-114148/v1
Özlem Doğan, Hacer Aktürk, Berna Özer, Elif Nurtop, Cansel Vatansever, Gülin Özcan, Aydın Çelikyurt, F. Khalilova, A. Okan, S. Incir, C. Saçkesen, Ö. Ergönül
We report infectivity of adult and pediatric COVID-19 patients in presence of viral shedding and anti-SARS-CoV-2 antibody response A total of 408 consequent samples from eleven adult and five pediatric patients with SARS-CoV-2 infection were included. The samples every second day from saliva, nasopharynx, feces, serum, urine, tear were studied by RT-PCR and viral culture. Anti-SARS-CoV-2 antibodies were measured. The median duration of RNA shedding in all specimens was 7(2-15) days in adults and 5(3-19) days in children. The median duration from onset of symptoms to admission was three days.The viral RNA was positive in 44.7 % of the nasopharynx and 37.6% of saliva samples up 16 days in adults and 19 days in chldren. The latest viral culture positivity was detected on day 8 of symptoms in nasopharynx. The viral RNA was found in 6.1% of feces, 4.4% ofserum, 4.3 % of tear, 2.9% of urine. The earliest seroconversion was the 7th day for adults and 8th day for children. Atthe 14th day, total antibody positivity was 78% in adults, and 80% in children. After seroconversion, the viral RNA was still detected in the nasopharynx and saliva of three patients, however, the infectious virus was not present. Earlier hospital admission could be associated with shorter SARS-CoV-2 RNA shedding. The infectivity of patient is very low after 8 days of symptoms. The risk of fecal-oral transmission is very low, and strict hand hygiene measures could be preventive. The positive antibody test result could be used as a discharge criterion.
我们报告了存在病毒脱落和抗SARS-CoV-2抗体应答的成人和儿童COVID-19患者的感染性,共纳入了11名成人和5名儿童SARS-CoV-2感染患者的408份相应样本。采用RT-PCR和病毒培养的方法对每隔一天采集的唾液、鼻咽、粪便、血清、尿液、泪液进行检测。检测抗sars - cov -2抗体。所有标本中RNA脱落的中位持续时间为成人7(2-15)天,儿童5(3-19)天。从出现症状到入院的中位持续时间为3天。病毒RNA在44.7%的鼻咽和37.6%的唾液样本中呈阳性,成人16天,儿童19天。最近一次病毒培养阳性是在出现症状的第8天。在6.1%的粪便、4.4%的血清、4.3%的泪液和2.9%的尿液中发现了病毒RNA。成人血清转化最早为第7天,儿童血清转化最早为第8天。第14天,成人总抗体阳性率为78%,儿童为80%。经血清转化后,3例患者的鼻咽和唾液中仍检测到病毒RNA,但不存在感染性病毒。早期住院可能与较短的SARS-CoV-2 RNA脱落有关。出现症状8天后,患者的传染性很低。粪口传播的风险很低,严格的手部卫生措施可以起到预防作用。抗体检测阳性可作为出院标准。
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引用次数: 1
Crusted (Norwegian) Scabies in a Malnourished Geriatric Patient with Dementia 营养不良老年痴呆患者的结痂性(挪威)疥疮
Pub Date : 2020-11-20 DOI: 10.36519/10.36519/idcm.2020.0017
Z. Karakoç, A. Basel, Yesim Koçak, Binnur Pınarbaşı Şimşek, S. Tuğrul, Figen Akın
Norwegian scabies, which is a highly contagious variant of scabies, is a common parasitic infestation in elderly persons living in care homes. Clinical symptoms may be different in this patient group (slow onset and insidious progression, often without intense itching) with the addition of comorbid conditions, such as dementia and neurological diseases. Healthcare workers should be aware of this form of scabies, which is more common in elderly and cognitively impaired patients. Early diagnosis can be made easily by a microscopic examination of skin lesions. Isolation precautions are important measures to prevent outbreaks. The treatment includes keratolytic agents besides topical and oral scabicides because of the high mite burden and hyperkeratotic lesions of the crusted scabies. In this study, we reported on a case who had resided in a geriatric care home. The patient was diagnosed with crusted scabies and died in our intensive care unit with pneumonia.
挪威疥疮是疥疮的一种高度传染性变种,是生活在养老院的老年人中常见的寄生虫感染。该患者组的临床症状可能不同(发病缓慢,进展隐匿,通常无强烈瘙痒),并伴有合并症,如痴呆和神经系统疾病。卫生保健工作者应该了解这种形式的疥疮,这在老年人和认知障碍患者中更为常见。早期诊断可以很容易地通过显微镜检查皮肤病变。隔离预防措施是预防疫情的重要措施。治疗包括角化剂除了局部和口服杀疥疮,因为高螨负担和过度角化病变结痂疥疮。在这项研究中,我们报告了一个住在老年护理院里的病例。病人被诊断为结痂性疥疮,死于重症监护病房的肺炎。
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引用次数: 0
Candida Infections: Clinical Features, Diagnosis and Treatment 念珠菌感染:临床特征、诊断和治疗
Pub Date : 2020-08-31 DOI: 10.36519/idcm.2020.0006
S. B. Tamo
Candidiasis is an opportunistic infection caused by yeasts of the genus Candida . In recent years, there has been a great deal of interest in Candida infections because of the resurgence of diseases that weaken the immune system and the widespread use of immunosuppressive chemotherapy. The choice of diagnosis method and identification of the Candida species at the origin of the infection is essential for better management of patients, because the infectious mechanisms and the sensitivity to antifungal agents can vary from one Candida species to another. This review provides an overview of the Candida species involved, clinical aspects, diagnostic methods, and treatments available against candidiasis encountered in human pathology.
念珠菌病是念珠菌属酵母菌引起的机会性感染。近年来,由于削弱免疫系统的疾病的死灰复燃以及免疫抑制化疗的广泛使用,人们对念珠菌感染产生了极大的兴趣。诊断方法的选择和感染源念珠菌种类的鉴定对于更好地管理患者至关重要,因为感染机制和对抗真菌药物的敏感性可能因不同的念珠菌种类而异。本文综述了念珠菌的种类、临床方面、诊断方法和治疗方法,以及在人类病理中遇到的念珠菌病。
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引用次数: 4
An Exceptional Use of Two Gloves Technique During COVID-19 Pandemic COVID-19大流行期间双手套技术的特殊使用
Pub Date : 2020-08-31 DOI: 10.36519/idcm.2020.0004
A. Tammaro, G. Adebanjo, C. Solé-Lleonart, J. Rello
1 NESMOS Dermatology Department, Sapienza University of Rome, Azienda Ospedaliera Sant’Andrea, Rome, Italy 2 Hospital Universitari de Vic, Barcelona, Spain 3 Centro de Investigación Biomedica en Red de Enfermedades Respiratorias (CIBERES), Instituto Salud Carlos III Madrid, Spain 4 Clinical Research/Epidemiology in Pneumonia and Sepsis (CRIPS), Vall d’Hebron Institute of Research (VHIR), Barcelona, Spain 5 Clinical Research, CHU Nîmes, Université Montpellier-Nîmes, Nîmes, France
1 NESMOS Dermatology Department,罗马Sapienza University of、Azienda Ospedaliera圣'Andrea,罗马,意大利2维克、巴塞罗那、西班牙3 Universitari医院研究中心网络Biomedica呼吸道疾病(CIBERES马德里卡洛斯三世)、卫生研究所,西班牙4 Clinical Research / Epidemiology in Pneumonia and败血症(CRIPS)、Vall d 'Hebron Institute of Research (VHIR)、巴塞罗那、西班牙5 Clinical Research,楚Nî学月Montpellier-Nî月,Nî月,France
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引用次数: 0
Footprints of the 21st Century Pandemic: Coronavirus History 21世纪大流行的足迹:冠状病毒的历史
Pub Date : 2020-08-31 DOI: 10.36519/idcm.2020.0016
Y. Beşli
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引用次数: 0
期刊
European Journal of Clinical Microbiology and Infectious Diseases
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