Turkey

Veterinarians and veterinary technicians are at risk for occupational brucellosis. We described the risk factors of occupational brucellosis among veterinary personnel in Turkey. A multicenter retrospective survey was performed among veterinary personnel who were actively working in the field. Of 712 veterinary personnel, 84(11.8%) had occupational brucellosis. The median number of years since graduation was 7 (interquartile ranges [IQR], 4-11) years in the occupational brucellosis group, whereas this number was 9 (IQR, 4-16) years in the non-brucellosis group (p < 0.001). In multivariable analysis, working in the private sector (odds ratio [OR], 2.8; 95% confidence interval [95% CI], 1.55-5.28, p = 0.001), being male (OR, 4.5; 95% CI, 1.05-18.84, p = 0.041), number of performed deliveries (OR, 1.01; 95% CI, 1.002-1.02, p = 0.014), and injury during Brucella vaccine administration (OR, 5.4; 95% CI, 3.16-9.3, p < 0.001) were found to be risk factors for occupational brucellosis. We suggest that all veterinary personnel should be trained on brucellosis and the importance of using personal protective equipment in order to avoid this infection. (C) 2014 Elsevier B.V. All rights reserved

Evaluation of patients with zygomycosis

Aim: Zygomycosis is a severe angioinvasive infection caused by Zygomycetes. We retrospectively investigated 16 cases of zygomycosis.Materials and methods: The data of patients, who had been followed between 2004 and 2010 in 8 tertiary-care teaching hospitals, were reviewed. Demographic characteristics, underlying diseases, and clinical signs and symptoms of the patients, as well as diagnostic methods, data obtained by radiological imaging methods, and the therapies, were recorded. Therapeutic approaches, antifungal agents and duration of use, and the characteristics of the cases were identified.Results: The study included 11 female and 5 male subjects. The most common symptoms and clinical signs were fever (n = 9) and retro-orbital pain (n = 7). Rhinocerebral zygomycosis was the most common form. The mean time elapsed for diagnosis was 14.26 +/- 13.96 (range: 2-52) days. Antifungal therapy was given to 15 patients (94%). In addition to antifungal therapy, 12 patients underwent surgical intervention 1 to 4 times. The mean duration of receiving antifungal therapy was 61.4 +/- 58.02 (range: 1-180) days. The median duration of treatment was 62.5 (range: 42-180) days in survivors.Conclusion: Zygomycosis is an infectious disease with high mortality despite antifungal therapy and surgical interventions

Risk factors for occupational brucellosis among veterinary personnel in Turkey.

Veterinarians and veterinary technicians are at risk for occupational brucellosis. We described the risk factors of occupational brucellosis among veterinary personnel in Turkey. A multicenter retrospective survey was performed among veterinary personnel who were actively working in the field. Of 712 veterinary personnel, 84 (11.8%) had occupational brucellosis. The median number of years since graduation was 7 (interquartile ranges [IQR], 4-11) years in the occupational brucellosis group, whereas this number was 9 (IQR, 4-16) years in the non-brucellosis group (p<0.001). In multivariable analysis, working in the private sector (odds ratio [OR], 2.8; 95% confidence interval [95% CI], 1.55-5.28, p=0.001), being male (OR, 4.5; 95% CI, 1.05-18.84, p=0.041), number of performed deliveries (OR, 1.01; 95% CI, 1.002-1.02, p=0.014), and injury during Brucella vaccine administration (OR, 5.4; 95% CI, 3.16-9.3, p<0.001) were found to be risk factors for occupational brucellosis. We suggest that all veterinary personnel should be trained on brucellosis and the importance of using personal protective equipment in order to avoid this infection

The evaluation of antifungal consumption: a point-prevalence survey

WOS: 00041171580024

Multicenter Analysis of Anidulafungin Use in Invasive Candida Infections

Introduction: Fungal infections are vital problems worldwide and their incidence have increased along with changing patient profile. Particularly candida species is still the most commonfungal agent, and the significance of non-albicans candida species have gained importance in recent years. In the present study, it was aimed to evaluate retrospectively the risk factors and distribution of candida species in patients with invasive candida infections, who were treated with anidulafungin.Materials and Methods: In the first three years (1 January 2012 to 31 December 2014) when anidulafungin came out in our country, we retrospectively evaluated the data of the patients with invasive candida infections who were treated by anidulafungin for more than 48 hours in seven university hospitals. Data were recorded to the case report forms.Results: Two hundreds and fifty-seven patients were included into the study. Fifty-six percent of the patients were male and mean age was 58.57 +/- 19.5 years. Two hundreds and three patients (79%) were hospitalized in intensive care units, 37 (14.3%) in internal medicine services, and 17 (0.07%) in surgery services. As previously described, we detected antibiotic usage in the last month (%96.9), presence of urinary catheter (90.3%) and presence of central venous catheter (82.1%) as risk factors for invasive candida infections. More than half of the patients (57.1%) with central venous catheter had candidemia. Sixty-six (47.7%) of the blood isolates were Candida albicans, 33 (23.7%) were Candida parapsilosis, 17 (12.2%) were Candida tropicalis and 13 (9.4%) were Candida glabrata. During follow up, 64.5% of 124 patients whose catheters couldn't be taken off and 47.6% of 86 patients whose catheters could be taken off died. During anidulafungin treatment, one anaphylaxis, one skin eruption and one thrombocytopenia were seen as side effects.Conclusion: In our study, we found that removal of central venous catheter of the patients with candidemia was a positive effect on mortality. We suggest that patients with candidemia, insisting on catheter removal besides antifungal treatment is necessary. We observed that anidulafungin is an effective and safe choice in invasive candida infections.C1 [Isikgoz Tasbakan, Meltem; Pullukcu, Husnu; Mermut, Gulsen] Univ Ege, Fac Med, Dept Infect Dis & Clin Microbiol, Izmir, Turkey.[Eren Kutsoylu, Oya; Alp Cavus, Sema; Avkan Oguz, Vildan; Yapar, Nur] Univ Dokuz Eylul, Fac Med, Dept Infect Dis & Clin Microbiol, Izmir, Turkey.[Sayin Kutlu, Selda; Kutlu, Murat] Univ Pamukkale, Fac Med, Dept Infect Dis & Clin Microbiol, Denizli, Turkey.[Ozturk, Barcin; Ertugrul, Mustafa Bulent] Adnan Menderes Univ, Fac Med, Dept Infect Dis & Clin Microbiol, Aydin, Turkey.[Kaya, Onur] Univ Suleyman Demirel, Fac Med, Dept Infect Dis & Clin Microbiol, Isparta, Turkey.[Turhan, Ozge] Univ Akdeniz, Fac Med, Dept Infect Dis & Clin Microbiol, Antalya, Turkey.[Senol Akat, Sebnem; Cetin, Cigdem Banu] Univ Celal Bayar, Fac Med, Dept Infect Dis & Clin Microbiol, Manisa, Turkey.[Metin, Dilek Yesim] Univ Ege, Fac Med, Dept Med Microbiol, Izmir, Turkey.[Ozhak, Betil] Univ Akdeniz, Fac Med, Dept Med Microbiol, Antalya, Turkey.[Ergin, Cagri] Univ Pamukkale, Fac Med, Dept Med Microbiol, Denizli, Turkey

Management of Brucella endocarditis: Results of the Gulhane study

PubMed ID: 22727531Brucella endocarditis (BE) is a rare but life-threatening complication of human brucellosis. The aim of this study was to investigate the course of BE along with the therapeutic interrelations. A total of 53 patients with BE hospitalised in 19 health institutions between 2006 and 2011 were included in the Gulhane study. Diagnosis of brucellosis was established by either isolation of Brucella sp. or the presence of antibodies, and the definition of endocarditis was made according to Duke's criteria. There were four treatment groups: ceftriaxone combined with oral antibiotics (Group 1); aminoglycosides combined with oral antibiotics (Group 2); oral antibiotic combinations (Group 3); and aminoglycoside plus ceftriaxone combined with an oral antibiotic (Group 4). Involvement rates of the aortic, mitral and tricuspid valves were 49.1%, 43.4% and 5.7%, respectively. Thirty-two patients (60.4%) had an underlying cardiac valvular problem, including previous prosthetic valve replacement (n = 18). Medical treatment was provided to 32 patients (60.4%), whilst concordant medical and surgical approaches were provided to 21 patients (39.6%). Mortality in Group 1 was 15% (3/20), whilst in Group 2 it was 5.3% (1/19). In Group 3, 25.0% (3/12) of the cases died, whereas none of the cases in Group 4 died. In conclusion, mortality increased 47-fold with pericardial effusion and 25-fold due to congestive heart failure that developed after BE. Although mortality was lower in the aminoglycoside-containing arm (Groups 2 and 4), statistical analysis could not be performed owing to the small number of patients. © 2012 Elsevier B.V. and the International Society of Chemotherapy. All rights reserved