Factors Affecting Inadequate Empirical Antimicrobial Therapy and the Clinical Course of Upper Urinary Tract Infections in Elderly Patients: A Multicenter Study

7th International Congress of Infectious-Diseases-and-Clinical-Microbiology-Speciality-Society-of-Turkey -- MAY 08-13, 2018 -- Antalya, TURKEYIntroduction: In this study, we aimed to determine the risk factors associated with inadequate empirical antibiotherapy (IEAT) and hospital-related mortality in elderly patients being treated for upper urinary tract infections (UTI). Materials and Methods: This study included individuals aged 65 years and over who were hospitalized after being diagnosed of community-acquired UTI or community-onset healthcare-associated UTI and followed-up in clinics and/or intensive care units (ICU) of 33 hospitals between March and September 2017. Results: A total of 525 patients (48% males; mean age: 76.46 +/- 7.93 years) were included in the study. Overall, 68.2% of the patients were hospitalized through the emergency department and 73.9% of patients were followed-up for pyelonephritis. Gram-negative, Gram-positive, and Gram-negative and positive mix growths were determined in 88%, 9.3%, and 2.7% of urine cultures, respectively. Fifty-six (10.7%) of the patients died. In multivariate analysis, the presence of chronic obstructive pulmonary disease [Odds ratio (OR): 2.278], age 85 years and over (OR: 2.816), admission to the ICU (OR: 14.831), and IEAT (OR: 2.364) were independent factors that significantly affected mortality. The presence of a urinary catheter, being followed-up in the ICU, benign prostate hypertrophy, use of antibiotics other than piperacillin-tazobactam and carbapenem were determined as independent factors that significantly affected IEAT (p<0.05). Conclusion: In our study, we found a direct correlation between IEAT and mortality. Therefore, knowing the most frequent microorganisms and antibiotic susceptibility profiles observed in the UTI of elderly patients may help to decrease the mortality and morbidity associated with these infections.Infect Dis & Clin Microbil Special Soc Turkiy

It Could Have Been Protected but Wasn't

INTRODUCTION[|]Introduction: Percutaneous injuries create shared occupational risk for all health workers. These injuries can lead to a loss of workforce and a decrease in the quality of health services by causing physical and psychiatric disorders. Our study aimed to identify the epidemiology of incised wounds that have occurred within the past four years effectiveness of preventive measures at the Kahramanmaraş Sütçü İmam University Faculty of Medicine Hospital.[¤]METHODS[|]Method This research was carried out with the retrospective study of incised wound cases that occurred at the KSU Faculty of Medicine Hospital between January 1, 2013 and December 31, 2016. Health personnel were examined in terms of gender, professional group, form of injury, locations of injury, compliance with protective barriers used, and precautions taken. The acquired data were evaluated in Microsoft Excel using numerical and percentage calculations.[¤]RESULTS[|]Findings: Of the injured health personnel, 61% were women and 39% were men. Of the group of injured personnel comprises nurses with 39% (94), followed by intern nurses 27% (65), sanitation personnel with 24% (56), doctors with 8% (18), three laboratory technicians, and two data-entry personnel. The most frequently injured bodily region was the left hand with 51.2% (122), followed by the right hand with 43.6% (104). The most frequent injury took place while covering the tip of a needle with 36%. No type of protective equipment was used for 71% of the health personnel who were included in the study.[¤]DISCUSSION AND CONCLUSION[|]Results: The fact that the most injuries occurred in nursing and sanitation personnel in the study produced the result of the provision of the education necessary to minimize contact with hands of cutting and perforating tools and for the propagation of the use of medical waste containers that provide for distancing the waste materials used, because the most frequent form of injury was recapping needle points. That there was high noncompliance with the use of protective equipment revealed that health workers needed to be subjected to certain, periodic training. In addition to this, the care for injuries and the provision of training in which the infection control committee needed to be referred to in situations of injury was brought to the forefront.[¤