Okuloglanduler ve orofaringeal tularemi: Olgu sunumu ve literatür derlemesi

Tularemi hastalığı küçük, Gram-negatif, pleomorfik kokobasil olan Francisella tularensis bakterisi ile oluşur. Okuloglanduler tularemi nadir görülen bir formdur. Okologlanduler tularemi ile ilgili az sayıda yayın vardır, PubMed taramasında günümüze kadar 20'den az yayın bulunmaktadır. Bu yazıda okuloglanduler ve orofaringeal tularemi tanısı konulan, 31 yaşında bir bayan olgu sunuldu ve okuloglanduler tularemi ile ilgili yayınlar derlendi. Olgu hastanemize üç haftadır devam eden ani başlangıçlı ateş, halsizlik, baş ağrısı, boğaz ağrısı, sol gözde kızarıklık, üst göz kapağında şişlik, göz yaşında artma ve sol preaurikuler bölgede ağrısız şişlik ve genel vücut ağrısı ile başvurdu, göz travması öyküsü yoktu. Tulareminin endemik olduğu bir köyde oturuyordu, hayvan teması öyküsü yoktu. Klinik bulgularla okuloglanduler ve orofaringeal tularemi tanısı konuldu, tanı mikroaglütinasyon testi ve PCR ile konfirme edildi. Olgu siprofloksasin tedavisinin sekizinci gününde tamamen iyileşti. Tularemi, ateş, boğaz ağrısı, konjunktivit ve servikal kitlesi olan ve özellikle penisilin veya sefalosporin tedavisine yanıt vermeyen ve tulareminin endemik olduğu bölgeden gelen olgularda akla gelmelidir.Tularemia is caused by a small, Gram-negative, pleomorphic coccobacillus, Francisella tularensis. Oculoglandular tularemia is a rare clinical form. There are few reports about oculoglandular tularemia, and less than 20 cases with oculaglandular tularemia have been reported in PubMed up to date. We reviewed the literature about oculoglandular tularemia, and reported a 31-year-old woman with oculoglandular and oropharyngeal tularemia. She admitted to our hospital with a three-week history of sudden onset of fever, fatigue, headache, sore throat, swollen left upper lid, injected and erythematous left eye, epiphora, preauricular nontender lump on the left and generalized aches, but there was no history of eye injury. She was living in a village where tularemia is endemic, but no history of encountering with an animal. The clinical diagnosis of oculoglandular and orophayngeal tularemia was confirmed by microagglutination test and PCR. She was fully improved on the eighth day of the ciprofloxacine treatment. Tularemia should come to mind in patients with fever, severe throat, conjunctivitis and cervical masses especially unresponsive to penicillin or cephalosporine therapy, coming from a tularemia endemic area

Factors effecting the duration of hospitalization and mortality in patients with community-acquired pneumonia

Toplum kökenli pnömoni (TKP) sık rastlanan, morbidite ve mortalitesi yüksek bir enfeksiyon hastalığıdır. Bu çalışmada Ocak 2005-Aralık 2007 tarihleri arasında kliniğimizce TKP tanısı ile takip ve tedavi edilen hastaların demografik özellikleri, altta yatan hastalıkları, etken dağılımları ve bu hastalarda yatış süresini ve mortaliteyi etkileyen risk faktörlerinin değerlendirilmesi amaçlanmıştır. Çalışmaya alınan 97 hastanın 65 (%67)'i erkek, 32 (%33)'si kadın olup, ortalama yaş 62.7 (yaş aralığı: 18-94) yıldır. Hastalar, Türk Toraks Derneği kriterlerine göre gruplandırıldığında; 22 hasta grup 2 (risk faktörü olan, ağırlaştırıcı faktörleri olmayan hastalar), 59 hasta grup 3 (ağırlaştırıcı faktörleri olan hastalar) ve 16 hasta grup 4 (yoğun bakıma yatırılma ölçütleri olan hastalar) olarak değerlendirilmiştir. Hastalar ayrıca Amerikan Toraks Der-neği'nin önerdiği skorlama sistemine (KÜSK-65= Konfüzyon, Üre > 7 mmol/L, Solunum hızı > 30/dakika, düşük Kan basıncı ve > 65 yaş) göre de değerlendirilmiş, buna göre KÜSK-65 skoru 0 ve 1 olan hastalar grup I (n= 65); 2 olanlar grup II (n= 20) ve > 3 olanlar grup III (n=12) olarak gruplandırılmıştır. On bir (%11.3) hastada mekanik ventilator desteğine ihtiyaç duyulmuş ve toplam altı (%6.2) hasta kaybedilmiştir. Balgam çıkarabilen 60 hastanın 27 (%45)'sinden nitelikli örnek alınabilmiş ve 14 (%23.3)'ünden etken izole edilmiştir (8 Streptococcus pneumoniae, 2 metisiline duyarlı Staphylococcus aureus, 2 Klebsiella pneumoniae, 1 Haemophilus influenzae, 1 Moraxella catarrhalis). Hastaların 37'si levofloksasin, 10'u mok-sifloksasin, 24'ü seftriakson ± klaritromisin, 16'sı sulbaktam-ampisilin ± siprofloksasin, 10'u farklı beta-lak-tam/beta-laktamaz inhibitörü kombinasyonları ile tedavi edilmiş ve hastaların 83 (%85.6)'ünde ateşin ortalama 2.5 gün içinde düştüğü izlenmiştir. Olguların hastanede yatış süresi ortalama 11.1 (3-29) gün olarak hesaplanmış ve yatış sürelerine etki eden faktörlerin değerlendirilmesinde; > 65 yaş, cinsiyet, altta yatan hastalık varlığı, santral venöz kateterizasyon, nazogastrik sonda uygulanması, kültürde üreme olması, önceden antibiyotik kullanımı, antibiyotik tedavisine rağmen ateşin > 3 günde düşmesi ve skorlama grupları anlamlı değilken (hepsi için p> 0.05), mekanik ventilasyon uygulaması anlamlı bir risk faktörü olarak saptanmıştır (p 3 günde düşmesi (p= 0.05) olarak belirlenmiştir. Sonuç olarak; TKP olgularında risk faktörlerinin iyi tanımlanması ve ulusal veya uluslararası rehberler doğrultusunda ampirik antibiyotik tedavisinin başlanması ile hastanede yatış süresinin, mortalitenin ve tedavi maliyetinin azaltılması sağlanabilir.Community-acquired pneumonia (CAP) is a common infectious disease with high morbidity and mortality. In this study, demographic features, underlying conditions, causative pathogens and factors affecting length of hospital stay and mortality were retrospectively investigated in patients who were diagnosed as CAP and followed-up in our unit between January 2005-December 2007. Among 97 patients 65 (67%) were male, 32 (33%) were female and the mean age was 62.7 (age range: 18-94) years. Patients were grouped according to criteria of Turkish Thoracic Society into four groups; 22 were group 2 (patients with risk factors, without aggrevating factors), 59 were group 3 (patients with aggre-vating factors), and 16 were group 4 (patients who have necessity for intensive care) CAP. The patients have also been grouped according to criteria of American Thoracic Society (CURB-65 score = Confusion, Urea > 7 mmol/L, Respiratory rate > 30/min, low Blood pressure and being > 65 years old), as group I (n= 65), group II (n= 20), and group III (n= 12). During follow-up 11 (11.3%) patients required mechanical ventilation support and 6 (6.2%) patients have died. Causative pathogens were isolated from 14 (23.3%) out of 27 well-qualified sputum samples obtained from 60 patients who could produce sputum (8 Streptococcus pneumoniae, 2 methicillin-sensitive Staphylococcus aureus, 2 Klebsiella pneumoniae, 1 Haemophilus influenzae, 1 Moraxella catarrhalis). Thirty-seven of cases were treated with levofloxacin, 10 with moxifloxacin, 24 with ceftriaxone ± clarithromycin, 16 with sulbactam-ampicillin ± ciprofloxacin, 10 with beta-lactam/beta-lactamase inhibitor combinations, and fever declined within 2.5 days in 83 (85.6%) of them. The mean duration of hospital stay was estimated as 11.1 days. In the evaluation of the factors that affect the length of hospital stay, being > 65 years old, gender, underlying conditions, central venous catheterisation, presence of nasogastric tube, positive culture result, previous antibiotic treatment, fever continuing for > 3 days despite antibiotic therapy and scoring groups were not determined as risk factors (p> 0.05 for all of these parameters). However, mechanical ventilation was found as a significant risk factor (p 3 days despite antibiotic therapy (p= 0.05) were found to be significant risk factors. In conclusion, length of hospital stay, mortality and treatment costs in CAP patients could be reduced by defining the risk factors and starting empirical antibiotic therapy according to the national and international guidelines

Diabetic Foot Infections: The Evaluation of 35 Cases

Diabetic foot infections cause substantial morbidity and mortality. We analysed laboratory and clinical findings of diabetic foot infections in 35 patients treated at Karaelmas University School of Medicine Department of Infectious Diseases and Clinical Microbiology, Zonguldak Turkey between January 2004 and November 2006. Eleven (31.4%) of the patients had osteomyelitis in addition to soft tissue infection. Erithrocyte sedimentation rate was ≥ 70 mm/hour in 27 (77.1%) of the patients. C-reactive protein values were negative in 4 (11.4%) of the patients and it was highly elevated in 31 (88.6%) of them. Five (14.3%) of the patients were administered medical treatment only and in 30 (85.7%) of the patients both medical and surgical treatment were performed. Amputation was performed in 19 (54.3%) patients. Mean treatment duration was 28.6 ± 26.6 (3-90) days. There was no microbiological evidence of infection in 11 (%31.4) of the patients. Diabetic foot infections are the leading cause of nontraumatic foot amputations. In the presence of osteomyelitis, amputation ratio is higher and achieving cure is more difficult. Diabetic foot infections require a coordinated management by a multidiciplinary foot-care team. For obtaining long term problem free survival, prevention of infection through patient training about foot care, and early treatment of infection for prevention of osteomyelitis is important

Piperacillin-tazobactam Versus Carbapenem Therapy With and Without Amikacin as Empirical Treatment of Febrile Neutropenia in Cancer Patients: Results of an Open Randomized Trial at a University Hospital

Ankarali, Handan Camdeviren/0000-0002-3613-0523;WOS: 000280537500009PubMed: 20427546Empirical beta-lactam monotherapy has become the standard therapy in febrile neutropenia. The aim of this study was to compare the efficacy and safety of piperacillin-tazobactam versus carbapenem therapy with or without amikacin in adult patients with febrile neutropenia. In this prospective, open, single-center study, 127 episodes were randomized to receive either piperacillin-tazobactam (4 x 4.5 g IV/day) or carbapenem [meropenem (3 x 1 g IV/day) or imipenem (4 x 500 mg IV/day)] with or without amikacin (1 g IV/day). Doses were adjusted according to renal function. Clinical response was determined during and at completion of therapy. One hundred and twenty episodes were assessable for efficacy (59 piperacillin-tazobactam, 61 carbapenem). Mean duration of treatment was 14.8 +/- 9.6 days in the piperacillin-tazobactam group and 14.7 +/- 8.8 days in the carbapenem group (P > 0.05). Mean days of fever resolution were 5.97 and 4.48 days for piperacillin-tazobactam and carbapenem groups, respectively (P > 0.05). Similar rates of success without modification were found in the piperacillin-tazobactam (87.9%) and in the carbapenem groups (75.4%; P > 0.05). Fungal infection occurrence rates were 30.5 and 18% in piperacillin-tazobactam and carbapenem groups, respectively (P = 0.05). Antibiotic modification rates were 30.5 and 13.1% (P = 0.02) and the addition of glycopeptides to empirical antibiotic regimens rates were 15.3 and 44.3% for piperacillin-tazobactam and carbapenem groups, respectively (P = 0.001). The rude mortality rates were 14% (6/43) and 29.3% (12/41) in piperacillin-tazobactam and carbapenem groups, respectively (P = 0.08). The effect of empirical regimen of piperacillin-tazobactam regimen is equivalent to carbapenem in adult febrile neutropenic patients

Causative agents of intravenous catheter-related infections and their antibiotic susceptibilities

Damar içi kateter kullanımı, kolonizasyonun yanı sıra kateter giriş yeri enfeksiyonundan bakteriyemiye kadar değişen spektrumda enfeksiyonlara neden olabilmektedir. Bu çalışmada, Zonguldak Karaelmas Üniversitesi Tıp Fakültesi Hastanesinde damar içi kateter kaynaklı kan dolaşımı ve kateter giriş yeri enfeksiyonu etkenleri ile kolonizasyona neden olan mikroorganizmaların saptanması ve enfeksiyon etkenlerinin antibiyotik duyarlılık durumlarının belirlenmesi amaçlanmıştır. Çalışmaya, Eylül 2007-Eylül 2009 tarihleri arasında hastanemizin çeşitli servislerinde yatan 201 hastadan alınan kateter ucu ile kateterden alınan kan ve kateter ile eş zamanlı periferik venden alınan kan örnekleri dahil edilmiş ve kültür sonuçları retrospektif olarak değerlendirilmiştir. Kateter örneklerinin ekimleri semikantitatif ve kantitatif kültür tekniklerine uygun olarak yapılmış; kateterden alınan kan ile periferik venöz kandan alınan kan kültürleri için BACTEC 9120 (Becton Dickinson, ABD) sistemi kullanılmıştır. Antibiyotik duyarlılık testleri “Clinical and Laboratory Standards Institute (CLSI)” kriterlerine göre disk difüzyon yöntemi kullanılarak yapılmıştır. Hastaların %13.9 (28/201)’unda kateter ile ilişkili kan dolaşımı enfeksiyonu (KİKDE), %6.4 (13/201)’ünde kateter giriş yeri enfeksiyonu ve %27.3 (55/201)’ünde kolonizasyon saptanmıştır. KİKDE tanısı alan olgular değerlendirildiğinde, beşi karbapeneme dirençli olmak üzere 11 olguda Acinetobacter spp., sekiz olguda metisiline dirençli koagülaz-negatif stafilokok (MRKNS), iki olguda metisiline duyarlı KNS (MSKNS), iki olguda Klebsiella pneumoniae ve birer olguda olmak üzere metisiline dirençli Staphylococcus aureus (MRSA), karbapeneme dirençli Pseudomonas aeruginosa, Enterococcus spp., Escherichia coli ve MRKNS + Enterococcus faecium izole edilmiştir. Kateter giriş yeri enfeksiyonu saptanan 13 hastanın beşinde MSKNS, ikisinde metisiline duyarlı S.aureus (MSSA), ikisinde E.coli ve birer olguda olmak üzere MRKNS, K.pneumoniae, Enterococcus spp. ve K.pneumoniae + P.aeruginosa izole edilmiştir. KİKDE ve kateter giriş yeri enfeksiyonu etkeni olan stafilokok izolatları arasında vankomisine ve teikoplanine dirençli suş saptanmamıştır. Elli beş kateterde kolonizasyon tespit edilmiş ve mikroorganizmaların dağılımı; MSKNS (n= 18), MRKNS (n= 18), K.pneumoniae (n= 5), Acinetobacter spp. (n= 4), E.coli (n= 3), MSSA (n= 2) ve birer adet olmak üzere MRSA, Proteus mirabilis, P.aeruginosa, Corynebacterium spp. ve Candida albicans olarak bulunmuştur. Çalışmamızda KİKDE olarak değerlendirilen olgularda en sık Acinetobacter spp. suşları saptanırken koagülaz- negatif stafilokoklar ikinci sırayı almıştır. Bu durumun, 2006 yılında gerçekleşen salgın sonrası bu izolatların hastanemizde yaygın olarak görülmesinden kaynaklandığı düşünülmüştür. Sonuç olarak, kateter kaynaklı enfeksiyonlar için her hastanenin kendi etken dağılımlarını ve antibiyotik duyarlılık profillerini düzenli olarak değerlendirmesinin, ampirik tedavinin planlanmasında büyük önem taşıdığı bir kez daha vurgulanmıştır.Intravenous catheterization can lead to colonization as well as a broad spectrum of infections ranging from catheter site infections to catheter-related blood stream infections (CRBSIs). The aim of this study was to evaluate the distribution of causative agents and their antibiotic susceptibility patterns in CRBSIs and catheter site infections along with the colonization rates and colonizing microorganisms in Zonguldak Karaelmas University Hospital, Turkey. The results of cultures from catheter tips and/or intracatheter blood cultures and simultaneously taken peripheral blood cultures were sent to medical microbiology laboratory and were retrospectively investigated for 201 patients hospitalized between September 2007 and September 2009. The catheter tips were cultured by semi-quantitative and quantitative culture methods. Blood cultures from the catheters and peripheral veins were performed in BACTEC 9120 (Becton Dickinson, USA) blood culture systems. The antibiotic susceptibility tests were done by Kirby-Bauer disk diffusion method according to the guidelines of the Clinical and Laboratory Standards Institute (CLSI). Out of 201 patients included, 28 (13.9%) had CRBSIs and 13 (6.4%) had catheter site infections while colonization was defined for 55 (27.3%) patients. Of 28 patients with CRBSIs, Acinetobacter spp. were isolated from 11 including five carbapenem-resistant strains, methicillin-resistant coagulase- negative staphylococci (MRCNS) from eight, methicillin-susceptible coagulase-negative staphylococci (MSCNS) from two, Klebsiella pneumoniae from two patients and one of each patient’s cultures yielded methicillin-resistant Staphylococcus aureus (MRSA), carbapenem-resistant Pseudomonas aeruginosa, Enterococcus spp., Escherichia coli and MRCNS + Enterococcus faecium. Of 13 patients with catheter site infections, five MSCNS, two methicillin-susceptible S.aureus (MSSA), two E.coli, and one of each K.pneumoniae, MRCNS, Enterococcus spp., K.pneumoniae + P.aeruginosa were isolated. No resistance to vancomycin and teicoplanin were detected among the staphylococci isolated from CRBSIs and catheter site infections. The distribution of the 55 colonizing microorganisms were as follows; 18 MSCNS, 18 MRCNS, four Acinetobacter spp., five K.pneumoniae, three E.coli, two MSSA, and one of each MRSA, P.mirabilis, P.aeruginosa, Corynebacterium spp., Candida albicans. In this study, the predominant microorganism isolated from CRBSIs was Acinetobacter spp., followed by coagulase-negative staphylococci. This unexpected distribution of the agents was related to the Acinetobacter spp. that have gained endemic potential following an Acinetobacter outbreak in our hospital in 2006. We emphasize that it is critical for any individual hospital to assess periodically the distribution and susceptibility profiles of isolates obtained from catheter-related infections to set out rational empirical treatment strategies

An adult case of visceral leishmaniasis in a province of black-sea region, Turkey

Viseral leyşmaniyaz (Visceral leishmaniasis, VL), Leishmania protozoonunun neden olduğu, tüm dünyada ve Akdeniz bölgesindeki pek çok ülkede yaygın görülen kronik bir hastalıktır. Vektör olan tatarcık sineği (Phlebotomus) ile bulaşan enfeksiyonun inkübasyon süresi uzun olup başlangıcı sinsidir. Daha ziyade çocuk yaş grubunda görülen VL, tedavi edilmediği takdirde ölümcül seyretmektedir. Bu raporda, Zonguldak’ta saptanan ilk erişkin VL olgusu olan 31 yaşında bir erkek hasta sunulmaktadır. Hastanemize iki aydır devam eden yüksek ateş, üşüme/titreme, terleme ve kilo kaybı şikayetleri ile başvuran hastanın hikayesinde, son 6 ayda il dışına seyahat öyküsü, sinek/böcek ısırma öyküsü yoktur. Ancak kömür madenlerinde çalıştığı öğrenilen hastadan, çalıştığı madenlerin içinde ve çevresinde tatarcıkların olduğu ve bunlar tarafından sokulmuş olabileceği bilgisi alınmıştır. Hastanın fizik muayenesinde, ateşi 39.2°C olup hepatosplenomegalisi mevcuttur. Laboratuvar incelemelerinde anemi, lökopeni, hipoalbuminemi ve hipergamaglobulinemi varlığı tespit edilmiş; eritrosit sedimentasyon hızı 62 mm/saat, C-reaktif protein düzeyi 113 mg/L, karaciğer enzimleri (alanin aminotransferaz, aspartat aminotransferaz) ise normalden 2-5 kat yüksek olarak belirlenmiştir. Ultrasonografi ve bilgisayarlı tomografide hepatosplenomegali dışında patolojik bir bulgu saptanmamıştır. Hasta, ayırıcı tanı amacıyla benzer semptomlar veren enfeksiyonlar, kanser ve kollajen doku hastalıkları açısından irdelenmiş ve herhangi bir sonuç alınamamıştır. Kemik iliği aspirasyonunda hiperselüler kemik iliği tespit edilmiş ve VL ön tanısı ile hastanın kemik iliği yaymaları, NNN besiyerine ekilmiş kemik iliği örnekleri ve serumu, Refik Saydam Hıfzıssıhha Merkezi Başkanlığı (RSHMB) Parazitoloji Laboratuvarına gönderilmiştir. Hastaya VL tanısı; “in-house” IFAT testi ile Leishmania IgG titresinin 1/512 bulunması, rK39 Dipstick (InBios, ABD) testinin pozitif olması ve kemik iliği yaymalarında amastigot formunda Leishmania parazitlerinin görülmesi üzerine konulmuş; ayrıca, kemik iliği örneklerinin ekildiği NNN besiyerinde 7. günde parazitin hareketli promastigot formları belirlenmiştir. Hastaya, ilk olarak 5-değerli antimon bileşiği [glucantime 1 x 10 mg/kg/gün intramusküler (IM)] başlanmış, ancak yan etkiler nedeniyle tedavi aynı gün lipozomal amfoterisin B’ye (3 mg/kg/gün) değiştirilmiştir. Bu tedavi ile hasta sekel kalmaksızın iyileşmiştir. Sonuç olarak, uzun süreli ateş, hepatosplenomegali ve pansitopenisi olan erişkin yaştaki hastalarda ayırıcı tanıda VL akılda tutulmalıdır.Visceral leishmaniasis (VL) which is a chronic disease caused by the protozoon, Leishmania, occurs widely worldwide and it is widespread in most of the countries in the Mediterranean basin. The infection which is transmitted by a sandfly (Phlebotomus) vector, has a prolonged incubation period and insidious onset. VL generally affects children and may be fatal if not treated. In this report, a 31 years old male patient, who was the first adult VL case from Zonguldak (a province located at western Black-Sea region of Turkey) was presented. He was admitted to the hospital with two-months history of fever, chills, sweating and weight loss. There was no history of travel outside the city nor insect bites, however, he indicated that there would be unnoticed sandfly bites since sandflies were very common in the coal mines he worked. His physical examination revealed body temperatue of 39.2°C and hepatosplenomegaly, while laboratory findings yielded anemia, leucopenia, hypoalbuminemia and hypergamaglobulinemia. Erythrocyte sedimentation rate was 62 mm/h, C-reactive protein was 113 mg/L and liver transaminases were 2 to 5 folds higher than the reference values. The only pathological finding was hepatosplenomegaly in the abdominal ultrasound and computerized tomography. He was further examined to rule out infections with similar signs and symptoms, connective tissue diseases and malignanci- es and all were found negative. Hypercellular bone marrow were detected in the aspiration material. Bone marrow smears, bone marrow samples inoculated in NNN medium and serum samples of the patient were sent to the reference parasitology laboratory of Refik Saydam National Public Health Agency for evaluation in terms of VL. The diagnosis was confirmed by the detection of Leishmania IgG titer as 1/512 with in-house indirect immunofluorescence antibody test, by positivite rK39 Dipstick (InBios, USA) test and by the observation of Leishmania amastigote forms in the bone marrow smears. Bone marrow culture in NNN medium also revealed positive result by the determination of Leishmania promastigote forms on the 7th day. The treatment was initiated by pentavalent antimony [glucantime 1 x 10 mg/kg/day intramuscular (IM)] however, due to severe adverse effects it has switched to liposomal amphotericin B (3 mg/kg/day). The patient completely recovered without complication. In conclusion VL should be considered in the differential diagnosis of patients, even adults, with persistent fever, hepatosplenomegaly and pancytopenia, in endemic countries such as Turkey

Healthcare personnel’s attitude and coverage about tetanus vaccination in Turkey: a multicenter study

The tetanus vaccine is not routinely given to Turkish adults. Protective tetanus immunity decreases with age. Health-care personnel (HCPs), who are role models in the field of health, are a target group in order to achieve a higher rate of tetanus vaccination in the community. This study was designed to evaluate attitudes and coverage regarding tetanus vaccination among a large sample of Turkish HCPs. This cross-sectional epidemiologic study was conducted from July to August 2019. A questionnaire was sent to HCPs using social media. Of the 10,644 HCPs included in the study, 65% were female. Overall, the tetanus vaccination coverage (TVC) among HCPs was 78.5% (95% CI: 77.7%-79.3%). TVC was significantly higher among physicians [83.4% (95% CI: 82%-84.6%); p < .001] compared with all other HCPs except nurses. Older age (≥40 years) and length of professional experience were significantly correlated with TVC. Of the 8353 HCPs who received tetanus vaccines during their lifetime, 73.03% received tetanus vaccination in the past 10 years. The self-vaccination rate for protection against tetanus was 13.1%. Acute injuries (25.42%) and pregnancy (23.9%) were the most common reasons for having the tetanus vaccine. One-third (33.7%) of HCPs did not have information about whether pregnant women could receive tetanus vaccinations. This survey study provided excellent baseline information about HCPs’ coverage rates and attitudes regarding tetanus vaccination. The present results suggested that tetanus boosters for HCPs should be established as soon as possible, and revealed that the HCPs younger than 30 years with relatively less professional experience and all other HCPs except nurses and physicians should be identified as the target population for future intervention programs