Asymptomatic Bacteriuria and Antibacterial Susceptibility Patterns in an Obstetric Population

Introduction. Asymptomatic bacteriuria (ASB), occurring in 2–11% of pregnancies, is a major predisposition to the development of pyelonephritis, which is associated with obstetrical complications, such as preterm labor and low birth weight infants. The aim of this study was to determine the prevalence of ASB, the antibacterial susceptibilities of the isolated microorganisms and the associated risk factors in an outpatient clinical setting in Zekai Tahir Burak Women's Health Education and Research Hospital in Ankara, Turkey. Material and Methods. Between December 2009 and May 2010, pregnant women admitted to the antenatal outpatient clinic were included in this study. The results of a complete urine analysis, midstream urine culture and antibacterial susceptibility were evaluated. Results. Of the 2011 pregnant women included, 171 had ASB (8.5%). E. coli was the most frequently isolated microorganism (76.6%), followed by Klebsiella pneumonia (14.6%). Both microorganisms were highly sensitive to fosfomycin, sensivity being 99.2% for E. coli and 88% for Klebsiella pneumonia. Conclusions. In this certain geographical region, we found E. coli as the most common causative agent of ASB in the obstetric population and it is very sensitive to fosfomycin. We recommend fosfomycin for ASB in pregnant women due to its high sensitivity, ease of administration and safety for use in pregnancy

Can We Determine The Time Elapsed Until The Birth In Preterm Premature Rupture Of Membranes (Pprom) And Preterm Labor (Pte) ? [Preterm Prematur Erken Membran Rupturu (Pprom) Ve Preterm Eylem (Pte)De Doguma Kadar Gecen Sureyi Belirleyebilir Miyiz?]

We aimed to determined; affect of clinical, laboratory, and ultrasonographic factors the time elapsed until the birth in midtrimester PPROM and PTE. Total 448 PPROM and PTE patients were conceived which applicant the Perinatology Department of zekai Tahir Burak Women's Health Education And Research Hospital between 2012-2014 years. PPROM group consisted of 237 patients, PTE group consisted of 211 patients. PPROM and PTE groups were divided into subgroups as cervical culture positive and negative PPROM and PTE groups. Risk factors of until the time of birth was determined by multivariate regression analysis in cervical culture positive PPROM and PTE groups. Cervical length measured by TVUSG=0,907, 95% Cl = 0,823-0,999 (p=0,047) and amniotic fluid index (or= 0,962, 95% Cl= 0,946-0,980 (p [Med-Science 2016; 5(2.000): 468-83

Confirmed Exposure to Tick-Borne Encephalitis Virus and Probable Human Cases of Tick-Borne Encephalitis in Central/Northern Anatolia, Turkey

Tick-borne encephalitis virus (TBEV) is the aetiological agent of tick-borne encephalitis (TBE), a potentially fatal central nervous system infection of humans. TBE is endemic in many areas of Europe and Asia; however, very scarce data on TBEV activity are available from Turkey. We aimed to identify TBEV exposure in healthy blood donors and the impact of TBEV in central nervous system infections in Central/Northern Anatolia. Two-thousand four hundred and fifty four sera, collected from blood donors at Ankara, Konya, Eskişehir and Zonguldak branches of the Turkish Red Crescent Middle Anatolia Regional Blood Center, were analysed for TBEV serosurveillance. Paired serum and cerebrospinal fluid samples from 108 patients with the diagnosis of aseptic meningitis/encephalitis of unknown aetiology were also evaluated to identify TBE and neuroborreliosis cases. Commercial enzyme-linked immunosorbent assays and indirect immunofluorescence tests were employed for antibody detection. Forty-seven donor samples (1.9%) were reactive for TBEV IgG. In 25 persons with IgG reactivity (53.1%), risk factors for tick-borne infections were revealed. One sample from Zonguldak province (1/198; 0.5%) in the Black Sea region of Turkey was confirmed to possess neutralizing antibodies via plaque reduction neutralization test. TBEV IgM was detected in 9.2% (8/108) of the patients. IgM was accompanied by IgG reactivity in two persons where, in one, recent history of a tick bite was also identified. Intrathecal antibody production for TBEV could not be demonstrated. No evidence for Borrelia infections could be found. Confirmed exposure to TBEV and/or an antigenically similar tick-borne flavivirus is documented for the first time in blood donors in Zonguldak in Northern Anatolia. Probable cases of TBE have also been identified from Central Anatolia. The epidemiology of TBEV activity in Turkey needs to be assessed and benefits of vaccination for general population, risk groups or travellers must be considered

The Association Between Preterm Premature Rupture of Membranes and Surgical Site Infection Following Cesarean Section

OBJECTIVE: To evaluate clinical characteristics of surgical-site infections (SSIs) following cesarean section (CS) and to identify infection rates and risk factors associated with SSIs following cesarean section. STUDY DESIGN: A total of 197 patients who underwent cesarean and complicated with SSIs was evaluated during hospital stay or within 30 days following cesarean section by readmission to the hospital or by post discharge survey. The clinical characteristics, subsequent microbiological culture results and management were recorded. RESULTS: There were 34 (17.25%) patients complicated with preeclampsia and 26 (13.17%) gestational diabetes mellitus (GDM) in the study group. Preterm rupture of membranes (PROM) rate was 17.31% and mean rupture period were 6.61 hours. In the study population, 66 patients had positive culture results. The most isolated microorganism was S. Aureus (n=13, 19.7%). Preeclampsia, GDM and PROM rates were statically significant high in patients with positive culture results (p<0.05). There were 31 patients complicated with PROM in the study group. The rates of positive culture results were significantly increased by PROM (mean 45%, p<0.05). CONCLUSION:  Independent risk factors for post-cesarean SSIs are younger age, obesity, diabetes, hypertension, premature rupture of membranes. Information regarding higher rates of SSIs should be provided to obese women undergoing cesarean delivery, especially when diabetes and hypertension coexists

Anne Duyarlılık Ölçeği: Geçerlilik ve güvenirlik çalışmaları

In the present study, reliability and validity of Maternal Sensitivity Scale (MSS) which is based on the items of Maternal Behavior Q-Sort (MBQS; Pederson ve Moran, 1995; Sümer, Sayıl, & Berument, 2016) were evaluated. A 29-item observational scale of mother-child interactions was constructed on the basis of MBQS. One hundred and twenty mother-child (18-36 months of age) dyads participated in the study. Data were collected through semi-structured home visits (lasting around 45 minutes), and each home visit was video-taped and coded later. Based on the results of factor analysis, two items were dropped from the scale and 3-factor structure (support/encouragement, responsiveness, and warmth) was obtained. Internal consistency of the whole questionnaire was found as .92, whereas internal consistencies of sub-factors ranged between .78 and .91. On the other hand, concurrent validity of MSS was evaluated by examining its association with MBQS scores based on 30 videotapes. The significant correlation between these two measures was .67, demonstrating the scale’s concurrent validity. Besides, criterion validity of MSS was tested by examining the correlation of maternal sensitivity scores with children’s secure attachment and mothers’ education level. These correlations were significant (.42 for secure attachment and .44 for maternal education), indicating criterion validity of MSS. Therefore, it can be stated that Maternal Sensitivity Scale is a reliable and valid instrument that can be used by researchers.Bu çalışmada, Anne Davranışları Sınıflandırma Seti (ADSS; Pederson ve Moran, 1995; Sümer, Sayıl ve Berument, 2016) maddeleri esas alınarak oluşturulan Anne Duyarlılık Ölçeği’nin (ADÖ) geçerlik ve güvenirliği test edilmiştir. ADSS maddelerinden yola çıkılarak, gözleme dayanan 29 maddelik bir ölçüm aracı oluşturulmuştur. Çalışmanın örneklemi 18-36 ay aralığındaki 120 çocuk ve annelerinden oluşmaktadır. Ev ziyaretleri sırasında, yarı- yapılandırılmış 45 dakikalık gözlemler videoya çekilmiş ve iki farklı değerlendirici tarafından kodlanmıştır. Yapılan faktör analizi sonuçlarında, 2 madde çıkarılmış ve 3 faktörlü bir yapı (destekleme/teşvik etme, çocuğun ihtiyacını karşılama ve duygusal sıcaklık) görülmüştür. Bütün ölçeğin iç tutarlılığı .92, alt faktörlerin iç tutarlılıkları ise .78 ile .91 aralığında bulunmuştur. ADÖ’nün çakışmalı geçerliği, 30 video üzerinden ADSS ile korelasyonu bakılarak incelenmiş ve istatistiksel olarak anlamlı bulunan .67 korelasyon, ADÖ’nün çakışmalı geçerliğinin olduğunu göstermiştir. ADÖ’nün kriter geçerliği ise güvenli bağlanma örüntüsü ve annenin eğitimi ile ilişkisine bakılarak test edilmiştir. Güvenli bağlanma ile bulunan .42 korelasyon ve annenin eğitimi ile bulunan .44 korelasyon ise, ADÖ’nün kriter geçerliğinin olduğunu göstermektedir. Dolayısıyla ADÖ’nün, akademik çalışmalarda kullanılmak için geçerli ve güvenilir bir ölçüm aracı olduğu sonucuna varılmıştır