Five-Years Tigecycline Experience an Analysis of Real-Life Data

Aim: Tigecycline has been approved by the Food and Drug Administration for the treatment of complicated intra-abdominal infections, skin and soft tissue infections and community-acquired pneumonia. In our study, we examined the efficacy of tigecycline in clinical practice and reported real life data from our hospital over a period of five years. Methods: The study was conducted between 2008 and 2013 on patients who received tigecycline for longer than 48 hours in Ankara Training and Research Hospital. Clinical success was defined as clinical recovery and microbiological cure in patients who used tigecycline. Any reason for discontinuation of tigecycline treatment was considered a clinical failure. Results: In our hospital, 320 patients were administered tigecycline between 2008 and 2013. Tigecycline was mainly used for pneumonia and skin and soft tissue infections. Tigecycline was used as monotherapy in 174 patients (54.1%). The most frequently isolated agent in tigecycline-treated patients was Acinetobacter baumannii (43.4%) followed by Enterococcus (6.9%). A change in treatment was not considered necessary in 243 (75.9%) patients who received tigecycline, while it was changed in 77 patients (24.1%). Conclusion: In conclusion, the use of tigecycline can be an effective treatment choice, either as monotherapy or as a combination antibiotic therapy

Evaluation of the Continuous Ambulatory Peritoneal Dialysis Related Peritonitis Attacks

Peritonitis is a common clinical problem that occurs in patients with end stage renal disease treated by peritoneal dialysis. The aims of this study were to assess demographic aspects, rates of peritonitis, causative organisms, clinical outcomes and treatment approach for continuous ambulatory peritoneal dialysis (CAPD) -related peritonitis of patients undergoing CAPD. Seventy cases of peritonitis occurred in 55 patients treated in Infectious Diseases and Clinical Microbiology Department of Ankara Training and Research Hospital between May 2003 and April 2004 were enrolled into this study. Cloudiness of the peritoneal dialysis fluid and/or abdominal pain were considered suggestive of peritonitis and were confirmed by cell count and culture. The overall incidence of peritonitis was 2.46 ± 2.52 episodes/patient-year. Age, gender, education and profession of the patients have not been found as a risk factor in peritonitis attacks. The most common presentations of peritonitis included abdominal pain, cloudiness of the peritoneal dialysis fluid, nausea and vomiting. Peritoneal dialysate fluid white blood cell count was 1773 ± 1224/mm3 in 70 episodes. Cultures were positive in 51 (%72.9) peritonitis episodes; coagulase-negative staphylococci was the most common organism (%22.8), followed by Staphylococcus aureus (%21.4), 19 episodes (%27.2) had negative culture results. At the end of the study, 61 episodes of peritonitis in 55 patients were treated with intraperitoneal cefazolin and gentamicin protocol. Seven of the patients did not respond to initial therapy and the therapy was converted to intravenous protocol. Nine episodes were treated with IV antibiotics on admission for medical reasons (systemic infection and/or concurrent exit-side or tunnel infection). There were two deaths. Two catheters were removed and the patients were transferred to haemodialysis programme. Despite all technical improvements during recent decades, peritonitis and exit-side infections are still the major complication of CAPD. For the optimizing complication rates in individual centers, causative organisms and their antimicrobial susceptibilities must be known

Participation and Compliance of Health Care Workers to the Hepatitis B Vaccination Campaigne

Hepatitis B virus (HBV) infection is a well recognized occupational risk for the health care workers (HCWs). The aim of this study was to vaccinate our HCWs and to find out the facts that affect the compliance to the vaccination shedule. A total of 508 HCWs who were working in Ankara Teaching and Research Hospital during January 2002- April 2003 were enrolled into the study. Among 508 HCWs, 154 seronegative HCWs were included in the vaccination program; fourty-one (26.6%) were vaccinated with three-dose regimen, 113 (73.4%) with four-dose regimen. One hundred (64.9%) of the 154 HCWs completed the vaccination schedule successfully and 35.1% were noncompliant with the program. Being 30 years old or younger and working at jobs other than doctors or nurses were found significant factors that increase the compliance to vaccination program (p= 0.029 and p= 0.003 respectively). Working at jobs other than doctors or nurses was found significant too, by logistic regression analysis (p= 0.012). On the other hand, gender, vaccination dose number and the type of the department which they worked were not found assignificant factors influencing the compliance to the schedule (p> 0.05)