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    Causative pathogens and antibiotic resistance in diabetic foot infections: A prospective multi-center study
    (Elsevier Science Inc, 2016) Hatipoglu, Mustafa; Mutluoglu, Mesut; Turhan, Vedat; Uzun, Gunalp; Lipsky, Benjamin A.; Sevim, Erol; Demiraslan, Hayati; Eryilmaz, Esma; Ozuguz, Cem; Memis, Ali; Ay, Hakan; Arda, Bilgin; Uysal, Serhat; Motor, Vicdan Koksaldi; Kader, Cigdem; Erturk, Ayse; Coskun, Omer; Duygu, Fazilet; Guler, Selma; Altay, Fatma Aybala; Ogutlu, Aziz; Bolukcu, Sibel; Yildiz, Senol; Kandemir, Ozlem; Aslaner, Halide; Polat, Arife; Karahocagil, Mustafa K.; Yasar, Kadriye Kart; Sehmen, Emine; Kilic, Sirri; Sunbul, Mustafa; Gencer, Serap; Bozkurt, Fatma; Yanik, Tugba; Oztoprak, Nefise; Batirel, Ayse; Sozen, Hamdi; Kilic, Inci; Celik, Ilhami; Ay, Bengisu; Tosun, Selma; Kadanali, Ayten; Comoglu, Senol; Denk, Affan; Hosoglu, Salih; Aydin, Ozlem; Elaldi, Nazif; Akalin, Serife; Kandemir, Bahar; Akbulut, Ayhan; Demirdal, Tuna; Balik, Recep; Azak, Emel; Sengoz, Gonul
    Aim: Clinical practice guidelines for the management of diabetic foot infections developed by the Infectious Diseases Society of America (IDSA) are commonly used worldwide. The issue of whether or not these guidelines need to be adjusted for local circumstances, however, has seldom been assessed in large prospective trials. Methods: The Turk-DAY trial was a prospective, multi-center study in which infectious disease specialists from centers across Turkey were invited to participate (NCT02026830). Results: A total of 35 centers throughout Turkey enrolled patients in the trial. Overall, investigators collected a total of 522 specimens from infected diabetic foot wounds for culture from 447 individual patients. Among all isolates, 36.4% were gram-positive organisms, with Staphylococcus aureus the most common among these (11.4%). Gram-negative organisms constituted 60.2% of all the isolates, and the most commonly isolated gram-negative was Escherichia coli (15%). The sensitivity rates of the isolated species were remarkably low for several antimicrobials used in the mild infection group. Conclusions: Based on our findings, several of the antimicrobials frequently used for empirical treatment, including some also recommended in the IDSA guidelines, would not be optimal for treating diabetic foot infections in Turkey. Although the IDSA guideline recommendations may be helpful to guide empiric antimicrobial therapy of DFIs, they should be adjusted to local conditions. (C) 2016 Elsevier Inc. All rights reserved.
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    Hand Hygiene Compliance in Some Intensive Care Units of Turkey: Results of Multicentre Asklepeion Study
    (Galenos Yayincilik, 2018) Onal, Aye Uyan; Aksoy, Firdevs; Azak, Emel; Koc, Meliha Meric; Ceviker, Sevil Alkan; Hatipoglu, Cigdem Ataman; Gozukucuk, Ramazan; Sehmen, Emine; Ugurlu, Kenan; Senol, Gunes; Durmus, Gul; Mert, Habibe Tulin Elmaslar; Alay, Handan; Koc, Filiz; Caglayan, Derya; Dikis, Demet; Korkmaz, Nilay Bilgili; Kucuker, Nilgiin Deniz; Kepeli, Nurhayat; Ulusoy, Behiye; Barik, Sukran Askit; Pullukcu, Husnu; Sipahi, Hilal; Arda, Bilgin; Ulusoy, Sercan; Sipahi, Oguz Resat
    Introduction: Hand hygiene is one of the most cost-effective infection control measures. In this multicenter Study we analysed the hand hygiene compliance observation results of 15 hospitals in Turkey. Materials and Methods: This study was performed in intensive care units (ICUs) of 15 hospitals (Eight terriary-care educational hospitals, six state hospitals and one private hospital) from 11 cities from six regions of Turkey The observations were made by infection control practitioners according to the World Health Organization - Five Moments for Hand Hygiene (WHO-5) indications rule for hand hygiene and overall compliance rates were calculated. Observations were unblinded (healthcare professionals knew that they were observed). The study period included 2015 and 2016 calendar years. Results: There was a statistically significant increase in hand hygiene compliance rates in 2016 versus 2015. The overall number of hand hygiene indications and compliance in 2015 and 2016 were 60071/78116-76,9% and 66551/83607-79,6% (p=0.0001), respectively. Nurses were the most compliant group in both years. The highest compliance was in after body fluid exposure indication (88.2%-2015 and 91.4%-2016) while the lowest compliance was in before patient contact indication (61.3%-2015 and 65%-2016). Conclusion: The presented data suggest that under unblinded observations, hand hygiene compliance seems to be in relatively acceptable rates in Turkey. Centers with compliance rates below 50 percentile rates in any of the 5 moments should increase efforts to enhance compliance in that indication.