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This study in a small cohort of patients suggests that the use of colistin in severe nosocomial infections caused by multidrug-resistant Gram-negative bacteria is well-tolerated and efficacious.

Introduction: Health care-associated infection (HCAI) is a serious problem of neonatal intensive care units (NICUs) which is related to morbidity, mortality and increased cost of medical care. This study aimed to determine the incidence of HCAI in a tertiary NICU and identify the risk factors. Methodology: This prospective cohort study was conducted between July 1, 2011 and June 30, 2012. All newborns admitted to the NICU except for those who died or were discharged within 48 hours after admission were included. The definitions of Centers for Disease Control and Prevention (CDC) were used to diagnose specific types of infections. The incidence, causative organisms, risk factors and mortality of HCAIs were evaluated. Results: Among 352 newborns, a total of 60 HCAI episodes were evaluated in 37 (10.5%) of the patients over 5,212 patient-days. The overall incidence of HCAI was 17%, and the rate was 11.5/1,000 patient-days. Blood stream infection (BSI) was the most common HCAI (n = 42, 70%). In a multivariable logistic regression analysis, the presence of a central venous catheter/umbilical catheter (CVC/UC), the presence of a urinary catheter, and gestational age (< 32 weeks of gestation) were identified as significant independent risk factors. Gram-negative pathogens were the most common isolates. The overall mortality rate was 4%. The HCAI-related mortality rate was 10.8%. Conclusions: Patient care quality can be improved with surveillance of HCAI. The incidence and rate of HCAI in our NICU were found to be higher than international reports with a direct impact on mortality of preterm infants.

Objective: Orbital infections require prompt diagnosis and treatment because of the risk of severe complications. Although preseptal cellulitis and orbital cellulitis are different clinical conditions, they can often be confused or can be seen concomitantly. In this study, we aimed to evaluate all patients diagnosed with these diseases treated in our clinic in order to analyze clinical findings, preferred imaging modalities, treatment choices, and clinical outcomes. Material and Methods: This retrospective study was performed between January 1999 and January 2013. We evaluated patients who were admitted to the Ankara University Pediatric Infectious Disease Clinic with a diagnosis of preseptal or orbital cellulitis. Clinical and laboratory characteristics of the patients were compared. Significance level was determined as α=0.05. Results: A total of 71 patients (34 girls, 37 boys) with a diagnosis of preseptal (50 patients) or orbital cellulitis (21 patients) were included into the study. The mean age at diagnosis was 49±37.4 (2-168) months. Waters graphy and/or orbital computed tomography was performed in 27 (54%) patients with preseptal cellulitis and in 18 (85%) patients with orbital cellulitis. Almost all of the patients responded to medical therapy without sequelae, and only 3 of them required surgical treatment additionally. The patients with preseptal and orbital cellulitis were treated successfully with sulbactam-ampicillin (150 mg/kg/day and 200 mg/kg/day, respectively). Conclusion: We conclude that these infections can be treated without any morbidity and mortality if it is diagnosed early and suitable antibiotic treatment is promptly instituted. Imaging tools can give us detailed information regarding disease involvement, differential diagnosis, and the need for surgical intervention. However, we think that these imaging modalities, such as computed tomography, should be restricted as much as possible because of high-dose radiation exposure risk.

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