We aimed to determine pathogen microorganisms, their antimicrobial resistance patterns, and the effect of initial treatment on clinical outcomes in patients with diabetic foot infection (DFI). Patients with DFI from 5 centers were included in this multicenter observational prospective study between June 2018 and June 2019. Multivariate analysis was performed for the predictors of reinfection/death and major amputation. A total of 284 patients were recorded. Of whom, 193 (68%) were male and the median age was 59.9 ± 11.3 years. One hundred nineteen (41.9%) patients had amputations, as the minor (n = 83, 29.2%) or major (n = 36, 12.7%). The mortality rate was 1.7% with 4 deaths. A total of 247 microorganisms were isolated from 200 patients. The most common microorganisms were Staphylococcus aureus (n = 36, 14.6%) and Escherichia coli (n = 32, 13.0%). Methicillin resistance rates were 19.4% and 69.6% in S aureus and coagulase-negative Staphylococcus spp., respectively. Multidrug-resistant Pseudomonas aeruginosa was detected in 4 of 22 (18.2%) isolates. Extended-spectrum beta-lactamase-producing Gram-negative bacteria were detected in 20 (38.5%) isolates of E coli (14 of 32) and Klebsiella spp. (6 of 20). When the initial treatment was inappropriate, Klebsiella spp. related reinfection within 1 to 3 months was observed more frequently. Polymicrobial infection ( p = .043) and vancomycin treatment ( p = .007) were independent predictors of reinfection/death. Multivariate analysis revealed vascular insufficiency ( p = .004), hospital readmission ( p = .009), C-reactive protein > 130 mg/dL ( p = .007), and receiving carbapenems ( p = .005) as independent predictors of major amputation. Our results justify the importance of using appropriate narrow-spectrum empirical antimicrobials because higher rates of reinfection and major amputation were found even in the use of broad-spectrum antimicrobials.

No abstract

Objective: To evaluate Turkey according to the number of work accidents, occupational diseases and related mortality rates, insured workers, establishments and cities, which are important issues in terms of showing countries' situation.

Istanbul, SO 2 concentrations were above the upper limit values recommended by WHO, but PM10 concentrations during 2013 and 2015 were over the recommended limit values by WHO. As the particulate matter pollution is at high concentrations during these two years, it has shown that air pollution emerges as a problem awaiting solutions in Istanbul, where is industrially intense, highly populated and also with high traffic density.

Amaç: İş kazaları, günümüz mesleki yaşamlarının insan kayıpları ve ekonomik kayıplarla ilgili en büyük sorunlarından biridir. Bu sorundan kaynaklı insan kaybı oldukça yüksek sayıdadır. Gereç ve Yöntem: Bu çalışmada, Ülkemizde SGK İstatistik Yıllığı standardize edilmiş iş kazaları, meslek hastalıkları verilerinin, AB ülkelerinin ölümlü olan ve olmayan iş kazası sonuçlarının karşılaştırılması amaçlanmıştır. Bulgular: SGK 2008-2017 İstatistik Yıllığı'ndan dolaylı standardizasyon yöntemi ile elde edilen veriler değerlendirildiğinde, maden endüstrisinin iş kazaları, iş kazası ölüm oranları ve meslek hastalıkları yönünden ilk sıralarda yer aldığı görülmektedir. En yüksek standardize oran 2008 yılında " Ev içi çalışanların faaliyetleri" ne ait olsa da, 2009-2017 yılları arasında "Kömür ve Linyit Çıkartılması" her zaman ilk sırada yer almaktadır. 2008-2017 yılları standardize edilmiş meslek hastalıkları hızlarında "Kömür ve Linyit Çıkartılması" ve "Metal Cevheri Madenciliği" endüstrileri en üst sıradadır. Tartışma: 6331'inci İş Sağlığı ve Güvenliği yasasının uygulanması ile geri bildirim miktarının artırılması beklenmektedir. Bu nedenle, devletin iş kazasıyla ilgili geri bildirimleriyle oranlar değişecek ve düzeltici hususlar daha etkili olacaktır.