No abstract

Introduction:The human population is aging at an astonishing rate. The aim of this study is to capture a situation snapshot revealing the proportion of individuals aged 65 years and over among inpatients in healthcare institutions in Turkey and the prevalence and type of infections in this patient group in order to draw a road map. Materials and Methods: Hospitalized patients over 65 years at any of the 62 hospitals in 29 cities across Turkey on February 9, 2017 were included in the study. Web-based SurveyMonkey was used for data recording and evaluation system. Results: Of 17,351 patients 5871 (33.8%) were !65 years old. The mean age was 75.1 AE7.2 years; 3075 (52.4%) patients were male. Infection was reason for admission for 1556 (26.5%) patients. Pneumonia was the most common infection. The median length of hospital stay was 5 days (IQR: 2-11 days). The Antibiotic therapy was initiated for 2917 (49.7%) patients at the time of admission, and 23% of the antibiotics prescribed were inappropriate. Healthcare-associated infections developed in 1059 (18%) patients. Urinary catheters were placed in 2388 (40.7%) patients with 7.5% invalid indication. Conclusion:This study used real data to reveal the proportion of elderly patients in hospital admissions. The interventions done, infections developed during hospitalization, length of hospital stay, and excessive drug load emphasize the significant impact on health costs and illustrate the importance of preventive medicine in this group of patients.

Lyme disease (LD) is a multisystemic zoonotic infection disease that occurs in the consequence of contamination of Borrelia type of spirochetes that ticks carry after they have bitten. Typical clinic findings are on the skin and in joints. In this paper, the study on heavy joint pain having suddenly been added to the profile and on limitation of movement, and the process of getting the diagnosis of LD were probed in the patient with lesions on her skin that occurred three months ago. The case not having reported a history of being bitten by ticks and who was a health professional was female patient of 41 years of age. In her examination, a large number of lesions similar to fly bites were seen on the skin in the periphery of extremities, and the patient, whose routine hematologic and biochemical examinations were within normal limits, was determined to be Borrelia IgM positive and Borrelia IgG negative in the enzyme-linked immunosorbent assay (ELISA) tests performed from peripheric blood. Through these findings, cutaneous lesions and arthralgia were thought to be related to Borrelia infection that developed after the tick bite that took place months ago and was not realized. The patient was treated with doxycycline (100 mg/day, 30 days) and prednisolone (16 mg/day, 30 days, reducing the dose). As a supplementary treatment, vitamin D was administered by way of IM as a support. Arthralgia and joint involvement started to recover the second day. Lesions partly regresses in three days after the treatment started. LD cases must be considered in the differential diagnosis of infectious diseases that start with unexplained arthralgia at the beginning and suspicious lesions on the skin, and the case is probed by scanning literature over these concepts.

Background Mecillinam is a β-lactam antibiotic that is increasingly being used for the treatment of uncomplicated urinary tract infections. Nevertheless, the international guidelines still recommend nitrofurantoin, fosfomycin trometamol, and pivmecillinam as first-line agents in the treatment of such infections. Aim The objective of this study was to determine the in vitro efficacy of mecillinam against Escherichia coli and Klebsiella pneumoniae strains isolated from children with urinary tract infections. Materials Methods We investigated E. coli and K. pneumoniae isolates, obtained within the period from January 2016 to October 2017, from urine samples of patients aged 0 to 16 years. Antibiotics susceptibility testing was conducted through the disk diffusion method based on the guidelines provided by EUCAST (European Committee on Antimicrobial Susceptibility Testing). Extended-spectrum β-lactamase (ESBL)-positivity was detected by the double-disk synergy test. Isolates with mecillinam inhibition-zone diameter breakpoints lower than < 15 mm were considered to be resistant according to EUCAST criteria. Results A total of 450 isolates were assessed in the study, 135 of which were ESBL-producing E.coli, 230 were non-ESBL-producing E. coli, 35 were ESBL-producing K. pneumoniae, and 50 were non-ESBL-producing K. pneumoniae isolates. Mecillinam susceptibility was observed in most of the non-ESBL-producing and ESBL-producing E. coli isolates (230/230, 100% and 115/135, 85.1%, respectively). The rates of susceptibility of the non-ESBL-producing and ESBL-producing K. pneumoniae isolates were 37/50 (74%) and 24/35 (68.6%), respectively. Conclusion The in vitro susceptibility results obtained support the usage of mecillinam as a first-line agent. The high susceptibility of non-ESBL-producing E. coli and K. pneumoniae isolates established in vitro brings the hope that this antibiotic could soon be used in clinical practice in Turkey.

Giriş: Çocukluk çağı ishalleri, birçok mikroorganizmanın etken olabildiği, klinik seyri değişkenlik gösterebilen, ancak sonuçları bakımından ciddiye alınması gereken hastalıklardır. Tüm dünyada rotavirüsler nedeniyle gelişen gastroenterit olguları en çok 0-5 yaş aralığında görülmektedir. Morbidite ve mortalite oranları, yaş azaldıkça artmaktadır.