Introduction This study aims to assess the association of piperacillin/tazobactam and meropenem minimum inhibitory concentration (MIC) and beta-lactam resistance genes with mortality in the MERINO trial. Methods Blood culture isolates from enrolled patients were tested by broth microdilution and whole genome sequencing at a central laboratory. Multivariate logistic regression was performed to account for confounders. Absolute risk increase for 30-day mortality between treatment groups was calculated for the primary analysis (PA) and the microbiologic assessable (MA) populations. Results 320 isolates from 379 enrolled patients were available with susceptibility to piperacillin/tazobactam 94% and meropenem 100%. The piperacillin/tazobactam non-susceptible breakpoint (MIC > 16 mg/L) best predicted 30-day mortality after accounting for confounders (odds ratio 14.9, 95% CI 2.8 – 87.2). The absolute risk increase for 30-day mortality for patients treated with piperacillin/tazobactam compared with meropenem was 9% (95% CI 3% – 15%) and 8% (95% CI 2% – 15%) for the original PA population and the post-hoc MA populations, which reduced to 5% (95% CI -1% – 10%) after excluding strains with piperacillin/tazobactam MIC values > 16 mg/L. Isolates co-harboring ESBL and OXA-1 genes were associated with elevated piperacillin/tazobactam MICs and the highest risk increase in 30-mortality of 14% (95% CI 2% – 28%). Conclusion After excluding non-susceptible strains, the 30-day mortality difference was from the MERINO trial was less pronounced for piperacillin/tazobactam. Poor reliability in susceptibility testing performance for piperacillin/tazobactam and the high prevalence of OXA co-harboring ESBLs suggests meropenem remains the preferred choice for definitive treatment of ceftriaxone non-susceptible E. coli and Klebsiella.

Objective We aimed to evaluate whether working at ICU, inpatient services, or the operating room creates differences in job satisfaction (JS), work-related strain (WRS), and perceived stress (PS) of nurses. Research methodology The study data were collected through face-to-face interviews. The data collection tools utilized in the study included a questionnaire form consisting of 19 questions. Work-Related Strain Inventory (WRSI), Short-Form Minnesota Job Satisfaction Questionnaire (SF-MSQ), and the Perceived Stress Scale (PSS) were used. Results Across all groups, the mean scores of SF-MSQ were statistically significantly the lowest in the groups of nurses, who were not economically satisfied with their salaries at all, who reported that they did not do their dream jobs and that they were not fond of their jobs. The mean scores of WRSI were statistically significantly the lowest across all groups in the groups of nurses. The mean PSS scores were statistically significantly the lowest across all compared groups in the groups of nurses, who commute to work by their private cars. Conclusion Hospital management and nursing services should address the overtime working conditions of nurses and provide satisfactory wage improvements.

Background/aim: A SARS-Cov2 infection which was first arised from Wuhan in December 2019 and named as COVID-19. Still there lacks either a specific treatment or a vaccine to treat COVID-19. Convalescent plasma (CP) was previously used successfully to treat SARS-CoV-1 and MERS infections. Health authority in Turkey has published a guideline to integrate this promising option in the treatment process of patients who are prone to high risk of developing severe COVID 19. Materials and Methods: 40 consecutive patients who had received CP at our center were included in the study. Demographics, COVID-19 specific parameters, biomarkers to detect the severity of COVID-19 infection and outcome variables were collected retrospectively. The correlation between outcome variables and the independent predictors of the outcome were reported. Results: Median age of the patients was 57.5 and 72.5 % were male. At least one COVID-19 PCR test was confirmed to be positive in 75 % of patients. Remaining 25 % had a Chest-CT which was reported to be compatible with an ongoing COVID-19. All patients (100 %) were classified as having severe COVID-19 infection. Over a half of the patients harbored an oxygen saturation of less than 90 despite of a continuous 5lt/min support of O2. 82.5 % of the patients had a need for mechanical ventilation and 45.5 % had a need for invasive mechanical ventilation. 9 out of 10 patients who have received CP outside ICU have totally recovered from COVID-19 at a median of 9 days, and a half of the patients who needed invasive mechanical ventilation were successfully free of mechanical ventilation support and managed to recover from COVID-19. Conclusion: According to the results of this study, CP is an efficient conjunct to conventional therapy against COVID-19 with a favorable safety profile.

Bu çalışma İstanbul'da bir vakıf üniversitesi hastaneler kompleksinde yeni tip 2019 koronavirüs hastalığı (COVID) ve COVID dışı servislerde çalışan hekimlerde anksiyetenin değerlendirilmesi amacıyla yapılmış tanımlayıcı bir çalışmadır. Gereç ve Yöntem: Çalışma kapsamına, pandemi servislerinde çalışan 50, pandemi dışı servislerde çalışan 52 hekim alınmıştır. Veri toplama aracı olarak hekimlerin sosyo-demografik ve mesleki bazı özelliklerini içeren anket formu ve durumluk-süreklilik kaygı ölçeği kullanılmıştır. Veriler online anket uygulaması yoluyla toplanmıştır. Verilerin değerlendirilmesinde verilerin normal dağılım gösterip göstermediğine Shapiro-Wilk normallik testi ile bakılmıştır. Verilerin normal dağılım göstermediği için iki grup karşılaştırmalarında Mann-Whitney U testi, ikiden fazla grup karşılaştırmalarında ise Kruskal-Wallis testi kullanılmıştır. Korelasyon analizinde ise Pearson korelasyon analizi yapılmıştır. Bulgular: Çalışmamızda pandemi servislerinde çalışan hekimlerin durumluk kaygı puan ortalamalarının, pandemi dışı servislerde çalışan hekimlerin kaygı puan ortalamalarından daha yüksek olduğu ve aradaki farkın istatistiksel olarak anlamlı olduğu saptanmıştır (p<0,05). Cinsiyete göre pandemi servisinde çalışan kadın hekimlerin durumluk kaygı puan ortalamalarının erkek hekimlerden daha yüksek ve farkın istatistiksel olarak önemli olduğu belirlenmiştir (p<0,05). Yaş gruplarına göre pandemi servislerinde çalışan 43 yaş ve üzerindeki hekimlerin süreklilik kaygı puan ortalamalarının diğer yaş gruplarındaki hekimlerden daha düşük ve farkın istatistiksel olarak önemli olduğu saptanmıştır (p<0,05). Hem pandemi servislerinde çalışan hekimlerin hem de pandemi servisleri dışında çalışan hekimlerin durumluk ve süreklilik kaygı ölçeği puan ortalamaları arasında pozitif yönlü kuvvetli ilişki saptanmıştır (p<0,05). Yani durumluk kaygı arttıkça süreklilik kaygı, süreklilik kaygı arttıkça durumluk kaygı da artmaktadır. Sonuç: Çalışmamızda pandemi servislerinde çalışan hekimlerin durumluk kaygısının diğer servislerde çalışan hekimlerden daha fazla olduğu ve süreklilik kaygısı arasında bir fark bulunamaması pandemi servisinde çalışmanın anksiyeteye neden olduğunu göstermektedir.