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Önal U, Akyol D, Kaya A, Başkol D, Kenanoglu B, Şanlıdağ G, Önal AU, Avşar CB, Mert M, Memetali S, Erdem HA, Bozkurt D, Şimşir A, Bozbıyık O, Kahraman Ü, Özgiray E, Korkmaz P, Çilli F, Pullukçu H, Yamazhan T, Taşbakan MI, Arda B, Ulusoy S, Sipahi OR. Ertapenem plus meropenem combination treatment in carbapenem-resistant Klebsiella pneumoniae bacteremia: an analysis of 53 cases. Eur J Clin Microbiol Infect Dis 2023; 42:1269-1273. [PMID: 37676420 DOI: 10.1007/s10096-023-04660-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2023] [Accepted: 09/03/2023] [Indexed: 09/08/2023]
Abstract
Herein, we aimed to describe the outcomes of patients with blood stream infections due to carbapenem-resistant Klebsiella pneumoniae (CR-Kp) who received ertapenem plus meropenem combination treatment (EMCT). A total of 53 patients with culture proven CR-Kp bacteremia treated with ertapenem + meropenem were included. The patients with secondary bacteremia due to urinary tract infection exhibited a significantly lower 1-month mortality (OMM), particularly in those with microbiological eradication and those with end-of-treatment success. Salvage EMCT resulted in 49% 1-month survival.
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Affiliation(s)
- Uğur Önal
- Department of Infectious Diseases and Clinical Microbiology, Faculty of Medicine, Ege University, Izmir, Turkey.
- Department of Infectious Diseases and Clinical Microbiology, Faculty of Medicine, Uludag University, Bursa, Turkey.
| | - Deniz Akyol
- Department of Infectious Diseases and Clinical Microbiology, Faculty of Medicine, Ege University, Izmir, Turkey
- Infectious Diseases Clinic, Kagizman State Hospital, Kars, Turkey
| | - Arda Kaya
- Department of Infectious Diseases and Clinical Microbiology, Faculty of Medicine, Ege University, Izmir, Turkey
| | - Dilşah Başkol
- Department of Infectious Diseases and Clinical Microbiology, Faculty of Medicine, Ege University, Izmir, Turkey
| | - Buse Kenanoglu
- Department of Infectious Diseases and Clinical Microbiology, Faculty of Medicine, Ege University, Izmir, Turkey
| | - Gamze Şanlıdağ
- Department of Infectious Diseases and Clinical Microbiology, Faculty of Medicine, Ege University, Izmir, Turkey
| | - Ayşe Uyan Önal
- Department of Infectious Diseases and Clinical Microbiology, Faculty of Medicine, Ege University, Izmir, Turkey
- Yüksek Ihtisas Teaching and Research Hospital, Bursa, Turkey
| | - Cansu Bulut Avşar
- Department of Infectious Diseases and Clinical Microbiology, Faculty of Medicine, Ege University, Izmir, Turkey
- Çiğli Teaching and Research Hospital, Bakırçay University, Izmir, Turkey
| | - Merve Mert
- Department of Infectious Diseases and Clinical Microbiology, Faculty of Medicine, Ege University, Izmir, Turkey
| | - Seichan Memetali
- Department of Infectious Diseases and Clinical Microbiology, Faculty of Medicine, Ege University, Izmir, Turkey
| | - Hüseyin Aytaç Erdem
- Department of Infectious Diseases and Clinical Microbiology, Faculty of Medicine, Ege University, Izmir, Turkey
| | - Devrim Bozkurt
- Department of Internal Medicine, Ege University Faculty of Medicine, Izmir, Turkey
| | - Adnan Şimşir
- Department of Urology, Ege University Faculty of Medicine, Izmir, Turkey
| | - Osman Bozbıyık
- Department of General Surgery, Ege University Faculty of Medicine, Izmir, Turkey
| | - Ümit Kahraman
- Department of Cardiovascular Surgery, Ege University Faculty of Medicine, Izmir, Turkey
| | - Erkin Özgiray
- Department of Neurosurgery, Ege University Faculty of Medicine, Izmir, Turkey
| | - Pervin Korkmaz
- Department of Chest Diseases, Ege University Faculty of Medicine, Izmir, Turkey
| | - Feriha Çilli
- Department of Medical Microbiology, Ege University Faculty of Medicine, Izmir, Turkey
| | - Hüsnü Pullukçu
- Department of Infectious Diseases and Clinical Microbiology, Faculty of Medicine, Ege University, Izmir, Turkey
| | - Tansu Yamazhan
- Department of Infectious Diseases and Clinical Microbiology, Faculty of Medicine, Ege University, Izmir, Turkey
| | - Meltem Işıkgöz Taşbakan
- Department of Infectious Diseases and Clinical Microbiology, Faculty of Medicine, Ege University, Izmir, Turkey
| | - Bilgin Arda
- Department of Infectious Diseases and Clinical Microbiology, Faculty of Medicine, Ege University, Izmir, Turkey
| | - Sercan Ulusoy
- Department of Infectious Diseases and Clinical Microbiology, Faculty of Medicine, Ege University, Izmir, Turkey
| | - Oğuz Reşat Sipahi
- Department of Infectious Diseases and Clinical Microbiology, Faculty of Medicine, Ege University, Izmir, Turkey
- Infectious Diseases Department, Bahrain Oncology Center, King Hamad University Hospital, Muharraq, Bahrain
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Eser F, Güner R, Gürbüz Y, Akdoğan M, Bilgiç Z, Korkmaz N, Arı D, Şanlıdağ G, Kesim Uçar Ş, Düzenli T, Yamazhan T. Impact of COVID-19 pandemic on diagnosis and treatment access of patients with viral hepatitis in Turkey. J Infect Dev Ctries 2023; 17:461-467. [PMID: 37159894 DOI: 10.3855/jidc.17585] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2022] [Accepted: 02/10/2023] [Indexed: 05/11/2023] Open
Abstract
INTRODUCTION We aimed to evaluate access to diagnosis, treatment and follow-up in patients with viral hepatitis during the COVID-19 pandemic. METHODOLOGY Patients who started treatment for hepatitis B and hepatitis C were included in the study and analyzed in two periods: before-pandemic and during-pandemic. Indication for treatment and frequency of laboratory follow-up was obtained from hospital records. A telephone survey was administered to evaluate treatment access and compliance. RESULTS Four centers with 258 patients were included in the study. Of these 161 (62.4%) were male, median age was 50 years. The number of patients, admitted to outpatient clinics was 134647 in the before-pandemic period and 106548 in the during-pandemic period. Number of patients who started treatment for hepatitis B were significantly high during-pandemic period compared with before-pandemic (78 (0.07%); 73 (0.05%) respectively; p = 0.04). The number who received treatment for hepatitis C was similar in both periods: 43 (0.04%); 64 (0.05%), respectively (p = 0.25). Prophylactic treatment for hepatitis B, due to immunosuppressive agents was significantly higher in during-pandemic period (p = 0.001). In the laboratory follow-ups at 4th, 12th and 24th weeks of treatment, worse adherence was detected in during-pandemic (for all p < 0.05). Access to treatment and compliance of all patients was over 90% and did not differ in the two periods. CONCLUSIONS During-pandemic, hepatitis patients' access to diagnosis, treatment initiation and follow-up had worsened in Turkey. The health policy implemented during the pandemic had a positive impact on patients' access to and compliance to treatment.
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Affiliation(s)
- Fatma Eser
- Ankara Yıldırım Beyazıt University, Ankara City Hospital, Infectious Disease and Clinical Microbiology, Ankara, Turkey
| | - Rahmet Güner
- Ankara Yıldırım Beyazıt University, Ankara City Hospital, Infectious Disease and Clinical Microbiology, Ankara, Turkey
| | - Yunus Gürbüz
- University of Health Sciences, Ankara Dışkapı Yıldırım Beyazıt Training and Research Hospital, Infectious Disease and Clinical Microbiology, Ankara, Turkey
| | - Meral Akdoğan
- University of Health Sciences, Ankara City Hospital, Department of Gastroenterology, Ankara, Turkey
| | - Zeynep Bilgiç
- Tunceli Public Hospital, Infectious Disease and Clinical Microbiology, Tunceli, Turkey
| | - Nesibe Korkmaz
- Ankara Dışkapı Yıldırım Beyazıt Training and Research Hospital, Infectious Disease and Clinical Microbiology, Ankara, Turkey
| | - Derya Arı
- Ankara City Hospital, Department of Gastroenterology, Ankara, Turkey
| | - Gamze Şanlıdağ
- Ege University, Infectious Disease and Clinical Microbiology, İzmir, Turkey
| | - Şengül Kesim Uçar
- Hitit University, Infectious Disease and Clinical Microbiology, Çorum, Turkey
| | - Tolga Düzenli
- Hitit University, Department of Gastroenterology, Çorum, Turkey
| | - Tansu Yamazhan
- Ege University, Infectious Disease and Clinical Microbiology, İzmir, Turkey
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Önal U, Akyol D, Mert M, Başkol D, Memetali SC, Şanlıdağ G, Kenanoğlu B, Uyan-Önal A, Quliyeva G, Avşar CB, Akdağ D, Demir M, Erdem HA, Kahraman Ü, Bozbıyık O, Özgiray E, Bozkurt D, Akarca FK, Demirağ K, Çankayalı İ, Uyar M, Çilli F, Arda B, Yamazhan T, Pullukçu H, Taşbakan MI, Sipahi H, Ulusoy S, Sipahi OR. Carbapenem-resistant Gram-negative pathogens associated with septic shock: a review of 120 cases. J Chemother 2022; 34:436-445. [PMID: 35446235 DOI: 10.1080/1120009x.2022.2064703] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
This study aimed to evaluate the influencing variables for outcomes in patients with septic shock having culture-proven carbapenem-resistant Gram-negative pathogens. It included 120 patients (mean age 64.29 ± 1.35 years and 58.3% female). The mean Sequential Organ Failure Assessment score during septic shock diagnosis was found to be 11.22 ± 0.43 and 9 ± 0.79 among the patients with mortality and among the survivors, respectively (P = 0.017). The logistic regression analysis showed that empirical treatment as mono Gram-negative bacteria-oriented antibiotic therapy (P = 0.016, odds ratio (OR) = 17.730, 95% confidence interval (CI): 1.728-182.691), Charlson Comorbidity Index >2 (P = 0.032, OR = 7.312, 95% CI: 5.7-18.3), and systemic inflammatory response syndrome score 3 or 4 during septic shock diagnosis (P = 0.014, OR = 5.675, 95% CI: 1.424-22.619) were found as independent risk factors for day 30 mortality. Despite early diagnosis and effective management of patients with septic shock, the mortality rates are quite high in CRGNP-infected patients.
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Affiliation(s)
- Uğur Önal
- Faculty of Medicine, Department of Infectious Diseases and Clinical Microbiology, Ege University, Bornova, Izmir, Turkey.,Faculty of Medicine, Department of Infectious Diseases and Clinical Microbiology, Uludag University, Bursa, Turkey
| | - Deniz Akyol
- Faculty of Medicine, Department of Infectious Diseases and Clinical Microbiology, Ege University, Bornova, Izmir, Turkey
| | - Merve Mert
- Faculty of Medicine, Department of Infectious Diseases and Clinical Microbiology, Ege University, Bornova, Izmir, Turkey
| | - Dilşah Başkol
- Faculty of Medicine, Department of Infectious Diseases and Clinical Microbiology, Ege University, Bornova, Izmir, Turkey
| | - Seichan Chousein Memetali
- Faculty of Medicine, Department of Infectious Diseases and Clinical Microbiology, Ege University, Bornova, Izmir, Turkey
| | - Gamze Şanlıdağ
- Faculty of Medicine, Department of Infectious Diseases and Clinical Microbiology, Ege University, Bornova, Izmir, Turkey
| | - Buse Kenanoğlu
- Faculty of Medicine, Department of Infectious Diseases and Clinical Microbiology, Ege University, Bornova, Izmir, Turkey
| | - Ayşe Uyan-Önal
- Faculty of Medicine, Department of Infectious Diseases and Clinical Microbiology, Ege University, Bornova, Izmir, Turkey.,Yüksek İhtisas Research and Teaching Hospital, Department of Infectious Diseases and Clinical Microbiology, Bursa, Turkey
| | - Günel Quliyeva
- Bona Dea International Hospital, Infectious Diseases Clinic, Baku, Azerbaijan
| | - Cansu Bulut Avşar
- Faculty of Medicine, Department of Infectious Diseases and Clinical Microbiology, Ege University, Bornova, Izmir, Turkey
| | - Damla Akdağ
- Faculty of Medicine, Department of Infectious Diseases and Clinical Microbiology, Ege University, Bornova, Izmir, Turkey
| | - Melike Demir
- Faculty of Medicine, Department of Infectious Diseases and Clinical Microbiology, Ege University, Bornova, Izmir, Turkey
| | - Hüseyin Aytaç Erdem
- Faculty of Medicine, Department of Infectious Diseases and Clinical Microbiology, Ege University, Bornova, Izmir, Turkey
| | - Ümit Kahraman
- Faculty of Medicine, Department of Cardiovascular Surgery, Ege University, Bornova, Izmir, Turkey
| | - Osman Bozbıyık
- Faculty of Medicine, Department of General Surgery, Ege University, Bornova, Izmir, Turkey
| | - Erkin Özgiray
- Faculty of Medicine, Department of Neurosurgery, Ege University, Bornova, Izmir, Turkey
| | - Devrim Bozkurt
- Faculty of Medicine, Department of Internal Medicine, Ege University, Bornova, Izmir, Turkey
| | - Funda Karbek Akarca
- Faculty of Medicine, Department of Emergency Medicine, Ege University, Bornova, Izmir, Turkey
| | - Kubilay Demirağ
- Faculty of Medicine, Department of Anaesthesiology and Reanimation, Ege University, Bornova, Izmir, Turkey
| | - İlkin Çankayalı
- Faculty of Medicine, Department of Anaesthesiology and Reanimation, Ege University, Bornova, Izmir, Turkey
| | - Mehmet Uyar
- Faculty of Medicine, Department of Anaesthesiology and Reanimation, Ege University, Bornova, Izmir, Turkey
| | - Feriha Çilli
- Faculty of Medicine, Department of Medical Microbiology, Ege University, Bornova, Izmir, Turkey
| | - Bilgin Arda
- Faculty of Medicine, Department of Infectious Diseases and Clinical Microbiology, Ege University, Bornova, Izmir, Turkey
| | - Tansu Yamazhan
- Faculty of Medicine, Department of Infectious Diseases and Clinical Microbiology, Ege University, Bornova, Izmir, Turkey
| | - Hüsnü Pullukçu
- Faculty of Medicine, Department of Infectious Diseases and Clinical Microbiology, Ege University, Bornova, Izmir, Turkey
| | - Meltem Işıkgöz Taşbakan
- Faculty of Medicine, Department of Infectious Diseases and Clinical Microbiology, Ege University, Bornova, Izmir, Turkey
| | - Hilal Sipahi
- Department of Medical Microbiology, Bornova Directorate of Health, Bornova, Izmir, Turkey
| | - Sercan Ulusoy
- Faculty of Medicine, Department of Infectious Diseases and Clinical Microbiology, Ege University, Bornova, Izmir, Turkey
| | - Oguz Resat Sipahi
- Faculty of Medicine, Department of Infectious Diseases and Clinical Microbiology, Ege University, Bornova, Izmir, Turkey
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Erdem HA, Şanlıdağ G, Çınar E, Yaşar M, Pullukçu H, Taşbakan MS, Çavuşoğlu C, Gökengin D, Işıkgöz Taşbakan M. [Friend or Foe? Evaluation of BCG Vaccine and Latent Tuberculosis Infection Effect in Patients Diagnosed with COVID-19 Infection]. MIKROBIYOL BUL 2021; 55:300-310. [PMID: 34416798 DOI: 10.5578/mb.20219802] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
While severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) continues to spread rapidly worldwide, some issues such as the uncertainty of the disease progress, whether intensive care will be needed, and risk classification are still important for clinicians. It is notable that in countries where latent tuberculosis infection (LTBI) is common and participating in the national Bacillus Calmette-Guerin (BCG) vaccination program, the case-fatality rates are relatively low throughout the world. In this study, it was aimed to evaluate the effects of the BCG vaccine and LTBI status on the course of the disease in patients diagnosed with coronavirus-19 (COVID-19) infection and to compare the LTBI rate with people with and without COVID-19 infection. The patients diagnosed with COVID-19 infection who were hospitalized during a period of seven months between May 1st to December 1st, 2020 were investigated by the QuantiFERON-TB Gold Plus (QFT-Plus) test in the blood samples for the presence of LTBI. For the comparison of the patients diagnosed with COVID-19 and people without COVID-19 infections in terms of LTBI rate retrospectively; all consecutive patients who were sent blood samples to the mycobacteriology laboratory for the QFT-Plus test between January 2016 and December 2019 were included in the study. Demographic, clinical, radiological, laboratory, and follow-up data of the patients were obtained from the electronic patient file. A total of 170 patients (n= 9 8 male [57.6%], n= 72 female [42.3%], mean age= 53.5 ± 15.8 years) were enrolled. Twenty-five patients' (25/170 [14.7%]) QFT-plus tests were positive. When the cases with positive QFT-Plus test (n= 25) and the cases with negative QFT-Plus test (n = 145) were compared in terms of disease severity respectively; it was determined that mild/moderate patients were 18/25 (72%) and 108/145 (74.5%), severe patients were 7/25 (28%) and 37/145 (25.5%) (p= 0.988). When these two groups were compared in terms of the clinical course respectively; the need for intensive care was 6/25 (24%) and 34/145 (23.4%) (p= 1.00), oxygen therapy requirement was 13/25 (52%) and 49/145 (33.8%) (p= 0.128), and death was 5/25 (20%) and 18/145 (12.4%) (p= 0.341). QFT-Plus positivity was 25/170 (14.7%) in patients diagnosed with COVID-19, while in control group it was 198/496 (39.9%) (OR= 0.259, 95% CI [0.164-0.411], p<0.001). When the values were evaluated quantitatively, in the COVID-19 patient group, QFT-Plus T1/T2 (IU/ml) interferon (IFN)-ɣ was 0.87 ± 1.52/0.62 ± 1.53, while in the control group it was 1.52 ± 3.69/1.50 ± 3.33 (p= 0.032, p= 0.04). There was no significant difference in the parameters investigated between 82 (48.2%) patients with BCG vaccine and those 88 (51.8%) without BCG vaccine. Although it was not statistically significant in our study, increased oxygen therapy requirement and higher mortality rates in the QFT-Plus positive group were remarkable. The detection of statistically significantly lower LTBI rates and T1-T2/IFN-ɣ values in the COVID-19 group supported that SARS-CoV-2 infection may suppress lymphocyte functions in patients and IFN-ɣ response. We believe that the results of our study are remarkably valuable, but more clinical studies are needed to elucidate the relationship between BCG vaccine, LTBI, and COVID-19 infection.
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Affiliation(s)
- Hüseyin Aytaç Erdem
- Ege University Faculty of Medicine, Department of Infectious Diseases and Clinical Microbiology, Izmir, Turkey
| | - Gamze Şanlıdağ
- Ege University Faculty of Medicine, Department of Infectious Diseases and Clinical Microbiology, Izmir, Turkey
| | - Ece Çınar
- Ege University Faculty of Medicine, Department of Physical Medicine and Rehabilitation, Izmir, Turkey
| | - Melike Yaşar
- Ege University Faculty of Medicine, Department of Medical Microbiology, Izmir, Turkey
| | - Hüsnü Pullukçu
- Ege University Faculty of Medicine, Department of Infectious Diseases and Clinical Microbiology, Izmir, Turkey
| | | | - Cengiz Çavuşoğlu
- Ege University Faculty of Medicine, Department of Medical Microbiology, Izmir, Turkey
| | - Deniz Gökengin
- Ege University Faculty of Medicine, Department of Infectious Diseases and Clinical Microbiology, Izmir, Turkey
| | - Meltem Işıkgöz Taşbakan
- Ege University Faculty of Medicine, Department of Infectious Diseases and Clinical Microbiology, Izmir, Turkey
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Şanlıdağ G, Sipahi OR. A travel-related infection case associated with triple vector-associated infections: Malaria-Dengue-Zika virus. Trop Doct 2021; 51:606-607. [PMID: 34098817 DOI: 10.1177/00494755211020899] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
As international travels and destinations increase, travel-related infections increase. It is reported that 6-87% of the travellers contract travel-related infection during or after the trip. Vector-associated pathogens comprise a significant percentage of travel-related infections. Apart from the ubiquitous COVID19, threats such as Dengue, Chikungunya and Zika virus and tick-borne agents have emerged or re-emerged in recent years. The fact that these infections are carried with similar vectors and cause similar symptoms makes diagnosis difficult. Herein, a case of travel-associated infection with nonspecific symptoms is presented.
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Affiliation(s)
- Gamze Şanlıdağ
- MD, Professor of Infectious Diseases, Ege University Medical Faculty, Department of Infectious Diseases and Clinical Microbiology, Ege University, Bornova, Turkey
| | - Oĝuz Reşat Sipahi
- MD, Professor of Infectious Diseases, Ege University Medical Faculty, Department of Infectious Diseases and Clinical Microbiology, Ege University, Bornova, Turkey
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Öztürk AM, Aljasim O, Şanlıdağ G, Taşbakan M. Retrospective evaluation of 377 patients with penetrating foreign body injuries: a university hospital experience (a present case of missed sponge foreign body injury). Turk J Med Sci 2021; 51:570-582. [PMID: 32967414 PMCID: PMC8203142 DOI: 10.3906/sag-2006-34] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2020] [Accepted: 09/24/2020] [Indexed: 12/18/2022] Open
Abstract
Background/aim This study aimed to retrospectively analyse patients with foreign body (FB) injuries in our hospital and to present a patient with missed penetrating sponge FB injury. Materials and methods This study lasted 12 years (2008–2020) and reviewed all patients with FB injuries who were admitted to the emergency department (ED) of our hospital. Along with our overall results, we present a case with missed penetrating sponge FB injury in detail. Results Approximately 377 patients were included in the study (age: 28.3 ± 18.3 years, m/f: 229/148). The foot (n = 148, 39.3%) and the hand (n = 143, 37.9%) were the most frequently injured body parts. Regarding FB types, sewing needles (n = 140, 37.1%), metal pieces (n = 91, 24.1%), and glass (n = 80, 21.2%) were the most frequently observed objects. Most of the patients were injured at home, often by needles or glass. The injury-admission mean time was 7.38 ± 2.5 days. FBs were frequently removed in the ED (n = 176, 46.7%). Plain radiography is the first line in identifying FBs. Soft tissue infection was the most common complication. MRIs were much useful than USGs in detecting the missed penetrating sponge injury of the single patient in the study. Conclusion For diagnosis of FBs, besides recording the patient’s history, obtaining a two-sided radiogram is of great importance. For nonradiolucent or deeply located FBs, further clinical or radiological investigation must be considered to avoid complications. Although most of the FBs can be removed in the ED, patients may require hospitalisation and operation for FB removal, depending upon FB location and age.
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Affiliation(s)
- Anıl Murat Öztürk
- Department of Orthopedics, Faculty of Medicine, Ege University, İzmir, Turkey
| | - Omar Aljasim
- Department of Orthopedics, Faculty of Medicine, Ege University, İzmir, Turkey
| | - Gamze Şanlıdağ
- Department of Infectious Diseases and Clinical Microbiology, Faculty of Medicine, Ege University, İzmir, Turkey
| | - Meltem Taşbakan
- Department of Infectious Diseases and Clinical Microbiology, Faculty of Medicine, Ege University, İzmir, Turkey
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7
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Akyol D, Uyan Önal A, Önal U, Akdağ D, Bulut Avşar C, Uysal S, Guliyeva G, Başkol D, Demir M, Mermer S, Chousein Memetali S, Şanlıdağ G, Mert M, Sipahi H, Ulusoy S, Reşat Sipahi O. 219. Is the modified quick SOFA scale superior to quick SOFA in patients with diagnosed septic shock? Open Forum Infect Dis 2019. [PMCID: PMC6810696 DOI: 10.1093/ofid/ofz360.294] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Background In this study it was aimed to compare the effects of qSOFA (Quick Sequential Organ Failure Assessment) score with modified qSOFA score (PLoS One. 2018 Sep 26;13(9):e0204608) for predicting one month survival in patients with diagnosed septic shock (SS) in a tertiary-care educational university hospital in a developing country. Methods Modified qSOFA was created by adding age factor (>50 years=1 point) to patients with qSOFA scale 1 or 2 or 3 who had SS (sepsis+hypotension+adrenergic agent) and consulted by Infectious Diseases consultants between December 2013-December 2018. Arterial lactate level of >2 mmol/L criterion was added as an including criteria for SS according to 3rd International Sepsis and Septic Shock Consensus Statement after 23rd February 2016. Statistical analysis was performed via Chi-square test and a p-value <0.05 was considered significant. Results The number of patients with qSOFA score of 1 or 2 or 3 from 527 patients are in Table1 [some of the cases were diagnosed as septic shock according to elder definition (without lactate criterion) and there was a subgroup with qSOFA score 1]. Among the >50-year aged group, the 30-day survival rate was lower in patients with qSOFA3 vs. qSOFA 2 vs. qSOFA 1 (Table1, 3x2 Chi Square test, P = 0.0057). Among the <50 years group, the qSOFA one month survival rate was lower in patients with qSOFA 3 vs. qSOFA 2 vs. qSOFA 1 (Table, 3x2 Chi Square Test, P = 0.0052). According to modified qSOFA, there was a significant difference for one month survival among SS cases with scores of 1, 2, 3 and 4 (12/21 57% vs. Fifty/126 40% vs. 78/269 29% vs. 22/111 20%, 4x2 Chi-square test, P = 0.0003). On the other hand, there was no significant difference in terms of one month survival when we performed subgroup analysis in qSOFA score 1, 2, or 3 subgroups, as ≤50 years vs. >50 years (table, Chi-square test, 12/21 vs. 39/97 P = 0.224, 11/29 vs. 75/244 P = 0.526, 3/25 vs. 22/111 P = 0.572). Conclusion In terms of survival at one month, there was a significant difference between qSOFA score 1, 2, 3 and 4 subgroups. In patients with qSOFA score of 1 or 2 or 3, being under 50 years did not have a significant effect on one-month survival. Modified qSOFA may be beneficial to foresee the probable mortality but these findings need to be validated in larger cohorts ![]()
Disclosures All authors: No reported disclosures.
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