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Author: Kinikli, SamiCOAR Access Rights: metadata only access

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    The Effect Of Constructivist Training On The Rate Of Catheter-Associated Urinary Tract Infections in The Intensive Care Unit
    (Anestezi Dergisi, 2025) Yarimoglu, Saliha; Erdinç, Fatma Şebnem; Kaymak, Çetin; Tulek, Eren, N.; Basa̧r, Hulya; Tuncer-Ertem, Günay,; Kinikli, Sami
    Objective: Catheter-associated urinary tract infections (CA-UTIs) are common healthcare-associated infections. Constructivist training is based on integrating new knowledge with previously learned knowledge. The aim of this study was to evaluate the effects of constructivist training on the rate of CA-UTIs in the Anesthesia and Reanimation Intensive Care Units (ARICU). Methods: This study was a retrospective-prospective intervention study. Over the period of one month, a total of 62 healthcare staff (seven doctors, 38 nurses, and 17 cleaning staff) working in ARICUs were organized into groups of 4-5 people and received forty-five minutes of constructivist training on preventing CA-UTI. Personnel from each of three ICUs participated in the same number of training sessions. Comparisons were made of the rates of CA-UTI and catheter use in the six-month periods before and after the training. A 4-item questionnaire was administered to the study participants six months after completion of the training. Results: The catheter-associated urinary tract infection rates before and after training were observed to be 8.3 and 8.7 per 1000 catheter days, respectively in ARICU-1, 7.0 and 8.1 per 1000 catheter days in ARICU-2, and 7.3 and 9.9 per 1000 catheter days in ARICU-3. No statistically significant difference was observed in the CA-UTI rate in each unit after constructivist training compared to the pre-training period. The intervention of constructivist training alone did not reduce the CA-UTI rates in the ICUs. According to the results of the survey conducted six months later, 92% of the nurses and 88% of the cleaning staff stated that constructivist training had positive effects. Conclusion: The intervention of constructivisit training alone did not reduce the rates of CA-UTIs in the ARICUs, but an increase was observed in the awareness of ICU nurses and cleaning staff. © 2025 Elsevier B.V., All rights reserved.
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    Citation - WoS: 19
    Citation - Scopus: 20
    The Effects of Antimicrobial Resistance and the Compatibility of Initial Antibiotic Treatment on Clinical Outcomes in Patients With Diabetic Foot Infection
    (Sage Publications inc, 2023) Saltoglu, Nese; Surme, Serkan; Ezirmik, Elif; Kadanali, Ayten; Kurt, Ahmet Furkan; Sahin Ozdemir, Meryem; Kinikli, Sami
    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.