Nagihan Aka Türkmen

Objective: Wound infections represent a major concern among earthquake survivors. Antibacterial prophylaxis is standard care for this population. However, there is no clear consensus guidelines regarding the choice of prophylactic agents. This study aimed to examine whether the spectrum of antibacterial prophylaxis affects wound infection rates in hospitalized survivors of the February 2023 earthquake in south-eastern Türkiye who were transferred to a tertiary care center outside the disaster zone. Materials and Methods: This retrospective study included patients with uninfected wounds upon hospital admission. Clinical characteristics, prophylaxis regimens, and microbiological data were analyzed to identify factors associated with subsequent infection. Results: The study included 83 patients. Post-admission wound infections developed in 13 patients (15.6%). These patients were more likely to require intensive care unit (ICU) admission, hemodialysis, and recurrent surgeries than those without infections. Notably, infected patients had received broader-spectrum prophylaxis (84.6% vs. 31.4%, p < 0.001), yet wound contamination with soil or debris was not significantly different between groups. Multivariable analysis identified ICU requirement as an independent risk factor for infection (adjusted odds ratio [aOR] 44.81; 95% confidence interval [CI] 6.55–306.51; p < 0.001), while prior antibiotic exposure before admission was associated with a lower risk of infection (aOR 0.10; 95% CI 0.01–0.69; p = 0.019). Among isolated bacteria, 76.5% were either extensively drug-resistant or multidrug-resistant, with Acinetobacter baumannii and Klebsiella pneumoniae being the predominant pathogens. Conclusion: The findings suggest that broad-spectrum prophylaxis alone is insufficient to prevent infections caused by highly resistant pathogens in disaster settings. The study highlights the critical need for strict adherence to infection prevention and control (IPC) measures. Overwhelming patient burden can diminish compliance with IPC practices and lead to prophylaxis failure. To manage difficult-to-treat infections, it is vital to implement additional protocols that ensure IPC integrity even under extreme workload conditions.

Background: Anaerobic infections remain clinically significant yet underrecognized due to diagnostic challenges and limited routine susceptibility testing in clinical laboratories. Among these pathogens, Bacteroides fragilis is a clinically important anaerobe associated with bloodstream and deep‐seated infections. This study aimed to evaluate the epidemiology, clinical characteristics, and antimicrobial resistance patterns of Bacteroides fragilis bacteremia in a tertiary care hospital. Materials and Methods: This retrospective study included patients with blood cultures positive for Bacteroides fragilis between July 2018 and January 2023. Demographic characteristics, clinical features, infection sources, treatment regimens, and antimicrobial resistance patterns were analyzed. Results: Our analysis found a higher rate of Bacteroides fragilis bacteremia among cancer patients, likely linked to cancer treatments that compromise gastrointestinal defenses. Notably, both hospital‐acquired infection (OR: 4.99, 95% CI: 1.3–19.07, p = 0.019) and respiratory tract infection (OR: 8.19, 95% CI: 1.21–55.35, p = 0.031) were associated with an increased risk of death within 30 days, highlighting the importance of vigilance in healthcare environments. Resistance to clindamycin was substantial, while ampicillin resistance was expected because of the intrinsic resistance profile of Bacteroides species. While carbapenem resistance was uncommon, its presence signals a shifting resistance pattern. Metronidazole remained effective, supporting its continued use. Conclusion: Bacteroides fragilis bacteremia is associated with significant mortality, particularly in nosocomial settings. Continuous surveillance and appropriate antimicrobial stewardship are essential for effective management.