Background There is neither a surveillance system nor a study to reveal the HD related infection rates in Turkey. We aimed to investigate the infection rate among HD outpatients and implement CDC’s surveillance system. Methods A multicenter prospective surveillance study is performed to investigate the infection rate among HD patients. CDC National Healthcare Safety Network dialysis event (DE) protocol is adopted for definitions and reporting. Results During April 2016–April 2018, 9 centers reported data. A total of 199 DEs reported in 10035 patient-months, and the overall DE rate was 1.98 per 100 patient-months. Risk of blood culture positivity is found to be 17.6 times higher when hemodialysis was through a tunneled catheter than through an arteriovenous fistula. DE rate was significantly lower in patients educated about the care of their vascular access site. Mean body mass index was significantly higher in patients with any DE. Staphylococcus aureus was the most causative microorganism among mortal patients. Outcomes of DEs were hospitalization (73%), loss of vascular access (18.2%), and death (7.7%). Conclusions This first surveillance study in Turkey gave insight into current DE status and will guide to generate a national surveillance system for maintaining much lower DE rates.

Objectives: Myroides spp. is an environmental pathogen and causes disease in immunocompromised patients. In this study, we report an outbreak of urinary tract infections caused by M. odoratimimus in a university hospital in Turkey. Methods: A total of 25 M. odoratimimus strains isolated from the clinical samples of 20 patients in our intensive care units and clinics were included in the study. Phenotypic and genotypic identification of isolates was performed using conventional methods, VITEK®-2 automated identification system, Matrix Assisted Laser Desorption/Ionisation-Time of Flight Mass Spectrometry and 16S-RNA Microbial Diagnosis methods. In addition, Repetitive Extragenic Palindromic Elements (REP) PCR Assay method was applied for molecular epidemiological analysis. Results: All cases were diagnosed with nosocomial urinary tract infection, except for one case diagnosed with nosocomial bacteraemia. One of the M. odoratimimus isolates was sensitive to piperacillin/tazobactam (MIC: ≤4 µg/ml) and one isolate was moderately sensitive to cefepime (MIC: 16 µg/ml). Other M. odoratimimus isolates were resistant to the tested antibiotics of beta lactams, monobactams, carbapenems, aminoglycosides, fluoroquinolones and sulphonamides. When 10 isolates were evaluated with the REP PCR method, DNA finger print similarities were visually determined and there was a similar DNA pattern among them. Myroides source was not detected in environmental samples. Conclusion: Clinicians should consider that Myroides spp. isolates with multiple and broad-spectrum drug resistance may be a serious nosocomial pathogen like Pseudomonas aeruginosa or Acinetobacter baumannii. In order to choose the best treatment regimen, this atypical pathogen needs to be quickly identified and antibiotic susceptibility tests performed.