Carbapenem-resistant Enterobacteriaceae (CRE) are the family difficult to treat with high resistance rates to broad spectrum antibiotic. Patients, following up in long term care facilities are the most affected for CRE infections and colonisation. Carbapenem resistance rates are increasing despite all precautions and the infections caused with CRE goes on with high mortality. CRE surveillance is recommended by Centers for Disease Control and Prevention (CDC) related to characteristic of health care facilities; point prevalence or active surveillance. Mechanical ventilation, urinary or intravenous catheters, long term antibiotic usage are the main risk factor for CRE infections. Treatment options are limited with older agents and mainly depends on aminoglycosides, polymyxins and fosfomycin. In addition combination therapies and high dose regimens are the other salvage strategies. In this review, it is examined that the epidemiology, precaution strategies and treatment for CRE infections.

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This study aimed to determine the clinical course of Streptococcus pneomoniae keratitis following penetrating keratoplasty.
A retrospective analysis was performed of hospital records of all patients who presented with culture-proven S. pneomoniae keratitis in the corneal graft between January 2011 and January 2016.
This study included 8 eyes of 8 patients. Five patients were male, and three were female. The mean age of the patients was 61 ± 9 years (range: 52–77 years). The median time interval between surgery and infection was 11 months (range: 3–25 months). Five eyes (62.5%) had graft failure after 6 weeks of treatment, and three eyes had complete remission with a mild corneal scarring. Re-penetrating keratoplasty was performed in two eyes with emergency tectonic penetrating keratoplasty and disease relapse in the graft.
S. pneumoniae keratitis after penetrating keratoplasty is an extremely damaging disease. The clinical and microbiological diagnosis of the disease should be performed urgently, and appropriate treatment should be initiated without delay.

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Intensive care units (ICUs) are the most important departments of a hospital regarding nosocomial infections. Many risk factors contribute to the infection rates in ICUs. These risk factors can be related to the patient or environment. Environmental conditions are important in infection control. Nurse/patient ratio has been shown to be related to nosocomial infection rates. This study aimed to investigate the effects of some of these factors on nosocomial infection rates in ICUs.The effects of changes in environmental conditions, such as area around the patient bed, temperature, humidity, and nurse/ patient rates on nosocomial infection rates were examined retrospectively in the ICU from January 2012 to June 2014 in this study.
The total infection rate, ventilator associated pneumonia rate, and catheter-related urinary tract infection rate were found to be 7.67%, 14.53%, and 5.47%, respectively. Despite a statistically significant relationship between all infection rates and the size of the area around the patient bed, no relationship was detected between the nurse/patient rates and the infection rates. Between temperature and humidity, only humidity had a statistically significant relationship with catheterrelated urinary tract infection rates.
Nurse/patient ratio is important in ICUs but the other factors related to the quality of the work and infection control are also important. The size of the area around the patient bed has been shown to have an important effect on infection control. This study reported a direct relationship of the size of the area around the patient bed with the infection rates. More studies are needed to evaluate the relationship between temperature and humidity and nosocomial infection rates.

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Necrotizing fasciitis is a rarely seen condition that affects the superficial fascia and subcutaneous fatty tissue and can be life threatening. It is mostly encountered in an acute fashion, but subacute progressive course can be seen rarely. Necrotizing fasciitis can affect any part of the body, but it is mostly seen in extremities, especially in the lower extremity. Although some traumatic events such as open fractures, crush injuries, lacerations, steroid injections, insect bites, burns, or frostbite injuries can cause necrotizing fasciitis, it can also be seen without any trauma. Affected extremity or the life of the patient can be protected with rapid diagnosis and treatment. Radiological tests are important as clinical doubt and examination. This study aimed to discuss the importance of the radiological assessment for the diagnosis of this lifethreatening condition in the context of current literature.

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Richter's hernia is defined as a type of hernia in which only part of the circumference of the antimesenteric border of a bowel wall is incarcerated within the hernia sac. This is discrete from other types of abdominal hernias in that only one intestinal wall protrudes through the defect, such that the lumen of the intestine is incompletely contained in the defect, while the rest remains in the peritoneal cavity. Due to the fact that, clinical presentation of Richter’s hernias is variable and it may be hard to diagnose immediately and high suspicion is also required for correct diagnose and promptly remediation. In this report, we present a case of Richter’s hernia after gynecological laparoscopic procedure occurring in a 62 year-old female,in order to warn surgeons and avoid similar complications.

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