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Objective: This study aims to determine the coinfection rate of hospitalized COVID-19 patients, investigate the etiological agents causing coinfection, and reveal the clinical characteristics of patients with coinfection. In addition, by identifying coinfections accompanying viral infections, we aim to prevent unnecessary antibiotic use and antimicrobial resistance. Methods: This study analyzed 76 hospitalized patients with prediagnoses of COVID-19 between Sep 2021 and Feb 2022. They had a positive RT-PCR test for SARS-CoV-2, compatible thoracic Computed Tomography findings, and biochemical parameters indicating coinfection. Patients' respiratory samples were tested for other respiratory pathogens by multiplex PCR. Results: Out of 76 patients, 54 (71.1%) were found to have one or more pathogens along with SARS-CoV-2. Among these patients, 35 had a single pathogen, while 19 had multiple pathogens. The most common pathogens were Staphylococcus aureus in 24 (31.6%) patients, influenza viruses in 18 patients (23.7%), and Streptococcus pneumoniae in 15 (17.1%) patients. There was no significant difference between mortality rates, length of hospital stay, hospitalization site, biochemical parameters (C-reactive protein, procalcitonin, lactate dehydrogenase, D-dimer, lymphocyte count, ferritin level) between patients with and without coinfection. Conclusion: Although no significant difference was found in parameters such as mortality rates and length of hospital stay in patients with comorbid pathogens in our study, we think that clinicians should take the risk of coinfection into account in the follow-up and treatment of hospitalized patients and perform appropriate tests in suspected cases. Our study showed that the viral and bacterial pathogens accompanying SARS-CoV-2 are significant and that more specific and large-scale studies are needed to examine the clinical effects of these factors. We also believe that influenza, pneumococcal, and COVID-19 vaccines should not be ignored, especially in risk groups, during the pandemic. [ABSTRACT FROM AUTHOR]

Objective: We aimed to compare the demographic and clinical characteristics, perceptions of disease, stigma, social support levels and psychosocial adaptations of patients with COVID-19 and patients with chronic infections (TB, hepatitis, HIV) who were followed as inpatients. Methods: The cross-sectional and descriptive study was conducted with 100 patients receiving inpatient treatment between January 2021 and January 2022. Criteria for selecting patients were being able to understand and speak Turkish, being at least literate, having TB, hepatitis, HIV or severe COVID-19 disease, and being an adult (over 18 years old). Data were collected using a personal information form, "Psychosocial Adjustment to Illness Scale-Self-Report", "Revised Illness Perception Questionnaire", and "Multidimensional Perceived Social Support Scale". Results: We determined that there was a significant difference in terms of demographic characteristics (age, education, marital and employment status) and hospitalization duration of individuals with COVID-19 and chronic infections (TB, hepatitis, HIV) who received inpatient treatment. There was also a significant difference in personal and treatment control, illness coherence, emotional representation dimensions, and attributions towards possible causes of the disease, as well as feelings of stigma, social support perceptions, and psychosocial adaptation. Conclusion: This study not only underscores the need for a biopsychosocial approach to individuals with contagious infectious diseases but also provides practical insights for healthcare professionals. Addressing the patients' perception of their illness early on can significantly improve patient beliefs, leading to more effective patient-centered treatment outcomes. Moreover, supporting individuals with infectious diseases in biopsychosocial management can play a crucial role in reducing psychological morbidity. [ABSTRACT FROM AUTHOR]

Objective: Ceftriaxone and metronidazole (CEF/MET) combination therapy is commonly used in the empirical therapy of intra-abdominal infections (IAIs). We aimed to evaluate the treatment response in patients started on empirical CEF/MET therapy and contribute current treatment data on IAIs. Methods: A retrospective analysis was conducted on patients receiving parenteral antibiotic therapy in the general surgery department between 2016 and 2018. Patients aged 18 and older who received CEF/MET therapy for more than 24 hours with a diagnosis of IAI were included. Patient characteristics, antibiotic use and/or surgical history in the last three months, infection source, need for surgical intervention, and clinical and laboratory data were evaluated. Treatment response was analyzed in groups of patients with or without treatment changes. Results: 10,649 patients were evaluated; 591 (5.5%) received CEF/MET therapy, and 297 (50.2%) met the study criteria. Among them, 243 (81.8%) received only CEF/MET treatment (Group 1), while 54(18.2%) received additional antibiotics (median day 5) (Group 2). There was a statistically significant correlation between malignancy, antibiotic use in the last three months and history of surgical intervention and treatment change (p=0.001). The gallbladder (63%) or the biliopancreatic tract (12.1%) were the infection foci in 75.1% of all patients. Treatment was modified in 9.6% of the patients with an infection focused on the gallbladder and 55.6% of the patients with an infection focused on the biliopancreatic tract (p=0.001). Patients with treatment modification had more extended hospital stays and higher mortality rates (p=0.001). Conclusion: Empirical CEF/MET initiation is appropriate for IAIs with a gallbladder focus, yielding a favourable response in four out of five patients. However, CEF/MET therapy may be insufficient in patients with a biliopancreatic tract focus, a history of antibiotic use, malignancy, or surgical intervention, despite source control. Therefore, learning the source of infection and patient characteristics will contribute to the determination of the antibiotic to be selected in empirical treatment, increase treatment success, shorten the hospitalization period, and reduce mortality. [ABSTRACT FROM AUTHOR]

Objective: Risky exposure of healthcare workers to blood and body fluids is one of the most critical global issues. This study aimed to determine the frequency, conditions, and interventions of risky contacts and provide guidance on infection control measures to enhance occupational safety. Methods: Healthcare workers' risky contact with blood and body fluids was investigated from January 2013 to December 2022. The contact tracking forms for blood and body fluid exposures in the Infection Control Committee (ICC) were retrospectively examined. Furthermore, the effects of the regulatory activities implemented by the ICC on the problems detected during the active surveillance of risky contacts and the effects of the COVID-19 pandemic during the monitoring process were evaluated. Results: During the ten-year follow-up period, a total of 700 risky contacts were identified in 625 healthcare workers, with 643 (91.9%) resulting from needlestick and sharp injuries and 57 (8.1%) from skin and mucosal contact. Of the risky contacts, 262 (37.4%) occurred in internal medicine units, 171 (24.4%) in surgical units, and 112 (16%) in the emergency department, making these the most common locations for risky contacts. The most frequently reported occupational groups were, respectively, 267 (38%) interns, 185 (26%) nurses, and 173 (25%) cleaning staff. When evaluating how risky contacts occurred, it was determined that 215 (30.7%) occurred during invasive procedures, 108 (15.4%) while recapping the needle, and 528 (75%) resulted from needlestick injuries. It was determined that 13% of risky contacts applied to the ICC after 72 hours, and 79% used appropriate personal protective equipment (PPE). The highest rate of PPE usage, at 93%, was observed in 2020, when the COVID-19 pandemic began. In 2013, it was observed that the most common risky contacts occurred during waste collection, and over the years, injuries during waste collection decreased with training. Although the source was unknown in 32% of risky contacts, a decrease in the rate of risky contacts with unknown sources was achieved over time. Out of 478 risky contacts with known sources, 71 (14.9%) occurred with patients infected with hepatitis B, 35 (7.3%) with hepatitis C, and seven (1.5%) with HIV. Ninety-six per cent of the nurses were exposed to risky contacts, 93% of interns, 87% of doctors, 56% of cleaning personnel, and 84% of other healthcare workers were immune to hepatitis B. After a one-year follow-up period with post-exposure prophylaxis, no healthcare worker developed hepatitis B or HIV infection, while one person was found to be anti-HCV positive. Conclusion: Needlestick-sharp object injuries remain a significant issue. All healthcare institutions must regularly monitor risky contacts with blood and bodily fluids, identify problems, develop targeted infection control measures, and plan periodic training. [ABSTRACT FROM AUTHOR]

Objective: Inborn errors of immunity (IEI), formerly known as primary immunodeficiencies, are a group of inherited diseases affecting different innate and adaptive immune system components. The most common finding in the heterogeneous group of patients with IEI is infections, which are associated with increased morbidity and mortality. This retrospective study aims to determine infections in a heterogeneous group of patients receiving immunoglobulin replacement therapy (IGRT). Methods: The medical records of the patients with IEI who received IGRT and were followed up in our clinic for the last five years were reviewed retrospectively. Results: In this study, including 45 patients diagnosed with IEI (55.6% male, average age 38.4±11.6 years), the most common subgroup was primary antibody deficiencies (40, 88.8%). The average age of diagnosis for patients was 26.8±14.8 years, with a median diagnostic delay of 6 years. Twenty (44.4%) of patients had bronchiectasis. All patients were receiving IGRT, with 82.2% using antimicrobial prophylaxis. Before diagnosis, the median annual number of infections was 4, which decreased to 1 post-treatment (p<0.001). Significant reductions in pneumonia and upper respiratory tract infection frequency were observed with IGRT compared to before the treatment (75.6% vs. 22.2%, p<0.001; 66.7% vs. 31.1%, p=0.003). Seventeen (37.8%) of patients were hospitalized due to infections during treatment. The rate of inactive influenza vaccination and the average body mass index (BMI) were significantly lower in patients with hospitalization than in those without hospitalization (20% vs 53.8%, p=0.034; 20.5 vs. 24.1 kg/m², p=0.019). Among those with bronchiectasis, the rate of pneumonia prior to diagnosis was significantly higher (95% vs. 60%, p=0.012). Lower BMI, the presence of bronchiectasis, and non-compliance with treatment were associated with more frequent infections under treatment. Conclusion: Many complications, especially infections, can be prevented by early diagnosis and treatment of IEI and increasing patient compliance with treatment. Therefore, increasing awareness of IEI both in society and among physicians from all specialties will enable patients to be diagnosed at an early stage and reduce hospitalization, mortality and morbidity. [ABSTRACT FROM AUTHOR]

Objective: This study aimed to investigate COVID-19 vaccine preferences among university students using a discrete choice experiment. Methods: A cross-sectional analytical study was conducted among university students. A questionnaire containing participants' sociodemographic characteristics and hypothetical COVID-19 vaccine choice sets was used. The mixed logit model was used to estimate students' preferences for different levels of vaccine attributes. Simulations of vaccine acceptance rates were calculated. Results: A total of 242 students participated in the study. 24.1% of the participants had a previous COVID-19 infection. 97.4% of the students had received a COVID-19 vaccine. Almost all of those who were vaccinated received two doses or more. 81.8% of them received the mRNA vaccine. The most frequent reasons for accepting vaccination were infection prevention and the belief that getting vaccinated is a societal responsibility to end the pandemic. 70.3% of the students agreed that COVID-19 vaccines were safe, while 89.2% agreed that vaccination contributed to herd immunity. According to the mixed logit model results, the most preferred attribute of the vaccine was effectiveness. Other attributes also affected the preferences of students in the following order of priority: frequency of severe side effects, reduction in transmission, duration of protection, origin, and type of the vaccine. Conclusion: These findings can guide low-risk groups to accept vaccination during a pandemic. In pandemic control, the importance of community participation and sharing up-to-date information on approaches to fighting pandemics, such as vaccines, should be prioritized. [ABSTRACT FROM AUTHOR]

Objective: Toxoplasma gondii, rubella, and cytomegalovirus (CMV) are among the TORCH (Toxoplasma, Others, Rubella, Cytomegalovirus, Herpes simplex virus) group microorganisms. Knowing regional epidemiological data on TORCH group infections is important, especially when deciding whether to perform routine screening at the regional and national levels. Our study aimed to evaluate the frequency of T. gondii, rubella, and CMV IgM and/or IgG antibodies in female patients admitted to a state hospital in İstanbul. Method: T. gondii, rubella, and CMV IgG and IgM antibody results tested in patient sera between January 2017 and December 2020 were evaluated retrospectively. Results: The results of 33 636 samples were evaluated. The highest rate of seropositivity was detected in the 20-29 age group (n=4626, 26.72%). The highest of antibody positivity was reported in 2019 (33.29%). The IgG seropositivity rate was 24.1% for T. gondii, 93.5% for rubella, and 98.3% for CMV. Conclusion: Except for the differences in T. gondii seroprevalence, the results of our study seem to be similar to those of other studies both in our country and globally. The seronegativity rate (74.9%) for T. gondii was high in our research, which indicates that pregnant women should be carefully monitored for T. gondii infection in our region. We conclude that more comprehensive studies are needed to establish national screening programs for TORCH group agents. [ABSTRACT FROM AUTHOR]

Objective: Although the tenofovir alafenamide/emtricitabine/bictegravir (TAF/FTC/BIC) regimen is recommended in national and international guidelines for changing treatment in treatment-experienced patients living with HIV (PLwHIV), there are limited real-life data reported in Türkiye. We aimed to evaluate the changes in virological and immunological indicators, renal functions, and lipid profiles in the follow-up of patients who switched to TAF/FTC/BIC. Methods: The study included treatment-experienced PLwHIV aged 18 years or older who were followed at the infectious diseases outpatient clinic between January 2020 and December 2021. Follow-up parameters before and after switching to TAF/FTC/BIC were evaluated retrospectively. Results: A total of 77 PLwHIV were included. Of those, 71 (92.2%) were male, and the median age was 42 years. The 24th and 48th week median HIV RNA values of patients whose viral loads were measured were 35 (27-77) copies/ml and 34 (24-49) copies/ml, respectively, after switching. We did not detected a significant difference in CD4+T lymphocyte count, CD4+ T lymphocyte percentage, and CD4+/CD8+ ratio when compared with pre-treatment values. Virological suppression was not maintained in 24.7% (n=19/77) of PLwHIV. While "incomplete virological response" was not detected in any patients, 2.6% (n=2/77) had virological rebound, 1.3% (n=1/77) were virological non-responders, 10.4% (n=8/77) had low-level viremia, and 20.8% (n=16/77) had virological blip. Glomerular filtration rate (GFR) (101 ml/min./1.73m² vs. 96 ml/min./1.73m², p=0.05) and total cholesterol level (199 mg/dl vs. 185 mg/dl, p=0.05) decreased at 48th week. In switching from tenofovir alafenamide/emtricitabine/elvitegravir/cobicistat (TAF/FTC/EVG/Cob) to TAF/FTC/BIC, significant decreases were detected in GFR (101 ml/min./1.73m² vs. 95 ml/min./1.73m², p=0.016) and total cholesterol levels (205 mg/dl vs. 182 mg/dl, p<0.001). Conclusion: Even if virological suppression is achieved before switching, virological suppression may be impaired in patients after switching to TAF/FTC/BIC. Moreover, renal functions should be closely monitored due to the significant decrease in GFR, especially when switching from TAF/FTC/EVG/Cob to TAF/FTC/BIC. [ABSTRACT FROM AUTHOR]

Objective: The study aimed to evaluate the clinical effects of levofloxacin (LEVO) and moxifloxacin (MOXI) prophylaxis during the treatment of acute myeloid leukemia (AML). Methods: This study had a prospective observational design and included AML patients who were scheduled for standard remission-induction (RI) or consolidation (C) chemotherapy. Prophylactic LEVO or MOXI was started at a ratio of 1:1 when neutropenia developed, and two groups were created. The primary endpoint was the frequency of febrile neutropenia (FN) and the time to FN. Results: 120 patients (60 patients in each group) were enrolled in the study. The frequency of FN tended to be higher in the LEVO group but was statistically insignificant (82.1% vs. 75.5%; p=0.702). The time to FN was 10.8±5.7 days and 10.1±5.7 days in the LEVO and MOXI groups, respectively (p=0.393). Microorganisms were izolated in 50.8% of patients who developed FN. The documented infection and bacteremia rate tended to be higher in the MOXI group (71.1% vs. 56.6%; p=0.331 and 87.5% vs. 80.5%; p=0.906). The rates of quinolone resistance were 69.2% and 75% in the LEVO and MOXI groups, respectively (p=0.451). The frequency of FN was higher during the RI phase than the C phase (89.1% vs. 70%; p=0.010). The frequency of documented infection was higher during the C phase than during the RI phase (77.1% vs. 49.1%; p=0.008). Conclusion: This study showed that prophylactic MOXI and LEVO have similar efficacy in AML patients. [ABSTRACT FROM AUTHOR]

Objective: C-reactive protein (CRP) is an acute-phase protein that is widely used and can be elevated in many conditions that lead to acute inflammation, including infectious diseases. In this study, we aimed to determine the rate of presence of an infectious disease in patients who were consulted because of a high CRP level. Methods: Inpatients and outpatients consulted to the Infectious Diseases and Clinical Microbiology (IHCM) Clinic between January and March 2022 because of high CRP levels were included in the study. The anamnesis, physical examination, and laboratory findings of the patients were recorded, and the existence of an infectious disease was investigated. Results: 124 patients were referred for consultation during the study period. CRP levels of 6 (4.9%) patients were within average reference values; the remaining 118 patients were included in the study. Of the 118 patients, 54 (45%) had clinical complaints consistent with an infectious disease. A focus of infection was detected in only 49 (42%) patients. We found that there was a significant relationship between the presence of symptoms consistent with an infectious disease and the presence of a positive physical examination finding with the presence of an infectious focus (p<0.05) Conclusion: In this study, we determined that more than half of the patients for whom consultation was requested due to high CRP levels did not have an infectious disease. We think that unnecessary consultation burden can be avoided by detailed clinical evaluation of the patients before referring them for consultation by only looking at the CRP results. [ABSTRACT FROM AUTHOR]

Objective: Identifying the presence and type of carbapenemases is essential to determine the treatment choices for carbapenem-resistant Gram-negative bacilli (CRB). Genotypic characterization of CRB needs technical support and experienced staff and is not an option for most laboratories due to its high cost. For this reason, especially in countries with limited resources, cheap, reliable phenotypic methods are an alternative, do not require experience, and can be easily applied in daily practice. The goal of the study was to evaluate the performance of phenotypic methods for carbapenemase production in CRB and to form a simple algorithm to differentiate carbapenemase types such as blaOXA-48 or blaNDM, which are common in our country. Methods: The study included 16 consecutive carbapenem-resistant, Gram-negative bacteria. Simplified carbapenem inactivation methods (sCIM) and modified Hodge test (MHT) were performed. Genes responsible for carbapenemase production (blaOXA-48, blaNDM, and blaKPC) were detected by real-time polymerase chain reaction. Temocillin resistance and ceftazidime-avibactam disc diffusion test were also applied to define carbapenemase types. Results: The carbapenemase gene was detected in 12 of the 16 strains; sCIM positivity was found in 11, and MHT was positive in 10. Sensitivity for sCIM and MHT were 91.9% and 83.3%, respectively. All Enterobacterales strains were positive for sCIM, and blaOXA-48 was the most common carbapenemase. sCIM false negativity was detected for only one strain. High-level temocillin resistance (MIC >128 μg/mL) was present in all strains with blaOXA-48; it wasn't detected in the strain carrying isolated blaNDM. Conclusion: sCIM positivity was present for all Enterobacterales, which were shown to carry the carbapenemase gene by RT-PCR. Our findings support the usage of sCIM in daily practice to screen for carbapenemase production in CRB. [ABSTRACT FROM AUTHOR]

Objective: This study aimed to determine the measles seroprevalence and related factors in healthcare professionals working in units with a high risk of encountering measles cases in Dokuz Eylül University Hospital. Methods: This cross-sectional study was conducted between June 2018 and September 2019. The study population consisted of all healthcare professionals working as specialist doctors, trainee doctors, and nurses in Pediatric hospital, Adult Emergency, Family Medicine, Infectious Diseases, and Clinical Microbiology and Dermatology departments. Healthcare professionals who agreed to participate were interviewed face-to-face, including questions about independent variables such as gender, age, occupation, working unit, and history of disease. The dependent variable was the seropositivity/seronegativity status of the participants, which was determined according to the quantitative anti-Rubella IgG antibody levels measured by the ELISA method from serum samples. P< 0.05 was accepted as statistical significance. Results: During the study period, 326 out of 368 healthcare professionals in the units in question agreed to participate (88.5%). Of the participants, 79 (24.2%) were seronegative and 247 (75.8%) were seropositive. Seronegativity increased with decreasing age (p=0.036) when evaluated according to age groups. Seronegativity was 29.4% in the 20-29 age group, 19.2% in the 30-39 age group, and 10.7% in the 40-49 age group, while all participants aged 50 years and over were seropositive. Seropositivity was not affected by gender (p=0.260), occupation (p=0.364), or department (p=0.129). The study group's median anti-measles IgG antibody level was 654 IU/ml (65-5000 IU/ml). The median antibody level increased with increasing age (p<0.001). Conclusion: In our study, a significant proportion of healthcare professionals at risk for encountering measles were susceptible. [ABSTRACT FROM AUTHOR]

Introduction: The increase in antibiotic resistance due to overuse and misuse has led to changes in the primary pathogens causing otitis media and antibiotic susceptibility. Empirical antibiotic treatment may cause treatment failure or result in complications in diseases caused by antibiotic-resistant bacteria. We aimed to identify bacterial pathogens associated with ear infections and to evaluate antibacterial resistance among isolated organisms. Methods: Ear swab samples of patients who applied to our hospital's Ear Nose and Throat Outpatient Clinic between February 2022 and February 2023, sent to our laboratory with the preliminary diagnosis of ear infection, were examined. The study included 144 patients whose ear swab samples' Gram staining and culture results were compatible with ear infection. Microorganisms that grew in culture were identified using conventional methods. The antimicrobial susceptibility of the isolated strains was determined using the Kirby-Bauer disk diffusion method and evaluated by the European Committee on Antimicrobial Susceptibility Testing (EUCAST) criteria. Results: The study examined 171 external ear canal culture results from 144 patients at their first admission and 19 patients due to recurrent external ear canal discharge in later periods. Pathogenic microorganism growth was observed in 90 specimens, normal microbial flora grew in 58 specimens, and no microorganism growth was observed in 23 specimens. Staphylococcus aureus was the most common, and Pseudomonas aeruginosa was the second most common pathogen. Ampicillin resistance was the highest among the isolated Gram-negative bacteria (77.7%). Conclusion: It is essential to monitor the frequency of causative pathogens and the rates of resistance to antimicrobial agents to start appropriate antimicrobial therapy in patients with ear infections. [ABSTRACT FROM AUTHOR]

Introduction: In this study, we aimed to determine the relationship between bacteremia and procalcitonin (PCT) and the cut-off value of PCT in detecting bacteremia. Methods: Adult (>18 years old) patients admitted to our hospital's emergency department and diagnosed with sepsis between January 1, 2019, and April 1, 2022, were evaluated retrospectively. Patients whose complete blood count, C-reactive protein (CRP), PCT, and biochemical tests were performed and who had two sets of blood cultures taken before antibiotics were started were included in the study. Patients with and without bacteremia were compared in terms of PCT, CRP, leukocyte count, and age. The cut-off value was determined for PCT in detecting bacteremia. Results: Of the 4036 patients evaluated, 301 patients were included in the study. 174 (57.8%) of the patients were male and 127 (42.2%) were female. Bacteremia was detected in 19% (56) of the cases. The most common pathogen was coagulase-negative staphylococci (46%), and Escherichia coli (23%) was the second most common. A cut-off value of ≥3.29 for PCT has 80% specifity, while the negative predictive value was 89.5% (area under the ROC curve [AUC]= 0.718, 95% confidence interval [CI]=0.663-0.768). There was a low level of positive correlation between leukocyte values and PCT values of the patients (r=0.373, p<0.001). Similarly, there was a low level of positive correlation between CRP values and PCT values (r=0.490, p<0.001). Conclusion: According to the results of the study, PCT value was found to have a high negative predictive value and high specificity in detecting bacteremia. Therefore, we conclude that PCT value should be measured for early and rapid antibiotic initiation in patients who apply to the emergency outpatient clinic and are suspected of having sepsis. [ABSTRACT FROM AUTHOR]

Objective: Central nervous system (CNS) infections are a significant cause of mortality and morbidity all over the world. Currently, molecular methods with high sensitivity and specificity provide a diagnosis from a small amount of cerebrospinal fluid (CSF) sample in a short time. Our study aims to determine whether the meningitis/encephalitis panel test is used rationally and to make appropriate recommendations for practical use in the approach to CNS infections. Methods: Between January 2022 and 2023, 46 samples with meningitis/encephalitis panel requests were included in the study. Cerebrospinal fluid samples of the patients were studied with the QIAstat-Dx Analyzer (Qiagen, Hilden, Germany )and the QIAstat-Dx® Meningitis/Encephalitis (ME) Panel kiti (Qiagen, Hilden, Germany). Data about age, gender, CSF leukocyte, erythrocyte, glucose and protein, blood leukocytes and C-reactive protein (CRP) values, presence of fever, headache, neck stiffness, and altered consciousness in patients were obtained retrospectively from patient files and the hospital information system. Results: Of the 46 patients, 22 were female and 24 were male. Three Varicella-zoster virus, two Herpes simplex virus-1, two Cryptococcus neoformans/gatti, one Escherichia coli K1 and one Listeria monocytogenes positivity were detected in the ME panel of a total of nine samples, five from female and four male patients; the total positivity rate was 19.5%. CSF leukocyte and erythrocyte value, blurred consciousness, blood leukocyte count, and CRP values did not differ significantly between panel (-) and panel (+) groups. Fever, headache, nuchal rigidity, high CSF protein, and low CSF glucose were very different in the group with panel (+) (p<0.05). Conclusion: Requesting an ME panel with a rational algorithm after microbiological and biochemical evaluation of CSF samples taken with a strong clinical suspicion will be convenient and cost-effective, prevent unnecessary antibiotic or antiviral use, and reduce hospital stays. [ABSTRACT FROM AUTHOR]

Introduction: Vaccination is one of the preventive measures that should be taken against COVID-19. In this study, we aimed to evaluate the COVID-19 vaccination status and factors affecting vaccination of healthcare workers (HCWs) working in our hospital. Methods: This cross-sectional study was conducted by filling out a questionnaire form with face-to-face or snowball methods to HCWs in our hospital. The questionnaire is composed of 10 questions, including demographic information, occupation of the person, working in the pandemic unit, COVID-19 and Influenza vaccination information, contracting COVID-19, and hospitalization status. Full-dose vaccination was defined as four doses in total. P<0.05 was accepted as a statistical significance level. Results: We included 744 HCWs in this study. The median age was 32 (17-60) years, and 60.8% (n=452) were women, mostly nurses (32.3%, n=240). The vaccination rate after contracting COVID-19 was 56.9% (n=269). Vaccination rates against COVID-19 were higher in women (94.5%) than in men (93%), in those who were vaccinated against influenza (99.4%) than those who were not (91%), and in doctors (99.3%) than in nurses (92.5%) and other HCWs (%90.8) (p=0.051, p=0.00, p=0.004). The rate of full-dose vaccination was found to be statistically significantly higher in those who worked in the pandemic unit (39.4%) than in those who did not (27.9%), in those who had influenza vaccination (44.5%) than those who did not (32.2%), and also higher in doctors (61.8%) compared to nurses (31.7%) and other HCWs (27.2%) (p=0.002, p=0.04, p=0.000). The rate of having COVID-19 disease was higher in HCWs who were unvaccinated or vaccinated with a missing dose (63.2%) compared to HCWs who were vaccinated with a full dose (41%) (p=0.000). Conclusion: Full-dose vaccination reduces the rate of COVID-19 disease, and doctors are more inclined to have fulldose vaccination than nurses and other HCWs. [ABSTRACT FROM AUTHOR]

Objective: Chronicity of acute HBV infection is higher in people living with HIV (PLWH) than in the general population. HIV/HBV coinfection has a higher risk of rapid progression to cirrhosis and liver-related death than in solely HBV-infected patients. Therefore, vaccination against HBV is recommended. In this study, we aimed to evaluate hepatitis B vaccination rates and the factors affecting response to the vaccine in PLWH. Methods: Outpatient follow-up files and laboratory test results at the hospital information system of 1394 patients aged >18 years diagnosed with HIV/AIDS and followed between January 1, 2007, and January 1, 2022, were evaluated retrospectively. Results: Of the PLWH, 81 (5.8%) had chronic hepatitis B infection, 114 (8.2%) had isolated anti-HBc IgG positivity, and 274 (19.6%) had a previous condition. 248 (17.7%) of the PLWH had been vaccinated before HIV/AIDS diagnosis. HBsAg, anti-HBc IgG and anti-HBs were negative in 673 PLWH. A total of 352 (44.7%) PLWHs were vaccinated, consisting of 63 (55.2%) of 114 PLWHs with isolated anti-HBc IgG positivity and 289 (42.9%) of 673 PLWHs with negative HBV serology. Immunity developed in 282 (84.1%) of those vaccinated. We found that the main factor determining the immune response was the CD4+ T lymphocyte count at the time of diagnosis, and there was a significant increase in immune response since 2015 when the recommendation of antiretroviral therapy independent of the CD4+ T lymphocyte level was implemented. We observed that comorbidities, age, gender, and sexual orientation did not significantly affect the vaccine response. Conclusion: Vaccination is critical in PLWH, and we observed that the ideal time for vaccination in those with negative HBV serology is when the CD4+ T lymphocyte count is >200 cells/mm³ and the viral load is suppressed. It should be considered that the vaccination rate and immune response will increase with the support of vaccination outpatient clinics, where vaccination status is closely monitored by healthcare personnel. [ABSTRACT FROM AUTHOR]

Objective: There is not a definitive virological treatment for chronic hepatitis B . Withdrawal of nucleos(t)ide analogue (NA) therapy frequently results in viral recurrence, necessitating lifetime treatment. We aimed to look into the results of discontinuation of nucleos(t)ide analogue therapy in HBeAg negative patients. Methods: Treatment of HBeAg-negative patients without cirrhosis who had suppressed HBV DNA for a mean of ≥7 years and underwent nucleos(t)ide analogue therapy for a mean of ≥7 years were stopped according to the EASL guideline stopping rule. Standard laboratory tests, such as HBV DNA viral load, HBsAg, alanine aminotransferase, and adverse events, were monitored for more than four years during therapy and afterwards. Results: HBsAg loss was not observed in any of the patients during the four-year follow-up period. After the first 12 weeks, HBV-DNA was detected in all patients whose nucleos(t)ide analogue treatment was discontinued. The percentage of patients with HBV DNA >2000 IU/mL was 70% at 6 months, 74% at 12 months, 78% at 24 months, and 79.7% at 36 months, HBV DNA >2000 IU/mL was not detected in remaining patients over a four-year period. In the first year, 26% (n=18) of patients were started treatment for relapse, 46% (n=32) in the second year, 49% (n=34) in the third year, and 55% (n=38) in the fourth year. 45% (n=31) of the patients were still being followed without treatment at the end of the fourth year. Conclusion: Although the follow-up of hepatitis B e antigen-negative CHB patients on NA therapy was longer than in the literature, our recurrence rates were similar to other studies, and no patient lost HBsAg. The most significant benefit was that we were able to follow half of the patients without therapy for more than four years, eliminating the need for the patients to use drugs. [ABSTRACT FROM AUTHOR]

Objective: Urinary tract infections are the most common bacterial infections among community-acquired infections in all age groups. In this study, we aimed to evaluate the distribution of Escherichia coli and Klebsiella spp. in community-acquired urinary tract infections by years and the resistance rates to trimethoprim-sulfamethoxazole (TMP-SXT) and ciprofloxacin antibiotics, which are used as the first choice in community-acquired urinary tract infections. Methods: All urine culture samples from all age groups admitted to the medical microbiology laboratory from outpatient clinics and emergency services between January 2011 and August 2021 were retrospectively analyzed. Samples with E. coli and Klebsiella spp. detected as causative agents in urine cultures were included in the study. Conventional methods and automated systems were used to identify bacteria and for antibiotic susceptibility tests. Results: E. coli (n=50 430) and Klebsiella spp. (n=7763) isolated from urine cultures between January 2011 and August 2021 were evaluated. The lowest and highest resistance rates for ciprofloxacin and TMP-SXT for E. coli were 25-40% and 35-51%, respectively. Ciprofloxacin and TMP-SXT resistance rates for Klebsiella spp. were the lowest and highest at 17-43% and 31-43%, respectively. Conclusion: Knowing the resistance rates of antibiotics used as the first choice against common agents such as E. coli and Klebsiella spp. in treating community-acquired urinary tract infections may guide the empirical antimicrobial therapy. [ABSTRACT FROM AUTHOR]

Objective: We aimed to evaluate the epidemiological, clinical features, laboratory findings, and treatment regimens of patients with brucellosis in the Tokat region. Methods: In this cross-sectional study, the data of 236 adult patients followed with brucellosis in Tokat Gaziosmanpaşa University Medical Faculty Hospital between January 2016 and December 2021 were evaluated retrospectively. Diagnostic criteria of brucellosis were determined as culture positivity, or positivity in the Wright test at ≥ 1/160 titration, or a 4-fold increase in titer of the Wright test repeated at 2 - 3 week intervals. Demographic data, symptoms, physical examination findings, and laboratory results of the patients were evaluated. Results: 72% (n=170) of the patients were male, and the mean age was 44.47±16.64. 53% (n=125) were engaged in animal husbandry, 21.6% (n=51) consumed unpasteurized dairy products, and 13.1% (n=31) had a family member with brucellosis. Seven (2.9%) patients with a prediagnosis of Crimean-Congo hemorrhagic fever (CCHF) were diagnosed with acute brucellosis. The most common symptoms were muscle-joint pain (70.3%), fever (50.8%), and sweating (43.2%). Spondylodiscitis was observed in 13.6%, epididymal-orchitis in 8.2%, and neurobrucellosis in 0.4% of the patients. Blood culture positivity was detected in 7.2% of the cases. 91.5% had elevated C-reactive protein (CRP) levels, and 48.3% had elevated erythrocyte sedimentation rates. The most common hematological findings were anemia (28%), leukopenia (10.6%), and thrombocytopenia (8.5%). As a therapy doxycycline + rifampicin combination was started at 36%, doxycycline + gentamicin to 5.8%, doxycycline + streptomycin to 5.4%, and doxycycline + rifampicin + gentamicin to 29.7% of the patients. Alternative treatment regimens were given to 22.9% (n=54) of the patients. Conclusion: Brucellosis is still a critical zoonotic disease in our region. It should be kept in mind when diagnosing patients with fever, muscle-joint pain, and sweating, with epidemiological histories, have elevated acute phase reactants and cytopenia. It should also be remembered that brucellosis can be confused with CCHF in endemic areas. [ABSTRACT FROM AUTHOR]

Objective: Infective endocarditis is a serious disease with high morbidity and mortality due to serious embolic complications. The follow-up of the patients requires multidisciplinary evaluation. We aimed to share the experience of the infective endocarditis team in our hospital and to guide the work of the teams to be formed in the future. Methods: Our study was planned as descriptive, cross-sectional, and observational. The patients were diagnosed by the modified Duke criteria. The National Infective Endocarditis Consensus Report was considered during the diagnosis, follow-up, and treatment process. Results: Fifty (45.4%) of 110 patients followed by the team were diagnosed with endocarditis. Thirty of the patients (51.8%) were male, the median age was 63.5 (18-87) days, and the median duration of symptoms was 35.7 (1-180) days. 76% of the diagnoses were definite endocarditis, 46% of the cases had an acute course, aortic valve involvement was 38%, and native valve involvement was 60%; the most isolated agent was Stapyhylococcus aureus. Community-acquired infection was 46%. The most common predisposing factors were prosthetic heart valve (38%) and hemodialysis (46%). Fever was observed in 64% of the patients and dyspnea in 58%. The rate of detection of vegetation by transesophageal echocardiography was 68%. Brain, pulmonary embolisms, and spondylodiscitis were the most common complications. The median time for blood culture to become negative was 3 (3-15) days, the operation time for 15 patients was 8 (1-30) days, and the 30-day hospital mortality was 28%. A statistically significant correlation was found between mortality and the presence of previous endocarditis, ejection fraction below 50%, complication development, hospitalization in the intensive care unit, presence of thrombocytopenia, Charlson comorbidity index ≥5, and vegetation size ≥1 cm (p<0.05). We determined that the presence of previous endocarditis increased the risk of mortality 14 times (p=0.025). Conclusion: Mortality and morbidity rates can be reduced by detecting underlying diseases, controlling complications, applying early effective antibiotic and anticoagulant treatment, surgical interventions at the right time, and rapid supportive treatments for sepsis by teams formed with a multidisciplinary approach. [ABSTRACT FROM AUTHOR]

Objective: The COVID-19 pandemic has caused significant morbidity and mortality and has challenged health systems worldwide. Immunosuppression is considered a risk factor for development of severe COVID-19. In this study, we aimed to determine the factors affecting morbidity and mortality in immunocompromised patients diagnosed with COVID-19. Methods: In this retrospective, cross-sectional study, laboratory findings and outcomes of 340 COVID-19 patients with secondary immunosuppression in a university hospital in Turkey from March 2020 to April 2022 were analyzed according to the 28-day clinical outcomes. Mortality-related factors were investigated in 3 patient groups with different forms of immunodeficiency: 1) malignancy (hematologic/solid), 2) organ transplantation, and 3) rheumatological diseases. Results: 172 (51%) of the patients were female, and the mean age was 61±15 years. A total of 122 (35.8%) patients died during hospitalization. The mortality rate (73.4%) in patients admitted to the intensive care unit (ICU) was significantly higher than those not admitted (p<0.001). The highest laboratory median values of urea, lactate dehydrogenase (LDH), D-dimer, ferritin, C-reactive protein (CRP), and fibrinogen values were found to be significantly higher, and the first measurement lymphocyte value was found to be considerably lower compared to the surviving patients (p<0.001) in the 28-day follow-up, ICU admission increased the mortality risk 13.6 (p<0.001) times. Anticoagulant treatment (p=0.029) and nasal oxygen support (p<0.001) led to a decrease in the risk of mortality. Conclusion: Immunocompromised patients are at risk for serious COVID-19 complications. LDH, D-dimer, CRP, and lymphocyte values can be used as markers to evaluate survival, and standard treatment is essential in immunosuppressive COVID-19 patients. [ABSTRACT FROM AUTHOR]

Objective: The cycle threshold value was used to predict disease severity, disease progression, determine transmissibility, and differentiate active viral replication from prolonged virus shedding. In this study, we aimed to evaluate the relationship between rRT-PCR cycle threshold and clinical course, mortality and laboratory parameters in COVID-19 patients. Methods: The patients included in the study were grouped according to how they were followed; as outpatients, service and intensive care unit patients. Data of age, gender, length of hospital stay, survival status and comorbidities of the patients were obtained from the hospital information system. In addition, CRP, ferritin, albumin, lactate dehydrogenase, procalcitonin and iron values of inpatients were reviewed retrospectively. Cycle threshold values of the patients were compared with each parameter separately. Results: 1339 patients with positive SARS-CoV-2 rRT-PCR test were included in the study. Of the patients, 774 (58%) were outpatients, 548 (41%) were in the ward, and 17 (1%) were in the intensive care unit. No significant difference was found between any of the groups when the cycle threshold values of the groups were compared statistically. Fifty (3.7%) of the patients included in the study died. Cycle threshold values of deceased patients were found to be significantly lower than those who survived (p=0.019). 306 (22.8%) of the patients had comorbidities. When the cycle threshold values of patients with and without comorbid disease were compared, no significant difference was found between any of the groups (p=0.850). In addition, no significant correlation was found between the length of hospital stay, age, CRP, LDH, ferritin, procalcitonin, albumin and iron values and the cycle threshold value. Conclusion: In conclusion, we did not find a significant difference between the cycle threshold values of outpatients, ward patients and intensive care patients. No significant correlation was found between the laboratory parameters, length of hospital stay and age, and the cycle threshold: however, deceased patients were found to have lower cycle thresholds than surviving patients. [ABSTRACT FROM AUTHOR]

Objective: We aimed to determine an appropriate anti-HCV test cut-off value for the HCV-RNA study and contribute to the development of correct algorithms by evaluating our hospital's anti HCV and HCV-RNA test results between 2017-2019. Methods: Available HCV-RNA test results of patients who were found to have reactivity in anti-HCV were analyzed. Patients with anti-HCV reactivity were analyzed by dividing into age groups 0-20 years, 21-40 years, 41-60 years, and ≥61 years. HCV-RNA results were also evaluated within the same age groups. Patients with anti-HCV reactivity were divided into three groups according to their S/Co values as 1-5 mLU/mL, 5.1-10 mLU/mL, and ≥10.1 mLU/mL, and statistical analysis was performed. Results: Anti-HCV reactive results were divided into groups of 1.0-3.8 mLU/mL and ≥3.9 mLU/mL according to S/Co values, and HCV-RNA positivity was 2% and 44.4% respectively. When divided into three groups as 1-5 mLU/mL, 5.1-10 mLU/mL, and ≥10.1 mLU/mL according to S/Co values, the HCV RNA positivi- ty rate was 1.8%, 25%, and 55.2%, respectively. The difference between the groups was statistically significant. Conclusion: Countries should carry out comprehensive studies to represent their populations to determine cut-off values for widely used kits and to make this applicable with algorithms. [ABSTRACT FROM AUTHOR]

Objective: We aimed to determine the frequency, type, and mortality rate of central nervous system infections (CNSI) in patients infected with the human immune deficiency virus (HIV). Methods: A total of 353 HIV/AIDS cases hospitalized in our clinic between January 2014 and March 2020 were retrospectively analyzed. Patients diagnosed with CNSI were included in the study. Epidemiological data, diagnoses, clinical, and laboratory information, and clinical progress data of the cases were collected from patient files and recorded. Variables were analyzed. Results: Thirty-four (9.6%) of 353 inpatients diagnosed with HIV/AIDS were followed with CNSI diagnosis. 88.2% of the cases were male, and the median age was 43.5 [interquartile range (IQR)= 26-62) ]. Toxoplasma encephalitis (n=7, 20.6% ), neurosyphilis (n=7, 20.6%), tuberculous meningitis (n=4, 11.8%), cryptococcal meningitis (n=4, 11.8%), HIV encephalopathy (n =3, 8.8%), progressive multifocal leukoencephalopathy (PML) (n=3, 8.8%), and bacterial meningitis (n=2, 5.9%), and 1 case of herpes simplex virus (HSV) encephalitis, varicella zoster virus (VZV) encephalitis, chronic encephalitis, cytomegalovirus (CMV) meningoencephalitis were seen. The median CD4+ T lymphocyte count of the cases was 44.5 /uL (IQR=5-627), HIV RNA level was 215 000 copies/mL (IQR=20-617 000) in patients under antiretroviral therapy (ART), 227 500 (IQR=32 000-4 500 000) copies/ml in patients not receiving ART. CD4+ T lymphocyte count of 25 (73.4%) patients was <200/uL. Twenty-one patients (61.8% ) were simultaneously diagnosed with HIV/AIDS and CNSI, and 14 were in the AIDS stage. The mortality rate was 32.4 % (n=11), and all fatal cases had CD4+ T lymphocyte counts below 200/uL. Conclusion: Central nervous system infections continue to cause severe mortality and morbidity in HIV-infected individuals. We observed that the frequency and mortality rate of CNSI is higher in patients who do not know their HIV status, late-presenters, and those who are not under treatment and/or do not adhere to treatment. Facilitating access to diagnostic tests, rapid treatment initiation, and counseling on treatment compliance is essential to prevent CNSI and, thus, reduce mortality. [ABSTRACT FROM AUTHOR]

Objective: The study aimed to investigate whether 6th-grade students in a medical school have sufficient knowledge about general and COVID-19 vaccine types at the end of the first year of the COVID-19 pandemic. Methods: In this qualitative study, the sample was selected by snowball method among 6th-year medical students in February 2021. The data were collected in-depth by using a semi-structured question guide with 10 participants who agreed to be interviewed. Results: Most of the participants stated that they did not feel knowledgeable enough about the general vaccine types, the newly produced COVID-19 vaccines, the mechanisms of action of COVID-19 vaccines, and the efficacy and safety of these vaccines. All participants agreed to have the recommended vaccine before the phase studies were completed. Conclusion: It is invaluable for the participants to report that they had decided to be vaccinated with the inactivated vaccine, which was Turkey's first recommended and current vaccine. Although they thought their COVID-19 vaccine knowledge was insufficient, they agreed to get vaccinated to protect themselves and society. Furthermore, it is remarkable that most participants also reported recommending the new vaccines to society. Therefore, we suggest that general and current vaccine information, including the COVID-19 vaccine, should be part of the medical school core education curriculum. In addition, it will be essential to repeat similar and qualitative research on available vaccine types and COVID-19 vaccines after the pandemic and compare the results with the data in the middle of the pandemic. [ABSTRACT FROM AUTHOR]

Objective: Transport of blood and saliva-contaminated materials such as impressions and prostheses between clinics and laboratories increases the risk of cross-infection. This study evaluates dental technicians knowledge, attitudes, and behaviors about infection control practices. Methods: This cross-sectional study was conducted through an online questionnaire for dental technicians working in Istanbul between July 03, 2021, and January 31, 2022. The questionnaire comprised 38 multiple-choice questions on demographic information, infection control awareness, disinfection practices, personal protective equipment use, and Hepatitis B vaccination. Results: In the research, 256 dental technicians took part, and 73% of them graduated from were graduates of dental lab technician school. The rate of those who received infection control training was 60.2%. 72.3% of the participants were vaccinated against hepatitis B, and 8.6% were not vaccinated due to their immunity. 59.4% of dentists did not inform the laboratories about the sent materials disinfection status. Although 97.3% of the technicians thought there was a risk of infectious disease transmission from impressions and prostheses delivered from dental clinics, they disinfected 88.7% of the alginate impressions and 87.5% of the silicone and polyether impressions. The rate of those who used all the equipment, gloves, masks, and eye protection during disinfection was 31.7%. Medical wastes were separated in 40.6% of the laboratories. 69.9% of technicians thought the infection control procedures were adequate in their laboratories, whereas 20.7% did not. Conclusion: It would be beneficial for dental technicians to receive infection control training to increase their knowledge about disinfection practices and the use of personal protective equipment. We suggest that contaminated materials be transported to laboratories after being disinfected at dental clinics, infection control guidelines for dental prosthesis laboratories should be established, and regular inspections should be conducted to reduce the risk of cross-infection. [ABSTRACT FROM AUTHOR]

Objective: The primary aim of the study was to analyze the changes in time in HIV care and management and virologic success rates. The secondary aims were to analyze the epidemiological features, clinical and laboratory findings, and factors affecting survival. Methods: HIV-infected individuals aged ≥ 18 years presenting to our clinic between January 1996 and December 2015 were included. Data were collected retrospectively from medical records, and two decades (1996-2005 and 2006-2015) were analyzed. Results: Overall, 80% were male; the median age (min; max) was 36.43 (17; 77) years. Patients with stage 3 disease were significantly higher in the first decade compared to the second decade (p=0.00). The median (min; max) CD4+ T lymphocyte count at baseline was 160 (3; 650) and 355 (0; 1800) cells/mm3 in the first and second decades, respectively (p=0.00). The treatment initiation rate was 94.2%; virologic suppression rates at six months of treatment and throughout the total follow-up time were 70.1% and 78.1%, respectively. The difference between the two decades in virologic suppression was significant (p=0.004). AIDS-defining disease developed in 12.9% (52.6% in the first and 11% in the second decade) (p=0.01). The adverse event rate was 60.8%; hyperlipidemia was the most common (60.2%). The death rate was 6.5% and lymphoma (14.3%) and tuberculosis (10.9%) were the most common causes of death. The estimated survival time was 272 months (95% confidence interval 225-320). The inability to achieve virologic suppression, an AIDS-defining disease, and a baseline CD4+ T lymphocyte count <200 cells/mm³ was inversely correlated with survival time. Conclusion: Significant improvements in HIV care and management were recorded in time in our cohort in line with the improvements in global HIV care. Treatment and viral suppression rates were above the Joint United Nations Programme on HIV/AIDS -- UNAIDS 90-90-90 target in the second decade. This may be attributed to the recent developments in antiretroviral treatment and the competence of the HIV team in the Aegean University Medical Faculty Infectious Diseases and Clinical Microbiology Department. [ABSTRACT FROM AUTHOR]

Objective: We conducted this study to determine the factors that cause foot ulcers in patients with type 2 diabetes mellitus (DM) with or without diabetic foot ulcer (DFU). Methods: This cross-sectional, descriptive study compared the feet examination results of 43 Type 2 DM patients with or without DFU. The study data were collected using a patient identification form and a diabetic foot examination form. Data are presented as percent, mean, and standard deviation. Chi-square and Fisher's exact tests were used for statistical analysis. The statistical significance level was taken as p<0.05. Results: Of the patients, 63% were male, 79% were married, their mean age was 63.16±9.43, and the mean diabetes year was 18.44±7.77. 74% of the patients had a previous DFU. Of the existing DFU, 58% were on the right foot, 49% were on the toes, 49% were Wagner grade 2, and 37% were infected. There was edema and warmth in the DFU foot (p<0.05). DFU foot had a weaker sense of touch and vibration than the other. Ankle-Brakial Index was below 0.9. Foot pulses were weak, and there were deformities. Conclusion: Patients with DFU feet have an increased risk of recurrent ulcer formation. These patients should be followed periodically and educated about ulcer formation and signs and symptoms of infection. [ABSTRACT FROM AUTHOR]

Objective: This study included participants from Hacettepe University 4th, 5th, and 6th-grade students of Medical School and 4th and 5th-grade students of Dental School; and aimed to evaluate the general health status, COVID-19 history, vaccination status, and SARS-CoV-2 antibody levels of the participants to support their physical and social health, during the pandemic period. Methods: A prospective cohort study was conducted with an integrated, matched, nested case-control study. Sociodemographic characteristics, life habits, COVID-19 history, vaccination status, compliance with mask-distance-hygiene rules, and risks (if any) for COVID-19 were inquired via online questionnaires. Physical examinations, complete blood count, biochemistry tests, and anti-SARS-CoV-2 anti-spike antibody tests were conducted for all consenting participants. All analyses were established using depersonalized data. Results: Of the 778 participants completing the baseline visit in June-July 2021, the percentages of those vaccinated with at least one, two, and three/more doses of COVID-19 vaccine were 99.1%, 98.0%, and 11.7%, respectively; one had four doses. The median (minimum-maximum) time since the last vaccination was 134 (34-166) days for those vaccinated with two doses [CoronaVac (Sinovac Life Sciences, Beijing, China)] and 25 (14-56) days for those vaccinated with three doses [two doses of CoronaVac and a last dose of Pfizer-BioNTech mRNA vaccine (Comirnaty®). The third dose was applied at a median of 164 (151-202) days after the second dose, and all were heterologous in type. The median (minimum-maximum) antibody level for the overall group was 53.55(0-5680) BAU/mL: 47.19 BAU/mL in those who received two doses, with a more than 100 times increase after a third dose (4943.64 BAU/mL). Of the 522 participants followed up to October 1, 2021, 6 PCR-positive symptomatic participants were diagnosed with COVID-19: the incidence rate was 4/1000 person-months. Conclusion: A 100-fold neutralizing antibody level following the third dose demonstrated the importance of a booster dose. Given the time lag between doses, antibody measurements of BioNTech recipients should be repeated in the upcoming months. Booster selection should involve antibody level, variant sensitivity of the vaccine, and individual characteristics of the recipient. [ABSTRACT FROM AUTHOR]

Objective: Extrapulmonary tuberculosis (EPTB) can be easily missed due to challenges in diagnosis or overlooked in the differential diagnosis. Therefore, EPTB should be considered in endemic regions, especially in the differential diagnosis of fever of unknown origin. Methods: Adult patients diagnosed and treated for EPTB at Ondokuz Mayıs University School of Medicine Hospital between 2005 and 2018 were analyzed retrospectively. Results: One hundred and nineteen patients with a mean age of 48.4±17.8 years, including 75 (63%) females and 44 (37%) males, were included in the study. The mean age of female patients was 51.8±16.7, and the mean age of male patients was 42.6±18.4. Female patients were significantly older than male patients (p<0.05). Urban and rural residency rates were 45.4 and 40%, respectively. EPTB involved lymph nodes in 60 (50.4%), the central nervous system in 15 (12.6%), the vertebral column in 14 (11.8%), bone in 7 (5.9%), the urogenital system in 7 (5.9%), peritoneum in 6 (5%), the gastrointestinal system in 6 (5%), pleura in 3 (2.5%) and eye in 1 (0.8%) patient. Acid-fast bacilli were seen in 4 (8.1%) of 49 samples; Mycobacterium tuberculosis grew in cultures of 29 (48.3%) of 60 samples; and the polymerase chain reaction was positive for tuberculosis in 24 (52%) of 46 samples. In the histopathologic examination, caseous granulomatous inflammation was the most reported finding (41.2%). The most common adverse event related to antituberculosis drugs was hepatotoxicity. Conclusion: EPTB can involve various organ systems and should be included in the differential diagnosis. [ABSTRACT FROM AUTHOR]

Objective: Human herpesvirus-8 (HHV-8) infection--also known as Kaposi sarcoma-associated herpesvirus (KSHV)--is the causative agent of Kaposi's sarcoma, especially in human immunodeficiency virus (HIV) / acquired immune deficiency syndrome (AIDS) patients. The prevalence of HHV-8/KSHV varies according to country and geographical region. However, despite the increasing amount of research on HHV-8/KSHV after identifying the virus, few studies have systematically collected data on the scientific production process. Therefore, this study aimed to make a bibliometric evaluation of the literature on HIV/AIDS-associated HHV-8/KSHV. Methods: Scientific publications produced in Turkey were analyzed using specific keywords of AIDS-related HHV-8/KSHV in the Scopus database between 2001 and 2020. Quantitative and qualitative analysis of the collected data was reviewed using appropriate bibliometric indicators regarding the number of publications, publication language, most influential institutions, most cited publications, active authors, and active journals. In addition, the VOSviewer v.1.6.16 program (Leiden University's Centre for Science and Technology Studies, Leiden, Holland) was used to create a keyword network map and determine research interest areas and relationships. Results: There were 40 scientific publications produced in Turkey. The first publication of AIDS-related HHV-8/KSHV in Turkey was in 2001 (n=5, 5%). Most studies were conducted in 2013 and 2020 (n=5, 12.5%). The highest number of publications were in English (82.5%), and 7.5% were published in the Journal of Microbiology Bulletin. Generally, the publications were in article form (82.5%) and in the area of medical sciences (95%). Kaposi's sarcoma was the most frequently used word in the map created with the network analysis of the keywords. Conclusion: The literature review shows that our study is the first bibliometric study on AIDS-related HHV-8/KSHV. Compared to worldwide publications in the study period, the publications from Turkey on the subject were observed to be late start and few. As a result, it has been concluded that new studies are essential in our country, where publications on AIDS-related HHV-8/KSHV are limited. [ABSTRACT FROM AUTHOR]

Objective: Our study aimed to reveal the syphilis coinfection data in patients living with HIV. In this context, data on coinfection rates, the period in which syphilis was diagnosed, reinfection rates, and the determination of the population at risk for syphilis in patients living with HIV/AIDS were presented. Methods: Patients with HIV/AIDS confirmed between January 2016 and December 2020 at a training and research hospital were retrospectively screened for syphilis serological examinations (RPR, TPHA). The conventional diagnostic algorithm was used in all patients. Results: The rate of syphilis co-infection was 23.38% (47/201) in 201 individuals living with HIV in our patient population. Of 47 HIV/syphilis co-infected patients included in the study, 4.2% were female, and 95.8% were male. The mean age of our patients was 41.11±12.42 years. Primary syphilis was diagnosed in 6 (14.2%) patients; secondary syphilis was diagnosed in 3 (7.1%) patients, and 38 (80.8%) patients were diagnosed in the latent syphilis period. We did not have a patient diagnosed with tertiary syphilis, neurosyphilis, or congenital syphilis. Twenty-six patients (55.3%) were heterosexual, 17 patients (36.2%) were men who had sex with men (MSM), and four patients (8.5%) were bisexual. While syphilis co-infection rates were 17.9% (26/145) in heterosexual individuals, it was 37.5% (21/56) in MSM and bisexual individuals. While 32 patients (68%) were in the HIV infection stage, 15 (32%) were diagnosed with AIDS. Reinfection was detected in 8.51% (4/47) of the patients. Conclusion: Most HIV/syphilis co-infected patients are male individuals who have sex with men diagnosed with latent syphilis. HIV/AIDS and syphilis infections are increasing every year in our country. Undetectable= Untransmissible approach causes prevention methods to be thrown into the background. Sexual protection with barrier methods in patients living with HIV continues to maintain its importance today due to co-infections. [ABSTRACT FROM AUTHOR]

Objective: Vaccines are one of the promising approaches to control the pandemic. The aim of this study, which was conducted on healthcare workers who previously were or were not infected with COVID-19, was to evaluate the undesirable effects that developed after the CoronaVac (Sinovac Life Sciences, Beijing, China). Methods: Volunteers who were administered the first dose of inactivated CoronaVac vaccine between January 14-24, 2021, were included in this retrospective study. Demographic information was obtained from the questionnaire results and from the data of the applications made due to side effects. Results: 911 healthcare workers, 232 of whom had a history of COVID-19 were included in the study. The mean age of those with a history of COVID-19, was 36 (20-66), and 33.6% were men. 26.7% were doctors, 34.9% were nurses, 155 (66.8%) worked in internal and 62 (26.7%) in surgical units. There was no significant difference between the two groups regarding age, gender, task, and the departments they worked in. Comorbidities were present in 25.9% of the group with a history of COVID-19; the most common disease was asthma (5.6%). Allergy history was 4.3% in the group with COVID-19 and 7.8% in the other group (p=0.070). The incidence of post-vaccine adverse events (62.9%) was higher in those with a history of COVID-19 than in those without (57.1%). The most common adverse event was a headache, and it was significantly higher in the group who had COVID-19 compared to those who had not (36.6% vs. 27.7%; p=0.01). Conclusion: In our study, we observed that the rates of undesirable effects after vaccination were high in individuals with a history of COVID-19. Although it is thought that this situation may be related to the developing antibody response rates, the insufficient number of cases and the lack of determination of the antibody response after infection and vaccination are a disadvantage of the study. [ABSTRACT FROM AUTHOR]

Objective: In this study serum tumor necrosis factor alpha (TNF-alpha), transforming growth factor beta (TGF-beta), interleukin-10 (IL-10) and alanine transferase (ALT) levels were measured in naive chronic hepatitis C patients and healthy control group. The relationship between the values and the histological activity of the liver was evaluated to make predictions about liver histology without the need for biopsy. Methods: A total of 86 individuals including 43 patients and 43 controls participated in the study. Serum AST, ALT, TNF-alpha, TGF-beta and IL-10 values were analyzed in patient and control groups. The correlation between liver fibrosis degree (stage) and histological activity index (HAI) scores and the IL-10, TNF-alpha, IL-10, TGF-BETA values of the case and control group was evaluated. Results: A very strong correlation was found between HAI and TNF-alpha (rho=0965). A significant relation was found between HAI and TGF-beta (rho=0.446) and statistical correlation was not found between HAI and IL-10. A significant relation was found between HAI and serum ALT values in the patient group. Conclusion: Liver biopsy is an invasive procedure with complications which may have severe results. There is a need for biochemical or radiological markers which extrapolate to liver biopsy. In our study, measurement of serum cytokine and ALT values was observed as a noninvasive method which can help to meet this need. [ABSTRACT FROM AUTHOR]

Objective: This study aims to evaluate occupational injuries in healthcare professionals exposed to the blood and body fluids of patients in our hospital for five years. Methods: A retrospective analysis of applications of healthcare professionals to the Infection Control Committee (ICC) between 2013-2017 was conducted based on the "registry and follow-up form for exposure to body fluids." Results:175 personnel applied to the ICC, and the average age of applicants was 31.5±8. 58.5% of the cases were male, and 41.5% were female. Nurses constituted the majority of applicants at 37.7%, followed by caregivers at 21.7% and interns at 17.1%. Most injuries were inflicted in operating rooms 22.3%, emergency services 18.8%, intensive care units 18.3% and surgical clinics 12.6%. 62.5% of the cases were needlestick injuries, 24.0% were due to sharps, and 13.5% were due to mucosal exposure. The source patient was identified in 144 cases (82%), whereas in 31 cases (%18), the source patient could not be identified. Sixteen of the source patients were HBsAg positive, five were anti-HCV positive, and one was anti-HIV positive. None of the personnel was infected due to the injuries. Conclusion: The number of sharp injuries can be reduced by employing more personnel, reducing work hours, and encouraging the use of personal protective equipment. In addition to providing fundamental medical knowledge, training programs should also encourage a positive attitude toward HIV / AIDS. [ABSTRACT FROM AUTHOR]

Objective: Vaccination is the most effective way to control the COVID-19 pandemic all over the world. We aimed to evaluate the relationship between antibody titers and vaccine side effects after the BNT162b2 vaccine was administered as a reminder dose in healthcare workers (HCW) who received two doses of inactivated SARS-CoV-2 vaccine name CoronaVac (Sinovac Life Sciences, Beijing, China). Methods: A total of428 HCWs participated in the study. Participants who received the mRNA vaccine as a reminder dose were evaluated with a questionnaire regarding antibody values and vaccine side effects. Three weeks after the first BNT162b2 vaccine, the same questionnaire was applied face-to-face to HCW, and the same questionnaire was applied to those who received a second reminder dose via telephone. Results: Out of428, 373 (87.1%) HCWs preferred one and 55 (12.9%) two doses of the BNT162b2 vaccine as reminder doses after being vaccinated with an inactivated vaccine. It was observed that side effects were more frequent in women aged 18-40 after a single dose of the BNT162b2 vaccine (p<0.001). The most common side effects are redness, swelling, and pain at the injection site, with a rate of 59.6%. Fatigue-weakness was the most common systemic reaction, with a rate of 58.6%. Axillary lymphadenopathy was observed seen in 3 (1.1%) HCWs. The median value of IgG titers in the third week after the reminder dose was found to be higher in HCW with side effects than those without side effects (p<0.001). When the cumulative incidence rate of vaccinated people was evaluated over 389 people, no cases were observed on the 14th and 30th days after the first reminder dose of BNT162b2. However, the first case was observed on the 60th day, and after the second reminder dose, cases were seen on the 14th, 30th, and 60th days. Conclusion: Since the side effects detected after the BNT162b2 reminder dose were mild to moderate and progressed with local symptoms, it was concluded that highly protective mRNA vaccines could be safely preferred for protection from COVID-19. [ABSTRACT FROM AUTHOR]

Objective: Substance use is a gradually increasing public health problem. Viruses such as hepatitis B, hepatitis C, and HIV can be transmitted with intravenous substance use and cause significant morbidity and mortality. Therefore, we aimed to evaluate the hepatitis B, hepatitis C, HIV, and syphilis test results of patients followed at the Şanlıurfa Alcohol and Drug Addiction Research Treatment and Training Center (AMATEM) clinic. Methods: The age, gender, background, information about type of substance addiction of the patients and HBsAg, anti-HBs, anti-HCV, anti-HIV, and venereal disease research laboratory (VDRL) test results were evaluated. Results: A total of 427 patients over 18 who were followed at the AMATEM clinic between 2021 and 2022 were included in the study. Of these, 408 (95.6%) were male, and 19 (4.4%) were female. The mean age of the participants was 27.03±5.5 years. Three hundred fifteen (73.8%) patients had intravenous substance use, and all these patients (100%) used opioids. HBsAg positivity was detected in 3 (0.71%), and Anti-HCV positivity was detected in 52 (12%) patients. While only 20 (38.46%) of these patients had applied to the relevant clinics for further testing and treatment, HCV-RNA positivity was detected in 12 (60%) of the patients. In addition, the frequency of genotype 3 was higher in HCV RNA-positive patients (66.67%). Conclusion: Opioid use was at the forefront both in the whole patient population and in patients with anti-HCV positivity. Although anti-HCV positivity was detected at a high rate compared to the general population, only one out of every three patients had applied to the relevant clinics for further testing and treatment. Thanks to the new treatment options Hepatitis C is a curable disease. Screening programs are extremely important to ensure both personal and community viral eradication by providing patients with suitable treatments. [ABSTRACT FROM AUTHOR]

Objective: There is a positive and significant relationship between severity and viral load in some viral diseases. Studies on the relationship between SARS-CoV-2 viral load at diagnosis and severity of coronavirus disease-2019 (COVID-19) have yielded conflicting results. Therefore, we aimed to evaluate the relationship between viral load and the clinical status of patients with COVID-19. Methods: Data of the patients diagnosed with COVID-19 and admitted to our center between May 01 and June 31, 2020, were retrospectively reviewed. The patients were divided into two groups according to their clinical characteristics as mild-moderate and severe. The demographic, laboratory, clinical, and radiological data were retrieved from electronic folders. Results: The entire cohort included 285 patients; 254 had a mild-moderate clinical course, and 31 had a severe course. Statistical analyses revealed that SARS-CoV-2 viral load was not associated with symptom duration and clinical status (p>0.05). According to multivariate logistic regression analysis, only ferritin, C-reactive protein, and lactate dehydrogenase elevations were positively correlated with severe clinical course. (p<0.05). Conclusion: We do not recommend using viral load to predict disease severity in COVID-19. We also found that only ferritin, C-reactive protein, and lactate dehydrogenase accompanied severe clinical course. [ABSTRACT FROM AUTHOR]

Objective: Sandfly fever (SF) is a self-limited vector-related viral infection caused by the SF virus and is spread by phlebotomine sandflies (PSF). Fever, headache, myalgia, arthralgia, loss of appetite, weakness, nausea, and vomiting are the most common symptoms. Laboratory findings include leukopenia, thrombocytopenia, and elevated liver trans-aminase enzymes. We aimed to examine the demographic, clinical, and laboratory data of patients who were followed with SF diagnosis. Methods: Patients who were followed with SF diagnosis in our hospital between January 2011 and December 2018 were included. The data were obtained retrospectively. Results: A total of 64 patients were included in the study. The mean age was 33.1 ± 9.7(min:19-max:58) years and 35(54.7%) of them were male. Although 53.1% had a history of contact with PSF, 92.2% had a bite mark. 91.6% of the patients were living on the ground and first floor. Fever was the most common symptom in 95.3% of the patients; 89% had myalgia-weakness, 79.6% had a headache, and 50% had a conjunctival rash. Increased transaminase enzyme levels were observed in approximately 93% of the patients. The average of ALT and AST were 284.7 U/L and 243.5 U/L, respectively. Leukopenia was observed in 79.6% (51/64) of them, and thrombocytopenia in 78% (50/64). CK elevation was 54% ratio (35/64). Samples were tested from 19 patients for the serological diagnosis of SF. IgM was positive in 15 (78.9%) of 19 patients and negative in 4(21%) patients. IgG was positive in 10 (52.6%) of 19 patients. Both IgG and IgM were positive in 9 patients. Only IgG positivity was detected in one patient. Conclusion: SF should be considered in patients presenting with complaints such as fever, headache, muscle joint pain, nausea-vomiting, redness in the eyes, leukopenia, thrombocytopenia, elevated transaminase enzyme, CK level, and living in or having a history of travel to subtropical regions, especially during the summer season and a history of PSF contact. [ABSTRACT FROM AUTHOR]

Objectives: Chronic hepatitis is a clinical and pathological condition defined by etiological, clinical, and pathological aspects, in which inflammation in the liver continues for more than six months. Hepatitis B virus is one of the most important causes of etiology. Although liver biopsy is accepted as the gold standard test, there is a need to search for an alternative method due to the risk of complications, invasiveness, and cost. Our aim in this study was; to evaluate the predictive value of calculating fibrosis four scores (FIB -4), age platelet index (API), AST ALT ratio (AAR), AST platelet ratio index (APRI), Hui score, Goteburg University cirrhosis index (GUCI) indices in relation to liver biopsy in patients with chronic hepatitis B diagnosis who have not received any treatment before. Methods: The study included treatment-naive cases who underwent liver biopsy at Ankara University School of Medicine Hospitals Gastroenterology Clinics between March 2013 and November 2017 and at Ankara City Hospital Gastroenterology Clinic between 2019-2021. Non-invasive scores of the cases were evaluated simultaneously with liver biopsy. Results: A total of 159 patients, 45 (28.3%) female and 114 (71.7%) male, were included in our study. Eight non-invasive fibrosis markers were used, including APRI, FIB-4, AAR, API, CDS, Lok, GUCI, and Hui. GUCI and Hui non-invasive fibrosis markers were numerically superior to all other parameters in differentiating mild hepatitis from severe hepatitis and patients with cirrhosis, without cirrhosis. In the comparison of area under -- receiver operating characteristic (AUROC) values using the Hanley-McNeal test to differentiate the cirrhosis patient from the non-cirrhosis patient, statistical superiority was found only against AAR and API (p<0.001, p<0.001). Conclusion: Although many markers were found successful in our study, AUC values were not significantly superior to each other, and we determined that they could not be an alternative to liver biopsy on their own. [ABSTRACT FROM AUTHOR]

Objective: To increase vaccine awareness, we aimed to determine individuals' knowledge and behavioral approach to the COVID-19 vaccine. Methods: The data of this cross-sectional study were obtained online between June and July 31, 2021. One thousand one hundred seventy-six people over the age of 18 were included in the study. The researchers developed a data collection form consisting of 27 questions. Mean±standard deviation and median (1st quarter-3rd quarter) values, numbers, and percentages were used to summarize the data. Chi-square (χ2) test was used to show the relationship between categorical variables. Independent predictors of participants' vaccine hesitancy/rejection were analyzed using logistic regression. Statistically, data with p<0.05 were considered significant. Results: A total of 1176 people, 55.7% of whom were women, with a mean age of 39.75±11.27 years, were included in the study. 71.6% of the participants were married, and 78.9% had a university/postgraduate degree. 9.7% of the participants stated that they were hesitant about the COVID-19 vaccine, and 7.1% refused the COVID-19 vaccine or would not be vaccinated when it was their turn. According to the logistic regression model established to examine the factors that may affect vaccine rejection; Age, the resources used to obtain information about the vaccine, the thought that it would not protect for two years, or the vaccine side effects were high, and the most effective way to get rid of the pandemic was not vaccination, were determined as the factors affecting vaccine rejection. Conclusion: As a result of the research, it was found that the participants had a positive attitude towards the COVID- 19 vaccine. It was determined that 9.7% of the study group had vaccine hesitancy, and 7.1% had vaccine rejection. [ABSTRACT FROM AUTHOR]

Objectives: This research was conducted to determine the effects of nurses' fear of COVID-19 on their dietary habits and use of supplements. Methods: The research, which is descriptive and cross-sectional, was shared as an online survey over the social networking site and social networking with the snowball sampling method. It was carried out between December 2020 and March 2021 with 485 nurses who worked actively during the pandemic and agreed to participate in the study. The data were obtained with the questionnaire in line with the relevant literature and the "COVID -19 Fear Scale". The data were used to evaluate the number, percentage, mean, standard deviation, median, minimum, maximum, t-test, ANOVA test, and x² test. Results: Fear levels were found to be higher in nurses who regularly took food supplements during the pandemic and didn't have adequate or balanced nutrition, who couldn't eat most of the time due to working conditions, who took the food supplements to help in the prevention and treatment of COVID-19 and who recommended them to the individuals around them (p<0.05). Conclusion: It was determined that there was an increase in nurses' use of food supplements before and during the pandemic, and this increase was statistically significant (p<0.001). [ABSTRACT FROM AUTHOR]

Objectives: The probability of detecting viral and atypical agents in pneumonia patients has increased with the molecular methods used in recent years. We aimed to investigate pneumonia pathogens in endotracheal aspiration samples (ETA) of patients with severe community-acquired (CAP), hospital-acquired pneumonia (HAP), and ventilator-associated pneumonia (VAP) by multiplex polymerase chain reaction (m-PCR) and culture method. Methods: A prospective study was performed between December 2019 and October 2020. Patients 18 years and older with pneumonia followed in ICU on the mechanical ventilator were included. COVID-19 patients were excluded. Patients were grouped as CAP, HAP, and VAP. Two ETA samples were obtained from patients within 48 hours of the pneumonia diagnosis. Respiratory pathogens were investigated in samples by viral-bacterial m-PCR and bacterial culture methods. Results: 74 patients were included in the study. m-PCR of ETA samples achieved pathogen detection in 87.8% of patients compared with 58.1% with culture methods. The most common pathogen detected by m-PCR was Streptococcus pneumoniae in both CAP and HAP patients and Klebsiella spp. in VAP patients. The most common pathogen isolated by culture was Staphylococcus aureus in both CAP and HAP patients and Klebsiella spp. in VAP patients. Atypical pneumonia pathogens were positive for 14.9% of the patients. Atypical pathogens were recovered from 28.5% of CAP patients and 23.1% of HAP patients. Viruses constituted all of the atypical pathogens recovered from HAP patients. No atypical pathogen was found in VAP patients. Conclusion: In this study, S. pneumoniae was the most common pathogen detected with m-PCR, and S. aureus and Klebsiella spp. were the most common pathogens detected with culture. Determination of microbial etiology of lower respiratory tract samples by molecular methods for diagnosing severe CAP and HAP may be beneficial in terms of treatment. [ABSTRACT FROM AUTHOR]

Objectives: We aimed to compare classical methods and chromogenic media to detect carbapenem-resistant Enterobacteriaceae (CRE) colonization among hospitalized patients and determine the risk factors causing infection in colonized patients. Methods: Between January and August 2017, 100 patients over the age of 18 who were hospitalized in the Reanimation Intensive Care Unit and the Trauma Emergency Intensive Care Unit of a university hospital were examined. From the first day of intensive care unit (ICU) admission, rectal swabs were collected once every week and were tested for the presence of CRE by using the classical method defined by the Centers for Disease Control and Prevention (CDC), ChromID CARBA chromogenic medium, and direct inoculation into MacConkey agar plates. In addition, MIC values for imipenem, ertapenem, meropenem and colistin were determined by using the Etest. Results: Rectal BDE carriage was detected by at least one method in 46 (46%) of 100 patients included in the study. Sensitivity and specificity values of the CDC classical method, direct MacConkey inoculation, and ChromID CARBA medium in the first 24 hours were found as 78%-42%, 87%-80%, and 91%-98%, respectively. Sensitivity and specificity values of these methods after 72 hours were determined as 78%-100%, 87%-100%, and 91%-100%, respectively. Conclusion: We observed that, although the ChromID CARBA method performed better than classical CDC and direct MacConkey inoculation methods, direct MacConkey inoculation can still be employed, especially in areas with limited resources. [ABSTRACT FROM AUTHOR]

Objective: The European Norm (EN) 1500 standard, which was developed to evaluate the antibacterial efficacy of widely used hand rub agents, is the most common in vivo test method used in Europe and has been accepted by the Turkish Standards Institute. This study aimed to test five antiseptic products supplied from the market and the hand antiseptic formulation II recommended by the World Health Organization (WHO-II) for two application types using the EN 1500. Methods: In the first application, the hands were rubbed with 3 mL of antiseptic for 30 seconds (1x3 ml; 30 sec); in the second application, which lasted 60 seconds, the hands were rubbed with 3 ml of antiseptic for 30 seconds, and the same process was repeated once more (2x3 ml; 2x30 sec). After the participants' hands were artificially contaminated with Escherichia coli K12 standard strain, the bactericidal efficacy of the tested antiseptics was compared with the application of a 60% by volume isopropyl alcohol solution (2x3 ml; 2x30 sec) as the reference procedure. Results: When the antiseptics were tested, and WHO-II was applied in the form of "1x3 ml; 30 sec", they were found to be significantly less effective than the reference procedure and did not meet the EN 1500. On the other hand, when they were applied in the "2x3 ml; 2x30 sec" procedure, all of them met the EN 1500. Conclusion: Tested antiseptic products and WHO-II should be applied in the form of "2x3 ml; 2x30 sec" to meet the EN 1500. Considering the length of the 60-seconds period in practice, raising the alcohol ratio should be considered in order to provide adequate hand antisepsis in 30 seconds. [ABSTRACT FROM AUTHOR]

Objective: The isolation of microorganisms in joint fluid samples is one of the most important laboratory findings guiding the treatment. Knowing the distribution of the isolated microorganisms allows for the correct empirical approach to treatment. The frequency of MRSA isolation from joint fluid cultures is increasing, and MRSA infections are increasing in importance among infectious arthritis cases. This study aimed to determine the distribution of microorganisms that grew in joint fluid cultures and the antibiotic susceptibility patterns of staphylococci grown in these cultures. Methods: Our study is retrospective and planned to cover the years between 2015 and 2019. Of the synovial fluid samples sent to the Microbiology Laboratory, 103 samples with growth in culture were included in the study. Bacteria isolated from the samples were identified with the MALDI-TOF MS device and were evaluated for antimicrobial susceptibility in the automated system. Results: Samples of 103 patients were included in the study. While 19 of the patients included in the evaluation had a history of joint replacement, 84 patients had natural joint involvement. Generally, S. aureus ranked first in both group samples (41.7% and 42.2%). Coagulase-negative staphylococci and streptococci came second and third, respectively. Gram-negative bacilli were in fourth place (10.8%) in samples belonging to natural joints. In comparison, only one growth (5.3%) was detected in samples of patients with a prosthetic history. However, no statistically significant difference was found between the natural joint and prosthesis in terms of pathogen distribution (p> 0.05). All MRSA isolates were susceptible to vancomycin, teicoplanin, linezolid, daptomycin, and tigecycline. No MRCNS isolate was resistant to vancomycin, tigecycline, and trimethoprim/sulfamethoxazole. Conclusion: We think that our study will contribute to the literature on the distribution of infectious arthritis agents, the evaluation of antimicrobial resistance profiles of these agents, and empirical antimicrobial selection. [ABSTRACT FROM AUTHOR]

Objective: The study aims to contribute to the literature by sharing the treatment process and results of patients who develop pneumothorax, pneumomediastinum, and subcutaneous emphysema, which are rarely seen in COVID-19 pneumonia, and to reveal the possible high mortality situation. Methods: Patients whose COVID-19 polymerase chain reaction (PCR) swab test was positive and were diagnosed as COVID-19 pneumonia by thoracic computed tomography (CT) and who developed pneumothorax, pneumomediastinum, and subcutaneous emphysema while under home treatment or inpatient treatment in the 14 months between April 2020 and June 2021and were followed in the pandemic emergency department were retrospectively included in the study. The cases were evaluated in terms of age, gender, occurrence, and timing of these pathologies during home or hospital treatment, hospitalization time, mortality, smoking, and comorbidities. Results: Twenty-six patients (4 women and 22 men, mean age 52 years) with COVID-19 pneumonia were included in the study. Fifteen patients (57.7%) were being treated at home while developing pneumothorax, pneumomediastinum, and subcutaneous emphysema pathologies. The mean age of female patients was 74 years; 3 had pneumomediastinum, and one had combined pneumothorax and pneumomediastinum. All of them were followed in the intensive care unit (ICU). Two patients were intubated, and the other two received treatment on a high-flow oxygen device. Three of them died. The mean age of male patients was 48.2. Twelve had pneumothorax, 8 had pneumomediastinum, and two had combined pneumothorax and pneumomediastinum. Fifteen patients were diagnosed while being followed at home, and 7 patients were diagnosed during ICU treatment. Five of the patients died, and all of them were ICU patients. Eight patients (30.8%) died in total. The mean age of these patients was 76.4 (min:63, max:82). The patients had additional diseases such as hypertension, diabetes mellitus, organ transplantation, heart, and kidney failure. Age, comorbidity, and being treated in the ICU were found to be statistically significant (p<0.005). Conclusion: The possible high mortality risk in these clinical situations, which can be seen in the ongoing COVID-19 pandemic, should be considered. [ABSTRACT FROM AUTHOR]

Objective: Healthcare professionals taking care of COVID-19 patients are considered to be at high risk for acquiring infection, and the protection of healthcare professionals is one of the top priorities. Inadequate knowledge of the disease by healthcare professionals and their inability to access or use personal protective equipment (PPE) required for protection may cause rapidly spreading of infection. In this study, we aimed to evaluate the knowledge levels of healthcare professionals regarding COVID-19 and PPE use. Methods: The prepared questionnaire was filled in face-face or electronically, ensuring that 502 healthcare professionals who volunteered to participate in the study remained anonymous. χ²2 test was used for data analysis, and p <0.005 was considered significant. Results: Five hundred two healthcare professionals participated in the study. The average age of the participants was 30.23 ± 6.02 years. Two hundred six of the participants were men, and 296 were women. Of the participants, 265 (52.8%) were physician, 168 (35.5%) nurse, 30 (6.0%) caregivers / cleaning staff, 24 (4.8%) emergency medical technician, and 5 (1.0%) were dialysis technician. Three hundred eighty of the participants (75.7%) had received training on COVID-19 and the use of personal protective equipment in the institution where they worked. 79.5% of the participants knew the causative agent of the disease, 91.0% the incubation period, and 97.6% the symptoms correctly. Hand washing rates were lower in physicians than in nurses and cleaning staff in indicated places. The rate of those who put on PPE in the correct order was 48.7%, and the rate of those who put off in the correct order was 38.9%. Conclusions: As the global COVID-19 pandemic continues to affect the world, increasing the knowledge level of healthcare professionals is critical. Protection of healthcare professionals from infection can be provided by the availability of adequate information and protective equipment. [ABSTRACT FROM AUTHOR]

Objective: Healthcare professionals will be key to the success of COVID-19 vaccination programs because they are in the primary vaccination group. This study aims to measure and evaluate the acceptance, attitudes, and behaviors of healthcare professionals towards the COVID-19 vaccine. Methods: A questionnaire was applied to healthcare professionals via face-to-face interviews between 15-25 December 2020. Results: 507 participants were included in the study; the mean age was 31.6 ± 8.2 (19-71), and 52.3% were women. 52.3% of healthcare professionals said they wanted to get the COVID-19 vaccine. Men were more likely to have the COVID-19 vaccine than women (p <0.001). While the willingness for the COVID-19 vaccine was highest in doctors (83%), it was the least in nurses (37.7%) (p <0.001). The willingness to be vaccinated was higher in those with a higher education level (p <0.001). Conclusions: We observed that healthcare professionals' willingness to be vaccinated against COVID-19 differed according to their roles in the hospital, and doctors were the most widely group to accept vaccination. We believe our findings can guide public health campaigns, particularly for healthcare professionals, to increase acceptance of the COVID-19 vaccine. [ABSTRACT FROM AUTHOR]