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Amaç: Bu çalışmanın amacı, kateter ilişkili üriner sistem enfeksiyonlarında (Kİ-ÜSİ) mortalite ile epidemiyolojik faktörler, komorbid durumlar, antibiyotik direnci, ampirik antimikrobiyal tedavi ve laboratuvar parametreleri arasındaki ilişkiyi değerlendirmektir. Gereç ve yöntemler: Yoğun bakıma 1 Ocak 2015 ile 1 Ocak 2020 arasında kabul edilen 18 yaş ve üzeri hastalarda retrospektif bir kohort çalışması tasarlanmıştır. Birincil sonlanım noktası hastanın kabulünün ilk 28 günü içinde ölüm, ikincil son nokta ise 28 günden sonra sağkalımdı. p< 0.05 değeri anlamlı kabul edildi. Bulgular: Çalışmaya medyan yaşı 78, 198'i (%52,8) kadın olan toplam 375 hasta alındı. En sık saptanan mikroorganizmalar Escherichia coli (%50.9) ve Enterococcus faecalis (%16.8) idi. Gram negatif bakterilerin 3. kuşak sefalosporinlere, siprofloksasine ve meropenem'e direnci sırasıyla %41,3, %40 ve %8,6 saptandı. Gram pozitif bakterilerin %0,3'ünde vankomisin direnci tespit edildi. Mortalite oranı %58,1 idi. Artmış mortalite riski ile ilişkili faktörler ≥ 65 yaş, malignite varlığı, mekanik ventilasyon, APACHE II skoru ≥ 20 ve septik şok tanısıydı. Daha düşük ölüm riski ile ilişkili tek faktör kültürde E. coli'nin saptanmasıydı. Sonuç: Epidemiyolojik faktörlerin, eşlik eden hastalıkların, klinik skorlama sistemlerinin ve mikrobiyolojik sonuçların mortalite üzerine etkisi olduğu belirlendi. Bu çalışmanın sonuçları, kılavuzlarda yer alan enfeksiyon kontrol önlemleri ve tedavi önerileri ile birlikte değerlendirildiğinde, Kİ-ÜSİ'ye bağlı mortalitenin azaltılabileceğini düşünmekteyiz.

Globally 364102 healthcare professionals have been infected with severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) and 1253 of them died until 15 January 2021. Healthcare professionals serving at the forefront of combating the pandemic are in the high risk group. In our country, the data about coronavirus-2019 (COVID-19) among healthcare professionals are limited. The aim of this study was to investigate the anti-SARS-CoV-2 IgG seroprevalence in healthcare professionals, to evaluate the risks they encountered during work, and to examine their relationships with antibody positivity. A total of 572 healthcare professionals serving in various units of our hospital participated in our study and the presence of anti-nucleocapsid IgG was investigated by chemiluminescent microparticle immunoassay (SARS-CoV-2 IgG test, Abbott Laboratories Diagnostics, USA) method in serum samples collected between May 18, 2020 and June 30, 2020. The demographic characteristics, medical history, work conditions, medical procedures performed and possible risk factors were questioned with a questionnaire form. The average age of the participants was 33.5 ± 9.2 (19-61) years, and 62.9% (360/572) of them were women. In our study, the anti-SARS-CoV-2 IgG seroprevalence was 3.7% (21/572). The association of the antibody positivity with age, gender and occupational status was not statistically significant (p> 0.05). Comorbid diseases which were significantly higher in seropositive healthcare professionals were hypertension (19%) and diabetes mellitus (14.3%) (p

Introduction: Acinetobacter baumanii causes difficulties in the treatment of nosocomial infections due to increasing resistance worldwide. With an increase in resistant infections, the use of colistin has come to the fore. We aimed to investigate the antimicrobial resistance profile of A. baumanii strains isolated from clinical specimens as hospital-acquired colonizations and infection agents and to evaluate the clinical and microbiologic responses and adverse effects of antibiotic regimens used in patients who were isolated because of having infectious agents. Materials and Methods: A retrospective descriptive study of 326 adult patients with nosocomial A. baumannii colonizations and infections was conducted between January 2012 and December 2017 in Niğde Education and Research Hospital. In addition, a total of 212 adult patients who received at least 72 hours of antimicrobial therapy were evaluated. Standard and automated methods were used to identify isolated strains and antibiotic susceptibility. The antimicrobial susceptibility profile change over the 6-year period was evaluated. Adverse effects, and clinical and microbiologic response were evaluated in patients receiving antimicrobial therapy. Analysis of the variables was performed using SPSS 22.0 (IBM Corporation, Armonk, New York, United States). Results: When antimicrobial resistance rates were examined, it was seen that imipenem (99.7%), ampicillin sulbactam (81.6%), cefoperazone sulbactam (60.3%), netilmicin (89.4%), tobramycin (88.4%), gentamicin (83.1%), amikacin (91.6%) and tigecycline (33.7%) had resistance rates; colistin resistance was not detected in the isolates. Resistance rate to other antibiotic groups was 100%. The resistance rates of ampicillin sulbactam, cefoperazone sulbactam, gentamicin, amikacin, and tigecycline were found to be statistically significant (p< 0.05). There were no significant differences in terms of nephrotoxicity, and clinical and microbiologic response among patients in whom colistin was used in combination with carbapenem, ampicillin/sulbactam, cefoperazone/sulbactam, and tigecycline (p> 0.05). Conclusion: In accordance with the global data, antimicrobial resistance rate in A. baumanii isolates was found to be high in our study. Treatment regimens in which colistin is used with other antimicrobial agents have no superiority in terms of efficacy and adverse effects. There is a clear need for new and effective antimicrobial agents in the treatment of resistant A. baumanii infections.

Bacteremia in the febrile neutropenic patients significantly increases the mortality. It takes a long time to complete the blood culture for the diagnosis of bacteremia. Therefore, quick and specific markers are needed for the prediction of bacteremia. The purpose of this study are to compare the diagnostic value of lactate, procalcitonin, C-reactive protein (CRP) and monocyte chemoattractant protein-1 (MCP-1) levels in a patient with febrile neutropenia, and to evaluate its usefulness in predicting bacteremia. This study was designed to be prospective case-control study. Forty-eight patients and forty control cases aged 18 years or older who were monitored between May 2016 and May 2017 were included in the study. P-value as

Coronavirus 2019 (COVID-19) infection causes excessive cytokine response and a decrease in cellular immune response and this increases susceptibility to fungal co-infections. Mucormycosis is a rare, lifethreatening invasive fungal infection. In this report, two cases who developed rhino-orbito-cerebral mucormycosis shortly after having COVID-19 infection were presented. The first case was a 68-year old woman who admitted to our clinic with orbital cellulitis in her left eye and had a known diagnosis of asthma and rheumatoid arthritis. She was diagnosed with COVID-19 pneumonia 40 days ago, stayed in the intensive care unit for a long time, and received pulse steroid (1000 mg methylprednisolone), interleukin-1 (IL-1) inhibitor (anakinra) and broad-spectrum antibiotic treatments together with antiviral therapy during this period. The second case was a 63-year-old male patient with known diabetes mellitus, hypertension and retinitis pigmentosa, with a history of hospitalization in the intensive care unit due to COVID-19 pneumonia 20 days ago and received pulse steroid therapy during this period. He admitted to our clinic with the complaints of droopy right eyelid, swelling, nausea and vomiting. In both cases, paranasal sinus tomography findings were consistent with invasive sinusitis. Functional endoscopic sinus surgery was performed immediately in less than 16 hours from the first admission in both cases. Histopathological examination of the both cases revealed results consistent with mucormycosis. Mucorales spp. was isolated in sinus tissue culture of the second case taken during the operation. Both of the patients received liposomal amphotericin B. First case died on the 19th day of the treatment. Second case was discharged with full recovery after nine weeks of treatment. The suppression of cellular immunity during the COVID-19 infection, and the use of steroids and interleukin inhibitors in the treatment of severe cases may increase secondary invasive fungal infections. Therefore, clinicians should more frequently consider possible fungal infections in patients with COVID-19.

SUMMARY OBJECTIVE: This study aims to investigate the antibody response and the side effects of the two-dose inactive SARS-CoV-2 vaccine (CoronaVac, Sinovac, China) among a health care worker population in Turkey. METHODS: This study was a prospective, cross-sectional, single-center study conducted between December 16, 2020, and March 15, 2021. We evaluated the side effects from a questionnaire, and anti-spike immunoglobulin G response to the vaccine (0- and 28-day schedule) using an enzyme-linked immunosorbent assay. RESULTS: A total of 94 of 184 health care workers completed this study. The percentages of participants who were seronegative at baseline and achieved to the seropositivity were 21.3 and 97.9%, respectively, on day 21 after vaccinations. The seropositivity was predominantly detected in 31–45 years of the age group (55.4%, p=0.636), normal body mass index (47.8%, p=0.999), nonsmokers (64.1%, p=0.999), those without any comorbidities (73.9%, p=0.463), and those without any side effects (70.2%, p=0.256). The frequencies of overall side effects within seven days after the first and second doses of CoronaVac were 37.2 and 28.7%, respectively. The most common side effects was localized pain at the injection site (15.7 and 11.6%, respectively). CONCLUSIONS: We found that vaccination by two-dose CoronaVac could elicit a specific humoral response, and it was well tolerated in health care workers. The high seropositivity developed after the second dose attracted attention. Our study will be useful in terms of showing short-term immunity and side effects.

Background and study aim : The aim of this study was to evaluate the effectiveness of noninvasive tests in predicting liver fibrosis levels in chronic hepatitis B (CHB) patients.

Introduction The aims of this study are to determine the seroprevalence for measles, mumps, rubella, and varicella zoster virus (VZV) in a cohort of nursing students, to evaluate vaccination response rates of nonimmune students, and to calculate the cost of vaccinating students based on seroprevalence screening. Material and methods A cross-sectional study was conducted August 2015–November 2016 among 326 healthy nursing students aged 14.1–18.1 years. Serum IgG antibodies were measured by ELISA. Results were analyzed by the Chisquare test; a p-value of < 0.05 was considered statistically significant. Results The number of seropositive participants (%) was 308 (94.5%) for rubella, 295 (90.5%) for VZV, 244 (74.9%) for measles, and 219 (67.2%) for mumps. A significant correlation was found between measles IgG and age. A relationship was also observed between VZV IgG and kindergarten attendance. Response rates to measles, rubella, VZV, and mumps vaccination were 96%, 92.3%, 87.5%, 78.8%, respectively. The total cost of vaccination after IgG screening was less than vaccination without screening. Conclusions In this study, participants’ immunity to measles and VZV was low. Prevaccination serological screening was cost-effectiveness method for preventing measles, mumps, rubella, and varicella infections. We believe that administering booster measles, mumps, and rubella (MMR) vaccine doses or developing a special MMR vaccination strategy for at-risk groups may prevent MMR outbreaks.

Viral hepatitis is the most common cause of serious health problems such as liver cirrhosis and hepatocellular carcinoma (HCC). Leading to immunodeficiency disorders through different mechanisms, Human Immunodeficiency Virus (HIV) causes the development of severe secondary infections. Hepatitis A (HAV) is thought to spread by the faecal-oral route, while Hepatitis B (HBV), Hepatitis C (HCV) and HIV are mostly transmitted vertically during childhood. In our study, we aimed to determine the seroprevalence of HAV, HBV, HCV and HIV among Syrian refugee children who were admitted to outpatient clinics. We conducted a retrospective review of data concerning 171 Syrian children aged between 0-18 years admitted between April 2014 and December 2015 to the outpatient infectious disease clinic of ?zmir Tepecik Training and Research Hospital and the social welfare outpatient clinic for Syrian refugees for reasons other than jaundice. Serum samples from patients were studied for HAV antibody IgG (anti-HAV IgG), HBV surface antigen (HBsAg), antibodies against HBV surface antigen (anti-HBs), antibodies against HBV core antigen (anti-HBc total), HCV antibody (anti-HCV) (anti-HIV) with the ELISA (Enzyme-Linked Immunosorbent Assay) method. In this study 51% of patients were female, with a mean age of 6.52 years among all patients. Six of the 140 patients (4.2%) scanned for HBV among the patients enrolled in the study were HBsAg and anti-HBc total positive and anti-HBs negative. Three patients (2.1%) were HBsAg negative, and anti-HBc total and anti-HBs positive, which indicated they had previously recovered from an HBV infection. HBsAg, anti-HBs, anti-HBc total data for 140 patients (81.9%), anti-HCV data for 109 patients (63.8%), anti-HIV data for 88 patients (51.5%) and HAV IgG data for 86 patients (50.3%) were obtained. Due to migration from regions in Syria where there is no regular follow-up of HBV vaccination in children, HBsAg seroprevalence of refugee children is thought to be higher than in other children in Turkey and anti-HBs positivity is thought to be lower. We expected to see a higher seroprevalence of anti-HCV and anti-HIV in Syria due to the lack of health facilities such as non-regular anti-HCV and anti-HIV screening before blood transfusions and during pregnancy in all regions of Syria. Yet in this study, the anti-HCV, anti-HIV seroprevalence of Syrian refugee children was similar to that in Turkey. According to the results, if the children of asylum seekers are admitted to the national HAV and HBV vaccination schedule, hepatitis infections and their complications may be prevented.