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Background: Cardiovascular disease (CVD) is a major cause of mortality among people living with HIV (PLWH). We aimed to assess the prevalence of diagnosed CVD and the risk of CVD among PLWH using 5 different tools. Methods: This retrospective, cross-sectional study was conducted in 20 tertiary centers in Türkiye between October 2021 and March 2022, among 1425 PLWH aged 40-75 years. About 82.7% were male, with a median age of 51. Web-based tools for each score were used for CVD risk calculations. Results: Of 1425 PLWH enrolled, 10.8% had confirmed CVD, and 1132 had their risk scores evaluated. Of those participants, 42.8% had a higher risk of CVD (10-year risk of atherosclerotic CVD risk score (ASCVD) above 7.5%), and according to the European Society of Cardiology systemic coronary risk evaluation 2 (SCORE2), 71.7% had a high- to very high-risk rate. The agreement between various CVD risk tools varied, with Framingham heart study risk score (FRS), modified FRS, data collection on adverse effects of anti-HIV drugs (DAD), and SCORE2 for high-risk countries showing overall agreement rates of 82%, 94%, 91%, and 36%, respectively, compared to ASCVD. According to the 2021 European and 2019 American Cardiology guidelines, 75.3% and 47.1% of PLWH would be eligible for lipid-lower-ing agents, respectively. Conclusion: The diagnosed CVD prevalence highlighted the importance of monitoring cardiovascular health and comorbidities in this population. SCORE2 identified a greater number of individuals at high/very high risk compared to other prediction tools. The implementation of CVD prevention through lipid-lowering therapy was far from desired levels in our cohort. [ABSTRACT FROM AUTHOR]

BACKGROUND: Long-COVID refers to a variety of symptoms that continue for at least 4 weeks following the onset of acute COVID-19 infection. "Microclots/microvasculopathy" is a potential cutting-edge theory. Nailfold capillaroscopy is a non-invasive method used to assess microvascularity. In this study, we aimed to compare baseline characteristics and capillaroscopic findings of patients with and without long-COVID syndrome. METHODS: Baseline clinical characteristics of 53 patients who tested positive for SARS-CoV-2 were recorded. At the time of COVID-19 diagnosis, patients underwent nailfold capillaroscopy. One year later, patients were rescreened for long-COVID symptoms. Comparisons were made between patients with and without long-COVID syndrome in terms of their baseline characteristics and capillaroscopic findings. RESULTS: There were 35 individuals (66%) with long-COVID syndrome. The most common symptoms related to long-COVID were fatigue (43.4%), myalgia (34%), arthralgia (20.8%), dyspnea (20.8%). In total, 22 patients (41.5%) had abnormal capillaroscopy findings. Like other baseline characteristics, the proportion of patients with abnormal capillaroscopic findings (40% vs 44%, p=0.76) was similar between patients with and without long-COVID syndrome. CONCLUSION: Microvasculopathy and microthrombotic vascular damage are among the strongest hypotheses discussed in this regard. Our results may suggest that factors, rather than baseline microvasculopathy, may drive pathophysiological mechanism underlying the poorly understood long-COVID syndrome [ABSTRACT FROM AUTHOR]

We evaluated neutralizing antibodies against the Omicron variant and Anti-Spike IgG response in solid organ (SOT) or hematopoietic stem cell (HSTC) recipients after a third dose of BNT162b2 (BNT) or CoronaVac (CV) following two doses of CV. In total, 95 participants underwent SOT (n = 62; 44 liver, 18 kidney) or HSCT (n = 27; 5 allogeneic, 22 autologous) were included from five centers in Turkey. The median time between third doses and serum sampling was 154 days (range between 15 to 381). The vaccine-induced antibody responses of both neutralizing antibodies and Anti-Spike IgGs were assessed by plaque neutralizing assay and immunoassay, respectively. Neutralizing antibody and Anti-Spike IgG levels were significantly higher in transplant patients receiving BNT compared to those receiving CV (Geometric mean (GMT):26.76 vs. 10.89; p = 0.03 and 2116 Au/mL vs. 172.1 Au/mL; p < 0.001). Solid organ transplantation recipients, particularly liver transplant recipients, showed lower antibody levels than HSCT recipients. Thus, among HSCT recipients, the GMT after BNT was 91.29 and it was 15.81 in the SOT group (p < 0.001). In SOT, antibody levels after BNT in kidney transplantation recipients were significantly higher than those in liver transplantation recipients (GMT: 48.32 vs. 11.72) (p < 0.001). Moreover, the neutralizing antibody levels after CV were very low (GMT: 10.81) in kidney transplantation recipients and below the detection limit (<10) in liver transplant recipients. This study highlights the superiority of BNT responses against Omicron as a third dose among transplant recipients after two doses of CV. The lack of neutralizing antibodies against Omicron after CV in liver transplant recipients should be taken into consideration, particularly in countries where inactivated vaccines are available in addition to mRNA vaccines. [ABSTRACT FROM AUTHOR]

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Abstract Background The aims of this study were to determine the antimicrobial susceptibility patterns of urinary isolates from community acquired acute uncomplicated urinary tract infections (uUTI) and to evaluate which antibiotics were empirically prescribed in the outpatient management of uUTI. Methods Among the patients which were admitted to outpatient clinics of Ankara University Medical Faculty, Ibni-Sina Hospital during 2005-2006, a total of 429 women between the age of 18 and 65 years old who were clinically diagnosed with uUTI and to whom prescribed empirical antibiotics were enrolled in this prospective observational study. Patients' demographical data, urine culture results, resistance rates to antimicrobial agents and prescribed empiric antimicrobial therapy were analyzed. Results Totally 390 (90.9%) patients among all study population were requested for urine culture by their physicians. 150 (38.5%) of these urine cultures were positive. The most common isolated uropathogen was Escherichia coli (E. coli) (71.3%). The variations of uropathogens according to age and menopause status were not significantly different. The resistance rates of E. coli isolates for ampicillin, ampicillin-sulbactam, amoxicillin-clavulonate, cefuroxime, ceftriaxone, fluoroquinolones (FQ), co-trimoxazole (TMP-SMX) and gentamicin were 55.1%, 32.7%, 32.7%, 23.4%, 15.9%, 25.2%, 41.1%, 6.1% respectively. FQ were the most common prescribed antibiotics (77.9%) (P < 0.001), followed by TMP-SMX (10.7%), fosfomycin (9.2%), nitrofurantoin (2.1%). Treatment durations were statistically longer than the recommended 3-day course (P < 0.001). Conclusion Empirical use of FQ in uUTI should be discouraged because of increased antimicrobial resistance rates.

Giriş: Psoas apsesi, iliak ve psoas kasların çevresinde süpüratif sıvı birikiminin sebep olduğu komplike enfektif tablodur. Etken; uzak bir enfeksiyon odağından hematojen ve lenfatik yolla ya da komşuluk yoluyla yayılır. Bu olgumuzda nörolojik bulgularla gelen, pelviste 14 cm boyutunda apseyle takip edilen, drenaj yapılamadığı için ampirik antitüberküloz tedavi başlanarak kısa sürede apsesi kontrol altına alınan bir olgudan bahsedilmiştir. Olgu: Bilinen hastalığı olmayan 67 yaş kadın hasta, 1 haftadır olan kollarda ve bacaklarda güçsüzlükle başvurdu. Fizik muayenede bilateral üst ve alt ekstremitede 3/5 motor kuvvet saptandı. Abdomen bilgisayarlı tomografide (BT) L2-L3 düzeyinde spondilodiskit, bilateral psoas kasında ve sağ iliakus kasında apse; toraks BT'de kavitasyon? septik emboli? saptanmasıyla yatışı yapıldı. Ampirik olarak piperasilin-tazobaktam başlanan hastanın takiplerinde kan kültüründe MSSA saptanması üzerine sefazoline geçildi, kan kültürü ve apse kültüründe MRSA üremeleri olması üzerine tedaviye vankomisin eklendi. Yaygın tutulum, apsenin organize olması nedeniyle nöroşirürji ve girişimsel radyoloji tarafından işlem planlanmadı. Septik emboli şüphesi nedeniyle yapılan TTE ve TEE'de vejetasyon saptanmadı, balgam mikobakteri polimeraz zincir reaksiyonu (PCR) ve aside-alkole rezistan basil negatif sonuçlandı. Antibiyotiklerle klinik yanıt alınamayan hastaya ampirik anti-tüberküloz tedavi başlandı. İlaç etkileşimi nedeniyle sefazolin ve vankomisin kesilerek teikoplanin başlandı. Bronkoskopi yapılan hastada BAL mikobakteri PCR pozitif saptandı. BAL tetkiklerinde ek patoloji görülmedi. 4'lü anti-tüberküloz tedavi 2 ay, idame tedavi en az 6 ay, teikoplanin toplam 3 ay alması planlanarak taburcu edildi. Kontrollerinde şikayetleri gerileyen hastanın nörolojik muayenesinde iyileşme saptandı. Teikoplanin 3. ayda kesildi. Anti-tüberküloz tedavinin 182. gününde kontrol manyetik rezonans görüntülemede apsenin tamamen kaybolması üzerine tedavisi kesildi. Sonuç: Psoas apsesi olan hastalar spesifik olmayan semptomlarla gelmektedir, bu nedenle tanı koymak güçleşmektedir. Hastalar genellikle ateş, sırt ve yan ağrısıyla başvurmaktadır. Psoas apsesine sebep olan en sık etkenler arasında Staphylococcus aureus, Escherichia coli görülmektedir. Drenajla birlikte etken saptanana kadar ampirik tedavide S. aureus'a karşı etkin antibiyotik seçimi önerilmektedir. Bizim olgumuzda apsenin organize olması nedeniyle drenaj yapılamamış ve ampirik anti-tüberküloz tedaviyle hastada kür sağlanmıştır. Literatürde olgumuzla benzer şekilde MSSA saptanan ancak etkin tedaviyle yanıt alınamayıp anti-tüberküloz tedaviden fayda gören olgular bildirilmiştir. Bu bildiride amacımız; ülkemiz için tüberkülozun endemik olması nedeniyle tanı konamayan ya da yanıt alınamayan hastalarda ampirik anti-tüberküloz tedavinin akılda bulundurulmasıdır. [ABSTRACT FROM AUTHOR]

Introduction: Brucellosis is an endemic disease with a high mortality rate still seen in Mediterranean countries such as our country. Neurobrucellosis, on the other hand, is a clinical condition with a high mortality, which occurs when the disease affects the central nervous system. We aimed to emphasize that it is a diagnosis that should be kept in mind by presenting a rare case of neurobrucellosis that we followed in our intensive care unit (ICU). Case: Sixty-eight years old female (hypertension, retired teacher), has a history of eating cheese. She was hospitalized in the ward with a preliminary diagnosis of neurobrucellosis due to joint pain, insomnia, fatigue for 20 days and syncope two days ago. Rose bengal test was negative, Brucella agglutination 1/160 positive, Brucella IgG/IgM negative, CRP: 71 and ESR: 69. Brain CT showed a 42x23 mm hypodense edema area in the left frontal area. The patient was admitted to our intensive care unit due to cardiac arrest in the infection ward. On mechanical ventilation, hypointense areas at the pons level in the contrast-enhanced brain MRI of the patient, who was hemodynamically stable, were found to be compatible with neurobrucellosis. During this period, doxycycline and rifampicin treatments were continued. Choreiform movements were observed. Upon detection of generalized slow wave activity and intermittent suppression activity in EEG, levatiracetam was started. Tracheostomy and PEG were performed for the patient who was in the prolonged intensive care unit. In the control brain MRI, it was determined that the ischemic area triggered by the infective process regressed (Figure 1). The patient died on the 99th day of hospitalization due to septic shock. Discussion: Neurobrucellosis is one of the rare and serious complications in regions where brucellosis is endemic, such as our country. It should be kept in mind in areas such as meningitis that are difficult to diagnose [ABSTRACT FROM AUTHOR]

Copyright of Mediterranean Journal of Infection, Microbes & Antimicrobials is the property of Galenos Yayinevi Tic. LTD. STI and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Tigecycline is a parenteral glycycline antibiotic that is used to treat severe infections caused by susceptible organisms, butitis also associated with hepatotoxicity. We present 2 similar patients with hepatic steatosis possibly associated with early tigecycline after transplant. In the first case, a 61-year-old woman underwent liver transplant for acute severe hepatitis; 6 days posttransplant, because of nonroutine resistant fever, the patient received tigecycline combined with daptomycin. Retransplant was applied to the patient on day 12 posttransplant because of acute liver failure secondary to hepatic vein thrombosis. After retransplant, biochemical levels gradually increased, exceeding the upper limit of normal. In liver biopsy, the patient had macrovesicular steatosis in 70% to 80% ofthe parenchyma. In the second case, a 53-yearold woman underwent liver transplant for liver cirrhosis. Tigecycline was added to the treatment because of recurrent fever on day 6 after transplant, with treatment also comprising piperacillin-tazobactam and meropenem. On day 15 of the patient's tigecycline treatment, her liver function tests were elevated. In liver biopsy, the patient had 30% to 40% macrovesicular steatosis and canalicular cholestasis in the parenchyma, especially in zone 3. Reports of hepatic steatosis associated with early tigecycline after transplant are quite new to the literature.