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Asl&inodot;han Candevir,1 Ferit Kuscu,1 Behice Kurtaran,1 Süheyla Kömür,1 Ay&scedil;e Seza &Idot;nal,1 Damla Ertürk,2 Ye&scedil;im Ta&scedil;ova1 1Infectious Diseases, Çukurova University, Adana, Türkiye; 2Infectious Diseases, Health Sciences University Izmir Tepecik Education and Research Hospital, &Idot;zmir, TürkiyeCorrespondence: Asl&inodot;han Candevir, Infectious Diseases Department, Çukurova University Medical School, Adana, Türkiye, Tel +90 5335775954, Email acandevir@gmail.comBackground: Late presentation for HIV care, continues to be a challenge, leading to increased morbidity, mortality, and society costs. The study aimed to determine the rates of late diagnosis (LD) and patient characteristics in Turkey, utilizing the new definition excluding recently infected.Methods: The study included patients admitted to the hospital between 1998 and 2023, with at least 1 year of follow-up. Patients without a CD4 count at their initial admission were excluded. Two definitions of presentation were used: LD, (CD4< 350 cells/mL or AIDS-defining event) and advanced disease (AD), (CD4< 200 cells/mL or AIDS-defining event). Individuals with recent evidence of infection were reclassified as “not late”.Results: Out of the 914 patients meeting the criteria and the analysis focused on 794 treatment-naïve patients, with 90.6% being male and an average age of 36.0 ± 12.0 years. Using the previous definition, 48.9% were diagnosed as late, while the new definition identified 47.2%. A total of 183 patients (23%) were diagnosed with AD, and 25.9% of the diagnoses occurred during the COVID-19 Pandemic. The rate of LD increased during the pandemic compared to before (55.8% vs 44.2%, p=0.005), as did the rate of AD (30.1% vs 20.6%, p=0.007). There was no significant relationship between gender and LD. Patients with LD were older (median ages were 31 vs 36 in groups, p< 0.001), had poorer virological response, higher mortality rates (4.8% vs 1.2%, p=0.003), and shorter survival compared to those without (log rank=0.004).Conclusion: HIV patients with LD have poorer prognosis with older age as well as disruption of health services during the pandemic as risk factors. To improve outcomes, multicenter studies should investigate missed opportunities and specific risk factors in our region, and we should screen at-risk populations, promote awareness among underdiagnosed populations, and advocate testing even in disastrous situations.Plain Language Summary: Late diagnosis of HIV remains a challenge, leading to increased health problems, deaths, and societal costs. This study aimed to determine the rates of late diagnosis and patient characteristics in Turkey, using a new definition that excludes recently infected individuals. The study included 794 treatment-naïve patients, mostly male with an average age of 36 years. With the new definition, 47.2% were diagnosed late, and 23% had advanced disease. The pandemic period saw higher rates of late diagnosis (55.8% vs 44.2%) and advanced disease (30.1% vs 20.6%). Gender did not significantly affect late diagnosis. Patients with late diagnosis were older, had lower CD4 counts, poorer treatment response, higher mortality rates (4.8% vs 1.2%), and shorter survival. Older age and disruptions in healthcare during the pandemic were identified as risk factors for late diagnosis. To improve outcomes, multicenter studies should investigate missed opportunities and specific risk factors, while focusing on screening high-risk populations, raising awareness among underdiagnosed groups, and promoting testing even during challenging situations.Keywords: human immunodeficiency virus, HIV, late diagnosis, new definition, risk factors

Introduction: COVID-19 is a significant cause of morbidity and mortality. It is crucial to identify biomarkers that can aid in predicting patients' prognosis and mortality. This study evaluated the relationship between galectin-3 (Gal-3), interleukin-1 (IL-1), interleukin-6 (IL-6), and tumor necrosis factor-alpha (TNF-α) levels and the prognosis and mortality of COVID-19 patients., Methodology: The study included 69 COVID-19 patients (32 outpatients, 37 inpatients) and 19 healthy controls. Gal-3, IL-1, IL-6, and TNF-α levels in serum samples were measured using an ELISA test., Results: In a comparison between the patient and healthy control groups, it was observed that the patient group had significantly higher levels of Gal-3, IL-6, and TNF-α. Comparison between the outpatient and inpatient groups revealed that the hospitalized patient group had significantly higher levels of IL-6 and TNF-α, while the Gal-3 levels were lower in this group. In the analysis of subgroups to assess disease severity, critical COVID-19 patients exhibited elevated levels of Gal-3 and IL-6 compared to those with severe COVID-19. Moreover, Gal-3 and IL-6 were identified as having predictive value for mortality in hospitalized patients, while both IL-6 and TNF-α demonstrated diagnostic accuracy across all patient groups., Conclusions: The study results indicate that the levels of IL-6 TNF-α play a crucial role in determining the hospitalization and mortality of COVID-19 patients. Additionally, it was observed that Gal-3 and IL-6 levels can be utilized to assess the severity of the disease and predict mortality in patients who require hospitalization., Competing Interests: No Conflict of Interest is declared, (Copyright (c) 2024 Merve Sancıoğlu Demir, Ferit Kuşcu, Behice Kurtaran, Aslıhan Candevir, Ayse Seza İnal, Süheyla Kömür, Yeşim Taşova.)

Background: HIV and syphilis are sexually transmitted infections with overlapping risk factors, potentially leading to increased HIV transmission and treatment challenges. Understanding the clinical management of syphilis co-infection among people living with HIV is crucial for public health interventions., Objective: This retrospective cohort study aimed to assess the prevalence of syphilis co-infection, clinical characteristics, treatment response, and public health implications among people living with HIV in southern Turkey., Methods: Records of 1352 people living with HIV 18 years and older, followed at a tertiary infectious diseases clinic between 2013 and 2023, were analyzed. Data on demographics, clinical stage of syphilis and HIV/AIDS, laboratory parameters, treatment response, and co-infections were collected. Statistical analyses were performed using SPSS 20.0 software., Results: Among the people living with HIV, 103 (7.6%) were diagnosed with syphilis. Most cases were male (97.1%), with a median age of 33 (IQR 28-49) years. Heterosexual transmission was predominant (60.2%), with a history of condomless sexual intercourse in 90.3% of cases. The majority (88.3%) were asymptomatic with latent syphilis. Syphilis was diagnosed concurrently with HIV in 77.7% of cases. Serological response to syphilis treatment was observed in 46.8% of patients, while 53.2% showed a serofast reaction. Neurosyphilis was rare, diagnosed in only one patient. Co-infections with hepatitis B and C were detected in 3.9% and 1.9% of patients, respectively., Conclusion: Syphilis co-infection among people living with HIV is a significant public health concern in southern Turkey. Routine screening for syphilis, along with comprehensive education on sexually transmitted infection prevention, is essential for early detection and optimal management. Further research is needed to improve treatment outcomes and address emerging challenges in HIV-syphilis co-infection management., (Copyright© Bentham Science Publishers; For any queries, please email at epub@benthamscience.net.)

Introduction: Characteristics of exposure and infection risk, are important in strategy development for infection control among healthcare workers (HCWs). Our objective was to investigate the characteristics of exposure of HCWs to SARS-CoV-2 and determine the risk of COVID-19 development., Methodology: This is a retrospective single-center cohort study, conducted between March and December 2020. Unvaccinated and exposed HCWs were asked to complete a standard form, including demographic data and characteristics of exposure(s). Exposures were stratified according to national guidelines. STROBE checklist was used., Results: Among a total of 4,385 healthcare workers, 1,483 HCWs (33.8%) with a total of 1,903 exposures to SARS-CoV-2 were identified. Median age was 31 (IQR: 26-40) years and 45.4% were male (N = 673). Following exposure, 78 HCWs became SARS-CoV-2-positive (attack rate: 3.9%) and secondary attack rate was 4/16. In terms of infection, exposure to SARS-CoV-2-positive HCWs posed a greater risk compared to contact with patients (8.9%, [n = 66] vs. 3.8% [n = 12], respectively, p = 0.003). PCR positivity rates were 11.5%, 6.3%, and 8.4% for low, medium, and high-risk contacts (p = 0.152). Median time to infection post-exposure was 7 (IQR: 4-13) days., Conclusions: Given the attack rates, there was no correlation between risk levels and PCR test positivity rates. There was no difference between HCWs with or without work restrictions, in terms of PCR positivity. Due to feasibility issues, prioritizing universally applied symptom screening and resource control strategies and suspending contact tracing and work restrictions, appear to be safe during high prevalence period., Competing Interests: No Conflict of Interest is declared, (Copyright (c) 2023 Aslıhan Candevir, Damla Ertürk, Ferit Kuşcu, Süheyla Kömür, Yasemin SAYGIDEĞER, A. Seza Inal, Ezgi Özyilmaz, Behice Kurtaran, Yeşim Taşova.)

Objective: We aimed to investigate the vaccination status and the risk factors for the intensive care unit (ICU) support need of the laboratory-confirmed breakthrough COVID-19 infection inpatients., Materials and Methods: This multi-center point-prevalence study was conducted on inpatients, divided into two groups as 'fully' and 'partially' vaccinated according to COVID-19 vaccination status., Results: Totally 516 patients were included in the study. The median age was 65 (55-77), and 53.5% (n=276) of the patients were male. Hypertension (41.9%, n=216), diabetes mellitus (DM) (31.8%, n=164), and coronary artery disease (CAD) (16.3%, n=84) were the predominant comorbidities. Patients were divided into two groups ICU (n=196) and non-ICU (n=301). Hypertension ( p =0.026), DM ( p =0.048), and congestive heart failure (CHF) ( p =0.005) were significantly higher in ICU patients and the median age was younger among non-ICU patients ( p =0.033). Of patients, 16.9% (n=87) were fully vaccinated, and this group's need for ICU support was statistically significantly lower ( p =0.021)., Conclusion: We conclude that older age, hypertension, DM, CHF, and being partially vaccinated were associated with the need for ICU support. Therefore, all countries should continuously monitor post-vaccination breakthrough COVID-19 infections to determine the national booster vaccine administration approach that will provide vulnerable individuals the highest protection., Competing Interests: The authors declare no conflict of interest., (Copyright &#xA9; 2024 Infectious Diseases and Clinical Microbiology.)

Background: People who inject drugs (PWID) should be treated in order to eliminate hepatitis C virus in the world. The aim of this study was to compare direct-acting antivirals treatment of hepatitis C virus for PWID and non-PWID in a real-life setting., Methods: We performed a prospective, non-randomized, observational multicenter cohort study in 37 centers. All patients treated with direct-acting antivirals between April 1, 2017, and February 28, 2019, were included. In total, 2713 patients were included in the study among which 250 were PWID and 2463 were non-PWID. Besides patient characteristics, treatment response, follow-up, and side effects of treatment were also analyzed., Results: Genotype 1a and 3 were more prevalent in PWID-infected patients (20.4% vs 9.9% and 46.8% vs 5.3%). The number of naïve patients was higher in PWID (90.7% vs 60.0%), while the number of patients with cirrhosis was higher in non-PWID (14.1% vs 3.7%). The loss of follow-up was higher in PWID (29.6% vs 13.6%). There was no difference in the sustained virologic response at 12 weeks after treatment (98.3% vs 98.4%), but the end of treatment response was lower in PWID (96.2% vs 99.0%). In addition, the rate of treatment completion was lower in PWID (74% vs 94.4%)., Conclusion: Direct-acting antivirals were safe and effective in PWID. Primary measures should be taken to prevent the loss of follow-up and poor adherence in PWID patients in order to achieve World Health Organization's objective of eliminating viral hepatitis.

Background: The number and proportion of elderly patients living with chronic hepatitis C are expected to increase in the coming years. We aimed to compare the real-world efficacy and safety of direct-acting antiviral treatment in elderly and younger Turkish adults infected with chronic hepatitis C., Methods: In this multicenter prospective study, 2629 eligible chronic hepatitis C patients treated with direct-acting antivirals between April 2017 and December 2019 from 37 Turkish referral centers were divided into 2 age groups: elderly (≥65 years) and younger adults (&lt;65 years) and their safety was compared between 2 groups in evaluable population. Then, by matching the 2 age groups for demographics and pretreatment risk factors for a non-sustained virological response, a total of 1516 patients (758 in each group) and 1244 patients (622 in each group) from the modified evaluable population and per-protocol population were included in the efficacy analysis and the efficacy was compared between age groups., Results: The sustained virological response in the chronic hepatitis C patients was not affected by the age and the presence of cirrhosis both in the modified evaluable population and per-protocol population (P = .879, P = .508 for modified evaluable population and P = .058, P = .788 for per-protocol population, respectively). The results of the per-protocol analysis revealed that male gender, patients who had a prior history of hepatocellular carcinoma, patients infected with non-genotype 1 hepatitis C virus, and patients treated with sofosbuvir+ribavirin had a significantly lower sustained virological response 12 rates (P &lt; .001, P = .047, P = .013, and P = .025, respectively)., Conclusion: Direct-acting antivirals can be safely used to treat Turkish elderly chronic hepatitis C patients with similar favorable efficacy and safety as that in younger adults.

Background/aim: HIV infection increase the risk of serious disease resulting from common vaccine-preventable infections. Vaccinations are particularly important for HIV infected adults. We aimed to investigate the immunity rates against measles, mumps, rubella, hepatitis A, B, and tetanus in newly diagnosed HIV patients., Materials and Methods: Patients who admitted to outpatient clinics of three centers with newly diagnosed HIV infection, between 1 January 2015 and 31 June 2017 were included. Measles, mumps, rubella, varicella zoster virus, hepatitis A, hepatitis B, and tetanus antibody levels were measured by commercial diagnostic kits. Demographical and laboratory data of the patients were recorded., Results: Five hundred and twenty-three patients were enrolled in the study. Of the patients 87% were male (n = 455) and the mean age was 38 ± 13 years. Serology was available for measles 74.2% (388/523), mumps 73.8% (386/523), rubella 77.8% (407/523), hepatitis A 88.5% (463/523), hepatitis B 97.7% (511/523), tetanus 8.6% (45/523), and VZV 79.9% (418/523). Seropositivity was 82% for measles, 75.6% for mumps, 92.1% for rubella. Of the patients whom all three of the components of the MMR vaccine was tested, 37.7% (127/337) were susceptible at least one and needed the vaccine. Mean age was lower in patients who are nonimmune to measles and mumps (p = 0.008). Younger patients were also nonimmune for hepatitis A, while older patients were nonimmune for hepatitis B., Conclusion: In our study we found that rates of nonimmunity can increase up to one third of the patients even though there is a national vaccination program. Nonimmune individuals should be detected and vaccinated in line with recent guidelines and response should be monitored because of the possibility of impaired immunity and possible suboptimal response. National campaigns can be launched for adult immunization and physicians should be aware of the importance of adult immunization., Competing Interests: All authors do not have any conflict of interest that may have influenced either the conduct or the presentation of the research., (This work is licensed under a Creative Commons Attribution 4.0 International License.)

Candida species are responsible for 70-90% of invasive fungal infections in the intensive care unit. Early diagnosis and treatment is important in candidemia. Improper diagnosis and treatment increases mortality and morbidity significantly. Because of the late results of blood cultures and low sensitivity of the serological tests when used alone, molecular methods should be investigated in this field. In this study, the results of the Candida real-time polymerase chain reaction (Rt-PCR) test, which was studied from blood culture and whole blood, were compared in patients with high candidemia risk who were followed in the General Surgery Intensive Care and Anesthesiology and Reanimation Unit of Cukurova University Faculty of Medicine. It was aimed to investigate the practical utility of Candida RT-PCR test, which is a rapid diagnosis method in patients with suspected candidemia. In our study, 90 patients with high risk of candidemia according to the criteria determined according to the guidelines were evaluated prospectively. Urine, perineum, axilla, tracheal aspirate culture and two sets of blood cultures were obtained from the patients. Blood sample was also drawn into an ethylenediaminetetraacetic acid (EDTA) tube and stored at -40°C for later Candida Rt-PCR study. In Candida Rt- PCR, species-specific primers were used to distinguish species. Candida score (CS) of the patients was calculated. Forty one (45.5%) of the patients were female and 49 (55.5%) were male. The median age of the patients was 61.5 years. Candida was positive in blood culture in three (3.3%) of the patients included in the study, while Candida Rt-PCR was positive in 17 (18.9%). Candida species detected in the blood culture and Rt-PCR test were compatible with each other. Rt-PCR was significantly more positive (p= 0.006). Candida Rt-PCR positivity was significantly higher in patients receiving total parenteral nutrition (p= 0.028), malignancy (p= 0.021), and history of surgery in the last three months (p=0.003). The difference in CS between patients with PCR positive and PCR negative was statistically significant (p= 0.015). Our study was conducted in a high-risk population for candidemia and the results of Candida Rt-PCR was found to be more positive than blood culture. Rt-PCR positivity and blood culture positivity were associated with high CS. In the light of these data, it was thought that it would be appropriate to use molecular methods in the diagnosis and support them with CS, especially in patients with high risk of candidemia. Considering that blood culture, which is the gold standard for the diagnosis of candidemia, gives late results and is 50% positive, using faster diagnostic methods for candidemia is important to reduce mortality and morbidity. The fast and good results of Candida PCR method have shown that it can be used in diagnosis. However, lack of standardization of primers used in PCR tests may cause false positives. Additional studies are needed in this respect.

Objective: Occult hepatitis B infection (OHBI) appears to have a higher prevalence in populations at high risk for hepatitis B virus (HBV) infection with concomitant liver disease. The aim was to assess the prevalence of OHBI in a sample of human immunodeficiency virus -1 positive and HBV surface antigen-negative (HIV-1+/HBsAg-) Turkish patients., Methods: Ten centres in Turkey were included in the study. Patients were selected on the basis of a power calculation with a known population size of HIV-positive patients and a reported prevalence of OHBI. Gender, age, occupation, place of residence, treatment and clinical status, and laboratory results, including immunodeficiency panel, antibody tests, hemogram, biochemistry, and coagulation studies were evaluated retrospectively., Results: The number of HIV-infected patients followed in these centres was 3172 and the sample population numbered 278. All 278 were HBsAg negative. The mean age of the sample was 37.2 ± 13.1 years and 235 (84.5%) were male. All but one patient (99.6%) had been treated with antiretroviral therapy. Of the 278 patients, 169 (60.6%) were positive for Anti-HBs and 125 (44.8%) were positive for Anti-HBc IgG. HIV RNA was detected in 203/278 (73%) of the patients. Four HBV DNA (1.4%) were diagnosed with OHBI. There was no significant difference in hemogram, hemoglobin or bilirubin concentrations in those with OHBI compared with the other patients., Conclusion: In a representative sample of HIV+ patients from 10 Turkish centres, the prevalence of OHBI was found to be 1.4%. In HIV positive patients, it is important to identify those with OHBI for optimal clinical management and prognosis., (© 2021 John Wiley & Sons Ltd.)

Objectives: Given the many medications used to treat novel coronavirus disease (COVID-19) and its comorbidities and complications, the risk of drug-drug interactions (DDIs) and resulting patient harm is concerning. This study aimed to shed light on physicians' knowledge of potential DDIs related to COVID-19 treatment, to determine the effect of an information brief about these DDIs on their correct response rates, and to identify factors associated with higher levels of knowledge about these DDIs., Methods: The knowledge of physicians regarding the clinical significance and intervention of 7 common potential DDIs during COVID-19 treatment was evaluated via an online survey. Using a pretest-posttest design, the physicians completed a multiple-choice questionnaire first using their existing knowledge, then received an information brief about the DDIs and completed the same questionnaire again. Pretest and posttest scores were evaluated and factors affecting correct response rates were determined using correlation, regression, and post-hoc analyzes., Results: A total of 244 physicians participated in the survey, 147 (60.2%) of whom were involved in the treatment of COVID-19 patients. After the information brief, there were significant increases in the number of correct responses for both clinical significance and interventions ( p < 0.0001). In comparisons of pretest knowledge, physicians involved in the treatment of COVID-19 patients showed significantly higher correct response rate for interventions compared to physicians who had not treated COVID-19 patients ( p = 0.003). Post-hoc analysis to compare pretest correct intervention responses among all medical specialties revealed significant differences between infectious diseases and family practice (mean difference: 1.059; p = 0.005) and between internal medicine and family practice (mean difference: 1.771; p < 0.0001)., Conclusion: Physicians involved in the treatment of COVID-19 patients had more knowledge regarding clinical significance and appropriate management of potential DDIs than those not involved. Therefore, it may be beneficial to organize trainings and issue guidelines about potential DDIs for physicians during the COVID-19 pandemic.

Objectives: In recent years, carbapenem-resistant Klebsiella pneumoniae (CRKP) have become an important threat to hospitalised patients. This study aimed to identify the genetic mechanisms of carbapenem resistance in CRKP isolated from patients in a Turkish centre., Methods: During 2013-2014, a total of 98 K. pneumoniae isolated from patients at Çukurova University Balcalı Hospital (Adana, Turkey) determined phenotypically as resistant to carbapenems were screened genotypically for the presence of carbapenemase enzymes by multiplex PCR., Results: Of the 98 patients for whom genetic investigation was made, 93 (94.9%) were adults, 56 (57.1%) were male and 81 (82.7%) were diagnosed as infected. The mean and median age were 51.8±20.5years and 55 years (range 1-89 years), respectively. The nosocomial infection rate was 87.8% (86/98). The mortality rate was 41.8% (41/98). Fifty-eight patients (59.2%) were admitted to intensive care units. Of the 12 non-nosocomial infections, 5 (41.7%) originated from the inpatient clinic of the urology department. The mean and median hospital length of stay (LOS) were 20.7±20.8days and 17days (range 0-90 days), respectively. The most common carbapenemase gene detected was bla OXA-48 (74.5%), followed by bla VIM (45.9%) and bla SME (37.8%). The bla NDM gene was detected in 20 isolates (20.4%). The most effective antibiotics were tigecycline and colistin, with susceptibility rates of 87.5% and 74.3%, respectively., Conclusions: Multiple resistance mechanisms were present in CRKP isolates in Turkey. Most of the isolates harboured bla OXA-48 , bla VIM and bla SME genes; meanwhile, the rate of 20.4% for bla NDM is alarming., (Copyright © 2017 International Society for Chemotherapy of Infection and Cancer. Published by Elsevier Ltd. All rights reserved.)

A 39-year-old man who was returning from the Amazon Jungle and had no medical history presented with a furuncular lesion on his right parietal scalp. Despite receiving appropriate antimicrobial treatment, his lesion did not heal. After surgical intervention, a Dermatobia hominis larva was extracted. The human botfly D. hominis is the most common causative agent of furuncular myiasis among travelers returning from Central and South America. Surgery is the main treatment option, and secondary bacterial infection should be kept in mind.

Background/aim: Mucormycosis is a rare invasive fungal infection most commonly encountered in the immunocompromised host. We analyzed 51 adult patients treated for mucormycosis between 2003 and 2013 and recorded at a tertiary university hospital in Turkey., Materials and Methods: We examined the following data for all patients: age, sex, predisposing disease, symptoms, treatment, surgical procedure, concomitant infections, intensive care requirement, and outcomes., Results: During the study period 51 cases of mucormycosis were documented; 54.9% of the patients were female. The mean age was 44.2 ± 18.2 years. Rhinocerebral presentation was reported in 94.1% of patients. Almost all patients (88.2%) had at least one risk factor. The common predisposing factors were hematologic malignancies (52.9%), diabetes mellitus (25.5%), and solid malignancies (5.8%). The most common initial symptoms were fever, cellulitis, and facial pain. The primary medication used was liposomal amphotericin B or conventional amphotericin B. Surgery was performed in 94.1% of patients. Mortality was 52.9%., Conclusion: Our study revealed that mucormycosis continues to be a mortal disease in about half of the cases. Our findings indicate that treatment with L-AMB is associated with a favorable response. Also, in the case of facial pain, the low mortality rate may indicate the importance of early diagnosis.

Background: Nosocomial infections caused by Carbapenem-resistant Klebsiella pneumoniae (CRKP) are increasing. Our aim in this study was to investigate the risk factors of CRKP infections., Material/methods: A retrospective cohort study was performed between 1 January and 31 December 2012 in ICU patients. Data was taken from the hospital infection control database for CRKP. The clinical samples collected from the patients were tested by an automatized system and disk diffusion. SPSS software v11.5 was used for statistical analysis., Results: Totally, 105 Klebsiella pneumoniae isolates were found in 2012 and the carbapenem resistance rate was 48%. The first episode of infection was taken into risk factor analysis. Of the 98 patients, 61 (62.2%) were male and the mean and median ages were 30.4±29.8 and 25 (0-93). The length of stay was longer in the resistant group (p=0.026). Mortality was 48% in the whole group and similar between groups (p=0.533). There was a relationship between meropenem and third-generation cephalosporin use and resistance (OR 3.244 (1.193-8.819) and OR: 3.590 (1.056-12.209). The other risk factors in univariate analysis were: Immunosuppression OR: 2.186 (1.754-2.724), nasogastric catheter OR: 3.562 (1.317-9.634), peripheral arterial catheter OR: 2.545 (1.027-6.307), and being admitted to the neurosurgical unit OR: 4.324 (1.110-16.842)., Conclusions: Restriction of third-generation cephalosporin and carbapenem use and invasive procedures, along with infection control precautions and disinfection policies, may be effective in reducing the carbapenem resistance in ICUs.

Background/aims: The natural course and clinical outcome of hepatitis C virus (HCV) infection is related to the interaction between HCV and the immune response of the host. Only a limited number of studies have investigated the role of mannose-binding lectin (MBL) levels in HCV infection. The aim of the present study was to explore the relationship between MBL levels and gene polymorphisms on treatment response in patients with chronic hepatitis C (CHC)., Materials and Methods: Serum MBL levels from 50 CHC patients who completed treatment at least 24 weeks before the present study and 75 healthy HCV-negative controls were measured. In addition, the presence of codon 54 mutations was investigated. Correlational analyses were performed to determine relationships between MBL levels and treatment response., Results: In patients, mean serum MBL levels were lower and the rate of codon 54 mutations was higher. However, these differences were not statically significant. In both patients and controls, serum MBL levels were significantly lower in individuals with codon 54 mutations. Moreover, serum MBL levels and the rate of the codon 54 mutation were similar in patients regardless of treatment response., Conclusion: Our findings suggest that low MBL levels do not increase the susceptibility for HCV infection. Furthermore, MBL levels were not found to have a significant effect on the course of the disease or treatment response.