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Copyright of Duzce University Journal of Science & Technology is the property of Duzce University Journal of Science & Technology 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.)

The consensus report on the management of chronic hepatitis B (CHB) was first published in 2014 by the Viral Hepatitis Study Group of the Turkish Society of Clinical Microbiology and Infectious Diseases. The need for updating has arisen due to reestablished stages of the infection course, changes in treatment indications, new biomarkers used in diagnosis and follow-up, and new biomarkers that are not yet in daily use. Therefore, we prepared a new consensus report by reviewing the current literature and international evidence-based guidelines. We hope the updated consensus report will be a valuable resource for CHB, which is still an essential problem in our country. [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.)

Background/aim: The aim of this study is to evaluate the distribution, sources, clinical features, and mortality rates of bacteremia due to evaluation of extensively drug-resistant (XDR) gram negative among solid-organ transplant (SOT) recipients. Materials and methods: A retrospective study of SOT recipients with bacteremia due to XDR gram-negative pathogens in 11 centers between 2016 and 2018 was conducted. Patients’ records were evaluated. Results: Of 171 bacteremia that occurred in 164 SOT recipients, 93 (56.7%) were liver, 46 (28%) kidney, 14 (8.5%) heart, and 11 (6.7%) lung recipients. Bacteremia episodes were recorded in the first year in 63.7% of the patients (n = 109), early-onset bacteremia was recorded in 45% (n = 77) of the episodes. In multivariate analysis, catheter-associated bacteremia was an independent risk factor for 7-day mortality (p = 0.037), and early-onset bacteremia was found as an independent risk factor for 30-day mortality (p = 0.017). Conclusion: Difficult-to-treat infections due to XDR bacteria in SOT recipients shadow the success of transplantation. Central venous catheters seem to be the main risk factor. Judicious use of medical devices is of pivotal importance. [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.)

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.)

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.)

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.)

Aim: In this study, clinical properties and treatment outcomes of 8 patients with unilateral epididymo-orchltis are evaluated. Material and Methods: A total of 8 cases were diagnosed with brucella induced epididymo-orchitis at the Urology and Infectious Diseases Clinics of Mus State Hospital within a period of 15 months. All related demographic data, clinical and laboratory findings, treatment progress and outcomes of these patients were evaluated, and the patients were followed for one year. The results obtained were statistically evaluated. Results: The mean age of the patients was 46.12 years (ranging between 20 and 58 years). The infection involvement was in the left side in five patients and in the right in three patients. All patients had applied to practitioners with acutely developing scrotal edema and pain. Systemic fever was detected in 6 (%75) patients, and Brucella spp. developed in the blood cultures of two patients. Wright agglutination test was positive in all cases. The Doppler USG examination conducted displayed ependymal cyst in two patients and testicular abscess In one. All 8 patients received antimicrobial treatment of streptomycine 1g/day for 21 days, and tetracycline 2 ×100mg and rifampisin 600mg/day for 6 weeks. One of the patients developed relapse due to low adherence to the treatment. Conclusion: In the endemic areas, brucella epididymo-orchitis must be considered in the possible diagnosis of the patients who apply with acutely developing scrotal pain and edema. Early diagnosis will prevent unwanted surgical interventions and complications such as infertility. [ABSTRACT FROM AUTHOR]

Giriş: Bruselloz, vücuttaki birçok sistemi etkileyerek farklı klinik tablolara yol açabilmektedir. Brusellozda depresyon ve dikkat kaybı sık karşılaşılan şikayetlerdir, ancak santral sinir sistemi direkt invazyonu, olguların %5’inden azında görülür. Nörobrusellozda görülen klinik tablolar menenjit, ensefalit, meningoensefalit, miyelit, beyin apsesi, epidural apse, granülom ile demiyelinizan ve meningovasküler sendromları kapsamaktadır. Olgumuz özellikle endemik bölgelerde nörobrusellozun akılda tutulması gerektiğini vurgulamak amacıyla sunulmuştur. Olgu: Otuz altı yaşında kadın hasta 2020 Mart ayında başlayan baş, diz, sırt ağrıları nedeniyle dış merkeze başvurmuştu. Bundan bir sene önce başlayan işitme kaybı nedeniyle çeşitli tedaviler almıştı. Tedavilere rağmen semptomlarda gerileme olmayıp, gözde ağrı ve bulanık görme eklenmişti. Hastaya 5 ay sonra bruselloz tanısı konulmuş, tedaviye başlanmıştı. Hasta 10 ay boyunca rifampisin + doksisiklin tedavisi almıştı. 2021 yılının temmuz ayında göz semptomları artınca nörobruselloz düşünülmüştü. Hastanın ilk bakılan Brucella coombs 1/5120 titrede pozitifti. Nörobruselloz şüphesi ile lomber ponksiyon yapılıp BOS Brucella coombs çalışılmış; 1/640 titrede pozitif gelmiş olup bos biyokimyası ve hücre sayımı bilgisi elimizde bulunmamaktadır. LP sonrası nörobruselloz tanısı konulup (2 ay yatarak seftriakson 2x2gr + bactrim forte 2x1 + doksisiklin 2x100 mg ve 5 ay ayakta doksisiklin + rifampisin + trimetoprim-sulfometaksazol kullanmış). Tedaviden 2 ay sonra yapılan LP’de BOS biyokimyasında; protein: 170 mg/ dl, glukoz: 35 mg/dl, klor: 124 mmol/l. Hücre sayımında 20 lökosit/mm³ görülmüştü. BOS Brucella coombs:1/320 titrede pozitifti. Hastaya yapılan kraniyal MR görüntülemesinde patoloji görülmemişti. Hastanın işitme kaybı ve görme bulanıklığı devam edince Ocak 2022’de tarafımıza başvurdu. Biz de yapılan tetkiklerde; Brucella coombs:1/5120 pozitif. BOS protein: 159 mg/dl, glukoz: 58 mg/dl, klor: 129 mmol/l. Thoma lamında 40 lenfosit sayılmıştır. Eş zamanlı bakılan parmak ucu kan şekeri: 111 mg/dl. BOS kültür, aseptik, viral, bakteriyel menenjit etkenleri, tüberküloz paneli negatif. BOS sitolojisinde patolojik bulgu görülmedi. Hastaya çekilen MR’de diffüz pakimeningeal tarzda kontrastlanma artışı mevcut (enfektif pakimenenjit?) olarak raporlandı. Sonuçlar ile beraber hastanın mevcut tedavisine devam edilmesine karar verildi. İki ay sonra kontrol tetkiklerde Brucella coombs: 1/1280, BOS protein: 126 mg/dl, glukoz: 46 mg/dl, klor: 127 mmol/l. Thoma hücre sayımı: 10 lökosit/mm³. Hastanın son klinik tablosunda işitme sekeli mevcut olup ayaktan tedavisi devam etmektedir. Sonuç: Bruselloz tüm organları tutabilen sistemik bir hastalıktır. Nörobruselloz bunlardan en önemli klinik tabloya sahip olup kalıcı nörolojik sekeller bırakabilir. [ABSTRACT FROM AUTHOR]

Giriş: Bruselloz, yeterince pastörize edilmemiş hayvansal gıdaların tüketilmesiyle insanlara bulaşan Gram-olumsuz zoonotik bir bakteridir. Fokal veya multiorgan tutulumlar yaklaşık %30 olguda gelişebilir. Granülomatöz hepatit, endokardit, meningoensefalit, spondilodiskit ve pansitopeniye varan değişken kan tabloları gözlenebilir. Bu bildiride viral hepatite sekonder gelişen kronik karaciğer yetmezliği tanısı olan bir olguda bruselloz tedavi yönetimi ve hemen sonrasındaki karaciğer nakli sürecini irdeledik. Olgu: Elli üç yaşında erkek hasta yaklaşık 20 yıldır HBV tanısıyla dış merkezde düzensiz takiplidir. Altı ay önce dış merkeze ateş, aşırı terleme, halsizlik ve şiddetli bel ve kalça ağrıları şikayetleriyle başvurmuştur. Yapılan tetkiklerde HDV süperenfeksiyonu tespit edilmiş, o dönem trombositopeni gerekçesiyle hastaya biyopsi yapılamadan entekavir 1x0,5 gr oral tedavi başlanmış. Eş zamanlı brusella tüp aglütinasyonu testi 1/640 pozitif gelince hastaya trimetoprim-sulfometaksazol, rifampisin ve doksisiklin tedavileri başlanmış. Tedavinin 25. gününde ALT ve AST değerlerinde yükselme ve batında yaygın asit tespit edilince hasta tedavileri kesilmeden üniversitemiz hastanesine nakil amaçlı yönlendirilmiştir. Hasta altı haftalık tedavisinin sonunda merkezimize ayaktan başvurdu. Hastanemizde yapılan tetkiklerde Brucella Coombs testi 1/1280, HBV-DNA negatif, HDV DNA 3015 kopya/ml, HBsAg 2426 ve ALT ve AST değerlerinde beş kat yükseklik tespit edildi. Hasta servisimize yatırıldı, sakroiliak MR çekilerek brusella spondilodiskiti dışlandı. Entecavir tedavisine devam edildi. Batında yaygın asit, trombositopeni ve portal venlerde dilatasyon nedeniyle gastroenteroloji ve organ nakli görüşleri alındı. Hastaya bruselloza yönelik yeniden ciprofloksasin ve trimetoprim-sulfometaksazol tedavileri başlandı, karaciğer nakli yapılabileceği, uygun bir canlı donör bulması istenerek ve mevcut tedavilerin altı haftaya tamamlanması önerileriyle hasta onuncu günde taburcu edildi. Mart 2022 başvurusunda Brucella Coombs testi yine 1/1280 pozitif geldi, ancak hastada hiçbir aktif bulgu ve şikayet yoktu. Hastaya bruselloza yönelik yeniden tedavi başlanmadı ve aynı hafta içinde canlı vericiden karaciğer nakli yapıldı. Nakil sonrası entecavir tedavisine devam edildi. Takiplerinde genel durumu iyi olan hastanın tüm laboratuvar parametreleri normal düzeylere geriledi ve postoperatif 23. günde şifa ile taburcu edildi. Sonuç: Kronik karaciğer yetmezliği tanısı olan hastalarda gelişen bruselloz yakın takiple mutlaka tedavi edilmelidir. Hasta yeterli süre tedavi almışsa ve aktif şikayeti yoksa, coombs testleri yüksek titrede bile olsa karaciğer nakli vakit geçirmeden yapılmalıdır. Zira vakit kaybedilmesinin daha ciddi sonuçlara neden olunabileceği unutulmamalıdır. [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.)

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.)

Human immunodeficiency virus (HIV)/acquired immundeficiency syndrome (AIDS) is a critical global public health problem that significantly affects both life expectancy and the overall quality of life of individuals in all age groups. The landscape of HIV infection has changed significantly in recent years due to the introduction of effective combination antiretroviral therapies (ART). A key component of first-line ART regimens for HIV treatment is abacavir, a nucleoside HIV reverse transcriptase inhibitor. Although abacavir is effective in suppressing viral replication and managing disease, its clinical utility is overshadowed by the potential for life-threatening hypersensitivity reactions in HLA-B*57:01-positive patients. In our country, local data obtained from various centers regarding the prevalence of HLA-B*57:01 in HIV-1-infected patients are available. In this study, it was aimed to determine the prevalence of the HLA-B*57:01 genotype in HIV-infected patients who were followed up and treated in many regions of our country. This retrospective study consists of the data of the patients aged 18 years and over diagnosed with HIV-1 infection between 01.01.2019 and 31.07.2022. Age, gender, place of birth, mode of transmission of the disease, death status, CD4+ T cell count and HIV RNA levels at the first clinical presentation, HLA-B*57:01 positivity, and the method used, clinical stage of the disease, virological response time with the treatment they received were recorded from the patient files. Data were collected from 16 centers and each center used different methods to detect HLA-B*57:01. These methods were sequence-specific oligonucleotide probe hybridization (SSOP), DNA sequence-based typing (SBT), single-specific primer-polymerase chain reaction (SSP-PCR), allele-specific PCR (AS-PCR) and quantitative PCR (Q-PCR). A total of 608 HIV-infected individuals, 523 males (86%) and 85 females (14%), were included in the study. The mean age of the patients was 36.9 ± 11.9 (18-73) years. The prevalence of HLA-B*57:01 allele was found to be 3.6% (22 patients). The number of CD4+ T lymphocytes in HLA-B*57:01 allele-positive patients was > 500/ mm3 in 10 patients (45.5%), while the number of CD4+ T lymphocytes in HLA-B*57:01 negative patients was > 500/mm3 in 216 patients (36.9%) (p> 0.05). Viral load at the time of diagnosis was found to be lower in patients with positive HLA-B*57:01 allele but it was not statistically significant (p> 0.05). Although different treatment algorithms were used in the centers following the patients, it was observed that the duration of virological response was shorter in HLA-B*57:01 positive patients (p= 0.006). Although the presence of the HLA-B*57:01 allele has a negative impact due to its association with hypersensitivity, it is likely to continue to attract interest due to its association with slower progression of HIV infection and reduced risk of developing AIDS. In addition, although the answer to the question of whether it is cost-effective to screen patients for HLA-B*57:01 before starting an abacavir-containing ART regimen for the treatment of HIV infection is being sought, it seems that HIV treatment guidelines will continue to recommend screening to identify patients at risk in this regard.

Background/aim: The aim of this study is to evaluate the distribution, sources, clinical features, and mortality rates of bacteremia due to evaluation of extensively drug-resistant (XDR) gram negative among solid-organ transplant (SOT) recipients., Materials and Methods: A retrospective study of SOT recipients with bacteremia due to XDR gram-negative pathogens in 11 centers between 2016 and 2018 was conducted. Patients’ records were evaluated., Results: Of 171 bacteremia that occurred in 164 SOT recipients, 93 (56.7%) were liver, 46 (28%) kidney, 14 (8.5%) heart, and 11 (6.7%) lung recipients. Bacteremia episodes were recorded in the first year in 63.7% of the patients (n = 109), early-onset bacteremia was recorded in 45% (n = 77) of the episodes. In multivariate analysis, catheter-associated bacteremia was an independent risk factor for 7-day mortality (p = 0.037), and early-onset bacteremia was found as an independent risk factor for 30-day mortality (p = 0.017)., Conclusion: Difficult-to-treat infections due to XDR bacteria in SOT recipients shadow the success of transplantation. Central venous catheters seem to be the main risk factor. Judicious use of medical devices is of pivotal importance., (This work is licensed under a Creative Commons Attribution 4.0 International License.)

Background/aim: Infections are one of the most important causes of mortality and morbidity after liver transplantation as in all transplantations. Infectious complications are known to be among the preventable causes with appropriate diagnosis and treatment. So early prediction of the risk of infections will provide an effective approach to determine the local antimicrobial resistance and prevention of specific risk factors. The aim of this study was to deterimne whether specific markers are useful or not to deterimne a suspected infection in patients that have undergone liver transplantation., Patients and Methods: The study included 65 patients with liver transplantation admitted to emergency room with suspicion of infection. These patient's CRP, procalsitonin (PCT), lactate, SAA and IL-6 levels were initially measured in the emergency department. The patients were classified to three categories according to culture results; culture-negative, culture-positive and control group. Studying parameters were investigated according to whether the culture was positive or negative in these patients., Results: CRP, PCT, lactate, SAA and IL-6 levels were significanlty high in patients with suspected infeciton when compared to the control group (p<0.05). CRP, PCT and IL-6 levels were higher in the culture-positive group than in the culture-negative group and there was a significant variation (p<0.05). When suspecting an infection evaluating the parameters CRP, PCT and IL-6 was very meaningfull (p<0.05)., Conclusion: We can use CRP, PCT, lactate, SAA and IL-6 parameters to identify presence of infection at the liver transplantation patients admitted to the emergency department with suspected infection. If CRP, PCT and IL-6 levels are significantly high we can guess the patient's positive culture., (Copyright© 2017, International Institute of Anticancer Research (Dr. George J. Delinasios), All rights reserved.)