Search

Amaç: Multilobar infiltrasyon, lenfositopeni, bakteriyel koenfeksiyon, sigara öyküsü, hipertansiyon ve yaş>65 (MuLBSTA) skoru, viral pnömonisi olan hastaları beklenen mortaliteye göre sınıflandırmak için kullanılan bir klinik tahmin kuralıdır. Hastanede yatan SARS-CoV-2 hastalarında kötü klinik sonuçlar için MuLBSTA’nın prediktif performansını PSI, CURB-65 ve qSOFA ile karşılaştırdık.Yöntemler: Bu çalışma 11 Mart 2020 ile 31 Mayıs 2020 tarihleri arasında üçüncü basamak bir üniversite hastanesinde yatan SARS-CoV-2’li hastalar üzerinde geriye dönük yapıldı. SARS-CoV-2 testi pozitif çıkan 900 hastadan 271’i çalışmaya dâhil edildi. Tüm hastalarda 30 günlük mortalite, Yoğun bakım ünitesi (YBÜ) ihtiyacı, mekanik ventilasyon gereksinimi ve akut respiratuar distress (ARDS) gelişimini değerlendirmek için MuLBSTA, PSI, CURB-65 ve qSOFA skoru kullanıldı. Otuz günlük mortalite için prognostik faktörler de analiz edildi.Bulgular: Hastanede yatan 271 hastanın 150’si (%55.3) erkekti. Ortalama yaş 54.2±15.4 yıldı. Otuz günlük ölüm oranı %10,7 idi. Çalışmaya dâhil edilen hastalardan; 39 hasta (%14,3) YBÜ’ye yatırıldı, 32 hasta (%11,8) mekanik ventilatör desteği aldı ve 23 hasta (%8,4) ARDS tanısı aldı. Mortaliteyi tahmin etmede MuLBSTA, PSI, CURB-65 ve qSOFA skorlarının eğri altında kalan alan (AUC) değerleri sırasıyla 0.877 (%95 CI 0.832 0.914), 0.853 (%95 CI 0.806-0.893), 0.769 (95% CI 0,714-0,817) ve 0,769 (95% CI 0,715-0,818). MuLBSTA puanı, diğer tahmin puanlarına kıyasla daha yüksek bir AUC değeri gösterdi. MuLBSTA ve PSI skorları, YBÜ ihtiyacı, mekanik ventilasyon gereksinimive ARDS gelişimi olan hastaları belirlemede CURB-65 ve qSOFA skorlarından daha iyi performans gösterdi.Sonuç: MuLBSTA skoru, hastanede yatan SARS-CoV-2 hastalarında kötü klinik sonuçları tahmin etmek için etkili bir araçtır. Kullanımını doğrulamak için daha fazla çalışmaya ihtiyaç vardır., Aim: Multilobar infiltration, lymphocytopenia, bacterial co-infection, smoking history, hypertension, and age>65 (MuLBSTA) score is a clinical prediction rule used to classify patients with viral pneumonia by expected mortality. We compared the predictive performance of MuLBSTA with PSI, CURB-65, and qSOFA for poor clinical outcomes in hospitalized severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) patients.Methods: A retrospective study was conducted on patients with SARS-CoV-2 who were hospitalized in a tertiary medical center between March 11, 2020, and May 31, 2020. 271 out of 900 patients who tested positive for SARS-CoV-2 were included in the study. The MuLBSTA, PSI, CURB-65, and qSOFA scores were used to assess thirty-day mortality, need for intensive care unit (ICU), mechanical ventilation (MV) requirement, and development of acute respiratory distress syndrome (ARDS) in all patients. Prognostic factors were also analyzed for thirty-day mortality.Results: Among all 271 hospitalized patients, 150 males (55.3%) were included. The mean age was 54.2±15.4 years. The 30-day mortality rate was 10.7%. Of the patients included in the study; 39 patients (14.3%) were admitted to the intensive care unit, 32 patients (11.8%) received mechanical ventilator support, and 23 patients (8.4%) were diagnosed with ARDS. In predicting mortality, the area under the curve (AUC) of the MuLBSTA, PSI, CURB-65 and qSOFA scores were 0.877 (95% CI 0,832 0,914), 0.853 (95% CI 0,806-0,893), 0.769 (95% CI 0,714-0,817) and 0.769 (95% CI 0,715-0,818), respectively. The MuLBSTA score showed a higher AUC value compared to other prediction scores. The MuLBSTA and PSI scores performed better than CURB-65 and qSOFA scores in determining patients’ need for ICU, MV requirement, and ARDS development.Conclusion: The MuLBSTA score is an efficient tool to predict poor clinical outcomes in hospitalized patients with SARS-CoV-2. Further studies are warranted to validate its use.

Objective: Antiretroviral agents provided a significant improvement in HIV-related mortality. Generic drugs decrease the cost and provide easieraccess to treatment. However, there are concerns about efficacy and safety. We assessed non-inferiority of generic tenofovir disoproxil fumarate/emtricitabine, Hivent® to brand name drug, Truvada® in a retrospective cohort.Methods: Nine centers from Turkey were enrolled and the study included 457 patients followed up between May 2015 and April 2017 with Truvada®(n = 227) and Hivent® (n = 230) in combination with other antiretrovirals. Baseline characteristics were comparable in both groups. Demographiccharacteristics and laboratory values at baseline and during treatment were recorded. The primary endpoint was virologic response after 12 monthsof therapy, as determined by Snapshot algorithm from Food and Drug Administration (FDA). The sample size calculation was based on the primaryendpoint. Non-inferiority margin was taken as 10%.Results: After 12 months of therapy, both drugs provided a comparable decline in HIV-RNA: The values at baseline, 1st, 3rd, 6th, 9th, and 12th monthby Truvada® were 6.32, 3.62, 2.52, 3.53, 3.01, and 1.71 log10 copies/mL, respectively and values by Hivent® were 5.93, 3.89, 2.18, 1.72, 3.63, and1.54 log10 copies/mL, respectively (P = .33). Both drugs provided a comparable significant increase in CD4+ cell count: values By Truvada® were338, 412, 472, 497, 511, and 580 cells/mL, respectively and values by Hivent® were 337, 503, 531, 553, 644, and 660 cells/mL (P = .13). The rateand severity of side effects were similar and the changes in biochemical parameters were not different.Conclusion: This retrospective cohort study showed that Hiv

Amaç: COVİD-19 pandemisi döneminde bazı sağlık anksiyetesi çalışmaları literatürde mevcuttur.Bununla birlikte mortalite ve morbiditesi yüksek, aynı zamanda toplumda damgalanma riski olan HİVpozitif kişilerin pandemi dönemine ait sağlık anksiyesini değerlendiren sınırlı sayıda çalışma mevcuttur.Literatürde, COVİD-19 pandemi döneminde genel ve sağlık anksiyetesini değerlendiren anket çalışmalarıbulunmaktadır. Sağlık anksiyetesini değerlendiren -Sağlık anksiyete envanteri- (HAI)’de 18 soru mevcut,sorular 0-3 arası puanlandırmıştır. Bu ölçeklendirme envanteri Türkçe’ye valide edilmiştir. Puan arttıkçasağlık anksiyetesi yükselmektedir. Literatürde HİV ve COVİD-19 pandemisi için özel bir ölçeklendirmebulunmadığı için bu ölçeklendirmeden faydalanılarak 14 soruluk mini bir anket oluşturuldu. Bilindiğiüzere HİV ile infekte bireylerin mortalite ve morbiditesi yüksektir. Bu nedenle bu hasta grubunda normalşartlarda anksiyetesi yüksek olan bireylerdir. Çalışmamızda pandemi döneminde toplum genelinde artansağlık anksiyetesinin özellikle HİV ile infekte olan kişilerdeki durumunu irdelemeyi amaçladık.Yöntem: Çalışmaya kliniğimizde takip ettiğimiz HİV ile infekte bireyler dahil edildi. Gönüllü olur formusözel olarak kendilerine iletilecek ve sözlü olarak onamları alındı ve telefon uygulaması üzerinden anketsoruları aktarıldı. Ankete katılan kişilerin demografik verileri, pandemi döneminde iş durumları ve HİV tanıve takibi ile ilgili süreci değerlendirilen sorular yanı sıra 14 soru anksiyetenin varlığını değerlendirmek içinsoruldu ve 0-3 arası puanlandı. Anket sonunda yüksek puan alan kişilere psikiyatrik muayene önerisindebulunuldu. Bu kişilerin sonrasında takibi yapıldı ve ilaç kullanımları da ayrıca sorgulandı.Bulgular: Çalışmaya 196 kişi dahil edildi. Bunların %86,7’si erkek (n=170), yaşlarının ortalaması 41,16±10,96ve tanı alma yıllarının ortancası 3,39 (1,5-5,6) idi. -Sağlığımla ilgili her zaman endişelenirim-, -Dışgörünüşüme ilgimi kaybettim-, -Eskiden zevk aldığım şeylerden eskisi kadar zevk alamıyorum-, -Gerginhissediyorum-, -Ailem ve dostlarım hastalık hastası olduğumu söyler- sorularına kadınlar anlamlı şekildeyüksek puan verdi (sırasıyla p=0,03, p=0,001, p=0,02, p=0,01 ve p=0,004) idi. Anti-psikiyatrik ilaç ihtiyacıve psikolog desteğine ihtiyacı olduğunu ifade edenler her iki cinsiyette benzerdi (p=0,05 ve p=0,26).Anti-psikiyatrik ilaç ihtiyacı olanların ve olmayanların yaş ortalamaları benzerdi (p=0,19)Sonuç: Çalışmamız salgın döneminde HİV ile yaşayan bireylerin COVİD-19 pandemisi döneminde özelliklekadın cinsiyette olanların ruh sağlığı açısından daha fazla etkilendiğini göstermektedir. HİV ile yaşayanbireylerin normal koşullarda dahi onları zorlayan şartların yanı sıra pandeminin getirdiği yeni duygusal vemaddi yüklerle ruh sağlıklarının daha fazla etkileneceği dikkate alınarak bu popülasyon için daha ayrıntılıtestlerin geliştirilmesinin yararlı olacağı kanısındayız.Anahtar Kelimeler: HİV, COVİD-19, anket

ÖZETTıp Eğitiminde; bilimsel araştırmatasarlama sorumluluğu üstlenebilen hekimler yetiştirmek, tıp fakültelerinin mezun yeterlilikleriarasında yer almaktadır. Her öğrencinin sorumluluğunu üstlenerek, bilimsel biraraştırma yapmasını sağlayacak “araştırma eğitimi programı” fakültemizde klinik dönemde bilimsellikkomitesi/stajı adı verilen bir yatay stajla gerçekleşmektedir. Bu çalışmanınamacı, uygulamanın nasıl yapıldığı ve değerlendirildiğini açıklamak ve edinilendeneyimleri paylaşmaktır. Bu stajda,amacı ve içeriği belirlenmiş altı modülde, araştırma eğitimine yönelik konferanslarve öğrencilerin mentörleri ile birlikte hazırlamış oldukları araştırmalarınaşamaları yer almaktadır. Öğrenciler, kendilerine bir mentör öğretim üyesiseçmekte ve bu öğretim üyesiyle standart bir sözleşme imzalamaktadırlar. İlkmodülden itibaren bir araştırma sorusu oluşturmaları, bilimsel literatürtaramaları yapmaları, etik kurul başvurusu, proje hazırlamaları ve projemalzemelerini sağlamaları gerekmektedir. İstatistiksel destek alma, araştırmayısürdürme ve bitirme sorumlulukları da bulunmaktadır. Modüllerde öğretim üyeleritarafından konferanslar verilmekte ve küçük gruplara ayrılan öğrenciler,projelerinin aşamalarını komisyonda yer alan öğretim üyesi ve gruparkadaşlarına sunmaktadır. Her modülün gerektirdiği aşama belirlenmiş ve birkılavuzda yayınlanmıştır. Üç yarıyıl süren bu yatay stajın sonunda öğrencileraraştırmalarını Tıp Bayramında düzenlenen “Araştırma Günü” etkinliklerindesözlü veya poster bildirileri şeklinde sunmaktadırlar. Fakültemiz öğretim üyelerindenoluşan Bilimsellik Stajı Komisyonu, uygulamayı düzenlemekte, modüllerde görevalmakta ve tüm taraflardan alınan geribildirimleri değerlendirerek üstbirimlere rapor etmektedir. Uygulamayı eşgüdümlü olarak yürüttüğümüz JohnsHopkins Üniversitesi öğretim üyeleri de her modüle katkı sunmaktadır. Ölçme vedeğerlendirme, modüllerde gösterdikleri ilerlemelere göre, yapılandırılmış birpuanlama sistemiyle gerçekleştirilir. Sonuç: BilimsellikKomitesi/Stajı, Bezmialem Vakıf Üniversitesi Tıp Fakültesi program çıktılarındada yer alan «Bilimsellik» maddesi kapsamında, öğrencilerimize bilimselokur-yazarlığı öğretmek amaçlı oluşturulmuştur. BVÜ öğrencilerinin bu aşamalarıbirebir yaşayarak ve yaparak öğrenmelerinin eğitimlerine önemli katkısınınolacağı ve benzer uygulamaların yaygınlaşmasının ülkemizde araştırmacı-hekimsayısında artış sağlayacağı kanısındayız., Aim: Research Training Program, which will enable to carry out scientific research by taking responsibility of each student, is carried out in our faculty with an internship called “Scholarly Concentrations Program” in clinical period. The aim of this study is to explain how the practice is done and to evaluate and to share the experiences gained.Material and Methods: In this internship, there are six modules whose purpose and content are determined. In these modules, there are conferences for research education and stages of research that students have prepared together with their advisors. Students choose a adviser among faculty member and sign a standard contract with them. A commission called the Scientific Internship Commission has been established to plan, conduct and control this program. From the first module, students should create a research question with their advisors, make scientific literature reviews, get approval from the ethics committee, and prepare a project if necessary and apply to Scientific Research Projects Unit (BAP). They also have the responsibility to receive statistical support and to continue and complete the research. In the modules, lectures are given by faculty members on research principles. Students are divided into small groups and present the stages of their projects to members of the Scientific Internship Commission and their group friends. Stages of each module have been created and published in a manual. At the end of three semesters of internship, students present their research in the form of oral or poster presentations in the “Research Day” activities organized at Medical Day. The Scientific Internship Commission organizes the program, takes part in the modules and evaluates the feedback received from all parties and reports to the upper units. The members of the Johns Hopkins University, which with whom we coordinate with the program, also contribute to each module. Measurement and evaluation is carried out with a structured scoring system for each module.Results: Scholarly Concentration in 2015-2016 academic year has begun with Term IV and on 14 March 2017 a total of 93 research has been completed and presented as an oral or poster presentation. On the 14th of March 2018, 100 students, who completed the next semester successfully, completed their studies. At present, 130 students in Term IV and 126 students in Term V are continuing their studies to carry out research projects. The research abstracts of 193 students have been published in the supplementary edition of Bezmialem Science, and it is planned to publish the completed projects each year.Conclusion: Scholarly Concentration is designed to teach students scientific literacy. We think that the learning of BVU students by making and living these stages will have a significant contribution to their education. We believe that the spread of similar practices will increase the number of researcher physician in our country.

WOS: 000511173500009, Amaç: Hem kronik hepatit B (KHB) hem de hepatosteatoz karaciğerde nekroinflamasyona yol açabilir. Bu nedenle hepatosteatozun varlığı antiviral tedavinin etkinliğini olumsuz yönde etkileyebilir. Bu çalışmada karaciğer yağlanmasının KHB’de entekavir (ETV) ve tenofovir (TDF) alan hastalarda virolojik yanıta etkisinin değerlendirilmesini amaçladık. Yöntemler: Çalışma retrospektif olarak planlandı. Yirmi dokuz farklı merkezde, Ocak 2012-Haziran 2017 tarihleri arasında İnfeksiyon Hastalıkları ve Klinik Mikrobiyoloji kliniklerinde KHB tanısıyla antiviral tedavi verilen tüm hastalar hastane dosyası kayıtları incelenerek tarandı. Bulgular: Çalışmaya toplam 1069 hasta dahil edildi. Çalışmaya dahil edilen hastaların 650’si TDF, 419’u ETV tedavisi almaktaydı. TDF tedavisi alanlarda steatoz olan hastalarda 48. haftada elde edilen virolojik yanıt oranı daha yüksekti (p=0.029). ETV tedavisi alan hastalarda steatoz olmayan hastalarda 24. ve 48. haftadaki virolojik yanıt oranı daha yüksekti (p=0.001). Hepatosteatozu olan hastalarda TDF ve ETV tedavilerinin etkinliği karşılaştırıldı ve virolojik yanıt yönünden 48. hafta sonunda virolojik yanıtın TDF grubunda yüksek olduğu tespit edildi. Sonuçlar: Steatoz, her iki nükleoz(t)id tedavisinin kısa dönemdeki sonuçları bakımından virolojik yanıt üzerinde etkili olsa bile uzun dönemdeki sonuçlar bakımından virolojik yanıtı etkilememektedir., Objective: Both chronic hepatitis B (CHB) and hepatosteatosis may lead to necroinflammation in liver. Therefore, the presence of hepatosteatosis might negatively affect the efficacy of antiviral therapy. We aimed to determine the effect of hepatosteatosis on virological response in patients with CHB receiving entecavir (ETV) and tenofovir (TDF) treatment. Methods: The study was designed retrospectively. All patients receiving antiviral therapy due to CHB in the departments of Infectious Diseases and Clinical Microbiology of 29 different hospitals between January 2012 and June 2017 were searched by examining medical records. Results: A total of 1069 patients were included. Six hundred and fifty of the patients had been receiving TDF and 419 of them had been receiving ETV. The rate of virological response obtained at the 48'h week of TDF was higher in patients with steatosis (p=0.029). Virological response at the 24th week and 48th week of ETV were higher in the patients without steatosis (p=0.001). TDF and ETV therapies were compared in the patients with hepatosteatosis and it was found that the virological response at 48th week was higher in the TDF group. Conclusion: Although steatosis has an effect on virological response in the short-term results of nucleos(t)ide therapy, it does not have any effect on virological response in the long-term results.

Objectives: Elvitegravir/cobicistat/emtricitabine/tenofovir alafenamide (E/C/F/TAF) is a recommended and widely used regimen for HIV infection. In this study, we aimed to determine the efficacy and safety of E/C/F/TAF in people living with HIV (PLWH), who are either treatment-naïve or switched from any tenofovir disoproxil fumarate-containing regimen. For switched patients, we aimed to determine the impact of switching from tenofovir disoproxil fumarate (TDF) to TAF on lipid profile and kidney functions. Methods: ACTHIV-IST Study Group produced a database, and five dedicated HIV centres in Istanbul entered data of PLWH who switched from any TDF-containing regimen to E/C/F/TAF and treatment-naïve patients who were initiated with the E/C/F/TAF regimen between January 2017 and December 2019. Clinical findings, viral parameters, lipid studies, renal function tests, adverse events and adherence to the treatment were recorded in this prospective observational study. Results: The study included a total of 614 switched and treatment-naïve patients. Of 430 treatment-experienced patients, 89% (382) were men, and the mean age was 42 ± 12 years. Among them, 47% (181/382) self-identified as men who have sex with men (MSM). The median duration of HIV diagnosis was 54 ± 29 months. The median duration of E/C/F/TAF use was 20 ± 36 months and that of previous treatment was 23 ± 18 months. HIV-RNA was undetectable at baseline and month 12 in 84.1% (360/428) and 86.1% (328/381) of patients, respectively ( p > 0.05). Mean CD4 counts were 708 ± 287 cells/µL and 802 ± 305 cells/µL at baseline and month 12, respectively ( p < 0.001). Serum creatinine levels remained stable during the treatment period. Mean total cholesterol levels at baseline and month 12 were 172 and 211 mg/dL ( p < 0.01), LDL-cholesterol 104 and 138 mg/dL ( p < 0.01), HDL-cholesterol 39 and 49 mg/dL ( p < 0.01) and triglycerides 134 and 174 mg/dL ( p < 0.01), respectively. The treatment was generally well tolerated. Eight patients discontinued the therapy (drug interaction: 3; lost to follow-up: 1; pregnancy: 1; pulmonary tuberculosis: 1; side effect: 1; patient’s decision: 1). Of 184 treatment-naïve patients, 88% (162) were men, and the mean age was 36.5± 12 years. Among them, 50% (81/162) self-identified as MSM. The mean duration of HIV infection was 21.6 ± 17.1 months. The mean duration of E/C/F/TAF use was 16 ± 4 months. HIV-RNA was undetectable at baseline and month 12 in 1% and 89.1% of patients, respectively. Mean CD4 counts at baseline and month 12 were 469 ± 223 cells/µL and 740 ± 298 cells/µL, respectively. During the treatment period, creatinine levels remained stable. Total cholesterol, LDL-cholesterol, triglyceride and also HDL-cholesterol levels increased. Mean total cholesterol levels at baseline and month 12 were 167 and 211 mg/dL ( p < 0.01), LDL-cholesterol 108 and 143 mg/dL ( p < 0.01), HDL-cholesterol 41 and 47 mg/dL ( p < 0.01) and triglycerides 136 and 172 mg/dL, respectively ( p < 0.01). The treatment was generally well tolerated. Three patients discontinued the therapy (drug interaction: 1; non-responder: 1; patient’s decision: 1). Conclusion: Starting with or switching to E/C/F/TAF in PLWH effectively suppresses HIV infection, is associated with an increase in CD4 cell count and is well tolerated in a real-life setting. Renal functions remained stable during the treatment. E/C/F/TAF use was associated with an increase in LDL-cholesterol and triglyceride levels along with an increase in HDL-cholesterol levels.

Introduction:Although vaccines are the safest and most effective means to prevent and control infectious diseases, the increasing rate of vaccine hesitancy and refusal (VHR) has become a worldwide concern. We aimed to find opinions of parents on vaccinating their children and contribute to available literature in order to support the fight against vaccine refusal by investigating the reasons for VHR on a global scale.Methodology:In this international cross-sectional multicenter study conducted by the Infectious Diseases International Research Initiative (ID-IRI), a questionnaire consisting of 20 questions was used to determine parents' attitudes towards vaccination of their children.Results:Four thousand and twenty-nine (4,029) parents were included in the study and 2,863 (78.1%) were females. The overall VHR rate of the parents was found to be 13.7%. Nineteen-point three percent (19.3%) of the parents did not fully comply with the vaccination programs. The VHR rate was higher in high-income (HI) countries. Our study has shown that parents with disabled children and immunocompromised children, with low education levels, and those who use social media networks as sources of information for childhood immunizations had higher VHR rates (p < 0.05 for all).Conclusions:Seemingly all factors leading to VHR are related to training of the community and the sources of training. Thus, it is necessary to develop strategies at a global level and provide reliable knowledge to combat VHR.Keywords:Vaccine hesitancy; parents; vaccine refusal.Copyright (c) 2022 Yakup Cag, Mohammad Emad al Madadha, Handan Ankarali, Yasemin Cag, Kubra Demir Onder, Aysegul Seremet-Keskin, Filiz Kizilates, Rok Civljak, Ghaydaa Shehata, Handan Alay, Sevil Alkan-Ceviker, Fatma Yilmaz-Karadag, Meliha Cagla-Sonmezer, Manar Ezzelarab Ramadan, Dumitru Irina Magdelena, Ljiljana Betica Radic, Jurica Arapovic, Fatma Kesmez-Can, Nagwa Mostafa El-Sayed, Oladapo Babatunde Campbell, Gulden Eser-Karlidag, Reham Khedr, Mehmet Emirhan Isik, Michael Mihailov Petrov, Roxana Cernat, Umran Erturk, Yesim Uygun-Kizmaz, Eva Huljev, Fatma Amer, Mehmet Resat Ceylan, Andrea Marino, Gulnur Kul, Tuba Damar-Cakirca, Yara Mohsen Khalaf, Arzu Cennet Isik, Olumuyiwa Elijah Ariyo, Ismail Necati Hakyemez, Rezaul Karim Ripon, Abdorrahim Afkhamzadeh, Emine Kubra Dindar-Demiray, Osasona Oluwadamilola Gideon, Maya Belitova, Mustafa Altindis, Rehab El-Sokkary, Recep Tekin, Mohammed Ahmed Garout, Joanna Zajkowska, Farhan Fazal, Muhammed Bekcibasi, Mirsada Hukic, Summiya Nizamuddin, Serkan Surme, Ricardo Fernandez, Amani El-Kholy, Nasim Akhtar, Saadia Ijaz, Andrea Cortegiani, Meliha Meric-Koc, Hakan Hasman, Agah Victor Maduka, Jehan Ali ElKholy, Sema Sari, Mumtaz Ali Khan, Yasemin Akin, Sukran Kose, Hakan Erdem.

Background: In this cross-sectional, international study, we aimed to analyze vector-borne and zoonotic infections (VBZI), which are significant global threats. Method: VBZIs’ data between May 20–28, 2018 was collected. The 24 Participatingcountries were classified as lower-middle, upper-middle, and high-income. Results: 382 patients were included. 175(45.8%) were hospitalized, most commonly in Croatia, Egypt, and Romania(P = 0.001). There was a significant difference between distributions of VBZIs according to geographical regions(P < 0.001). Amebiasis, Ancylostomiasis, Blastocystosis, Cryptosporidiosis, Giardiasis, Toxoplasmosis were significantly more common in the Middle-East while Bartonellosis, Borreliosis, Cat Scratch Disease, Hantavirus syndrome, Rickettsiosis, Campylobacteriosis, Salmonellosis in Central/East/South-East Europe; Brucellosis and Echinococcosis in Central/West Asia; Campylobacteriosis, Chikungunya, Tick-borne encephalitis, Visceral Leishmaniasis, Salmonellosis, Toxoplasmosis in the North-Mediterranean; CCHF, Cutaneous Leishmaniasis, Dengue, Malaria, Taeniasis, Salmonellosis in Indian Subcontinent; Lassa Fever in West Africa. There were significant regional differences for viral hemorrhagic fevers(P < 0.001) and tick-borne infections(P < 0.001), and according to economic status for VBZIs(P < 0.001). The prevalences of VBZIs were significantly higher in lower-middle income countries(P = 0.001). The most similar regions were the Indian Subcontinent and the Middle-East, the Indian Subcontinent and the North-Mediterranean, and the Middle-East and North-Mediterranean regions. Conclusions: Regional and socioeconomic heterogeneity still exists for VBZIs. Control and eradication of VBZIs require evidence-based surveillance data, and multidisciplinary efforts.

We aimed to explore factors for optimizing antimicrobial treatment in emergency departments. A single-day point prevalence survey was conducted on January 18, 2020, in 53 referral/tertiary hospitals in 22 countries. 1957 (17%) of 11557 patients presenting to EDs had infections. The mean qSOFA score was 0.37 +/- 0.74. Sepsis (qSOFA >= 2) was recorded in 218 (11.1%) patients. The mean qSOFA score was significantly higher in low-middle (1.48 +/- 0.963) compared to upper-middle (0.17 +/- 0.482) and high-income (0.36 +/- 0.714) countries ( P < 0.001). Eight (3.7%) patients with sepsis were treated as outpatients. The most common diagnoses were upper-respiratory (n = 877, 43.3%), lower-respiratory (n = 316, 16.1%), and lower-urinary (n = 201, 10.3%) infections. 1085 (55.4%) patients received antibiotics. The most-commonly used antibiotics were beta-lactam (BL) and BL inhibitors (n = 307, 15.7%), third-generation cephalosporins (n = 251, 12.8%), and quinolones (n = 204, 10.5%). Irrational antibiotic use and inappropriate hospitalization decisions seemed possible. Patients were more septic in countries with limited resources. Hence, a better organizational scheme is required.

Infective endocarditis (IE) is a rare but still important as an infectious disease due to high rate of morbidity and substantial mortality. Although IE is not a notifiable disease in Turkey, and an incidence study has not been performed, the incidence may be higher than that in the developed countries due to frequent predisposing cardiac conditions and higher rates of nosocomial bacteremia, which may lead to IE in risk groups. IE generally affects the elderly in developed countries but it is frequently encountered among young individuals in Turkey. In order to reduce mortality and morbidity, it is critical to diagnose IE, to determine the causative agent, and to start treatment rapidly. Most patients cannot be diagnosed at the first visit, about half can be diagnosed after 3 months, and the disease often goes unnoticed. In patients diagnosed with IE, the rate of the identification of a causative organism is significantly lower in Turkey than that in developed countries. Some important microbiological diagnostic tests are not performed in most centers and several antimicrobials that are recommended as the first option for the treatment particularly antistaphylococcal penicillins, are unavailable in Turkey. These problems necessitate reviewing the epidemiological, laboratory, and clinical characteristics of IE in our country, as well as the current information about its diagnosis, treatment, and prevention together with local data. The diagnosis and treatment processes of IE should be standardized at every stage so that the management can be conducted in a setting in which physicians of various specialties are involved and is consistent with the current recommendations. The Study Group for Infective Endocarditis and Other Cardiovascular Infections of the Turkish Society of Clinical Microbiology and Infectious Diseases called for the collaboration of the relevant specialist organizations to establish a consensus report on the diagnosis, treatment, and prevention of IE in the context of current information and local data in Turkey.

Hasan, M. Shahnaz/0000-0002-7493-7416; Abouqal, Redouane/0000-0002-6117-4341; Altindis, Mustafa/0000-0003-0411-9669; Masjedi, Mansoor/0000-0001-6175-9289; Popescu, Roxana/0000-0002-9387-1141; Mikaszewska-Sokolewicz, Malgorzata A/0000-0002-1148-7817; Meco, Basak Ceyda/0000-0003-2951-9634; Kumar, Perikala Vijayananda/0000-0001-8315-7000; Zand, Farid/0000-0003-3489-3372; Maghsoudi, Behzad/0000-0002-1279-8799; KAMARUL ZAMAN, MAZUIN/0000-0002-7920-6399; Gan, Chin Seng/0000-0002-6758-4798; Horoz, Ozden Ozgur/0000-0001-7590-650X; Medeiros, Eduardo A/0000-0002-6205-259X; Sabetian, Golnar/0000-0001-8764-2150; UNAL, SERHAT/0000-0003-1184-4711; Gan, Chin Seng/0000-0002-6758-4798; Delia, Muntean/0000-0001-9100-4530; Yalcin, Ata Nevzat/0000-0002-7243-7354; Leblebicioglu, Hakan/0000-0002-6033-8543; Horhat, Florin George/0000-0001-6133-0204; Yousef, Reham H. A./0000-0003-4004-3008; Delgado Aguirre, Hector Alberto/0000-0001-5448-7975; El Kholy, Amani/0000-0002-0645-7664; Rodriguez Ferrer, Marena Luz/0000-0002-8053-8454; Sanaei Dashti, Anahita/0000-0002-2827-3575; KARABAY, OGUZ/0000-0003-1514-1685; Barahona G., Nayide/0000-0003-3559-6900; Stagnaro, Juan Pablo/0000-0003-3836-9957; Alexandru Florin, Rogobete/0000-0003-1286-4431; KAYA, ZEYNEP/0000-0002-8468-2103; Dragan, Barbara/0000-0003-3108-4211; alvarez Moreno, carlos Arturo/0000-0001-5419-4494; Gonzalez Martinez, Marisela del Rocio/0000-0003-1474-736X; Jayatilleke, Kushlani/0000-0002-3931-6630; Unal, Necmettin/0000-0002-9440-7893; Duszynska, Wieslawa/0000-0002-5880-4904; Ngo, Quy Chau/0000-0002-6787-2757; Elmanakhly, Arwa/0000-0001-8557-0536; yildizdas, dincer/0000-0003-0739-5108; Kanj, Souha/0000-0001-6413-3396; Gupta, Umesh/0000-0001-7717-1404 WOS: 000392626300014 PubMed: 27742143 Background: We report the results of International Nosocomial Infection Control Consortium (INICC) surveillance study from January 2010-December 2015 in 703 intensive care units (ICUs) in Latin America, Europe, Eastern Mediterranean, Southeast Asia, and Western Pacific. Methods: During the 6-year study period, using Centers for Disease Control and Prevention National Healthcare Safety Network (CDC-NHSN) definitions for device-associated health care-associated infection (DAHAI), we collected prospective data from861,284 patients hospitalized in INICC hospital ICUs for an aggregate of 3,506,562 days. Results: Although device use in INICC ICUs was similar to that reported from CDC-NHSN ICUs, DA-HAI rates were higher in the INICC ICUs: in the INICC medical-surgical ICUs, the pooled rate of central lineassociated bloodstream infection, 4.1 per 1,000 central line-days, was nearly 5-fold higher than the 0.8 per 1,000 central line-days reported from comparable US ICUs, the overall rate of ventilator-associated pneumonia was also higher, 13.1 versus 0.9 per 1,000 ventilator-days, as was the rate of catheterassociated urinary tract infection, 5.07 versus 1.7 per 1,000 catheter-days. From blood cultures samples, frequencies of resistance of Pseudomonas isolates to amikacin (29.87% vs 10%) and to imipenem (44.3% vs 26.1%), and of Klebsiella pneumoniae isolates to ceftazidime (73.2% vs 28.8%) and to imipenem (43.27% vs 12.8%) were also higher in the INICC ICUs compared with CDC-NHSN ICUs. Conclusions: Although DA-HAIs in INICC ICU patients continue to be higher than the rates reported in CDC-NSHN ICUs representing the developed world, we have observed a significant trend toward the reduction of DA-HAI rates in INICC ICUs as shown in each international report. It is INICC's main goal to continue facilitating education, training, and basic and cost-effective tools and resources, such as standardized forms and an online platform, to tackle this problem effectively and systematically. (C) 2016 Association for Professionals in Infection Control and Epidemiology, Inc. Published by Elsevier Inc. All rights reserved. VDR; Foundation to Fight against Nosocomial Infections The funding for design, development, maintenance, technical support, data validation, and report generation of the Surveillance Online System, and the activities carried out at International Nosocomial Infection Control Consortium headquarters, were provided by VDR and the Foundation to Fight against Nosocomial Infections.

WOS: 000463053800027, Introduction: Hand hygiene is one of the most cost-effective infection control measures. In this multicenter Study we analysed the hand hygiene compliance observation results of 15 hospitals in Turkey. Materials and Methods: This study was performed in intensive care units (ICUs) of 15 hospitals (Eight terriary-care educational hospitals, six state hospitals and one private hospital) from 11 cities from six regions of Turkey The observations were made by infection control practitioners according to the World Health Organization - Five Moments for Hand Hygiene (WHO-5) indications rule for hand hygiene and overall compliance rates were calculated. Observations were unblinded (healthcare professionals knew that they were observed). The study period included 2015 and 2016 calendar years. Results: There was a statistically significant increase in hand hygiene compliance rates in 2016 versus 2015. The overall number of hand hygiene indications and compliance in 2015 and 2016 were 60071/78116-76,9% and 66551/83607-79,6% (p=0.0001), respectively. Nurses were the most compliant group in both years. The highest compliance was in after body fluid exposure indication (88.2%-2015 and 91.4%-2016) while the lowest compliance was in before patient contact indication (61.3%-2015 and 65%-2016). Conclusion: The presented data suggest that under unblinded observations, hand hygiene compliance seems to be in relatively acceptable rates in Turkey. Centers with compliance rates below 50 percentile rates in any of the 5 moments should increase efforts to enhance compliance in that indication.

Infective endocarditis is a growing problem with many shifts due to ever-increasing comorbid illnesses, invasive procedures, and increase in the elderly. We performed this multinational study to depict definite infective endocarditis. Adult patients with definite endocarditis hospitalized between January 1, 2015, and October 1, 2018, were included from 41 hospitals in 13 countries. We included microbiological features, types and severity of the disease, complications, but excluded therapeutic parameters. A total of 867 patients were included. A total of 631 (72.8%) patients had native valve endocarditis (NVE), 214 (24.7%) patients had prosthetic valve endocarditis (PVE), 21 (2.4%) patients had pacemaker lead endocarditis, and 1 patient had catheter port endocarditis. Eighteen percent of NVE patients were hospital-acquired. PVE patients were classified as early-onset in 24.9%. A total of 385 (44.4%) patients had major embolic events, most frequently to the brain (n = 227, 26.3%). Blood cultures yielded pathogens in 766 (88.4%). In 101 (11.6%) patients, blood cultures were negative. Molecular testing of vegetations disclosed pathogens in 65 cases. Overall, 795 (91.7%) endocarditis patients had any identified pathogen. Leading pathogens (Staphylococcus aureus (n = 267, 33.6%), Streptococcus viridans (n = 149, 18.7%), enterococci (n = 128, 16.1%), coagulase-negative staphylococci (n = 92, 11.6%)) displayed substantial resistance profiles. A total of 132 (15.2%) patients had cardiac abscesses; 693 (79.9%) patients had left-sided endocarditis. Aortic (n = 394, 45.4%) and mitral valves (n = 369, 42.5%) were most frequently involved. Mortality was more common in PVE than NVE (NVE (n = 101, 16%), PVE (n = 49, 22.9%), p = 0.042)., SCOPUS: ar.j, info:eu-repo/semantics/published