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Data in the literature on the use of ceftazidime-avibactam (CAZ-AVI) in carbapenem-resistant Klebsiella pneumoniae bloodstream infections (CRKP-BSIs) are limited especially in OXA-48 (Oxacillinase-48) predominant regions. Our study aimed to evaluate the effect of CAZ-AVI use on outcomes in CRKP-BSIs in Turkey, where OXA-48 is endemic. A multicenter retrospective observational study was conducted between January 2017 and September 2021. The effects of clinical and treatment characteristics on 30-day mortality and relapse in CRKP-BSIs were analyzed. Predictors of outcomes were detected using a Cox regression model. The study enrolled 106 adults with CAZ-AVI-sensitive CRKP-BSIs who received CAZ-AVI for at least 72 h. Patients who received CAZ-AVI as initial therapy had lower mortality rates when compared to those who switched from last resort regimens [14.3% (n = 3/21) vs. 37.7% (n = 32/85), p = 0.04]. In multivariate analysis, older age and severe neutropenia were detected to be associated with higher mortality, significantly. Initiation of CAZ-AVI on the day of blood culture was obtained, was found to be significantly associated with lower mortality (HR: 0.25, CI: 0.07–0.84, p = 0.025). CAZ-AVI monotherapy is an important treatment option for CRKP-BSIs in OXA-48 endemic areas. Early initiation of CAZ-AVI should be preferred rather than switching from a last-resort regimen as it profoundly improves the survival rates. [ABSTRACT FROM AUTHOR]

Turkish Society of Clinical Microbiology and Infectious Diseases Viral Hepatitis Working Group updated the consensus report on the management of chronic hepatitis B (CHB) in private hosts and special situations. Relevant literature and international guidelines are reviewed, and agreed recommendations are presented at the end of each chapter. In the report, treatment of hepatitis B virus (HBV) and human immunodeficiency virus (HIV) coinfection, management of HBV and hepatitis C virus (HCV) coinfection, management of CHB in severe COVID-19 patients, non-transplant immunocompromised patients. [ABSTRACT FROM AUTHOR]

The National HIV/AIDS Congress, organized every year by the Turkey HIV/AIDS Platform, which was formed by the five physician associations operating in the field of HIV infection in Turkey, was held in Antalya on 24-27 November 2022. This congress, AIDS and Sexually Transmitted Diseases Association (AIDS and STD Association), HIV/AIDS Prevention and Education Association (HAKED), HIV Infection Association (HIVEND), Turkish Infectious Diseases and Clinical Microbiology Specialist Association (EKMUD) and Turkish Clinical Microbiology and Infectious Diseases (KLİMİK) Association. In addition, the Red Ribbon Association, Positive-iz Association, and Positive Living Association, three subject associations operating in the field, contributed. This report aims to summarize the data presented by the health professionals, health authorities, and non-governmental organizations working at the forefront of the response to the HIV/AIDS epidemic in our country, their shares and discussions during the congress, and to determine the needs by analyzing the current situation in our country in the light of these. [ABSTRACT FROM AUTHOR]

Coinfection with hepatitis B virus (HBV) and hepatitis C virus (HCV) in human immunodeficiency virus (HIV) infected individuals results in increased hepatic complications. HBV and HIV viruses are transmitted by blood and unprotected sexual intercourse. People with HIV and HBV coinfection are at increased risk for liver-related morbidity and mortality. HCV-related liver injury progresses more rapidly among people coinfected with HIV. HCV coinfection may also affect the management of HIV infection. This review aims to go over the management of HIV-HCV and HIV-HBV coinfections. [ABSTRACT FROM AUTHOR]

Coronavirus disease-2019 (COVID-19) is a major global human threat caused by severe acute respiratory syndrome-coronavirus-2 (SARS-CoV-2). Following the first pneumonia case in China in December 2019, humanity faced a dreadful infection in a short period when the World Health Organization declared a pandemic on March 11, 2020. This review aims to look at the epidemiology of COVID-19, the virological characteristics of SARS-CoV-2, and the methods of transmission and prevention. [ABSTRACT FROM AUTHOR]

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Coronavirus disease 2019 (COVID-19), is caused by a novel coronavirus named as Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2). It became a major global health threat in a short time after being declared by the World Health Organization (WHO) as a pandemic on March 11, 2020. Viral, environmental, and host factors play a role in the course of COVID-19. The disease is more common in the elderly, men, and people with diabetes mellitus, hypertension, cardiovascular disease, chronic renal disease, and malignancy. While some risk scores are used to predict ICU admission and mortality, they are not specific to COVID-19. Identifying high-risk individuals and preventing their infection can reduce mortality in the disease. [ABSTRACT FROM AUTHOR]

Recent developments in research have put forward claims on the protective effect of allergic diseases--especially allergic airway inflammation including allergic asthma--against the COVID-19 pandemic. This was first suggested by the underrepresentation of asthma patients in some cohorts and was later investigated by angiotensin-converting enzyme II (ACEII) receptor expression studies. Controversial data on this matter persists and continue to be a challenge for clinicians when it comes to managing allergic diseases during the pandemic. We present in this study a thorough review of related findings so far and our own experience with 2 severe asthma patients who presented with atypical symptoms. Interestingly, both patients were administered anti-IgE therapy prior to the initial positive polymerase chain reaction (PCR) results for COVID-19 and showed no symptoms of severe respiratory disease during the infection unlike what we know from other viral respiratory illnesses. Stemming from that, we wanted to combine the perspectives of allergists and infectious disease specialists to address certain concerns in the management of allergic diseases, such as biologicals, in the light of current guidelines. We have also pointed out certain gaps in clinical and molecular level research, such as the lack of phenotypical subgroup analysis among ill asthma patients and the lack of data concerning the molecular effects of biologicals on viral infection. [ABSTRACT FROM AUTHOR]

Corona virus disease 2019 (COVID-19), caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) virus, affected all the world and has been a major cause for significant morbidity and mortality. COVID-19 represents with pulmonary manifestations, but in more than half of the cases, other organs, especially hepatic involvement, are observed. Chronic hepatitis C (CHC) is an important public health problem worldwide. Sustained virological response (SVR) can be achieved and HCV-related mortality and morbidity can be prevented with direct-acting antiviral agents (DAAs), which have been used in recent years. However, if CHC is not diagnosed, it can cause cirrhosis and liver cancer. Since the diagnosis and treatment of these patients require follow-up, they are among the most affected chronic diseases during the pandemic. It does not seem possible to predict when the COVID-19 outbreak will end. Diagnosis and treatment need of CHC patients should be met in special areas where protection measures are taken in health institutions. In patients who undergo DAA treatment, the follow-up should be carried out by health institutions that do not provide pandemic services, and if necessary, telemedicine should be used. [ABSTRACT FROM AUTHOR]

It has been observed that the degree of pulmonary involvement shown in chest computed tomography (CT) scans tended to decrease as the prevalence of coronavirus disease 2019 (COVID‐19) infection decreased in the Turkish population. The purpose of this study was to investigate the relationship between the disease severity based on chest CT scans and the temporal evolution of the epidemic. This study recruited 179 patients with confirmed COVID‐19 disease who had received a chest CT scan between March 14 and April 28, 2020. The participants were divided into three successive temporal groups based on their date of CT examination. The early (March 14–29), mid (March 30–April 13), and late (April 14–28) groups were compared regarding the presence and extent of pulmonary involvement and CT characteristics of lesions. COVID‐19 pneumonia was less extensive in participants under 45 years of age and patients presenting late in the course of epidemic (i.e., the late group) compared those presenting earlier. When each group was subcategorized on the basis of age, older patients in the late group had less extensive lung involvement than older patients in the early group. However, there was no significant difference in the extent of lung involvement in younger patients between the late and early groups. The severity of COVID‐19 pneumonia appears to be variable at different temporal windows of the epidemic curve and decreases in patients presenting in the later weeks compared to the earlier weeks, particularly in older patients. [ABSTRACT FROM AUTHOR]

Copyright of Klimik Journal / Klimik Dergisi is the property of DOC Design & Informatics Co. Ltd 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 Klimik Journal / Klimik Dergisi is the property of DOC Design & Informatics Co. Ltd 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.)

Objective: The aim of this study was to investigate rotavirus and adenovirus antigens in stool samples of patients who were admitted to the hospital with a preliminary diagnosis of acute gastroenteritis and to determine their distribution by sex, age and seasons. Methods: A total 6525 and 6242 stool samples of patients with acute gastroenteritis, that were sent to Microbiology Laboratory between January 2014 and December 2017 were examined for rotavirus and adenovirus, respectively. Rotavirus group A and adenovirus serotype 40 and 41 antigens were investigated by rapid immunochromatographic test. Results: In 438 (6.7%) of the samples rotavirus antigens and in 80 (1.3%) of them adenovirus antigens were detected. The percentages of male patients in rotavirus- and adenovirus-detected samples were 55% (n=240) and 62.5% (n=50), respectively. Rotavirus positivity was found to be highest in patients aged 13-24 months and in adenovirus patients aged 0-12 months (p<0.05). Rotavirus antigen positivity was observed to be the highest in spring and winter while adenovirus antigen positivity was observed to be the highest in summer and autumn (p<0.001). Conclusions: According to this study, viral gastroenteritis agents were observed more frequently in 0-2 year-old children. Especially in spring, the disease was found to be more common. We are of the opinion that detection of viral agents in patients with acute gastroenteritis will provide both early diagnosis and symptomatic treatment and prevent unnecessary use of empirical antibiotics. [ABSTRACT FROM AUTHOR]

Hepatitis B virus (HBV) infection results in various consequences ranging from asymptomatic state to progressive liver disease, chronic hepatitis, hepatic failure, liver cirrhosis and hepatocellular carcinoma (HCC). Currently available nucleo(s)tide analogue (NA) drugs approved in the treatment, suppress viral replication. Since NAs have little effect on HBV cccDNA synthesis in infected hepatocytes, they do not provide complete cure of HBV infection, and the optimal endpoint of NA therapy, i.e. HBV surface antigen (HBsAg) loss, is rarely achieved. Some of the current HBV management guidelines have begun to consider treatment cessation in selected populations of patients. Concerns regarding treatment cessation include virological and clinical relapse and also the possibility of fibrosis or cirrhosis, hepatic decompensation, liver failure and death. On the other hand, there are some potential concerns about lifelong NA treatment, like side effects on kidneys and bone, increase in the incidence of some chronic conditions such as metabolic syndrome and diabetes mellitus, economic burden to the countries, and possible effects on newborn infants of pregnant women treated with the NAs. So, some unanswered questions remain, namely "in which patients could treatment cessation strategy be effective?" and "what is the optimal time point to perform it?". The outcome of chronic hepatitis B depends on the equilibrium between HBV and the host's immune system. In this review, potential immunological and several viral biomarkers for safe NA discontinuation and areas of uncertainty in deciding the best timing to stop NA treatment in chronic hepatitis B is discussed by summarizing the recommendations on actual guidelines. [ABSTRACT FROM AUTHOR]

Copyright of Klimik Journal / Klimik Dergisi is the property of DOC Design & Informatics Co. Ltd 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 Klimik Journal / Klimik Dergisi is the property of DOC Design & Informatics Co. Ltd 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.)