Background/aim: To have country-wide information about multidrug resistance (MDR) in isolates from community-acquired urinary tract infections (CAUTI) of Turkey, in terms of resistance rates and useful options. Materials and methods: We used a geocode standard, nomenclature of territorial units for statistics (NUTS), and a total of 1588 community-acquired isolates of 20 centres from 12 different NUTS regions between March 2019 and March 2020 were analysed. Results: Of the 1588 culture growths, 1269 (79. 9%) were Escherichia coli and 152 (9.6%) were Klebsiella spp. Male sex, advanced age, and having two or more risk factors showed a statistically significant relation with MDR existence (p < 0.001, p: 0.014, p < 0.001, respectively) that increasing number of risk factors or degree of advancing in age directly affects the number of antibiotic groups detected to have resistance by pathogens. In total, MDR isolates corresponded to 36.1% of our CAUTI samples; MDR existence was 35.7% in E. coli isolates and 57.2% in Klebsiella spp. isolates. Our results did not show an association between resistance or MDR occurrence rates and NUTS regions. Conclusion: The necessity of urine culture in outpatient clinics should be taken into consideration, at least after evaluating risk factors for antibacterial resistance individually. Community-acquired UTIs should be followed up time- and region-dependently. Antibiotic stewardship programmes should be more widely and effectively administrated.

Objective: Urinary tract infections (UTI) are the most common among the community and hospital-acquired infections. Escherichia coli is the most frequently isolated microorganism in UTIs. The treatment is mostly empirical. However, resistance related to the inappropriate use of antibiotics causes problems. Therefore, determining regional antibiotic resistance profiles and regular surveillance is essential. Therefore, we aimed to evaluate the distribution of strains and their resistance patterns isolated from urine samples at our laboratory. Methods: The results of urine samples sent to our laboratory between January 1, 2018, and December 31, 2018, were analyzed retrospectively. Conventional methods and the automatized device performed identification and antimicrobial susceptibility of the isolates. Results: Significant bacterial growth was detected in 2331(14.1%) of 16 521 urine samples, and 2051 were included in the study. The most frequently isolated strain was E. coli (70.4%). The resistance rate was highest for ampicillin (61.4%) among the bacteria that belong to the Enterobacteriaceae family. The most susceptible antibiotics were fosfomycin, imipenem, and meropenem, respectively. Pseudomonas aeruginosa and Acinetobacter spp. were found to have multidrug resistance. ESBL positivity was 19.3%. Among ESBL positive strains, the highest resistance rates were against ampicillin (98.2%). All the Enterococcus spp. isolates were susceptible to linezolid. All the S. saprophyticus isolates were susceptible to ciprofloxacin, linezolid, vancomycin, teicoplanin, and trimethoprim-sulfamethoxazole. All S. agalactiae strains were susceptible to penicillin, vancomycin, teicoplanin, and linezolid. Conclusion: Pathogens responsible for urinary tract infections and antibiotic resistance rates differ among inpatients and outpatients. Therefore, it is essential to identify UTI agents, perform antibiotic susceptibility tests, and conduct surveillance studies at hospitals and regional levels to guide successful empirical treatment of in-and-outpatients.

Background: Bloodstream infections caused by Gram-negative bacteria are highly mortal. In this study, we aimed to investigate the relationship between antimicrobial resistance profile and novel serological biomarkers and mortality in bloodstream infections (BSIs) caused by Gram-negative bacteria in intensive care units (ICUs). Methods: 366 Patients diagnosed with healthcare-associated Gram-negative bloodstream infection in the ICUs of our hospital between February 2015 and December 2021 were included in the study. Demographic variables (age, gender, comorbidities), causative microorganisms and antimicrobial susceptibilities, time to first positive blood culture after hospitalization, length of stay in hospital, surgical procedures, laboratory data (hemograms, C-reactive protein (CRP) levels, albumin), and survival data were collected. Novel serological biomarkers were calculated. Results: Mortality in Gram-negative bloodstream infection was found to be associated with age and novel serological biomarkers, but not with carbapenems and colistin minimum inhibitory concentration (MIC) values. Mortality rates increased with age (p˂0.001). Patients who died had higher C-reactive protein/albumin ratio (CAR) (p<0.001) and neutrophil/lymphocyte ratio (NLR) (p=0.009) and lower prognostic nutritional index (PNI) (p<0.001). Conclusion: The study emphasizes that resistance to colistin and carbapenems is not associated with mortality in BSIs caused by Gram-negative bacteria. Novel serological biomarkers may be useful in predicting mortality. These results support the need for further studies to elucidate the true impact of infections caused by resistant bacteria.

COVID-19 disrupts the balance between coagulation and fibrinolysis. Especially in the clinical course of serious disease, plasminogen activator inhibitor-1 (PAI-1), thrombin activatable fibrinolysis inhibitor (TAFI), and tissue plasminogen activator levels increase in association with hypercoagulable state and hypofibrinolysis. This explains the increased incidence of thrombosis seen in COVID-19 infection. In this study, we aimed to examine the changes in PAI-1 and TAFI levels of COVID-19 patients. Department of Infectious Diseases and Clinical Microbiology, University of Health Sciences, Dişkapi Yildirim Beyazit Training and Research Hospital—Ankara Turkey, between April 1 and May 7, 2021. Patients who were diagnosed with COVID-19 were included in this retrospective study. TAFI and PAI-1 levels were analyzed from the samples that had been stored at –80 °C formerly. One hundred thirty-five patients diagnosed with COVID-19 and followed up in the service or intensive care unit were included in the study. Thirty-four (25.2%) patients required follow-up in the intensive care unit. Mortality rate was 10.4%, the coagulation tests of these patients were also compared. PA1-1 levels were found to be statistically significantly higher in intensive care unit patients (median: 133 pg/mL vs 31 pg/mL; P < .001), and there was no significant difference in TAFI levels (median:7.31 ng/mL vs 9.80 ng/mL; P = .171) between the 2 groups. TAFI levels were found to be higher in patients who died. In COVID-19 infection, as the severity of the disease increases, the coagulation balance deteriorates and eventually a hypercoagulable state occurs with an increase in PAI-1 and TAFI levels. Markers such as PAI and TAFI can be illuminating in further studies in determining prognosis and mortality and developing new treatment options.

Cystic echinococcosis (CE) is an endemic zoonotic disease in Turkey. Despite advances in treatment approaches, full eradication is not always possible. So, recurrence remains a major concern with a long-lasting silent-course necessitating close follow-up. Recurrence has higher morbidity and mortality requiring more complex treatment approaches. We aimed to evaluate the epidemiologic, laboratory data, treatment approaches, and their relationship with recurrence. This retrospective, cross-sectional study assessed patients with CE who were admitted to a training and research hospital between January 2015 and August 2021. Demographic, clinical characteristics, and laboratory findings of the patients were examined, and comparisons were made between those with and without recurrence. Multivariable logistic regression analysis was conducted to identify potential risk factors for CE recurrence. Of the total 214 patients with a mean age was 50.4 ± 16.5 years; 62.6% (n = 134) were female and 60.2 % (129) had a history of living in a rural area. The most common cyst localization was in the liver in 167 (78%). Although the diagnosis was confirmed by imaging methods in all patients, serological test positivity was found only in 72% (n = 140). Recurrence was seen in 17.8% (n = 38) of the patients, and recurrence most commonly occurred within the first 3 years in 25 patients (65.7%), 12 of whom (31.6%) experienced recurrence in the 1st year after treatment. The recurrence rate was higher in the patients with multiorgan involvement (odds ratios [OR] 2.5, 95% confidence interval [CI]: 1.1–5.6, P = .019), a hydatid cyst duration of more than 5 years (OR 5.5, 95% CI: 2.6–11.8, P < .001), and those who underwent invasive procedure (OR 4.6, 95% CI: 1.3–15.7, P = .014). Hydatid cyst duration > 5 years was an independent risk factor for the recurrence of CE (OR 3.5, 95% CI: 1.5–8.1, P = .003). CE is frequently seen in females, especially living in rural areas. It is difficult to diagnose with routine serological testing, so imaging techniques are needed for diagnosis. Although longer duration of the disease, multiorgan involvement, and invasive treatment were more in patients with recurrences, only the long duration of the disease was independently associated with recurrences. In addition, due to presence of very late recurrences, long-term follow-up is important.