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Aim of this study is to evaluate the epidemiological, clinical characteristics and the parameters that determine the clinical course and prognosis of the COVID-19 patients admitted to the Ankara City Hospital during the first month of the pandemic In Turkey. SARS-CoV-2 PCR positive patients who were hospitalized between March 10 and April 10, 2020 were included. Among 222 patients, mean age was higher in SARI/critical disease group (p < 0,001). Median time from illness onset to admission, presence of co-morbidity, especially coronary artery disease and chronic obstructive pulmonary disease, was significantly higher in severe acute respiratory illness (SARI)/critical disease group (p < 0.05). Cough and fever were the most common symptoms, while anosmia and loss of taste were observed in 8.6 % and 7.7 % patients, respectively. Mortality rate was 5.4 %. High neutrophil/lymphocyte ratio, low lymphocyte, monocyte and platelet count, elevated liver enzymes, low GFR, high levels of muscle enzymes, ferritin and IL-6 on admission were found to be associated with SARI/critical disease (p<0.05). Bilateral ground-glass opacity and patchy infiltration were more frequently seen in SARI/critical disease group (p < 0.001). Patients older than 65 years have 8-fold increased risk for development of SARI/critical disease. This cohort study regarding COVID-19 cases in Turkey reveals that older age, presence of co-morbidity, bilateral infiltration on CT, high neutrophil/lymphocyte ratio, low monocyte and platelet count, elevated liver enzymes, low GFR, high levels of muscle enzymes, and high levels of ferritin and IL-6 on admission are predictors of SARI and severe disease.

Although brucellosis is very common in the world and Türkiye, there are no evidence-based guidelines to guide the diagnosis and treatment of the disease. This guide has been prepared by the Turkish Society of Clinical Microbiology and Infectious Diseases to provide evidence-based recommendations to physicians from different specialties interested in the diagnosis and treatment of brucellosis. The recommendations of the Clinical Practice Guide Development Guide of the Infectious Diseases Society of America (IDSA) were taken as the basis for preparing this guide. The guideline preparation group determined 20 questions considered to be important in the diagnosis and treatment of brucellosis, and the publications that could answer these questions prepared in PICO (Population/Patient [P], Intervention [I], Comparison [C], Outcome [O]) format, were searched in ULAKBİM Tr Dizin, PubMed, Cochrane databases without date restrictions. The Grading of Recommendations, Assessment, Development, and Evaluation (GRADE) Working Group method was used to rank the evidence and determine the strength of the recommendations for each PICO question and for each individual outcome. Meta-analyses of comparative clinical studies were performed to answer the PICO questions. Individual participant data (IPD) meta-analyses with data obtained from case reports and case series were conducted in the absence of comparative clinical studies. It is planned to update the recommendations at regular intervals in line with the results of new studies.

Background:Candida auris (now Candidozyma auris) is an emerging pathogen that causes nosocomial candidemia, particularly in intensive care unit (ICU) settings. Its high resistance rates, prolonged environmental persistence, and outbreak potential underscore the need for robust comparative studies with non-auris Candida species (NACS). Methods: In this retrospective, case–control study, adult ICU patients with candidemia were enrolled between April 2022 and October 2024. Clinical data, risk factors, and mortality at 14, 30, and 90 days were compared between the C. auris and NACS groups. Univariate and multivariate logistic regression analyses were performed to identify mortality-associated factors. Results: Of the 182 patients analyzed, candidemia due to C. auris was identified in 33 (18.1%) cases, while 149 (81.9%) cases involved NACS. Fluconazole resistance (p < 0.001), prior antifungal exposure (p = 0.003), urinary catheter use (p = 0.040), and the length of ICU stay before the onset of candidemia (p < 0.001) were significantly higher in the C. auris cases. However, mortality rates at 14, 30, and 90 days were similar between the groups (p = 0.331, 0.108, and 0.273, respectively). The Sequential Organ Failure Assessment score was the only consistent independent predictor of mortality at all time points. In the NACS cases, the Pitt Bacteremia Score and sepsis also predicted 30- and 90-day mortality. While late recurrence was more frequent in the cases of C. auris, early recurrence and other risk factors were similar between the groups. Conclusions:C. auris candidemia was associated with higher fluconazole resistance, prior antifungal use, longer ICU stay, more frequent urinary catheterization, and later recurrence than the NACS cases. However, the mortality rates at 14, 30, and 90 days were comparable. Outcomes were primarily influenced by illness severity rather than the infecting Candida species, highlighting the importance of timely therapy, stewardship, and infection control.

Endocarditis is the most common cause of death from brucellosis. The information used to guide the management of cases with Brucella endocarditis has relied on case reports/series. Risk factors related to death and other adverse outcomes in patients with Brucella endocarditis were identified by an individual-patient data analysis of all reported Brucella endocarditis cases in the literature. The keywords “Bruce” and “endocard” were used to search articles published until July 2022 on PubMed and ULAKBIM databases. Case reports/series containing patients with endocarditis caused by Brucella spp., aged ≥17 years, and with data on antimicrobial or surgical treatment were included in the study. Epidemiological, clinical, laboratory, and treatment characteristics and outcomes of 273 cases from 86 eligible articles were recorded. It was found that male gender, a Wright serum tube agglutination (STA) titer of ≥1/1280 on admission, development of heart failure due to endocarditis were independent risk factors that increase mortality, while the usage of aminoglycoside and cardiac surgical intervention for endocarditis were factors reducing mortality. Including streptomycin or gentamicin in the treatment regimen may benefit patients with Brucella endocarditis. Valve surgery could be life-saving in patients with Brucella endocarditis. An STA titer of ≥1/1280, which probably reflects long-term and advanced disease, may be used as a marker for increased mortality. However, additional and more reliable studies are needed to define the most appropriate management approach in diagnosing and treating cases with Brucella endocarditis due to the low quality of the current evidence.

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.