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.

Coronavirus disease 2019 (COVID-19) has been demonstrated to be the cause of emerging atypical pneumonia. In patients with tracheostomy, coronavirus hypothetically coexists with well-known bacterial agents. A 61-year-old male patient with tracheostomy was admitted to the hospital with dyspnea, fever and increased tracheal secretions. Laboratory findings revealed lymphopenia and elevated C-reactive protein and procalcitonin levels. Chest computed tomography showed consolidation areas and ground-glass opacities more prominent in subpleural areas. Although; two consecutive RT-PCR analyses of combined nasopharengeal/oropharengeal swabs were found to be negative for SARS-CoV-2 RNA, positivity was reported for endotracheal aspirate (ETA) sample. Significant growth of Pseudomonas aeruginosa and Stenotrophomonas maltophilia was detected in the bacterial culture of ETA sample. In conclusion, clinical samples for SARS-CoV-2 should be obtained through the lower respiratory tract, if possible and if upper airway samples are negative. To the best our knowledge, our paper is the first report of the patient with tracheostomy who was treated successfully for COVID-19.

Objective: Multidrug-resistant Gram-negative bacteria cause difficult-to-treat infections associated with high mortality. Carbapenems are widely used; however, their overuse has led to the emergence of carbapenem-resistant bacteria. This study aimed to evaluate the indications, clinical and microbiological efficacy, and side effects of ceftazidime-avibactam (CAZ-AVI) and to identify factors influencing mortality, based on data from a large multicenter patient cohort in Türkiye. Materials and Methods: Patients with carbapenem-resistant but CAZ-AVI-susceptible Gram-negative bacterial infections who received CAZ-AVI treatment were retrospectively reviewed. Results: A total of 1245 patients were included. The most common indication for CAZ-AVI use was hospital-acquired pneumonia (47.8%). Klebsiella pneumoniae was the predominant pathogen (81.3%). CAZ-AVI was used as a monotherapy in 80% of cases. Clinical side effects were observed in 8 (0.64%) patients, while laboratory abnormalities occurred in 73 (5.86%). The 7-day, 14-day, and 28-day all-cause mortality rates were 13.8%, 28.9%, and 45.2%, respectively. Microbiological eradication was achieved in 82.3% of patients. Higher Sequential Organ Failure Assessment (SOFA) and Acute Physiology and Chronic Health Evaluation II (APACHE II) scores at admission, requirement for continuous renal replacement therapy, mechanical ventilation, and elevated C-reactive protein levels were identified as independent risk factors for mortality. Conclusion: This large multicenter real-world analysis demonstrates that CAZ-AVI is an effective treatment option for severe infections with high mortality, such as those caused by carbapenem-resistant Enterobacterales and Pseudomonas aeruginosa.

Objective: We aimed to identify the needs and the roles of infectious diseases and clinical microbiology (IDCM) specialists during the COVID-19 pandemic. Methods: We performed an electronic survey among the IDCM physicians who are members of the Turkish Society of Clinical Microbiology Infectious Diseases (Turkish SCMID, KLİMİK). Results: In total 414 IDCM physicians responded to the survey with a response rate of 22.3%. Sixty-five out of 81 (80%) cities were represented with 300 health care facilities. The participants reported that COVID-19 emergency tasks including swabbing, triage and night shifts performed most commonly by IDCM physicians (92.7%) followed by emergency medicine physicians (86.1%) and daily tasks in inpatient clinics are most commonly performed by IDCM (98%) physicians followed by chest diseases physicians (78.1%). In 20% of health care facilities, the access to personal protective equipment and drugs was limited. The participants reported that from May to August 2020 at least 70 IDCM specialists have resigned because of work overload and exhaustion.
Conclusion: Successful management of a pandemic could only be possible by participation and harmony of all local and national task forces. Professional societies such as KLİMİK became more important after the experience of the pandemic. Keywords: COVID-19, infectious diseases and clinical microbiology specialty, management