In this multicenter prospective cohort study, it was aimed to evaluate the bacterial and viral etiology in community-acquired central nervous system infections by standart bacteriological culture and multiplex polymerase chain reaction (PCR) methods. Patients hospitalized with central nervous system infections between April 2012 and February 2014 were enrolled in the study. Demographic and clinical information of the patients were collected prospectively. Cerebrospinal fluid (CSF) samples of the patients were examined by standart bacteriological culture methods, bacterial multiplex PCR (Seeplex meningitis-B ACE Detection (Streptococcus pneumoniae, Neisseria meningitidis, Haemophilus influenzae, Listeria monocytogenes, Group B streptococci) and viral multiplex PCR (Seeplex meningitis-V1 ACE Detection kits herpes simplex virus-1 (HSV1), herpes simplex virus-2 (HSV2), varicella zoster virus (VZV), cytomegalovirus (CMV), Epstein Barr virus (EBV) and human herpes virus 6 (HHV6)) (Seeplex meningitis-V2 ACE Detection kit (enteroviruses)). Patients were classified as purulent meningitis, aseptic meningitis and encephalitis according to their clinical, CSF (leukocyte level, predominant cell type, protein and glucose (blood/CSF) levels) and cranial imaging results. Patients who were infected with a pathogen other than the detection of the kit or diagnosed as chronic meningitis and other diseases during the follow up, were excluded from the study. A total of 79 patients (28 female, 51 male, aged 42.1 ± 18.5) fulfilled the study inclusion criteria. A total of 46 patients were classified in purulent meningitis group whereas 33 were in aseptic meningitis/encephalitis group. Pathogens were detected by multiplex PCR in 41 patients. CSF cultures were positive in 10 (21.7%) patients (nine S.pneumoniae, one H.influenzae) and PCR were positive for 27 (58.6%) patients in purulent meningitis group. In this group one type of bacteria were detected in 18 patients (14 S.pneumoniae, two N.meningitidis, one H.influenzae, one L.monocytogenes). Besides, it is noteworthy that multiple pathogens were detected such as bacteria-virus combination in eight patients and two different bacteria in one patient. In the aseptic meningitis/encephalitis group, pathogens were detected in 14 out of 33 patients; single type of viruses in 11 patients (seven enterovirus, two HSV1, one HSV2, one VZV) and two different viruses were determined in three patients. These data suggest that multiplex PCR methods may increase the isolation rate of pathogens in central nervous system infections. Existence of mixed pathogen growth is remarkable in our study. Further studies are needed for the clinical relevance of this result.

Çocukluk dönemi aşı programlarının yaygın kullanımı ile çok sayıda bulaşıcı hastalığın morbidite ve mortalitesi önemli ölçüde azaltılabilmiştir ancak erişkin yaş grubunda aşı ile önlenebilir hastalıklar halen önemli bir halk sağlığı sorunu olmaya devam etmektedir. Bu çalışmada, aşılama endikasyonu bulunan erişkin yaş grubundaki kişilerin altta yatan risk faktörlerine göre aşılanma oranlarının değerlendirilmesi amaçlanmıştır. Bu çalışmada 01.04.2024-30.04.2024 tarihleri arasında enfeksiyon hastalıkları polikliniğine başvuran 18 yaş ve üzeri olgular retrospektif olarak değerlendirilmiştir. Olguların yaş grupları veya altta yatan risk faktörlerine (diyabet, malignite, kronik akciğer, renal veya kardiyak hastalık, sağlık çalışanı vb.) göre aşılama endikasyonları ve aşılama oranları değerlendirildi. Polikliniğimizde değerlendirilen 495 olgunun %56'sını kadın hastalar oluştururken, yaş ortalaması 46,1 ± 18,1 yıl idi. Olguların %19,6'sı 65 yaş ve üzerindeydi ve %15,2'sinin aşılanmaya engel bir durumu bulunmaktaydı. Polikliniğe başvuran 177 kişide kronik hastalık saptanmazken, 201 olguda bir, 117 olguda ise iki veya daha fazla kronik hastalık mevcuttu. Kronik hastalıklar arasında en yaygın olanlar diyabet, hipertansiyon, HIV, otoimmün hastalıklar ve malignitelerdi. Olguların son 10 yıl içindeki aşılama durumlarına göre en yaygın uygulanan aşılar Covid-19, difteri/tetanoz ve pnömokok aşılarıydı. Aşılama endikasyonları benzer olmasına rağmen, tüm hasta gruplarında influenza aşısının pnömokok aşısına kıyasla daha düşük seviyelerde uygulandığı görüldü. Sağlık hizmeti sunucularının erişkin aşılaması konusunda farkındalıklarını artırmak, erişkin bağışıklama polikliniklerinde danışmanlık hizmetlerinin güçlendirilmesi, aşıya erişim kolaylığının sağlanması ve toplum bilincinin artırılması aşılamada kaçan fırsatların önüne geçilmesinde önemli bir katkı sağlayacaktır.

Streptococcus pneumoniae infections continue to pose significant health risks, particularly in adults with underlying conditions. This study assesses both demographic and clinical profiles of adult patients with invasive and non-invasive pneumococcal diseases, focusing on their vaccination status and outcomes. We retrospectively analyzed clinical data from 217 adults diagnosed with pneumococcal infections at Eskişehir Osmangazi University Faculty of Medicine, a tertiary-care university hospital in Eskişehir, Türkiye, from January 2016 to November 2023. Cases meeting specific clinical and microbiological criteria were included. Logistic regression was utilized to identify key predictors of mortality. Of the 217 patients initially screened, 155 were included in the final analysis, comprising 75 cases of invasive and 80 cases of non-invasive disease. Notably, among those recommended for pneumococcal vaccination, only 20.6% were vaccinated, and strikingly, only 9% were vaccinated before infection. Significant correlations were observed between mortality and various factors, including age, comorbidities, bacteremia, invasive disease, and intensive care unit admissions. Mortality occurred in 39 (25.2%) of the patients, with notably higher risks among those with comorbidities and requiring intensive care. Pneumococcal infections continue to impose a significant health burden, particularly among older adults and those with pre-existing conditions. Our findings highlight the critical role of comorbidities and intensive care unit admissions in affecting patient outcomes, stressing the importance of timely interventions and enhanced health strategies to improve vaccination rates and overall outcomes in high-risk populations.

Introduction: Urinary tract infections (UTIs) remain a significant public health issue worldwide, particularly affecting the geriatric population with increased morbidity and mortality. Aging-related immune changes, comorbidities, and urogenital abnormalities contribute to the higher incidence and complexity of UTIs in elderly patients. Antimicrobial resistance, especially extended-spectrum beta-lactamase (ESBL) production and carbapenem resistance, poses a major challenge in managing UTIs in this group. Methods: This retrospective, multicenter study included 776 patients aged 65 and older, hospitalized with a diagnosis of urinary tract infection between January 2019 and August 2024. Clinical, laboratory, and microbiological data were collected and analyzed. Urine samples were obtained under sterile conditions and pathogens identified using conventional and automated systems. Antibiotic susceptibility testing was performed according to CLSI standards. Logistic regression analyses were conducted to identify factors associated with ESBL production, carbapenem resistance, and mortality. Results: Among the patients, the median age was 78.9 years, with 45.5% female. ESBL production was detected in 56.8% of E. coli isolates and carbapenem resistance in 1.2%. Klebsiella species exhibited higher carbapenem resistance (37.8%). Independent predictors of ESBL production included the presence of urogenital cancer and antibiotic use within the past three months. Carbapenem resistance was associated with recent hospitalization, absence of kidney stones, and infection with non-E. coli pathogens. Mortality was independently associated with intensive care admission at presentation, altered mental status, Gram-positive infections, and comorbidities such as chronic obstructive pulmonary disease and urinary incontinence. Discussion: Our findings suggest that urinary pathogens and resistance patterns in elderly patients are similar to those in younger adults reported in the literature, highlighting the need for age-specific awareness in empiric therapy. The identification of risk factors for multidrug-resistant organisms emphasizes the importance of targeted antibiotic stewardship, especially in high-risk geriatric populations. Multicenter data contribute to regional understanding of resistance trends, aiding clinicians in optimizing management strategies for elderly patients with UTIs. Conclusions: This study highlights that E. coli and Klebsiella species are the primary causes of UTIs in the elderly, with resistance patterns similar to those seen in younger adults. The findings also contribute important data on risk factors for ESBL production and carbapenem resistance, supported by a robust patient sample.