Bloodstream infections (BSIs) caused by carbapenem-resistant Klebsiella pneumoniae (CRKP) are a serious threat to public health. In this study, it was aimed to evaluate the risk factors, treatment, length of hospitalisation and mortality of patients with BSI caused by CRKP. Between October 2021 and October 2023, patients aged 18 years and older who were treated for BSI at Mersin University Faculty of Medicine Hospital and had pathogens identified as CRKP or carbapenem-sensitive Klebsiella pneumoniae (CSKP) were retrospectively reviewed and included in the study. Of the 107 patients with BSI included in the study, 66 (61.7%) had CRKP and 41 (38.3%) had CSKP. The risk factors associated with CRKP in BSIs were found to be acute renal failure (p = 0.048), mechanical ventilation (MV) (p = 0.042), post-earthquake period (p = 0.022) and use of carbapenem (p < 0.0005) and other beta-lactam antibiotics (p = 0.039). Mortality was significantly higher in BSIs caused by CRKP (80.3%/29.3%, p < 0.0005). In the CRKP group, intensive care unit follow-up (p = 0.020), intubation (p = 0.039), MV monitoring (p = 0.025) and concomitant pneumonia (p = 0.043) significantly increased mortality. There were no significant differences in treatment outcomes between ceftazidime-avibactam and carbapenem combinations (p > 0.05). In the CRKP group, the duration of treatment and hospital stay were significantly longer in patients who started treatment three days or later (p = 0.036/p = 0.011). This study demonstrates that identifying risk factors for BSIs caused by CRKP and implementing early treatment protocols may lead to a reduction in treatment time and mortality rate.

Amaç: Bu çalışmada ishal ön tanılı hastaların rotavirüs, enterik adenovirüs ve enterik parazit inceleme sonuçlarının demografik verilerle ilişkilerinin analiz edilmesi amaçlandı. Yöntem: Ocak 2014 – Aralık 2019 tarihleri arasında Niğde Eğitim ve Araştırma Hastanesi laboratuvarında taze dışkı örneğinde immünkromatografik yöntemle çalışılmış rotavirüs, adenovirüs antijeni ve ışık mikroskobu altında 40x büyütmede parazit inceleme sonuçları retrospektif olarak değerlendirildi. Test sonuçları yaşa, cinsiyete, uyruğa, mevsimlere, yıllara ve hastaneye başvuru şekline göre ki-kare yöntemi ile analiz edildi. p değeri <0.05 istatistiksel olarak anlamlı kabul edildi. Bulgular: İncelenen altı yıllık rotavirüs, adenovirüs ve dışkıda parazit inceleme testlerinin pozitiflik oranları; rotavirüs için %7.7, adenovirüs için %2.3 ve parazit inceleme için %16.8 olarak bulundu. Rotavirüs ve adenovirüs pozitifliği en yüksek 0-2 yaş grubunda (%11.1), parazit görülme oranları ise en yüksek 6-10 yaş grubunda (%23.9) tespit edildi. Rotavirüs pozitifliği kış aylarında, parazit görülme oranları ise yaz aylarında yüksek bulundu (p<0.001). Adenovirüs pozitifliği ise sonbahar ve kış aylarında yüksek oranda tespit edildi (p=0.009). Rotavirüs pozitifliği göçmenlerde daha yüksek oranda tespit edildi (p=0.021). Rotavirüs ve adenovirüs pozitifliği yatan hastalarda, gaitada parazit görülme oranları ayaktan başvuran hastalarda yüksek bulundu (p<0.001). Sonuç: Bölgemizde klinik tanı açısından rotavirüs ve adenovirüse bağlı gastroenteritlerin özellikle kış aylarında ve beş yaş ve altı çocuklarda daha fazla görüldüğü, bunun yanında parazitlere bağlı gastroenteritlerin de yaz aylarında ve 6-10 yaş arası çocuklarda daha sık rastlandığı göz önünde bulundurulmalıdır.

The purpose of this study was to evaluate the SARS‐CoV‐2 immunoglobulin M/immunoglobulin G (IgM/IgG) rapid antibody test results in symptomatic patients with COVID‐19 and their chest computed tomography (CT) data. A total of 320 patients admitted to our hospital for different durations due to COVID‐19 were included in the study. Serum samples were obtained within 0–7 days from COVID‐19 patients confirmed by reverse‐transcription polymerase chain reaction (RT‐PCR) and chest CT scan. According to the SARS‐CoV‐2 RT‐PCR results, the patients included in the study were divided into two groups: PCR positive group (n = 46) and PCR negative group (n = 274). The relationship between chest CT and rapid antibody test results were compared statistically. Of the 320 COVID‐19 serum samples, IgM, IgG, and IgM/IgG were detected in 8.4%, 0.3%, and 11.6% within 1 week, respectively. IgG/IgM antibodies were not detected in 79.7% of the patients. In the study, 249 (77.8%) of 320 patients had positive chest CT scans. Four (5.6%) of 71 patients with negative chest CT scans had IgM and two (2.8%) were both IgM/IgG positive. IgM was detected in 23 (9.2%), IgG in one (0.4%), and IgM/IgG in 35 (14%) of chest CT scan positive patients. The rate of CT findings in patients with antibody positivity was found to be significantly higher than those with antibody negativity. The results of the present study show the accurate and equivalent performance of serological antibody assays and chest CT in detecting SARS‐CoV‐2 within 0–7 days from the onset of COVID19 symptoms. When RT‐PCR is not available, we believe that the combination of immunochromatographic test and chest CT scan can increase diagnostic sensitivity for COVID‐19.

The combination of sofosbuvir/velpatasvir/voxilaprevir (SOF/VEL/VOX) is recommended as a salvage therapy for treatment-experienced chronic hepatitis C (CHC) patients. However, it is used in our country for treatment-naïve and treatment-experienced patients. This study aims to present real-world data from Türkiye on CHC patients treated with SOF/VEL/VOX. The present study was conducted by the Viral Hepatitis Study Group of the Turkish Society of Clinical Microbiology and Infectious Diseases (KLİMİK). It was a multicenter, retrospective, observational study. The data were collected from patients receiving SOF/VEL/VOX therapy at 12 medical centers in Türkiye between 1 June 2022 and 31 December 2024. The patients had received the treatment for 8 to 12 weeks. Of the 139 patients enrolled, 63.3% (n = 88) were male, with a mean age of 54.4 years. Most patients were non-cirrhotic (94.2%, n = 131) and treatment-naïve (92%, n = 128); 49.6% (n = 69) were infected with genotype 1b. Early virologic response (EVR) could be assessed in 126 patients, with an EVR rate of 82.5% (n = 104). End-of-treatment data were available for 113 patients, all achieving an end-of-treatment response. Among the 80 patients for whom week-12 post-treatment data were available, 97.5% sustained virologic response at week 12 (SVR12). Significant improvements were observed in AST, ALT, and platelet levels, along with reductions in APRI and FIB-4 scores (p = 0.001).” No serious adverse events leading to treatment discontinuation were reported. Mild adverse events included pruritus (2.1%, n = 3), fatigue (2.1%, n = 3), and nausea (1.4%, n = 2). The SOF/VEL/VOX combination is a highly effective and well-tolerated treatment option in treatment-naïve CHC patients, achieving an SVR12 rate of 97.5%.

Candida species are responsible for 70-90% of invasive fungal infections in the intensive care unit. Early diagnosis and treatment is important in candidemia. Improper diagnosis and treatment increases mortality and morbidity significantly. Because of the late results of blood cultures and low sensitivity of the serological tests when used alone, molecular methods should be investigated in this field. In this study, the results of the Candida real-time polymerase chain reaction (Rt-PCR) test, which was studied from blood culture and whole blood, were compared in patients with high candidemia risk who were followed in the General Surgery Intensive Care and Anesthesiology and Reanimation Unit of Cukurova University Faculty of Medicine. It was aimed to investigate the practical utility of Candida RT-PCR test, which is a rapid diagnosis method in patients with suspected candidemia. In our study, 90 patients with high risk of candidemia according to the criteria determined according to the guidelines were evaluated prospectively. Urine, perineum, axilla, tracheal aspirate culture and two sets of blood cultures were obtained from the patients. Blood sample was also drawn into an ethylenediaminetetraacetic acid (EDTA) tube and stored at -40 degrees C for later Candida Rt-PCR study. In Candida Rt-PCR, species-specific primers were used to distinguish species. Candida score (CS) of the patients was calculated. Forty one (45.5%) of the patients were female and 49 (55.5%) were male. The median age of the patients was 61.5 years. Candida was positive in blood culture in three (3.3%) of the patients included in the study, while Candida Rt-PCR was positive in 17 (18.9%). Candida species detected in the blood culture and Rt-PCR test were compatible with each other. Rt-PCR was significantly more positive (p=0.006). Candida Rt-PCR positivity was significantly higher in patients receiving total parenteral nutrition (p=0.028), malignancy (p=0.021), and history of surgery in the last three months (p=0.003). The difference in CS between patients with PCR positive and PCR negative was statistically significant (p=0.015). Our study was conducted in a high-risk population for candidemia and the results of Candida Rt-PCR was found to be more positive than blood culture. Rt-PCR positivity and blood culture positivity were associated with high CS. In the light of these data, it was thought that it would be appropriate to use molecular methods in the diagnosis and support them with CS, especially in patients with high risk of candidemia. Considering that blood culture, which is the gold standard for the diagnosis of candidemia, gives late results and is 50% positive, using faster diagnostic methods for candidemia is important to reduce mortality and morbidity. The fast and good results of Candida PCR method have shown that it can be used in diagnosis. However, lack of standardization of primers used in PCR tests may cause false positives. Additional studies are needed in this respect.