Background/Introduction: Carbapenem-resistant Klebsiella pneumoniae (CRKP) bacteremia is a serious public health problem due to its high mortality rate and limited treatment options. This study aimed to identify risk factors associated with ceftazidime–avibactam (CAZ-AVI) resistance in CRKP bacteremia and to evaluate its impact on clinical outcomes. Methods: This retrospective single-center cohort study included adult patients with CRKP bloodstream infections treated at a tertiary hospital in Türkiye between January 2021 and December 2024. Demographic, clinical, and laboratory data were collected, and risk factors for CAZ-AVI resistance and 30-day mortality were analyzed. Results: Among 154 patients, 42.8% had CAZ-AVI-resistant strains. Resistant infections were associated with longer hospital stays and higher Charlson Comorbidity Index (CCI) scores. The resistance rate was lower in patients with intra-abdominal infections, while fluoroquinolone and fosfomycin use was more common in the resistant group. The overall 30-day mortality rate was 57%. Pitt bacteremia score and creatinine levels were identified as independent predictors of mortality. Discussion: CAZ-AVI resistance in CRKP bacteremia appears to develop in patients with prolonged hospitalization and high comorbidity burden. These factors likely increase exposure to resistant microorganisms and antibiotic pressure, complicating treatment outcomes. Conclusions: CAZ-AVI resistance in CRKP bacteremia is associated with specific clinical risk profiles and contributes to high mortality. Identifying high-risk patients and optimizing antimicrobial stewardship are essential to improve prognosis.

Brucellosis is a zoonotic disease that causes high rates of morbidity and mortality due to difficulties in diagnosis and inadequate treatment. The purpose of this study was to assess the diagnostic significance of presepsin, trigger receptor expressed on soluble myeloid cells-1 (sTREM-1), and interferon-gamma (IFN-gamma) levels in patients with brucellosis. One hundred twenty-one brucellosis patients aged 18 or over and 39 healthy volunteers were included in this prospective study. The cases were classified as either acute, subacute or chronic according to the duration of symptoms. Serum was separated from blood samples taken from all groups and presepsin, sTREM-1, and IFN-gamma levels were determined before treatment. Serum presepsin, sTREM-1, and IFN-gamma levels were all significantly elevated in patients with Brucellosis compared to the control group (p< 0.05). Serum presepsin and sTREM-1 levels were also significantly higher in patients with acute brucellosis compared to the subacute and chronic groups (p< 0.05). The lowest serum IFN-gamma levels were observed in the chronic Brucellosis group. Significant moderately strong, positive correlations were determined between presepsin and sTREM-1 and IFN-gamma values (r= 0.695, r= 0.769, p< 0.001). Significant low-level positive correlations were observed between presepsin and AST, BUN and CRP (r= 0.215, r= 0.214, and r= 0.279, respectively p< 0.05). Higher serum presepsin levels were determined in patients with positive blood cultures than in those with no blood culture growth (p< 0.05). At a threshold value of 469.43 pg/mL, the presepsin test exhibited 95% sensitivity and 89% specificity in differentiating cases of Brucellosis from the healthy group. At a threshold value of 27.14 pg/mL, the sTREM-1 test exhibited 93% sensitivity and 84% specificity in differentiating Brucellosis cases from the healthy control group. Serum presepsin, sTREM-1 and IFN-gamma levels may be helpful in distinguishing patients with Brucellosis from healthy individuals and in differentiating between acute, subacute, and chronic Brucellosis.

Aims: This study aimed to evaluate changes in human papillomavirus (HPV) knowledge, attitudes toward HPV vaccination, and vaccination intentions following a structured HPV educational intervention among medical students.Methods: This single-group, uncontrolled pretest-posttest study was conducted among 312 medical students in years 1-5 at Balıkesir University Faculty of Medicine between February and June 2026. HPV knowledge was assessed using the validated Turkish 33-item HPV Knowledge Scale (HPV-KS). Attitudes toward HPV vaccination were evaluated using a 20-item Likert-type section, and vaccination intentions were assessed using matched pre- and post-intervention questions. Participants received a standardized face-to-face HPV educational intervention between the pretest and posttest assessments.Results: The total HPV-KS score increased from 19.37±5.89 to 23.57±4.08 (mean change, 4.20; 95% CI, 3.70-4.70; p

Brucellosis and leptospirosis are zoonotic infections with overlapping clinical features, especially in endemic regions. Coinfection of these pathogens is rare and may trigger secondary inflammatory disorders through excessive immune activation. In this report, a rare case of Kikuchi-Fujimoto disease following brucellosis and leptospirosis coinfection with gastrointestinal bleeding was presented. A 31-year-old male presented with fever, malaise, diarrhea and black, foul-smelling stools for three days. Physical examination revealed conjunctival hyperemia, hepatosplenomegaly and diffuse abdominal tenderness. Laboratory findings showed elevated AST, ALT and creatine kinase levels, thrombocytopenia, and prolonged international normalized ratio. Upper gastrointestinal endoscopy demonstrated antral erosions with an active bleeding site. Serologic tests revealed positive Brucella agglutination and Leptospira microscopic agglutination tests with titers of 1/320 and 1/400, respectively. The patient was treated with doxycycline and rifampicin. Three weeks later, he developed painful cervical lymphadenopathy. Excisional biopsy showed necrotizing lymphadenitis consistent with Kikuchi-Fujimoto disease. The patient improved with symptomatic therapy and showed no recurrence at three-month follow-up. Although brucellosis and leptospirosis coinfection is rare, it may induce immune dysregulation leading to secondary inflammatory lymphadenitis. This case highlights the potential link between zoonotic coinfections and Kikuchi-Fujimoto disease and underlines the importance of considering this diagnosis in patients presenting with fever and lymphadenopathy following infectious episodes.