This is the first study to evaluate the adequacy and reliability of the ChatGPT and Gemini chatbots on viral hepatitis. A total of 176 questions were composed from three different categories. The first group includes “questions and answers (Q&As) for the public” determined by the Centers for Disease Control and Prevention (CDC). The second group includes strong recommendations of international guidelines. The third group includes frequently asked questions on social media platforms. The answers of the chatbots were evaluated by two different infectious diseases specialists on a scoring scale from 1 to 4. Cohen’s kappa coefficient was calculated to assess inter-rater reliability. The reproducibility and correlation of answers generated by ChatGPT and Gemini were analyzed. ChatGPT and Gemini’s mean scores (3.55 ± 0.83 vs. 3.57 ± 0.89, p = 0.260) and completely correct response rates (71.0% vs. 78.4%, p = 0.111) were similar. In addition, in subgroup analyses with the CDC questions Sect. (90.1% vs. 91.9%, p = 0.752), the guideline questions Sect. (49.4% vs. 61.4%, p = 0.140), and the social media platform questions Sect. (82.5% vs. 90%, p = 0.335), the completely correct answers rates were similar. There was a moderate positive correlation between ChatGPT and Gemini chatbots’ answers (r = 0.633, p < 0.001). Reproducibility rates of answers to questions were 91.3% in ChatGPT and 92% in Gemini (p = 0.710). According to Cohen’s kappa test, there was a substantial inter-rater agreement for both ChatGPT (κ = 0.720) and Gemini (κ = 0.704). ChatGPT and Gemini successfully answered CDC questions and social media platform questions, but the correct answer rates were insufficient for guideline questions.

Introduction: Mpox virus is an orthopoxvirus that causes the zoonotic infectious disease known as mpox. The disease can also spread from humans to humans. It can be transmitted through contact with bodily fluids, lesions on the skin, or internal mucosal surfaces. Method: The number of mpox cases increased during the COVID-19 pandemic. Early diagnosis and prompt management of mpox are critical in people living with HIV (PLHIV). In this study, a cross-sectional survey was conducted among PLHIV followed at the outpatient clinic between 20 April–20 August 2023. A questionnaire was used to assess the knowledge and anxiety levels of patients as well as their opinions about vaccination against mpox. The severity of symptoms in the past two weeks was assessed using the Generalised Anxiety Disorder 7-item scale. A total of 203 PLHIV were interviewed for this survey study. Result: The mean age was 39.37±11.93. The majority of them were male (86.7%), and 41.4% were men who have sex with men (MSM). Only 21 of the surveyed participants (10.4%) had a “good knowledge” score about mpox. The mean knowledge score on human Mpox was 2.05 (min:0-max:8), and 107 (52.7%) had a score of 0. Conclusion: The future study should focus on continuous education, promoting awareness through programs and establishing measures to successfully overcome identified variables that contribute to mpox pandemic understanding and attitudes. Applying the lessons learned from the COVID-19 pandemic will help the management of mpox virus.

Objective: We aimed to define the clinical features and antimicrobial susceptibility profiles of Burkholderia cepacia complex infections and to determine the predictors for mortality. Materials and Methods: Our single-center retrospective study included patients with nosocomial B. cepacia complex infection between 2018 and 2022. We evaluated the predictors of 14-day and 28-day mortality by analyzing clinical and microbiological data. Results: A total of 87 patients were included. Most infections (79.3%) occurred in the intensive care units (ICUs). Among B. cepacia complex isolates, 74.7% were susceptible to trimethoprim-sulfamethoxazole, 70.3% to levofloxacin, 50% to meropenem, and 23.4% to ceftazidime. The rates of 14-day mortality, 28-day mortality, and in-hospital mortality were 41.3% (n=36), 52.8% (n=46), and 64.3% (n=56), respectively. Multivariate analysis revealed neutrophil/lymphocyte ratio (NLR) (odds ratio [OR]=1.05, p=0.024), platelet count (OR=1.00, p=0.011), creatinine (OR=2.14, p=0.006), and aspartate aminotransferase (AST) (OR=1.02, p=0.028) as predictors for 14-day mortality. In addition to NLR (OR=1.07, p=0.014), platelet count (OR=1.00, p=0.039), creatinine (OR=2.05, p=0.008), and AST (OR=1.02, p=0.035), procalcitonin (OR=1.05, p=0.049) was also found as an independent predictor for 28-day mortality. In receiver operating characteristic (ROC) curve analysis for predicting 14-day mortality, area under the ROC curve (AUC) values were 0.684 (p=0.003) in NLR, 0.719 (p<0.001) in platelet count, 0.673 (p=0.003) in procalcitonin, 0.743 (p<0.001) in creatinine, and 0.700 (p<0.001) in AST. In ROC curve analysis for predicting 28-day mortality, AUC values were 0.674 (p=0.002) in NLR, 0.651 (p=0.010) in platelet count, 0.638 (p=0.020) in procalcitonin, 0.730 (p<0.001) in creatinine, and 0.692 (p=0.001) in AST. Conclusion: Increasing antibiotic resistance and higher mortality rates justify that B. cepacia complex is a significant threat to hospitalized patients, especially in ICUs. Elevated levels of NLR, AST, creatinine, procalcitonin, and decreased platelet may predict poor clinical outcomes and could help clinicians in the management of this notorious bacterial pathogen. Keywords: antimicrobial susceptibility, antibiotic resistance, Burkholderia cepacia complex, mortality, predictors

Objective: The causative agent of COVID‐19 is a novel member of coronaviridaes, SARS‐CoV‐2. It has been reported that the spike (S) protein of SARS‐CoV‐2 is responsible of infectivity. The S protein is demonstrated to be inactivated under environmental condition, such as hypertonicity and alkaline pH. The aim of the study was to investigate the effect of hypertonic alkaline nasal irrigation (HANI) on SARS‐CoV‐2.Methods: Sixty patients divided into two groups. The patients in Group 1 used hydroxychloroquine (HCQ), and the patients in Group 2 used HCQ and HANI. Nasopharyngeal samples were collected at the beginning, on 3rd and 7th day of the PCR test positivity. The nasopharyngeal viral load (NVL) changes analyzed with quantitative PCR.Results: NVL decrease in weekly period was statistically significant for both groups, when the difference between NVL day 0 and 3rd in Group 1 and NVL difference between day 0 and 3rd in Group 2 were compared. The difference between Groups 1 and 2 in terms of NVL change was statistically significant (P < 0.05).Conclusion: We demonstrated a significant decrease in nasopharyngeal SARS‐CoV‐2 load with HANI solution and suggest that HANI may be promising modality for the COVID‐19 treatment.Level of evidence: IB

We aimed to compare vaccinated and unvaccinated patients hospitalized with COVID-19 in terms of disease severity, need for intensive care unit (ICU) admission, and death. In addition, we determined the factors affecting the COVID-19 severity in vaccinated patients. Patients aged 18–65 years who were hospitalized for COVID-19 between September and December 2021 were retrospectively analyzed in three groups: unvaccinated, partially vaccinated, and fully vaccinated. A total of 854 patients were included. Mean age was 47.9 ± 10.6 years, 474 patients (55.5%) were male. Of these, 230 patients (26.9%) were fully vaccinated, 97 (11.3%) were partially vaccinated, and 527 (61.7%) were unvaccinated. Of the fully vaccinated patients, 67% (n = 153) were vaccinated with CoronaVac and 33% (n = 77) were vaccinated with Pfizer-BioNTech. All patients (n = 97) with a single dose were vaccinated with Pfizer-BioNTech. One hundred thirteen (13.2%) patients were transferred to ICU. A hundred (11.7%) patients were intubated and 77 (9.0%) patients died. Advanced age (P = 0.028, 95% CI = 1.00–1.07, OR = 1.038) and higher Charlson Comorbidity Index (CCI) (P < 0.001, 95% CI = 1.20–1.69, OR = 1.425) were associated with increased mortality, while being fully vaccinated (P = 0.008, 95% CI = 0.23–0.80, OR = 0.435) was associated with survival in multivariate analysis. Full dose vaccination reduced the need for ICU admission by 49.7% (95% CI = 17–70) and mortality by 56.5% (95% CI = 20–77). When the fully vaccinated group was evaluated, we found that death was observed more frequent in patients with CCI>3 (19.1 vs 5.8%, P < 0.01, OR = 3.7). Therefore, the booster vaccine especially in individuals with comorbidities should not be delayed, since the survival expectation is low in patients with a high comorbidity index.

Introduction: Stenotrophomonas maltophilia is the only opportunistic human pathogen in the genus Stenotrophomonas. These bacteria can be isolated from healthcare settings, possibly resulting in bacterial colonization of medical devices, which cause nosocomial infections. S. maltophilia bacteremia results in high mortality and morbidity. This study aimed to determine the outcomes of S. maltophilia bacteremia and its associated mortality risk factors. Methodology: This was a retrospective study conducted at the University of Medical Sciences, Bakirkoy Dr. Sadi Konuk Training and Research Hospital (Istanbul, Turkey) from December 2015 to December 2022. Medical records, demographic information, clinical conditions, laboratory data, antimicrobial susceptibility, and clinical outcomes were retrospectively analyzed for the period between December 2015 and December 2022. Results: Data from 87 patients (median age 61 years) with bacteremia were included in this study. The most common underlying conditions were diabetes mellitus (DM; 32.2%), hypertension (29.9%), and malignancies (19.5%). The most common sources of bacteremia were central venous catheters (CVCs; 44%), primary blood infection (32%), respiratory tract infection (20.7%), and wound site/abscess infection (2.3%). Seventy-eight percent of the patients were admitted to the intensive care unit (ICU) when bacteremia was detected. The 28-day mortality rate was 55%. The mortality rate was significantly higher in the ICU (p < 0.001). Elevated values of procalcitonin and C-reactive protein, and the presence of CVC were significant risk factors for mortality in those with S. maltophilia bacteremia. Conclusions: S. maltophilia bacteremia should be carefully monitored in patients with CVCs. Timely removal of CVCs can result in decreased mortality.