Healthcare-associated infections (HAIs) are important because they increase morbidity and mortality, prolong hospital stays, raise healthcare costs, and re

Background & objectives: Crimean-Congo hemorrhagic fever (CCHF) is a tick-bome viral infection with a wide geographic distribution globally. The clinical severity of CCHF varies, with reported mortality rates reaching up to 60%. Despite its spread to new geographic areas and its potential to cause severe and fatal disease, no approved vaccine or antiviral treatment is currently available. Studies on the use of ribavirin for CCHF have yielded conflicting results. Consequently, many physicians manage CCHF patients with supportive care. In this study, we share the positive outcomes observed in CCHF patients who were managed exclusively with supportive treatment without the use of ribavirin. Methods: The epidemiological characteristics, laboratory results and treatment outcomes of patients with CCHF diagnosis followed up in our clinic between April 1 2020, and September 31 2023 were evaluated retrospectively. Results: The study included 20 patients (5 females and 15 male) with confirmed CCHF. Based on the Severity Scoring Index (SSI) scores, 7 patients with SSI 0-2 were classified as mild cases, 12 patients with SSI 3-9 as moderate cases, and 1 patient with SSI 10-13 as a severe case. No patients received ribavirin as part of their treatment. All patients were managed with supportive care, and no mortality was observed. Interpretation & conclusion: Supportive care remains the standard treatment for CCHF management. The effectiveness of ribavirin in CCHF remains unclear.

Background/Objectives: Carbapenem-resistant Klebsiella spp. (CRK) causes healthcare-associated infections with high mortality. This study evaluated the clinical outcomes of ceftazidime–avibactam (CZA) therapy in CRK infections. Methods: Patients hospitalized in a tertiary care hospital in Türkiye between June 2021 and December 2022 with CRK-positive cultures, CZA susceptibility, and ≥72 h of CZA treatment were retrospectively analyzed. Results: Ninety-nine patients (61.6% male; mean age 63.7 ± 17.5 years) were included, 89.9% of whom were treated in the intensive care unit (ICU). Hypertension (29.3%), diabetes (28.3%), and malignancy (26.3%) were the most frequent comorbidities. The main infection types were bloodstream infection (56.6%) and ventilator-associated pneumonia (29.3%). CZA was used as monotherapy in 49.5%, and in combination in 50.5% of cases. The mean treatment duration was 13.2 ± 6.3 days. Clinical improvement occurred at 3.4 ± 1.2 days and microbiological eradication at 4.7 ± 2.1 days. Treatment success was achieved in 76.8% of patients, while 30- and 90-day mortality rates were 48.5% and 72.7%, respectively. Only treatment duration significantly affected clinical outcome (p < 0.001). Conclusions: CZA demonstrates favorable outcomes in CRK infections, with no significant difference between monotherapy and combination therapy. These findings support the use of CZA as an effective treatment option for severe CRK infections in real-world clinical settings and may help guide antimicrobial stewardship strategies in high-risk hospitalized patients.

Background: Candidaemia remains a common, life‐threatening infection among intensive care unit (ICU) patients, with high mortality, particularly in patients with delayed diagnosis and treatment. Objectives: This international, multicentre, prospective, observational study aimed to identify risk factors for candidaemia in ICU patients and to develop an easy‐to‐use predictive tool, the CanDi‐Score, for early initiation of empirical antifungal treatment. Patients/Methods: All adults over 18 years hospitalised for more than 48 h in the ICUs were included in the study and followed for 30 days. Data on demographics, comorbidities, clinical severity scores including APACHE II and SOFA scores, Charlson comorbidity index (CCI), established risk factors for candidaemia and their time‐dependent effects such as total parenteral nutrition (TPN), mechanical ventilation (MV), and central venous catheter (CVC) were collected. Univariate and multivariate logistic regression analyses were used to identify factors associated with candidaemia development, and fast backwards variable selection was used. To account for between‐centre heterogeneity, sensitivity analyses were performed using mixed‐effects logistic regression models including centre‐specific random intercepts. A nomogram model was constructed using independent risk factors identified in multivariable analysis, and its predictive performance was evaluated with Area Under the Curve (AUC), sensitivity, and specificity. Results: A total of 2,704 ICU patients, including 204 with candidaemia, were enrolled. Patients with candidaemia had higher APACHE II (19 vs. 13) and CCI scores (6 vs. 5; both p < 0.001), and more frequently had chronic renal failure, haemodialysis, malignancy, recent gastrointestinal surgery, and neutropenia (all p ≤ 0.05). Patients were randomly split into development (80%) and validation (20%) cohorts. Multivariate analysis identified higher CCI, concurrent infection, neutropenia, ICU stay > 14 days, MV > 3 days, CVC duration and TPN > 14 days as independent risk factors. The risk associated with CVC increased substantially with prolonged use (OR: 0–7 days: 3.69; 8–21 days: 8.58; > 21 days: 17.21). The model demonstrated good performance in both the development and validation cohorts, with sensitivity, specificity, and AUC values of 79.6%, 76.5%, and 0.86 (95% CI: 0.83–0.88) in the development cohort, respectively, and comparable predictive performance in the validation cohort. The score model was demonstrated by a nomogram. Conclusions: Given the high mortality of candidaemia in ICU patients, the CanDi‐Score may serve as a valuable tool for early prediction and timely empirical antifungal treatment. Key predictors include CCI, presence of concurrent infections, the duration of CVC use, and TPN administration. CanDi‐Score provides clinicians with a practical approach to identify high‐risk patients and guides decision‐making for the early initiation of antifungal treatment.