Stenotrophomonas maltophilia, a pathogen that colonizes medical equipment and causes nosocomial infections due to its ability to form biofilms, has high mortality rates. This study investigated the risk factors related to mortality in patients who were diagnosed with S. maltophilia bacteremia. It is a multi-center, retrospective ad observational cohort study. The demographic characteristics, clinical findings, microbiological data, and risk factors for patients were obtained from the medical records of patients at ten different hospitals between January 1, 2018, and June 30, 2023. The study included a total of 321 patients. The observed thirty-day mortality rate was 46.1%. A central venous catheter (CVC) was present in 276 patients (86%), and in 66 of these patients (23.9%) the CVC was removed. While only 18 patients (5.6%) received appropriate empirical antibiotics, 242 (75.4%) patients received appropriate antibiotics according to antimicrobial susceptibility test (AST) results and treatment revisions. Multivariate analysis revealed that advanced age (hazard ratio [HR] = 1.02; 95% confidence interval [CI]: 1.00– 1.03), appropriate antibiotic treatment (HR = 0.35; 95% CI: 0.23–0.52), and removal of central venous catheters (HR = 0.31; 95% CI: 0.16–0.60) were significantly related to reduced mortality. S. maltophilia is a significant pathogen, and to reduce its high mortality rate, removal of the CVC and switching to appropriate antibiotics should be performed as soon as possible.

Introduction: Tuberculous lymphadenitis (TBLN) is the most common infectious etiology of peripheral lymphadenopathy in adults, in Turkiye. This study aimed to identify the demographic, clinical, and laboratory variables that differentiate TBLN from non-tuberculous lymphadenitis (NTBLN), as well as the etiology of lymphadenopathy in adults. Methodology: Patients who were over 18 years old and were referred to the infectious disease outpatient clinics with complaints of swollen peripheral lymph nodes, and who underwent lymph node biopsy between 1 January 2010 and 1 March 2021, were included in this multicenter, nested case-control study. Results: A total of 812 patients at 17 tertiary teaching and research hospitals in Turkiye were included in the study. TBLN was the most frequent diagnosis (53.69%). The proportion of patients diagnosed with TBLN was higher among females; and among those who had a higher erythrocyte sedimentation rate, positive purified protein derivative test, and positive interferon-gamma release test result (p < 0.05). However, TBLN was less frequent among patients with generalized lymphadenopathy, bilateral lymphadenopathy, axillary lymphadenopathy, inguinal lymphadenopathy, hepatomegaly, splenomegaly, leukocytosis, and moderately increased C reactive protein levels (p < 0.05). Conclusions: Identifying the variables that predict TBLN or discriminate TBLN from NTBLN will help clinicians establish optimal clinical strategies for the diagnosis of adult lymphadenopathy.

Objective: Multidrug-resistant Gram-negative bacteria cause difficult-to-treat infections associated with high mortality. Carbapenems are widely used; however, their overuse has led to the emergence of carbapenem-resistant bacteria. This study aimed to evaluate the indications, clinical and microbiological efficacy, and side effects of ceftazidime-avibactam (CAZ-AVI) and to identify factors influencing mortality, based on data from a large multicenter patient cohort in Türkiye. Materials and Methods: Patients with carbapenem-resistant but CAZ-AVI-susceptible Gram-negative bacterial infections who received CAZ-AVI treatment were retrospectively reviewed. Results: A total of 1245 patients were included. The most common indication for CAZ-AVI use was hospital-acquired pneumonia (47.8%). Klebsiella pneumoniae was the predominant pathogen (81.3%). CAZ-AVI was used as a monotherapy in 80% of cases. Clinical side effects were observed in 8 (0.64%) patients, while laboratory abnormalities occurred in 73 (5.86%). The 7-day, 14-day, and 28-day all-cause mortality rates were 13.8%, 28.9%, and 45.2%, respectively. Microbiological eradication was achieved in 82.3% of patients. Higher Sequential Organ Failure Assessment (SOFA) and Acute Physiology and Chronic Health Evaluation II (APACHE II) scores at admission, requirement for continuous renal replacement therapy, mechanical ventilation, and elevated C-reactive protein levels were identified as independent risk factors for mortality. Conclusion: This large multicenter real-world analysis demonstrates that CAZ-AVI is an effective treatment option for severe infections with high mortality, such as those caused by carbapenem-resistant Enterobacterales and Pseudomonas aeruginosa.

Background/Objectives: Brucella-related epididymo-orchitis (BEO) is one of the most common genitourinary complications of brucellosis. This study aimed to evaluate the clinical and epidemiological characteristics of BEO in male patients with brucellosis and to identify clinical factors associated with its development. Methods: In this retrospective single-center cohort study, adult male patients diagnosed with brucellosis were included. Patients with and without BEO were compared in terms of epidemiological, clinical, and laboratory characteristics. Multivariate logistic regression analysis was performed to identify clinical factors associated with BEO. Results: Among 262 male patients with brucellosis, BEO was identified in 44 (16.8%). Of these patients, 38 (86.4%) presented with local scrotal symptoms, and combined involvement of the epididymis and testis was observed in 30 patients (68.2%). In univariable analysis, the patients who developed BEO were younger (33 vs. 44 years, p < 0.001), more frequently presented with fever (59.1% vs. 31.2%, p < 0.001), and had a shorter symptom duration (2 vs. 4 weeks, p < 0.001). In addition, leukocyte counts and C-reactive protein levels were significantly higher in this group (p = 0.009 and p < 0.001, respectively). In multivariable analysis, younger age (OR: 0.959, 95% CI: 0.930–0.988, p = 0.006), shorter symptom duration (OR: 0.852, 95% CI: 0.745–0.975, p = 0.020), and the presence of fever (OR: 2.265, 95% CI: 1.103–4.652, p = 0.026) were independently associated with BEO. Conclusions: BEO is a clinically significant genitourinary complication in male patients with brucellosis, notably associated with younger age, shorter symptom duration, and a more pronounced inflammatory response. In endemic regions, BEO should be considered in the differential diagnosis of patients presenting with fever and acute scrotal symptoms.