Naiv hepatit C enfeksiyonlu hastaların on-altı yıllık prognozu

Objectives: In this study, we aimed to evaluate the clinical course of treatment-naive patients infected with hepatitis C virus (HCV) who were followed up in various centers in Turkey. Materials and Methods: This was a retrospective study performed with the participation of 15 centers. Patients aged 18 years and older with HCV infection were included. Results: A total of 391 treatment-naive patients infected with HCV were included in this study. During the follow-up period, the final values of alanine aminotransferase, aspartate transaminase, and total protein were significantly decreased when compared to the initial values (p<0.001, p<0.001, and p=0.005, respectively). In the study group, 19.2% of the patients underwent liver biopsy and 4.1% underwent transient elastography (FibroScan). An increased histological activity index (HAI) score and fibrosis in the second biopsy were observed in one patient, only increased HAI in two patients and increased fibrosis in one patient, as shown on the FibroScan. In the 16 years of the study period, cirrhosis was radiologically detected in only one patient. Conclusion: Even if rapid progression is not observed, close monitoring of the clinical findings related to liver failure and fibrosis with invasive or non-invasive methods may be useful.Amaç: Bu çalışmada ülkemizin çeşitli merkezlerinde takip edilen naiv hepatit C virüs (HCV) ile enfekte hastaların klinik seyrini değerlendirmeyi amaçladık. Gereç ve Yöntemler: Bu çalışma retrospektif olarak 15 merkezin katılımıyla gerçekleştirilmiştir. Çalışmaya 18 yaş üstü, HCV enfeksiyonu olan hastalar dahil edilmiştir. Bulgular: Çalışmada 391 tedavi-naiv HCV enfeksiyonlu hasta yer almıştır. Hastaların takip süresinde son alanine aminotransferase, aspartate transaminase ve total protein değerleri ilk düzeyine göre önemli düzeyde azalmıştır (sırasıyla p<0,001, p<0,001, p=0,005). Çalışma grubunda hastaların %19,2’sine karaciğer biyopsisi, %4,1’ine elastografi (FibroScan) uygulanmıştır. Takip esnasında bir hastada ikinci biyopside histolojik aktivite indeksi (HAI) ve fibroziste artma, iki hastada sadece HAI’da artma, birinde FibroScan ile fibrozis değerinde artma olduğu gözlenmiştir. Bir hastada 16 yıl içinde radyolojik olarak siroz saptanmıştır. Sonuç: Hızlı progresyon gözlenmemekle birlikte hastaların izleminde karaciğer yetmezliği ile ilgili klinik bulguların ve invaziv veya noninvaziv yöntemlerle fibrozisin yakın takibi yararlı olabilir

Characteristics of Streptococcus Strains Isolated From Clinical Specimens Other Than Throat Culture and Characteristics of Streptococcal Infections

Aim: This study was to investigate the laboratory and clinical features of patients in whom Streptococcus spp. were isolated from cultures other than throat cultures. Methods: A total of 161 Streptococcus strains isolated from clinical specimens from 101 (64%) hospitalized patients and 65 (36%) outpatients and clinical and laboratory features of patients were investigated retrospectively. Isolated Streptococcus strains were further identified for type and antibiotic susceptibility according to the Clinical and Laboratory Standards Institute guidelines. Results: Streptococcus strains types were determined as follows; group A (9-5.6%), group B (64-39.7%), group C (2-1.2%), group D (2-1.2%), group G (2-1.2%), viridans (57-32.2%), and Streptococcus pneumonia (24-14,9%). Most frequently observed infections were urinary system infections (52-32.2%), skin and soft tissue infections (48-29.8%) and pulmonary infections (25-15.5%). In 87 (54%) of patients, there was more than one comorbid condition. While all group A Streptococcus pyogenes strains were susceptible to penicillin, 13% of Streptococcus pneumonia were resistant to penicillin and 36.3% were resistant to macrolides. Mortality was observed in eight patients. Conclusion: Invasive streptococcal infections may cause serious mortality and morbidity especially in patients with comorbid conditions. Early detection and appropriate antimicrobial therapy are most important parameters for the management of streptococcal infections

Characteristics of Streptococcus Strains Isolated From Clinical Specimens Other Than Throat Culture and Characteristics of Streptococcal Infections

Aim: This study was to investigate the laboratory and clinical features of patients in whom Streptococcus spp. were isolated from cultures other than throat cultures. Methods: A total of 161 Streptococcus strains isolated from clinical specimens from 101 (64%) hospitalized patients and 65 (36%) outpatients and clinical and laboratory features of patients were investigated retrospectively. Isolated Streptococcus strains were further identified for type and antibiotic susceptibility according to the Clinical and Laboratory Standards Institute guidelines. Results: Streptococcus strains types were determined as follows; group A (9-5.6%), group B (64-39.7%), group C (2-1.2%), group D (2-1.2%), group G (2-1.2%), viridans (57-32.2%), and Streptococcus pneumonia (24-14,9%). Most frequently observed infections were urinary system infections (52-32.2%), skin and soft tissue infections (48-29.8%) and pulmonary infections (25-15.5%). In 87 (54%) of patients, there was more than one comorbid condition. While all group A Streptococcus pyogenes strains were susceptible to penicillin, 13% of Streptococcus pneumonia were resistant to penicillin and 36.3% were resistant to macrolides. Mortality was observed in eight patients. Conclusion: Invasive streptococcal infections may cause serious mortality and morbidity especially in patients with comorbid conditions. Early detection and appropriate antimicrobial therapy are most important parameters for the management of streptococcal infections

Listeriosis and Infectious Disease Emergencies: Three Cases

Listeria monocytogenes, is the causative agent of life-threatening bacteremia, sepsis, and meningoencephalitis in non-pregnant aduts. Those infectious diseases feared to cause permanent organ and tissue damage and/or death and requiring immediate intervention are known as emergent infections. Although it is an uncommon disease in the community, three adult invasive listeriosis cases diagnosed in two consecutive months, were discussed. For patients suffering from life-threatening bacteremia, sepsis, and central nervous system infections and needing immediate therapy, it is important to add an antimicrobial agent susceptible to L. monocytogenes to prevent complications and improve the outcome of the disease