Investigation of atypical agents in respiratory tract infections

Bu prospektif çalışmada, yaklaşık 1 yıllık bir sürede (Ocak 1999-Mayıs 2000) solunum yolu infeksiyonlarının etyolojik tanısı için 7 viral ve 3 atipik bakteriye ait antijenler immünfloresan yöntemle araştırılmıştır. Solunum yolu infeksiyonu semptomu olan pediatrik (grup l, 76 olgu) ve erişkin (grup II, 135 olgu) yaş grubundaki hastalarda, solunum yolu sekresyonları elde edilmiştir. Etyolojik tanı; pediatrik olgularda %45.4, erişkin olgularda ise %67.3 oranında konulmuştur. Grup l ve grup ll'de sırasıyla; Chlamydia pneumoniae %17.8, %13.3; Mycoplasma pneumoniae %0, %9.6; influenza A virüsü %3.9, %16.3; adenovirüs %3.9, %14.8; parainfluenza virüs tip 1 %5.3, %7.4; respiratuar sinsityal virüs %9.2, %1.5; parainfluenza virüs tip 2 %3.9, %3.0 ve influenza B virüs %1.3, %1.5 oranlarında tespit edilmiştir. Hastaların %2.6 ve %3.9'unda birden fazla etken bulunurken, parainfluenza virüs tip 3 ile Legionella pneumophila'ya ait antijen tespit edilmemiştir. Kullanılan immünfloresan yöntemin etyolojik tanıya katkısı ve sonuçların rasyonel antibiyotik kullanımına etkisi tartışılmıştır.In this prospective study, 7 viral and 3 atypical bacteria antigens were investigated by immunofluorescence method during January 1999-May 2000 for the etiological diagnossis of respiratory tract infections. Respiratory tract secretions were obtained from children (group I, 76 cases) and adults (group II, 135 cases) who had symptoms of respiratory tract infections. Etiological diagnosis was reported as 45.4% in pediatric cases and 67.3% in adults. In group I and group II; the rates of Chlamydia pneumoniae was 17.8%, 13.3%; Mycoplasma pneumoniae 0%, 9.6%; influenza A virus 3.9%, 16.3%; adenovirus 3.9%, 14.8%; parainfluenza virus type 1 5.3%, 7.4%; respiratory syncytial virus 9.2%, 1.5%; parainfluenza virus type 2 3.9%, 3.0%; and influenza B virus 1.3%, 1.5% respectively. In 2.6% and 3.9% of the patients in two groups two or more etiological agents were identified. Parainfluenza virus type 3 and Legionella pneumophila antigens could not be determined in any of the patients. The advantage of immunofluorescence method for the etiological diagnosis and the effect of results to the rational antibiotic use were discussed

Investigation of atypical agents in respiratory tract infections

Bu prospektif çalışmada, yaklaşık 1 yıllık bir sürede (Ocak 1999-Mayıs 2000) solunum yolu infeksiyonlarının etyolojik tanısı için 7 viral ve 3 atipik bakteriye ait antijenler immünfloresan yöntemle araştırılmıştır. Solunum yolu infeksiyonu semptomu olan pediatrik (grup l, 76 olgu) ve erişkin (grup II, 135 olgu) yaş grubundaki hastalarda, solunum yolu sekresyonları elde edilmiştir. Etyolojik tanı; pediatrik olgularda %45.4, erişkin olgularda ise %67.3 oranında konulmuştur. Grup l ve grup ll'de sırasıyla; Chlamydia pneumoniae %17.8, %13.3; Mycoplasma pneumoniae %0, %9.6; influenza A virüsü %3.9, %16.3; adenovirüs %3.9, %14.8; parainfluenza virüs tip 1 %5.3, %7.4; respiratuar sinsityal virüs %9.2, %1.5; parainfluenza virüs tip 2 %3.9, %3.0 ve influenza B virüs %1.3, %1.5 oranlarında tespit edilmiştir. Hastaların %2.6 ve %3.9'unda birden fazla etken bulunurken, parainfluenza virüs tip 3 ile Legionella pneumophila'ya ait antijen tespit edilmemiştir. Kullanılan immünfloresan yöntemin etyolojik tanıya katkısı ve sonuçların rasyonel antibiyotik kullanımına etkisi tartışılmıştır.In this prospective study, 7 viral and 3 atypical bacteria antigens were investigated by immunofluorescence method during January 1999-May 2000 for the etiological diagnossis of respiratory tract infections. Respiratory tract secretions were obtained from children (group I, 76 cases) and adults (group II, 135 cases) who had symptoms of respiratory tract infections. Etiological diagnosis was reported as 45.4% in pediatric cases and 67.3% in adults. In group I and group II; the rates of Chlamydia pneumoniae was 17.8%, 13.3%; Mycoplasma pneumoniae 0%, 9.6%; influenza A virus 3.9%, 16.3%; adenovirus 3.9%, 14.8%; parainfluenza virus type 1 5.3%, 7.4%; respiratory syncytial virus 9.2%, 1.5%; parainfluenza virus type 2 3.9%, 3.0%; and influenza B virus 1.3%, 1.5% respectively. In 2.6% and 3.9% of the patients in two groups two or more etiological agents were identified. Parainfluenza virus type 3 and Legionella pneumophila antigens could not be determined in any of the patients. The advantage of immunofluorescence method for the etiological diagnosis and the effect of results to the rational antibiotic use were discussed

Immunosuppressive therapy and the risk of hepatitis B reactivation: Consensus report

This consensus report includes expert opinions and recommendations regarding the screening, and if necessary, the follow-up, prophylaxis, and treatment of hepatitis B before the treatment in patients who will undergo immunosuppressive therapy due to the risk of hepatitis B reactivation emergency. To increase awareness regarding the risk of hepatitis B reactivation in immunosuppressive patients, academicians from several university health research and training centers across Turkey came together and discussed the importance of the subject, current status, and issues in accordance with the current literature data and presented solutions

In a real-life setting, direct-acting antivirals to people who inject drugs with chronic hepatitis c in Turkey

Background: People who inject drugs (PWID) should be treated in order to eliminate hepatitis C virus in the world. The aim of this study was to compare direct-acting antivirals treatment of hepatitis C virus for PWID and non-PWID in a real-life setting. Methods: We performed a prospective, non-randomized, observational multicenter cohort study in 37 centers. All patients treated with direct-acting antivirals between April 1, 2017, and February 28, 2019, were included. In total, 2713 patients were included in the study among which 250 were PWID and 2463 were non-PWID. Besides patient characteristics, treatment response, follow-up, and side effects of treatment were also analyzed. Results: Genotype 1a and 3 were more prevalent in PWID-infected patients (20.4% vs 9.9% and 46.8% vs 5.3%). The number of naïve patients was higher in PWID (90.7% vs 60.0%), while the number of patients with cirrhosis was higher in non-PWID (14.1% vs 3.7%). The loss of follow-up was higher in PWID (29.6% vs 13.6%). There was no difference in the sustained virologic response at 12 weeks after treatment (98.3% vs 98.4%), but the end of treatment response was lower in PWID (96.2% vs 99.0%). In addition, the rate of treatment completion was lower in PWID (74% vs 94.4%). Conclusion: Direct-acting antivirals were safe and effective in PWID. Primary measures should be taken to prevent the loss of follow-up and poor adherence in PWID patients in order to achieve World Health Organization’s objective of eliminating viral hepatitis

Pathogenesis of HIV Infection

Although 15 years have elapsed from the first reported HIV infection, the pathogenesis has been understood recently. Plasma HIV RNA quantity and viral load can be correctly quantified with new sensitive assays nowadays. Recent advances have greatly illuminated on the virologic and immunologic dynamics of HIV infection. In the light of these findings, an individual’s risk of disease progression can be assessed early in the course of the infection and the efficacy of antiretroviral therapies can now be determined accurately and expeditiously

Azoles

Azole class of antifungal agents has been used in treatment of invasive fungal infections since 1944. The azoles classified as imidazoles or triazoles according to the number of nitrogen in the azole ring. Fluconazole, itraconazole, voriconazole, posaconazole, ravuconazole, albaconazole and isavuconazole were reviewed in this manuscript

Anti-sitomegalovirus (HCMV) IgM pozitif olgularda HCMV antijenemisinin araştırılması

Sitomegalovirus (HCMV); gebelikte, yenidoğan döneminde ve immünsüpresif konakta önemli infeksiyonlara neden olan bir etkendir. Seroloji, kültür ve moleküler yöntemler erken ve pratik tanı için yetersiz kalmaktadır. Anti-HCMV IgM pozitifliği antijenemi döneminden sonra görülmektedir. Ancak özellikle bağışıklığı baskılanmış bireylerde antijenemi ile anti-HCMV IgM pozitifliği eşzamanlı bulunabilmektedir. Bu çalışmanın amacı, anti-HCMV IgM ile antijeneminin birlikte olduğu durumları saptamak idi. Anti-HCMV IgM pozitifliği saptanan ve gebelik, böbrek yetmezliği, malignensi ve akut ateşli hastalık gibi klinik tablolara sahip 56 değişik olguda, immünfloresans yöntemiyle HCMV antijenemisi (HCMV pp65) araştırıldı. Yalnız lenfoma nedeniyle kemoterapi alan bir olguda pozitiflik saptandı. HCMV antijenemisinin araştırılması anti-HCMV IgM pozitif olguların yerine, transplant alıcısı, seronegatif gebe gibi risk altındaki kişilerde periyodik olarak yapılması gerektiği sonucuna varıldı

Fungal Infections; Species Distribution and Treatment Response

Introduction: Fungal infections are rapidly progressive, life threatening, difficult to recognize and resistant to antifungals. In recent years, these infections are frequently encountered. It is aimed to determine the fungal infections and the distribution of fungal species seen in our hospital, and the antifungal treatment response of the patients. Materials and Methods: Data collected from the medical records of the patients with fungal strains included demographic characteristics, underlying diseases, invasive procedures, treatment and outcome. The strains were identified through germ tube test, clamdiospor formation and a commercial kit labeled API 20C AUX. Antifungal susceptibility was investigated by microdilution and E test methods. Results: A total of 125 fungal strains isolated from the patients (61 female and 49 male) were evaluated. 37.3% of the patients included in our study were hospitalized in the anesthesiology-reanimation intensive care unit, 18.2% of them in the internal medicine unit, and 44.5% of them in other units. Of patients’ clinics, 24.5% was found to be consistent with candidemia and 75.5% with candiduria. The distribution of the strains isolated from both clinical samples is as follows: 59.2% (74/125) of the strains was Candida albicans, 15.2% (19/25) was Candida tropicalis, 12.8% (16/125) was Candida parapsilosis, 4.8% (6/125) was Candida krusei, 4% (5/125) was Trichosporon asahii, 1.6% (2/125) was Candida kefyr, 2.4% (3/125) was Candida glabrata, Candida lipolytica and Candida lusitaniae, each with one isolate. Antifungal treatment response rate was 89.5%. Conclusion: Our results show the importance of defining the fungal agents isolated at the level of species. It is also emphasized that clinical findings along with the fungal culture results and the characteristics of the underlying disease are of great importance in deciding how to treat fungal infections

Cyclospora cayetanensis Infection in Immunocompetan Cases

Cyclospora cayetanensis one of the coccoidian parasite which presenting by gastrointestinal symptoms like prolonged wet diarrhea, abdominal pain, anorexia, weakness and nausea gastrointestinal diseases. Infections are mostly seen in immunocompromised hosts such HIV/AIDS patients. The clinical spectrum of the diseases can vary from asymptomatic infection to life-threating infections in immunocompromised patients. Differantial diagnosis should be made carefully and proper antibiotic treatment should be given in symptomatic cases. It should pay attention to distinguish C. cayetanensis from Cryptosporidium cysts on stool exams especially. In our study, 22 and 88 years-old symptomatic male patients with C. cayetanensis infection had been presented. Diagnosis is made by modified Ziehl-Neelsen staining and ultraviole microscopy in addition to direct microscopy in our patients. Both of the patients had no history of travel and antibiotic consumption however young patient had fast-food habits. Anti-HIV antibodies were found as negative in sera samples. Our patients were evaluated as immunocompetent individuals. The patient which had prolonged symptoms been treated successfully by trimethoprim-sulphametoxazole (TMP-SMX) 2 x 160/800 mg/day orally during one week. In other patient, succesfull response was achieved by moxifloxacin 1 x 400 mg/day IV which mainly starting for treatment of cellulitis and the treatment was continued for one week. Cyclopora cayatensis cycts were completely disappeared on control stool examinations in addition to improvement of clinical findings in our cases. Relapse was not observed in the three month follow-up of patients. C. cayetanensis should also take into consideration for immunocompetent patients with complaint of enteritis or nausea, abdominal pain. If these patients have prolonged complaints they should also treat such as immunocompromiseds