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

Splenic Abscess in Salmonella Infections

Although during pre-antibiotic period splenic abscess was seen 1.5-1.8% of patients with typhoid fever, recently splenic abscess was reported as a rare complication of Salmonella infections. In order to identify splenic abscess, systemic salmonellosis diagnosed patients with the isolation of Salmonella spp. from blood culture were examined by abdominal ultrasonography prospectively. Splenic abscess was identified two (3.2%) of patients. Primary treatment for splenic abscess is splenectomy accomplished by IV antibiotic usage. Also percutaneous drainage is one of the recent developed treatment. However it is reported that when the infecting microorganism has been identified by a positive blood culture and the lesions were small and solitary, prolonged antimicrobial therapy and follow-up US or CT scanning would be appropriate. Ofloxacin was used for 35 days in one case with spenic abscess and in an other case ciprofloxacin was used for 30 days. After these prolonged treatments clinical and ultrasonographic findings showed complete cure

The Role of Procalcitonin in Diagnosis of Different Bacterial Infections

It is reported that procalcitonin (PCT), the precursor of calcitonin is elevated in patients with severe bacterial infections. In this study our aim is to determine the value of PCT in different bacterial infections and sepsis as a marker of infection. Six brusellosis, 8 systemic salmonellosis, 9 bacterial meningitis, 11 sepsis, total 33 patients and 20 healthy adults as control group were included in the study. PCT value was measured and compared by diagnostic value of C-reactive protein (CRP). PCT determination was performed by immunoluminometric assay (Brahms Diagnostica Lumitest, PCT, Berlin). A significant difference was found between all patients and control group for both tests. There were significant differences between PCT concentrations in sepsis and other bacterial infections but no difference was found for CRP. PCT levels increased in patients with bacterial infections like CRP but PCT was a more valuable marker than CRP for indicating the severity of infection

Comparison of Efficacy and Safety of Doxycycline + Rifampin Combination Versus Rifampin + Trimethoprim-Sulfamethoxazole Combination in the Treatment of Brucellosis

Brucellosis is a zoonosis existing worldwide. Although a variety of combinations of drugs have been used in the treatment of brucellosis, the best regimen has not been clearly determined. In our study 50 cases of acute brucellosis were examined prospectively to compare the efficacy of doxycycline plus rifampin versus rifampin plus trimethoprim-sulfamethoxazole combinations. No statistically significant difference was found between the two regimens but early clinical response was observed in rifampin plus trimethoprim sulfamethoxazole combination

Evaluation of Risk Factors in Nosocomial Vancomycin-Resistant Enterococci Colonization and Infection

Introduction: Vancomycin-resistant enterococci (VRE) have recently been observed as an increasingly responsible agent among nosocomial infections. In our study, we aimed to investigate the possible risk factors for VRE colonization and infection. Materials and Methods: This study was conducted prospectively in the hematology, oncology and bone marrow transplantation departments between September 2004 and April 2005. Rectal swab culture was obtained on admission day and once a week from patients who had been hospitalized in these departments. A follow-up form was completed for each patient. Stata version 8.0 was used for statistical analysis. Results: A total of 462 rectal swab samples were obtained in the seven-month period. VRE was isolated in 13 patients. All these patients were from the hematology department. Female gender, long duration of hospitalization, prolonged neutropenia, total parenteral nutrition, sucralfate usage, central venous catheterization, and duration of antibiotic usage (third- and fourth- generation cephalosporins, metronidazole, amikacin, glycopeptides, macrolides, carbapenems, quinolones) were found as risk factors with univariate analysis. In multivariate analysis, long duration of hospitalization was found as an independent risk factor. Conclusion: Establishing the risk factors for colonization and infection with VRE can contribute to the implementation of effective infection control measures

The evaluation of HBV-DNA levels In patients who had lost Hbsag after recovery from Hepatitis B virus infection

Amaç: Hepatit B enfeksiyonu geçiren kişilerin kanında HBsAg negatifleşse de hepatit B virüsünü bulaştırma riskinin devam ettiği bildirilmektedir. Gereç ve Yöntemler: Çalışmamızda; hepatit B enfeksiyonu geçiren ve HBsAg negatifleşen olgularda, hepatit B virüs DNA’sının polimeraz zincir reaksiyonu yöntemi ile araştırılması amaçlandı. Toplam 57 olgu değerlendirmeye alındı. Akut hepatit B virüs enfeksiyonu geçirip HBsAg negatifleşen 44 olgunun 19’unda (%43,2) hepatit B virüs DNA pozitif saptandı. Bulgular: Doğal immünitesi olup antiHBs pozitif saptanan 13 olgunun ise 2’sinde (%15,4) hepatit B virüs DNA’sı pozitif bulundu. Toplam 21 (%36,8) olguda enfektivitenin devam ettiği gözlendi. Bu olgularda hepatit B virüs DNA düzeyleri 4,6x102 ile 1x105 genom/mL arasında saptandı. Sonuç: Çalışmamızda hepatit B virüs enfeksiyonu geçirip HBsAg negatifleşen olgularda HBV-DNA’nın pozitif olabileceği görülmüştür. Bu nedenle; kan donörü seçiminde antiHBc bakılmasının HBsAg aramaya göre daha güvenilir olduğu, organ transplantasyonu uygulamalarında ise HBV serolojik göstergelerinden herhangi birinin pozitif bulunduğu vericilerde, serum ve dokularda polimeraz zincir reaksiyonu ile hepatit B virüs DNA aranmasının uygun olacağı düşünülmektedir.Objective: The risk of transmitting hepatitis B virus has been reported to continue in the blood of people with loss of HBsAg after recovery from hepatitis B virus infection. The aim of the present study was to investigate the hepatitis B virus DNA in patients with loss HBsAg after recovery from hepatitis B virus infection by using polymerase chain reaction. Materials and Methods: Total 57 cases were evaluated. Hepatitis B virus DNA was detected in 19 (43.2%) of 44 patients with loss of HBsAg after acute hepatitis B virus infection, and in 2 (15.4%) of 13 cases who had natural immunity with positive antiHBs. Results: Infectivity continued in 21 (36.8%) cases. Hepatitis B virus DNA levels were detected between 4.6 x102 with 1x105 genome / mL in these serum samples. Conclusion: In our study, hepatitis B virus DNA can positive in patients with loss of HBsAg after hepatitis B virus infection have been shown. For this reason, antiHBc screening more reliable than HBsAg was thought in the selection of blood donors. It was thought that hepatitis B virus DNA testing with polymerase chain reaction is appropriate in serum and tissues of donors with positive hepatitis B virus serology in the organ transplantation practices

Risk Factors for Oropharyngeal Colonization in Intensive Care Units

In this study, the risk factors for oropharyngeal colonization in intensive care units were determined. Daily throat cultures in the first week and once a week in the following weeks were obtained from the patients admitted to intensive care units of Ankara Numune Education and Research Hospital from October 2000 to December 2000. A hundred and thirty adult patients were included, and the mean age was 53. Risk factors for oropharyngeal colonization were analysed by multivariate logistic regression analysis. The risk factors studied by multivariate analysis were length of stay > 5 days (odds ratios (OR); 5.1, confidence interval (CI); 1.9-13.2, p= 0.001), Glasgow coma scala score < 10 (OR; 4.5, CI; 1.6-12.1, p= 0.003), use of broad spectrum antibiotics (OR; 4.8, CI; 2.3-9.9, p< 0.001)