Assessment of the requisites of microbiology based infectious disease training under the pressure of consultation needs

<p>Abstract</p> <p>Background</p> <p>Training of infectious disease (ID) specialists is structured on classical clinical microbiology training in Turkey and ID specialists work as clinical microbiologists at the same time. Hence, this study aimed to determine the clinical skills and knowledge required by clinical microbiologists.</p> <p>Methods</p> <p>A cross-sectional study was carried out between June 1, 2010 and September 15, 2010 in 32 ID departments in Turkey. Only patients hospitalized and followed up in the ID departments between January-June 2010 who required consultation with other disciplines were included.</p> <p>Results</p> <p>A total of 605 patients undergoing 1343 consultations were included, with pulmonology, neurology, cardiology, gastroenterology, nephrology, dermatology, haematology, and endocrinology being the most frequent consultation specialties. The consultation patterns were quite similar and were not affected by either the nature of infections or the critical clinical status of ID patients.</p> <p>Conclusions</p> <p>The results of our study show that certain internal medicine subdisciplines such as pulmonology, neurology and dermatology appear to be the principal clinical requisites in the training of ID specialists, rather than internal medicine as a whole.</p

Effectiveness of CoronaVac in preventing COVID-19 in healthcare workers

The CoronaVac vaccine was found to be effective against symptomatic COVID-19 and protective against severe disease in phase 3 studies. However, there are little data about its effectiveness in real-world conditions. The aim of the current study was to investigate the protective effect of the CoronaVac vaccine in health-care workers (HCWs) in Turkey, a country where CoronaVac is widely used. The questionnaire was sent to all employees in the form of a survey link by using a telephone application. In the survey, HCWs were asked about demographic characteristics; CoronaVac vaccination status, history of a COVID-19 infection, whether COVID-19 infection was before or after the CoronaVac vaccination; the time between being vaccinated and the COVID-19 infection; the clinical pictures of COVID-19 infection. Those who experienced COVID-19 before vaccination were compared with the breakthrough cases in terms of demographic and clinical features. A total of 628 HCW agreed to participate in the study. A total of 536 (85.3%) volunteers had been vaccinated and 92 (14.6%) had not been vaccinated against COVID-19 with CoronaVac. There was a history of COVID-19 infection in 234 (37.2%) subjects and 188 (35%) had been vaccinated and 46 (50%) not vaccinated. The rate experiencing COVID-19 disease was significantly lower in the vaccinated than the unvaccinated volunteers. The rate of breakthrough cases after CoronaVac was found to be 7%. The hospitalization rate was similar in the breakthrough cases and those who had COVID-19 before CoronaVac vaccination. The results of our study indicate that CoronaVac provides protection against COVID-19

EDITORIAL

WOS: 00045445090000

Pityriasis Rosea in Chronic Hepatitis C REPLY

WOS: 000348654600020

Bacterial Profile and Antimicrobial Resistance Patterns of Diabetic Foot Infections in a Major Research Hospital of Turkey

Background/Aim: Diabetic foot infection (DFI) occurs frequently in patients, followed up with diabetic foot ulcers (DFU). For this reason, antibiotic treatment is often used in patients followed with DFU. Inappropriate use of antibiotics and increasing antibiotic resistance threaten public health. We aimed to investigate the microbial spectrum and antimicrobial resistance patterns isolated from diabetic foot infections in Turkey and help clinicians to choose optimal antibiotics empirically. Materials and Methods: This study was planned as a retrospective, single-center, cross-sectional study. Two hundred sixty-two patients whose causative microorganism was isolated in culture of tissue between 1 January 2021 and 31 December 2022 were included in this study. Bacterial profile and antimicrobial resistance patterns were analyzed. Results: Four hundred thirty two isolates from 262 patients isolated in culture of tissue were evaluated. Of these microorganisms, 57.60% were Gram-negative, 41.20% were Gram-positive bacteria, and 1.2% were Candida spp. The most frequently detected Gram-positive microorganism was Staphylococcus spp. Gram-negative microorganisms were Escherichia coli (E. coli) and Pseudomonas aeruginosa (P. aeruginosa). Polymicrobial infections were observed in 40.5% of the patients. Methicillin-resistant Staphylococcus spp. rate was 51.3%, while extended-spectrum beta-lactamase (ESBL) resistance for E. coli was 66.7%. Conclusions: Due to increasing antibiotic resistance rates, treatment of common infections becomes more difficult. Knowledge of the microbiological profile and antibiotic resistance patterns of patients with DFIs is useful to guide empirical therapy

Clinical importance and cost of bacteremia caused by nosocomial multi drug resistant acinetobacter baumannii

Background: A. baumannii is an important nosocomial pathogen associated with high mortality, morbidity and medical cost. Aim: The aim of this study was to investigate risk factors for MDR A. baumannii bacteremia and also evaluate cost of hospitalization of these patients. Methods: Study was conducted in Ankara Atatürk Training and Research Hospital. Patients who were hospitalized in ICU and diagnosed for nosocomial blood stream infection (BSI) between January 2007 and December 2010 were checked retrospectively. Patients with nosocomial BSI caused by multidrug resistant A. baumannii were compared with the patients who had BSI caused by other Gram-negative microorganisms in terms of risk factors, mortality and medical costs. Findings: In multivariate analysis previous use of carbapenem, quinolone and metronidazole, and SAPS II score were found as independent risk factors. In case group; immunosupression, SAPS II score, and hospital stay until infection were independently associated with mortality in multivariate analysis. Conclusion: Our results suggest that the occurrence of MDR A.baumannii bacteremia was related with the usage of the wide spectrum antibiotics, and mortality rates were increased in patients that high SAPS II scores, long term hospitalization. Infection control procedures and limited antibiotic usage are very important for prevent nosocomial infections

Real life efficacy, renal and lipid profile data of tenofovir alafenamide in switched chronic hepatitis B patients

[No Abstract Available

Remdesivir treatment for patients with moderate to severe COVID-19

Background/aim: Remdesivir, which was first developed for the treatment of Ebola disease but failed to meet expectations, has become hope in the fight against the COVID-19 pandemic. This study aimed to evaluate risk factors for mortality and prognosis of adult moderate/severe COVID-19 patients treated with remdesivir, and safety and tolerability of 5 days of remdesivir treatment. Materials and methods: This multicenter prospective observational study was conducted in 14 centers in Turkey. Pregnancy or breastfeeding, multiorgan failure, or usage of vasopressors for septic shock, ALT>5 x the upper limit of the normal range, or eGRF<30 mL/min or dialysis and receiving favipiravir were the exclusion criteria of the study. Results: Among 500 patients, 494 patients were included in the study. On admission, 392 (79.3%) patients had moderate and 102 (20.6%) patients had severe COVID-19. The 28-day mortality was 10.1%. The median of the scores of the seven-category ordinal scale assessed on days 0, 3, 5, 7 were 4 and 3 on day 14. When the survival status of the patients was evaluated according to the time between the remdesivir start date and the end date of the symptoms, no statistically significant difference was found between the medians of the groups (p = 0.404). In multivariable analysis, age (OR, 1.05; 95%CI, 1.02-1.08; p = 0.003), SpO(2) level on admission (OR, 3.03; 95%CI, 1.35-6.81; p = 0.007), heart rate (OR, 2.48; 95%CI, 1.01-6.07; p = 0.047), follow-up site at the hospital (clinic/ICU) (OR, 26.4; 95%CI, 11.6-60.17; p<0.001) were independently associated with increased mortality. Grade 3 adverse event (AE) was observed in 4 (0.8%) patients. None of the patients experienced grade 4 or 5 AEs. Conclusion: Remdesivir is a safe and well-tolerated drug and older age, low SpO(2) l evel on admission, tachycardia, and ICU admission are independently associated with increased mortality among patients with moderate/severe COVID-19 receiving remdesivir treatment.Health Institutes of Turkey [COVID-19-PMSRMD]Health Institutes of Turkey (Project ID: COVID-19-PMSRMD)