Drug resistance in pulmonary tuberculosis in new and previously treated cases: Experience from Turkey

SummaryThe emergence of drug resistance is a major problem for tuberculosis (TB) control. The aim of this study was to determine the rates of resistance against TB drugs in patients with pulmonary tuberculosis (PTB). Data from 387 patients with active PTB between the years of 1999 and 2004 from the Research and Education Hospital for Chest Diseases and Chest Surgery were evaluated retrospectively. The patients were categorized as new, re-treatment, extrapulmonary and chronic cases. The study group consisted of 268 (69%) new, 57 (14.7%) re-treatment, 49 (12.6%) extrapulmonary and 13 (3.3%) chronic TB cases. The rates of resistance to isoniazid (INH), rifampicin (R), ethambutol (E) and streptomycin (S) were calculated separately for each group. The resistance to any of the drugs was 7.8% in the new cases, 58.5% in the re-treatment cases and 100% in the chronic cases. The multidrug-resistance (MDR)-TB rates were found to be 2.16%, 11.3% and 92.3% among the new, re-treatment and chronic cases, respectively. These data are important as they reflect the drug resistance rates during the pre-notification time period in western Turkey

Risk factors for infections caused by carbapenem-resistant Enterobacterales: an international matched case-control-control study (EURECA)

Cases were patients with complicated urinary tract infection (cUTI), complicated intraabdominal (cIAI), pneumonia or bacteraemia from other sources (BSI-OS) due to CRE; control groups were patients with infection caused by carbapenem-susceptible Enterobacterales (CSE), and by non-infected patients, respectively. Matching criteria included type of infection for CSE group, ward and duration of hospital admission. Conditional logistic regression was used to identify risk factors. Findings Overall, 235 CRE case patients, 235 CSE controls and 705 non-infected controls were included. The CRE infections were cUTI (133, 56.7%), pneumonia (44, 18.7%), cIAI and BSI-OS (29, 12.3% each). Carbapenemase genes were found in 228 isolates: OXA-48/like, 112 (47.6%), KPC, 84 (35.7%), and metallo-beta-lactamases, 44 (18.7%); 13 produced two. The risk factors for CRE infection in both type of controls were (adjusted OR for CSE controls; 95% CI; p value) previous colonisation/infection by CRE (6.94; 2.74-15.53; <0.001), urinary catheter (1.78; 1.03-3.07; 0.038) and exposure to broad spectrum antibiotics, as categorical (2.20; 1.25-3.88; 0.006) and time-dependent (1.04 per day; 1.00-1.07; 0.014); chronic renal failure (2.81; 1.40-5.64; 0.004) and admission from home (0.44; 0.23-0.85; 0.014) were significant only for CSE controls. Subgroup analyses provided similar results. Interpretation The main risk factors for CRE infections in hospitals with high incidence included previous coloni-zation, urinary catheter and exposure to broad spectrum antibiotics

Assessment of Lymph Node Tuberculosis in Two Provinces in Turkey

SUMMARY: The aim of this study was to evaluate lymph node tuberculosis (LNT) cases in two provinces in Turkey with different demographic and socioeconomic characteristics. A total of 109 LNT cases were reviewed retrospectively. The cases were analyzed and compared for symptoms, findings, age, vaccination status, and diagnostic procedures. Socioeconomic conditions were also assessed for the two provinces. A palpable cervical node was considered a significant predictor for all LNT. Mediastinal lymph node involvement was found to be common in cases of pulmonary manifestation of LNT. Female patients were predominantly from the Van Province, while older patients were found to be from Izmir Province. LNT should be suspected in lymphadenitis patients of all age-groups especially in young adolescents with cervical lymph node enlargements. In the presence of mediastinal lymphadenopathy, pulmonary tuberculosis should be investigated

Leaky Forms: A Study of Email and Password Exfiltration Before Form Submission (USENIX Security'22)

The released dataset contains data from ten crawls performed between May 2021 and June 2021 using an extended version of DuckDuckGo’s Tracker Radar Collector.A list of the included crawls is given in the README.md file. Details of the data collection methods can be found in the published paper: Leaky Forms: A Study of Email and Password Exfiltration Before Form Submission (USENIX Security'22). Asuman Senol and Gunes Acar and Mathias Humbert and Frederik Zuiderveen Borgesius. In Proceedings of the 31st USENIX Security Symposium, Boston, USA, August 10–12, 2022.- Project website: https://homes.esat.kuleuven.be/~asenol/leaky-forms/- Paper: https://homes.esat.kuleuven.be/~asenol/leaky-forms/leaky-forms-usenix-sec22.pdf- Crawler source code: https://github.com/leaky-forms/leaky-forms-crawle

Leaky Forms: A Study of Email and Password Exfiltration Before Form Submission

The released dataset contains data from ten crawls performed between May 2021 and June 2021 using an extended version of DuckDuckGo’s Tracker Radar Collector.A list of the included crawls is given in the README.md file. Details of the data collection methods can be found in the published paper: Leaky Forms: A Study of Email and Password Exfiltration Before Form Submission (USENIX Security'22). Asuman Senol and Gunes Acar and Mathias Humbert and Frederik Zuiderveen Borgesius. In Proceedings of the 31st USENIX Security Symposium, Boston, USA, August 10–12, 2022.- Project website: https://homes.esat.kuleuven.be/~asenol/leaky-forms/- Paper: https://homes.esat.kuleuven.be/~asenol/leaky-forms/leaky-forms-usenix-sec22.pdf- Crawler source code: https://github.com/leaky-forms/leaky-forms-crawle

Risk Factors for Presence of Resistant Microorganisms in Sputum Cultures of Patients with Infectious Exacerbations of Chronic Obstructive Lung Disease

Introduction: Antibiotics reduce the risk of short-term mortality. Certain bacteria may be resistant to initial regimens which is related to mortality. The aim of this study was to find risk factors for the presence of resistant bacteria during exacerbation of Chronic Obstructive Pulmonary Disease (COPD). Materials and Methods: Ethics committee approval was obtained for the study. The patients hospitalized with an exacerbation of COPD between 2015 and 2020 were retrospectively ieviewed. The patients with a sputum culture result were divided into: Group A with conventional microorganisms (susceptible to initial antibiotic regimen) and Group B with non-conventional microorganisms (resistant to initial antibiotic regimen). The risk factors for Group B microorganisms were investigated. Results: One hundred and nineteen patients were included in the study. Median age was 68 (40-88) years. There were 22 patients in Group A and 97 in Group B. Most common microorganism in Group A was Haemophilus influenza (12.6%). Most encountered microorganisms in Group B were Pseudomonas aeruginosa (49.6%). Male sex (HR= 2.9; 95% CI= 0.9-9.5; p= 0.073), age >61 (HR=4.8; 95% CI= 1.7-13.6; p= 0.003), and >5 hospitalizations last year (HR= 8.2; 95% CI= 0.9-67.7; p= 0.051) were found to be independent risk factors for resistant microorganisms. Conclusion: Proposed risk factors for the isolation of multidrug resistant microorganism in patients hospitalized with COPD exacerbations should be considered when choosing the initial antibiotic regimen