Five-year experience of neurosyphilis cases in a tertiary care hospital in Turkey

Aim: To evaluate retrospectively the cases of syphilis who applied to different clinics of our hospital in the last 5 years and to emphasize the importance of admission screening tests in the diagnosis of neurosyphilis which is a rare but serious form of syphilis. Methods: Sixty-one patients who admitted to different clinics of our hospital between 2013 and 2017 with different clinical manifestations and positive Venereal Disease Research Laboratory (VDRL) and Treponema pallidum microhemagglutination assay (TPHA) tests were recorded and analyzed retrospectively. Results: Both VDRL and TPHA tests were positive in 44 males with a mean age of 57.4 ± 18.4 years and 17 females with a mean age of 65.3 ± 19.1 years. It was found that of the 61 patients who were examined for differential diagnosis of syphilis, 36 (%59) of them were referred from neurology clinic, 15 (25%) from infectious diseases clinic, 7 (12%) from dermatology clinic and 3 (4%) from gynecology clinic.   The clinical presentation was venereal chancre in 15 cases, asymptomatic ischemic brain lesions in 17 cases, acute ischemic stroke in 13 cases, movement disorder in three cases, tabes dorsalis in two cases, tendinitis-arthritis in eight cases, Amyotrophic lateral sclerosis (ALS) in one case, Deep venous thrombosis (DVT) in one case, and pulmonary nodule in one case.  Conclusions: In conclusion, syphilis is often overlooked in the differential diagnosis in patient with neurological findings. Since neurosyphilis is an easily treatable disease, it should be considered in the differential diagnosis of patients presenting with neurological findings

Investigation of a healthcare-associated candida infections in a Turkish intensive care unit: risk factors, therapy and clinical outcome

Aim: Candida infections develop especially in intensive care unit (ICU) patients and increase the mortality rates. So, early and accurate diagnosis of Candida infections and determination of risk factors are very important. We aimed to retrospectively investigate Candida infections in terms of species and risk factors for candidemia caused by fungi. Methods: Candida infections in critically ill patients hospitalized in the ICU between January 2014 and December 2018 at Bolu Abant Izzet Baysal University Training and Research Hospital were retrospectively analyzed. The isolated Candida species were evaluated according to the sample types. The cases were investigated in terms of mortality due to candidiasis, previously used antibiotics and isolated Candida species. Results: 34 Candida species isolated from fungal cultures in ICUs were included in the study. Candida albicans (73.5%) was the most prevalent species isolated (NAC 26.5%). Patients with Candida isolated in their urine samples (76%) had a higher mortality rate than patients with Candida from other regions. Conclusion: The results of our study suggest that the highest rate of candidiasis (88%) is in patients who received beta-lactam antibiotic treatment. In addition, we think that when Candida species are detected in the urine samples of critically ill patients in the ICU, care should be taken in terms of candidiasis

Investigation of Intrafamilial Transmission in Hepatitis B Surface Antigen (HBsAg) Positive Cases in Harran University Hospital

WOS: 000273915500037Objective: Hepatitis B virus (HBV) is a public health problemowing to communicable and widespreant. In addition to It is important issue because of preventable and prevent to people from contaminated persons. Transmission of HBV may be connected to transmission carrecteristics such as horizontal, vertical, sexual and blood, priority. Aim of this study is to determine the possible route of HBV transmission throughout a family setting. Material and Methods: 173 members (29 spouses, 82 offspring, 11 mothers, 11 fathers and 40 siblings) of 40 index cases (HBsAg carriers and chronic active hepatitis cases) attending the Harran University Medical Faculty Hospital between Augst 2006 and March 2007 were screened prospectively for markers of HBV by using an ELISA. The chi-squared and Logistic regression analyses were used for statistical analysis. Results: Index cases was 18.8% of all family members, while HBsAg prevalence is 15.0% among family members except index cases. Among family members, the highest prevalences of antiHBc were in the mothers (54.5%) and sisters (45.5%), brothers (33.3%), sons (32.6%)and wifes (31.3%), the least prevalences of antiHBc were husbands (7.7%), fathers (18.2%), and doughters (22.2%) of all index cases. Transmission of HBV to both the mothers and sisters were positive was high, Transmission of HBV to fathers was low in all families. There was significant difference in cases where only the mother and husbands of index cases for HBV transmission (p=0.012). In the logistic regression model; living with chronic hepatitis B index case (OR=1.92; CI=1.03-3.57), to be illiterate (OR=6.81 CI=1.27-22.13), born at home with traditional methods (OR=3.70; CI=1.15-11.87) and born at home with the help of midwife (OR=3.44; CI=1.47-7.91) were higher risk for hepatitits B transmision. Conclusion: The family members of index cases with inactive HBV carriers, particularly in the case of chronic active hepatitis have a high risk of transmission

Prospective analysis of febrile neutropenia patients with bacteraemia: The results of an international ID-IRI study

OBJECTIVES: Bacteraemia during the course of neutropenia is often fatal. We aimed to identify factors predicting mortality to have an insight into better clinical management. METHODS: The study has a prospective, observational design using pooled data from febrile neutropenia patients with bacteraemia in 41 centres in 16 countries. Polymicrobial bacteraemias were excluded. It was performed through the Infectious Diseases-International Research Initiative platform between 17 March 2021 and June 2021. Univariate analysis followed by a multivariate binary logistic regression model was used to determine independent predictors of 30-d in-hospital mortality (sensitivity, 81.2%; specificity, 65%). RESULTS: A total of 431 patients were enrolled, and 85 (19.7%) died. Haematological malignancies were detected in 361 (83.7%) patients. Escherichia coli (n = 117, 27.1%), Klebsiellae (n = 95, 22% %), Pseudomonadaceae (n = 63, 14.6%), Coagulase-negative Staphylococci (n = 57, 13.2%), Staphylococcus aureus (n = 30, 7%), and Enterococci (n = 21, 4.9%) were the common pathogens. Meropenem and piperacillin-tazobactam susceptibility, among the isolated pathogens, were only 66.1% and 53.6%, respectively. Pulse rate (odds ratio [OR], 1.018; 95% confidence interval [CI], 1.002-1.034), quick SOFA score (OR, 2.857; 95% CI, 2.120-3.851), inappropriate antimicrobial treatment (OR, 1.774; 95% CI, 1.011-3.851), Gram-negative bacteraemia (OR, 2.894; 95% CI, 1.437-5.825), bacteraemia of non-urinary origin (OR, 11.262; 95% CI, 1.368-92.720), and advancing age (OR, 1.017; 95% CI, 1.001-1.034) were independent predictors of mortality. Bacteraemia in our neutropenic patient population had distinctive characteristics. The severity of infection and the way to control it with appropriate antimicrobials, and local epidemiological data, came forward. CONCLUSIONS: Local antibiotic susceptibility profiles should be integrated into therapeutic recommendations, and infection control and prevention measures should be prioritised in this era of rapidly increasing antibiotic resistance