Five-Years Tigecycline Experience an Analysis of Real-Life Data

Aim: Tigecycline has been approved by the Food and Drug Administration for the treatment of complicated intra-abdominal infections, skin and soft tissue infections and community-acquired pneumonia. In our study, we examined the efficacy of tigecycline in clinical practice and reported real life data from our hospital over a period of five years. Methods: The study was conducted between 2008 and 2013 on patients who received tigecycline for longer than 48 hours in Ankara Training and Research Hospital. Clinical success was defined as clinical recovery and microbiological cure in patients who used tigecycline. Any reason for discontinuation of tigecycline treatment was considered a clinical failure. Results: In our hospital, 320 patients were administered tigecycline between 2008 and 2013. Tigecycline was mainly used for pneumonia and skin and soft tissue infections. Tigecycline was used as monotherapy in 174 patients (54.1%). The most frequently isolated agent in tigecycline-treated patients was Acinetobacter baumannii (43.4%) followed by Enterococcus (6.9%). A change in treatment was not considered necessary in 243 (75.9%) patients who received tigecycline, while it was changed in 77 patients (24.1%). Conclusion: In conclusion, the use of tigecycline can be an effective treatment choice, either as monotherapy or as a combination antibiotic therapy

Lung Abscess in Crimean-Congo Hemorrhagic Fever: A Case Report

Crimean-Congo hemorrhagic fever is a viral zoonotic infection that affects multiple organs and systems, and causes various complications and death. Here, we present a case of a Crimean-Congo hemmorrhagic fever with pulmonary abscess complication, which has not been previously reported

Interleukin-6 and Interleukin-10 Levels in Patients with Chronic Hepatitis B Virus Infection

Hepatitis B virus (HBV) infection may progress to liver failure and liver cancer, for this reason it is a serious health problem. The mechanisms of chronicity are poorly understood. The balances in cytokine production profiles may play a crucial role in determining the resolution or persistence of infection. In this study, we aimed to determine various cytokine levels in patients with chronic HBV infection and to reveal the relationship between levels of cytokines and different clinical phases. HBsAg positive patients with a duration of positivity longer than six months who applied to outpatient clinic of Infectious Diseases and Clinical Microbiology Department of Ankara Training and Research Hospital between October 2005 and June 2006 were included to the study. There were 57 patients in chronic hepatitis B group. There were 24 healthy individuals in the control group. Serum interleukin (IL)-6 and IL-10 levels were detected and compared between patients and controls. There were 25 chronic hepatitis and 32 inactive carrier patients in the patient group. Serum IL-6 levels in patients with chronic HBV infection (8.496 pg/mL) were higher than those of the control group (6.850 pg/mL) and the difference was statistically significant (p= 0.022). Serum IL-10 levels were 0.784 pg/mL and 0.052 pg/mL in patient and control groups, respectively. There was a statistically significant difference between these groups (p= 0.019). Correlation between serum alanin aminotransferase (ALT) levels and cytokine levels were also examined. There wasn’t any correlation between the levels of IL-6 and IL-10, and ALT in patients. As a conclusion, increased IL-10 levels may be associated with persistence of hepatitis B infection. Testing the level of serum IL-6 may be helpful to determine the liver inflammation in patients with chronic hepatitis B infection

Aspartate Aminotransferase to Platelet Ratio Index for the Evaluation of Fibrosis in Chronic Viral Hepatitis

The aspartate aminotransferase to platelet ratio index (APRI), developed for the diagnosis of significant liver fibrosis, and is calculated by the simple parameters used for the routine follow-up of the chronic hepatitis patients. The aim of this study was to evaluate the value of APRI for predicting significant fibrosis in chronic hepatitis B (CHB) and chronic hepatitis C (CHC) patients. CHB and CHC patients who were admitted to our clinic and were performed liver biopsy between 1999 to 2005 were included into the study. APRI values of 0.5 or less and greater than 1.5 were evaluated for predicting significant fibrosis. Fibrosis was considered to be insignificant in cases with scores 0 to 1 and significant in cases with scores 2 and 3. Ninety-seven male and 58 female patients were included into the study. CHB was present in 114 patients and CHC was present in 41 patients. Average Knodell and fibrosis score of the patients were 8.5 ± 3.6 and 1.3 ± 1.0, respectively. Significant fibrosis was detected in 50 of 155 patients and 34 of them were infected with CHB. CHC were detected in rest of them. Average age, serum gama-glutamyl-transpeptidase, Knodell scores and thrombocytopenia were detected statistically high in patients with significant fibrosis (p 1.5 (p 1.5 classified correctly %31 of patients with and without significant fibrosis. In conclusion, APRI can not replace liver biopsy for the detection of significant fibrosis in chronic hepatitis patients, but it might be helpful in cases in which liver biopsy could not be performed

The Evaluation of Risk Factors for Catheter-Related Bloodstream Infections in Neurology and Neurosurgery Intensive Care Units

Introduction: Catheter-related bloodstream infections (CRBSI) are considered as one of the most common serious complications associated with the use of central venous catheters (CVC). In this study, we aimed to determine the rate and epidemiological and microbiological characteristics of the CRBSIs and the effective risk factors in patients hospitalized in the neurology and neurosurgery intensive care units (ICU). Patients and Methods: This prospective study was carried out between January 2007 and January 2008. All patients hospitalized in neurology and neurosurgery ICUs with newly inserted CVC were enrolled into the study. CRBSI rate and epidemiological and microbiological characteristics and risk factors for CRBSIs were studied. Results: During the study period, 199 CVCs in 148 patients were followed. Eighty-two patients (55.4%) were female and 66 (44.6%) were male, and the mean age was 58.7 ± 21.8 years. Sixty-seven patients (45.3%) were hospitalized in the neurology ICU and 81 (54.7%) in the neurosurgery ICU. Mean hospital stay in the ICU was 15.6 ± 15.3 days. Mean duration of catheterization was 8.5 ± 5.2 days. Total catheter days were 1703. CRBSI rates were 30.25 per 1000 catheter days in the neurology ICU and 12.45 per 1000 catheter days in the neurosurgery ICU. The most commonly isolated microorganisms were methicillin-resistant coagulase negative staphylococcus (25%) and penicillin-resistant enterococcus (25%). In univariate analyses, we found that prior antibiotic therapy rate was higher (p= 0.02) and mean hospital stay in ICU was longer (p< 0.001) in patients with CRBSI compared with patients without CRBSI. In patients hospitalized in the neurology ICU, CRBSI risk was 2.4 times higher than in neurosurgery ICU patients (p= 0.004). Catheters kept in place for more than 7 days increased the risk of CRBSI 6.3 times (p< 0.001). In multivariate analyses, catheterization days and hospital stay in ICU were found to be independent risk factors (p< 0.001). Conclusion: Catheterization days and hospital stay were found to be independent risk factors for CRBSIs. We think that for patients with CVC whose catheterization day and hospital stay are prolonged, physicians should be attentive for the development of CRBSIs

Real-World Data from Turkey: Is Sofosbuvir/Ledipasvir With or Without Ribavirin Treatment for Chronic Hepatitis C Really Effective?

Background: In this study, we aimed to investigate the efficacy and safety of sofosbuvir-based therapies in the treatment of chronic hepatitis C in real-world clinical practice