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Abstract Background Stenotrophomonas maltophilia, a pathogen that colonizes medical equipment and causes nosocomial infections due to its ability to form biofilms, has high mortality rates. This study investigated the risk factors related to mortality in patients who were diagnosed with S. maltophilia bacteremia. Methods It is a multi-center, retrospective ad observational cohort study. The demographic characteristics, clinical findings, microbiological data, and risk factors for patients were obtained from the medical records of patients at ten different hospitals between January 1, 2018, and June 30, 2023. Results The study included a total of 321 patients. The observed thirty-day mortality rate was 46.1%. A central venous catheter (CVC) was present in 276 patients (86%), and in 66 of these patients (23.9%) the CVC was removed. While only 18 patients (5.6%) received appropriate empirical antibiotics, 242 (75.4%) patients received appropriate antibiotics according to antimicrobial susceptibility test (AST) results and treatment revisions. Multivariate analysis revealed that advanced age (hazard ratio [HR] = 1.02; 95% confidence interval [CI]: 1.00- 1.03) was associated with increased mortality, whereas appropriate antibiotic treatment (HR = 0.35; 95% CI: 0.23-0.52) and removal of central venous catheters (HR = 0.31; 95% CI: 0.16-0.60) were significantly related to reduced mortality. Conclusions S. maltophilia is a significant pathogen, and to reduce its high mortality rate, removal of the CVC and switching to appropriate antibiotics should be performed as soon as possible.

Cystic echinococcosis is a common parasitic infestation that can still cause serious complications in endemic areas. Intrabiliary rupture is a well-defined complication, but rupture into the gallbladder is rare. The disease may present with cholecystitis and cholangitis. Clinicians and radiologists working in the emergency room will find the management of the disease much easier if they become familiar with the clinical and radiological findings of the cyst. In this article, a 28-year-old male admitted to the emergency department with acute abdominal pain who was examined for suspected acute cholecystitis and diagnosed with a rupture of the hydatid intra/extrahepatic bile ducts and gallbladder is presented. Our aim is to present the clinical findings and surgical images of the case (ultrasonography, computed tomography, magnetic resonance imaging) and compare them with the literature.

This study aimed to use bibliometric tools to investigate onchocerciasis research conducted worldwide between 2000 and 2022. This bibliometric study was carried out using the Scopus database. The analysis unit was the documents conducted on onchocerciasis between 2000 and 2022. The data obtained after the last evaluations were transferred to VOSviewer (VOSviewer 1.6.19 for Microsoft Windows systems) and biblioshiny (bibliometrix R package) programs for analysis. The present results showed that 1026 documents on onchocerciasis were indexed in the Scopus database between 2000 and 2022. 2554 authors have published this literature, and the annual growth rate was 1.34 %. Forty-one articles were published in 2000, and after 2014, there was an increase in the number of articles. The most publications were published in 2018 (n = 82). PLOS Neglected Tropical Diseases (n = 97) and Parasites & Vectors (n = 46) published the most publications on onchocerciasis. Most of the publications were published by authors from the United States (n = 341), the United Kingdom (n = 228), Cameroon (n = 150), Nigeria (n = 132), and Germany (n = 120). The documents originating from the United States (n = 2372) had the highest citation numbers. The onchocerciasis research landscape between 2000 and 2022 is outlined in this report. Furthermore, the analysis offers an enhanced comprehension of the trends in onchocerciasis development over the previous 23 years, which might serve as a scientific benchmark for subsequent research.

Background: We aimed to determine the prevalence of Giardia intestinalis and Cryptosporidium spp. in patients who admitted hospital with diarrhea and to gain information about the transmission of these parasites in Ağrı, Türkiye. Methods: This study included 184 patients who applied to Ağrı-Diyadin State Hospital, Türkiye in 2022. The immunochromatographic card test was used for detection of the G. intestinalis and Cryptosporidium spp. Nested PCR-RFLP analysis of the COWP gene and sequence analysis of the gp60 gene were used to genotype and subtype Cryptosporidium spp., whereas Nested PCR and sequence analyses of β-giardin gene were used genotype G. intestinalis. Results: Of the 184 stool specimens examined, 12 (14.29%) and 7 (3.80%) were positive for G. intestinalis and Cryptosporidium spp., respectively. The Cryptosporidium species were identified as C. parvum belonging to the IId subtype family. The G. intestinalis were identified assemblages A. Conclusion: Assemblage A, which is associated with diarrhea, is responsible for giardiasis and C. parvum IId subtype, often found in sheep, goats and cattle, is responsible for cryptosporidiosis in Ağrı, Türkiye.

Objective:In this study, it was aimed to investigate the physical and chemical properties of different spring waters and parasitic factors with different methods.Methods:This study was carried out on 69 water samples collected from different spring waters in and around Iğdır Province in April and June 2021. The samples were analyzed by native-Lugol, modified acid-fast staining, and nested polymerase chain reaction (nPCR). In addition, altitude (meter) and pressure (mmHg) measurements were made at the point where the water samples were taken.Results:One or more parasites were detected in 27.5% of the 69 water samples examined. Only C. cayetanensis was found in 13% of the samples, only Cryptosporidium spp. in 10.1%, only Giardia spp. in 1.4%, only C. cayetanensis and Giardia spp. in 1.4%, only C. cayetanensis, Cryptosporidium spp., and Giardia spp. in 1.4%. Only Giardia spp. cyst (4.3%) was detected by the direct examination method. While C. cayetanensis and Cryptosporidium spp. oocysts were detected in 8.7% and 7.2% of the samples by the modified acid-fast staining method, C. cayetanensis was detected in 15.9% and Cryptosporidium spp. was detected in 11.6% of the samples by nPCR. When the C. cayetanensis and Cryptosporidium spp. positivity rates were compared according to the characteristics of the water, there was no statistical difference between the altitude, salinity, pH, mmHg, and temperature (kelvin) values, but a significant correlation was found between the amount of dissolved oxygen and Cryptosporidium spp. positivity (p=0.047).Conclusion:Cryptosporidium spp., C. cayetanensis, and G. intestinalis are important waterborne pathogens that can cause epidemics. It is our belief that in order to reduce the risk of contamination of these parasitic factors with spring waters, public awareness should be raised, infrastructures should be improved, and new water treatment techniques, such as ultraviolet, ozonation and monitoring systems, should be used.

Aim: Chlamydia trachomatis, is one of the most important sexually transmitted disease (STD) pathogens on a global scale. In this study we aimed to analyze the publication developments with bibliometric methods on C.trachomatis by examining the research articles published between January 1970–December 2021. Material and methods: Herein, a bibliometric design was used to achieve the developments in C. trachomatis research. Research articles published in the Web of Science (WoS) database between January, 1970–December, 2021 were included in the study. The keywords selected for the search were ‘Chlamydia trachomatis, Chlamydia, and C. trachomatis’. Results: The search of the WoS database for C. trachomatis research articles from 1970 to 2021 yielded 8133 results. Of the documents, 5696 were articles. 95.769% were published in Science Citation Index Expanded (SCI-EXPANDED) indexed journals. Most were published in English (94.803%). The articles were mostly from the Infectious Diseases (33.251%) research area. Most of the articles were from the USA. About 51% of the studies had funding organizations, with the United States Department of Health and Human Services provided the most financial support. Most of the articles (n=346, 6.074%) were published in the Journal of Sexually Transmitted Diseases. Although the number of publications seems to be irregular, it has not fallen below 80 articles per year, especially since 1980. The articles were cited 147,672 times (25.93 times per article) and the H-index was 133. Conclusion: STDs are still an important public health problem in almost all parts of the world. We have found that the number of published articles and citations to articles on C. trachomatis has increased rapidly, especially in recent years. However, although the number of publications in developed countries has increased, the number of publications in developing and underdeveloped countries is below the expected level. Since C. trachomatis is a global public health problem, countries with a lower number of publications should be supported financially.

Introduction: Changes in the immune system during pregnancy have been associated with reactivation of the hepatitis B virus in women chronic hepatitis B infection not receiving antiviral therapy. The aim of this study is to examine the development of intrapartum and postpartum hepatitis B reactivation in pregnant patients not being treated for chronic hepatitis B. Material and Methods: Pregnant women diagnosed with chronic hepatitis B and not receiving treatment between 2017 and 2022 in five centres in the east and southeast Turkey included in this study. In order to evaluate biochemical and viral reactivation from intrapartum and postpartum periods, patients with data for at least two periods were included in the study. Results: Evaluations were made on 171 pregnant women diagnosed with chronic hepatitis B. Reactivation occurred in 43 (25.2%) patients, in the postpartum period in 14 (32.35%) and in the intrapartum period in 29 (67.44%). Reactivation occurred most often in the 3rd trimester (n: 13, 30.2%). A significant increase was observed in the alanine aminotransferase levels of the patients with reactivation in the first trimester compared to 6 months prepartum and in the second trimester compared to the first trimester (p=0.038, p=0.039, respectively). The prepartum HBV DNA level (cut-off point =192 IU/ml) of patients with HBeAg negativity was found to have diagnostic power for reactivation of 0.684 (95% CI: 0.575-0.792, p=0.002) with 65.9% sensitivity and 68.6% specificity. Viral reactivation was observed in the first trimester in one patient and hepatitis B surface antibody was seen in the postpartum period. Conclusions: Asymptomatic viral reactivation occurred at the high rate of 25.1% in this series. To be able to identify reactivation as early as possible, pregnant patients should be followed up closely in the intrapartum and postpartum periods.

Purpose: COVID-19 is a viral disease that has recently caused a pandemic and significantly affects human health. In this study, superoxide dismutase, glutathione peroxidase, glutathione, total thiol, natural thiol, disulfide, oxidative DNA damage and malondialdehyde levels in COVID-19 were investigated. Materials and Methods: Thirty-five patients and 35 healthy volunteers were included in this study. The diagnosis of COVID-19 was made by reverse transcriptase-polymerase chain reaction. Serum glutathione, glutathione peroxidase, superoxide dismutase, natural thiol, total thiol and disulphide levels by enzyme-linked immunosorbent assay and malondialdehyde and 8-hydroxy-2-deoxyguanosine/10⁶ deoxyguanosine levels by high-pressure liquid chromatography measured. Results: While serum superoxide dismutase, glutathione peroxidase, malondialdehyde, 8-hydroxy-2-deoxyguanosine/10⁶ deoxyguanosine, disulfide levels were higher in the COVID-19 patient group than in the healthy control group, glutathione, total thiol, natural thiol levels were lower. In addition, there was a negative correlation between 8-hydroxy-2-deoxyguanosine/10⁶ deoxyguanosine and glutathione, natural thiol and total thiol, and a positive correlation with disulfide. Conclusion: This study revealed that serum superoxide dismutase, glutathione peroxidase, malondialdehyde, 8-hydroxy-2-deoxyguanosine/10⁶ deoxyguanosine, and disulfide levels increased and glutathione, thiol and natural thiol levels decreased in COVID-19 patients. These results revealed that there was a decrease in antioxidant marker levels and an increase in oxidative stress markers in COVID-19 patients.

Objective:Pneumocystis jirovecii (P. jirovecii) is an opportunistic pathogen in humans. Early diagnosis and optimal treatment of patients with P. jirovecii pneumonia (PJP) remains a key priority. This study investigated P. jirovecii in patients with lung cancer using the nested-polymerase chain reaction (PCR) method and examined the relationship between P. jirovecii and clinical findings.Methods:The study included 60 patients with lung cancer and 30 patients without lung cancer. The bronchoalveolar lavage (BAL) fluid samples of these 90 individuals were taken for diagnostic purposes in the University of Health Sciences Turkey, Van Training and Research Hospital, Clinic of Chest Diseases. Patient information was recorded. After DNA isolation from the BAL fluid samples taken from patients, the nested-PCR protocol for amplification of mtLSUrRNA in P. jirovecii was performed.Results:P. jirovecii DNA was detected in 40 (66.67%) of the lung cancer patients included in the study and in six (20%) patients without lung cancer, that is, in 46 (51.11%) patients. The rate of nested-PCR positivity in the lung cancer group was significantly higher than that in the non-lung cancer group (p=0.0001). Additionally, a statistically significant correlation was found between anorexia and weight loss, fever and sputum P. jirovecii positivity in patients with lung cancer (p

Objective:To investigate intestinal and blood parasites in people who have a history of traveling abroad during the Coronavirus disease-2019 pandemic and returning to Turkey.Methods:In this study, 104 patients with gastrointestinal system and/or fever complaints who had traveled abroad during the pandemic period and returned to Turkey were included. Parasitic agents were investigated by taking blood and stool samples from the patients. Additionally, urine samples were obtained from patients with hematuria or dysuria with the suspicion of schistosomiasis. A direct microscopic examination, the Crypto-Giardia immunochromatographic test, and ELISA methods were used in the examination of the stool samples. In order to detect Plasmodium species, blood samples were examined by preparing both the rapid diagnostic test and thick drop and thin smear preparations.Results:One or more parasite species were detected in 38 (38.5%) of 104 patients included in the study. While intestinal parasites were detected in 16 (32%) of 50 patients who traveled to Iran and 16 (33.3%) of 48 patients who traveled to Northern Iraq, blood parasites were not found. Schistosoma mansoni was detected in all 5 of the patients with a history of traveling to Sudan. Plasmodium falciparum was detected in 1 patient who traveled to the African continent.Conclusion:It is vital to take precautions to prevent parasitic diseases, such as malaria and schistosomiasis, during travels to African countries. During travels to neighboring countries of Turkey, such as Northern Iraq and Iran, hygiene should be paid attention to, so as to prevent contracting intestinal parasitic diseases. In addition, it was concluded that people who plan to travel abroad should have information about the endemic parasitic diseases of the country that they are going to.

INTRODUCTION: The aim of this study is to identify seroprevalence of Rubella, Cytomegalovirus and T. gondii in pregnancies, determination of stillbirth and preterm delivery rates and comparison of IgG avidity with avidity in pregnant patients with positive IgG antibodies. METHODS: The study was carried out by ELISA method in order to investigate Cytomegalovirus, Rubella and T.gondii IgG and IgM antibodies in 300 blood samples taken from pregnant patients between the ages of 18-48 who applied to the Gynecology and Obstetrics Outpatient Clinic. RESULTS: Rubella IgG 96% and Rubella IgM 4%, CMV IgG 99%, CMV IgM 1.3%, T. gondii IgG 56.3% and IgM 7.6% seropositivity were detected in pregnant blood samples. The ratios of stillbirth and preterm delivery are respectively determined as Rubella IgM 2 (18.1%) / 4 (17.3%), Rubella IgG 11 (100%) / 22 (95.6%) and CMV IgM 1 (9%) / 2 (8,3%), CMV IgG 11 (100%) / 23 (100%), T. gondii IgM 1 (9%) / 3 (13%), T. gondii IgG 4 (34.7%). The avidity values were determined as 3/0/2 in Rubella, 0/0/3 in Cytomegalovirus and 8/1/12 in T. gondii in low / gray zone / high values respectively DISCUSSION AND CONCLUSION: As a result, Toxoplasma gondii, Cytomegalovirus and Rubella, which may cause aborts or stillbirths, are among the important health problems in pregnant patients in our region. It has been concluded that serologic methods may be a method of guiding medicine in diagnosing these infections and clarifying suspicious cases by performing IgG avidity test.

Background: This study aimed to identify factors that influence the mortality rate of patients with coronavirus disease (COVID-19)-associated pulmonary aspergillosis (CAPA). Methods: In this cross-sectional study, data from 23 centers across 15 countries, spanning the period of March 2020 to December 2021, were retrospectively collected. The study population comprised patients who developed invasive pulmonary aspergillosis while being treated for COVID-19 in the intensive care unit. Cox regression and decision tree analyses were used to identify factors associated with mortality in patients with CAPA. Results: A total of 162 patients (males, 65.4 %; median age: 64 [25th–75th: 54.0–73.8] years) were included in the study, of whom 113 died during the 90-day follow-up period. The median duration from CAPA diagnosis to death was 12 (25th–75th: 7–19) days. In the multivariable Cox regression model, an age of ≥65 years (hazard ratio [HR]: 2.05, 95 % confidence interval [CI]: 1.37–3.07), requiring vasopressor therapy at the time of CAPA diagnosis (HR: 1.80, 95 % CI: 1.17–2.76), and receiving renal replacement therapy at the time of CAPA diagnosis (HR: 2.27, 95 % CI: 1.35–3.82) were identified as predictors of mortality. Decision tree analysis revealed that patients with CAPA aged ≥65 years who received corticosteroid treatment for COVID-19 displayed higher mortality rates (estimated rate: 1.6, observed in 46 % of patients). Conclusion: This study concluded that elderly patients with CAPA who receive corticosteroids are at a significantly higher risk of mortality, particularly if they experience multiorgan failure.

Objectives: Urinary tract infection (UTI) is the second most common cause of infection among all infectious diseases at hospitals. Antibiogram results are needed to maintain treatment in patients with suspected UTI. However, empirical antibiotic treatment is initiated in patients since it takes time to obtain the results of antibiograms. The aim of this study was to evaluate the urine culture and antibiogram results of patients who were admitted to our hospital with suspected UTI and compare the results with other studies. Methods: Urine cultures requested from the hospital information system database between January of 2018 and 2019 were analyzed. Microorganism-positive urine samples and antibiogram results were evaluated and included in the study. Results: Of the patients, 748 (61.8%) were female and 463 (38.2%) were male. The average age of all patients was 44.9 years. Escherichia coli was the most frequently isolated microorganisms from urine cultures (n = 828, 68.4%). Among all microorganism-positive urine samples, antibiotic resistance against Cefalexin, Fusidic acid, Ampicillin, Erythromycin, Levofloxacin, Cefuroxime Axetil, Trimethoprim/ Sulfamethoxazole, Ceftriaxone and Ciprofloxacin was 83.9%, 68.4%, 61.8%, 44.7%, 42.7%, 36.4%, 30%, 28.6% and 26.7%, respectively. Conclusions: High resistance to Cefalexin, Ampicillin, Cefuroxime, Axetil, Trimethoprim/ Sulfamethoxazole, Ceftriaxone and Ciprofloxacin, which are often preferred in empirical antibiotic selection, has been found. We believe that empirical antibiotic selection should not be overlooked in cases of UTI. Our study may help clinicians use appropriate antibiotics for the clinical management of UTIs.