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Introduction: During the severe acute respiratory syndrome-Coronavirus-2 pandemic, intensive care units (ICUs) were pivotal in treating severe cases. In the ICU, invasive procedures and the use of immunosuppressive drugs have been associated with an increased risk of infection. We aimed to compare the antibiotic use, infection types, culture positivity, and resistance patterns among patients in the ICU during and after the pandemic period. Materials and Methods: The patients who were followed up in the adult ICU at our hospital were retrospectively assessed after being divided into two groups. Group 1 included patients admitted between December 1, 2020, and May 5, 2021, (pandemic group). Group 2 consisted of patients admitted between June 1, 2021, and November 1, 2023 (post-pandemic). Results: Antibacterial (100% vs. 92.7%, p=0.003), and antifungal (33.3% vs. 10.7%, p

Introduction: The healthcare burden of carbapenem-resistant Klebsiella pneumoniae (K. pneumoniae) infections is growing. The newly developed beta-lactam/beta-lactamase inhibitor combination, ceftazidime-avibactam, shows promise in the treatment of such infections. We aimed to explore the in vitro efficacy of ceftazidime-avibactam against carbapenem-resistant K. pneumoniae isolates carrying the blaOXA-48 gene. Materials and Methods: The isolates were identified using MALDI-TOF MS (Brucker, USA). The isolates that were non-susceptible to imipenem, meropenem, or ertapenem by the disk diffusion method using the European Committee of Antimicrobial Susceptibility Testing (EUCAST) breakpoints were screenes. Minimum inhibitory concentration (MIC) values were determined via broth microdilution according to the EUCAST criteria. A time-kill study was performed according to Clinical and Laboratory Standards Institute guidelines. Beta-lactamase genes were screened for using polymerase chain reaction with previously published primers. Results: A total of 129 K. pneumoniae isolated between April 2011 and February 2021 were studied. Of these, 98, 23, and eight isolates carried the blaOXA-48, blaNDM, and blaOXA-48 with blaNDM genes, respectively. All isolates carrying the blaNDM gene were resistant to ceftazidime-avibactam. Approximately 79.6% of the blaOXA-48-positive isolates were susceptible to ceftazidime-avibactam. The time-kill study for ceftazidime-avibactam was performed with one blaOXA-48-positive isolate (MIC, 4 mg/l). Ceftazidime-avibactam time-kill kinetics were evaluated in multiples of MIC. There was a decrease of ≥3-log10 in CFU/ml count at a concentration of 8, 16, and 32 MIC at 6 hours. The minimum bactericidal concentration was 8 mg/l. Conclusion: Ceftazidime-avibactam is an important treatment alternative alternative for blaOXA-48 positive carbapenem-resistant K. pneumoniae infections. The most rational approach to the treatment of carbapenem-resistant K. pneumoniae infections appears to be the initiatiion of targeted therapy according to culture antibiogram results or revision of the empirically initiated combination or monotherapy as early as possible according to culture antibiogram results.

Introduction: In this study, it was aimed to obtain information about the perspectives of infectious diseases and clinical microbiology (IDCM) specialists on online education applications and web-based seminars, and their usage and utilization rates. Materials and Methods: In this descriptive, cross-sectional study, online survey responses of the IDCM specialists in who were members of Infectious Diseases Clinical Microbiology Specialty Society of Turkey (EKMUD) were evaluated. Results: A total of 184 IDCM specialists answered the survey questions. Of the participants, 77.2% thought that the pandemic disrupted post-graduate medical education and 84.8% thought that the pandemic disrupted pre-graduate medical education. Medical educators involved in education during the Coronavirus disease-2019 (COVID-19) pandemic reported that they mostly continued online education. Of the participants, 84.9% reported that they were able to use the internet in an effective way to gain access to information during the COVID-19 pandemic. Of the responders, 58.2% reported that they followed online training programs, such as web-based seminars and lectures, and 51.6% reported that these online programs contributed to their learning. Participants found online training programs such as web-based seminars and lectures useful in terms of learning competence, that online training programs provided people with gain in space and time, and that they found them more instructive because they gave them the chance to receive training in subjects of their interest. Participants reported that these programs provided learning competency in that these programs were more beneficial to the participants in view of place, the subject that they need/they are interested in and saving time for the trainer and the participants. Due to the COVID-19 pandemic, the participants mostly wanted the 2020 EKMUD congress to be held online. A total 92.9% of the participants reported that online congresses and seminars would decrease travel, participation and sponsorship costs. Only 24.5% of the participants considered that online congresses and seminars would be more effective in terms of social interaction and gaining information than face-to-face congresses. Conclusion: The IDCM specialists reported that online educational practices such as webinars were benefical. The rate of participation in webinars and online education practices were high during the COVID-19 pandemic.

Introduction: In this study, it was aimed to determine the problems encountered by Infectious Diseases and Clinical Microbiology residents during residency training in order to identify solutions to these difficulties. Materials and Methods: A survey was conducted between December 19 and 31, 2018 using a 46-item questionnaire. Participants were able to participate in the survey anonymously via the website of the Infectious Diseases and Clinical Microbiology Specialty Society of Turkey. Residents were informed via text message and e-mail to encourage participation. The survey included questions about current problems with the physical conditions, access to scientific information resources, the quality of residency education, examinations, night shifts, mobbing, rotations, and the possibility of following up special patient subgroups. Results: A total of 134 residents completed the questionnaire, 73 of whom were in university educational hospitals and 61 were in training and research hospitals operating under the Ministry of Health. Around 68% of the participants stated that they were working in unsuitable physical conditions and 33% had no access to medical information resources outside of the hospital. Ninety-four participants (61%) declared that their clinic had a regular training program which was renewed annually, but only 36% of these asserted that it was adequate for their training. When asked about the frequency of coworking with faculty members for scientific data/study production, 46% of the respondents answered once a year or less. Fifty-nine participants (44%) had seven or more night shifts per month. Thirty-six percent of the participants reported that they were subject to workplace bullying, which they said was perpetrated most frequently by faculty members (36%). Only 22 participants (16%) considered the microbiology training was adequate and 15% rated the training received during rotations as adequate. Thirty-three of the residents had performed a liver biopsy or been trained in this procedure. Fifty-five participants (46%) had never worked at a vaccine outpatient clinic. According to the trainees, the most important problem was inadequate education (28%) and 55% declared that they would not choose the same specialty if they entered the national medical specialty exam again. Conclusion: Residents describe many problems during their specialty training, such as inadequate education, excessive night shifts, increased workload, and workplace bullying. These problems should be presented more frequently with valid scientific data within the professional societies, and in light of this information, physician working groups should be formed to develop solutions.

Sepsis is a major healthcare problem worldwide. Its mortality and morbidity is still high. Early diagnosis of sepsis and appropriate management in the initial hours improve outcomes. The Surviving Sepsis Campaign published new definitions for sepsis in 2016. In Sepsis-3 definitions, sepsis is defined as life-threatening organ dysfunction caused by a dysregulated host response to infection. Organ dysfunction can be identified as an acute change in total SOFA score of at least two points consequent to the infection. However, this definition is endorsed by two international societies and there is much discussion regarding new definitions. Prospective validation of this definition on different levels is needed. The infectious source in sepsis depends on patients" underlying diseases and origin of the infection (community-acquired or healthcare-associated). In the literature, urinary tract and skin-soft tissue infection are the common sites in community-acquired sepsis, whereas respiratory system and intraabdominal infections are more common in nosocomial sepsis. Another challenge in sepsis management is the increasing incidence of sepsis due to multidrugresistant bacteria and limited treatment options. New antibiotics may be treatment options in the future. In this review, current definitions of sepsis, physiopathology of sepsis, foci of sepsis and causative microorganisms, microbiological diagnosis and rapid diagnosis methods, biomarkers used in the diagnosis of sepsis, antimicrobial treatment and resistance, new antibiotics and non-antibiotic therapy are discussed.