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Summary Background In low- and middle-income countries (LMICs), the burden of healthcare-associated infections (HCAIs) is not known due to a lack of national surveillance systems, standardized infection definitions, and paucity of infection prevention and control (IPC) organizations and legal infrastructure. Aim To determine the status of IPC bundle practice and the most frequent interventional variables in LMICs. Methods A questionnaire was emailed to Infectious Diseases International Research Initiative (ID-IRI) Group Members and dedicated IPC doctors working in LMICs to examine self-reported practices/policies regarding IPC bundles. Responding country incomes were classified by World Bank definitions into low, middle, and high. Comparison of LMIC results was then made to a control group of high-income countries (HICs). Findings This survey reports practices from one low-income country (LIC), 16 middle-income countries (MICs) (13 European), compared to eight high-income countries (HICs). Eighteen (95%) MICs had an IPC committee in their hospital, 12 (63.2%) had an annual agreed programme and produced an HCAI report. Annual agreed programmes (87.5% vs 63.2%, respectively) and an annual HCAI report (75.0% vs 63.2%, respectively) were more common in HICs than MICs. All HICs had at least one invasive device-related surveillance programme. Seven (37%) MICs had no invasive device-related surveillance programme, six (32%) had no ventilator-associated pneumonia prevention bundles, seven (37%) had no catheter-associated urinary tract infection prevention bundles, and five (27%) had no central line-associated bloodstream infection prevention bundles. Conclusion LMICs need to develop their own bundles with low-cost and high-level-of-evidence variables adapted to the limited resources, with further validation in reducing infection rates.

Aims: Limited information is available about the efficacy and adverse events of COVID-19 vaccines introduced into public use with Emergency Usage Licences without completing phase-3 trials. Data refer to healthy and mostly younger people, with lacking evidence about the protectivity. This study aimed determining seroconversion rates and levels specific to anti-S-RBD IgG and total anti-spike/anti-nucleocapsid IgM and IgG antibodies against SARS-CoV-2 after the administration of two doses of the inactivated SARS-CoV-2 vaccine in Turkey, comparing three types of antibodies. It was also aimed to assess short-term adverse events due to the vaccine. It is intended to answer the questions about efficacy and safety, which lack in phase trials, especially at community level. It is also aimed to collect data, which will form the basis for assessing whether antibodies are protective at different community settings. Methods: The study carried out in Turkey, comprised 282 healthcare workers who received two doses of the inactivated SARS-CoV-2 vaccine administered in two 3µg doses, 28 days apart. In day-28 after the second dose, anti-S-RBD IgG and total anti-spike/anti-nucleocapsid IgM and IgG antibodies against SARS-CoV-2 were detected by in-vitro chemiluminescence immunoassay. Results: At day 28 after the second dose, the seroconversion rates were found to be 92.9% for total anti-spike/anti-nucleocapsid IgG and 15.2% for IgM and 98.2% for anti-S-RBD IgG antibodies. The immunogenicity was affected by pre-vaccination natural COVID-19 history and age. The incidence of at least one adverse event was found as 29.8% after the first dose and 24.1% after the second dose, with the most common events being pain at the injection site, weakness, fatigue and headache. Conclusion: A high rate of seroconversion was observed with no serious adverse events. Prior natural COVID-19 history and age significantly contributed to strong immunogenicity. A booster dose appears required for older ages and individuals without immune response.

Giriş: Son yıllarda giderek artan oranlarda kullanılan protez eklemler beraberinde protez eklem infeksiyonlarını da gündeme getirmektedir. Protez infeksiyonları artmış mortalite ve morbidite oranları ve maliyeti nedeniyle de önemini korumaktadır. Protez eklem infeksiyonlarında etkene ve hastaya göre uygun tedavi protokollerinin seçilmesi ve yeterli süre tedavi verilmesi hayati önem arz etmektedir. Bu çalışma ile hastanemizde diz ve kalça protez eklem infeksiyonu tanısı alan, tedavi ve takip edilen hastaların infeksiyon kaynağı, etken mikroorganizmalar, risk faktörleri, tedavi stratejileri ve prognozu tespit edilerek gelecekteki hasta yönetimimize katkı sağlamak amaçlanmıştır.Materyal ve Metod: Araştırmada 1998-2009 yılları arasında hastanemizin infeksiyon hastalıkları ve klinik mikrobiyoloji ve ortopedi klinik ve polikliniklerine başvuran, diz ve kalça protez eklem infeksiyonu tanısı alan, tedavi ve takip edilen hastaların dosyaları retrospektif olarak incelenmiştir. Bulgular: Protez eklem infeksiyonu tanısı alan 88 hastanın yaş ortalaması 58.8 ± 15.9 yıl olup 57 (%64.8)'si kadındır. En sık protez takılma nedeni 36 (%40.9) hastada travma olarak tespit edilmiştir. Semptomların ortaya çıkış zamanına göre 36 (%40.9) hastada erken evre, 18 (%20.5) hastada gecikmiş, 34 (%38.6) hastada ise geç evre protez eklem infeksiyonu saptanmıştır. En sık semptom 80 (%90.9) hastada ağrı olarak tespit edilmiştir. Aynı eklemde geçirilmiş cerrahi öyküsü varlığının sonuçla ilişkisi istatistiksel olarak anlamlı bulunmuştur (p= 0.008). Hem akıntı hem de peroperatif kültürlerde en sık izole edilen etkenler koagülaz-negatif stafilokoklardır. Hastaların %53.3'ünde akıntı kültürü ile peroperatif kültür uyumlu bulunmuştur. Hastaların 17 (%19.3)'sinde etken izole edilememiştir. Çalışmamızda C-reaktif protein ve eritrosit sedimentasyon hızı düzeyi ortalamaları yüksek tespit edilmiştir. İki aşamalı revizyon yapılan hastalarda iyi sonuç alınma oranı %75.9 ile daha yüksek bulunmuştur (p= 0.016). İyi sonuç alınan hastalarda diz ve kalça eklemi protez infeksiyonlarında toplam tedavi süreleri daha uzun bulunmuştur (sırasıyla p< 0.001 ve p< 0.001).Sonuç: Protez eklem infeksiyonlarında etkenin izole edilmesi cerrahi yaklaşımı ve antimikrobiyal tedaviyi yönlendirdiği için önem taşımaktadır. Ancak hastaya uygun seçilmiş cerrahi yöntem eşliğinde uzun süreli antimikrobiyal tedavi ile infeksiyonun eradikasyonu mümkün olabilmektedir. Introduction: Prosthetic joints, increasingly used in recent years, raises the prosthetic joint infections which are important due to increased mortality, morbidity and cost. Appropriate treatment protocols according to the patient and sufficient time for treatment are vital. This study aimed at identifying the source of infection, microorganisms, risk factors, treatment strategies and prognose for the patient diagnosed with hip prosthetic joint infection and followed at our hospital and thereby contributing to future patient management. Materials and Methods: The files of patients admitted to our Clinical Microbiology and Infectious Diseases and Orthopedics inpatient and outpatient clinics, diagnosed with knee and hip prosthetic joint infection and treated and followed between 1998-2009 were respectively examined. Results: Mean age of the 88 patients of whom 57 were female (64.8%) was 58.8 ± 15.9. The most frequent reason of prosthesis insertion for the patients was trauma (n= 36) (40.9%) and the most frequent symptom was pain 80 (90.9%). The stages in the emergence of symptoms were as follows; early stage in 36 (40.9%) patients delayed stage in 18 (20.5%) and late stage in 34 (38.6%). Previous surgery at the same joint was associated with infection (p= 0.008). The most frequent isolated microorganisms in both discharge and perioperative cultures were coagulase negative staphylococcus. The discharge and perioperative cultures were consistent in 24 (53.3%) patients. The pathogen could not be isolated in 17 (19.3%) of the patients. The mean level of CRP and ESR were high. In the patients who underwent two-stage revision, good result rate was higher (75.9%) (p= 0.016). The total treatment time for hip and knee prosthetic joint infections in the patient with good results was longer (

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Background/Aims: The natural course and clinical outcome of hepatitis C virus (HCV) infection is related to the interaction between HCV and the immune response of the host. Only a limited number of studies have investigated the role of mannose-binding lectin (MBL) levels in HCV infection. The aim of the present study was to explore the relationship between MBL levels and gene polymorphisms on treatment response in patients with chronic hepatitis C (CHC).Materials and Methods: Serum MBL levels from 50 CHC patients who completed treatment at least 24 weeks before the present study and 75 healthy HCV-negative controls were measured. In addition, the presence of codon 54 mutations was investigated. Correlational analyses were performed to determine relationships between MBL levels and treatment response.Results: In patients, mean serum MBL levels were lower and the rate of codon 54 mutations was higher. However, these differences were not statically significant. In both patients and controls, serum MBL levels were significantly lower in individuals with codon 54 mutations. Moreover, serum MBL levels and the rate of the codon 54 mutation were similar in patients regardless of treatment response.Conclusion: Our findings suggest that low MBL levels do not increase the susceptibility for HCV infection. Furthermore, MBL levels were not found to have a significant effect on the course of the disease or treatment response. Background/Aims: The natural course and clinical outcome of hepatitis C virus (HCV) infection is related to the interaction between HCV and the immune response of the host. Only a limited number of studies have investigated the role of mannose-binding lectin (MBL) levels in HCV infection. The aim of the present study was to explore the relationship between MBL levels and gene polymorphisms on treatment response in patients with chronic hepatitis C (CHC).Materials and Methods: Serum MBL levels from 50 CHC patients who completed treatment at least 24 weeks before the present study and 75 healthy HCV-negative controls were measured. In addition, the presence of codon 54 mutations was investigated. Correlational analyses were performed to determine relationships between MBL levels and treatment response.Results: In patients, mean serum MBL levels were lower and the rate of codon 54 mutations was higher. However, these differences were not statically significant. In both patients and controls, serum MBL levels were significantly lower in individuals with codon 54 mutations. Moreover, serum MBL levels and the rate of the codon 54 mutation were similar in patients regardless of treatment response.Conclusion: Our findings suggest that low MBL levels do not increase the susceptibility for HCV infection. Furthermore, MBL levels were not found to have a significant effect on the course of the disease or treatment response.