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Anti-N-methyl-D-aspartate (NMDA) receptor encephalitis is a type of autoimmune encephalitis characterized by seizures, psychiatric symptoms, and movement disorder, which may present with an acute or subacute course. It has been reported that the production of anti-NDMA receptor antibodies can be triggered in the course of herpes simplex encephalitis and anti-NMDA receptor encephalitis may occur clinically. It has been reported that 25% of patients with HSV encephalitis have anti-NDMA receptor antibodies and are associated with impaired improvement in cognitive performance. In this article, we present a case of anti-NMDA receptor encephalitis associated with HSV-type 1 encephalitis in a 30-year-old woman and review the literature. After the patient's treatment for HSV encephalitis ended, her psychiatric symptoms such as anxiety, agitation, hallucinations and euphoria persisted and he was diagnosed with anti NMDA receptor antibodies detected in CSF. The patient was transferred to the neurology clinic and intravenous immunoglobulin treatment was started.

Streptococcus intermedius is part of the normal oropharyngeal, genitourinary and gastrointestinal flora, and can cause purulent infections characterized by abscess formation involving the brain and the liver tissue In this report, multiple pyogenic liver abscesses due to S intermedius in a 46-year-old male admitted to the emergency department with complaints of fever, cough, and weakness, and hospitalized with a diagnosis of suspected COVID-19 with pneumonia, is presented The diagnosis was made by isolating the agent from the abscess After percutaneous abscess drainage and antimicrobial treatment, the patient fully healed

Amaç: Bu çalışmanın amacı HIV enfeksiyonu pozitif saptanan hastalarda HHV-6 DNA sıklığının, HHV-6 DNA’sı pozitif saptanan olgularda ise HHV-6 varyant türünün (varyant A veya varyant B) belirlenmesiydi.Gereç ve Yöntem: Çalışmaya 20 HIV pozitif hasta ile 57 HIV negatif sağlıklı birey dahil edildi. Hasta ve kontrol grubunda HHV-6 DNA’sı polimeraz zincir reaksiyonu (PZR) ile araştırıldı. HHV-6 DNA pozitif saptanan olgularda HHV-6 varyant türü restriksiyon parça uzunluğu polimorfizmi (restriction fragment lenght polymorphisim: RFLP) ile araştırıldı. İstatistiksel değerlendirme SPSS programında yapıldı, p≤0.05 istatistiksel olarak anlamlı kabul edildi. Bulgular: HIV pozitif hastalarda HHV-6 DNA pozitifliği %45 (9/20), HIV negatiflerde ise %33,3 (19/57) olarak belirlendi. Toplamda pozitiflik oranı %36,3 (28/77) idi. HIV pozitif hastalarda HHV-6 varyant B saptanırken, varyant A saptanmadı. Sonuç: HIV pozitif hastalarda HHV-6 seropozitifliği ve varyant tiplerinin öneminin belirlenmesi için daha fazla sayıda olgu içeren başka klinik çalışmalara gereksinim olduğu görüşündeyiz.

Chronic hepatitis B (CHB) is an important public health problem in the world and Turkey. The aim of this study was to evaluate the histological, virological, serological and biochemical response rates in CHB patients receiving tenofovir or entecavir therapy. Control liver biopsies were performed on patients who received tenofovir or entecavir therapy for one year or longer. Histopathological grading was scored according to the modified Knodell system. Eighty-seven CHB patients were included in this study, 56 patients were receiving tenofovir and 31 patients were receiving entecavir therapy. Patients in two treatment groups were similar in terms of baseline parameters (p> 0.05). At the end of the treatment, there was a significant decrease in mean values of HBV DNA, alanine aminotransferase and necroinflammatory scores for both groups (p 0.05). Histological responses were obtained 66.1% from the tenofovir group and 54.8% from the entecavir group. Treatment with tenofovir and entecavir resulted with improvement in Ishak fibrosis scores in 12.5% and 12.9% of the patients, respectively. For 14.3% of the tenofovir-treated patients and for 22.6% of the entecavir-treated patients, the Ishak fibrosis scores worsened. Baseline intermediate/ advanced fibrosis stage (Ishak fibrosis score: 3-6) was found as independent determinant factor on histological response and improvement of fibrosis score (OR= 3.99, p= 0.01; OR= 31.67, p= 0.002; respectively) and treatment duration longer than five years is an independent determinant for improvement of necroinflammatory score (OR= 5.79, p= 0.02). There was no significant difference in the virological, serological, biochemical and, histological responses and improvement of necroinflammatory and fibrosis scores between tenofovir and entecavir groups (p> 0.05). Similar histological, virological, serological and biochemical responses were obtained in patients with CHB receving tenofovir and entecavir treatments. Further studies involving a large number of patients receiving long-term therapy should be done to understand the effects of antiviral treatments on healing of liver histology.

Neisseria meningitidis is a gram negativediplococcus and is one of the common causes of community-acquiredmeningitis inour country. In meningococcal meningitis, taking infection control measures andchemoprophyla is are important for the prevention of transmission. In thisarticle, a 20-year-old military personel who developed meningitis due to Neisseria meningitidis serogroup B waspresented and the infection control measures taken for the military unit andthose with close contact with the patient were reviewed., Neisseriameningitidis gram negatif diplokok olup ülkemizdetoplum kaynaklı menenjitin yaygın etkenlerinden biridir. Meningokok menenjitinde infeksiyonkontrol önlemlerinin alınması vekemoprofilaksi bulaşın önlenmesi açısından önemlidir. Bu yazıda, Neisseriameningitidis serogrup B’ye bağlı olarak menenjit gelişen, 20 yaşındaki birasker sunularak askeri birlik ve hastanın yakın temaslılarına yönelik alınan infeksiyonkontrol önlemleri gözden geçirilmiştir.

Proteus penneri (P.penneri) is a rare Gram negative bacilli that can cause invasive infectious diseases. P. penneri may cause clinical manifestations such as urinary tract infection, wound infection, sepsis.In this article, a 57-years-old female patient who developed wound infection and purulent discharge in the shoulder due to P. penneri after dog bite was presented and did not respond to amoxicillin-clavunate treatment. According to the antibiogram, piperacillin-tazobactam treatment was started intravenously (i.v.) at a dose of 3x4.5 g. The treatment was administered for 7 days. After treatment, the discharge in the lesion area completely resolved., Proteus penneri (P.penneri)invaziv infeksiyon hastalalıklarına neden olabilen, nadir görülen bir Gramnegatif basildir. P.penneri üriner sistem infeksiyonu, yara infeksiyonu,sepsis gibi klinik tablolara neden olabilir. Bu yazıda , köpek ısırığısonrasında P.penneri'ye bağlı sağkolunda yara infeksiyonu ve pürülan akıntı gelişen, amoksisilin-klavunattedavisine yanıt vermeyen 57 yaşında bir kadın olgu sunuldu. Hastayaantibiyogram sonucuna göre piperasilin-tazobaktam tedavisi 3x4.5 gr dozdaintravenöz (i.v.) yolla başlandı, tedavi 7 gün süreyle uygulandı. Tedavisonrası lezyon bölgesindeki akıntı ve yara yeri infeksiyonu tamamen düzeldi.

Pacemakers are foreign bodies which often used in the treatment of arrhythmias. Infection of pacemaker and the parts associated with pacemaker is extremely rare. The most important risk factors for development of infection; duration of the procedure, complications during operation and immunodeficiency of the patient. These infections are often seen when the pacemaker was inserted or removed as a result of the contamination. Although pacemaker infections are rare, the mortality rate is high. The most common causative agent is staphylococcus, gram negative bacteria and fungi may also be rarely causative agents. Ochrobactrum anthropi is a gram-negative, aerobic, oxidase positive, urease positive, motile and non-lactose-fermenting bacillus previously known as “ Achromobacter group”. It is an opportunistic pathogen that can cause infection in especially immunosupressive patients with permanent central venous catheter. The main infections reported due to this agent; bacteremia, central venous catheter-related sepsis, endocarditis, endophthalmitis, pancreatic abscess, urinary tract infections, meningitis, pelvic abscess and osteomyelitis. In the literature, just one case has been reported which developed pacemaker infection due to this agent. In this manuscript, fifty-four-year-old Afghan nationality patient was presented with the diagnosis of pacemaker and pacemaker lead infections.

İntrakraniyal tüberkülom,tüberküloza bağlı santral sinir sistemi infeksiyonunun önemli komplikasyonlarındanbirisidir. İntrakraniyal tüberkülomlar görüntüleme yöntemlerinde beyintümörleri ile karışabilir. Tanıda etkenin kültürden izolasyonu vehistopatolojik inceleme kullanılabilir. Tedavide cerrahi girişim veantitüberküloz tedavi uygulanır. Bu yazıda, Cibuti, Afrika’dan gelen ve intrakraniyalkitle nedeni ile opere edilen ancak biyopsi materyalinin histopatolojikincelemesi sonucunda tüberkülom olduğu saptanan 34 yaşında bir kadın hastasunuldu., Intracranial tuberculoma is one of the significant complicationsof central nervous system infection due to tuberculosis. Intracranialtuberculomas may be confused with brain tumors in imaging modalities. Diagnosisis made with the isolation of the causative agent from culture orhistopathological examination. Surgical intervention and antituberculosistreatment are used in the treatment. In this article, 34 years old femalepatient from Cibuti, Africa, who is operated with the diagnosis of intracranialmass is presented. The definite diagnosis of tuberculosis is made with thehistopathologic examination of biopsy specimens.

Objective: The purpose of this study is to compare the HHV-8 IgM and IgG positivity rates in patients with different malignancies, including non-Hodgkin lymphoma, Hodgkin’s lymphoma, acute lymphocytic leukemia, acute myelocytic leukemia, multiple myeloma, and chronic myelocytic leukemia. Material and Method: Totally 58 individuals, fifty patients with malignancies and eight healthy individuals were included in the study. Indirect fluorescent an tibody method was used to analyze HHV-8 IgM and HHV-8 IgG antibodies in patient and control groups. Statistical analysis was conducted with SPSS software. Fischer’s Exact Ki-kare test and the Mann-Whitney U-test were used in the statistical evaluation. P values ≤0.05 were considered statistically significant. Findings: In the patient group, 20% of the patients (10/50) were HHV-8 IgM positive. On the other hand, none of the individuals in the control group were HHV-8 IgM positive. In the patient group, 56% of the patients (28/50) were HHV-8 IgG positive, whereas 50% of the individuals (8/16) in the control group were HHV-8 IgG positive. HHV-8 IgM positivity was significantly higher in the patient group when compared to the control group. The highest level of HHV-8 IgM positivity was detected in AML patients, whereas MM patients had the highest level of HHV-8 IgG positivity. Conclusion: HHV-8 IgM and HHV-8 IgG positivity in patients with malignancies can be associated with reactivation or reinfection. Further clinical studies should be carried out on higher number of patients with different malignancies to identify the clinical significance of HHV-8 in these patients.

Introduction: This study investigated the association and prognostic values of serum C-reactive protein (CRP), procalcitonin (PCT), soluble urokinase plasminogen activator receptor (suPAR), and neopterin levels in patients with ventilator-associated pneumonia (VAP). Materials and Methods: This prospective observational age-and gender-matched study included 38 adult patients who were diagnosed with VAP and 40 adult patients without VAP. The Acute Physiology and Chronic Health Evaluation II (APACHE II), Sequential Organ Failure Assessment (SOFA) and Clinical Pulmonary Infection Scores were calculated, and the daily positive end-expiratory pressure values of the patients were recorded. The serum levels of CRP, PCT, suPAR, and neopterin were measured once in controls (control group) and on days 0, 3, and 5 and at the end of treatment in the VAP group. Results: The CRP, PCT, neopterin, and suPAR levels were significantly higher in the VAP group than in the control group. APACHE II and SOFA values were higher in the VAP group than in the control group. C-reactive protein value on day 0 of >14.5 ng/ml and PCT level on day five of >1.23 ng/ml were 100% specific for the prediction of mortality in the VAP group. Conclusion: Measuring CRP, PCT, neopterin, and suPAR levels may aid in the early diagnosis of VAP in patients hospitalized in the ICU. High CRP and PCT levels, as well as high APACHE II and SOFA scores, may have prognostic value in the follow-up of patients with VAP.

Herpes zoster is a disease characterized by painful vesicular rash, most commonly involving the thoracic region, involving the cervical, lumbar, sacral and ophthalmic regions, resulting from the reactivation of varicella zoster virus, which remains latent in the dorsal root ganglia. In this case report, we present a case of shingles characterized by painful vesicular eruptions in the sacral and inguinal regions in a 72-year-old patient with underlying rheumatoid arthritis. The patient was diagnosed by physical examination and laboratory tests (varicella zoster-IgG positivity). After acyclovir treatment, the lesions regressed. The case is presented because of sacral and inguinal involvement (atypical presentation).

ORIGINAL ARTICLE: Yılmaz N, Çifci A, Balcı M, Cesur S, Sabah Özcan S, Şen SS, et al. Hemodiyaliz hastalarında okült hepatit B ve hepatit C enfeksiyonu sıklığı [Frequency of occult hepatitis B and C infections in hemodialysis patients]. Ortadogu Tıp Derg 2018;10(2):174-8. https://doi.org/10.21601/ortadogutipdergisi.324840 This document states corrections to the original article., ORİJİNAL MAKALE: Yılmaz N, Çifci A, Balcı M, Cesur S, Sabah Özcan S, Şen SS, et al. Frequency of occult hepatitis B and C infections in hemodialysis patients [Frequency of occult hepatitis B and C infections in hemodialysis patients]. Ortadogu Tıp Derg 2018;10(2):174-8. https://doi.org/10.21601/ortadogutipdergisi.324840Bu doküman, orijinal makaledeki hataları bildirmektedir.

Red neck syndrome which is aside effect of vancomycin, is associated with excessive release of histamine andis sometimes a life threatening complication. In patients who developredneck syndrome, if necessary, vancomycin therapy may be continued withcorticosteroids and antihistamines or an alternative antibiotic may be started.In this report, a 54 year-old female patient who wasstarted vancomycin therapy because of penicillin resistant pneumococcalmeningitis and developed red neck syndrome on 8th day of the therapy waspresented. It was learned that the patient's vancomycin infusion that morningwas shorter than one hour. Vancomycin therapy was stopped and intravenouslinezolide was started. In conclusion, red neck syndrome may develop due to rapidinfusion of vancomycin. In this patients linezolide may be used as alternativetherapy., Vankomisine bağlı olarak gelişen yan etkilerdenred neck (kırmızı boyun) sendromu histamin aşırı salınımına bağlı bazen hayatıtehdit edebilen bir komplikasyondur. Red neck sendromu gelişen hastalarda zorunluhallerde kortikosterod ve antihistaminiklerle birlikte vankomisin tedavisinedevam edilebilir veya alternatif bir antibiyotik tedavisine geçilebilir. Buyazıda, penisiline dirençli pnömokok menenjiti tanısıyla vankomisin tedavisibaşlanan ve tedavinin 8. gününde red neck sendromu gelişen 54 yaşında bir kadınhasta sunuldu. Hastanın o sabah verilen vankomisin infüzyonunun bir saatten kısasürdüğü öğrenildi. Hastanın vankomisintedavisi kesilerek intravenöz linezolid tedavisine geçildi. Sonuç olarak, vankomisinin hızlı infüzyonuna bağlı olarak red necksendromu gelişebilir ve bu olgularda tedavi yönetiminde alternatif ilaç olaraklinezolid kullanılabilir.

Listeria monocytogenes, fekal-oral yolla bulaşan zoonotik bir enfeksiyon etkeni olup, gebelerde, 50 yaş üzeri hastalarda, immün yetmezlikli hastalarda ve alkolik hastalarda menenjit, ensefalit, meningoensefalit ve rombensefalit gibi santral sinir sistemi enfeksiyonlarına neden olabilir. Gebelik, Listeria monocytogenes enfeksiyonları için önemli bir predispozan durumdur ve gebelerde enfeksiyon ağır seyredebilir. Bu yazıda, 3 gündür ateş, baş ağrısı, baş dönmesi, bulantı, kusma yakınmaları ile başvuran ve hiperemezis gravidarum ön tanısıyla kadın hastalıkları ve doğum kliniğine yatırılan, Listeria monocytogenes ’e bağlı olarak gelişen rombensefalit tanısı konulan 28 yaşında 8 haftalık gebe kadın hasta sunuldu. Hastanın tanısı, klinik bulgularla birlikte kan kültüründen etkenin izole edilmesi ve manyetik rezonans görüntülemede rombensefalit saptanması ile konuldu. Gebeliği medikal abortusla sonlandırılan hastaya antimikrobiyal tedavi toplam 6 ay süreyle uygulandı, tedavi bitiminde klinik bulguları ve manyetik rezonans görüntülemede saptanan lezyonları tamamen düzeldi., Listeria monocytogenes is a fecal-orally transmitted zoonotic agent, and can cause central nervous system infections such as meningitis, encephalitis, meningoencephalitis, and rhomboncephalitis in pregnant women. Pregnancy is an important predisposing condition for Listeria monocytogenes infections and infection may be severe in pregnant women. In this article, we presented a 28-years-old 8-weeks pregnant woman who was admitted to gynecology and obstetrics clinic with the diagnosed of hyperemesis gravidarum with the complaints of fever, headache, dizziness, nausea and vomiting for 3 days and diagnosed as Listeria monocytogenes. The diagnosis of the patient was made by isolating the bacteria from blood culture together with clinical fndings and detection of rhombencephalitis in magnetic resonance imaging. Antimicrobial treatment was applied to the patient, her pregnancy was terminated with medical abortion. After 6 months therapy, the clinical findings and lesions detected in magnetic resonance imaging were completely recovered.

Renal tüberküloz akciğer tüberkülozunun lenfohematojen yayılımı sonucunda gelişir. Renal tüberkülozun en önemli bulgusu steril pyüridir. Gelişmekte olan ülkelerde Addison hastalığının %10-15’inden tüberküloz hastalığı sorumludur. Tüberküloza bağlı adrenal tutulum bilateral adrenal genişleme, atrofi ve kalsifikasyon şeklinde görülebilir. Mycobacterium tuberculosis komplekse bağlı adrenal bezlerin infeksiyonu hematojen yaylılım sonucu gelişir. Klinik bulguları yıllar sonra belirgin olabilir, asemptomatik infeksiyon oldukça sıktır. Bu yazıda, önceden Addison hastalığı (adrenokortikal yetmezlik) tanısı alan 60 yaşında bir kadın hastada saptanan renal tüberküloz sunuldu .

Data are relatively scarce on gastro-intestinal tuberculosis (GITB). Most studies are old and from single centers, or did not include immunosuppressed patients. Thus, we aimed to determine the clinical, radiological, and laboratory profiles of GITB. We included adults with proven GITB treated between 2000 and 2018. Patients were enrolled from 21 referral centers in 8 countries (Belgium, Egypt, France, Italy, Kazakhstan, Saudi Arabia, UK, and Turkey). One hundred four patients were included. Terminal ileum (n = 46, 44.2%), small intestines except terminal ileum (n = 36, 34.6%), colon (n = 29, 27.8%), stomach (n = 6, 5.7%), and perianal (one patient) were the sites of GITB. One-third of all patients were immunosuppressed. Sixteen patients had diabetes, 8 had chronic renal failure, 5 were HIV positive, 4 had liver cirrhosis, and 3 had malignancies. Intestinal biopsy samples were cultured in 75 cases (78.1%) and TB was isolated in 65 patients (86.6%). PCR were performed to 37 (35.6%) biopsy samples and of these, 35 (94.6%) were positive. Ascites samples were cultured in 19 patients and M. tuberculosis was isolated in 11 (57.9%). Upper gastrointestinal endoscopy was performed to 40 patients (38.5%) and colonoscopy in 74 (71.1%). Surgical interventions were frequently the source of diagnostic samples (25 laparoscopy/20 laparotomy, n = 45, 43.3%). Patients were treated with standard and second-line anti-TB medications. Ultimately, 4 (3.8%) patients died and 2 (1.9%) cases relapsed. There was a high incidence of underlying immunosuppression in GITB patients. A high degree of clinical suspicion is necessary to initiate appropriate and timely diagnostic procedures; many patients are first diagnosed at surgery., SCOPUS: ar.j, info:eu-repo/semantics/published

ORIGINAL ARTICLE: Yilmaz N, Cifci A, Balci M, Kaya C, Cesur S, Uyar M, et al. Hemodiyaliz hastalarinda hepatit E, hepatit G ve TTV seroprevalansi [The seroprevalance of hepatitis E, hepatitis G and TTV in haemodialysis patients]. Ortadogu Tip Derg 2017;9(1):6-11. https://doi.org/10.21601/ortadogutipdergisi.291105 This document states corrections to the original article.

Kırım-Kongokanamalı ateşi Bunyaviridea ailesinden Nairovirus cinsinin neden olduğu birzoonotik enfeksiyon hastalığıdır. Hastalığın etkeni olan virus Hyalomma cinsikenelerin tutunması, enfekte hayvanın kan ve vücut sıvılarıyla temas veya enfektehastanın kan veya vücut sıvıları ile temas sonucu bulaşabilir. Zona,diğer adıyla herpes zoster, duyusal gangliyon içindeki endojen latent varisellazoster virüsü enfeksiyonunun reaktivasyonu sonucunda gelişen rekürren enfeksiyondur.Zonaya bağlı olarak trigeminal sinirin oftalmik dalının tutulması oftalmik zona(herpes zoster oftalmikus) olarak isimlendirilir ve ciddi bir komplikasyondur. Bu yazıda, Çankırı ilinden gelen27 yaşında bir erkek hastada Kırım-Kongo kanamalı ateş ile oftalmik zonabirlikteliği sunulmuştur., Crimean-Congo haemorrhagic fever is a zoonotic infectious disease caused by the genus Nairovirus in the Bunyaviridea family. The virus that is the causative agent of the disease can be transmitted by contact with the infected animal's blood and body fluids or by contact with the infected patient's blood or body fluids. Zona, also known as herpes zoster, is a recurrent infection caused by reactivation of endogenous latent varicella zoster virus infection in the sensory ganglion. The retention of the ophthalmic branch of the trigeminal nerve, depending on the zone, is called an ophthalmic shingles (herpes zoster ophthalmicus) and is a serious complication. In this article, a 27-year-old male patient from the province of Çankırı is presented with Crimean Congo hemorrhagic fever and ophthalmic shingles.

WOS: 000366655100045, PubMed ID: 26386176, BACKGROUND CONTEXT: No direct comparison between brucellar spondylodiscitis (BSD) and tuberculous spondylodiscitis (TSD) exists in the literature. PURPOSE: This study aimed to compare directly the clinical features, laboratory and radiological aspects, treatment, and outcome data of patients diagnosed as BSD and TSD. STUDY DESIGN: A retrospective, multinational, and multicenter study was used. PATIENT SAMPLE: A total of 641 (TSD, 314 and BSD, 327) spondylodiscitis patients from 35 different centers in four countries (Turkey, Egypt, Albania, and Greece) were included. OUTCOME MEASURES: The pre- and peri- or post-treatment spinal deformity and neurologic deficit parameters, and mortality were carried out. METHODS: Brucellar spondylodiscitis and TSD groups were compared for demographics, clinical, laboratory, radiological, surgical interventions, treatment, and outcome data. The Student t test and Mann-Whitney U test were used for group comparisons. Significance was analyzed as two sided and inferred at 0.05 levels. RESULTS: The median baseline laboratory parameters including white blood cell count, C-reactive protein, and erythrocyte sedimentation rate were higher in TSD than BSD (p

Objective: In this study, nine commercial Nucleic Acid Amplification Test Systems (NAATs) were evaluated for diagnostic performance of Mycobacterium tuberculosis complex (MTBC) from smear positive sputum species (SPss) and smear negative sputum specimens (SNss). Methods: Sixty SPss and 55 SNss were examined microscopically by Ehrlich Ziehl Neelsen (EZN) staining method, and also inoculated on Löwenstein Jensen (LJ) medium for culture. The sensitivity and specificity of nine NAATs were calculated according to LJ culture method accepted as gold standard. Results: When LJ culture results were taken as gold standard; the sensitivity rates of method COBAS Amplicor MTB (Method A), GenProbe MTD (Method B), Cobas TaqMan MTB PCR (Method C), iCycler iQ RT PCR (Method D), TaqMan PCR AB 5700 (Method E), TaqMan PCR AB7700 (Method F), LightCycler® 480 RT PCR (Method G), Rotor Gene RT PCR (Method H) and the AdvanSure TB/NTM RT PCR (Method I) for SPss were 98.3 %, 93.3 %, 96.7 %, 100 %, 93.3 %, 100 %, 100 %, 100 % and 100 %, respectively. The sensitivity was 53.84% for the methods A, B, D, E, G and I; 38.46% for the method C and H; 61.5% for the method F for the method I in SNss. There were no statistical significant differences between the nine NAATs (p≥0.05). The specificity was 100% for all nine NAATs in SNss. The positivity rates of methods were 53.8% for methods A, B, D, E, G, I; 38.5% for methods C and H, and 61.5% for method F in SNss. These rates were 100% for D, F, G, H and I; 98.3% for method A; 96.7% for method C; 93,3% for methods B and E in SPss. Statistical analysis showed that there was no statistically significant differences among the nine NAATs (p≥0.05).Conclusion: It is concluded that the nine NAATs might be useful for detecting MTBC from SPss, but not effective for SNss. J Microbiol Infect Dis 2015;5(3): 103-109Key words: Tuberculosis, polymerase chain reaction, nucleic acid amplification test, smear positive, smear negative, sputum, Amaç: Bu çalışmada, yayma pozitif balgam örneklerinde ve yayma negatif balgam örneklerinde Mycobacterium tuberculosis kompleks (MTBK)’nin hızlı tanısında dokuz ticari Nükleik Asit Amplifikasyon Test sistemi (NAAT)’nin tanı performansı değerlendirildi. Yöntemler: Çalışma sırasında kullanılan 60 yayma pozitif ve 55 yayma negatif balgam örneği mikroskopik olarak Erlich Zielh Neelsen (EZN) boyama yöntemi ve Löwenstein Jensen (LJ) besiyerinde kültür ile değerlendirildi. Löwenstein-Jensen kültür yöntemi altın standart olarak kabul edilerek dokuz NAAT yönteminin duyarlılık ve özgüllükleri hesaplandı.Bulgular: Löwenstein Jensen kültür sonuçları altın standart olarak alındığında; Yayma pozitif örneklerde (COBAS Amplicor MTB (Metot A), GenProbe MTD (Metot B), Cobas TaqMan MTB PCR (Metot C), iCycler iQ RT-PCR (Metot D), TaqMan PCR AB 5700 (Metot E), TaqMan PCR AB7700 (Metot F), LightCycler® 480 RT PCR (Metot G), Rotor Gene RT PCR (Metot H) ve AdvanSure TB/NTM RT PCR (Metot I) yöntemlerinin duyarlılık oranı sırası ile % 98,3, % 93,3, % 96,7, % 100, % 93,3, % 100, % 100, % 100 ve % 100 olarak bulundu. Bu oran yayma negatif örneklerde A, B, D, E, G ve I yöntemleri için % 53,8; C ve H yöntemi için % 38,5; F yöntemi için % 61,5 olarak bulundu. Dokuz NAAT metodu arasında istatistiksel olarak anlamlı fark bulunmadı. (p≥0.05). Yayma negatif balgam örneklerinde özgüllük bütün NAAT yöntemleri için % 100 olarak saptandı. Pozitif saptama oranı yayma negatif örneklerde A, B, D, E, G ve I yöntemleri için % 53,8, C ve H yöntemleri için % 38,5 ve F yöntemi için % 61,5 olarak bulundu. Bu oran yayma pozitif balgam örneklerinde D, F, G, H ve I yöntemleri için % 100; A yöntemi için % 98,3, C yöntemi için % 96,7, B ve E yöntemleri için % 93,3 olarak saptandı. Dokuz NAAT yöntemi arasında istatistiksel olarak anlamlı fark bulunmadı (p≥0.05). Sonuç: Dokuz NAAT yönteminin yayma pozitif örneklerde MTBK tanısında yararlı olabileceği, ancak yayma negatif örneklerde etkin olmadığı sonucuna varıldı

Multi drug resistant tuberculosis (MDR-TB) is defined as tuberculosis that is resistant to at least isoniazid and rifampicin, the two most powerful first-line anti-TB drugs. Extensively drug resistant tuberculosis (XDR-TB) is defined as tuberculosis that is resistant to resistant to isoniazid and rifampin and to any fluoroquinolone and at least one of three injectable second-line drugs (namely, amikacin, kanamicin, or capreomycin). MDR-TB and XDR- TB are great dangers that threaten the public health. XDR-TB has been reported from many countries including the United States. In Turkey, among newly diagnosed cases, it was reported that the number of MDR-TB patients was 101 (3.1%), MDR-TB rate in the retreatment cases was 17.7% (90 patients), and MDR-TB rate in all cases was 5.1 (191 patients) in 2005. The percentages were calculated through the number of patients who were tested in terms of susceptibility for both isoniazide and rifampin. In 2009, it was reported that the number of MDR-TB patients was 99 (2.7%) among newly diagnosed cases, it was 123 (20.5 %) in the retreatment cases and the total number of MDR-TB cases was 222 (5.1%). The first patient with XDR-TB was identified in 2010 in Turkey. Diagnosis of XDR TB takes several weeks by using conventional culture-based methods, although (however) some molecular test can detect it rapidly. Treatment of XDR-TB patients is difficult and usually requiring at least 18-24 months of four to six second-line anti-TB drugs. The success rate with the treatment is about 30-50%, and mortality rate is higher in HIV-infected patients. Prevention of contact to XDR-TB patients is more complicated by the lack of a proven effective preventive treatment for XDR latent tuberculosis infection. Rapid diagnostic tests and new anti-TB drugs are needed to control the spread of this worldwide public health problem. [Dis Mol Med 2013; 1(4.000): 72-76]

Peritonitis is a major complication of peritoneal dialysis (PD). Although bacteria are the most responsible pathogens, fungi can also be the cause of this condition. Candida species (spp.) are common agents in fungal peritonitis with a rate of 70% while Aspergillus spp. is rare. Aspergillus spp. can lead to severe life threatening peritonitis in PD patients. Early diagnosis is essential for a good outcome but it may be difficult to detect the pathogen. Our observation in this case supports the hypothesis that the enriched culture materials designed for detecting blood pathogens can provide an advantage for determining the cause of peritonitis in peritoneal fluid. Clinicians should remember this clue when managing peritonitis, especially in patients who are refractory to empiric antibiotic therapy.

Tumor necrosis factor-like weak inducer of apoptosis (TWEAK) is a member of the tumor necrosis factor super family of structurally-related cytokines. The aim of this study was to determine the diagnostic and prognostic role of serum TWEAK concentration in patients with acute pancreatitis.Twenty four patients with acute pancreatitis and 24 consecutive healthy age- and sex-matched control subjects were included in the study. The serum concentrations of TWEAK were measured at admission and then at remission. The average time between admission and remission was 7-10 days.At admission, TWEAK concentration was significantly lower in patients with acute pancreatitis compared to control subjects (p0.001). Serum TWEAK concentrations were elevated after the remission period, however the differences were not statistically significant. In addition, serum TWEAK concentration showed a significant, inverse correlation with amylase, lipase, CRP, AST, fibrinogen, LDH and a positive correlation with calcium, albumin and platelet count.Patients with acute pancreatitis have lower serum TWEAK concentration than healthy subjects. These results suggest that serum TWEAK concentration could be a potential biomarker of acute pancreatitis.

Objectives: The purpose of this trial was to investigate in patients with sepsis, the correlation between prognosis ofdisease and factors, which influence prognosis like gender, focus of infection, bacterial growth in blood culture, growingpathogens in addition to serum levels of cytokines (TNF-α, IL-10, leptin) and C-reactive protein.Material and methods: Forty-six adult patients with sepsis and 55 healthy adults as control group were enrolled in thisstudy. Serum cytokine (TNF-α, IL-10 and leptin) levels were determined by ELISA method and C-reactive protein (CRP)levels were measured by nephelometric method. Serum cytokine and CRP levels on day 0 (initial), day 3 and day 5 werecompared in surviving sepsis patients and patients who died because of sepsis.Results: Serum IL-10 level on day 0 (initial) of adult patients who died as a result of sepsis was found to be higher thansurviving patients and the difference was statistically significant (p=0.025). On 3rd day of treatment, serum TNF-α andCRP levels of patients who dies because of sepsis were higher than values of surviving patients (for TNF-α p=0.033, forCRP p=0.026). In adult patient group with sepsis who died on the 5th day of treatment, serum TNF-α level was significantlyhigher than levels in surviving patients (p=0.030).Conclusion: It was determined that in patients who died due to sepsis, initial serum IL-10 level, TNF- α and CRP levelson 3rd day of treatment and finally on 5th day of treatment, only serum TNF- α level was higher than surviving patients.We believe that determining serum TNF-α and IL-10 levels in patients with sepsis before and during treatment will helpclinicians to clarify prognosis and enable them to implement appropriate treatment modifications. J Microbiol Infect Dis2011; 1(3):101-109

Objective: Tuberculous meningitis (TBM) is the most severe and lethal form of tuberculosis (TB).Bacteriologic confirmation of TBM is difficult and slow. Therefore, most patients receive antituberculosis treatment based only on clinical and cerebrospinal fluid (CSF) characteristics. Rapid diagnosis of TBM is important to decrease morbidity and mortality. The aim of the study was to demonstrate that COBAS Amplicor MTB and Rotorgene Real Time (RT) PCR is a rapid method of diagnosing TBM before and after initiating anti-tuberculosis treatment. Methods: A retrospective study was conducted between December 2002 and January 2009 in 468 patients with suspected TBM. Clinical specimens were collected from different hospitals in Ankara. All specimens were evaluated by smear microscopy and culture methods with Lowenstein-Jensen (LJ) and MGIT culture system. Results: Using culture results as a gold standard, the sensitivity, specificity, positive predictive values (PPV), and negative predictive values (NPV) were 71.0%, 98.8%, 97.8% and 75.0%, respectively, for COBAS Amplicor MTB and 80%, 98.9%, 99.0% and 80.0%, respectively, for Rotorgene RT PCR. Statistical analysis showed no significant differences between the COBAS Amplicor MTB and Rotorgene RT PCR (p≥0.05). All isolates were susceptible to isoniazid, rifampin, streptomycin, and ethambutol with proportion method in LJ medium. All isolates were defined as LAM7-TUR by spoligotyping. Conclusion: Retrospective analysis of COBAS Amplicor MTB and Rotorgene RT PCR found that both tests are effective in rapidly diagnosing MTB using CSF. It was concluded that Rotorgene RT PCR test is more sensitive (81.0%) than COBAS Amplicor MTB (71.0%). J Microbiol Infect Dis 2015;5(4): 156-161 Key words: Tuberculous meningitis, COBAS Amplicor MTB, Rotorgene Real Time PCR

Objectives: Crimean-Congo hemorrhagic fever (CCHF) is a tick borne zoonotic infection. Up till now knowledge about pathogenesis of the disease is limited. Cytokine response is quite important during this infection. The aim of this study was to determine the serum tumor necrosis factor-alpha (TNF-α) and the interleukin-4 (IL-4) levels in patients with CCHF and compare with those of healthy controls. Materials and methods: Forty-two adult CCHF patients and 40 healthy subjects were included in this study. The diagnosis of CCHF was based upon anti-CCHF virus IgM positivity (ELISA method), and/or positivity in real time-polymerase chain reaction (RT-PCR) in acute phase serum samples. Serum TNF-α and IL-4 levels were determined by ELISA method. Results: In patients with CCHF the mean serum TNF-α level was significantly higher than the control group (15.01 vs. 7.69 pg/ml; p

WOS: 000349144300018, PubMed ID: 25821319, Objectives: To compare the efficacy of colistin (COL) monotherapy versus non-COL based combinations in the treatment of bloodstream infections (BSIs) due to multidrug resistant Acinetobacter spp.(MDR-A) . Materials and Methods: Retrospective data of 107 MDR-A BSI cases from 27 tertiary centers in Turkey were included. Primary End-Point: 14-day mortality. Secondary End-Points: Microbial eradication and clinical improvement. Results: Thirty-six patients in the COL monotherapy (CM) group and 71 in the non-COL based combinations (NCC) group were included in the study. Mean age was 59.98 20 years (range: 18-89) and 50.5% were male. Median duration of follow-up was 40 days (range: 9-297). The 14-day survival rates were 52.8% in CM and 47.23% in NCC group (P = 0.36). Microbiological eradication was achieved in 69% of CM and 83% of NCC group (P = 0.13). Treatment failure was detected in 22.9% of cases in both CM and NCC groups. Univariate analysis revealed that mean age (P = 0.001), Charlson comorbidity index (P = 0.03), duration of hospital stay before MDR-A BSI (P = 0.04), Pitt bacteremia score (P = 0.043) and Acute Physiology and Chronic Health Evaluation II score (P = 0.05) were significant in terms of 14-day mortality. Advanced age (P = 0.01) and duration of hospital stay before MDR-A BSI (P = 0.04) were independently associated with 14-day mortality in multivariate analysis. Conclusion: No significant difference was detected between CM and non-COL based combinations in the treatment of MDR-A BSIs in terms of efficacy and 14-day mortality.

Maghsoudi, Behzad/0000-0002-1279-8799; Kritsotakis, Evangelos/0000-0002-9526-3852; Yalcin, Ata Nevzat/0000-0002-7243-7354; Mikaszewska-Sokolewicz, Malgorzata A/0000-0002-1148-7817; ALDEMIR KOCABAS, Bilge/0000-0002-6396-5243; Masjedi, Mohammad Reza/0000-0002-6871-382X; Masjedi, Mansoor/0000-0001-6175-9289; Gan, Chin Seng/0000-0002-6758-4798; Oncul, Oral/0000-0002-1681-1866; Sabetian, Golnar/0000-0001-8764-2150; YAMAN, Ayhan/0000-0002-5651-1286; Ozdemir, Halil/0000-0002-7318-1688; Leon, Hector Armando Rincon/0000-0003-0715-200X; Delia, Muntean/0000-0001-9100-4530; Atasay, Fatma Begum/0000-0002-9114-5293; Zand, Farid/0000-0003-3489-3372; Kuchenbecker, Ricardo/0000-0002-4707-3683; Medeiros, Eduardo A/0000-0002-6205-259X; ROMERO LOPEZ-ALBERCA, CRISTINA/0000-0001-5856-8668; Salomao, Reinaldo/0000-0003-1149-4598; ozdemir, sonay incesoy/0000-0003-2863-901X; Meco, Basak Ceyda/0000-0003-2951-9634; Horoz, Ozden Ozgur/0000-0001-7590-650X; Horhat, Florin George/0000-0001-6133-0204; Kazi, Mohammad Mukhit/0000-0003-3824-5540; Ciftci, Ergin/0000-0002-4955-160X; Abouqal, Redouane/0000-0002-6117-4341; Leblebicioglu, Hakan/0000-0002-6033-8543; Garcell, Humberto Guanche/0000-0001-7279-0062; Kendirli, Tanil/0000-0001-9458-2803; de Souza, Maria Cecilia B V/0000-0003-0318-3087; Sanaei Dashti, Anahita/0000-0002-2827-3575; UNAL, SERHAT/0000-0003-1184-4711; alvarez Moreno, carlos Arturo/0000-0001-5419-4494; Barahona G., Nayide/0000-0003-3559-6900; Rodriguez Ferrer, Marena Luz/0000-0002-8053-8454; Karabay, Oguz/0000-0003-0502-432X; Kaya, Sehnaz/0000-0003-0002-1517; ERDEVE, OMER/0000-0002-3193-0812; Gonzalez Martinez, Marisela del Rocio/0000-0003-1474-736X; Gikas, Achilleas/0000-0002-8455-9631; Baylan, Orhan/0000-0002-6529-7824; Mitrev, Zan/0000-0001-7859-8821; yildizdas, dincer/0000-0003-0739-5108; Ngo, Quy Chau/0000-0002-6787-2757; Duszynska, Wieslawa/0000-0002-5880-4904; KAYA, ZEYNEP/0000-0002-8468-2103; Dragan, Barbara/0000-0003-3108-4211; Gupta, Umesh/0000-0001-7717-1404; Navarro Fuentes, Karla Reyna/0000-0002-6894-8872; zali, Mohammadreza/0000-0002-9027-4560; Morocho Tutillo, Diego Rolando/0000-0002-4974-7856; El Kholy, Amani/0000-0002-0645-7664; Kanj, Souha/0000-0001-6413-3396; Assiri, Abdullah/0000-0002-5605-2876; Unal, Necmettin/0000-0002-9440-7893; Jayatilleke, Kushlani/0000-0002-3931-6630; KARABAY, OGUZ/0000-0003-1514-1685 WOS: 000341307100001 PubMed: 25179325 We report the results of an International Nosocomial Infection Control Consortium (INICC) surveillance study from January 2007-December 2012 in 503 intensive care units (ICUs) in Latin America, Asia, Africa, and Europe. During the 6-year study using the Centers for Disease Control and Prevention's (CDC) U.S. National Healthcare Safety Network (NHSN) definitions for device-associated health care-associated infection (DA-HAI), we collected prospective data from 605,310 patients hospitalized in the INICC's ICUs for an aggregate of 3,338,396 days. Although device utilization in the INICC's ICUs was similar to that reported from ICUs in the U.S. in the CDC's NHSN, rates of device-associated nosocomial infection were higher in the ICUs of the INICC hospitals: the pooled rate of central line-associated bloodstream infection in the INICC's ICUs, 4.9 per 1,000 central line days, is nearly 5-fold higher than the 0.9 per 1,000 central line days reported from comparable U. S. ICUs. The overall rate of ventilator-associated pneumonia was also higher (16.8 vs 1.1 per 1,000 ventilator days) as was the rate of catheter-associated urinary tract infection (5.5 vs 1.3 per 1,000 catheter days). Frequencies of resistance of Pseudomonas isolates to amikacin (42.8% vs 10%) and imipenem (42.4% vs 26.1%) and Klebsiella pneumoniae isolates to ceftazidime (71.2% vs 28.8%) and imipenem (19.6% vs 12.8%) were also higher in the INICC's ICUs compared with the ICUs of the CDC's NHSN. Copyright (C) 2014 by the Association for Professionals in Infection Control and Epidemiology, Inc. Published by Elsevier Inc. All rights reserved.

The aim of this study was to measure the alterations in serum trace element concentrations, including zinc (Zn) and copper (Cu) in patients with brucellosis and to compare them with the results of healthy individuals. Seventy-five subjects, 60 patients with brucellosis and 15 healthy individuals were included in this study. The serum Zn and Cu concentrations were measured by using atomic absorbtion spectrophotometer in sera of patients with brucellosis and statistically compared with those of healthy individuals. Serum Cu concentration was found to be significantly higher in patients with brucellosis than that of healthy individual (130.5+/-24.7, 96+/-8.65 microg/dl, respectively) (p0.01). Serum Zn concentration was lower in patients with brucellosis than those of healthy subjects (79.5 +/-13.5 and 83+/-5.59 microg/dl, respectively) (p0.01). Serum trace element concentrations showed significant alterations in patients with brucellosis compared with healthy subjects.

The aim of this study was to determine the serum adenosine deaminase (ADA) and plasma platelet factor (PF-4) activities in patients with active pulmonary tuberculosis, HIV seropositive subjects, cancer patients (acute and chronic type lymphoblastic leukaemia) and to compare them with the results of healthy individuals. Eighty-eight subjects were enrolled in this study, 24 patients with active pulmonary tuberculosis, 20 patients with HIV seropositive subjects, 24 patients with cancer, 12 patients with acute type lymphoblastic leukaemia, 12 patients with chronic type lymphoblastic leukaemia) patients and 20 healthy individuals. ADA activity was determined in serum samples using colorimetric method and plasma PF4 activity was measured by using a sandwich-type enzyme immunoassay. When all study groups were compared with the control group, mean serum ADA activities were found to be significantly (p

The aim of this study was to measure the alterations in serum trace elements, including zinc and copper in patients with chronic hepatitis C and to compare them with the results of healthy individuals. Seventeen patients with chronic hepatitis C and 17 healthy individuals were included in this study. Serum zinc and cooper concentrations were measured by using atomic absorption spectrophotometer of patients with chronic hepatitis C and the results were statistically compared with those of healthy individuals. Serum zinc concentrations were 105.6+/-22.8 microg/dl in patients with chronic hepatitis C and 94.41+/-19 microg/dl in healthy controls, respectively. Serum copper concentrations were 103.17+/-20.8 microg/dl in patients with chronic hepatitis C and 90.8+/-14.3 microg/dl in healthy subjects, respectively. Serum zinc and copper concentrations were not found statistically different in patients with chronic hepatitis C compared with those of healthy individuals (p>0.05). In conclusion, serum trace element concentrations did not show statistical alterations in patients with chronic hepatitis C compared to healthy subjects.

This study was undertaken to study the resistance of Candida species isolated from oropharyngeal swabs of cancer patients to ketoconazole (KET), fluconazole (FLU), amphotericin B (AmpB), and flucytosine (FCU). The most common species identified was C. albicans, followed by C. tropicalis, C. glabrata, C. famata, C. krusei, C. kefyr, and C. gulliermondii. The minimum inhibitory concentration (MIC) of the antifungal agents was evaluated by RPMI 1640 medium with microdilution method. There were no C. albicans strains resistant to KET, FLU and AmpB. All Candida isolates were found highly susceptible to AmpB (MIC AmpB < 1 microg/ml), followed by KET (MIC KET < or =8 microg/ml), FLU (MIC FLU < or =8 microg/ml) and FCU (MIC FCU < or =4 microg/ml). The main conclusion of this study is that prophylactic therapy planned according to typing and antifungal susceptibility will contribute to the prevention of invasive fungal infections in immunosuppressied oncology patients.

Brucellosis is a zoonotic infection involving many systems and it is widespread in Turkey. Involvement of muscular and skeletal systems is a common complication of brucellosis. Involvement of genitourinary system (epididymo-orchitis) is a rarer complication (Sozen TH. Infeksiyon Hastaliklari . 1996; pp. 486–493; Edward J. Young. Principles and Practice of Infectious Diseases, Vol. 2, 5th edn. 2000; pp. 22386–22393). Brucellosis accompanied by abscess formation in the vertebra is frequently seen in the elderly and patients with a chronic disease (Sozen TH. Infeksiyon Hastaliklari . 1996; pp. 486–493; Edward J. Young. Principles and Practice of Infectious Diseases, Vol. 2, 5th edn. 2000; pp. 22386–22393; Af-Eissa YA, Kambal AM et al. Ann Rheum Dis 1990; 49 : 896–900; Colmenore JD, Cisneron JM, Orjuela DL et al. Infection 1992; 20 : 38–42). Brucellosis accompanied by paravertebral abscess and epididymo-orchitis is extremely rare. In this report, we present a case of epididymo-orchitis and paravertebral abscess due to brucellosis.

Objective: Neopterin is a sensitive marker for cell-mediated immune response. Because of this, the neopterin levels of body fluids show cell-mediated immune response in different infectious diseases which involve T cells and macrophages.The aim of this study was to determine the clinical importance of neopterin levels in patients with tuberculosis and compare with those levels of healthy subjects. Methods: Seventy patients with tuberculosis (46 newly diagnosed cases, 15 relapse cases, and 9 multidrug-resistant tuberculosis cases) and 18 healthy adult individuals were included in the study. Neopterin concentrations were measured by the ELISA method according to the protocol of the manufacturer. Chi-square test was used in statistical analysis; p?. 0.05 was considered statistically significant. Results: Serum mean neopterin levels were 23.74. ±. 21.8. nmol/L (median: 18.3) in newly diagnosed patients with pulmonary tuberculosis; 28.69. ±. 21.2. nmol/L (median: 21.2) in relapse patients and 31.28. ±. 14. nmol/L (median: 25.4) in multidrug-resistant tuberculosis cases, respectively. Serum mean neopterin levels were 4.03. ±. 5.12. nmol/L (median: 5.1) in healthy subjects. The serum neopterin levels were found to be significantly higher in patients with tuberculosis than the control group.There was a statistically significant correlation between neopterin positivity (neopterin level ?10. nmol/L was accepted to be positive) and clinical symptoms of hemoptysis and weight loss. Besides statistically significant correlations between neopterin positivity and hemoglobin level, sedimentation rate, mean leukocyte count and radiological involvement (localized or diffuse) were determined. Conclusion: Serum neopterin levels can be used as a helper laboratory finding for the diagnosis of patients with tuberculosis. For this aim, further controlled studies are needed. © 2014 Asian-African Society for Mycobacteriology.