Search

Abstract Background Herein, we analyzed the efficacy of main antibiotic therapy regimens in the treatment of healthcare-associated meningitis (HCAM). Materials/methods This retrospective cohort study was conducted in 18 tertiary-care academic hospitals Turkey, India, Egypt and Romania. We extracted data and outcomes of all patients with post-neurosurgical meningitis cases fulfilling the study inclusion criteria and treated with empirical therapy between December 2006-September 2018. Results Twenty patients in the cefepime + vancomycin-(CV) group, 31 patients in the ceftazidime + vancomycin-(CFV) group, and 119 patients in the meropenem + vancomycin-(MV) group met the inclusion criteria. The MV subgroup had a significantly higher mean Glasgow Coma Score, a higher rate of admission to the intensive care unit within the previous month, and a higher rate of antibiot herapy within the previous month before the meningitis episode (p 0.05) among the three cohorts. No regimen was effective against carbapenem-resistant bacteria, and vancomycin resulted in an EOT clinical success rate of 60.6% in the methicillin-resistant staphylococci or ampicillin-resistant enterococci subgroup (n = 34). Conclusions Our study showed no significant difference in terms of clinical success and mortality among the three treatment options. All regimens were ineffective against carbapenem-resistant bacteria. Vancomycin was unsuccessful in approximately 40% of cases involving methicillin-resistant staphylococci or ampicillin-resistant enterococci.

Raoultella species are gram-negative, non-motile bacilli primarily considered to be environmental bacteria. R. planticola is a rare cause of human infections. Here in we report a case of complicated skin and soft tissue infection, necrotizing fasciitis with a rare etiologic agent R. planticola, treated with tigecycline. A 32-year-old male admitted to the emergency service with complaints of swelling in the neck, pain and a purulent wound on the mandible. He also had toothache for the last three weeks for which he was prescribed metronidazole and non-steroid anti-inflammatory drug by another doctor. He was internalized in the Plastic and Reconstructive Surgery clinic and debridement was performed and empirical antibiotic was started. Bacteriological culture revealed Acinetobacter baumannii and R. planticola. The case was successful treated with tigecycline. Necrotizing fasciitis may be fulminant and invasive in the diabetic host. To our knowledge this was the first R. planticola case treated successfully treated with tigecycline. In addition, it emphasizes once again the importance of bacteriological sampling in the management of necrotizing fasciitis and complicated soft tissue infection.

Objective:Human and canine leishmaniasis (CanL) are endemic in Turkey, and cutaneous leishmaniasis (CL) is a primary public health problem among vector-borne diseases, with 1500-2000 autochthonous cases per year. In this study, we aimed to perform a comprehensive entomological survey, including the detection of sand fly fauna, seasonal activity, and altitudinal distribution, together with the ecological features of Aydın Mountains and their surroundings that are endemic areas for CL caused by Leishmania tropica and CanL caused by L. infantum MON-1.Methods:The survey was carried out from June 2009 to July 2010. Ten localities with different altitudes were selected. Sand fly collection was done every 15 days in July and August when sand flies are most active and every 30 days between September and June (14 months, 16 samplings) using CDC light traps and sticky traps. During the collection, the temperature, humidity, and ecological and environmental features were recorded. Sand fly specimens were dissected and identified at species level using written keys.Results:A total of 6712 sand fly specimens (3268 females and 3444 males) were collected from 10 localities throughout all study periods. Species identification revealed that nine and three species belonging to Phlebotomus (P. major s.l. 30.38%, P. tobbi 22.93%, P. papatasi 5.88%, P. sergenti s.l. 4.51%, P. alexandri 4.26%, P. simici 3.50%, P. burneyi 0.63%, P. brevis 0.45%, and Transphlebotomus spp. 0.28%) and Sergentomyia (S. dentata 23.17%, S. minuta 2.43%, and S. antennata 1.58%) were found, respectively. The seasonal activities of these 12 sand fly species were determined, and P. major s.l. and P. tobbi, which were probable vectors of VL and CanL, were present in the study area. P. sergenti s.l., a probable vector of CL, was also found in the region and was active for seven months between April and October. P. sergenti s.l. was found in the 400–600 m altitude in July, while P. major and P. tobbi were found in high densities in the 200-400 m altitude in September.Conclusion:Our results showed that leishmaniasis vectors are present in different altitudes in the Aydın mountains and surroundings. The findings revealed the time intervals of parasite transmission in the area and the period of applying protective measures, such as insecticide application.

While the Coronavirus disease-2019 (COVID-19) pandemic has been going on for more than two years, the drug studies required for treatment still continue. As a result of these studies, molnupiravir, which has been approved for use in many countries in the treatment of COVID-19, has been put into use in our country with the guide published on February 12, 2022. One of the most important parameters required for a drug to be used at the appropriate dose and duration is its low side-effect profile. Molnupiravir is a generally well tolerated antiviral, and the most common side effects associated with its use are diarrhea, nausea, vomiting, headache, dizziness, and rash. In this report, it was aimed to present the details of the tremor symptom that developed during molnupiravir treatment in three patients we followed up.