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The purpose of this work was to evaluate the reactivation of cytomegalovirus (CMV) and Epstein–Barr virus (EBV) in immunocompetent patients in the intensive care unit (ICU) and to identify risk factors associated with reactivation. In this observational prospective study, 60 adult immunocompetent patients who stayed at least 7 days in an ICU were evaluated. During hospitalization, the viral load was monitored at admission and on day 7 with polymerase chain reaction to detect viral reactivation and weekly thereafter on days 14, 21, and 28 if hospitalization continued. The mean age of patients was 63.3 years (±23.4 years) and 34 (56.7 %) of them were male. Mean APACHE II scores for patients was 25 at admission. Of these patients, 28 were hospitalized in the internal ICU and 32 were hospitalized in the anesthesiology ICU. CMV/EBV reactivation was found in 17 individuals (12 for EBV, 3 for CMV, and 2 for both). The median high-sensitive C-reactive protein value in patients with CMV reactivation was significantly higher than in those patients without CMV reactivation (p = 0.037). EBV reactivation was statistically higher in patients with mechanical ventilation compared to patients without mechanical ventilation (p = 0.023). EBV reactivation in patients with fever was found to be statistically higher than in the patients without fever (p = 0.035). There is a need for extended studies with a larger number of patients from specific groups to better understand the reactivation frequency and identify risk factors. EBV and CMV reactivation should be taken into consideration in critically ill patients with fever, without specific symptoms and unresponsive to the treatment.

This paper describes primary subcutaneous infection caused by N. abscessus in a 60-year-old male patient with the history of non-Hodgkins lymphoma and chronic lymphocytic leukemia. The patient was presented with pain and swelling in his left thigh for 45 days. Soft tissue ultrasonography showed a heterogeneous and hypoechoic mass consistent with an abscess. Gram-positive and branched filamentous bacilli, along with neutrophils, were identified in gram-stained smears of the pus. Pus culture was positive for Gram-positive bacilli, which identified as N. abscessus. Initially, the patient was treated with trimethoprim-sulfamethoxazole. Due to insufficient clinical response, ceftriaxone was added for two weeks. Then, the patient was prescribed a 3-month course of trimethoprim-sulfamethoxazole. It is important to start appropriate and effective treatment as soon as possible in patients with immunosuppression. [Dis Mol Med 2016; 4(3.000): 31-33]

tp://dx.doi.org/10.1016/j.tmaid.20 77-8939/a 2015 Elsevier Ltd. All rig Dear sir, it is well known that Shigella spp. primarily cause gastrointestinal infections. Extra-intestinal manifestations are uncommon and mainly include neurological manifestations and arthritis [1]. Urinary tract infections (UTIs) due to Shigella spp. are rare, and Shigella sonnei UTIs are particularly unusual [2]. S. sonnei can be responsible for UTI during pregnancy even when no predisposing factors or an apparent source of infection can be identified [3]. In a study from USA, laboratory confirmed 208,368 Shigella isolates were examined and of these 71.7% were S. sonnei, 18.4% S. flexneri, 1.6% S. boydii, and 0.7% S. dysenteriae. Nearly all of these strains (99%) were recovered from stool and only 0.63% from urine [4]. This study also stressed that urine is the second most common source of positive isolates after feces. The contribution of fecal contamination should be noted for this rate. Unlike other studies, S. boydii was the most common isolated pathogen

Introduction: This study aimed to review the possible sources of infection of 16 oropharyngeal tularemia hospital cases, and to document their epidemiological and demographical characteristics, laboratory findings, treatment methods, and treatment results. Methodology: Sixteen cases from a Turkish military hospital between January 2011 and December 2012 were retrospectively evaluated. The age, sex, occupation, place of residence, symptoms, duration of symptoms, laboratory results, treatment and duration, and treatment results were recorded. Tularemia was diagnosed through tularemia-specific tests once the other conditions that may have caused lymphadenopathy were excluded. Results: Twelve of the patients included in this study were males. The average age of the patients was 32.1±17.2 years. Sore throat, fatigue, and fever were the most frequent symptoms. The mean duration of symptoms was 21.6±6.9 days. All the patients had been treated for tonsillopharyngitis in primary healthcare institutions previously. However, despite the treatment, cervical lymphadenopathy had developed in these cases. Patients were given streptomycin, doxycycline, and ciprofloxacin monotherapy or in combination. Ten of the cases fully recovered, while five required surgical lymph node drainage. Spontaneous drainage occurred in the single remaining case. Conclusions: Turkey is considered to be an endemic country with regards to tularemia. Prompt diagnosis and proper treatment of the disease is imperative in providing cure. Since it can be potentially confused with tuberculous lymphadenitis, differential diagnosis is vital. Patients presenting with a condition of tonsillopharyngitis in endemic areas must be carefully monitored.

Brucellosis is a zoonotic disease caused by Brucella species that is a gram negative coccobacilli and can cause symptoms such as fever, diaphoresis, arthalgia and myalgia. Although humans become infected by contact with animals or consuming dairy products that are contaminated with Brucella, cases in which humans are infected by vaccination are rarely mentioned in the literature. Here, we present the a case of a 24-year old veterinarian who was diagnosed with brucellosis upon being exposed to Brucella abortus S19 while vaccinating a young cattle and accidentally inoculating the pathogen to the thumb of his left hand. He was admitted to the Kocaeli Ozel Konak hospital 36 hours after the inoculation with an edema and sensitivity to pressure in the innoculation site, while the other physical examination findings were normal. At this stage theserological tests (Rose Bengal and agglutination) were negative, while the routin biochemical tests were within normal range. In addition, samples collected from the inoculation site didn’t show any bacterial growth. Despite chemoprophylactic treatment with doxycycline, the patient developed fever, diaphoresis, and testicular pain 21 days after the contact. His body temperature was 38.3 OC and the patient complained about pain when the finger was bended during his second visit. Laboratory tests showed the aspartat aminotransferaz (AST) level was 32 U/L, alanin aminotransferaz (ALT) 25 U/L, and CRP 8.94 mg/dL. The OZET Bruselloz, gram negatif kokobasil olan Brucella cinsi bakterilerin neden oldugu, insanlarda ates, terleme, kas ve eklem agrisi gibi belirtilerle seyreden bir zoonotik hastaliktir. Bruselloz esas olarak enfekte hayvanlarla temas ve enfekte sut-sut urunlerinin tuketilmesi ile bulasmasina ragmen, literaturde asi kaynakli olgular da nadiren bildirilmektedir. Burada; genc sigirlarin asilanmasi sirasinda canli Brucella abortus S19 asisina maruz kalan bir veteriner hekimde gelisen mesleki bruselloz olgusu sunulmustur. Yirmi dort yasindaki erkek veteriner hekim, B. abortus S19 asisi ile sigirlari asilarken asiyi yanlislikla sol el basparmagina inokule etmistir. Hasta, asi inokulasyonundan 36 saat sonra Kocaeli Ozel Konak Hastanesine basvurmustur. Ilk muracaat ettiginde asi inokulasyon yerinde odem, sislik ve hassasiyet saptanmis, diger fizik muayene bulgulari normal olarak degerlendirilmistir. Baslangicta calisilan serolojik testler (Rose Bengal ve serum tup aglutinasyon testi) negatif, rutin biyokimyasal testler ise normal sinirlarda bulunmustur. Ayrica inokulasyon yerinden alinan yara kulturunde bakteri izole edilememistir. Hasta, doksisiklin ile kemoproflaksi uygulanmasina ragmen olaydan 21 gun sonra ates, terleme ve testis agrisi ile tekrar basvurdugu ikinci muracaatinda atesi 38,3 OC olarak saptanmis, inokulasyon bolgesinde fleksiyon sirasinda agri ve gerginlik yakinmasi oldugu belirlenmistir. Laboratuvar incelemesinde aspartat aminotransferaz (AST) 32 U/L, alanin aminotransferaz (ALT) 25 U/L, CRP 8,94 mg/dL, serolojik incelemede Turk Hijyen ve Deneysel Biyoloji Dergisi 1 Gulhane Askeri Tip Fakultesi, Enfeksiyon Hastaliklari ve Klinik Mikrobiyoloji Ana Bilim Dali, ANKARA 2 Ozel Konak Hastanesi, KOCAELI Gelis Tarihi / Received : Kabul Tarihi / Accepted : Iletisim / Corresponding Author : Ahmet KARAKAS Gulhane Askeri Tip Fakultesi, Enfeksiyon Hastaliklari ve Klinik Mikrobiyoloji Ana Bilim Dali, ANKARA Tel : +90 312 304 43 08 E-posta / E-mail : akarakas@gata.edu.tr 24,10,2011 05.02.2012 DOI ID : 10.5505/TurkHijyen.2012.64325 Karakas A, Mert G, Coskun O, Alga OH, Besirbellioglu BA, Eyigun CP. S19 hayvan asisinin kazayla inokulasyonu sonucu gelismis bir bruselloz olgusu. Turk Hij Den Biyol Derg, 2012; 69(1): 37-40. Cilt 69  Sayi 1  2012 Turk Hij Den Biyol Derg 38 Bruselloz gram negatif kokobasil olan Brucella cinsi bakterilerin neden oldugu, insanlarda ates, terleme, kas-eklem agrisi gibi belirtilerle seyreden bir zoonotik hastaliktir. Hastalik esas olarak hayvanlarla direkt temas, enfekte et ve sut urunlerinin tuketilmesi ile bulasir (1). Bununla birlikte; inhalasyon, solid organ ve hematopoetik kok hucre nakli, cinsel iliski ve veteriner hekimlikte kullanilan brusella asilarina maruziyet sonucu da hastalik gelistigi bildirilmistir (2-4). Bu makalede bir veteriner hekimde canli Brucella abortus S19 asisina maruziyet sonucu gelisen bir bruselloz olgusu sunulmus ve literatur isiginda temas sonrasi olgu yonetimi gozden gecirilmistir.

The aim of this study, which evaluated historical data, was to delineate the probable impacts of infectious diseases on human populations under extraordinary circumstances. The second goal was to disclose the mortality rates for infectious diseases in the absence of antibiotics.The Third Ottoman Army records at the Turkish General Staff Military History and Strategic Study Directorate were studied retrospectively for the period between March 1915 and February 1916.For the Third Ottoman Army, the number of infection-related deaths over the single-year period was 23,601. Malaria, relapsing fever and dysentery were the most common infections. In that pre-antibiotic era, the highest mortality rates were seen for cholera (80%), pulmonary tuberculosis (58%) and typhoid fever (51%). However, typhus had the maximum share in soldier deaths (6053 soldiers). The rate of vector-borne infections peaked in the summer of 1915, while the frequency of respiratory tract infections was highest in the colder months. In contrast, gastrointestinal tract infections appeared to maintain a steady state throughout the year.If the wartime data for 1915 are accepted to provide a model for extraordinary circumstances in the 21st century, vector-borne, respiratory tract and gastrointestinal infections can be accepted as the challenging issues with significant mortality.

Objective The central nervous system involvement of Brucellosis causes a hard to treat infection with multiple sequelae. The aim of this paper is to discuss the course of neurobrucellosis in response to therapy. Patients and Methods Patients with neurobrucellosis were evaluated. The diagnosis was established by the isolation of bacteria, abnormal CSF findings and positive serology. Ceftriaxone, rifampicin, doxycycline and trimethoprim sulfamethoxazole were the antibiotic choices for these cases. Results We present 11 cases with neurobrucellosis. None of our patients died, albeit one case has a critical situation due to subarachnoid hemorrhage and its' concordant sequelae. Only one of four patients with walking difficulty and two with hearing loss were normalized with therapy. Imaging techniques did not provide any specific contribution regarding the Brucella infection. Conclusions Parenteral ceftriaxone should be used as an initial alternative in the management of neurobrucellosis. Although the therapy should be individualized, the duration of therapy should be a minimum of six months with suitable antibiotics.

Objective: The purpose of this trial was to determine the spectrum of diseases with fever of unknown origin (FUO) in Turkey. Methods: A prospective multicenter study of 154 patients with FUO in twelve Turkish tertiarycare hospitals was conducted. Results: The mean age of the patients was 42 +/- 17 years (range 17-75). Fifty-three (34.4%) had infectious diseases (ID), 47 (30.5%) had non-infectious inflammatory diseases (NIID), 22 (14.3%) had malignant diseases (MD), and eight (5.2%) had miscellaneous diseases (Mi). In 24 (15.6%) of the cases, the reason for high fever could not be determined despite intensive efforts. The most common ID etiologies were tuberculosis (13.6%) and cytomegalovirus (CMV) infection (3.2%). Adult Still's disease was the most common NIID (13.6%) and hematological malignancy was the most common MD (7.8%). In patients with NIID, the mean duration of reaching a definite diagnosis (37 +/- 23 days) was significantly longer compared to the patients with ID (25 +/- 12 days) (p = 0.007). In patients with MD, the mean duration of fever (51 +/- 35 days) was longer compared to patients with ID (37 +/- 38 days) (p = 0.052). Conclusions: Although infection remains the most common cause of FUO, with the highest percentage for tuberculosis, non-infectious etiologies seem to have increased when compared with previous studies. (C) 2007 International Society for Infectious Diseases. Published by Elsevier Ltd. All rights reserved.

Nekrotizan fasiit temelolarak fasya ve subkutan dokuları tutan, hızlı ilerleyen yıkıcı bir yumuşakdoku infeksiyonudur. Yüksek mortalite riski nedeni ile erken tanı ve tedavihayati önem taşımaktadır. Altmış altı yaşında kronik obstrüktif akciğerhastalığı olan erkek hasta ateş, sağ kalçada, ağrı-şişlik, sağ bacakta şişlik,yürümede güçlük, ağız kuruluğu ve halsizlik yakınmaları ile hastanemizebaşvurdu. Anamnezde intramüsküler steroid enjeksiyonu yaptırdığı öğrenildi.Fizik muayenede sağ gluteal bölgede, sağ uyluk ön ksımından popliteal fossayakadar yayılan hiperemik, ödemli ve dokunmakla ağrılı şişlik saptandı. Sepsisile komplike nekrotizan fasiit olarak değerlendirildi. Hastaya destek ve genişspektrumlu antibiyotik tedavisine ilave olarak cerrahi debritman, vakumdestekli kapama ve hiperbarik oksijen tedavisi uygulandı. Altı aylık tedavisüresi sonunda şifa ile taburcu edildi. Nekrotizan fasiit gelişimi açısındanriskli olduğu değerlendirilen hastalara intramüsküler enjeksiyon yapılırkendikkatli olunmalıdır. Nekrotizan fasiit gelişen olgularda erken tanı, uygunantibiyotik tedavisi ve erken geniş debritmana ilave hiperbarik oksijentedavisi sağ kalım oranlarını arttıracağı değerlendirilmektedir., Necrotising fasciitis is a devastating soft tissue infection which characterised by rapidly progressing necrosis involving mainly fascia and subcutaneous tissues. A 66-year old male patient with chronic obstructive pulmonary disease admitted to our hospital with fever, pain and swelling in the right thigh and right leg, difficulty in walking, dry mouth and weakness. There was a single dose intramuscular steroid injection story in his anamnesis. Physical examination revealed swelling, hyperemia and pain in the right gluteal region spreading through the right femur and popliteal fossa. He was diagnosed necrotizing fasciitis complicated with sepsis. We administered the supportive therapy and broad-spectrum antibiotic therapy in addition to the surgical debridement, vacuum assisted closure and hyperbaric oxygen therapy. The patient was discharged after six months of the follow-up period in hospital. In conclusion, Health-care personnel should be careful when the intramuscular injections planned for patients at the risk of development of necrotizing fasciitis reason of their chronic illnesses or immunosuppressive conditions. In patients who developed necrotizing fasciitis despite everything, we want to strongly emphasise the advantageous hyperbaric oxygen therapy as an additional therapy to the broad spe ctrum antibiotherapy and surgical debridement

PCR-RFLP (restriction fragment length polymorphism) analysis was used to determine the relation of Giardia duodenalis Groups A and B. Of these, 17 (85%) were found as Group A in symptomatic cases; 22 (92%) were Group B in asymptomatic cases by using PCR-RFLP (p < 0.001). Interestingly, 5 (83%) were Group A in examination of endoscopy aspirates of symptomatic cases, as 5 (83%) were Group B in asymptomatic cases.

In total, 171 students from a boarding school in Izmir, Turkey, with mild and non-specific symptoms of toxoplasmosis, were screened during September–October 2002. All 171 students were seropositive for Toxoplasma gondii IgG and IgM. Of 43 students tested, 40 (93%) had low IgG avidity. None showed evidence of ophthalmic involvement. The data suggest that T. gondii may spread rapidly in close living conditions, possibly following exposure to cat litter. This is the largest recent outbreak of toxoplamosis described in the medical literature.

Clinical features, cerebrospinal fluid (CSF) examination, and neuroimaging findings can yield a presumptive diagnosis of tuberculosis meningitis (TM). However, confirmed diagnosis depends on the culture of Mycobacterium tuberculosis from the CSF [1]. Generally, the decision to begin with tuberculostatic treatment cannot await the proof of the causative agent and the prognosis of the disease may be devastating even if treatment is started promptly [2]. Sometimes the clinicians are confused from the diagnostic burden whether to start therapy for TM or not. In some TM cases without microbiological confirmation, the clinical and laboratory parameters resolve very quickly after the initiation of antibiotics. There remains another controversy in this situation, i.e. whether the clinician will stop therapy or continue for 12 months. There is little knowledge on the changes of CSF biochemical parameters during antituberculosis therapy in TM patients. What happens to the biochemical profile in CSF in due course? To the authors’ knowledge there are no data in the literature on this issue. Our study, which was performed between 1 January 2000 and 31 December 2004, focuses on these CNF changes in biochemical profiles for TM patients receiving therapy. There is a chain of military hospitals over the country in Turkey. If a soldier is diagnosed as TM in 1 of the military hospitals, the patient is given antibiotics and sent home for 2 /3 months of rest following the hospitalization necessary for patient stabilization. The patient returns to hospital either in an emergency situation or following the end of the official rest period. Thus, all TM patients return to military hospitals every 2 to 3 months, but the patient does not necessarily apply to the hospital where the disease is diagnosed. Generally the patient applies to the military hospital nearest to where he lives, i.e. another institution may follow a TM case diagnosed in our hospital in the follow-up periods or we may follow a previously diagnosed case in another military hospital during the therapeutic course. In every periodical visit the patient was punctured once again either to delineate the status of infection or to present an official clue to provide the patient with an additional rest time. After the end of 12-month therapy, the surveillance of the patient is stopped. Therefore we have sparse data on TM patients which we may have encountered at any period during anti-tuberculosis therapy. All the cases were young males ranging from 20 to 28 y of age without immunosuppression. Dexamethasone was given to all patients in standard dosages

A 79-year-old male suffering from nasal congestion was referred to our hospital. Endoscopic examination revealed a hyperemic mass obstructing the left nasal passage. The lesion's surface was smooth. The findings of imaging studies were consistent with a benign tumor despite the erosion and perforation of the septum. The lesion originated from the middle concha and was attached to it with a thin stalk. It was removed easily by endoscopic resection. Histopathology revealed significant infiltration of mononuclear inflammatory cells, mostly lymphocytes and histiocytes, into the edematous subepithelial connective tissue. High-power magnification showed numerous Leishmania amastigotes in the cytoplasm of the histiocytes. A polymerase chain reaction experiment for Leishmania also confirmed the morphological diagnosis. No relapse was observed in the 12 months after surgery and the patient was doing well.

This research was carried out to determine most important risk factors in the development of MRSA by comparing infections due to methicillin resistant and susceptible strains to make suggestions to decrease MRSA ratios by pointing out the importance of pre-infection antibiotic usage in the development of MRSA infection and its place among the other risk factors.

Aim: The aim of this study is to explore the knowledge and motivations of voluntary blood donors toward allojeneic hematopoietic stem cell donation also, and to determine predictors of hematopoietic stem cell donation motivation among them. Material and methods: The knowledge and motivations of voluntary blood donors toward hematopoietic stem cell donation were evaluated using a questionnaire with 42 items. The sample consisted of 100 voluntary blood donors that admitted to Gulhane Military Medical Faculty Blood Training Center and Blood Bank Department, between May 1st and September 1st, 2015. Results: The mean age of participant was 33.5±6.8 and 83% of them was male. 91% of participant have never get information about hematopoietic stem cell donation and transplantation and 80% of them would like to get information. although 47% of participants keen on for donate ; they haven’t considered such concerns as the deterioration of bodily integrity (75.5%), a negative impact on their health (64.1%) and discomfort (37.7%) before. It was found to be willing for HSC donor both in routine blood donors and in higher education group (respectively values of p

Therapy with metronidazole is the recommended option in giardiasis. However, some clinical trial reports suggest the appearance of drug resistance to explain therapeutic failure. Several investigations have been carried out on the effect of probiotic microorganisms for preventing or treating gastrointestinal diseases, but little is known about their efficacy against protozoal infections. The principal objective of our study was to evaluate the efficacy of Saccharomyces boulardii against Giardia lamblia infections. A double-blind, placebo-controlled study was carried out on adult patients with giardiasis. Group 1 (30 patients) included metronidazole 750 mg 3 times daily along with S. boulardii capsules (250 mg b.i.d. orally) for 10 d while group 2 (35 patients) was treated with metronidazole 750 mg 3 times daily and with empty capsules as placebo for 10 d. Patients were re-examined at 2 and 4 weeks after treatment, and stool examinations were performed. At week 2, G. lamblia cysts were detected in 6 cases (17.1%) of group 2 and none in group 1. At the end of the fourth week, presence of the cysts continued in the same 6 cases in group 2 (control group). These findings indicated that S. boulardii may be effective in treating giardiasis when combined with metronidazole therapy.

Cephalosporins are widely used and trustworthy antibiotics in daily medical practice. Although antibacterial resistance has been reported in hospital wards, there are less data for community-acquired infections. In this study we investigated the cephalosporin susceptibility profiles of community-acquired Gram-negative bacteria isolates in Sivas Kizilay Medical Center (Turkey) between March 2002 and March 2003. In our study, 949 Escherichia coli, 165 Proteus spp., 97 Enterobacter spp., 24 Klebsiella spp and 84 Pseudomonas aeruginosa strains were evaluated. Cefepime seemed to be the most effective antibiotic against our community-acquired Gram-negative isolates. Resistance to this drug was 19.3% for P. aeruginosa and around 0-10.6% for enteric bacteria. Enteric pathogen resistance ranged between 44.3-100% for cefazolin, 25-51.9% for cefuroxime, 4.8-25.3% for ceftriaxone, 5.4-14.5% for ceftazidime. Resistance in enteric pathogens to gentamicin ranged between 5.8-15.4%, to amikacin between 3.8-6.25%, to ciprofloxacin between 6.7-20%. 8.1% of P. aeruginosa were resistant to ciprofloxacin. With these profiles the aminoglycosides and ciprofloxacin resemble highly effective cephalosporins like cefepime. On the contrary, first- and second-generation cephalosporins, trimethoprim-sulfamethoxazole, ampicillin and ampicillin-sulbactam are no longer used in probable Gram-negative bacterial infections in our region. Since treatment based on cephalosporins was less efficacious than expected in community-acquired infections, urgent measures are needed to limit antibacterial resistance outside of hospitals.

We developed a new TaqMan-based one-step real-time reverse transcription-polymerase chain reaction (RT-PCR) assay for detection and quantification of mumps virus RNA. Oligos targeting the matrix protein gene of mumps virus were designed by using our oligo designing and analyzing software, Oligoware 1.0. Oligos's specificity was tested with 5 strains (4 laboratory isolated and 1 Jeryl Lynn strain) of mumps virus. The suggested TaqMan-based one-step real-time RT-PCR assay correctly detected the 4 laboratory-isolated strains and 1 Jeryl Lynn strain. To confirm the specificity of the TaqMan PCR assay, parainfluenza type 1, 2, 3 strains, sendai virus, and measles virus (vaccine strain) were tested, and no cross-reactivity was observed between mumps and tested strains. In addition, a BLAST (NCBI) search showed no genomic cross-reactivity with other viruses or cells. Testing of the assay's reproducibility was repeated several times, and the same results were achieved. The new assay was able to quantify the concentrations of mumps virus gene ranging from 10(1) to 10(8) copies per reaction sensitively with generated plasmid standards. In addition, it was shown that a significant correlation (R2 = 0.9564) between genome number as determined by one-step real-time RT-PCR and the corresponding number of plaque in paired samples was found with regression analysis. The results of one-step real-time RT-PCR assay also corresponded well to those of nested PCR. We conclude that our one-step real-time RT-PCR assay is a reliable, specific, and sensitive tool for the diagnosis of mumps virus. We consider that these results come from highly conserved primers and probe set that were designed with Oligoware 1.0.

PubMed ID: 22177310, Background: Training of infectious disease (ID) specialists is structured on classical clinical microbiology training in Turkey and ID specialists work as clinical microbiologists at the same time. Hence, this study aimed to determine the clinical skills and knowledge required by clinical microbiologists.Methods: A cross-sectional study was carried out between June 1, 2010 and September 15, 2010 in 32 ID departments in Turkey. Only patients hospitalized and followed up in the ID departments between January-June 2010 who required consultation with other disciplines were included.Results: A total of 605 patients undergoing 1343 consultations were included, with pulmonology, neurology, cardiology, gastroenterology, nephrology, dermatology, haematology, and endocrinology being the most frequent consultation specialties. The consultation patterns were quite similar and were not affected by either the nature of infections or the critical clinical status of ID patients.Conclusions: The results of our study show that certain internal medicine subdisciplines such as pulmonology, neurology and dermatology appear to be the principal clinical requisites in the training of ID specialists, rather than internal medicine as a whole. © 2011 Erdem et al; licensee BioMed Central Ltd.