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Introduction Pharmacy staff are part of the healthcare delivery. In some cases, the patient goes to the pharmacy before the doctor and asks for a medicine suitable for his own complaint. The aim of this study is to evaluate the awareness about the importance of high fever in patients with leukemia and lymphoma receiving chemotherapy among healthcare professionals working in non-hospital pharmacies. Material and method The study is a survey study. 140 pharmacy employees working in non-hospital pharmacies in Ankara Province were included in the study. Volunteer participants were included in the study. Seven questions were asked to the participants. Results About 47.1% of the participants stated that they would advise patients to go immediately to the nearest hospital's emergency department when they presented to the pharmacy and said that they had high fever. It was stated by 56.5% of the participating pharmacy employees that high fever did not pose the same risk for a leukemia or lymphoma patient receiving chemotherapy as it did for a leukemia or lymphoma patient not receiving chemotherapy. Conclusion In this study, it was found that awareness about importance of high fever in leukemia and lymphoma patients receiving chemotherapy among healthcare professionals working in pharmacies other than hospital pharmacies was not very high. Providing necessary information to the pharmacy personnels and increasing the awareness about importance of high fever in leukemia and lymphoma patients receiving chemotherapy among the non-hospital pharmacy staff might also contribute to the reduction of negativities associated with infections in such patients.

Hematopoietic stem cell transplantation (HSCT) recipients may be at an elevated risk of developing active tuberculosis infection due to suppression in the cellular immune system. Herein, we aimed to evaluate the prevalence of latent tuberculosis and active tuberculosis in patients with allogeneic and autologous HSCT. In this cohort, data were obtained retrospectively from patients' records. The patients who were followed up in the bone marrow transplantation unit of the University of Health Sciences Dr Abdurrahman Yurtaslan Ankara Oncology Education and Research Hospital between January 2016 and December 2019 were screened for the study. And the HSCT recipients who had tuberculin skin test and/or QuantiFERON-TB gold (QFT-GIT) test results were included in the study. A total of 361 patients were included in the study, 227 patients had autologous HSCT, and 134 patients had allogeneic HSCT. QFT-GIT was performed in 10 patients with allogeneic HSCT, and it was found positive in only 1 patient. Tuberculin skin test ≥5 mm was accepted as positive and was accepted to have latent tuberculosis, and it was positive in 18.2% (41) of the patients with autologous HSCT and was positive in 21.6% (29) of the patients with allogeneic HSCT. There was no significant difference between the 2 groups (P = .429). Isoniazid (INH) prophylaxis was started in 16.7% of patients with autologous HSCT and 22.4% of patients with allogeneic HSCT. During follow-up, active tuberculosis did not develop in any patients in both groups. There was no statistically significant difference found between allogeneic and autologous HSCT recipients regarding the prevalence of latent tuberculosis. Active tuberculosis infection did not develop in any of the patients who started INH prophylaxis. INH prophylaxis seems to be very efficient in preventing the reactivation of latent tuberculosis in patients going through allogeneic HSCT and/or autologous HSCT.

Introduction: In cancer patients, percutaneous nephrostomy (PN) catheters can be used to relieve obstruction from chemotherapy, radiation therapy, or surgery, thereby improving kidney function and preventing further kidney damage. One of the complications of PN catheters is infections. Recurrent infections may delay chemotherapy, increase antimicrobial resistance with frequent antibiotic use, deteriorate the quality of life of patients, and increase costs. In this study, it was aimed to evaluate risk factors, causative pathogens, and treatment in recurrent PN catheter-related urinary tract infections in cancer patients. Material and method: The study had a retrospective design. Cancer patients with PN catheter-associated urinary tract infection who were followed-up in the Infectious Diseases and Clinical Microbiology Clinic between 01/01/2012 and 12/31/2021 were included in the study. IBM SPSS Statistics for Windows 24.0 was used to compare the statistical data. Results The study included 48 patients with recurrent PN catheter-related urinary tract infections and 75 patients without. The total catheterization time, and occurrence of pre-infection catheter replacement, active chemotherapy, and kidney stones were significantly higher in patients with recurrent infection when compared to the other group (P = 0.000, P = 0.000, P = 0.007, and P = 0.018, respectively). ESBL-positive Escherichia coli and ESBL-positive K. pneumoniae were most commonly isolated from the left and right PN catheter urine cultures of patients with recurrent infections. The most commonly used antibiotic in the treatment was ertapenem, followed by meropenem. Discussion Long-term use of the PN catheter increases the risk of urinary tract infection and sepsis. In this study, the total catheterization time, and occurrence of pre-infection catheter replacement, active chemotherapy, and kidney stones were found to be risk factors for the development of recurrent PN catheter-related urinary tract infection in cancer patients. Conclusion It is important to know the risk factors in recurrent PN catheter-related urinary tract infections in cancer patients, take maximum protective measures, and follow-up. Knowing both the causative profile and the resistance rates will increase the chance of success in the treatment when empirical treatment is required. It should also be noted that these patients should be included in the group of patients who need prophylaxis for urinary tract infection.

Introduction: Healthcare workers are at increased risk of vaccine-preventable diseases than the normal population. In this study conducted in an oncology hospital, the immunity rates of healthcare workers against measles, rubella, mumps (MMR) and chickenpox and the agreement between immunity and the history of illness were evaluated. Materials and Methods: Serological tests against MMR and chickenpox were performed by the ELISA method in healthcare workers who applied to the Personnel Health Polyclinic. With a questionnaire, age, sex, profession, duration of work, the diseases and vaccination history and the ways of transmission were questioned. In statistical analysis, “IBM SPSS Statistics 24” package program and the kappa (κ) coefficient of concordance were used. Results: In a total of 328 healthcare workers, the average age was 40.1 ± 7.4 years and 75.9% were females. IgG seropositivity for measles, rubella, mumps and chickenpox was found 95.7%, 93.6%, 82.3%, and 95.4% respectively. A statistically significant proportion of those who were seronegative for measles (50.0%; p= 0.041) were in the age group ≤ 34. The nurses group answered transmission routes significantly correctly (44,8%; p< 0.05). The kappa (κ) coefficient of concordance between seropositivity and the history of the diseases was weak (κ< 0.10). Conclusion: This study shows that especially in hospitals where immunosuppressive patients are treated, the immune status of healthcare workers against MMR and chickenpox should be determined by serological tests, and seronegative workers should be vaccinated.

Thiol-disulphide homeostasis in patients with surgical site infections Duygu Mert1, Murat Alışık2, Cihat Oğan1, Salim Neşelioğlu3, Mustafa Ertek1, Özcan Erel3 1University of Health Sciences Dr. Abdurrahman Yurtaslan Ankara Oncology Training and Research Hospital, Department of Infectious Diseases and Clinical Microbiology, Ankara, Turkey 2Muş State Hospital, Department of Medical Biochemistry, Muş, Turkey 3Ankara City Hospital, Department of Medical Biochemistry, Ankara, Turkey ABSTRACT Objectives: In infectious diseases, various inflammatory cells are active and reactive oxygen species are produced to fight against intra cellular and extra cellular microorganisms. This leads to an increase in potential antioxidant capacity and free radical production. Thiol is an important antioxidant. Thiols enter oxidation reactions with oxidative molecules and it form disulphide bonds. The aim of this study was to evaluate the dynamic thiol/disulphide homeostasis in patients with surgical site infection (SSI). Methods: Sixty-eight patients with SSI and 66 healthy persons (control group) were included in this study. Complete blood count, biochemistry, erythrocyte sedimentation rate, C-reactive protein values and thiol levels were studied in blood of the patients at 0th day and 10th day. The blood thiol disulphide homeostasis was analysed using a new automated method developed by Erel and Neselioglu. Results: Native thiol, total thiol, albumin levels and native thiol/total thiol ratio were found significantly lower in the blood samples at day 0th compared to 10th day. There was a statistically significant difference between the patient group and the control group in IMA, native thiol, total thiol, albumin, disulphide levels, disulphide/native thiol, disulphide/total thiol and native thiol/total thiol ratios Conclusions: The thiol-disulphide balance is impaired in SSI. The elevated disulphide/total thiol ratio and disulphide/native thiol ratio, and reduced native thiol/total thiol ratio indicate increased oxidation in SSI. There is also a strong association between CRP, ESH and thiol-disulphide parameters. Thiol-disulphide homeostasis may potentially be of benefit in inflammatory response. J Microbiol Infect Dis 2020; 10(3):160-166.

Introduction: We aimed to evaluate the epidemiology of infections and factors associated with mortality in patients with febrile neutropenia (FEN). Methodology: The adult patients, who developed FEN after chemotherapy due to a hematologic malignancy or a solid tumor in a training and research hospital were evaluated, retrospectively. The demographic data of the patients, underlying malignancy, administered antimicrobial therapy, microbiological findings, and other risk factors associated with mortality were evaluated. Results: A total of 135 FEN episodes of 115 patients, who comprised of 72 (63%) patients with 89 FEN episodes due to hematologic malignancies (hemato-group) and 43 (37%) patients with 46 FEN episodes due to solid organ cancers (onco-group), were evaluated in the study. The median age was 47 years (range: 17-75 years) and 66 (57%) patients were male. A total of 12 patients (8.8%) died during 135 episodes of FEN including nine cases from hemato-group and three cases from onco-group. Those factors including a presence of pneumonia, advanced age, persistent fever despite an antimicrobial treatment, and need for mechanical ventilation in intensive care unit (ICU) with were determined as risk factors associated with mortality. Conclusions: Morbidity and mortality are more common in patients with hematological malignancies compared to patients with solid organ cancers due to prolonged neutropenia. In case of persistent fever, an invasive fungal infection (IFI) should be kept in mind in patients with hematologic malignancies and then antifungal treatment should be initiated. Although a persistent fever is also common in patients with solid tumors, the necessity of antifungal therapy is rare due to the short duration of neutropenia.

Introduction: Hepatitis C virus infection is a major cause of cirrhosis and liver cancer worldwide. The knowledge of physicians about what should they do in case of any anti-HCV positivity in screening tests is of great importance. In this study the awareness and knowledge of physicians is evaluated by analyzing the rate of the referrals of anti-HCV positive patients to HCV RNA test and their treatment by different clinics. Methodology: The patients tested for anti-HCV in internal medicine, surgery, gastroenterology and infectious disease clinics between 1 January and 31 December 2017 were evaluated retrospectively in a tertiary care hospital. Results: Anti-HCV testing was performed in 32,803 patients. Anti-HCV positivity was detected in 95 (0.28%) patients aged 88 years of age or younger (mean 60.89 ± 16.96 years), 57.89% of them were female. HCV RNA was tested in 50 (%52,63) of anti-HCV positive patients and it was found positive in 18 (36%) patients. In anti-HCV positive patients HCV RNA testing was requested most by infectious disease (100%) and gastroenterology (70.58%) clinics and least by surgery and other clinics (21% and 25% respectively). These differences were found to be statistically significant ( =33.65, p < 001). Conclusions: Our study highlights the significant deficiencies existed in the referring patients with anti-HCV positivity for further examination and treatment by the attending physicians especially in surgical clinics. Performing HCV screening in the different steps of medical care and using electronic reminder systems directing physicians at appropriate diagnostic and treatment protocols can maximize the likelihood of the detection and treatment of HCV- infected patients.

Backgrounds: Non-Hodgkin's lymphoma and Hodgkin's lymphomas (HL) are lymphoid neoplasms. Hepatitis B virus (HBV), hepatitis C virus (HCV), and human immunodeficiency virus (HIV) are viruses that could proliferate in lymphoid tissues. These viruses may cause lymphoproliferative diseases. The aim of this study was to evaluate the seroprevalence of HBV, HCV, and HIV in patients with diffuse large B-cell lymphoma (DLBCL) and HL, to compare the relationship between these two disease groups and to determine the relationship between the three viruses and their characteristics. Materials and Methods: The study was a retrospective study. Patients who were followed up in hematology and hepatitis outpatient units between January 01, 2012, and May 01, 2019, were included in the study. Results: A statistically significant relationship was observed between the disease groups in terms of hepatitis B surface antigen (HBsAg), hepatitis B core (HBc) IgG antibody, hepatitis B e antigen (HBeAg), and anti-HBe seropositivities (P = 0.004, P = 0.006, P = 0.041, and P = 0.014, respectively). There was also a statistically significant relationship between the disease groups in terms of anti-HCV seropositivity (P = 0.029). HBsAg, anti-HBc IgG, HBeAg, anti-Hbe, and HCV seropositivity rates were higher in patients with DLBCL than in patients with HL. Conclusion: These findings suggest that there may be a relationship between hepatitis viruses and DLBCL. Evaluation of HBV and HCV infections in these patients before starting treatment is thought to be beneficial in initiating antiviral prophylaxis to prevent reactivation in seropositive cases. In addition, care should be taken for the development of lymphoma in the follow-up of HCV and HBV infections.

Objective To evaluate the possible neutropenia-related effects of administering adriamycin [doxorubicin], bleomycin, vinblastin, dacarbazine (ABVD) chemotherapy in Hodgkin’s lymphoma patients with moderate or severe neutropenia without granulocyte-colony stimulating factor supplementation. Methods This study evaluated neutropenia-related outcomes and the need for granulocyte-colony stimulating factor use during the periods between chemotherapy rounds. Forty-three rounds of ABVD chemotherapy were evaluated in the study. The outcomes that could be related to neutropenia were analyzed. In addition, rounds of ABVD chemotherapy given in the presence of severe neutropenia were compared with ABVD chemotherapy rounds given in the presence of moderate neutropenia in terms of neutropenia-related outcomes and the need for granulocyte-colony stimulating factor use. The study only included patients with classical Hodgkin's disease (lymphoma). Patients with a final neutrophil count of 3 cells/µL (Results We observed that none of the patients with moderate neutropenia before the start of chemotherapy round needed granulocyte-colony stimulating factor, and four patients with severe neutropenia prior to the start of chemotherapy round required granulocyte-colony stimulating factor. However, there was no statistically significant relationship between the severity of neutropenia (in terms of moderate and severe) before chemotherapy and granulocyte-colony stimulating factor requirement after chemotherapy (p> 0.05). Furthermore, none of the patients included in the study had bleomycin-related lung toxicity during the treatment periods included in the study. Conclusion Administering ABVD chemotherapy to patients with moderate neutropenia seems to be safe.

Objectives: In this research article, the authors carried out a multi-center study to evaluate the exposure and vaccination status of selected Turkish health-care workers for measles, rubella, mumps, and varicella zoster. Methods: The authors conducted a survey research by a questionnaire for health-care workers. The participants were questioned about vaccination and exposure of mumps, measles, rubella and varicella zoster virus. Results: A total of 5165 health-care workers; 1665 male (32.2%) and 3500 female (67.8%) participated in the study. The rates of measles, rubella, mumps and varicella history in the participants were found to be 39.2%, 21.8%, 50.8% and 56.9%, respectively. When health-care workers were asked about vaccination against measles, mumps and rubella; 2327 (47.4%) participants could not remember, 1423 (29%) participants stated that they had not been vaccinated and 763 (15.5%) had been vaccinated. Only 55 (1.1%) of the participants stated that they had measles vaccination. In total 2376 (49%) participants stated that they had not been vaccinated against varicella zoster and 451 (9.4%) people did not have vaccination since they already had developed disease and 1913 (39.8%) people did not remember their vaccination status for varicella zoster. Only 68 (1.4%) health-care workers stated that they had been vaccination against varicella zoster. Conclusions: The authors found that only a small group of health-care workers were vaccinated against these diseases and most of them could not remember whether they had been exposed to these viruses. J Microbiol Infect Dis 2019; 9(3):104-111.

Introduction: Patients with hematological malignancies, who are in the high risk group for infectious complications and bacterial bloodstream infections. The aim of the study evaluated epidemiology and mortality in bacterial bloodstream infections in patients with hematologic malignancies. In addition to determine the risk factors, changes in the distribution and frequency of isolated bacterias. Methodology: In this retrospective study. There were investigated data from 266 patients with hematological malignancies and bacterial bloodstream infections who were hospitalized between the dates 01/01/2012 and 12/31/2017. Results: There were 305 blood and catheter cultures in febrile neutropenia attacks in total. In these total attacks, primary bloodstream infections were 166 and catheter-related bloodstream infections were 139. In blood cultures; Escherichia coli and Klebsiella pneumoniae bacteria were detected in 58,0% and 22,9% of the samples, respectively. 52,4% of the cultured Gram-negative bacterias were extended spectrum beta-lactamase (ESBL). Carbapenemase positive culture rate was 17,2% in Gram-negative bacteria cultures. Staphylococcus epidermidis was found in 38,4% of the Gram-positive bacteria cultures. In Gram-positive bacteria; methicillin resistance were detected in 82,2% of the samples. There was a statistically significant relationship between bloodstream infection and disease status. 60 patients with primary bloodstream infections were newly diagnosed. Conclusions: In patients with hematological malignancies, certain factors in the bloodstream infections increase the mortality rate. With the correction of these factors, the mortality rate in these patients can be reduced. The classification of such risk factors may be an important strategy to improve clinical decision making in high-risk patients, such as patients with hematological malignancies.

Introduction: Bloodstream infection (BSI) caused by Enterobacteriaceae is associated with mortality in cancer patients receiving chemotherapy. The aim of this study is to identify the risk factors and outcomes related to BSIs caused by extended-spectrum beta-lactamase (ESBL)-producing Enterobacteriaceae in cancer patients. Methodology: Hematology/oncology patients, who were diagnosed with BSIs caused by Enterobacteriaceae by positive blood cultures were evaluated retrospectively. Patients were divided into two groups by ESBL-positive and ESBL-negative Enterobacteriaceae bacteremia. Patients' demographic features, underlying conditions, comorbidity, neutrophil count, duration of neutropenia, antibiotic use in the previous three months before infection, mechanical ventilation, steroid use, central venous catheter implementation, total parenteral nutrition (TPN), hospitalization in the past three months, stay in intensive care unit, quinolone prophylaxis, and history of infection with ESBL-producing Enterobactericeae were evaluated. Risk factors related to BSIs caused by ESBL-producing Enterobacteriaceae and mortality were assessed. Results: A total of 122 patients were evaluated retrospectively. Quinolone propyhlaxis, TPN, infection with Extended Spectrum Beta-Lactamase positive ESBL-P Enterobacteriaceae during the previous three months, treatment with piperasillin-tazobactam or carbapenems in the previous three months were found to be independent risk factors for ESBL-P BSIs. Longer duration of neutropenia before BSI and complication at the beginning of BSI were found to be independent risk factors for mortality related to infection. Conclusions: ESBL-producing Enterobacteriacea should be treated with an appropriate antibiotic that is associated with better outcomes in hematology/oncology patients with BSIs. History of broad-spectrum antibiotic use and stay in hospital in the previous three months should be taken into consideration upon commencing antibiotic therapy.

Introduction: Patients treated in the intensive care unit (ICU) are usually patients who deteriorated health condition and could have longer hospital stay compared to other patients. Hospital infections are more common in ICU patients. The aim of this study was to evaluate the bacteria and treatment resistance profiles isolated from clinical specimens sent for hospital infections in ICU patients between January 1, 2014 and December 31, 2018. Methodology: Bacteria isolated from various clinical samples sent for hospital infections in hospitalized patients in the Anesthesia and Reanimation Intensive Care Unit were retrospectively analyzed. Results: Culture positivity was detected in 547 of the sent clinical samples. Eighty Gram-positive bacteria, 389 Gram-negative bacteria and 78 fungi infection were identified in a total of 547 positive cultures. In Gram-positive bacteria, 4 MRSA, 6 VRE and 30 MRCoNS were identified as resistant strains. In Gram-negative bacteria, Acinetobacter spp. was the most culture positive strain with the number of 223. Carbapenem resistance was found in 258 of the Gram-negative bacteria and ESBL positivity was found in 44 of the Gram-negative bacteria strains. Conclusions: Gram-negative bacteria were the most frequently isolated strain in samples. Recently, colistin resistance has been increasing in Acinetobacter spp. and the increase in carbapenemase enzyme in Escherichia coli, Pseudomonas and Klebsiella species has increased resistance to carbapenems. Knowing the microorganisms that grow in ICUs and their antibiotic resistance patterns may help to prevent contamination of resistant microorganisms by both appropriate empirical antibiotic treatment and more isolation as well as general hygiene standard precautions.

Aim: The aim of this study is to evaluate the attitudes of healthcare workers against seasonal influenza vaccine and the reasons for vaccine avoidance. Materials and Methods: This national survey was conducted from April 1st to June 30th in 2017. The study was carried out among health care workers working in primary, secondary and tertiary care settings. A total of 12 questions were sent to 5046 health care professionals from 55 different cities who agreed to participate in the survey.Results: 7% of the participants stated that they get vaccinated regularly every year. 65.8% of the participants stated that they don’t get vaccinated at all. The most important reason for those who did not receive influenza vaccination was their disbelief in the necessity of the vaccination (51.9%). The most common reason for the seasonal influenza vaccination was the prevention of influenza infection (56.7%).Conclusion: The results of the study showed that HCWs influenza vaccination rates are very low. Doctors have been found to have slightly better rates than other HCWs. The high level of education and the increase in professional experience had a positive effect on the vaccination rate. It is important to know the HCWs attitudes and behaviors towards the vaccination to increase the rates., Amaç: İnfluenza tüm dünyada önemli ölçüde morbidite, mortalite ve maliyet yükünden sorumludur. Sağlık çalışanları (HCP) mesleksel bulaş açısından risk altındadırlar. Bu çalışmada sağlık çalışanlarının mevsimsel influenza aşısına karşı tutumlarının ve aşıdan kaçınma nedenlerinin değerlendirilmesi amaçlanmıştır.Gereç ve Yöntem: Bu çok merkezli ulusal anket çalışması 1 Nisan-30 Haziran 2017 tarihleri arasında gerçekleştirildi. Ankete katılmayı kabul eden 55 şehirden toplam 5046 HCP uzaktan katılım yoluyla cevaplamaları için toplam 12 sorudan oluşan bir anket gönderildi.Bulgular: Çalışmaya katılanların %7’si her yıl düzenli olarak aşı yaptırdığını belirtti. Hiç yaptırmıyorum diyenlerin oranı %65,8 idi. İnfluenza aşışını yaptırmayanların en önemli nedeni grip aşısının gerekliliğine inanmama idi (%51,9). Mevsimsel grip aşısı yaptıranların en önemli gerekçesi grip infeksiyonundan korunma (%56,7) idi.Sonuç: Sonuçlarımız, tüm HCP influenza aşılama oranlarının çok düşük olduğunu göstermiştir. Doktorların diğer HCP’lerden biraz daha iyi oranlara sahip olduğunu görülmüştür. Eğitim düzeyinin yüksek olması ve mesleki tecrübenin artması aşılama oranını olumlu yönde etkilemiştir. Sağlık çalışanlarının aşılanma oranlarının artırılabilmesi için öncelikle aşı konusundaki tutum ve davranışlarının bilinmesi gerekir.

Mature natural killer /T-cell (NK/T-cell) lymphomas are a rarely occurring subgroup of Non Hodgkin Lymphomas (NHL). A large majority of NK/T cell lymphomas are extranodal. Nasal type is the most common one. As clinical symptoms are usually nasal obstruction associated with mass lesion and epistaxis in extranodal NK/T cell lymphomas. Their diagnosis is usually delayed when the disease is advanced, it may have serious consequences. The aim of the present article was to present the clinical, radiological and histopathological findings of a 69-year old female patient who had refractory ulcerated wound on left side of nose and followed for soft tissue infection. It was diagnosed with extranodal NK/T cell lymphoma after deep biopsy was obtained from the lesion and to discuss this rare disease in view of literature data. J Microbiol Infect Dis 2016;6(3): 140-144

Hepatitis B (HBV) and hepatitis C (HCV) viruses are hepatotropic and lymphotropic viruses that can proliferate either in lymphocytes and monocytes or hepatocytes. The aim of this study was to evaluate the seroprevalence of HBV, HCV, and human immunodeficiency virus (HIV) in patients with plasma cell disorders. We also aimed to compare patients with plasma cell disorders and chronic lymphocytic leukemia (CLL) in terms of HBV, HCV, and HIV seropositivity. This is a retrospective study. The patients who had patient file in the Multiple Myeloma Outpatient Unit of our hospital and were followed in our outpatient unit between January 1, 2012 and September 15, 2019, with diagnoses of either of the plasma cell disorders were included in the study. In addition, 272 CLL patients who were admitted to the Leukemia Outpatient Unit of our hospital were also enrolled in the study. The 2 disease groups were compared in terms of HBV, HCV, and HIV seropositivity. A statistically significant relationship was found between disease groups according to hepatitis B surface antigen (P

Mature natural killer /T-cell (NK/T-cell) lymphomas are a rarely occurring subgroup of Non Hodgkin Lymphomas (NHL).A large majority of NK/T cell lymphomas are extranodal. Nasal type is the most common one. As clinical symptoms areusually nasal obstruction associated with mass lesion and epistaxis in extranodal NK/T cell lymphomas. Their diagnosisis usually delayed when the disease is advanced, it may have serious consequences. The aim of the present article wasto present the clinical, radiological and histopathological findings of a 69-year old female patient who had refractoryulcerated wound on left side of nose and followed for soft tissue infection. It was diagnosed with extranodal NK/T celllymphoma after deep biopsy was obtained from the lesion and to discuss this rare disease in view of literature data. JMicrobiol Infect Dis 2016;6(3): 140-144 &nbsp

Objective:At the present time viral hepatitis and HIV infection are important global health problems. The aim of this study was to investigate the rates of HAV, HBV, HCV and HIV seropositivity in people those admitted to Batman State Hospital between Macrh 2010 and March 2011.Materials and Methods:Blood samples were searched for HAV IgG, HBsAg, AntiHBs, Anti-HCV and Anti-HIV with CMIA (Chemiluminescent Microparticle Immunoassay) method (Architect İ2000 SR, USA).Results:For anti-HBs, 10957 samples were analyzed and 5266 (48.06%) of these samples were positive. For anti-HCV 9666 samples were analyzed and 186 (1.9%) of these samples were positive. For HAV IgG 2606 samples were analyzed and 2447 (93.9%) of these samples were positive. For anti-HIV 1/2 6442 samples were analyzed and only 1 sample was positive (0.015%).Conclusion:In conclusion; despite the relatively lower rate of HIV seropositivity, hepatitis viruses, particularly HBV remains to be a significant health problem in our province. Effective vaccination coverage and public awareness about infection control measures would be expected to decrease the emergence of new cases.

Hepatitis A is a widespread infectious disease. The prevalence of the disease is closely related to socioeconomic status (SES) and environmental factors. Understanding its prevalence is essential for instituting appropriate precautions. The aim of this study was to determine the prevalence of hepatitis A and evaluate the associated demographic features in children and young adults in Istanbul. In total, 630 individuals between the ages of 5-24 were included in the study. They were classified into four age groups (5-9, 10-14, 15-19 and 20-24 years). The seropositivity of hepatitis A in the whole study population was 40%. Age-specific prevalence was 11.4% in children 5-9 years old, 29% in those 10-14 years old, 49.7% in those 15-19 years old and 69% in those 20-25 years old. Seropositivity was associated with increasing age, low SES, large family size, low maternal educational level, use of unsafe drinking water and living in regions with poor infrastructure and incomplete urbanization. When we compared our results with previous seroprevalence studies performed in Istanbul, we found an epidemiological shift towards increasing age. Factors associated with changes in prevalence were urbanization and associated infrastructure improvement, knowledge of the disease by the population, use of good hygiene and use of vaccination in those at high risk.

Uncomplicated lower urinary tract infections (UTIs) are the most frequent infections in females. Increased resistance rates against commonly used antibiotics have led to the use of novel antimicrobials. The aim of the present study was to evaluate the bacteriological and clinical effects of single-dose fosfomycin trometamol (FMT) and 5-day ciprofloxacin in females with uncomplicated UTIs. In this randomized comparative study, 260 female patients between 18 and 65 years of age enrolled, of whom 142 completed the study. The most frequently isolated bacterial pathogen in the urine cultures of patients were Escherichia coli (82.3%) and Enterobacter spp. (8.4%). FMT sensitivity was 94% and ciprofloxacin sensitivity was 59% in Escherichia coli; in comparison, FMT sensitivity was 75% and ciprofloxacin sensitivity was 50% in Enterobacter spp. The MIC90 for FMT was 4 μg/ml. Of the 142 patients, 77 were treated with FMT and 65 were treated with ciprofloxacin. The clinical remission rate was 83% in the FMT group and 81% in the ciprofloxacin group; the bacterial eradication rate was 83% in the FMT group and 78% in the ciprofloxacin group, and there was no significant difference between the two study groups. In conclusion, a single dose of FMT (at 3 g) was as effective as ciprofloxacin, at 500 mg twice a day for 5 days, in the treatment of uncomplicated lower UTIs. It was concluded that the use of FMT as a first-line treatment in the empirical treatment of uncomplicated UTIs might have a positive impact on the problem of resistance to other antibiotics.

Tenofovir disoproxil fumarate (Tenofovir DF) is a nucleotide analogue. This multicentre study reports retrospectively the long-term efficacy and safety data with tenofovir DF treatment in nucleosid(t)e-naive, hepatitis B e antigen (HBeAg)-positive chronic hepatitis B patients. Thirty-one patients (11 females, 20 males) received 245 mg tenofovir DF per diem. All patients' initial serum hepatitis B virus (HBV) DNA levels were over 2,000 IU/ml. Serum alanine aminotransferase (ALT) levels, HBeAg, hepatitis B e antibodies (anti-HBe), hepatitis B surface antigen (HBsAg), hepatitis B surface antibodies (Anti-HBs), HBV DNA, creatinine and urea levels were evaluated at baseline, and at weeks 12, 24, 48 and 96 during therapy. Thirty-one patients completed 96 weeks of treatment. Mean age was 37.6 ± 9.4 years. The initial mean value of ALT was 79 ± 39.9 IU/L. At baseline, mean of fibrosis (Ishak) of liver biopsies was 2.3 ± 0.7. Two of the patients (5.9%) achieved HBV DNA less than 300 copies at week 12 of treatment and 97.1 % at week 96. HBeAg loss was observed in 6.7% of patients. At week 96, HBsAg loss was not observed in any of the patients. Mean ALT at week 48 was 32.7 U/L, at week 96 32.6 U/L. Renal safety was good. Creatinine remained stable. Tenofovir DF was well tolerated and produced potent, continuous viral suppression with increasing HBeAg loss.

Objectives: The aim of this study was to evaluate the clinical, laboratory findings and therapeutic features of the patients inhabiting in Diyarbakır, Mardin and Batman province, in Southeastern Anatolia of Turkey. Materials and methods: In this study, 286 patients with brucellosis, followed in departments of infectious diseases and clinical microbiology between June 2007 and July 2009, were evaluated retrospectively. Results: One hundred fifty six (55%) of the patients were female and 130 (45%) were male. Mean age was 32.8 + 15.3 (range15-78) years. The patients were categorized as acute (75%), subacute (23%) and chronic (2%) brucellosis. Major transmission route was the consumption of unpasteurized fresh cheese. The transport of animals in the region is not controlled. Malaise, fever, myalgia arthralgia and sweating were the most frequently observed symptoms. The most common signs were fever 90.8%, arthritis 54.1%, splenomegaly 18.3% and hepatomegaly 11%. The most frequent laboratory finding was a high C-reactive protein level (60%). Diagnosis was made based on the clinical features and positive Rose-Bengal test combination with an initial Brucella antibody titer greater than or equal to 1/160. The most frequently preferred antimicrobial regimen was rifampin and doxycycline combination. Conclusions: Brucellosis is still an important public health problem in Turkey. The disease has an important morbidity and mortality. Brucellosis should be kept in mind in endemic regions of our country with the symptoms of fever, leukopenia and osteoarticular symptoms., Amaç: Çalışmamızda; Türkiye\'nin Güneydoğu Anadolu bölgesinde yer alan Diyarbakır, Mardin ve Batman illerindeki brusellozlu hastaların klinik, laboratuvar ve tedavi özellikleri yönünden değerlendirilmesi amaçlanmıştır. Gereç ve yöntem: Haziran 2007- Temmuz 2009 tarihleri arasında Enfeksiyon Hastalıkları ve Klinik Mikrobiyoloji Kliniğinde bruselloz tanısı ile izlenen 286 hasta geriye dönük olarak değerlendirilmiştir. Bulgular: Hastaların 156 (%55)\'i kadın, 130 (%45)\'i erkek ve yaş ortalamaları 32,8 + 15,3 (15-78) idi. Vakaların %75 akut, %23 subakut ve %2\'sini kronik olarak gruplandırıldı. Hastalığın bulaşmasındaki en önemli faktörün taze peynir yeme olduğu ve bölgede hayvan hareketlerinin kontrolünün olmadığı belirlendi. Hastalarda en sık rastlanan şikayetler yorgunluk, ateş, kas ve eklem ağrıları ve gece terlemesi idi. Ateş (%90,8), artrit (%54,1), splenomegali (%18,3) ve hepatomegali (%11) en sık rastlanan muayene bulgularıydı. Laboratuvarda ise C- Reaktif Protein (CRP) değerinin %60 yüksek olarak saptanması en sık rastlanan bulguydu. Tanı klinik belirtilerle birlikte pozitif Rose-Bengal ve Brusella tüp aglütinasyon testinin 1/160 ve üzeri olması ile konuldu. Tedavide ise çoğunlukla rifampisin ve doksisiklin kombinasyonu tercih edildi. Sonuç: Bruselloz hala ülkemizde önemli mortalite ve morbiditeye neden olan bir halk sağlığı sorunudur. Brucella, özellikle endemik bölgelerde, ateş, lökopeni ve osteoartiküler bulguların varlığında ayırıcı tanıda mutlaka akılda bulundurulmalıdır.

Entecavir is a guanosine analogue with activity against hepatitis B virus. The aim of this 4-year trial was to evaluate entecavir treatment in nucleos(t)ide-naïve HBeAg-positive chronic hepatitis B patients. Forty-nine patients received entecavir and nine of them withdrew from the trial at the end of week 96. The initial mean value of alanine aminotransferase was 79.4 +/- 41.5 IU/L, and at the end of the 4-year study period, 90% of patients had alanine aminotransferase values within the normal range. At week 96, 91.7% of patients had HBV DNA300 copies; at month 48, 90% of patients had HBV DNA50 IU/mL. HBeAg loss was recorded in 7.1% of patients at week 96 and in 12.5% at month 48. The rate of HBeAg seroconversion was 4.8% at week 96 and 7.5% at month 48. The rate of HBsAg seroconversion was 2.1% at week 96 and 2.5% at month 48. Entecavir as a potent and safe agent leading to continuous viral suppression proved to be safe and well tolerated therapy.

It is possible that brucellosis may be related to increase free radical production and antioxidant depletion. Thus, in the present study we aimed to evaluate the oxidative status in patient with brucellosis and healthy controls. Methods: This study includes the patients with brucellosis diagnosed by clinical findings and positive agglutination titer. The paraoxonase, ceruloplasmin, total antioxidant capacity and total oxidant status values were measured from the samples taken. The oxidative stress index value was calculated through the total antioxidant capacity and total oxidant status values. Results: A total number of 93 people, 40 women (43%) and 53 men (57%) were included to the study. The levels of ceruloplasmin were found higher in patients when compared to the control group (p < 0.001). The total antioxidant capacity level was found significantly higher in the patients group when compared to the control group (p < 0.001). The oxidative stress index value was significantly lower in the patients group when compared to the control group (p < 0.001). The paraoxonase-1 level was not different in control and patient groups (p = 0.077). Conclusions: Brucellosis is an infection that is frequently seen in Mediterranean countries. This infection breaks the oxidant and antioxidant balance. In this disease, oxidant-antioxidant system indicators such as ceruloplasmin, total antioxidant capacity, total oxidant status and oxidative stress index can be used for showing the role of the brucella infection and for the monitoring of the treatment results.

To evaluate the effects of tenofovir disoproxil fumarate (TDF) use during late pregnancy to reduce hepatitis B virus (HBV) transmission in highly viremic mothers.This retrospective study included 45 pregnant patients with hepatitis B e antigen (+) chronic hepatitis B and HBV DNA levels10⁷ copies/mL who received TDF 300 mg/d from week 18 to 27 of gestation (n = 21). Untreated pregnant patients served as controls (n = 24). All infants received 200 IU of hepatitis B immune globulin (HBIG) within 24 h postpartum and 20 μg of recombinant HBV vaccine at 4, 8, and 24 wk. Perinatal transmission rate was determined by hepatitis B surface antigen and HBV DNA results in infants at week 28.At week 28, none of the infants of TDF-treated mothers had immunoprophylaxis failure, whereas 2 (8.3 %) of the infants of control mothers had immunoprophylaxis failure (P = 0.022). There were no differences between the groups in terms of adverse events in mothers or congenital deformities, gestational age, height, or weight in infants. At postpartum week 28, significantly more TDF-treated mothers had levels of HBV DNA250 copies/mL and normalized alanine aminotransferase compared with controls (62% vs none, P0.001; 82% vs 61%, P = 0.012, respectively).TDF therapy during the second or third trimester reduced perinatal transmission rates of HBV and no adverse events were observed in mothers or infants.