Infectious diseases & clinical microbiology最新文献

{"title":"The Incidence and Risk Factors of Early Periprosthetic Joint Infections.","authors":"Zeynep Tekin-Taş, Hasan Selçuk Özger, Ulunay Kanatlı, Kenan Hızel","doi":"10.36519/idcm.2024.332","DOIUrl":"10.36519/idcm.2024.332","url":null,"abstract":"<p><strong>Objective: </strong>Periprosthetic joint infections (PJI) represent major complications in arthroplasty, contributing to increased patient morbidity and imposing substantial financial burdens. Meticulous surveillance of PJI occurrences and identification of associated risk factors is imperative for accurately gauging the incidence rates and implementing proactive infection control measures. This study aimed to ascertain the early incidence of PJI and elucidate the key risk factors involved in its occurrence.</p><p><strong>Materials and methods: </strong>This monocentric, prospective descriptive study conducted between June 2018 and June 2019, including all patients aged 18 years and above who underwent hip and knee arthroplasty. The research documented and evaluated patient demographic characteristics, clinical findings, laboratory results, treatment practices, and potential risk factors associated with the surgical process. After the 90-day postoperative period, patients were categorized into PJI and non-PJI groups, allowing for a comprehensive comparison of identified risk factors.</p><p><strong>Results: </strong>This study identified a cohort of 590 patients, of whom 185 underwent hip arthroplasties (31.4%) and 405 underwent knee arthroplasties (68.6%). The average age of the patients was 65.2 years, with females constituting 80.2% of the population. The overall incidence of early PJI was found to be 2.88% (n=17). Following hip arthroplasties, the PJI incidence was 4.86%, while knee arthroplasties exhibited a lower incidence of 1.9%. Several potential risk factors associated with PJI were identified, including comorbid diseases (adjusted odds ratio [aOR]=3.35, 95% confidence interval [CI]=1.18-9.47), preoperative length of stay (aOR=0.89, 95% CI=0.79-1.01), postoperative erythrocyte suspension replacement (aOR=1.96, 95% CI=0.71-5.44), and a National Nosocomial Infections Surveillance System (NNIS) score of 1 or higher (aOR=3.10, 95% CI=1.10-8.71). These factors were identified as potential contributors to the risk of PJI in patients undergoing hip and knee arthroplasties.</p><p><strong>Conclusion: </strong>Compared to other reported outcomes in the literature, this study observed a higher incidence of early-stage PJI. The higher incidence may be due to PJI surveillance deficiencies such as difficulty in post-discharge surgical site infection (SSI) follow-up, reporting, and bacterial sampling. This discrepancy underscores the importance of actively monitoring patients with risk factors for PJI development, including medical comorbidities and a high NNIS score. Implementing prospective active surveillance in such cases is deemed crucial for the timely identification and management of PJI.</p>","PeriodicalId":519881,"journal":{"name":"Infectious diseases & clinical microbiology","volume":"6 2","pages":"93-101"},"PeriodicalIF":0.0,"publicationDate":"2024-06-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11243772/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141617912","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Causative Microorganisms in Community-Acquired Urinary Tract Infections and Risk Factors for the Development of Infection with Extended-Spectrum β-Lactamase-Producing Species.","authors":"Rüveyda Korkmazer, Bircan Kayaaslan, Ayşe Kaya-Kalem, Zeynep Oktay, Fatma Eser, İmran Hasanoğlu, Rahmet Güner","doi":"10.36519/idcm.2024.340","DOIUrl":"10.36519/idcm.2024.340","url":null,"abstract":"<p><strong>Objective: </strong>This study aimed to determine the microorganisms grown in the urine cultures of patients followed up with the diagnosis of community-acquired urinary tract infection (CA-UTI), their antibiotic susceptibility, and the risk factors that cause extended-spectrum β-lactamase (ESBL) production in microorganisms.</p><p><strong>Materials and methods: </strong>Patients diagnosed with CA-UTI in the Yıldırım Beyazıt University City Hospital Infectious Diseases and Clinical Microbiology Clinic between February 2019 and February 2020 were prospectively analyzed. The microorganisms grown in the urine cultures and antibiotic susceptibility rates were examined. The clinical and demographic characteristics of the patients were compared in terms of the isolated agent producing ESBL.</p><p><strong>Results: </strong><i>Escherichia coli</i> (63.8%) and <i>Klebsiella pneumoniae</i> (22.0%) were the most common microorganisms detected in the urine cultures; the rate of those producing ESBL was 46.6%. Antibiotics with high resistance rates were ampicillin (74.2%), cefuroxime (49.6%), and ceftriaxone (49%). Male gender, complicating factors, immunosuppression, kidney transplantation and history of antibiotic use were determined as significant risk factors for ESBL production. Male gender, immunosuppression, and history of antibiotic use were also independent risk factors. ROC analysis of risk factors showed ESBL-producing bacteria were isolated at a high rate in patients having ≥3 risk factors.</p><p><strong>Conclusion: </strong>The resistance rates in our study are quite high. Male gender, history of antibiotic use and immunosuppression status were found to be independent risk factors for ESBL positivity in patients with CA-UTI, and the more risk factors a patient has, the higher the risk of ESBL positivity.</p>","PeriodicalId":519881,"journal":{"name":"Infectious diseases & clinical microbiology","volume":"6 2","pages":"112-122"},"PeriodicalIF":0.0,"publicationDate":"2024-06-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11243775/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141617935","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Antimicrobial Susceptibility of Various MRSA Clinical Isolates and the Impact of Glycopeptide MICs on Clinical and Microbiological Outcomes.","authors":"Elif M Sarıcaoğlu, Fügen Yörük","doi":"10.36519/idcm.2024.330","DOIUrl":"10.36519/idcm.2024.330","url":null,"abstract":"<p><strong>Objective: </strong>While vancomycin has remained the mainstay of the treatment for methicillin-resistant <i>Staphylococcus aureus</i> (MRSA) infections, there is growing evidence of the clinical impact of increased glycopeptide minimum inhibitory concentrations (MICs) in MRSA isolates. This study aimed to determine the susceptibility of various MRSA isolates to different antibiotics with antistaphylococcal activity and the impact of glycopeptide MICs on clinical and microbiological outcomes.</p><p><strong>Materials and methods: </strong>This retrospective cohort study, conducted between 2013 and 2017, evaluated the susceptibility of MRSA strains isolated from various clinical samples to antistaphylococcal antibiotics using the gradient strip method. The clinical and laboratory features of patients infected with MRSA isolates with elevated glycopeptide MICs (>1 mg/L) and with isolates that had low glycopeptide MICs (≤1 mg/L) were compared.</p><p><strong>Results: </strong>A total of 104 patients infected with MRSA strains were included in this study. Male sex (odds ratio [OR]=2.48, 95% confidence interval [CI]=1.01-6.10, <i>p</i>=0.048), two or more comorbidities (OR=2.48, 95% CI=1.03-6.50, <i>p</i>=0.044), history of MRSA infection (OR=4.91, 95% CI=1.70-14.28, <i>p</i>=0.003) and a longer hospital stay prior to MRSA infection (OR=2.32, 95% CI=1.05-7.85, <i>p</i>=0.040) were independent risk factors for high glycopeptide MICs. In MRSA infections with a teicoplanin MIC of >0.75mg/L, the microbiological and treatment failures were 46.2% (<i>p</i>=0.044) and 60.6% (<i>p</i>=0.042), respectively.</p><p><strong>Conclusion: </strong>This study showed that the critical MIC value, which suggested treatment failure as well as microbiological failure in the teicoplanin-treated MRSA infections, was >0.75 mg/L rather than >1 mg/L in our study cohort. The identification of high-risk patients;for treatment failures and mortality considering gradient strip method MIC values is crucial for the effective management of MRSA infections.</p>","PeriodicalId":519881,"journal":{"name":"Infectious diseases & clinical microbiology","volume":"6 2","pages":"102-111"},"PeriodicalIF":0.0,"publicationDate":"2024-06-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11243782/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141617934","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Urinalysis in Medical Diagnosis: the Historical and Contemporary Usage.","authors":"Oğuz Usta, Yeşim Beşli, Önder Ergönül","doi":"10.36519/idcm.2024.389","DOIUrl":"10.36519/idcm.2024.389","url":null,"abstract":"","PeriodicalId":519881,"journal":{"name":"Infectious diseases & clinical microbiology","volume":"6 2","pages":"147-150"},"PeriodicalIF":0.0,"publicationDate":"2024-06-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11243776/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141617913","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"COVID-19 Vaccines and COVID-19 in People Living with HIV.","authors":"Muhammed Fatih Karaşın, Zeynep Bayraktar, Müge Toygar-Deniz, Sıla Akhan, Mehmet Kağan Özdemir","doi":"10.36519/idcm.2024.271","DOIUrl":"10.36519/idcm.2024.271","url":null,"abstract":"<p><strong>Objective: </strong>Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) spread rapidly around the world, and COVID-19 and HIV co-infection also became common. In this study, we aimed to investigate the impact of vaccination preferences and vaccination rates on the severity of COVID-19 in patients with HIV co-infection.</p><p><strong>Materials and methods: </strong>People living with HIV who were followed in our hospital during the COVID-19 pandemic (January 2020- December 2022) were retrospectively included in the study. The diagnosis of COVID-19 was made by detecting SARS-CoV-2 RNA in nasopharyngeal swab specimens using real-time reverse transcriptase-polymerase chain reaction (rRT-PCR). Patients requiring hospital admission were classified as severe. The patient's demographics and vaccination status were collected from the hospital data system.</p><p><strong>Results: </strong>Our study included 205 patients using antiretroviral therapy for HIV. The mean day count between the last vaccine date and SARS-CoV-2 PCR positivity was 163 days in the Comirnaty® group,149 days in the CoronaVac® group, and 154 days in the mixed-vaccinated group. Those vaccinated with Comirnaty® were statistically significantly less infected with COVID-19 after vaccination (p<0.05).</p><p><strong>Conclusion: </strong>The course and the outcomes of COVID-19 among SARS-CoV-2 vaccinated people living with HIV, especially with well-controlled HIV infection, seem to be similar to people living without HIV.</p>","PeriodicalId":519881,"journal":{"name":"Infectious diseases & clinical microbiology","volume":"6 2","pages":"78-82"},"PeriodicalIF":0.0,"publicationDate":"2024-06-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11243773/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141617937","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prospective Clinical Follow-Up Results of Infective Endocarditis.","authors":"Merve Arslan, İlknur Kaleli, Murat Kutlu","doi":"10.36519/idcm.2024.327","DOIUrl":"10.36519/idcm.2024.327","url":null,"abstract":"<p><strong>Objective: </strong>Infective endocarditis incidence has been rising in recent years, with high mortality. Risk factors such as underlying heart diseases, chronic diseases, healthcare-associated infections, advanced age, and intravenous (IV) drug use have gained importance in the incidence, the treatment approach, and the disease course. The aim of this study is to contribute to Türkiye's data on infective endocarditis epidemiology and risk factors.</p><p><strong>Materials and methods: </strong>This study examined risk factors, diagnostic and treatment approaches, and prognosis of infective endocarditis cases at Pamukkale University Faculty of Medicine Hospital. It was carried out prospectively for 28 months.</p><p><strong>Results: </strong>During this period, 67 endocarditis cases were detected in 65 patients. Among cardiac diseases, the rate of congenital heart diseases (41%), degenerative heart diseases (37%), and acute rheumatic fever (ARF) related valvular heart disease (31%) were found to be high. Hospitalization in the last six months (53.7%), history of cardiac surgery (41.8%), use of IV catheters (22.4%), hemodialysis (14.9%) and IV drug use (7.5%) were also determined. Staphylococci, streptococci, and enterococci were the primary agents. The most used empirical treatments were ampicillin, ampicillin-sulbactam, and gentamicin. Natural valve endocarditis was most determined. Surgical treatment was applied in 56.7% of endocarditis cases. Septic embolism and cardiac failure were the most common complications.</p><p><strong>Conclusion: </strong>This study's findings regarding the epidemiology and prognosis of infective endocarditis pointed out that it is still a disease with a high mortality rate.</p>","PeriodicalId":519881,"journal":{"name":"Infectious diseases & clinical microbiology","volume":"6 2","pages":"133-140"},"PeriodicalIF":0.0,"publicationDate":"2024-06-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11243778/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141617939","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"ChatGPT as a Novel Consultant in Infectious Diseases and Clinical Microbiology: Correspondence.","authors":"Hinpetch Daungsupawong, Viroj Wiwanitkit","doi":"10.36519/idcm.2024.354","DOIUrl":"https://doi.org/10.36519/idcm.2024.354","url":null,"abstract":"","PeriodicalId":519881,"journal":{"name":"Infectious diseases & clinical microbiology","volume":"6 2","pages":"151-153"},"PeriodicalIF":0.0,"publicationDate":"2024-06-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11243771/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141617936","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"How Successful Are APRI and FIB-4 Scores in Predicting Liver Fibrosis in Chronic Hepatitis B Patients?","authors":"Deniz Gür-Altunay, Pınar Yürük-Atasoy","doi":"10.36519/idcm.2023.276","DOIUrl":"https://doi.org/10.36519/idcm.2023.276","url":null,"abstract":"<p><strong>Objective: </strong>We aimed to evaluate the correlation of fibrosis severity in liver biopsies, the gold standard for the diagnosis of patients with chronic hepatitis B (CHB), using noninvasive methods such as the aspartate aminotransferase (AST)-to-platelet ratio index (APRI) and fibrosis-4 score (FIB-4).</p><p><strong>Materials and methods: </strong>The study included patients who were followed and treated for CHB in 2018-2023. Biochemical markers and liver biopsy findings of the cases were retrospectively, and their correlations with APRI and FIB-4, which are noninvasive scores, were compared.</p><p><strong>Results: </strong>The study included 202 patients. The biochemical markers and liver biopsy findings of the cases were examined retrospectively, and their correlations with the noninvasive scores APRI and FIB-4 were compared. According to liver biopsy results, 109 (54.0%) cases had no fibrosis (stage 0.1), 85 (42.1%) cases had mild fibrosis (stage 2, 3), and 8 (4%) cases had severe fibrosis (stage 4, 5, 6). The median FIB-4 score was 0.79 (0.25 -11.74), and the median APRI score was 0.29 (0.10-29.40). When the predictive power of the APRI score to discriminate between \"without fibrosis\" and \"with fibrosis (mild and severe)\" was evaluated by receiver operating characteristic (ROC) curve analysis, for the APRI score >0.408 as the ideal cut-off point, the sensitivity and specificity were found to be 34% and 79%, respectively. When the cut-off point for the FIB-4 score was >0.701, the sensitivity and specificity were 71% and 46%, respectively. Although the area under the curve (AUC) ratios ranged between 52% and 64% in the ROC analyses, the sensitivity ratios of the cut-off points calculated for FIB-4 were higher. The likelihood ratios of the cut-off point we found for the APRI score (1.61 and 1.75, respectively) were relatively better than those for FIB-4 (1.31 and 1.41, respectively).</p><p><strong>Conclusion: </strong>Noninvasive tests used to detect liver fibrosis in individuals with CHB do not eliminate the need for liver biopsy but may provide insight into the fibrosis status of patients.</p>","PeriodicalId":519881,"journal":{"name":"Infectious diseases & clinical microbiology","volume":"5 4","pages":"332-340"},"PeriodicalIF":0.0,"publicationDate":"2023-12-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10986711/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140872949","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Psychosocial Status of Healthcare Workers During the COVID-19 Pandemic.","authors":"Emrah Emiral, Yunus Emre Bulut, Gülsüm Öztürk-Emiral, Hüsna Sarıca-Çevik, Abide Aksungur","doi":"10.36519/idcm.2023.282","DOIUrl":"https://doi.org/10.36519/idcm.2023.282","url":null,"abstract":"<p><strong>Objective: </strong>This study aimed to determine the depression, anxiety, and stress levels of healthcare workers (HCWs) working actively in different health services during the pandemic.</p><p><strong>Materials and methods: </strong>This cross-sectional study was conducted in Ankara at the Provincial Health Directorate Numune Campus between January and April 2022. The depression, anxiety, and stress levels of HCWs working actively in different health services during the pandemic were evaluated using the Depression, Anxiety and Stress Scale 21 (DASS-21). Univariate and multivariate linear regression analyses were performed to analyze the data.</p><p><strong>Results: </strong>The study included 381 healthcare workers, 272 (71.4%) of whom were female. The mean age was 40.0±9.9 (21-63) years, and 44.9% (n=171) of the HCWs had a COVID-19 infection at some point. While 28.6% of HCWs needed psychological support before the pandemic, the rate increased to 36.2% during the pandemic (<i>p</i><0.001). DASS-21 results showed that the frequency of depression was 31.0%, anxiety 47.2%, and stress 22.8% among participants during the pandemic.</p><p><strong>Conclusion: </strong>One out of three HCWs reported experiencing mental health problems. It is essential to improve the working conditions of HCWs to help them cope with the effects of the pandemic on their mental health and to provide psychosocial support.</p>","PeriodicalId":519881,"journal":{"name":"Infectious diseases & clinical microbiology","volume":"5 4","pages":"300-310"},"PeriodicalIF":0.0,"publicationDate":"2023-12-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10986714/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140861623","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"\"Good\" News from IDCM and Thanks to All Who Contributed.","authors":"Murat Akova","doi":"10.36519/idcm.2023.312","DOIUrl":"https://doi.org/10.36519/idcm.2023.312","url":null,"abstract":"","PeriodicalId":519881,"journal":{"name":"Infectious diseases & clinical microbiology","volume":"5 4","pages":"266"},"PeriodicalIF":0.0,"publicationDate":"2023-12-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10986688/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140867555","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}