A different combination of adjunct therapies did not seem to bring additional value to rehydration therapy in children with rotavirus diarrhea except for in those receiving only zinc and zinc plus S. boulardii. Further studies are required to determine the optimal protocol of adjunct therapy use in children with rotavirus diarrhea.

Objectives Coronavirus 2019 disease (COVID‐19) lead to one of the pandemics of the last century. We aimed to predict poor prognosis among severe patients to lead early intervention. Methods The data of 534 hospitalized patients were assessed retrospectively. Risk factors and laboratory tests that might enable the prediction of prognosis defined as being transferred to the intensive care unit and/or exitus have been investigated. Results At the admission, 398 of 534 patients (74.5%) were mild‐moderate ill. It was determined that the male gender, advanced age, and comorbidity were risk factors for severity. To estimate the severity of the disease, receiver operating characteristic analysis revealed that the areas under the curve which were determined based on the optimal cut off values that were calculated for the variables of values of neutrophil to lymphocyte ratio (NLR > 3.69), C‐reactive protein (CRP > 46 mg/L), troponin I ( > 5.3 ng/L), lactate dehydrogenase (LDH > 325 U/L), ferritin ( > 303 ug/L), d‐dimer ( > 574 μg/L), neutrophil NE ( > 4.99 × 109/L), lymphocyte (LE < 1.04 × 109/L), SO2 ( < %92) were 0.762, 0.757,0.742, 0.705, 0.698, 0.694,0.688, 0.678, and 0.66, respectively. To predict mortality, AUC of values for optimal cutoff troponin I ( > 7.4 ng/L), age ( > 62), SO2 ( < %89), urea ( > 40 mg/dL), procalcitonin ( > 0.21 ug/L), CKMB ( > 2.6 ng/L) were 0.715, 0.685, 0.644, 0.632, 0.627, and 0.617, respectively. Conclusions The clinical progress could be severe if the baseline values of NLR, CRP, troponin I, LDH, are above, and LE is below the specified cut‐off point. We found that the troponin I, elder age, and SO2 values could predict mortality.

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Worldwide increase in carbapenem resistance and transferable carbapenemases are significant challenges in treatment of Pseudomonas aeruginosa infections. In this study, investigation of carbapenemase production in carbapenem-resistant P. aeruginosa isolates recovered from clinical specimens in a tertiary hospital was aimed. A total of 84 carbapenem-resistant P. aeruginosa isolates were examined. "Carbapenem inactivation method" (CIM) was used for phenotypic detection of carbapenemase production. The existence of bla, bla, bla, bla, bla, and bla genes was investigated by polymerase chain reaction (PCR). Subtypes of the detected genes were identified by sequence analysis. Arbitrarily primed PCR (AP-PCR) was performed to evaluate the clonal relationship among the isolates. The presence of high-risk clones in carbapenemase producers was investigated by Matrix-assisted laser desorption/ionization-time of flight mass spectrometry (MALDI-TOF MS). Three isolates (3.5%) were identified as carbapenemase producers by CIM tests, while PCR tests demonstrated three isolates carrying carbapenemase genes as well. bla gene was found in two isolates and bla gene was found in one isolate. Sequence analysis demonstrated that the carbapenemases were VIM-1, VIM-2, and GES-5. AP-PCR yielded high clonal diversity among the isolates. According to MALDI-TOF MS analysis, none of the carbapenemase-producing strains belonged to the high-risk clones. In conclusion, the presence of VIM-1, VIM-2, and GES-5 type carbapenemases in P. aeruginosa isolates was demonstrated for the first time in our hospital, GES-5 being reported for the second time in Turkey. Our results will lead strategies for controlling the spread of carbapenemases and contribute to epidemiological data from Turkey.

In hypothyroid cases, H. pylori gastritis may be responsible for an inadequate response to the treatment. H. pylori eradication in the cases receiving high doses of thyroxine has a risk for thyrotoxicosis.

The Mycobacterium tuberculosis complex (MTBC) consists of a group of closely related species that differ in their epidemiological profiles, host ranges, pathogenicities, geographic distributions, and drug resistances. Identification of members in the MTBC is essential for monitoring the epidemiology of tuberculosis (TB) and implementing appropriate public health control measures. In this study, 188 consecutive MTBC clinical isolates from 2007 to 2010 were evaluated to determine the prevalence of MTBC species in Turkey. PCR and restriction fragment length polymorphism analysis (PCR-RFLP) of the gyrB gene were used, and results for species other than M. tuberculosis were confirmed using the GenoType MTBC assay (Hain Lifescience, Nehren, Germany). Most of the strains were found to be M. tuberculosis (94.1%). The prevalences of M. bovis and M. caprae were 4.3% and 1.6%, respectively. Only one M. bovis BCG strain was identified. Overall, the frequency of bovine tuberculosis in humans was 5.3%. We had assumed that bovine TB infection was under control in animal herds, but primary M. bovis infections in humans caused by transmission from infected animals are still an issue in Turkey. Our results indicate that the frequent identification of M. bovis in routine mycobacteriological laboratory work has further importance due to the well-known resistance of this species to pyrazinamide.The Mycobacterium tuberculosis complex (MTBC) consists of a group of closely related Mycobacterium species, including M. tuberculosis, M. bovis, M. africanum, M. microti, and M. caprae. These species are the primary cause of tuberculosis in humans, and they also infect wild and domesticated animals. The close interrelatedness of these species has been demonstrated by DNA-DNA hybridization, multilocus enzyme electrophoresis, and sequencing of the 16S rRNA genes and the 16S-23S rRNA gene internal transcribed spacers (12,16).However, the epidemiology, host range, pathogenicity, geographic distribution, and drug resistance of these species are quite different (12,16,22). Different species display different phenotypic characteristics according to conventional biochemical tests. Because differentiation of species in the MTBC by these methods is labor-intensive, time-consuming, and dependent on sufficient bacterial growth, these tests may not be performed routinely in every laboratory (19,23). Therefore, various molecular methods have been used for differentiation, such as DNA sequencing (i.e., gyrB and hsp65) and PCR amplification of regions of differences (RDs) or spoligotyping (9,11,26,29,30). Although they are rapid and more accurate than the conventional methods, such procedures usually require specialized molecular laboratories and technical experience (22,26,29).In this study, our goal was to determine the distribution of consecutive MTBC isolates at the species level from 2007 to 2010 in one of the largest research and training hospitals in Istanbul. We also wished to investigate the current status of bovine tuberculosis in Turkey. To our kn...

PurposeDiagnosis of tuberculosis (TB) in children is more challenging than in adults. This study aimed to describe demographical, clinical and laboratory findings of children diagnosed with tuberculosis in Turkey, including the issues of contact tracing, culture positivity and forms of the disease.Materials and MethodsClinical and laboratory data of 51 children with a mean age of 8.0±4.6 years who were diagnosed with TB were retrospectively reviewed. Main diagnostic tools included tuberculin skin test, chest X-ray, sputum/gastric aspirate culture with sensitivity testing, and direct microscopy for acid-fast bacilli on available samples. Clinical characteristics and outcomes of the patients were examined.ResultsThirty-six (70.6%) children were diagnosed with intra-thoracic and 15 (29.4%) with extra-thoracic tuberculosis. Twenty-eight of the patients had a positive Bacillus Calmette-Guérin vaccine scar (28/51, 54.9%) and 23/51 (45.1%) had a positive tuberculin skin test. An adult TB contact was identified in 27 (52.9%) of the cases. On direct microscopy, acid-fast bacilli were found in nine (17.6%) patients and positive culture for Mycobacterium tuberculosis was found in 19 (37.3%). Drug resistance to isoniazid was detected in four (7.8%). One patient with nephrotic syndrome and miliary tuberculosis died during follow-up. All other patients responded well to the treatment.ConclusionFocusing on active contact tracing among all household contacts of tuberculous cases may be helpful in early identification and controlling childhood disease, even in regions with low disease prevalence. Adopting a suspicious and proactive approach in this particular age group is warranted.

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