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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.

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.

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.

ÖZETAmaç: 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: 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 Creactive 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. J Clin Exp Invest 2012; 3 (3): 335-339

BK viras is a human polyoma viras. It is acquired in early childhood and remains life-long latent in the genitourinary system. BK virus replication is more common in receiving immunosuppressive therapy receiving patients and transplant patients. BK virus could cause hemorrhagic cystitis in patients with allogeneic stem cell transplantation. Hemorrhagic cystitis is a serious complication of hematopoietic stem cell transplantation. Hemorrhagic cystitis could cause morbidity and long stay in the hospital. Diagnosis is more frequently determined by the presence of BK virus DNA detected with quantitative or real-time PCR testing in serum or plasma and less often in urine. The reduction of immunosuppression is effective in the treatment of BK virus infection. There are also several agents with anti-BK virus activity. Cidofovir is an active agent against a variety of DNA viruses including poliomyoma viruses and it is a cytosine nucleotide analogue. Intravenous immunoglobulin IgG (IVIG) also includes antibodies against BK and JC (John Cunningham) viruses. Hereby, we report three cases of hemorrhagic cystitis. Hemorrhagic cystitis developed in all these three cases of allogeneic stem cell transplantation due to acute myeloid leukemia (AML). BK virus were detected as the cause of hemorrhagic cystitis in these patients. Irrigation of the bladder was performed. Then levofloxacin 1 x750 mg intravenous and IVIG 0.5 gr/kg were started. But the hematuria did not decreased. In the first case, treatment with leflunomide was started, but patient died due to refractory AML and severe graft-versus-host disease after 4th day of leflunamide and levofloxacin treatments. Cidofovir treatment and the reduction of immunosuppressive treatment decreased the BK virus load and resulted symptomatic improvement in the second case. Initiation of cidofovir was planned in the third case. Administration of cidofovir together with the reduction of immunosuppression in the treatment of hemorrhagic cystitis associated with BK virus in allogeneic stem cell transplant recipients could be a good option.

The entomopathogenic bacterium Bacillus thuringiensis is the most widely used biopesticide. In this study, to find and identify the more toxic B. thuringiensis strains against coleopteran pests, we isolated a B. thuringiensis strain (Xd3) from European shot-hole borer, Xyleborus dispar (Coleoptera: Scolytidae), a higly damaging pest of hazelnut. Based on various morphological, physiological, biochemical, and molecular characteristics, the bacterial isolate was identified as B. thuringiensis subsp. tenebrionis (morrisoni) serovar H8a8b. This isolate was compared with the reference strains by scanning electron microscopy, SDS-PAGE analysis, cry gene content, and insecticidal activity. Isolate Xd3 forms a flat-square inclusion containing a protein component of c. 70 kDa. PCR analysis showed that the Xd3 has a cry gene, cry3. Toxicity tests were performed against coleopteran species. One hundred percent mortality was observed against larvae of Agelastica alni (Coleoptera: Chrysomelidae). The others were 90% for Amphimallon solstitiale