Carbapenem-resistant Klebsiella pneumoniae (CRKP) has been known as a nosocomial pathogen, both for the last 10 years in Turkey and for 20 years worldwide. Due to limited treatment options and high mortality rates, despite improvements in the field of medicine at the present time, CRKP is still a big threat for public health. This study was carried out between the dates of January 2010 and September 2014. Patients ≥18 who were hospitalized for at least 72 h and who also had CRKP growth were included in the study as a case group. In the same period patients, who were hospitalized in the same ward and did not have CRKP growth were selected as the control group. It was determined that no glycopeptides and steroids use nor tracheostomy as protective factors would be employed in terms of non-development of CRKP. Mechanical ventilation, tracheostomy, urinary catheter presence, central venous catheterization, nasogastric tube placement, advanced age, acute renal insufficiency, total parenteral nutrition, carbapenem, glycopeptide, and piperacillin tazobactam were all detected as risk factors in terms of CRKP infection development. As a result, rational usage of antibiotics for preventing infections developing with CRKP should be targeted.

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Background Protective long‐term immunity following coronavirus disease 2019 (COVID‐19) is unclear. The study evaluated the relationship between the vaccination status and risk factors in the re‐infection of patients with a diagnosis of COVID‐19 who reported to the Public Health Management System in a province in south‐eastern Turkey. Methods Patients with positive results for the severe acute respiratory syndrome coronavirus 2 by the real‐time reverse transcription polymerase chain reaction (RT‐PCR) test in respiratory samples were defined as confirmed cases. Reinfection was diagnosed in cases with COVID‐19 real‐time RT‐PCR positivity, with or without COVID‐19–like symptoms, in at least 90 days after the first infection/disease. Results A total of 58 811 patients with the diagnosis of COVID‐19 from March 11, 2020, to August 31, 2021, were included in the study. Re‐infection was detected in 421 (0.7%) of all patients. The mean age of the cases was 38.0±16.0 years, and 51% of them were female. Eight (2.0%) of the cases resulted in death due to re‐infection. No hospitalization or mortality was observed in fully vaccinated patients. Additionally, none of the mortal cases had completed the vaccination schedule. Conclusions We are concerned that the re‐infection rates and mortality may increase due to new variant strains. Vaccination is the greatest weapon against progression to critical illness in re‐infections, even with existing mutations. Therefore, it is important for those without a full vaccination schedule to be vaccinated, even if they have been previously infected.

Background:The hepatitis B virus (HBV) is one of the major causes of chronic liver disease. From the perspective of hospital workers (HWs), employees are at risk of hepatitis B infection because of occupational exposure. Apart from this occupational risk, health professionals may still be affected by HBV, depending on the epidemiological characteristics of the country and geographical region they live in.Objectives: This study aimed to determine HBV, HCV, and HIV seroprevalence among HWs using data obtained from 21 hospitals located in six geographical regions in Turkey and the Turkish Republic of Northern Cyprus. Methods: The study was designed as a retrospective, multicentre, descriptive study. Twenty hospitals from Turkey and one hospital from the Turkish Republic of Northern Cyprus were involved in the study. The variables of the study were vaccination status against HBV and hepatitis A and HBsAg, anti-HBs, anti-HBcIgG, anti-HAV IgG, anti-HCV, anti-HDV, and anti-HIV serology results belonging to the previous year.Results: Women constituted 58.9% (n = 5,622) of the HWs included in the study. The mean age was 36.3 ± 9.09 years (min = 18, max = 72). In terms of occupation, 42.5% (n = 4,064) were nurses/health officers, and 24.8% (n = 2365) were physicians. HBsAg seroprevalence was found to be 1.8% (n = 169; 95% CI = 1.5% -2.0%), while anti-HBs seropositivity was 75.7% (n = 7,234). About 7.3% (n = 701) had natural immunity to hepatitis B. About 21.6% (n = 2,066) of the HWs did not receive hepatitis B vaccine. Conclusions: This study is the first study involving a large sample size from different locations of Turkey. According to the results, hepatitis B and hepatitis A vaccines should be administered to susceptible individuals and HWs.

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Background: In chronic hepatitis B patients with or exposed to the risk of osteoporosis or renal dysfunction, switching from tenofovir disoproxil fumarate (TDF) to tenofovir alafenamide fumarate (TAF) or entecavir (ETV) may be the right choice. Objectives: This study aimed to present real-life data in terms of the efficacy and safety of a TAF/ETV treatment change while receiving TDF. Methods: This retrospective study was conducted on 344 adult patients from 10 centers. The data of patients who had changed to ETV (n = 107) and TAF (n = 237) while receiving TDF were analyzed. The data collected at 0 and 6 months of treatment were analyzed. The virological response was assessed based on undetected hepatitis B virus (HBV) DNA. Serum alanine aminotransferase (ALT) values were used to evaluate the biochemical response. For renal function, serum creatinine and phosphorus, as well as estimated glomerular filtration rate (eGFR), were recorded. Moreover, lumbar spine and hip T-scores along with the serum lipid profile were evaluated. Results: The mean age of patients was 41.14 ± 13.46 years, and 224 (65.1%) of the participants were male. The treatment arms were not significantly different in terms of demographic characteristics, comorbid diseases, infection duration, family history of HBV infection, blood platelet count, serum biomarkers, such as ALT, phosphorus, creatinine, total bilirubin, albumin, lipid profile, and HBV DNA levels at the beginning. No statistically significant difference was found between the proportion of undetectable HBV DNA of the two treatment groups after 6 months (P = 0.221). The ALT normalization in the ETV and TAF groups at the sixth month compared to the baseline levels was not significantly different (P = 0.853, P = 0.330, respectively). There was no statistically significant difference between the two treatment arms regarding changes in eGFR, creatinine, phosphorus, hip, and spine T-scores from baseline to 6 months (P = 0.296, P = 0.78, P = 0.141, P = 0.832, P = 0.947, respectively). In those who switched to TAF or ETV, low-density lipoproteins cholesterol were observed to be significantly higher after 6 months compared to baseline values (P = 0.002, P = 0.049, respectively). The TC increased significantly in the TAF group (P = 0.035). Conclusions: Our study showed that switching to ETV and TAF sustained the viral suppression and biochemical response achieved by TDF therapy. The treatment switch to TAF of ETV can control renal dysfunction and reduce bone mineral density caused by TDF.

Objective: It is increasingly important to identify risk factors for COVID-19-associated mortality to provide access to early treatment. This study aimed to investigate the relationship between COVID-19 severity and laboratory data and demographic characteristics of hospitalized patients and to identify factors predicting mortality in COVID-19. Materials and Methods:The study is a retrospective and single-center study. Data of 1298 COVID-19 patients confirmed by a positive real-time polymerase chain reaction test for COVID-19 and treated at the hospital were retrospectively analyzed. Study patients were divided into three groups based on the clinical severity of disease: the mild-moderate group (n:954) and the severe (n:310) and critical (n:34) groups. Demographic characteristics, underlying diseases, and laboratory findings were compared between groups.Results: Multivariate logistic and ordinal logistic regression analysis revealed that male gender, old age, diabetes mellitus, coronary artery disease, cerebrovascular event, malignancy, chronic obstructive pulmonary disease, chronic renal failure, chronic hepatitis B, and Alzheimer's disease/dementia/Parkinson's disease (among neurological diseases) were independently associated with and significantly increased the development of severe disease and mortality. Conclusion:The COVID-19 pandemic continues to be a significant health problem affecting all of humanity. Determining risk factors for COVID-19 severity and mortality are critical for classifying critical cases at the time of initial diagnosis, establishing appropriately specific treatment protocols, and ensuring access to early treatment.

Background: Epidemiological importance of Carbapenemresistant Klebsiella pneumoniae (CRKP) is to be a nosocomial pathogen, which has come to be known for the last 10 years in our country and for 20 years in the world. Infections developing with CRKP has been threatening the community health care due to limited treatment options and high mortality rates in despite of the whole improvements in the field of medicine at the present time.Methods & Materials: Our study was carried out between the dates January 2010-September 2014. Patients, who were hospitalized at least for 72 hours in the hospital, are 18 years old or older, have CRKP growth and are admitted as active and are given treatment, were included in the study. In the same period patients, who hospitalized in the same ward and have not CRKP growth, have been selected as the control group as well.Results: In our study, it was determined that glycopeptide and steroid use, absence of tracheostomy inhibited the development of CRKP as mechanical ventilation, tracheostomy, urinary catheter presence, central venous catheterization, nasogastric tube placement, advanced age, Acute Renal Insufficiency (ARI), Total Parenteral Nutrition (TPN), carbapenem, glycopeptide, piperacillin tazobactam use was being detected as risk factor in terms of CRKP.Conclusion: As a result, to remove risk factors in order to minimalize CRKP infection with rational use of antibiotics for preventing infections developing with CRKP should be aimed.