Our aim in this study is to compare the standard culture method with the multiplex PCR and the Speed-Oligo® Bacterial Meningitis Test (SO-BMT) – a hybridization-based molecular test method – during the CSF examination of the patients with the pre-diagnosis of acute bacterial meningitis. For the purposes of this study, patients with acute bacterial meningitis treated at the Dicle University Medical Faculty Hospital, Infectious Diseases and Clinical Microbiology Clinic between December 2009 and April 2012 were retrospectively evaluated. The diagnosis of bacterial meningitis was made based on the clinical findings, laboratory test anomalies, CSF analysis results, and the radiological images. Growth was observed in the CSF cultures of 10 out of the 57 patients included in the study (17.5%) and Streptococcus pneumoniae was isolated in all of them. The CSF samples of 34 patients (59.6%) were positive according to the SO-BMT and S. pneumoniae was detected in 33 of the samples (97.05%), while Neisseria meningitidis was found in 1 sample (2.95%). In a total of 10 patients, S. pneumoniae was both isolated in the CSF culture and detected in the SO-BMT. The culture and the SO-BMT were negative in 23 of the CSF samples. There was no sample in which the CSF culture was positive although the SO-BMT was negative. While SO-BMT seems to be a more efficient method than bacterial culturing to determine the pathogens that most commonly cause bacterial meningitis in adults, further studies conducted on larger populations are needed in order to assess its efficiency and uses.

Introduction: This study investigated the seroprevalence of hepatitis B virus surface antigen (HBsAg), antibody against hepatitis C virus (anti-HCV), antibody against human immunodeficiency virus type 1/2 (anti-HIV 1/2), and antibody against Treponema pallidum (antiTreponemal or syphilis antibody) in healthy volunteer blood donors, and assessed their distribution according to the years and genders. Methodology: HBsAg, anti-HCV, anti-HIV ½, and syphilis screening results of a total of 266,035 healthy volunteer blood donors who had been admitted for blood donation to the Regional Blood Center of Dicle University Hospital between January 2000 and December 2010 were evaluated, retrospectively. HBsAg, anti-HCV, and anti-HIV 1/2 screening were performed using a fully automated device with the microparticle enzyme immunoassay method (MEIA). Syphilis screening was performed by Rapid Plasma Reagin (RPR) carbon test between January 2000 and December 2009, and by using a fully automated device with the MEIA method between January 2010 and December 2010. Results: Of 266,035 healthy volunteer blood donors, 259,384 (97.5%) were male and 6,651 (2.5%) were female. Statistically, there was not any significant difference between male and female genders for HBsAg, anti-HCV and syphilis seropositivities (P = 0.729, P = 0.748, and P = 0.861, respectively). HBsAg was found to be positive in 8,422 (3.17%), anti-HCV in 1,703 (0.64%), anti-HIV 1/2 in one (0.0004%) of 266,035 healthy volunteer blood donors, and syphilis antibody with RPR in 166 (0.07%) of 246,341 healthy volunteer blood donors. Conclusion: Blood donor forms should be carefully tailored to improve the identification of possible risks of transfusion-transmitted infections.

Although the prevalence of anthrax is a decreasing worldwide, it remains a significant problem in developing countries. Rapid identification of the signs and symptoms of cutaneous anthrax is essential for effective treatment. Early supportive treatment and appropriate antimicrobial measures are necessary to address this potentially life-threatening disease.

COVID-19 infection under omalizumab therapy for chronic spontaneous urticaria: three cases Dear Editor, Information on the use of omalizumab in the COVID-19 pandemic is limited. There are case-level studies showing that this drug is beneficial or harmful in those with COVID-19 infection. Omalizumab has anti-inflammatory effects and anti-IGE properties. Here, three patients who had COVID-19 pneumonia and upper respiratory tract infection while using omalizumab regularly due to chronic spontaneous urticaria are presented. Information on the use of biological drugs used in dermatology in the COVID-19 pandemic is limited and controversial. Omalizumab (OMZ) is approved by the Food and Drug Administration (FDA) for the treatment of moderate to severe allergic asthma and chronic spontaneous urticaria (CSU) resistant to H1-antihistamine. 1 There are no cases or studies regarding the safety of use of OMZ in the COVID-19 pandemic. Here, we present three cases who received OMZ treatment for CSU and developed pneumonia and upper respiratory tract infection due to COVID-19 during the pandemic period. A 59-year-old female patient presented to the emergency department 3 weeks ago with the complaints of cough and weakness. On computed tomography (CT) scan, there was a ground-glass opacity in both lungs, more prominent in the lower lobes, and it was considered to be compatible with moderate COVID-19 pneumonia. Despite this, polymerase chain reaction (PCR) was negative on nasopharyngeal and oropharyngeal swab. It was learned that the patient had been using OMZ 300 mg/4 weeks intermittently for 3 years and took the last dose 4 , MD

Background & objectives:Brucellosis can lead to haematological abnormalities including cytopenia confusing with haematological malignancies. The aim of this study was to compare the main characteristics of brucellosis patients without cytopenia (Group 1) and with cytopenia (Group 2).Methods:This five-year period study which was performed in two referral hospitals in Turkey, included all adult brucellosis patients. Abnormally, low counts of leucocyte or haemoglobin or platelets in a patient were considered as cytopenia. The demographics, clinical, laboratory, treatment and outcome data were analyzed.Results:A total of 484 brucellosis patients were enrolled. Among the cases, 162 (33.5%) of them had cytopenia. One hundred and four (21.5%) had anaemia, 88 (18.8%) had thrombocytopenia, 71 (14.6%) had leucopenia and 28 (5.8%) had pancytopenia. The mean age of group 2 was 35.01±16.05 yr and it was 33.31±14.39 yr in group 1. While there was no difference between the groups in terms of duration of treatment, the median length of hospital stay (LOS) was significantly longer in group 2 (9 vs 10 days; P <0.001). The most frequently applied combination therapy consisted of doxycycline plus rifampicin and doxycycline plus streptomycin regimens. No significant difference was observed in terms of duration of treatment, LOS and restoration time of cytopenia between the patients who received either of these combinations.Interpretation & conclusions:Our findings suggested that the patients with cytopenia should be investigated for brucellosis, especially if living in, or with a history of travel to, endemic areas, in view of the increase in world travel.

Chronic hepatitis B (CHB) infection is a life-threatening global public health problem caused by the hepatitis B virus (HBV). Approximately 257 million people worldwide have been estimated to be infected with HBV, and more than 887 000 people have died because of HBV complications, such as cirrhosis and liver cancer. 1 HBV infection causes a wide range of diseases ranging from acute hepatitis (including fulminant liver failure) to chronic hepatitis, cirrhosis and hepatocellular carcinoma. 2 With HBV-DNA, HBeAg and anti-HBe detection, the stages of CHB infection have been determined; however, sufficient assessment of the stage of liver damage and fibrosis is lacking. In cases where biochemical and HBV markers reveal inconclusive results, liver biopsy or non-invasive tests have been recommended to determine disease activity. 3 Differences in interpretation, insufficient sampling, errors in sampling and lifethreatening complications have been the limitations of liver biopsy. 4 Therefore, reproducible and non-invasive biochemical tests and serum markers have been considered as alternatives to standard methods for evaluating the course of CHB. 5,6 Cytokines play an important role in the defense against viral infections by direct inhibition of viral replication and indirectly in determining the predominant pattern of host response. However, the inflammatory response of cytokines to viruses can also cause liver damage. 7 Studies have shown that the differences in cytokine expression in CHB patients may be related to the prognosis of HBV infection, but data from HBeAg-negative patients where antiviral therapy has been given the most is limited. 8 In this study, the aim was to evaluate the serum levels of tumour necrosis factor (TNF)α, interleukin (IL)-1β and IL-6 in chronic HBV-infected patients.

Background: Many noninvasive methods, including amino transaminase (AST)/amino transaminase (ALT) ratio (AAR), AST-to-platelet ratio index (APRI), Bonacini cirrhosis discriminant score (CDS), fibrosis-4 (FIB4) index, and age-platelet index (API), have been described to determine the stage of hepatic fibrosis. However, these methods are developed for patients with chronic hepatitis C (CHC) and produce conflicting results in the prediction of liver fibrosis in patients with chronic hepatitis B (CHB). Objectives: The aim of this study was to evaluate the relationship between 7 noninvasive models, including AAR, APRI, CDS, API, FIB-4, neutrophil-to-lymphocyte ratio (NLR), and red cell distribution width (RDW)-to-platelet ratio (RPR) in patients with CHB. Methods: The study population included all patients with CHB, undergoing liver biopsy to determine HBsAg and HBV DNA positivity in more than 6 months. Results: A total of 2520 treatment-naive CHB patients from 40 different centers were included in the study. In total, 62.6% of the patients were male, and the mean age

Introduction: Although vaccines are the safest and most effective means to prevent and control infectious diseases, the increasing rate of vaccine hesitancy and refusal (VHR) has become a worldwide concern. We aimed to find opinions of parents on vaccinating their children and contribute to available literature in order to support the fight against vaccine refusal by investigating the reasons for VHR on a global scale. Methodology: In this international cross-sectional multicenter study conducted by the Infectious Diseases International Research Initiative (ID-IRI), a questionnaire consisting of 20 questions was used to determine parents’ attitudes towards vaccination of their children. Results: Four thousand and twenty-nine (4,029) parents were included in the study and 2,863 (78.1%) were females. The overall VHR rate of the parents was found to be 13.7%. Nineteen-point three percent (19.3%) of the parents did not fully comply with the vaccination programs. The VHR rate was higher in high-income (HI) countries. Our study has shown that parents with disabled children and immunocompromised children, with low education levels, and those who use social media networks as sources of information for childhood immunizations had higher VHR rates (p < 0.05 for all). Conclusions: Seemingly all factors leading to VHR are related to training of the community and the sources of training. Thus, it is necessary to develop strategies at a global level and provide reliable knowledge to combat VHR.