Background. In the oral cavity, which plays an important role in the transmission of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), it is possible to reduce the viral load of SARS-CoV-2 with antiseptics, thereby minimizing the transmission of the virus during dental procedures.Objectives. The aim of this study was to clinically evaluate the effect of the hypochlorous acid (HClO) and povidone-iodine (PVP-I) solutions on the oral viral load of SARS-CoV-2.Material and methods. This randomized controlled trial was conducted on 75 patients hospitalized in the COVID-19 ward of a local hospital. All the patients included in the study were within the first 24 h of hospitalization and the first 5 days of coronavirus disease 2019 (COVID-19) symptoms. The viral load of mouthwash samples was measured with the cycle threshold (Ct) value of SARS-CoV-2 through a realtime reverse transcription polymerase chain reaction (RT-PCR). The patients were divided into 3 groups. The effect on the patient's SARS-CoV-2 viral load was investigated after gargling the mouths and throats for 30 s with HClO, PVP-I and isotonic saline. First, a sample was taken after gargling with isotonic saline, then another sample was taken after gargling for 30 s with a particular antiseptic to determine the viral load of SARS-CoV-2. Results.Comparing the before and after mouthwash samples from all 3 groups, there were no statistically significant differences in the Ct values before and after gargling (p > 0.05). However, there were statistically significant differences in the number of negative samples after the use of HClO and PVP-I, which were positive before gargling (p < 0.05). Conclusions.In the light of the data obtained in this study, there is insufficient evidence that gargling with HClO or PVP-I reduces viral load. Taken together, these findings imply no role for antiseptics in the transmission of SARS-CoV-2 by the aerosol generated during dental procedures, or more generally, SARS-CoV-2 infection control.
BackgroundMeningitis is infection of the central nervous system with high mortality and morbidity in adults. Markers for diagnostic purposes can therefore be useful guides in differential diagnosis. Procalcitonin (PCT), platelet distribution width (PDW) and red blood cell distribution width (RDW) can be easily calculated with automated blood systems, and have been regarded as biomarkers showing inflammation in infection-related diseases. The purpose of this study was to determine the diagnostic significance of these biomarkers in adult meningitis.MethodsThis study was a retrospective investigation. Diagnosis of meningitis was based on clinical findings and microbiological and biochemical investigations of CSF specimens. Patients’ white blood cell count (WBC), C-reactive protein (CRP), PDW, RDW and PCT levels at time of presentation were compared. P < 0.05 was regarded as statistically significant.Results137 patients were assessed. Ninety-five patients had acute bacterial meningitis (ABM), 17 had aseptic meningitis (AM) and 25 had chronic meningitis (CM). When patients were evaluated by age, AMB was more common in the elderly and AM in the young (P < 0.05). CRP and PCT levels at presentation were significantly higher in AM than in AM and CM (P < 0.05). WBC levels differed statistically significantly between ABM and CM (P < 0.05). PDW levels were significantly higher in AM then in CM (P < 0.05). RDW was statistically significantly higher in CM than in ABM and AM (P < 0.05). When ROC analysis was performed to differentiate ABM from the other forms (table). Correlation analysis between CSF biochemistry and biomarkers revealed that PCT was positively correlated with CRP, PDW and CSF protein and negatively correlated with CSF glucose. Table: ROC analysis for PCT, CRP and WBC in subjects with ABM Biomarker Cut-off AUC Sensitivity Specificity PPV NPV P PCT 0.90.71356.386.190.744.9 <0.001 CRP 2.20.74076.864.383.055.1 <0.001 WBC 144000.64734.792.991.738.6 0.002 Conclusion Our results suggest that PCT and CRP have diagnostic characteristics in favor of ABM at differential diagnosis in cases in which LP is contraindicated and/or CSF examination cannot be performed immediately or the agent cannot be identified. WBC and RDW can be useful guides in differentiating ABM from CM, and PDW and RDW in differentiating CM from ABM and AM.Disclosures All authors: No reported disclosures.
Objectives: During the healthcare services, healthcare workers are under the risk of sharps and needle stick injuries. In this study, we evaluated occupational injuries seen in our hospital and emphasized the importance of reducing the risk of exposure to these injuries through compliance with infection control precautions. Materials and Methods: In this study, we retrospectively evaluated the data of the Infection Control Committee of Karadeniz Technical University Faculty of Medicine on work-related sharp injuries among healthcare workers between 01.01.2016 and 01.02.2018. Results: This study was carried out with sixty-six healthcare workers. The mean age of the healthcare workers was 29.3(±7.62) years. The injuries were most frequently observed in nurses. Majority of the injuries had occurred in internal medicine clinics and most of them were needle stick injuries. In 99.7% of the injuries, contamination state was known. Forty-nine of 66 employees were immune to the hepatitis B virus. After the injuries, any acute viral infection was not developed. Three out of the 6 employees injured by positive serology of human immunodeficiency virus sources were given prophylaxis for four weeks after contact. Conclusion: All healthcare workers should be informed about the measures against injuries, the proper use of protective equipment and the importance of vaccination and, they should be subjected to periodic training.
Funguslara bağlı kemik eklem enfeksiyonları nadirdir. Kandida türlerine bağlı osteomiyelit de oldukça nadir görülen bir durumdur. Etken olarak en sık Candida albicans görülür, ancak son yıllarda non-albicans Candida'ların da osteomiyelitlerde sıklığının arttığı bildirilmektedir. Bu yazıda nonalbicans Candida osteomiyeliti olan üç olgu sunuldu. Osteoartiküler tutuluma bakıldığında olguların birinde lomber vertebra, birinde el, diğerinde ise ayak osteomiyeliti vardı. Olguların üçünde diabetes mellitus ve uzun süreli antibiyotik kullanımı ortak risk faktörleriydi. Vertebral osteomiyelit olan olguda ayrıca cerrahi girişim ve yabancı cisim varlığı diğer risk faktörleriydi. Olguların tanısında manyetik rezonans görüntüleme kullanıldı ve alınan derin doku kültüründe etken izole edildi. Tüm olgulara cerrahi debritman yapılarak altı hafta ile 24 hafta arasında değişen sürede antifungal tedavi verildi. Olgularda klinik ve radyolojik takiplerde enfeksiyon tekrarlamadı. Ayağında osteomiyeliti olan olgu akut serebrovasküler hastalık nedeni ile eksitus oldu. Çalışmamızda Nisan 2010-Haziran 2019 tarihleri arasında osteoartiküler Candida enfeksiyonu ile ilgili literatür taraması yapıldı ve 44 olgu derlendi. Çalışmamızda bu olguları sunmadaki amacımız, kandidaya bağlı osteoartiküler enfeksiyonlara dikkati çekmek ve etken tanımlanmasıyla hedefe yönelik tedavinin önemini vurgulamaktır. Anahtar Kelimeler: Spondilodiskit, flukonazol, kaspofungin, sistematik derleme, lipozomal amfoterisin b Fungal infections in the bones and joints are rare. Candida spp. osteomyelitis is also a very rare entity. The most common pathogen is Candida albicans, but an increase in the incidence of non-albicans Candida osteomyelitis has been reported in recent years. Herein, we present three patients with non-albicans Candida osteomyelitis. Osteoarticular involvement occurred in the lumbar vertebrae in one patient, in the hand in one patient, and the foot in the other patient. Diabetes mellitus and long-term antibiotic use were common risk factors in all three cases. In the patient with vertebral osteomyelitis, surgical intervention and foreign body were other risk factors. Magnetic resonance imaging was used in the diagnosis and the pathogens were isolated from deep tissue cultures. Surgical debridement was performed in all cases and antifungal treatment was given for 6-24 weeks. There was no reinfection or relapse during clinical and radiological follow-up. The patient with osteomyelitis of the foot died due to to acute cerebrovascular disease. In our study, the literature review for publications related to osteoarticular Candida infection was made between April 2010 and June 2019 and 44 cases are reviewed. Our aim in this study was to draw attention to Candida osteoarticular infections and to emphasize the importance of targeted treatment by defining the pathogen.
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