Abstract
Purpose
In this study, we aimed to evaluate the epidemiology and antimicrobial resistance (AMR) patterns of bacterial pathogens in COVID-19 patients and to compare the results with control ...groups from the pre-pandemic and pandemic era.
Methods
Microbiological database records of all the COVID-19 diagnosed patients in the Ege University Hospital between March 15, 2020, and June 15, 2020, evaluated retrospectively. Patients who acquired secondary bacterial infections (SBIs) and bacterial co-infections were analyzed. Etiology and AMR data of the bacterial infections were collected. Results were also compared to control groups from pre-pandemic and pandemic era data.
Results
In total, 4859 positive culture results from 3532 patients were analyzed. Fifty-two (3.59%) patients had 78 SBIs and 38 (2.62%) patients had 45 bacterial co-infections among 1447 COVID-19 patients. 22/85 (25.88%) patients died who had bacterial infections. The respiratory culture-positive sample rate was 39.02% among all culture-positive samples in the COVID-19 group. There was a significant decrease in extended-spectrum beta-lactamase (ESBL)-producing
Enterobacterales
(8.94%) compared to samples from the pre-pandemic (20.76%) and pandemic era (20.74%) (p = 0.001 for both comparisons). Interestingly,
Acinetobacter baumannii
was the main pathogen in the respiratory infections of COVID-19 patients (9.76%) and the rate was significantly higher than pre-pandemic (3.49%, p < 0.002) and pandemic era control groups (3.11%, p < 0.001).
Conclusion
Due to the low frequency of SBIs reported during the ongoing pandemic, a more careful and targeted antimicrobial prescription should be taken. While patients with COVID-19 had lower levels of ESBL-producing
Enterobacterales,
the frequency of multidrug-resistant (MDR)
A. baumannii
is higher.
Amaç: Toxoplasma gondii (T. gondii), çoǧu sıcakkanlı hayvan türünü enfekte eden ve toksoplazmoza neden olan bir protozoon parazitidir. Özellikle gebelik esnasında ortaya çıkan enfeksiyonlar ciddi ...klinik tablolara yol açabilir. Bu çalışmada, Kastamonu ilindeki gebe kadınlarda T. gondii seroprevalansmm retrospektif olarak ortaya konulması amaçlanmıştır. Yöntemler: Ocak 2018-Ocak 2022 yılları arası Kastamonu Eǧitim ve Araştırma Hastanesi Kadın Hastalıkları ve Doǧum Polikliniǧi'ne başvuran 15-44 yaş arasındaki 1,294 gebenin serum örneklerinde anti-T. gondii IgM ve IgG pozitifliǧi retrospektif olarak araştırılmıştır. Anti-T. gondii IgM ve IgG birlikte pozitif olan olgularda IgG avidite testi çalışılmıştır. Bulgular: Anti-T. gondii IgM ve IgG seropozitifliǧi sırasıyla %1,1 (n=14) ve %20,3 (n=263) olarak tespit edilmiştir. On bir hastada ise anti-T. gondii IgM ve IgG birlikte pozitif olarak saptanmıştır. Anti-T. gondii IgG avidite test sonuçlarına ulaşılan altı gebeden dördünde düşük avidite, iksinde ise yüksek avidite belirlenmiştir. Anti-T. gondii IgG için, yaş artışı ile birlikte pozitiflik oranının arttıǧı tespit edilmiştir (p=0,039). Sonuç: Kastamonu'da serónegatif gebe sayısı yüksek oranda bulunmuştur. Bu nedenle ilimizdeki anne adaylarının Toksoplazmoza yakalanmamaları adına enfeksiyondan korunma yöntemleri hakkında bilgi sahibi olmaları önem arz etmektedir.
RESİST-4 O.K.N.V. assay is a lateral immunochromatocraphic test for the identification of oxacillinase (OXA)-48-like,
carbapenemase (KPC), New Delhi metallo-β-lactamase (NDM), and Verona ...integron-encoded metallo-β-lactamase (VIM) producing strains. It was aimed to evaluate the performance of the RESIST-4 O.K.N.V. test and to compare it with the reference method polymerase chain reaction (PCR). Also, the objective was to determine the distribution of carbapenemase types of CRE strains isolated in our hospital.
Between January 2016-October 2019, 187 strains isolated from clinical samples were included in this study. Bacterial identification was done using MALDI-TOF MS. Antibiotic susceptibility tests were studied with the VITEK-2 automated system. Meropenem minimum inhibitory concentrations (MICs) were determined by the gradient test. All strains were studied with the RESIST-4 O.K.N.V. test and then the strains were selected for the PCR test.
,
,
, and
were investigated with PCR.
NCTC® 13438 (KWIKSTIKTM, Microbiologics®, USA) was used as the positive control,
ATTC® 25922 TM (Microbiologics®, USA) and three carbapenem-sensitive clinical isolates were also used as the negative control.
Meropenem MIC
and MIC
values were determined to be >32 mg/L. With PCR
,
,
and
were detected in 79, 63, 20, and 4 strains, respectively.
and
were found together in 51 of the isolates.
,
,
, and
were not detected in two strains with carbapenem resistance in susceptibility tests. The sensitivity of the immunochromatographic test was 100% for OXA-48, KPC, and VIM but 84.1% for NDM. Specificity was determined as 100% for OXA-48, NDM, KPC, and VIM.
RESIST-4 O.K.N.V. test showed high sensitivity and specificity in detecting OXA-48, KPC, NDM, and VIM type carbapenemases. However, it should be kept in mind that there may be false-negative results related to NDM.
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DOBA, IZUM, KILJ, NUK, PILJ, PNG, SAZU, UILJ, UKNU, UL, UM, UPUK
The aim was to evaluate the sensitivity and the possible factors affecting the sensitivity of the QuantiFERON®-TB Gold Plus (QFT-Plus) assay in culture-positive active TB (Tuberculosis) patients, to ...investigate the possible causes of negative and indeterminate results in active TB patients, and to compare the QFT-Plus results of active TB patients and latent tuberculosis infection (LTBI) cases. The QFT-Plus assay was performed in 46 active TB patients and 64 LTBI. The sensitivity of the test was found as 79.5% in all culture-positive patients, 72.7% in the immunocompromised patients, and 86.4% in the non-immunocompromised patients. Compared to active TB, individuals with LTBI had a lower T-cell response and lower IFN-ɣ concentrations. It was determined that the immunocompromisation reduced the sensitivity of the test and the secreted IFN-ɣ concentrations and increased the indeterminate results in patients with active TB. There was no difference in secreted IFN-ɣ concentrations between M. tuberculosis clones, but higher IFN-ɣ concentrations in patients infected with M. tuberculosis strains compared to patients infected with zoonotic strains. Compared with active TB, response to “only to TB2” was significantly higher in LTBI. In conclusion, it was concluded that TB2 tube increased sensitivity in LTBI but may not contribute to sensitivity in active TB.
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GEOZS, IJS, IMTLJ, KILJ, KISLJ, NLZOH, NUK, OILJ, PNG, SAZU, SBCE, SBJE, UILJ, UL, UM, UPCLJ, UPUK, ZAGLJ, ZRSKP
Introduction: Individuals co-infected with human immunodeficiency virus (HIV) and Mycobacterium tuberculosis have an increased risk of the reactivation of latent tuberculosis (TB) infection (LTBI) to ...active TB. The addition of peptides to stimulate CD8+ T cells is expected to increase the sensitivity of the QuantiFERON®-TB Gold Plus (QFT-Plus) assay in detecting LTBI and TB infection in patients. This study aimed to determine the prevalence of LTBI in patients with HIV infection in our region and to evaluate the possible factors that may interfere with the performance of the QFT-Plus assay in HIV infection. Materials and Methods: The study included 132 HIV-positive and 133 HIV-negative cases presented to the Ege University Medical Faculty Hospital between January 2016 and December 2019. Demographic and clinical data and laboratory/culture results were obtained from the mycobacteriology laboratory and hospital database. Results: QFT-Plus positivity rates were 30.1% (40/133) in the HIV-negative and 21.2% (28/132) in HIV-positive groups. The indeterminate results of the HIV-positive and HIV-negative groups were 4.5% and 3%, respectively. The CD4+ T cell count was below 200/mm3 in five of the six patients in the HIV-positive group with indeterminate results, and the median lymphocyte count was significantly lower. Although no significant difference was found between the median lymphocyte counts of the HIV-positive and HIV-negative group, the positivity rates and secreted interferon (IFN)-ɣ levels were lower, and the indeterminate results were higher in the HIV-positive group than in the HIV-negative group, but the difference was not significant. The rate of QFT-Plus positivity was 32.4% in patients with a viral load below 10,000 copies/ml and 16.1% in patients with a viral load above 10,000 copies/ml (p=0.047). Conclusion: The positivity rates and secreted IFN-ɣ levels were lower, and the indeterminate results were higher in the HIV-positive group than in the HIV-negative group. The addition of TB2 tube to the QFT-Plus assay could contribute to the sensitivity of the test in both HIV-positive and HIV-negative individuals with LTBI.
We aimed to develop a new procedure for rapid detection of the carbapenemase activity using MALDI-TOF MS, and to determine the sensitivity and specificity of the method. Also, we aimed to determine ...the distribution of carbapenemase genes among the K.pneumoniae strains isolated in our hospital using real-time PCR.
Between January 2017-February 2019; K. pneumoniae strains(n = 74) isolated from blood culture samples were included. Klebsiella pneumoniae NCTC 13438 was used as a positive control and Escherichia coli ATCC 25922 as a negative control. First, Imipenem, meropenem, and ertapenem MIC values of strains were determined. Then bla
, bla
and/or bla
genes were investigated with PCR. Carbapenemase activity was investigated in strains with the newly developed method using MALDI-TOF MS. The performance of the new method was evaluated for both the second and fourth hours of the incubation period.
While 65 strains were found resistant to tested carbapenems, nine of them were susceptible. Of the 65 resistant strains, 57 had bla
, 15 had bla
, and four had bla
genes. Bla
and bla
genes were detected together in 11 strains. Bla
, bla
and bla
genes were not detected in any of the susceptible strains. The sensitivity and specificity of MALDI-TOF MS at the second hour were 83.1% and 100%, respectively. At the fourth hour, the sensitivity and specificity of MALDI-TOF MS were 100%. No false-positive results were observed.
The sensitivity of the method at the fourth hour was better than the second hour. The false-negative results observed in the second hour disappeared when the incubation period was extended to 4 h. MALDI-TOF MS which is still under development is a fast, cost-effective, promising method for the detection of carbapenemase activity.
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GEOZS, IJS, IMTLJ, KILJ, KISLJ, NLZOH, NUK, OILJ, PNG, SAZU, SBCE, SBJE, UILJ, UL, UM, UPCLJ, UPUK, ZAGLJ, ZRSKP
Aims: Hepatitis B virus (HBV) and hepatitis C virus (HCV) infections during pregnancy have a risk of transmission to the
newborn. Therefore, pregnant women are routinely screened for HBV and HCV in ...many countries. This study aimed to reveal the seroprevalence of HBsAg, anti-HBs, and anti-HCV in pregnant women in the Kastamonu region and to compare the obtained data with the results of studies conducted in Turkey.
Methods: Pregnant women who applied to Kastamonu Training and Research Hospital Microbiology laboratory between
January 2022 and January 2023 for HBsAg, anti-HBs, and anti-HCV tests were included in this study. The pregnant women
were separated into two groups ?24 and >24 age groups. The tests were performed using the chemiluminescence microparticle immune assay method on the Abbott Architect i2000SR instrument, and the results were evaluated per the manufacturer’s instructions.
Results: HBsAg, anti-HBs, and anti-HCV positivity were 0.5% (n=9/1712), 51.1% (n=874/1712), and 0.1% (n=2/1713),
respectively. While there was no significant difference between age groups for HBsAg positivity (p>0.05), anti-HBs positivity
was found to be significantly higher in the ?24 age group than in the >24 age group (p=0.002).
Conclusion: The results showed that HBsAg and anti-HCV positivity was lower than in most studies conducted in recent years in Turkey, and anti-HBs positivity was higher than in most studies. It is essential to continue routine HBV and HCV screening in pregnant women’s first follow-up and encourage anti-HBs-negative individuals to be vaccinated against HBV.
Aim: This study purposed to determine anti-spike IgG levels at the fourth week after the second dose in healthcare workers (HCWs) who had two doses of the CoronaVac vaccine (Sinovac Life Sciences, ...Beijing, China). The second purpose of the study was to evaluate several factors that may affect antibody levels.
Material and Method: The study was performed at Kastamonu Training and Research Hospital. A total of 197 HCWs of both genders aged 20-63 were included in this study. Antibody levels that neutralize the SARS-CoV-2 spike protein S1 subunit were determined using the SARS-CoV-2 IgG II Quant kit from serum samples collected from the subjects between 10-16 March 2021. Also, a questionnaire containing information about demographic and clinical data was administered to all subjects. It was statistically investigated whether these data affected the anti-spike IgG levels.
Results: All subjects had anti-spike IgG levels positive. The median value of the subjects' anti-spike IgG levels was calculated as 860.2 AU/mL (519.1-1674.1 AU/mL). Anti-spike IgG levels were statistically higher in non-smokers and Rh-positive subjects versus the smokers and Rh-negative subjects (p=0.001 and p=0.046, respectively). However, age groups, gender, COVID-19 history, blood type, and seasonal influenza vaccine did not significantly affect anti-spike IgG levels in the subjects (p>0.05).
Conclusion: Anti-spike IgG responses were positive in all HCWs who received the CoronaVac vaccine. Besides, the results showed that smoking and Rh-factor affect the anti-spike IgG response. On the other hand, further studies need to examine more parameters with a larger number of subjects.
Objective: Toxoplasma gondii (T. gondii) is a protozoan parasite that infects most warm-blooded animal species and causes toxoplasmosis. Especially infections that occur during pregnancy can lead to ...serious clinical symptoms. This study retrospectively revealed the T. gondii seroprevalence of pregnant women in Kastamonu province, Turkey. Methods: Anti-T. gondii IgM and IgG positivity of 1.294 pregnant women between the ages of 15-44 years who applied to the Obstetrics and Gynecology Outpatients of Kastamonu Training and Research Hospital from January 2018 to January 2022 were investigated retrospectively. The IgG avidity test was performed for both anti-T. gondii IgM and IgG positivity. Results: Anti-T. gondii IgM and IgG seropositivity were determined as 1.1% (n=14) and 20.3% (n=263), respectively. Anti-T gondii IgM and IgG positivity were detected together in 11 pregnant women. IgG avidity test results of only six pregnant women could be reached, two pregnant had high IgG avidity, and four pregnant had low IgG avidity. Anti-T. gondii IgG positivity rate increased with increasing age (p=0.039). Conclusion: The number of seronegative pregnant women was considered high in Kastamonu. It is significant for expectant mothers to know about prevention methods in order not to acquire toxoplasmosis. Keywords: Pregnancy, IgG, IgM, seroprevalence, Toxoplasma gondii Amaç: Toxoplasma gondii (T. gondii), çogu sicakkanli hayvan türünü enfekte eden ve toksoplazmoza neden olan bir protozoon parazitidir. Ãzellikle gebelik esnasinda ortaya çikan enfeksiyonlar ciddi klinik tablolara yol açabilir. Bu çalismada, Kastamonu ilindeki gebe kadinlarda T. gondii seroprevalansinin retrospektif olarak ortaya konulmasi amaçlanmistir. Yöntemler: Ocak 2018-Ocak 2022 yillari arasi Kastamonu Egitim ve Arastirma Hastanesi Kadin Hastaliklari ve Dogum Poliklinigi'ne basvuran 15-44 yas arasindaki 1,294 gebenin serum örneklerinde anti-T. gondii IgM ve IgG pozitifligi retrospektif olarak arastirilmistir. Anti-T. gondii IgM ve IgG birlikte pozitif olan olgularda IgG avidite testi çalisilmistir. Bulgular: Anti-T. gondii IgM ve IgG seropozitifligi sirasiyla %1,1 (n=14) ve %20,3 (n=263) olarak tespit edilmistir. On bir hastada ise anti-T. gondii IgM ve IgG birlikte pozitif olarak saptanmistir. Anti-T. gondii IgG avidite test sonuçlarina ulasilan alti gebeden dördünde düsük avidite, iksinde ise yüksek avidite belirlenmistir. Anti-T. gondii IgG için, yas artisi ile birlikte pozitiflik oraninin arttigi tespit edilmistir (p=0,039). Sonuç: Kastamonu'da seronegatif gebe sayisi yüksek oranda bulunmustur. Bu nedenle ilimizdeki anne adaylarinin Toksoplazmoza yakalanmamalari adina enfeksiyondan korunma yöntemleri hakkinda bilgi sahibi olmalari önem arz etmektedir. Anahtar Kelimeler: Gebelik, IgG, IgM, seroprevalans, Toxoplasma gondii
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