ÖZET

Introduction: Human immunodeficiency virus/acquired immunodeficiency syndrome (HIV/AIDS) is the leading cause of death from infectious diseases in the world. With the antiretroviral treatments developed over the years, viral replication is suppressed even though the disease cannot be cured yet. However, antiretroviral therapy (ART), like all drugs, has brought with it undesirable side effects as well as positive effects. In addition, demographic characteristics, accompanying comorbidities, organ dysfunctions, viral load, CD4 T lymphocyte count, ART resistance status, coinfections, pregnancy are also effective factors in the initial ART decision and change. In this study, we aimed to show the treatment status of HIV-positive patients followed in the infectious diseases outpatient clinic of our hospital and to determine the factors that affect ART change. Materials and Methods: Demographic data of HIV-positive patients followed in the infectious diseases outpatient clinic between January 2016 and May 2021, HIV-RNA and CD4 T lymphocyte results obtained before and after antiretroviral therapy, and the reasons for changing treatment were evaluated retrospectively. Results: The mean age of the patients included in the study was 40.0 ± 13.9 (min: 20-max: 76), and 16 (18%) were female and 71 (82%) were male. Treatment was changed in 32% of the patients. Changes were made due to drug-related side effects in 43%, patient-related reasons (such as single tablet request, non-compliance with treatment) in 25%, and virological unresponsiveness in 18% of patients who underwent treatment change. The most common cause of drug changes due to side effects was hyperlipidemia. The treatment regimens that changed the initial treatment were most frequently TDF/FTC/LPV/r and TDF/FTC/EFV, respectively. Conclusion: As a result of our study, we found that the most common cause of ART change in HIV-positive patients in our hospital was drug-related side effects, and patient non-compliance was the second most common. It is important to know the factors that cause these changes in advance and to make choices accordingly when starting the treatment, in order to increase patient compliance and facilitate follow-up.

Introduction: Human immunodeficiency virus/acquired immunodeficiency syndrome (HIV/AIDS) continues to be a serious public health problem with the increasing number of cases, especially in developing countries, and it is very important to screen for vaccine-preventable diseases and vaccinate susceptible individuals in the follow-up of these patients. In this study, immunization status of HIV-diagnosed patients followed in Düzce University Hospital Infectious Diseases Outpatient Clinic against vaccine-preventable diseases such as measles, rubella, mumps, varicella (VZV), hepatitis B (HBV), hepatitis A (HAV), pneumococcus, meningococcus, influenza were evaluated. Materials and Methods: 79 HIV-positive patients followed in our infectious diseases outpatient clinic between 2013-2021 were retrospectively analyzed. Results: Of 79 patients, 14 (18%) were female and 65 (82%) were male, with a mean age of 41±13.88 (min:20-max:76). The seropositivity rates of the patients were 93% for measles, 97% for rubella, 97% for mumps, 99% for VZV, and 80% for hepatitis A. As a result of HBV tests, 43% of the patients were found to be anti-HBs positive, 8% to chronic hepatitis B, and 49% to be seronegative for hepatitis B. It was determined that 57% of the patients received pneumococcal vaccine, 56% meningococcal vaccine, and 71% annual influenza vaccine. Conclusion: The number of HIV/AIDS patients is increasing every year in our country. It is important to determine the immunity status of these patients against vaccine-preventable diseases and to make the necessary vaccinations.

Aim: Early diagnosis of bacterial infections is crucial in planning treatment. Thus, it is important to determine the gram staining property of bacteria as well as the presence of bacterial infection. The acute bacterial infection leads to morphological changes in neutrophils. In this study, we investigated the use of neutrophil volume, conductivity and lightscattering (VCS) parameters as potential indicators for rapid diagnosis of bacterial infections, and to distinguish infections caused by gram-positive and gram-negative bacteria. Material and Methods: Patients with urinary tract infections, pneumonia, wound site infections and sepsis were included. The control group comprised patients without bacterial infections. The blood samples of the patients were examined for white blood cell and neutrophil counts; neutrophil VCS parameters were determined using a Coulter Analyzer. The VITEK 2 Compact System was used to detect microbial growth. Results:The blood sample data of 472 patients sent to our laboratory for Complete Blood Count analyses from various clinics were analyzed in this study. A total of 370 samples showed significant growth in their bacteriological culturing, whereas the remaining 102 samples showed no growth. For the detection of bacterial growth, the specificities of median neutrophil volume (MNV) and median neutrophil conductivity (MNC) were found to be 96% and 99%, respectively. In addition, median neutrophil light scattering (MNS) was higher in the gram-negative bacterial group than in the grampositive bacterial group. Conclusion:The use of neutrophil VCS parameters is an effective and time-saving method to identify bacterial infections and distinguish between gram-positive and gram-negative bacterial infections.

ÖZET Nonfermentatif Gram negatif bakterilerin yol açtığı infeksiyonlarda tedavi sorun oluşturmaktadır. Karbapenemlere karşı gelişen dirençte en önemli mekanizma metallo-beta-laktamaz (MBL) üretimidir. Son yıllarda MBL üretimi nedeniyle ortaya çıkan karbapenem direnç Anahtar sözcükler: Acinetobacter baumannii, metallo-beta-laktamaz, Pseudomonas aeruginosa SUMMARY Investigation of Metallo-Beta-Lactamase Activity by Various Phenotypic Methods in Non-Fermentative Gram Negative Bacteria Treatment of infections caused by non-fermentative Gram-negative bacteria (NFGNB) is a problem. The most important mechanism for developing resistance against carbapenems is metallo-beta-lactamase (MBL) production. This study was performed to investigate the prevalence of MBL in NFGNB which cause infections in our hospital and to compare different phenotypic methods for detecting the presence of MBL. A total of 86 isolates which are intermediately resistant or/ resistant to imipenem, consisting of 50 Pseudomonas aeruginosa and 36 Acinetobacter baumannii, which were isolated at Düzce University Hospital Microbiology Laboratory from various clinics were included the study. Antimicrobial susceptibility testing of the isolates were performed by Kirby-Bauer disk diffusion method and VITEK2 automated system. Presence of MBL was investigated by four different phenotypic methods (Double Disk Synergy Test-DDST, the Combined Disk Test-CDT, modified Hodge test-MHT, E-test (bioMerieux, France).The majority of the samples (44%) were deep tracheal aspirate specimens. In addition, 46.5 % of the samples were sent from intensive care units. In our study, MBL positivity was detected as 34 %, 55 %, 45 %, 48 % by using DDST, CDT, respectively