In this multicentre study, which is the largest case series ever reported, we aimed to describe the features of tularaemia to provide detailed information. We retrospectively included 1034 patients from 41 medical centres. Before the definite diagnosis of tularaemia, tonsillitis (n = 653, 63%) and/or pharyngitis (n = 146, 14%) were the most frequent preliminary diagnoses. The most frequent clinical presentations were oropharyngeal (n = 832, 85.3%), glandular (n = 136, 13.1%) and oculoglandular (n = 105, 10.1%) forms. In 987 patients (95.5%), the lymph nodes were reported to be enlarged, most frequently at the cervical chain jugular (n = 599, 58%), submandibular (n = 401, 39%), and periauricular (n = 55, 5%). Ultrasound imaging showed hyperechoic and hypoechoic patterns (59% and 25%, respectively). Granulomatous inflammation was the most frequent histological finding (56%). The patients were previously given antibiotics for 1176 episodes, mostly with β-lactam/β-lactamase inhibitors (n = 793, 76%). Antituberculosis medications were provided in seven (2%) cases. The patients were given rational antibiotics for tularaemia after the start of symptoms, with a mean of 26.8 ± 37.5 days. Treatment failure was considered to have occurred in 495 patients (48%). The most frequent reasons for failure were the production of suppuration in the lymph nodes after the start of treatment (n = 426, 86.1%), the formation of new lymphadenomegalies under treatment (n = 146, 29.5%), and persisting complaints despite 2 weeks of treatment (n = 77, 15.6%). Fine-needle aspiration was performed in 521 patients (50%) as the most frequent drainage method. In conclusion, tularaemia is a long-lasting but curable disease in this part of the world. However, the treatment strategy still needs optimization.

Aim Influenza vaccination is the most effective method in prevention of influenza disease and its complications. Our study aimed to investigate the rates of vaccination and the behaviors and attitudes against the vaccine in healthcare workers in Turkey. Methods This multicenter national survey is a descriptive study in which 12475 healthcare workers. Healthcare workers were asked to answer the questionnaire consisting of 12 questions via the survey. Results It was found that 6.7% of the healthcare workers regularly got vaccinated each year and that 55% had never had the influenza vaccine before. The biggest obstacle against getting vaccinated was determined as not believing in the necessity of the vaccine (53.1%). Conclusion The rates of influenza vaccination in healthcare workers in Turkey are quite low. False knowledge and attitudes on the vaccine and disease are seen as the most important reasons to decline vaccination. It is important to detect reasons for anti‐vaccination and set a course in order to increase the rates of vaccination.

Background/aim To have country-wide information about multidrug resistance (MDR) in isolates from community-acquired urinary tract infections (CAUTI) of Turkey, in terms of resistance rates and useful options. Materials and methods We used a geocode standard, nomenclature of territorial units for statistics (NUTS), and a total of 1588 community-acquired isolates of 20 centres from 12 different NUTS regions between March 2019 and March 2020 were analysed. Results Of the 1588 culture growths, 1269 (79. 9%) were Escherichia coli and 152 (9.6%) were Klebsiella spp. Male sex, advanced age, and having two or more risk factors showed a statistically significant relation with MDR existence (p < 0.001, p: 0.014, p < 0.001, respectively) that increasing number of risk factors or degree of advancing in age directly affects the number of antibiotic groups detected to have resistance by pathogens. In total, MDR isolates corresponded to 36.1% of our CAUTI samples; MDR existence was 35.7% in E. coli isolates and 57.2% in Klebsiella spp. isolates. Our results did not show an association between resistance or MDR occurrence rates and NUTS regions. Conclusion The necessity of urine culture in outpatient clinics should be taken into consideration, at least after evaluating risk factors for antibacterial resistance individually. Community-acquired UTIs should be followed up time- and region-dependently. Antibiotic stewardship programmes should be more widely and effectively administrated.

Objective: Although the influenza vaccine is offered on request, free of charge every year since 2002 to healthcare workers in our country, vaccination rates are low. This study was carried out to determine the approach of healthcare workers in two different hospitals to the influenza vaccination. Material and Method: This descriptive study, in which demographic characteristics of employees of Kırıkhan State Hospital and Ağrı State Hospital and their answers given to the ten questions about influenza vaccination by face to face interview have been recorded in the survey form, was conducted on 2-9 January 2019. The data were analyzed using the SPSS program. Statistically, the p-value <0.05 level was considered significant. Results: 31 doctors, 215 assistant medical staff, 72 other healthcare workers, and 52 company staff, from two different centers, were involved in the study. We learned that 134 (%36.1) of the study participants had at least one vaccination in their life. The raised rate of vaccination was also observed as the education level increased. The leading causes of not wanting to get an influenza vaccine were unbelieving the necessity of the vaccine (26%) and preferring other protection methods (22.1%). When asked about ways to prevent influenza to the study participants, 64% responded as regular nutrition, doing sport, and taking vitamin C supplements, while %5.7 responded as getting an influenza vaccination. Conclusions: In training will be done on influenza vaccination, by taking into account also the reasons for not being vaccinated that were determined in studies performed in healthcare workers, good explanation of the necessity, effectiveness, and low side effects of vaccines should be required. At the same time, by taking suggestions from hospital staff, new strategies could be developed to transfer the relevant information.

Objectives: Increasing influenza vaccine intake in healthcare workers during the pandemic period will benefit the management of respiratory tract infections. This study aimed to investigate the effects of COVID-19 pandemic on influenza vaccination and COVID-19 vaccine.Material and Method: Healthcare workers were questioned over a survey about their status of having received the previous influenza vaccine and the influenza vaccine and COVID-19 vaccine this year. Their relationship with occupation, working in risky conditions and demographic characteristics of the individuals was investigated.Results: 768 healthcare workers participated in our study. While the rate of those who received the influenza vaccine in 2019 was 19.1% (n=147) this rate was 27.5% (n=211) in 2020 (p<0.001). While 101 of the 221 people who were vaccinated in 2020 were vaccinated in 2019, 110 people agreed to be vaccinated in 2020 even though they were not vaccinated in 2019. Those who received the influenza vaccine in 2019 accepted to receive the vaccine in 2020 as well (p<0.001) and it was observed that those who did not receive the vaccine in 2019 did not receive it in 2020, either (p<0.001). The rate of physicians who accepted both vaccines was higher than the rate of the other groups. When those who accepted to receive the COVID-19 vaccine were analyzed it was observed that the rate of those who accepted to receive the influenza vaccine in 2019 and 2020 was significantly higher than the rate of those who did not (p<0.001). Conclusion:It has been understood with the COVID-19 pandemic, how important the vaccine is, and this awareness has also increased the vaccination rates of influenza in healthcare workers. In this period, we should encourage health workers for higher vaccination rates. One of the most important factors for vaccination is that get individuals to accept vaccination once.