The serogroup epidemiology of invasive meningococcal disease (IMD), which varies considerably by geographic region and immunization schedule, changes continuously. Meningococcal carriage data are crucial for assessing IMD epidemiology and designing f potential vaccination strategies. Meningococcal seroepidemiology in Turkey differs from that in other countries: serogroups W and B are the predominant strains for IMD during childhood, whereas no serogroup C cases were identified over the last 10 y and no adolescent peak for IMD was found. There is a lack of data on meningococcal carriage that represents the whole population. The aims of this multicenter study (12 cities in Turkey) were to evaluate the prevalence of Neisseria meningitidis carriage, the serogroup distribution and the related risk factors (educational status, living in a dormitory or student house, being a household contact with Hajj pilgrims, smoking, completion of military service, attending bars/clubs) in 1518 adolescents and young adults aged 10-24 y. The presence of N. meningitidis DNA was tested, and a serogroup analysis was performed using polymerase chain reaction. The overall meningococcal carriage rate was 6.3% (n = 96) in the study population. A serogroup distribution of the 96 N. meningitidis strains isolated from the nasopharyngeal specimens revealed serogroup A in 5 specimens (5.2%), serogroup B in 9 specimens (9.4%), serogroup W in 64 specimens (66.6%), and serogroup Y in 4 specimens (4.2%); 14 were classified as non-grouped (14.4%). No serogroup C cases were detected. The nasopharyngeal meningococcal carriage rate was 5% in the 10-14 age group, 6.4% in the 15-17 age-group, and 4.7% in the 18-20 age group; the highest carriage rate was found in the 21-24 age group (9.1%), which was significantly higher than those of the other age groups (p < 0.05). The highest carriage rate was found in 17-year-old adolescents (11%). The carriage rate was higher among the participants who had had close contact with Hajj/Umrah pilgrims (p < 0.01) or a history of upper respiratory tract infections over the past 3 months (p < 0.05). The nasopharyngeal carriage rate was 6.3% among adolescents and young adults in Turkey and was similar to the recent rates observed in the same age groups in other countries. The most prevalent serogroup was W, and no serogroup C cases were found. In conclusion, the present study found that meningococcal carriage reaches its peak level by age 17, the highest carriage rate was found in 21 - to 24 - year-olds and the majority of the carriage cases were due to serogroup W. Adolescents and young adult carriers seem to be a potential reservoir for the disease, and further immunization strategies, including adolescent immunization, may play a role in the control of IMD.

Drug rash with eosinophilia and systemic symptoms (DRESS) syndrome is a rare, potentially life-threatening, drug-induced hypersensitivity reaction that includes rash, hematologic abnormalities, lymphadenopathy, and internal organ involvement. The pathogenesis of DRESS syndrome is partially understood. Various medications have been described as the cause of DRESS syndrome. Phenytoin and allopurinol are the most commonly reported culprit drugs, although more than 50 drugs can induce DRESS syndrome. Members of the cytochrome P450 (CYP) superfamily are the most commonly involved enzymes in metabolism of drugs such as phenytoin. This case report addresses the influence of CYP2C9 genetic polymorphism (a single nucleotide polymorphism) on phenytoin drug metabolism, thereby causing DRESS syndrome.

Objective: Incidence of Acinetobacter infections is increasing both in Turkey and worldwide. Based on their ability to develop resistance, Acinetobacter species can cause morbidity and mortality, particularly in newborns, children, immunocompromised patients, and critically ill intensive care patients. There are limited treatment options, particularly in carbapenem resistant Acinetobacter strains. In this study, we aimed to compare in vivo activities of colistin sulphate, tigecycline, and cefoperazone-sulbactam in an experimental mouse sepsis model. Material and Methods: Each of the four study groups consisted of eight Wistar breed albino rats. In total, 107 colonies of the Acinetobacter baumannii/calcoaceticus complex were administered intraperitoneally to each rat after the presence of neutropenia with cyclophosphamide. Blood culture samples were taken from all rats after 24 h of treatment and colony count from lung, liver, and kidney specimens were taken after 72 h of treatment. Results: In the tigecycline-treated group, the presence of positive blood culture results at 24 h were found to be lower than the control group (p=0.01). Presence of positive cultures from lung samples in the tigecycline (p<0.05), colistin (p<0.05), and cefoperazone-sulbactam (p<0.05) groups were found to be lower than the control group. Positive culture of liver samples were found to be significantly lower in colistin (p<0.05) and cefoperazonesulbactam (p<0.05) groups than the control. Positive culture of kidney samples were found to be significantly lower in colistin (p<0.05), cefoperazone-sulbactam (p<0.05), and tigecycline (p<0.05) groups than the control. However, antibiotic groups did not differ among themselves with respect to positive culture. A comparison of colony counts in lung samples revealed a statistically significant decrease in tigecycline and colistin groups than the control group (p<0.01 and p<0.05, respectively). Conclusion: In our study, tigecycline, colistin, and cefoperazone-sulbactam were found to be effective on culture positivity in lung, kidney, and liver specimens of rats and they may be a choice for treatment. Tigecycline was found to be more effective on colony counts in lungs and kidneys and is also more effective in reducing the 24 h bacteraemia than the control group. The results of the ongoing clinical trials about tigecycline use in children with severe infection due to resistant microorganisms will give us an idea about this situation.