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.

Bruselloz retiküloendotelyal sistem doku ve organlarını tutan zoonotik bir infeksiyondur. Brusellozda splenomegali görülebilmesine rağmen dalak apsesi veya dalak infarktı nadiren bildirilmiştir. Dalak infarktında sol üst kadran ağrısı ve ateş en sık görülen semptomlardır. Bu yazıda, bruselloza bağlı dalak infarktı gelişen ve splenektomi ve bruselloza yönelik antimikrobiyal tedavi uygulanan 79 yaşında bir kadın hasta sunuldu.

Aim: COVID-19 is an important public health problem in world and Turkey. The present study aimed to compare the clinical and laboratory findings and mortality rates among vaccinated and unvaccinated COVID-19 inpatients.Material and Method: We included patients receiving inpatient treatment in COVID-19 wards of our hospital between April 25 and October 22, 2021. The patients were divided into two groups: those with and without the COVID-19 vaccine. We extracted patient information from anamnesis files and the hospital information system. Then, we recorded the patients’ epidemiological and laboratory findings and vaccination status. Patients with at least two doses of the COVID-19 vaccine were considered “vaccinated.” We performed Fisher’s exact test and Chi-square test to analyze the data. All statistical analyses were performed in SPSS, and a p-value <0.05 was accepted as statistically significant.Results: The study included 63 vaccinated and 83 unvaccinated patients. With a mean age of 71.4±12.3 years, thirty (47.6%) of the vaccinated patients were females, and 33 (52.3%) were males. Of the unvaccinated ones, 40 (48.1%) were females, while 43 (51.8%) were males (mean age=52.2±14.4 years). The mean age was significantly higher in the vaccinated group than in the unvaccinated group (p<0.01). While 82.5% of the vaccinated patients received two doses, 17.5% received three doses of the COVID vaccine. Besides, 95.3% of the patients received their first dose of inactivated vaccine (Sinovac, China) and 4.7% of an mRNA vaccine (BioNTech, Germany). We found that comorbidities were significantly more prevalent in the vaccinated group than in the unvaccinated group (44 (69.8%) vaccinated and 34 (40.9%) unvaccinated patients had a comorbid disease, p<0.01). Among the accompanying diseases, hypertension was significantly more prevalent in the vaccinated group than in the unvaccinated group (p<0.01). Considering their laboratory findings, the vaccinated patients had significantly higher leukocyte, troponin, and ferritin values than the unvaccinated patients (p=0.008). Consequently, five (57.9) of the vaccinated patients and 4 (4.8%) of the unvaccinated patients died (p=0.05). Conclusion: Similar mortality rates between our vaccinated and unvaccinated patients may be attributed to the fact that the vaccinated group was relatively older, had more comorbid diseases, and received their second dose after an average of 100.6 days following their first dose of inactivated vaccine. In conclusion, further clinical research involving more cases that received different COVID-19 vaccines is needed to uncover the factors affecting mortality and morbidity among vaccinated patients.

Aims: Catheter-related bloodstream infections are important causes of mortality and morbidity. In this study, it was aimed to retrospectively determine the distribution of bacterial factors isolated from intra-catheter blood culture and antibiotic susceptibility rates of patients diagnosed with catheter infection in the intensive care unit of XXXXXXX Training and Research Hospital, Cardiovascular Surgery and Neurosurgery. Methods: In the intensive care unit of XXXXXXX Training and Research Hospital, Cardiovascular Surgery, and Neurosurgery, 79 bacteria isolated from intra-catheter blood cultures of patients diagnosed with catheter infection between January 1, 2021, and December 31, 2022, were included in the study.Antibiotic susceptibility of the factors reproducing in catheter blood culture was obtained from the hospital information system. Antibiotic susceptibilities of bacteria isolated from intra-catheter culture were determined by the disc diffusion method or VITEK-2 automated system. Results: The frequency of factors reproducing from intra-catheter blood culture of patients hospitalized in the intensive care unit of cardiovascular surgery and neurosurgery were Enterococcus spp., Klebsiella pneumoniae, Staphylococcus epidermidis, and Escherichia. coli retrospectively. Klebsiella pneumoniae isolates from intra-catheter blood cultures were resistant to ceftriaxone 75%, piperacillin-tazobactam 25%, amikacin 6.25%, but not to imipenem and meropenem. Antibiotic resistance rates of Staphylococcus aureus isolates isolated from intra-catheter blood cultures were as follows: 100% with penicillin, no resistance to vancomycin. In Escherichia coliisolate isolated from intra-catheter blood cultures, resistance to ceftriaxone was 6.3%, to piperacillin-tazobactam, 12.5%, to imipenem and meropenem, 16.6%, but not to amikacin. Acinetobacter baumanniiisolates isolated from intra-catheter blood culture showed 100% resistance to ceftriaxone, 100% to piperacillin-tazobactam, 85.7% to imipenem, 83.3% to meropenem, and no resistance to amikacin. In the Stenotrophomonas maltophilia isolatesisolated from intra-catheter blood culture, resistance to ceftriaxone, piperacillin-tazobactam, imipenem and meropenem was 100% and levofloxacin was 25%, while no resistance to trimethoprim/sulfamethoxazole was detected. Conclusion: Determining the antibiotic susceptibility of bacteria isolated from catheter culture will contribute to the determination of the appropriate treatment option in the empirical treatment of catheter infections in our hospital and contribute to decreasing in mortality and morbidity rates due to catheter infections.

Objective: We evaluated PCR negativity in oropharyngeal and nasopharyngeal secretions of COVID-19 patients at the end of hydroxychloroquine and/or favipiravir treatments. Methods: Study inclusion criteria were being hospitalized, being older than 18 years, PCR positivity in oropharyngeal and nasopharyngeal secretions and being tested for SARS CoV-2-RNA PCR after treatment. Initially hydroxychloroquine treatment (group 1) was administered to the patients according to COVID-19 guide of Health Ministry. Favipiravir (group 2) alone or in combination with hydroxychloroquine (group 3) was administered to patients who were unresponsive to hydroxychloroquine or had severe pneumonia or were admitted to intensive care unit. Control respiratory specimens were taken no earlier than 24 hours, after the end of therapy. Repeated tests with 24–48-hour intervals were performed in patients with still positive PCR test results. The detection of SARS CoV-2-RNA was made by real-time PCR. Results: The study group included 492 patients who received treatment. Mean duration of symptoms was similar among three groups. PCR negativity rate was 52.8% in the specimens taken 24 hours after the end of treatment. PCR negativity rates was 27.9% (200/492) in 48 hours after the end of treatment, %13.8 (123/492) in 72nd hour and %3.8 (80/492) in 96th hour. The ratios of PCR negativity for all specimen days were similar in three groups. There was no statistically significant difference between the groups for time to PCR negativity from the date of positivity and after the end of treatment. We determined that early or late treatment did not make a difference in terms PCR negativity time. Conclusion: No difference was found in terms of the ratios of PCR negativity or time for negativity in oropharyngeal and/or nasopharyngeal specimens taken after the end of treatment in COVID-19 patients receiving hydroxychloroquine and/or favipiravir treatment.