Evaluation of candidemia risk factors and Candida species distribution in intensive care units among patients with and without COVID-19.

OBJECTIVES: To assess the risk variables related to the types of candidemia for each patient, who was admitted into the intensive care unit regardless of the patient with or without complete diagnosis of COVID-19, during the period of March 2019 to December 2022. METHODS: The evaluation comparison of demographic and clinical data of COVID-19 positive and negative patients with candidemia confirmed in blood, 113 cases were assessed. Variables such as gender, age, age of hospitalization, history of hospitalization, concurrently infection, The acute physiology and chronic health evaluation-II scores, comorbidity checking, intubation, central venous catheter use, parenteral nutrition use, steroid use, antibiotic use, lymphopenia, and laboratory variables were evaluated. Candida species distribution, antifungal susceptibility in blood culture were determined. RESULTS: Coronavirus disease-19 was present in 62.8% of cases confirmed candidemia, and these cases were significantly different from COVID-19 negative cases. Significance was found in more intubation, central venous catheter use, parenteral nutrition, and steroid therapy in Group 2. There was no significance with species distribution and associated infection. In total, COVID-19 positive had higher hemoglobin, aspartate aminotransferase, alanine transaminase, and white blood cell levels, which may be associated with the possibility of revealing and controlling candidemia. CONCLUSION: Candida albicans and Candida Parapsilosis (C. parapsilosis) are the species seen in infected COVID-19 patients, while C. parapsilosis and Candida tropicalis are found in non-COVID-19 ones. Risk factors were intubation, parenteral nutrition, central venous catheter, and steroid in the COVID-19 group.

Bibliometric analysis on infective endocarditis

Introduction: Although infective endocarditis (IE) is rare disease, this disease has importance due to its high morbidity and mortality rates. The exact incidence is not known as it is not a reportable disease. Unlike developed countries, the disease affects the young more than the elderly in developing countries. Most of the time, the diagnosis cannot be made at the first examination and the disease is often overlooked. In order to reduce the mortality and morbidity of this disease, it is important to quickly recognize the disease by following current diagnosis and treatment methods, to identify the causative agent and to treat accordingly. Both the epidemiology and the management of IE are changing due to medical advances. This situation may also be reflected in scientific publications. We aimed to analyze the global researches on IE. Material and methods: The Scopus database was searched for bibliometric analysis without selecting document type. Data were retrieved for the time period January 1, 1940 and Semptember 26, 2021, containing the keywords " Infective’’ and’’endocarditis " in their title. Results: 7911 publications were included in the study. The first publication was made in the year 1891. Most of the publications were research articles [n=5784 (73.11%)] and were from the United States of America (USA) [n =1622 (20.50%)]. Japan, France, United Kingdom and Spain were also in the top 5 publishing countries on IE. Conclusions: Infective endocarditis is still an important reason of mortality, and there are many unanswered questions about the managament and preventation of this disease. This situation reflected the scientific publications. Since this is a global problem, not just some developed countries involved in the IE research, also more countries should be encouraged to participate the studies on IE. (AU)

Introducción: Si bien la endocarditis infecciosa (EI) es una enfermedad rara, esta enfermedadtiene importancia por sus altas tasas de morbilidad y mortalidad. No se conoce la incidencia exacta ya que no es una enfermedad de notificación obligatoria. A diferencia de los países desarrollados, la enfermedad afecta más a los jóvenes que a los ancianos en los países en desarrollo. La mayoría de las veces, el diagnóstico no se puede hacer en el primer examen y la enfermedad a menudo se pasa por alto. Para reducir la mortalidad y morbilidad de esta enfermedad, es importante reconocer rápidamente la enfermedad siguiendo los métodos de diagnóstico y tratamiento actuales, para identificar el agente causal y tratar en consecuencia. Tanto la epidemiología como el manejo de la EI están cambiando debido a los avances médicos. Esta situación también puede verse reflejada en publicaciones científicas. Nuestro objetivo era analizar las investigaciones globales sobre la EI. Material y métodos: Se buscó en la base de datos Scopus para el análisis bibliométrico sin seleccionar el tipo de documento. Se recuperaron datos para el período de tiempo del 1 de enero de 1940 y el 26 de septiembre de 2021, que contenían las palabras clave "Infeccioso" y "Endocarditis" en su título. Resultados: Se incluyeron 7911 publicaciones en el estudio. La primera publicación se realizó en el año 1891. La mayoría de las publicaciones fueron artículos de investigación [n = 5784 (73,11%)] y fueron de los Estados Unidos de América (EE.UU.) [n = 1622 (20,50%)]. Japón, Francia, Reino Unido y España también se encontraban entre los 5 principales países editores en la EI. Conclusiones: La endocarditis infecciosa sigue siendo una causa importante de mortalidad y hay muchas preguntas sin respuesta sobre el manejo y prevención de esta enfermedad. Esta situación reflejó las publicaciones científicas... (AU)

The Role of Serum Procalcitonin, Interleukin-6, and Fibrinogen Levels in Differential Diagnosis of Diabetic Foot Ulcer Infection.

AIMS: We aimed to evaluate the roles of interleukin-6 (IL-6), PCT, and fibrinogen levels in the differential diagnosis of the patients with infected diabetic foot ulcer (IDFU) and noninfected diabetic foot ulcer (NIDFU) and to compare those with C-reactive protein (CRP), white blood cell (WBC), and erythrocyte sedimentation rate (ESR). METHODS: Patients over 18 years with a diagnosis of type 2 diabetes mellitus and DFU who were followed up in our hospital between 1 January 2016 and 1 January 2017 were included in the study. In addition to this patient group, patients with diabetes but without DFU were determined as the control group. RESULTS: Thirty-eight patients with IDFU, 38 patients with NIDFU, and 43 patients as the control group were included in the study. Fifty-six point three percent of the patients who participated in the study were males, and the mean age was 61.07 ± 11.04 years. WBC, ESR, CRP, IL-6, and fibrinogen levels of the cases with IDFU were determined to be significantly higher compared to the cases in NIDFU (p < 0.01). The area under the ROC curve (AUROC) value was highest for CRP (0.998; p < 0.001), and the best cut-off value for CRP was 28 m/L. The best cut-off values for fibrinogen, IL-6, ESR, and WBC were 480 mg/dL, 105.8 pg/mL, 31 mm/h, and 11.6 (103 µ/L), respectively. CONCLUSION: Serum PCT levels were not found to be effective in the discrimination of IDFU and NIDFU. Serum IL-6 and fibrinogen levels seem to be two promising inflammatory markers in the discrimination of IDFU.

A Case of Brucellosis with Recurrent Attacks of Vasculitis.

Brucellosis is a zoonosis that affects several organs or systems. Skin involvement is nonspecific and it is reported to range between 0,4 and 17% of the patients with brucellosis. Here, we defined a 36-year-old female patient presented to our clinic with a clinical picture of recurrent attacks of vasculitis due to brucellosis for the first time. Skin involvement and vasculitic lesions as a finding of skin involvement are nonspecific in brucellosis. Therefore, in the regions like Turkey where brucellosis is endemic, brucellosis should be kept in mind necessarily in the differential diagnosis of vasculitis.

KNOWLEDGE AND ATTITUDE OF HEALTH CARE WORKERS TOWARD PATIENTS WITH HEPATITIS C INFECTION.

This study aimed to evaluate the level of knowledge of healthcare workers in Kutahya (a western province of Turkey) about HCV infection and their attitudes toward patients with hepatitis C infection. A total of 335 healthcare workers working in Kutahya Evliya Celebi Research and Training Hospital were included in the study. A questionnaire evaluating demographic characteristics, level of knowledge and attitudes of healthcare workers toward patients with hepatitis C infection was administered to the participants. Thirty-six point four percent of the participants were males. According to the occupations, distributions of the participants were as followings: 54.6% nurse, 25.1% physician, 11.6% trainee nurse, 4.5% intern and 4.2% anesthesia technician. The mean age of healthcare professionals was 30.32±8.10 years. Fifty-eight point eight percent of them experienced percutaneous injury. The mean knowledge score was 18.05±3.01 (from a total of 25). There was a statistically significant relationship between knowledge score and age, working year, occupational group (p<0.001). There was also a significant relationship between total attitude score and gender (p=0.006), age (p=0.002), working year (p=0.021) and occupational group (p<0.001). It was determined that as total knowledge score of the participants increased they exhibited a more positive attitude toward patients with hepatitis C infection (p<0.001). A positive relationship was determined between the level of knowledge of healthcare workers and positive attitudes toward patients with hepatitis C infection. Therefore, increasing the level of knowledge is necessary for more positive attitudes.

Comparison of FibroTest-ActiTest with histopathology in demonstrating fibrosis and necroinflammatory activity in chronic hepatitis B and C.

AIMS: FibroTest and ActiTest are noninvasive tests used in determining the level of fibrosis and the degree of necroinflammatory activity in the liver. In our study, we aimed to investigate whether these tests could be alternative to liver biopsy. MATERIALS AND METHODS: Fifty patients were included in the study. Serum samples were obtained and liver needle biopsy was performed on the same day. Levels of fibrosis in FibroTest and levels of activity in ActiTest, both determined via serum biochemical markers, were compared with levels of fibrosis and activity in histopathological examination. For statistical analyses, Mc Nemar chi square test and Spearman's correlation tests were used. RESULTS: There was a significant positive correlation between fibrosis in biopsy and the level of fibrosis in FibroTest in patients with hepatitis B virus (HBV) (rho: 0.67, P < 0.0001). However, no significant correlation was determined between the activity in biopsy and the degree of activity in ActiTest (rho: 0.29, P < 0.05). No significant correlation was determined between both fibrosis and activity established in biopsy and the results of FibroTest and ActiTest in the group of patients with hepatitis C virus (HCV) (rho: 0.22, P < 0.05 and rho: 0.15, P < 0.05, respectively). CONCLUSION: Our results suggest that novel and safer noninvasive biochemical tests are needed as an alternative to histopathology in patients infected with HBV and HCV. Consequently, we believe that liver biopsy maintains its place as a gold standard in determining the histopathological condition of the liver.