RESUMO
PURPOSE: Subacute thyroiditis(SAT) is a destructive thyroiditis associated with viral infections. Several SAT cases associated with SARS-CoV-2 infection/vaccination were recently reported. We aimed to evaluate prospectively all cases applied to our tertiary center and their relationship with SARS-CoV-2 during 16 months of the pandemic. Cases during similar pre-pandemic period were recorded for numeric comparison. METHODS: Prospective study took place between March 2020 and July 2021. SAT was diagnosed by classical criteria. Swabs for SARS-CoV-2 and a wide respiratory viral panel (RV-PCR) were taken. Previous COVID-19 was assessed by SARS-CoV-2 IgM&IgG levels. Study group was divided into three as: CoV-SAT, patients who had or still have COVID-19, Vac-SAT, patients diagnosed within three months after SARS-CoV-2 vaccination and NonCoV-SAT, those not associated with COVID-19 or vaccination. RESULTS: Out of 64 patients, 18.8% (n = 12) was classified as CoV-SAT, 9.3% (n = 6) as Vac-SAT and 71.9% as (n = 46) NonCoV-SAT. SARS-CoV-2 RT-PCR tests on the diagnosis of SAT were negative in all, but two patients tested positive five days later, in second testing, performed upon clinical necessity. CoV-SAT and NonCoV-SAT groups were similar in terms of clinical, laboratory, and treatment characteristics. However, symptoms were milder and treatment was easier in Vac-SAT group (p = 0.006). CONCLUSIONS: Total number of SAT cases during the pandemic period was comparable to pre-pandemic period. However, a considerable rate of SARS-CoV-2 exposure in SAT patients was established. COVID-19 presented with SAT, as the first manifestation in three cases. Vaccine-related cases developed in a shorter time period, clinical presentation was milder, and only a few required corticosteroids.
Assuntos
Vacinas contra COVID-19/efeitos adversos , COVID-19/complicações , Tireoidite Subaguda/epidemiologia , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , COVID-19/epidemiologia , COVID-19/prevenção & controle , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Pandemias , Estudos Prospectivos , Tireoidite Subaguda/etiologia , Adulto JovemRESUMO
BACKGROUND: Community-acquired infection caused by extended-spectrum beta-lactamase (ESBL)-producing microorganisms has an increasing frequency. AIM: The aim of this study was to determine the fecal carriage of ESBL and AmpC beta-lactamase-producing Enterobacteriaceae in community and to investigate cefotaxime-M (CTX-M) genes among ESBL isolates. MATERIALS AND METHODS: A total of 1402 fecal specimens which were collected from outpatients included in the study. ESBL screening, ESBL production, and AmpC beta-lactamase detection were performed. Matrix-assisted laser desorption ionization-time-of-flight (MALDI-TOF) was used for identification of species. Antibiotic susceptibilities of the isolates were detected by disk diffusion method. CTX-M beta-lactamase genes were investigated by polymerase chain reaction. RESULTS: During the study period, a total of 1402 fecal samples were analysed with ESBL screening test and 490 Enterobacteriaceae strains isolated from these samples (Escherichia coli [n = 461, 94.1%], Klebsiella pneumoniae [n = 25, 5.1%], and Enterobacter cloacae [n = 4, 0.8%]). Fecal carriage of ESBL-producing Enterobacteriaceae in the community was 34.3%. AmpC beta-lactamases were detected in 26 (5.3%), and the frequency of CTX-M was found as 96.9%. The resistance rates of the E. coli strains to fluoroquinolones, trimethoprim-sulfamethoxazole, and carbapenems were 31.2%, 33.3%, and 0%, respectively. CONCLUSION: The relative high prevalence of fecal carriage of ESBL-producing bacteria in community warrants further study in this field including developing policies about antimicrobial use and close monitoring of resistance patterns.
Assuntos
Proteínas de Bactérias/biossíntese , Portador Sadio/epidemiologia , Portador Sadio/microbiologia , Enterobacteriaceae/enzimologia , Enterobacteriaceae/isolamento & purificação , Fezes/microbiologia , beta-Lactamases/biossíntese , Adulto , Idoso , Antibacterianos/farmacologia , Proteínas de Bactérias/análise , Enterobacter cloacae/enzimologia , Enterobacter cloacae/genética , Enterobacter cloacae/isolamento & purificação , Enterobacteriaceae/genética , Escherichia coli/efeitos dos fármacos , Escherichia coli/enzimologia , Escherichia coli/isolamento & purificação , Proteínas de Escherichia coli/genética , Fezes/enzimologia , Humanos , Klebsiella pneumoniae/enzimologia , Klebsiella pneumoniae/genética , Klebsiella pneumoniae/isolamento & purificação , Testes de Sensibilidade Microbiana , Pessoa de Meia-Idade , Prevalência , Turquia/epidemiologia , Adulto Jovem , beta-Lactamases/análise , beta-Lactamases/genéticaRESUMO
Systemic yeast infections are the Leading cause of mortality and morbidity in immunocompromized patients. Candida albicans, being the most frequently isolated fungal pathogen in these patients, can be divided into three genotypes (genotypes A, B and C) by 25S intron analysis. In our study, we found that molecular sizes of genotype A C. albicans isolates were heterogeneous. In order to determine the molecular basis of this difference, Haelll digestion was applied, and strains forming different band patterns were analyzed by automated sequence analysis. As a result of sequence analysis, eight different subtypes (a --> h) were found among genotype A C. albicans strains and an easy differentiation scheme consisting of Haelll and MspI digestions was constructed.
Assuntos
Candida albicans/classificação , Candida albicans/genética , Impressões Digitais de DNA , DNA Fúngico/genética , Análise de Sequência de DNA , Sequência de Bases , Candida albicans/isolamento & purificação , Candidíase/microbiologia , DNA Fúngico/química , Desoxirribonuclease HpaII , Desoxirribonucleases de Sítio Específico do Tipo II , Eletroforese em Gel de Ágar , Genótipo , Humanos , Dados de Sequência Molecular , Polimorfismo de Fragmento de RestriçãoRESUMO
The aim of this study was to genotype Candida albicans strains isolated from patients with invasive and non-invasive deep-seated infections. For this purpose, 301 C. albicans isolates (81 invasive and 220 non-invasive) were genotyped by using specific PCR primers designed to span the transposable group I intron of the 25S rDNA gene. Fifty-three of the 81 invasive isolates were genotype A (65.4%), eight were genotype B (9.9%) and 20 were genotype C (24.7%), while 98 of the 220 non-invasive isolates were genotype A (44.6%), 46 were genotype B (20.9%) and 76 were genotype C (34.5%). Genotype A was more prevalent among invasive isolates and genotypes B and C were more prevalent among non-invasive isolates (P = 0.0046). Genotypes D and E which represent C. dubliniensis were not found. These results indicate that there may be a relationship between C. albicans genotypes and invasiveness; genotype A being more invasive than others. The presence or absence of the transposable group I intron in the 25S rDNA gene may be important in determining the invasiveness of C. albicans.