Sibel Yıldız Kaya

Objective: To determine the patient-level frequency of rectal carbapenem-resistant Klebsiella pneumoniae (CRKP) colonization in an adult hematopoietic stem cell transplantation unit and describe the frequency, timing, and outcomes of subsequent clinical CRKP infection. Methods: This single-center retrospective cohort study included adults undergoing rectal CRKP surveillance at admission and weekly during hospitalization between August 2023 and February 2026. Patients with known CRKP colonization before admission were excluded. Colonized patients were evaluated for subsequent CRKP infection, defined as CRKP isolation from a clinical specimen obtained after the first positive rectal culture together with compatible clinical findings. Fisher’s exact test and exploratory Kaplan–Meier analyses were performed. Results: Among 188 patients, rectal CRKP colonization was detected in 10 (5.3%). Six colonized patients (60.0%) developed a subsequent clinical infection after a median of 14.5 days; 4 infections occurred within 15 days and all within 31 days. No clinical CRKP infection occurred among the 178 patients without detected colonization (60.0% vs 0.0%; P < .001). Bacteremia occurred in 2 colonized patients (20.0%). Six colonized patients died; all-cause mortality was numerically higher among those with infection than among those without infection (83.3% vs 25.0%; P = .19). Median infection-free survival and overall survival after colonization were 28 and 136 days, respectively. Conclusion: Rectal CRKP colonization was uncommon but identified patients at substantial risk of early clinical infection. Surveillance results may support clinical monitoring and infection-control measures but should not be used alone to guide antimicrobial treatment. Cite this article as: Kaya SY, Çelik ÖF, Arsu HY, et al. Carbapenem-resistant Klebsiella pneumoniae colonization and subsequent infection in a hematopoietic stem cell transplantation unit. Cerrahpaşa Med J 2026, 50, 0134, doi: 10.5152/cjm.2026.26134.

Background: Diabetic hand infections are uncommon but potentially severe complications of diabetes mellitus. Because of the complex anatomy and functional importance of the hand, these infections may progress rapidly and result in serious morbidity, including osteomyelitis and amputation. Clinical data on this condition remain limited. Methods: This case series included patients hospitalized with diabetic hand infection at a tertiary care center between 2020 and 2026. Patients, ≥ 18 year-old, with confirmed diabetes mellitus and clinical, microbiological, and/or radiological evidence of hand infection were included. Demographic data, comorbidities, HbA1c levels, laboratory findings, microbiological results, imaging findings, and treatment outcomes were reviewed from medical records. Results: Seven patients were included. Osteomyelitis was identified in 57% of patients, while 43% had isolated soft tissue infection. Polymicrobial infection was present in 85% of cases. Staphylococcus spp. were the most commonly isolated pathogens, followed by Enterococcus spp. and Gram-negative organisms. Gram-negative bacteria were identified in 28% of cases. Surgical intervention was required in most patients, and 28% underwent amputation. Poor glycemic control, minor trauma, polymicrobial infection, and deep tissue involvement were common features in this series. Conclusions: Diabetic hand infections should be recognized as serious and potentially aggressive complications of diabetes mellitus. Early diagnosis, appropriate imaging, timely surgical management, and culture-guided antimicrobial therapy are essential to improve outcomes. Larger multicenter studies are needed to better define prognostic factors and to guide more standardized treatment strategies.

We report the case of a woman with diabetes mellitus who developed a skin and soft tissue infection of the left thumb following trauma caused by a cactus thorn. Despite initial antibiotic therapy, no clinical improvement was observed. Broad-spectrum antimicrobial therapy was subsequently initiated, and wound cultures were obtained. Candida tropicalis was identified as the causative pathogen. Targeted antifungal therapy led to clinical improvement. The patient required repeated surgical debridement, and a skin graft was applied during the healing process. The patient ultimately recovered without recurrence. Keywords: Diabetes mellitus, hand, Candida

Background/Aims: Selecting the initial antiviral regimen for chronic hepatitis B (CHB) requires balancing patients’ comorbidities and long-term safety. This study examines differences in patient and disease-related factors that guide clinicians to prescribe either ente cavir (ETV) or tenofovir disoproxil fumarate (TDF) as the initial treatment. Materials and Methods: The study included treatment-naïve CHB patients aged 18 or older who had been diagnosed for at least 1 year since 2010 and initiated on antiviral therapy. The data included variables such as age, gender, body mass index (BMI), comorbidities, liver disease activity, biopsy results, cirrhosis, hepatic steatosis, hepatitis B e-antigen status, hepatitis B virus DNA levels, triglycerides, cholesterol, renal function, and baseline bone mineral density (BMD), which were assessed by dual-energy x-ray absorptiometry (DEXA). Results: Among 2259 patients (61.6% male), 1270 patients (56.22%) received TDF, while 989 patients (43.78%) received ETV as firstline therapy. The TDF was more commonly prescribed to patients with a lower BMI (median

We report a unique case of post-treatment HIV control in a married couple from Türkiye, contributing to the growing evidence on the heterogeneity of post-treatment controllers. In 2018, a 36-year-old woman and her 28-year-old male partner were concurrently diagnosed with (...)

Background/Aims: This study evaluates the efficacy and safety of direct-acting antivirals (DAAs) in treating hepatitis C virus (HCV) genotype 2 (GT-2) and genotype 3 (GT-3) in Türkiye. Materials and Methods: This cohort is a multicenter, retrospective, and observational study. Data from 267 GT-2 or GT-3 patients treated with a DAA were analyzed. Results: An overall sustained virological response (SVR) rate of 95.9%, with no significant difference between GTs. The SVR rates were relatively lower in patients with cirrhosis. Prior pegylated interferon and ribavirin reduced SVR rates, particularly in males and patients with cirrhosis. The most common treatments were sofosbuvir-based regimens, which demonstrated comparable efficacy. No significant drug interactions were observed. The most commonly reported adverse events were fatigue and mild anemia, particularly in cirrhotic patients; however, these did not lead to treatment discontinuation. Conclusion: This study supports the efficacy and tolerability of DAA regimens for these HCV GTs, thereby reinforcing their role in HCV eradication. Cite this article as: Kaya SY, Kurtaran B, Çuvalcı NÖ, et al. Real-life experience of hepatitis C treatment with direct-acting antivirals in genotypes 2 and 3. Turk J Gastroenterol. Published online September 10, 2025. doi: 10.5152/tjg.2025.24751.

Aspergillus spp. are ubiquitous and frequently inhaled by humans as spores in the natural environment and hospital settings. Despite this high frequency of exposure, aspergillosis is a rare disease in humans. Many Aspergillus spp. have been defined as causing infections, including Aspergillus fumigatus and Aspergillus flavus, among the most common

Background: Emerging carbapenem-resistant Klebsiella pneumoniae (K. pneumoniae) (CRKP) bacteremias are presenting significant public health risks due to limited treatment options and increased mortality. K. pneumoniae isolates exhibit carbapenem resistance rates that vary from 25% to 50% throughout the European continent, including our country. Aims: To assess the characteristics of CRKP bacteremia, a condition that has recently demonstrated an increasing prevalence in our center. We sought to ascertain the resistance rates of isolated strains to antibiotics other than carbapenems, identify the responsible carbapenemase genes, evaluate the efficacy of antibiotics, determine mortality rates, explore clonality among strains, and investigate the influence of the COVID-19 pandemic on all these factors. Study Design: Retrospective observational study. Methods: This study included patients aged 18 and older who had experienced meropenem-resistant K. pneumoniae bacteremia. Meropenem resistance was confirmed by employing the Kirby-Bauer disk diffusion method. Meropenem minimum inhibitory concentration (MIC) levels were determined using the gradient test, while colistin MIC levels were ascertained using the disk elution technique. Carbapenemase genes were evaluated via colony polymerase chain reaction (PCR), and clonality analysis was performed using the arbitrarily primed PCR technique. Results: The study comprised 230 patients, with a mean age of 63.1 +/- 15.9 years, of whom 58.7% were male. Oxacillinase-48 (OXA-48) was detected in 74.8% of the patients, New Delhi metallo-beta-lactamase (NDM) in 12.6%, OXA-48 + NDM in 7.8%, and KPC in 4.8%. The 14-day and 30-day mortality rates were 57% and 69.6%, respectively. Multivariate analysis of the 30-day mortality revealed several crucial factors, including bacteremia development in the intensive care unit, the occurrence of bacteremia during the COVID-19 pandemic, polymicrobial bacteremia, the use of indwelling intravenous catheters, a platelet count of <= 140,000/ mu l, procalcitonin levels of >= 6 mu g/l, and a Charlson comorbidity score >= 3. Notably, the OXA-48 and KPC genes were upregulated significantly during the COVID-19 pandemic, while the NDM gene groups were downregulated. Additionally, both 14-day and 30-day mortality rates increased significantly. Conclusion: In this study, the most prevalent carbapenemase gene was OXA-48; however, there has been a recent increase in KPC genes. No dominant epidemic strain was identified through clonality analysis. The clustering rate was 68% before the pandemic, increasing to 85.7% during the pandemic. The significance of infection control measures is underscored by the rise in both clustering and mortality rates during the COVID-19 pandemic.