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Background: Lyme borreliosis is a multisystemic tick-borne infection caused by Borrelia burgdorferi sensu lato complex. Renal involvement is well documented in dogs with Lyme nephritis, whereas human renal manifestations have been reported only rarely, mainly as isolated case reports of glomerular disease. Because a proportion of chronic kidney disease (CKD) cases remain unexplained, we aimed to determine the possible contribution of previous exposure to idiopathic CKD. Methods: The study included 45 patients and 45 age and sex matched controls. Serum samples were tested for anti-Borrelia IgG using enzyme-linked immunosorbent assay (ELISA). Positive or borderline ELISA results were further evaluated by Western blot (WB) analysis. Results: Overall, anti-Borrelia IgG seropositivity was 5.55% with WB. In the CKD group, ELISA positivity was 11.1% and WB-confirmed positivity was 8.9%. In the control group, ELISA positivity was 4.4% and WB-confirmed positivity was 2.2%. (p > 0.05). All confirmed patients were living in rural areas, engaged in farming and/or animal husbandry, and reported repeated tick exposure. Conclusions: IgG seropositivity was numerically higher among patients with CKD of unknown etiology than among healthy controls; however, this difference was not statistically significant. Larger, risk-factor-adjusted studies are needed to clarify whether Borrelia exposure may be associated with unexplained CKD.

Background: The objective of this study is to compare the measles immunoglobulin G (IgG) and rubella IgG levels in patient groups with mild and severe COVID-19 disease and reveal the possible relationship. Methods: This study was conducted among COVID-19-confirmed patients over 18, under 65 years of age. This study involved 75 participants- divided into two groups. The first group usually comprised asymptomatic patients who did not require hospitalization (n=43), and the second group consisted of patients who had diffuse pneumonia on thoracic CT and required hospitalization (n=32). Results: Anti-measles and anti-rubella IgG titers were detected to be higher in the group with severe disease compared to the group with mild disease (p=0.001 and p=0.001, respectively). The analyses were repeated by taking n=27 in Group 1 and n=27 in Group 2, which were similar in terms of age, gender and number. In the analysis performed without any age difference between the groups, no significant difference was found between the two groups in terms of Anti Measles IgG antibody titers (p=0.068). However, Anti Rubella antibody titers were found to be higher in the group with severe COVID-19 disease than in those with mild disease (p=0.03). Regardless of the severity of the disease, there was a positive correlation between Anti Rubella and Anti Measles IgG antibody titers and age (p=< 0.001 Spearman’s rho 0.517; p=0.008 Spearman’s rho 0.304, respectively). Conclusion: We believe that the pre-existing Anti-Rubella IgG antibodies in the patient may increase in parallel with the patient’s viral load by recognizing the common macrodomain of SARS-CoV-2 and Rubella viruses. The common macrodomain of SARS-CoV-2 and Rubella viruses is also present in the attenuated rubella virus used in the MMR vaccine4. In this case, we predict that previously administered MMR vaccine may be protective for COVID-19 patients. disease compared to those with mild disease.

Amaç: Günümüzde hala cinsel yolla bulaşan hastalıklar içinde önemli bir sağlık sorunu oluşturan sifilizin erken teşhisi hastalığın tedavisi ve kontrolü için temeldir. Çalışmamızda sifiliz tanı ve izleminde kullanılan testlerin istem nedenlerini ve sonuçlarını değerlendirmek amaçlanmıştır. Yöntem: 1 Ocak 2019-31 Aralık 2019 tarihleri arasında, treponemal testleri pozitif olan 88 hastanın tanı, tedavi ve takibi açısından istenen serolojik testleri, şikayetleri ve koinfeksiyonları retrospektif olarak incelendi. Bulgular: Hastaların yaş ortalaması 41±17.97, en fazla seropozitiflik oranı cinsel aktif yaş grubu olan 18-44 yaşta olup ve %69.3’ü erkek hastaydı. 33 hastada (%37.5) doğrulama testi olan TPHA testinin hiç istenmediği, 40 hastada (%45.4) tedavi öncesi veya sonrası CMIA testinin fazladan tekrarlandığı, 33 hastada (%37.5) tedavi takibinde gereksiz TPHA titre istendiği ve sadece 13 hastada tedavi takibinde gerekli olan VDRL titre çalışıldığı saptanmıştır. CMIA test sonucu 1.00-2.00 s/co değerleri arasında yalancı pozitifliğin %90 (9/10) olduğu, 12 s/co ve üzerinde ise yalancı pozitifliğe hiç rastlanılmadığı görülmüştür. Sonuç: Klinisyenlerin laboratuvarlarında kullanılan tanı algoritmalarını bilmeleri laboratuvar ile iş birliği içinde olması, gereksiz ve yetersiz test istemlerinin önüne geçilmesi, sifilizin doğru tanısı ve tedavi takibinin uygun şekilde yapılması önem arz etmektedir.

The COVID-19 (Coronavirus Disease 2019) outbreak has not yet ended and poses a persistent hazard to individuals, communities, and healthcare systems globally. Similar to numerous other diseases, the immune system of the patient is intricately associated with the advancement and mortality rates of COVID-19. In general, the immune system plays a crucial role in protecting the host against infections and neoplastic cells, and a well-balanced diet can enhance the immune system's ability to effectively defend against infectious agents. There have been suggestions that the administration of zinc supplements may decrease the occurrence of lower respiratory tract infections in children who are deficient in zinc. This study will thus examine the potential of zinc as a preventive and therapeutic agent, either on its own or in conjunction with other techniques, as zinc fulfills all the requirements outlined above. The study cohort was stratified into three distinct groups, namely critical care patients, service patients, and a healthy control group; a total of 24 COVID-19 patients in critical care, 27 ward-treated COVID-19 patients, and 26 healthy individuals. The groups exhibited a notable disparity in age distribution (p<0.001). A statistically significant difference was seen among the groups in relation to the survey results, presence of chronic disease, and length of hospital stay (p<0.001, p<0.001, and p=0.007, respectively). COVID-19 patients (n=51) exhibited markedly reduced zinc levels in comparison to a control group of healthy individuals (n=26). It was observed that the average zinc level in patients diagnosed with COVID-19 was 89 μg/dl (range: 43-123 μg/dl). In comparison, the median zinc level in individuals without COVID-19 was found to be 99.5 μg/dl (range: 79-125 μg/dl). A statistically significant difference was observed between the groups (p=0.023). The study revealed that a total of 13 individuals, accounting for 25.5% of the COVID-19 patients, exhibited a deficiency in zinc levels. The findings of our study indicate that zinc potentially plays a significant role in the context of COVID-19. However, additional research is required to get a comprehensive understanding of the association between COVID-19 and zinc.

This study has investigated the vaccination rates against SARS-CoV-2 infection, antibody response to vaccine types, and factors affecting mortality in maintenance hemodialysis patients.98 of 143 patients undergoing hemodialysis in our clinic had 3 doses of BNT162b2 (Pfizer-BioNTechh) or CoronaVac (Sinovac Life Sciences) vaccine. Of these 98 patients, blood samples were obtained from 52 patients who agreed to obtain serum samples before and after vaccination. The serum samples were analyzed using the Abbott SARS-CoV-2 immunoassay designed to detect IgG antibodies against the receptor-binding domain of the S1 subunit of the spike protein of SARS-CoV-2. The rate of vaccination with at least one dose of vaccine was 85.3%, and the frequency of SARS-CoV-2 infection was 58.7%. The patients whose antibody titer was obtained after the third dose of vaccine (n=52) were divided into two groups according to the last vaccine type, as BioNTechh group of 16 patients and the Sinovac group of 36 patients. Considering all 52 patients with 3 doses of vaccine, the median antibody level was 397.3 (min-max) (4.5-40000) before the third vaccine dose, while 1325.3 (min-max) (10.5-40000) after the third vaccine dose (P

Amaç: Tüm dünyada son yıllarda Enterobacteriaceae ailesi üyeleri arasında çoklu ilaç direncine sahip izolatlar artış göstermekte ve enfeksiyonların tedavisinde zorluklara yol açmaktadır. Bu çalışmanın amacı, Genişlemiş Spektrumlu Beta-Laktamaz Üreten ve karbapenem dirençli Enterobacteriaceae izolatlarına karşı seftazidim-avibaktam’ın in vitro etkinliğinin araştırılmasıdır. Yöntem: Çalışmaya, laboratuvarımıza gönderilen çeşitli örneklerden izole edilen, genişlemiş spektrumlu beta-laktamaz üreten 114 Enterobacteriaceae türü dahil edildi. İzolatların tanımlanması ve antimikrobiyal duyarlılıkları otomatize sistemler kullanılarak gerçekleştirildi. İzolatların seftazidim avibaktama duyarlılıklarının saptanması amacıyla CAZ/AV 10/4 mg (Bioanalyse) ile disk difüzyon testi; zon çaplarının değerlendirilmesi için European Committee on Antimicrobial Susceptibility Testing (EUCAST) rehberi kullanılmıştır. Bulgular: Çalışmaya 42 tanesi (%36.8) Escherichiae coli ve 72 tanesi (%63,2) Klebsiella pnemoniae olmak üzere toplam 114 tane Enterobacterales suşu dahil edildi. Suşların %44.7’si idrar örneklerinden izole edilmiştir. Tüm izolatların 67 (%58.8)’si karbapenemlere duyarlı iken, 47 (%41.2)’si karbapenemlere dirençli olarak bulundu. 103 tanesi (%90,4) ceftazidim avibactama duyarlı iken, 11 tanesi (%9,6) dirençli olarak saptandı. Sonuç: Genişlemiş spektrumlu beta-laktamaz üreten veya metallo-β-laktamaz dışında karbapenem dirençli Enterobacteriaceae suşları için mevcut en iyi tedavi seçeneği, mümkün olduğunda ve fiyatın kullanımına izin verdiği durumlarda seftazidime-avibaktamdır.

Stenotrophomonas maltophilia, özellikle bağışıklığı baskılanmış hasta popülasyonunda ve toplum kökenli vakalarda önemi giderek artan fırsatçı bir patojendir. S. maltophilia'nın neden olduğu enfeksiyonların tedavisi birçok antibiyotiğe karşı intrensek direnci nedeniyle oldukça zordur. Bu çalışmanın amacı, on yıllık bir süre içinde izole edilen S. maltophilia suşlarının yıllar içerisindeki direnç oranlarının değişiminin irdelenmesi ve S. maltophilia enfeksiyonu için risk faktörlerinin değerlendirilmesidir. On yıllık süre boyunca (Ocak 2010 – Aralık 2019) çeşitli klinik örneklerden izole edilen S. maltophilia klinik izolatlarının antibiyotiklere direnç oranları retrospektif olarak incelenmiştir. İzolatların identifikasyonu ve antimikrobiyal duyarlılıkları VITEK2 Compact (BioMérieux, Fransa) ile çalışılmıştır. Çalışmaya toplam 276 S. maltophilia izolatı dahil edilmiş, her hastadan tek izolat alınmıştır. İzolatların %20.7'si ayaktan, %79.3'ü hastanede yatan hastalardan izole edilmiştir. Yatan hastaların %38.8’inin (85/219) yoğun bakım ünitesindeki hastalardan oluştuğu gözlenmiştir. Hastaların %64.5’inin erkek, %35.5’inin kadın; yaş ortalamalarının erkeklerde 60, kadınlarda 66 olduğu saptanmıştır. Çalışmaya dahil edilen izolatların %53.6’sı (148/276) alt solunum yolu örneklerinden izole edilmiştir. Antibiyotik duyarlılıkları trimetoprim-sülfametoksazol (SXT), levofloksasin ve seftazidim için sırasıyla %92.8, %93.1 ve %60.1 olarak tespit edilmiştir. 2010-2014 yılları arasındaki ve 2015-2019 yılları arasındaki antibiyotik direnç oranları karşılaştırıldığında ikinci dönemde seftazidim (p<0.001) ve levofloksasin (p<0.001) direnç oranının düştüğü ancak SXT direnç oranının arttığı tespit edilmiştir (p=0.485). Sonuç olarak çalışmamızdaki S. maltophilia izolatlarına karşı levofloksasin ve SXT etkisini sürdürmektedir. İstatistiksel olarak anlamlı olmamasına ragmen, SXT’ye karşı artan direnç oranları açısından dikkatli olunmalıdır. Ayrıca antimikrobiyal direnç oranları değişiklik gösterebileceği için her hastane kendi antimikrobiyal direnç oranlarını takip etmeli, ampirik tedavi politikasını kendi direnç durumuna göre belirlemelidir.

The first SARS‐CoV‐2 vaccination campaign in Turkey has started in mid‐January for the healthcare workers (HCWs) with the inactive virus vaccine CoronaVac (Sinovac). After four and a half months, the Turkish Ministry of Health rolled out a booster‐dose vaccination campaign for HCWs and all people over 50 years old beginning in July 2021. The individuals eligible were given the choice of either CoronaVac or mRNA vaccine BNT162b2 for the third booster‐dose vaccination. This study aimed to evaluate SARS‐CoV‐2 IgG antibody titers against the S1 subunit of the spike protein as a marker of the humoral response in 179 HCWs who received a third booster dose of either CoronaVac or BNT162b2. A total of 136 HCWs, 71 female (52.2%) and 65 male (47.8%), completed both serum collections on Days 0 and 28. The median SARS‐CoV‐2 IgG S Protein (SP) titer in all participants before the vaccination was 175.7 AU/ml. Of 136 HCWs, 103 (75.73%) chose BNT162b2 vaccine and 33 (24.26%) chose CoronaVac as the third booster dose. There was a significant difference between the BNT162b2 group and the CoronaVac group in terms of SARS‐CoV‐2 IgG SP titers ( p < 0.001). The median SARS‐CoV‐2 IgG SP titers in BNT162b2 group ( n = 103) and in CoronaVac group ( n = 33) were 17619.3 AU/ml and 1153.0 AU/ml, respectively. The third booster dose with BNT162b2 and CoronaVac increased antibody titers in each participant a mean of 162‐fold and 9‐fold, respectively. HCWs in the BNT162b2 group reported more frequent adverse events than HCWs in the CoronaVac group ( p < 0.001).

Accumulating evidence shows that secondary infection increases the risk of disease severity in respiratory diseases. There have been few studies about secondary infections among COVID-19 patients. Therefore we aimed to investigate prevalence, predisposing factors and causative organisms associated with COVID-19 secondary infection. This study was conducted at Training and Research Hospital in Samsun Turkey between March 15, 2020 and June 15, 2020. Hospitalized COVID-19 patients confirmed with Reverse Transcription Polymerase Chain Reaction (RT-PCR) were included in this study. Various clinical specimens (urine, sputum, endotracheal aspirate, blood etc.) of these patients have been sent to the microbiology laboratory were evaluated retrospectively. During the study period, 270 patients have been diagnosed COVID‐19 confirmed with PCR. The bacterial secondary infection rate among COVID-19 patients was 4% (11 of 270). The mortality rate among intensive care unit (ICU) patients with secondary infections was 80%. The most common secondary infection was urinary tract infection followed by bacteremia, and pneumonia. The most common isolated bacteria is Escherichia coli (E. coli) followed by coagulase-negative staphylococci (CoNS). Among COVID-19 patients, secondary infection may significantly inhibit the immune system of host and leads to significant morbidity and mortality. This is problematic and especially impacts patient clinical management, infection control, and antimicrobial stewardship programs. Therefore, further studies are needed to identify the possible pathogens and to evaluate the influence of secondary infections on the severity of SARS-CoV-2 infection.