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Cag Y, Al Madadha ME, Ankarali H, Cag Y, Demir Onder K, Seremet-Keskin A, Kizilates F, Čivljak R, Shehata G, Alay H, Alkan-Ceviker S, Yilmaz-Karadag F, Cagla-Sonmezer M, Ezzelarab Ramadan M, Magdelena DI, Radic LB, Arapovic J, Kesmez-Can F, El-Sayed NM, Campbell OB, Eser-Karlidag G, Khedr R, Isik ME, Petrov MM, Cernat R, Erturk U, Uygun-Kizmaz Y, Huljev E, Amer F, Ceylan MR, Marino A, Kul G, Damar-Cakirca T, Khalaf YM, Isik AC, Ariyo OE, Hakyemez IN, Ripon RK, Afkhamzadeh A, Dindar-Demiray EK, Gideon OO, Belitova M, Altindis M, El-Sokkary R, Tekin R, Garout MA, Zajkowska J, Fazal F, Bekcibasi M, Hukic M, Nizamuddin S, Surme S, Fernandez R, El-Kholy A, Akhtar N, Ijaz S, Cortegiani A, Meric-Koc M, Hasman H, Maduka AV, ElKholy JA, Sari S, Khan MA, Akin Y, Kose S, Erdem H. Vaccine hesitancy and refusal among parents: An international ID-IRI survey. J Infect Dev Ctries 2022; 16:1081-1088. [PMID: 35797304 DOI: 10.3855/jidc.16085] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2021] [Accepted: 02/22/2022] [Indexed: 10/31/2022] Open
Abstract
INTRODUCTION Although vaccines are the safest and most effective means to prevent and control infectious diseases, the increasing rate of vaccine hesitancy and refusal (VHR) has become a worldwide concern. We aimed to find opinions of parents on vaccinating their children and contribute to available literature in order to support the fight against vaccine refusal by investigating the reasons for VHR on a global scale. METHODOLOGY In this international cross-sectional multicenter study conducted by the Infectious Diseases International Research Initiative (ID-IRI), a questionnaire consisting of 20 questions was used to determine parents' attitudes towards vaccination of their children. RESULTS Four thousand and twenty-nine (4,029) parents were included in the study and 2,863 (78.1%) were females. The overall VHR rate of the parents was found to be 13.7%. Nineteen-point three percent (19.3%) of the parents did not fully comply with the vaccination programs. The VHR rate was higher in high-income (HI) countries. Our study has shown that parents with disabled children and immunocompromised children, with low education levels, and those who use social media networks as sources of information for childhood immunizations had higher VHR rates (p < 0.05 for all). CONCLUSIONS Seemingly all factors leading to VHR are related to training of the community and the sources of training. Thus, it is necessary to develop strategies at a global level and provide reliable knowledge to combat VHR.
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Affiliation(s)
- Yakup Cag
- Department of Pediatrics, University of Health Sciences Kartal Dr. Lutfi Kirdar City Hospital, Istanbul, Turkey.
| | - Mohammad Emad Al Madadha
- Department of Microbiology and Immunology, Institute of Marine and Environmental Technology, University of Maryland School of Medicine, Baltimore, Maryland, United States
| | - Handan Ankarali
- Department of Biostatistics and Medical Informatics, Istanbul Medeniyet University Faculty of Medicine, Istanbul, Turkey
| | - Yasemin Cag
- Department of Infectious Diseases and Clinical Microbiology, Istanbul Medeniyet University Faculty of Medicine, Istanbul, Turkey
| | - Kubra Demir Onder
- Department of Infectious Diseases and Clinical Microbiology, University of Health Sciences Antalya Training and Research Hospital, Antalya, Turkey
| | - Aysegul Seremet-Keskin
- Department of Infectious Diseases and Clinical Microbiology, University of Health Sciences Antalya Training and Research Hospital, Antalya, Turkey
| | - Filiz Kizilates
- Department of Infectious Diseases and Clinical Microbiology, University of Health Sciences Antalya Training and Research Hospital, Antalya, Turkey
| | - Rok Čivljak
- Department for Respiratory Tract Infections, Dr. Fran Mihaljević University Hospital for infectious Diseases, University of Zagreb School of Medicine, Zagreb, Croatia
| | - Ghaydaa Shehata
- Department of Neurology, Assiut University Faculty of Medicine, Assiut, Egypt
| | - Handan Alay
- Department of Infectious Diseases and Clinical Microbiology, Ataturk University Faculty of Medicine, Erzurum, Turkey
| | - Sevil Alkan-Ceviker
- Department of Infectious Diseases and Clinical Microbiology, Onsekiz Mart University Faculty of Medicine, Canakkale, Turkey
| | - Fatma Yilmaz-Karadag
- Department of Infectious Diseases and Clinical Microbiology, University of Health Sciences Sancaktepe Şehit Prof. Dr Ilhank Varank Training and Research Hospital. İstanbul, Turkey
| | - Meliha Cagla-Sonmezer
- Department of Infectious Diseases and Clinical Microbiology, Hacettepe University Faculty of Medicine, Ankara, Turkey
| | | | - Dumitru Irina Magdelena
- Department of Infectious Diseases, Clinical Infectious Diseases Hospital Constanta, Ovidius University of Constanta, Constanta, Romania
| | | | - Jurica Arapovic
- Department of Infectious Diseases, University Clinical Hospital Mostar, Mostar, Bosnia and Herzegovina
| | - Fatma Kesmez-Can
- Department of Infectious Diseases and Clinical Microbiology, Ataturk University Faculty of Medicine, Erzurum, Turkey
| | | | | | - Gulden Eser-Karlidag
- Department of Infectious Diseases and Clinical Microbiology, University of Health Sciences Fethi Sekin City Hospital, Elazig, Turkey
| | - Reham Khedr
- Department of Pediatric Oncology, National Cancer Institute - Cairo University / Children Cancer Hospital Egypt, Cairo, Egypt
| | - Mehmet Emirhan Isik
- Department of Infectious Diseases and Clinical Microbiology, University of Health Sciences Kosuyolu Training and Research Hospital, Istanbul, Turkey
| | - Michael Mihailov Petrov
- Department of Microbiology and Immunology, Medical University of Plovdiv Faculty of Pharmacy, Plovdiv, Bulgaria
| | - Roxana Cernat
- Department of Infectious Diseases, Clinical Infectious Diseases Hospital Constanta, Ovidius University of Constanta, Constanta, Romania
| | - Umran Erturk
- Department of Infectious Diseases, Bahrain Oncology Center, Bahrain
| | - Yesim Uygun-Kizmaz
- Department of Infectious Diseases and Clinical Microbiology, University of Health Sciences Kosuyolu Training and Research Hospital, Istanbul, Turkey
| | - Eva Huljev
- Department for Respiratory Tract Infections, Dr. Fran Mihaljević University Hospital for Infectious Diseases, Zagreb, Croatia
| | - Fatma Amer
- Department of Medical Microbiology and Immunology, Faculty of Medicine, Zagazig University, Zagazig, Egypt
| | - Mehmet Resat Ceylan
- Department of Infectious Diseases and Clinical Microbiology, MD. University of Harran Faculty of Medicine, Şanliurfa, Turkey
| | - Andrea Marino
- Department of Clinical and Experimental Medicine, ARNAS Garibaldi Unit of Infectious diseases, University of Catania, Catania, Italy
| | - Gulnur Kul
- Department of Infectious Diseases and Clinical Microbiology, Kirikhan state Hospital, Hatay, Turkey
| | - Tuba Damar-Cakirca
- Department of Infectious Diseases and Clinical Microbiology, Şanliurfa training and research hospital, Sanliurfa, Turkey
| | - Yara Mohsen Khalaf
- Department of epidemiology High institute of public health,Alexandria University Infectious Disease Clinical pharmacist, Antimicrobial stewardship department, International Medical Center Hospital, Alexandria, Egypt
| | - Arzu Cennet Isik
- Department of Internal Medicine, University of Health Sciences Kartal Dr. Lutfi Kirdar City Hospital, Istanbul, Turkey
| | - Olumuyiwa Elijah Ariyo
- Department of Infectious Diseases and Tropical Medicine, Federal Teaching Hospital Ido-Ekiti, Ekiti, Nigeria
| | - Ismail Necati Hakyemez
- Department of Infectious Diseases and Clinical Microbiology, Balikesir University Faculty of Medicine, Balikesir, Turkey
| | - Rezaul Karim Ripon
- Department of Public Health and Informatics, Jahangirnagar University, Savar, Bangladesh
| | - Abdorrahim Afkhamzadeh
- Department of Community Medicine, Kurdistan University of Medical Sciences, Sanandaj, Iran
| | | | | | - Maya Belitova
- Department of Anesthesiology and Intensive Care, University Hospital "Queen Giovanna"-ISUL, EAD, Sofia, Bulgaria
| | - Mustafa Altindis
- Department of Microbiology, Sakarya University Faculty of Medicine, Sakarya, Turkey
| | - Rehab El-Sokkary
- Department of Medical Microbiology and Immunology, Faculty of Medicine, Zagazig University, Zagazig, Egypt
| | - Recep Tekin
- Department of Infectious Diseases and Clinical Microbiology, Dicle University Faculty of Medicine, Diyarbakir, Turkey
| | - Mohammed Ahmed Garout
- Department of Community Medicine and Health Care for Pilgrims, Umm Al-Qura University Faculty of Medicine, Makkah, Saudi Arabia
| | - Joanna Zajkowska
- Department of Infectious Diseases and Neuroinfections, Medical University in Białystok, Bialystok, Poland
| | - Farhan Fazal
- Department of Medicine, Kasturba Medical College Mangalore, Mangalore, India
| | - Muhammed Bekcibasi
- Department of Infectious Diseases and Clinical Microbiology, Bismil State Hospital, Diyarbakir, Turkey
| | - Mirsada Hukic
- Department of Clinical Microbiology, Institute for Biomedical Diagnostic and Research NALAZ, Sarajevo, Bosnia and Herzegovina
| | - Summiya Nizamuddin
- Section of Microbiology, Department of Pathology, Shaukat Khanum Memorial Cancer Hospital and Research Centre, Lahore, Pakistan
| | - Serkan Surme
- Department of Infectious Diseases and Clinical Microbiology, University of Health Sciences Haseki Training and Research Hospital, Istanbul, Turkey
| | - Ricardo Fernandez
- Department of Pulmonary and Critical Care, San Juan City Hospital, San Juan, Puerto Rico
| | - Amani El-Kholy
- Department of Clinical Pathology, Cairo University Hospital, Cairo, Egypt
| | - Nasim Akhtar
- Department of Infectious Diseases, Pakistan Institute of Medical Sciences, Islamabad, Pakistan
| | - Saadia Ijaz
- Department of Pathology, Shalamar institute of health sciences, Lahore, Pakistan
| | - Andrea Cortegiani
- Department of Surgical, Oncological and Oral Science (Di.Chir.On.S.), University of Palermo, Palermo, Italy
| | - Meliha Meric-Koc
- Department of Infectious Diseases and Clinical Microbiology, Bezmialem Vakif University Faculty of Medicine, Istanbul, Turkey
| | - Hakan Hasman
- Department of Emergency, Ankara Medicalpark Private Hospital, Ankara, Turkey
| | - Agah Victor Maduka
- Department of microbiology, Ebonyi State University Teaching Hospital Abakaliki, Ebonyi State, Nigeria
| | - Jehan Ali ElKholy
- Department of Anesthesia, Pain Management, Cairo University Hospital, Cairo, Egypt
| | - Sema Sari
- Department of Intensive Care, Nigde Training and Research Hospital, Nigde, Turkey
| | - Mumtaz Ali Khan
- Department of Epidemiology and Disease Surveillance, National institute of health Islamabad, Islamabad, Pakistan
| | - Yasemin Akin
- Department of Pediatrics, University of Health Sciences Kartal Dr. Lutfi Kirdar City Hospital, Istanbul, Turkey
| | - Sukran Kose
- Department of Infectious Diseases and Clinical Microbiology, Tepecik Training and Research Hospital, Izmir, Turkey
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Saydam FN, Erdem H, Ankarali H, El-Arab Ramadan ME, El-Sayed NM, Civljak R, Pshenichnaya N, Moroti RV, Mahmuodabad FM, Maduka AV, Mahboob A, Prakash Kumari PH, Stebel R, Cernat R, Fasanekova L, Uysal S, Tasbakan M, Arapović J, Magdalena DI, Angamuthu K, Ghanem-Zoubi N, Meric-Koc M, Ruch Y, Marino A, Sadykova A, Batirel A, Khan EA, Kulzhanova S, Al-Moghazi S, Yegemberdiyeva R, Nicastri E, Pandak N, Akhtar N, Ozer-Balin S, Cascio A, Dimzova M, Evren H, Puca E, Tokayeva A, Vecchi M, Bozkurt I, Dogan M, Dirani N, Duisenova A, Khan MA, Kotsev S, Obradovic Z, Del Vecchio RF, Almajid F, Barac A, Dragovac G, Pishmisheva-Peleva M, Rahman MT, Rahman T, Le Marechal M, Cag Y, Ikram A, Rodriguez-Morales AJ. Vector-borne and zoonotic infections and their relationships with regional and socioeconomic statuses: An ID-IRI survey in 24 countries of Europe, Africa and Asia. Travel Med Infect Dis 2021; 44:102174. [PMID: 34699956 DOI: 10.1016/j.tmaid.2021.102174] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2021] [Revised: 09/25/2021] [Accepted: 10/12/2021] [Indexed: 02/08/2023]
Abstract
BACKGROUND In this cross-sectional, international study, we aimed to analyze vector-borne and zoonotic infections (VBZI), which are significant global threats. METHOD VBZIs' data between May 20-28, 2018 was collected. The 24 Participatingcountries were classified as lower-middle, upper-middle, and high-income. RESULTS 382 patients were included. 175(45.8%) were hospitalized, most commonly in Croatia, Egypt, and Romania(P = 0.001). There was a significant difference between distributions of VBZIs according to geographical regions(P < 0.001). Amebiasis, Ancylostomiasis, Blastocystosis, Cryptosporidiosis, Giardiasis, Toxoplasmosis were significantly more common in the Middle-East while Bartonellosis, Borreliosis, Cat Scratch Disease, Hantavirus syndrome, Rickettsiosis, Campylobacteriosis, Salmonellosis in Central/East/South-East Europe; Brucellosis and Echinococcosis in Central/West Asia; Campylobacteriosis, Chikungunya, Tick-borne encephalitis, Visceral Leishmaniasis, Salmonellosis, Toxoplasmosis in the North-Mediterranean; CCHF, Cutaneous Leishmaniasis, Dengue, Malaria, Taeniasis, Salmonellosis in Indian Subcontinent; Lassa Fever in West Africa. There were significant regional differences for viral hemorrhagic fevers(P < 0.001) and tick-borne infections(P < 0.001), and according to economic status for VBZIs(P < 0.001). The prevalences of VBZIs were significantly higher in lower-middle income countries(P = 0.001). The most similar regions were the Indian Subcontinent and the Middle-East, the Indian Subcontinent and the North-Mediterranean, and the Middle-East and North-Mediterranean regions. CONCLUSIONS Regional and socioeconomic heterogeneity still exists for VBZIs. Control and eradication of VBZIs require evidence-based surveillance data, and multidisciplinary efforts.
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Affiliation(s)
- Fatma Nurhayat Saydam
- Department of Infectious Diseases and Clinical Microbiology, Yuksek Ihtisas University, Faculty of Medicine, Batikent Medical Park Hospital, Ankara, Turkey
| | - Hakan Erdem
- ID-IRI Lead Coordinator, Ankara, Turkey; Department of Infectious Diseases, Bahrain Oncology Center, King Hamad University Hospital, Busaiteen, 24343, Bahrain.
| | - Handan Ankarali
- Istanbul Medeniyet University, School of Medicine, Department of Biostatistics and Medical Informatics, Istanbul, Turkey
| | | | | | - Rok Civljak
- "Dr. Fran Mihaljevic" University Hospital for Infectious Diseases, University of Zagreb School of Medicine, Zagreb, Croatia
| | | | - Ruxandra Valentina Moroti
- National Institute for Infectious Diseases 'Matei Bals', and 'Carol Davila' University of Medicine and Pharmacy', Bucharest, Romania
| | | | | | - Amjad Mahboob
- Gajju Khan Medical College/Bacha Khan Medical Complex, Swabi, Khyber Pakhtunkhwa, Pakistan
| | | | - Roman Stebel
- Department of Infectious Diseases, University Hospital Brno and Faculty of Medicine, Masaryk University, Czech Republic
| | - Roxana Cernat
- Clinical Infectious Disease Hospital Constanta, Ovidius University of Constanta, Romania
| | - Lenka Fasanekova
- Department of Infectious Diseases, University Hospital Brno and Faculty of Medicine, Masaryk University, Czech Republic
| | - Serhat Uysal
- Department of Infectious Diseases and Clinical Microbiology, Firat University Faculty of Medicine, Elazig, Turkey
| | - Meltem Tasbakan
- Department of Infectious Diseases and Clinical Microbiology, Ege University Medical School, Izmir, Turkey
| | - Jurica Arapović
- Department of Infectious Diseases, Mostar University Clinical Hospital, Mostar, Bosnia and Herzegovina
| | | | | | | | - Meliha Meric-Koc
- Department of Infectious Diseases and Clinical Microbiology, Bezmialem Vakif University, Hospital of Medical Faculty, Istanbul, Turkey
| | - Yvon Ruch
- Strasbourg University Hospital (Nouvel Hôpital Civil - Centre Hospitalo-Universitaire de Strasbourg), Strasbourg, France
| | - Andrea Marino
- Department of Infectious Diseases, Garibaldi Nesima Hospital, Italy
| | - Ainur Sadykova
- Department of Infectious and Tropical Diseases, Asfendiyarov Kazakh National Medical University, Almaty, Kazakhstan
| | - Ayse Batirel
- Department of Infectious Diseases and Clinical Microbiology, University of Health Sciences, Dr. Lutfi Kirdar Training and Research Hospital, Istanbul, Turkey
| | - Ejaz Ahmed Khan
- Shifa Tameer-E-Millat University, Shifa International Hospital, Islamabad, Pakistan
| | - Sholpan Kulzhanova
- Department of Infectious Diseases, Astana Medical University, Nur-Sultan, Kazakhstan
| | - Samir Al-Moghazi
- National Institute for Infectious Diseases L. Spallanzani IRCCS, Italy
| | - Ravilya Yegemberdiyeva
- Department of Infectious and Tropical Diseases, Asfendiyarov Kazakh National Medical University, Almaty, Kazakhstan
| | - Emanuele Nicastri
- National Institute for Infectious Diseases L. Spallanzani IRCCS, Italy
| | | | - Nasim Akhtar
- Pakistan Institute of Medical Sciences, G-8/3, Islamabad, Pakistan
| | - Safak Ozer-Balin
- Department of Infectious Diseases and Clinical Microbiology, Firat University, Faculty of Medicine, Elazıg, Turkey
| | - Antonio Cascio
- Department of Health Promotion Sciences, Maternal and Infant Care, Internal Medicine and Medical Specialties (PROMISE) - Infectious Disease Unit, Policlinico "P. Giaccone", University of Palermo, Italy
| | - Marija Dimzova
- Clinic for Infectious Diseases and Febrile Conditions, Medical University, Skopje, Macedonia
| | - Hakan Evren
- Department of Infectious Diseases and Clinical Microbiology, University of Kyrenia, Kyrenia, Cyprus
| | | | - Alma Tokayeva
- Department of Infectious Diseases, Semey Medical University, Semey, Kazakhstan
| | | | - Ilkay Bozkurt
- Department of Infectious Diseases, Ondokuz Mayis University, School of Medicine, Samsun, Turkey
| | - Mustafa Dogan
- Namik Kemal University, Faculty of Medicine, Tekirdag, Turkey
| | - Natalia Dirani
- Department of Infectious Diseases, Dar Al Amal University Hospital, Douris, Baalbak, Lebanon
| | - Amangul Duisenova
- Department of Infectious and Tropical Diseases, Asfendiyarov Kazakh National Medical University, Almaty, Kazakhstan
| | | | - Stanislav Kotsev
- Pazardzhik Multiprofile Hospital for Active Treatment, Department of Infectious Diseases, Bulgaria
| | - Zarema Obradovic
- Faculty for Health Studies University of Sarajevo, Bosnia and Herzegovina
| | | | | | - Aleksandra Barac
- Clinic for Infectious and Tropical Diseases, University of Belgrade, Faculty of Medicine, Belgrade, Serbia
| | - Gorana Dragovac
- Centre of Disease Prevention and Control, Institute of Public Health of Vojvodina, Faculty of Medicine, University of Novi Sad, Serbia
| | - Maria Pishmisheva-Peleva
- Pazardzhik Multiprofile Hospital for Active Treatment, Department of Infectious Diseases, Bulgaria
| | - Md Tanvir Rahman
- Department of Microbiology and Hygiene, Faculty of Veterinary Science, Bangladesh Agricultural University, Mymensingh 2202, Bangladesh
| | | | - Marion Le Marechal
- Grenoble Alpes University, CHUGA, Infectious Diseases Department, 38043, Grenoble, France
| | - Yasemin Cag
- Department of Infectious Diseases and Clinical Microbiology, Istanbul Medeniyet University, Faculty of Medicine, Istanbul, Turkey
| | - Aamer Ikram
- National Institute of Health, Islamabad, Pakistan
| | - Alfonso J Rodriguez-Morales
- Grupo de Investigación Biomedicina, Faculty of Medicine, Fundación Universitaria Autónoma de las Américas, Pereira, Risaralda, Colombia; Master of Clinical Epidemiology and Biostatistics, Universidad Científica del Sur, Lima, Perú
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Erdem H, Hargreaves S, Ankarali H, Caskurlu H, Ceviker SA, Bahar-Kacmaz A, Meric-Koc M, Altindis M, Yildiz-Kirazaldi Y, Kizilates F, Alsalman J, Cag Y, Kamal AHM, Dokmetas I, Dindar-Demiray EK, Shehata GA, Hasman H, Sadykova A, Llopis F, Ramosaco E, Logar M, Alay H, Kesmez-Can F, Ruch Y, Bulut D, Makek MJ, Marino A, Mahboob A, El-Kholy A, Abdallah D, Sefa-Sayar M, Karaali R, Aslan S, Dar RE, Abdalla E, Monzón-Camps H, Baljić R, Mgdalena DI, Naghili B, Abbas Dafalla ME, Alwashmi ASS, Carmen CR, Ramirez-Estrada S, Wojewodzka-Zelezniakowicz M, Akyildiz O, Zajkowska J, El-Sokkary R, Pandya N, Amer F, Alavi-Darazam I, Grgić S, Wegdan AA, El-Kholy J, Bulut-Avsar C, Kulzhanova S, Tasbakan M, Kumari HP, Dirani N, Koganti K, Konkayev AK, Petrov MM, Cascio A, Liskova A, Del Vecchio RF, Lambertenghi L, Mladenov N, Oncu S, Rello J. Managing adult patients with infectious diseases in emergency departments: international ID-IRI study. J Chemother 2021; 33:302-318. [PMID: 33734040 DOI: 10.1080/1120009x.2020.1863696] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
Abstract
We aimed to explore factors for optimizing antimicrobial treatment in emergency departments. A single-day point prevalence survey was conducted on January 18, 2020, in 53 referral/tertiary hospitals in 22 countries. 1957 (17%) of 11557 patients presenting to EDs had infections. The mean qSOFA score was 0.37 ± 0.74. Sepsis (qSOFA ≥ 2) was recorded in 218 (11.1%) patients. The mean qSOFA score was significantly higher in low-middle (1.48 ± 0.963) compared to upper-middle (0.17 ± 0.482) and high-income (0.36 ± 0.714) countries (P < 0.001). Eight (3.7%) patients with sepsis were treated as outpatients. The most common diagnoses were upper-respiratory (n = 877, 43.3%), lower-respiratory (n = 316, 16.1%), and lower-urinary (n = 201, 10.3%) infections. 1085 (55.4%) patients received antibiotics. The most-commonly used antibiotics were beta-lactam (BL) and BL inhibitors (n = 307, 15.7%), third-generation cephalosporins (n = 251, 12.8%), and quinolones (n = 204, 10.5%). Irrational antibiotic use and inappropriate hospitalization decisions seemed possible. Patients were more septic in countries with limited resources. Hence, a better organizational scheme is required.
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Affiliation(s)
| | - Sally Hargreaves
- Institute for Infection and Immunity, St George's University of London, London, UK
| | - Handan Ankarali
- Department of Biostatistics and Medical Informatics, Faculty of Medicine, Istanbul Medeniyet University, Istanbul, Turkey
| | - Hulya Caskurlu
- Department of Infectious Diseases and Clinical Microbiology, Faculty of Medicine, Istanbul Medeniyet University, Istanbul, Turkey
| | - Sevil Alkan Ceviker
- Department of Infectious Diseases and Clinical Microbiology, Kutahya Evliya Celebi Research and Education Hospital, Kutahya, Turkey
| | - Asiye Bahar-Kacmaz
- Department of Infectious Diseases and Clinical Microbiology, Bezmialem Vakif University, Istanbul, Turkey
| | | | - Mustafa Altindis
- Department of Medical Microbiology, Faculty of Medicine, Sakarya University, Sakarya, Turkey
| | | | - Filiz Kizilates
- Department of Infectious Diseases and Clinical Microbiology, Antalya Training and Research Hospital, Health Sciences University, Antalya, Turkey
| | | | - Yasemin Cag
- Institute for Infection and Immunity, St George's University of London, London, UK
| | | | - Ilyas Dokmetas
- Department of Infectious Diseases and Clinical Microbiology, Sisli Etfal Training and Research Hospital, Istanbul, Turkey
| | | | | | - Hakan Hasman
- Emergency Department, Ankara Medicalpark Hospital, Ankara, Turkey
| | - Ainur Sadykova
- Department of Infectious and Tropical Diseases, City Clinical Infectious Hospital, Kazakh National Medical University, Almaty, Kazakhstan
| | - Ferran Llopis
- Emergency Department, Hospital Universitari de Bellvitge, Barcelona, Spain
| | - Ergys Ramosaco
- Infectious Diseases Clinic, University Hospital Center "Mother Teresa", Tirana, Albania
| | - Mateja Logar
- Department of Infectious Diseases, UMC Ljubljana, Ljubljana, Slovenia
| | - Handan Alay
- Department of Infectious Diseases and Clinical Microbiology, Faculty of Medicine, Ataturk University, Erzurum, Turkey
| | - Fatma Kesmez-Can
- Department of Infectious Diseases and Clinical Microbiology, Faculty of Medicine, Ataturk University, Erzurum, Turkey
| | - Yvon Ruch
- Department of Infectious Diseases, Strasbourg University Hospital, Strasbourg, France
| | - Dilek Bulut
- Department of Infectious Diseases and Clinical Microbiology, Van Training and Research Hospital, Van, Turkey
| | | | - Andrea Marino
- Department of Infectious Diseases, ARNAS Garibaldi Hospital, University of Catania, Catania, Italy
| | - Amjad Mahboob
- Bacha Khan Medical Complex Swabi, Khyber Pakhtunkhwa, Pakistan
| | | | - Dirar Abdallah
- Department of Intensive Care, Prime Hospital, Dubai, United Arab Emirates
| | - Merve Sefa-Sayar
- Department of Infectious Diseases and Clinical Microbiology, Van Training and Research Hospital, Van, Turkey
| | - Ridvan Karaali
- Department of Infectious Diseases and Clinical Microbiology, Cerrahpasa School of Medicine, İstanbul Üniversitesi, Istanbul, Turkey
| | - Selda Aslan
- Department of Infectious Diseases and Clinical Microbiology, Cengiz Gokcek Maternity and Children's Hospital, Gaziantep, Turkey
| | - Razi Even Dar
- Department of Internal Medicine, Rambam Health Care Campus, Haifa, Israel
| | - Esam Abdalla
- Department of Anesthesia & ICU, Assiut University Hospital, Assiut, Egypt
| | - Helena Monzón-Camps
- Emergency Department and Infectious Diseases, Hospital Universitary Mútua Terrassa, Terrassa, Spain
| | - Rusmir Baljić
- Clinic for Infectious Diseases, Sarajevo, Bosnia and Herzegovina
| | - Dumitru Irina Mgdalena
- Clinical Infectious Diseases Hospital, Ovidius University of Constanta, Constanta, Romania
| | - Behrouz Naghili
- Department of Infectious Diseases, Imam Reza Hospital, Tabriz, Iran
| | | | - Ameen S S Alwashmi
- Medical Laboratories Department, College of Applied Medical Sciences, Qassim University, Saudi Arabia
| | - Cernat Roxana Carmen
- Clinical Hospital for Infectious Diseases, Ovidius University Constanta, Constanta, Romania
| | | | | | - Ozay Akyildiz
- Department of Infectious Diseases and Clinical Microbiology, Adana Acibadem Hospital, Adana, Turkey
| | | | - Rehab El-Sokkary
- Medical Microbiology and Immunology Department, Faculty of Medicine, Zagazig University, Zagazig, Egypt
| | | | - Fatma Amer
- Department of Medical Microbiology and Immunology, Faculty of Medicine, Zagazig University, Zagazig, Egypt
| | - Ilad Alavi-Darazam
- Department of Infectious Diseases and Tropical Medicine, Loghman Hakim Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Svjetlana Grgić
- Clinic for Infectious Disease, University Hospital Mostar, Mostar, Bosnia and Herzegovina
| | | | | | - Cansu Bulut-Avsar
- Department of Infectious Diseases and Clinical Microbiology, School of Medicine, Ege University, Izmir, Turkey
| | - Sholpan Kulzhanova
- Department of Infectious Diseases, Astana Medical University, Nur-Sultan, Kazakhstan
| | - Meltem Tasbakan
- Department of Infectious Diseases and Clinical Microbiology, School of Medicine, Ege University, Izmir, Turkey
| | | | | | | | - Aidos K Konkayev
- Institution of Trauma and Orthopaedics, Astana Medical University, Nur-Sultan, Kazakhstan
| | - Michael M Petrov
- Department of Microbiology and Immunology, Faculty of Pharmacy, Medical University, Plovdiv, Bulgaria
| | - Antonio Cascio
- Infectious and Tropical Diseases Section, Department PROMISE, University of Palermo, Palermo, Italy
| | | | | | | | | | - Serkan Oncu
- Department of Infectious Diseases and Clinical Microbiology, School of Medicine, Adnan Menderes University, Aydin, Turkey
| | - Jordi Rello
- Critical Care Department, Hospital Vall d'Hebron, Barcelona, Spain.,CIBERES, Madrid, Spain.,Universitat Autonma de Barcelona, Barcelona, Spain
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4
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Erdem H, Puca E, Ruch Y, Santos L, Ghanem-Zoubi N, Argemi X, Hansmann Y, Guner R, Tonziello G, Mazzucotelli JP, Como N, Kose S, Batirel A, Inan A, Tulek N, Pekok AU, Khan EA, Iyisoy A, Meric-Koc M, Kaya-Kalem A, Martins PP, Hasanoglu I, Silva-Pinto A, Oztoprak N, Duro R, Almajid F, Dogan M, Dauby N, Gunst JD, Tekin R, Konopnicki D, Petrosillo N, Bozkurt I, Wadi J, Popescu C, Balkan II, Ozer-Balin S, Zupanc TL, Cascio A, Dumitru IM, Erdem A, Ersoz G, Tasbakan M, Ajamieh OA, Sirmatel F, Florescu S, Gulsun S, Ozkaya HD, Sari S, Tosun S, Avci M, Cag Y, Celebi G, Sagmak-Tartar A, Karakus S, Sener A, Dedej A, Oncu S, Del Vecchio RF, Ozturk-Engin D, Agalar C. Portraying infective endocarditis: results of multinational ID-IRI study. Eur J Clin Microbiol Infect Dis 2019; 38:1753-1763. [PMID: 31187307 DOI: 10.1007/s10096-019-03607-x] [Citation(s) in RCA: 25] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2019] [Accepted: 05/29/2019] [Indexed: 01/18/2023]
Abstract
Infective endocarditis is a growing problem with many shifts due to ever-increasing comorbid illnesses, invasive procedures, and increase in the elderly. We performed this multinational study to depict definite infective endocarditis. Adult patients with definite endocarditis hospitalized between January 1, 2015, and October 1, 2018, were included from 41 hospitals in 13 countries. We included microbiological features, types and severity of the disease, complications, but excluded therapeutic parameters. A total of 867 patients were included. A total of 631 (72.8%) patients had native valve endocarditis (NVE), 214 (24.7%) patients had prosthetic valve endocarditis (PVE), 21 (2.4%) patients had pacemaker lead endocarditis, and 1 patient had catheter port endocarditis. Eighteen percent of NVE patients were hospital-acquired. PVE patients were classified as early-onset in 24.9%. A total of 385 (44.4%) patients had major embolic events, most frequently to the brain (n = 227, 26.3%). Blood cultures yielded pathogens in 766 (88.4%). In 101 (11.6%) patients, blood cultures were negative. Molecular testing of vegetations disclosed pathogens in 65 cases. Overall, 795 (91.7%) endocarditis patients had any identified pathogen. Leading pathogens (Staphylococcus aureus (n = 267, 33.6%), Streptococcus viridans (n = 149, 18.7%), enterococci (n = 128, 16.1%), coagulase-negative staphylococci (n = 92, 11.6%)) displayed substantial resistance profiles. A total of 132 (15.2%) patients had cardiac abscesses; 693 (79.9%) patients had left-sided endocarditis. Aortic (n = 394, 45.4%) and mitral valves (n = 369, 42.5%) were most frequently involved. Mortality was more common in PVE than NVE (NVE (n = 101, 16%), PVE (n = 49, 22.9%), p = 0.042).
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Affiliation(s)
| | - Edmond Puca
- Department of Infectious Diseases, University Hospital Center "Mother Teresa", Tirana, Albania
| | - Yvon Ruch
- Department of Infectious Diseases, Strasbourg University Hospital, Nouvel Hôpital Civil, Strasbourg, France
| | - Lurdes Santos
- Infectious Diseases Department, Centro Hospitalar São João and Faculdade de Medicina da Universidade do Porto, Porto, Portugal
| | | | - Xavier Argemi
- Department of Infectious Diseases, Strasbourg University Hospital, Nouvel Hôpital Civil, Strasbourg, France
| | - Yves Hansmann
- Department of Infectious Diseases, Strasbourg University Hospital, Nouvel Hôpital Civil, Strasbourg, France
| | - Rahmet Guner
- Ataturk Training and Research Hospital, Department of Infectious Diseases and Clinical Microbiology, Yildirim Beyazit University, Ankara, Turkey
| | - Gilda Tonziello
- Clinical & Research Department for Infectious Diseases, National Institute for Infectious Diseases "Lazzaro Spallanzani", IRCCS,, Via Portuense, 292, 00149, Rome, Italy
| | - Jean-Philippe Mazzucotelli
- Department of Cardiovascular Surgery, Strasbourg University Hospital, Nouvel Hôpital Civil, Strasbourg, France
| | - Najada Como
- Service of Infectious Disease, UHC, Tirana, Albania
| | - Sukran Kose
- Department of Infectious Diseases and Clinical Microbiology, Tepecik Training and Research Hospital, Izmir, Turkey
| | - Ayse Batirel
- Department of Infectious Diseases and Clinical Microbiology, Dr. Lutfi Kirdar Training and Research Hospital, Health Sciences University, Istanbul, Turkey
| | - Asuman Inan
- Department of Infectious Diseases and Clinical Microbiology, Haydarpasa Numune Training and Research Hospital, Istanbul, Turkey
| | - Necla Tulek
- Department of Microbiology, Atilim University, School of Medicine, Ankara, Turkey
| | - Abdullah Umut Pekok
- Department of Infectious Diseases and Clinical Microbiology, Pendik Medical Park Hospital, Istanbul, Turkey
| | - Ejaz Ahmed Khan
- Shifa International Hospital and Shifa Tameer-e-Millat University, Islamabad, Pakistan
| | - Atilla Iyisoy
- Department of Cardiology, Gulhane Training and Research Hospital, Health Sciences University, Ankara, Turkey
| | - Meliha Meric-Koc
- Department of Infectious Diseases and Clinical Microbiology, Bezmialem Vakıf University School of Medicine, Istanbul, Turkey
| | - Ayse Kaya-Kalem
- Ataturk Training and Research Hospital, Department of Infectious Diseases and Clinical Microbiology, Yildirim Beyazit University, Ankara, Turkey
| | - Pedro Palma Martins
- Infectious Diseases Department, Centro Hospitalar São João and Faculdade de Medicina da Universidade do Porto, Porto, Portugal
| | - Imran Hasanoglu
- Ataturk Training and Research Hospital, Department of Infectious Diseases and Clinical Microbiology, Yildirim Beyazit University, Ankara, Turkey
| | - André Silva-Pinto
- Infectious Diseases Department, Centro Hospitalar São João and Faculdade de Medicina da Universidade do Porto, Porto, Portugal
| | - Nefise Oztoprak
- Department of Infectious Diseases and Clinical Microbiology, Antalya Training and Research Hospital, Health Sciences University, Antalya, Turkey
| | - Raquel Duro
- Infectious Diseases Department, Centro Hospitalar São João and Faculdade de Medicina da Universidade do Porto, Porto, Portugal
| | - Fahad Almajid
- Department of Medicine, Infectious Diseases Division, King Saud University Hospital, Riyadh, Saudi Arabia
| | - Mustafa Dogan
- Department of Infectious Diseases and Clinical Microbiology, Corlu State Hospital, Tekirdag, Antalya, Turkey
| | - Nicolas Dauby
- Department of Infectious Diseases, Centre Hospitalier Universitaire Saint-Pierre, Université libre de Bruxelles (ULB), 322 rue Haute, 1000, Brussels, Belgium
| | | | - Recep Tekin
- Department of Infectious Diseases and Clinical Microbiology, Dicle University Faculty of Medicine, Diyarbakır, Turkey
| | - Deborah Konopnicki
- Department of Infectious Diseases, Centre Hospitalier Universitaire Saint-Pierre, Université libre de Bruxelles (ULB), 322 rue Haute, 1000, Brussels, Belgium
| | - Nicola Petrosillo
- Clinical & Research Department for Infectious Diseases, National Institute for Infectious Diseases "Lazzaro Spallanzani", IRCCS,, Via Portuense, 292, 00149, Rome, Italy
| | - Ilkay Bozkurt
- Department of Infectious Diseases and Clinical Microbiology, Ondokuz Mayis University School of Medicine, Samsun, Turkey
| | - Jamal Wadi
- Department of Infectious Diseases, School of Medicine, The University of Jordan, Amman, Jordan
| | - Corneliu Popescu
- Dr Victor Babes Clinical Hospital of Infectious and Tropical Disease, Bucharest, Romania
| | - Ilker Inanc Balkan
- Department of Infectious Diseases and Clinical Microbiology, Cerrahpasa Medical Faculty, Istanbul University, Istanbul, Turkey
| | - Safak Ozer-Balin
- Department of Infectious Diseases and Clinical Microbiology, Faculty of Medicine, Firat University, Elazig, Turkey
| | | | - Antonio Cascio
- Department of Health Promotion Sciences and Mother and Child Care "G. D'Alessandro", University of Palermo, Palermo, Italy
| | | | - Aysegul Erdem
- Department of Pathology, Kecioren Training and Research Hospital, Ankara, Turkey
| | - Gulden Ersoz
- Department of Infectious Diseases and Clinical Microbiology, Mersin University School of Medicine, Mersin, Turkey
| | - Meltem Tasbakan
- Department of Infectious Diseases and Clinical Microbiology, Ege University Faculty of Medicine, Izmir, Turkey
| | - Oday Abu Ajamieh
- Department of Infectious Diseases, School of Medicine, The University of Jordan, Amman, Jordan
| | - Fatma Sirmatel
- Department of Infectious Disease and Clinical Microbiology, Izzet Baysal University School of Medicine, Bolu, Turkey
| | - Simin Florescu
- Dr Victor Babes Clinical Hospital of Infectious and Tropical Disease, Bucharest, Romania
| | - Serda Gulsun
- Department of Infectious Diseases and Clinical Microbiology, Diyarbakir Training and Research Hospital, Diyarbakir, Turkey
| | - Hacer Deniz Ozkaya
- Department of Infectious Diseases and Clinical Microbiology, Cigli Regional Education Hospital, Izmir, Turkey
| | - Sema Sari
- Department of Intensive Care Unit, Turkey Advanced Specialty Education and Research Hospital, Ankara, Turkey
| | - Selma Tosun
- Department of Infectious Diseases and Clinical Microbiology, Izmir Bozyaka Training and Research Hospital, Izmir, Turkey
| | - Meltem Avci
- Department of Infectious Disease and Clinical Microbiology, Usak University School of Medicine, Usak, Turkey
| | - Yasemin Cag
- Department of Infectious Diseases and Clinical Microbiology, Medeniyet University, Goztepe Training and Research Hospital, Istanbul, Turkey
| | - Guven Celebi
- Department of Infectious Diseases and Clinical Microbiology, Faculty of Medicine, Bulent Ecevit University, Zonguldak, Turkey
| | - Ayse Sagmak-Tartar
- Department of Infectious Diseases and Clinical Microbiology, Faculty of Medicine, Firat University, Elazig, Turkey
| | - Sumeyra Karakus
- Department of Infectious Diseases and Clinical Microbiology, Medeniyet University, Goztepe Training and Research Hospital, Istanbul, Turkey
| | - Alper Sener
- Department of Infectious Diseases and Clinical Microbiology, Onsekiz Mart University School of Medicine, Canakkale, Turkey
| | - Arjeta Dedej
- Department of Nephrology, American Hospital, Tirana, Albania
| | - Serkan Oncu
- Department of Infectious Diseases and Clinical Microbiology, Adnan Menderes University School of Medicine, Aydin, Turkey
| | - Rosa Fontana Del Vecchio
- Department of Clinical and Molecular Biomedicine, Section of Infectious Diseases, University of Catania, Catania, Italy
| | - Derya Ozturk-Engin
- Department of Infectious Diseases and Clinical Microbiology, Fatih Sultan Mehmet Training and Research Hospital, Istanbul, Turkey
| | - Canan Agalar
- Department of Infectious Diseases and Clinical Microbiology, Fatih Sultan Mehmet Training and Research Hospital, Istanbul, Turkey
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5
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Tosun S, Batirel A, Oluk AI, Aksoy F, Puca E, Bénézit F, Ural S, Nayman-Alpat S, Yamazhan T, Koksaldi-Motor V, Tekin R, Parlak E, Tattevin P, Kart-Yasar K, Guner R, Bastug A, Meric-Koc M, Oncu S, Sagmak-Tartar A, Denk A, Pehlivanoglu F, Sengoz G, Sørensen SM, Celebi G, Baštáková L, Gedik H, Dirgen-Caylak S, Esmaoglu A, Erol S, Cag Y, Karagoz E, Inan A, Erdem H. Tetanus in adults: results of the multicenter ID-IRI study. Eur J Clin Microbiol Infect Dis 2017; 36:1455-1462. [PMID: 28353183 DOI: 10.1007/s10096-017-2954-3] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2017] [Accepted: 02/28/2017] [Indexed: 02/08/2023]
Abstract
Tetanus is an acute, severe infection caused by a neurotoxin secreting bacterium. Various prognostic factors affecting mortality in tetanus patients have been described in the literature. In this study, we aimed to analyze the factors affecting mortality in hospitalized tetanus patients in a large case series. This retrospective multicenter study pooled data of tetanus patients from 25 medical centers. The hospitals participating in this study were the collaborating centers of the Infectious Diseases International Research Initiative (ID-IRI). Only adult patients over the age of 15 years with tetanus were included. The diagnosis of tetanus was made by the clinicians at the participant centers. Izmir Bozyaka Education and Research Hospital's Review Board approved the study. Prognostic factors were analyzed by using the multivariate regression analysis method. In this study, 117 adult patients with tetanus were included. Of these, 79 (67.5%) patients survived and 38 (32.5%) patients died. Most of the deaths were observed in patients >60 years of age (60.5%). Generalized type of tetanus, presence of pain at the wound area, presence of generalized spasms, leukocytosis, high alanine aminotransferase (ALT) and C-reactive protein (CRP) values on admission, and the use of equine immunoglobulins in the treatment were found to be statistically associated with mortality (p < 0.05 for all). Here, we describe the prognostic factors for mortality in tetanus. Immunization seems to be the most critical point, considering the advanced age of our patients. A combination of laboratory and clinical parameters indicates mortality. Moreover, human immunoglobulins should be preferred over equine sera to increase survival.
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Affiliation(s)
- S Tosun
- Department of Infectious Diseases and Clinical Microbiology, Izmir Bozyaka Training and Research Hospital, Izmir, Turkey
| | - A Batirel
- Department of Infectious Diseases and Clinical Microbiology, Dr. Lutfi Kirdar Training and Research Hospital, Istanbul, Turkey
| | - A I Oluk
- Department of Infectious Diseases and Clinical Microbiology, Izmir Bozyaka Training and Research Hospital, Izmir, Turkey
| | - F Aksoy
- Department of Infectious Diseases and Clinical Microbiology, Karadeniz Technical University School of Medicine, Trabzon, Turkey
| | - E Puca
- Department of Infectious Diseases, University Hospital Center "Mother Teresa", Tirana, Albania
| | - F Bénézit
- Infectious Diseases and Intensive Care Unit, University Hospital of Pontchaillou, Rennes, France
| | - S Ural
- Ataturk Training and Research Hospital, Department of Infectious Diseases and Clinical Microbiology, Katip Celebi University, Izmir, Turkey
| | - S Nayman-Alpat
- Department of Infectious Diseases and Clinical Microbiology, Osmangazi University School of Medicine, Eskisehir, Turkey
| | - T Yamazhan
- Department of Infectious Diseases and Clinical Microbiology, Ege University School of Medicine, Izmir, Turkey
| | - V Koksaldi-Motor
- Tayfur Ata Sokmen School of Medicine, Department of Infectious Diseases and Clinical Microbiology, Mustafa Kemal University, Hatay, Turkey
| | - R Tekin
- Department of Infectious Diseases and Clinical Microbiology, Dicle University School of Medicine, Diyarbakir, Turkey
| | - E Parlak
- Department of Infectious Diseases and Clinical Microbiology, Ataturk University School of Medicine, Erzurum, Turkey
| | - P Tattevin
- Infectious Diseases and Intensive Care Unit, University Hospital of Pontchaillou, Rennes, France
| | - K Kart-Yasar
- Department of Infectious Diseases and Clinical Microbiology, Bakırköy Dr. Sadi Konuk Training and Research Hospital, Istanbul, Turkey
| | - R Guner
- Ataturk Training and Research Hospital, Department of Infectious Diseases and Clinical Microbiology, Yildirim Beyazit University, Ankara, Turkey
| | - A Bastug
- Department of Infectious Diseases and Clinical Microbiology, Numune Training and Research Hospital, Ankara, Turkey
| | - M Meric-Koc
- Department of Infectious Diseases and Clinical Microbiology, Kocaeli University School of Medicine, Izmit, Turkey
| | - S Oncu
- Department of Infectious Diseases and Clinical Microbiology, Adnan Menderes University School of Medicine, Aydin, Turkey
| | - A Sagmak-Tartar
- Department of Infectious Diseases and Clinical Microbiology, Firat University School of Medicine, Elazig, Turkey
| | - A Denk
- Department of Infectious Diseases and Clinical Microbiology, Firat University School of Medicine, Elazig, Turkey
| | - F Pehlivanoglu
- Department of Infectious Diseases and Clinical Microbiology, Haseki Training and Research Hospital, Istanbul, Turkey
| | - G Sengoz
- Department of Infectious Diseases and Clinical Microbiology, Haseki Training and Research Hospital, Istanbul, Turkey
| | - S M Sørensen
- Department of Infectious Diseases, Aalborg University Hospital, Aalborg, Denmark
| | - G Celebi
- School of Medicine, Department of Infectious Diseases and Clinical Microbiology, Bulent Ecevit University, Zonguldak, Turkey
| | - L Baštáková
- Faculty Hospital Brno, Department of Infectious Diseases and Faculty of Medicine, Masaryk University, Brno, Czech Republic
| | - H Gedik
- Department of Infectious Diseases and Clinical Microbiology, Bakırköy Dr. Sadi Konuk Training and Research Hospital, Istanbul, Turkey
| | - S Dirgen-Caylak
- Department of Infectious Diseases and Clinical Microbiology, Mugla Sitki Kocman University School of Medicine, Mugla, Turkey
| | - A Esmaoglu
- Faculty of Medicine, Department of Anesthesiology Intensive Care Unit, Erciyes University, Kayseri, Turkey
| | - S Erol
- Department of Infectious Diseases and Clinical Microbiology, Haydarpasa Numune Training and Research Hospital, Istanbul, Turkey
| | - Y Cag
- School of Medicine, Department of Infectious Diseases and Clinical Microbiology, Medeniyet University, Istanbul, Turkey
| | - E Karagoz
- Department of Infectious Diseases and Clinical Microbiology, Fatih Sultan Mehmet Training and Research Hospital, Istanbul, Turkey
| | - A Inan
- Department of Infectious Diseases and Clinical Microbiology, Haydarpasa Numune Training and Research Hospital, Istanbul, Turkey
| | - H Erdem
- Principal Coordinator of ID-IRI, Ankara, Turkey.
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6
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Erdem H, Ak O, Elaldi N, Demirdal T, Hargreaves S, Nemli SA, Cag Y, Ulug M, Naz H, Gunal O, Sirmatel F, Sipahi OR, Alpat SN, Ertem-Tuncer G, Sozen H, Evlice O, Meric-Koc M, Dogru A, Koksaldi-Motor V, Tekin R, Ozdemir D, Ozturk-Engin D, Savasci U, Karagoz E, Cekli Y, Inan A. Infections in travellers returning to Turkey from the Arabian peninsula: a retrospective cross-sectional multicenter study. Eur J Clin Microbiol Infect Dis 2016; 35:903-10. [PMID: 26964538 PMCID: PMC7087946 DOI: 10.1007/s10096-016-2614-z] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2016] [Accepted: 02/17/2016] [Indexed: 11/17/2022]
Abstract
Mass gatherings pooling people from different parts of the world—the largest of which is to Mecca, Saudi Arabia, for Hajj—may impose risks for acquisition and dissemination of infectious diseases. A substantial number of pilgrims to Hajj and Umrah are Turkish citizens (456,000 in 2014) but data are lacking on scale of the problem. We did a retrospective cross-sectional multicenter study in Turkey to explore the range of infections among inpatients who had recently returned from the Arabian Peninsula. Our inclusion criteria were patients who had acquired an infection during their trip to an Arabian Peninsula country, or who became symptomatic within 1 week of their return. The data were collected retrospectively for January 1, 2013 and March 1, 2015. 185 Turkish patients were recruited to the study across 15 referral centers with travel associated infectious diseases after returning from Arabian Peninsula countries (predominantly Saudi Arabia 163 [88.1 %] for religious purposes 162 [87.5 %]). Seventy four (40.0 %) of them were ≥ 65 years old with numerous comorbidities including diabetes (24.3 %) and COPD (14.1 %). The most common clinical diagnosis was respiratory tract infections (169 [91.5 %]), followed by diarrheal diseases (13 [7 %]), and there was one case of MERS-CoV. Patients spent a median of 5 (3–7) days as hospital inpatients and overall mortality was 1.1 %. Returning travellers from the Arabian Peninsula present as inpatients with a broad range of infectious diseases similar to common community acquired infections frequently seen in daily medical practices in Turkey.
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Affiliation(s)
- H Erdem
- Department of Infectious Diseases and Clinical Microbiology, Gulhane Medical Academy, Ankara, Turkey.
| | - O Ak
- Department of Infectious Diseases and Clinical Microbiology, Dr. Lutfi Kirdar Training and Research Hospital, Istanbul, Turkey
| | - N Elaldi
- Department of Infectious Diseases and Clinical Microbiology, Cumhuriyet University School of Medicine, Sivas, Turkey
| | - T Demirdal
- Department of Infectious Diseases and Clinical Microbiology, Katip Celebi University School of Medicine, Izmir, Turkey
| | - S Hargreaves
- International Health Unit, Section of Infectious Diseases and Immunity, Imperial College London, Commonwealth Building, Hammersmith Campus, London, UK
| | - S A Nemli
- Department of Infectious Diseases and Clinical Microbiology, Katip Celebi University School of Medicine, Izmir, Turkey
| | - Y Cag
- Goztepe Training and Research Hospital, Department of Infectious Diseases and Clinical Microbiology, Medeniyet University, Istanbul, Turkey
| | - M Ulug
- Department of Infectious Diseases and Clinical Microbiology, Private Umit Hospital, Eskisehir, Turkey
| | - H Naz
- Department of Infectious Diseases and Clinical Microbiology, Kocaeli State Hospital, Kocaeli, Turkey
| | - O Gunal
- Department of Infectious Diseases and Clinical Microbiology, Samsun Training and Research Hospital, Samsun, Turkey
| | - F Sirmatel
- School of Medicine, Department of Infectious Diseases and Clinical Microbiology, Abant Izzet Baysal University, Bolu, Turkey
| | - O R Sipahi
- Department of Infectious Diseases and Clinical Microbiology, Ege University School of Medicine, Izmir, Turkey
| | - S N Alpat
- Department of Infectious Diseases and Clinical Microbiology, Osmangazi University School of Medicine, Eskisehir, Turkey
| | - G Ertem-Tuncer
- Department of Infectious Diseases and Clinical Microbiology, Ankara Training and Research Hospital, Ankara, Turkey
| | - H Sozen
- Department of Infectious Diseases and Clinical Microbiology, Mugla Sitki Kocman University School of Medicine, Mugla, Turkey
| | - O Evlice
- Department of Infectious Diseases and Clinical Microbiology, Dr. Lutfi Kirdar Training and Research Hospital, Istanbul, Turkey
| | - M Meric-Koc
- Department of Infectious Diseases and Clinical Microbiology, Kocaeli University School of Medicine, Izmit, Turkey
| | - A Dogru
- Goztepe Training and Research Hospital, Department of Infectious Diseases and Clinical Microbiology, Medeniyet University, Istanbul, Turkey
| | - V Koksaldi-Motor
- Tayfur Ata Sokmen School of Medicine, Department of Infectious Diseases and Clinical Microbiology, Mustafa Kemal University, Hatay, Turkey
| | - R Tekin
- Department of Infectious Diseases and Clinical Microbiology, Dicle University School of Medicine, Diyarbakir, Turkey
| | - D Ozdemir
- Department of Infectious Diseases and Clinical Microbiology, Duzce University School of Medicine, Konuralp, Duzce, Turkey
| | - D Ozturk-Engin
- Department of Infectious Diseases and Clinical Microbiology, Haydarpasa Numune Training and Research Hospital, Istanbul, Turkey
| | - U Savasci
- Department of Infectious Diseases and Clinical Microbiology, Gulhane Medical Academy, Ankara, Turkey
| | - E Karagoz
- Department of Infectious Diseases and Clinical Microbiology, Military Hospital, Van, Turkey
| | - Y Cekli
- Department of Infectious Diseases and Clinical Microbiology, Gulhane Medical Academy, Ankara, Turkey
| | - A Inan
- Department of Infectious Diseases and Clinical Microbiology, Haydarpasa Numune Training and Research Hospital, Istanbul, Turkey
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7
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Erdem H, Elaldi N, Batirel A, Aliyu S, Sengoz G, Pehlivanoglu F, Ramosaco E, Gulsun S, Tekin R, Mete B, Balkan II, Sevgi DY, Giannitsioti E, Fragou A, Kaya S, Cetin B, Oktenoglu T, DoganCelik A, Karaca B, Horasan ES, Ulug M, Inan A, Kaya S, Arslanalp E, Ates-Guler S, Willke A, Senol S, Inan D, Guclu E, Tuncer-Ertem G, Meric-Koc M, Tasbakan M, Senbayrak S, Cicek-Senturk G, Sırmatel F, Ocal G, Kocagoz S, Kusoglu H, Guven T, Baran AI, Dede B, Yilmaz-Karadag F, Kose S, Yilmaz H, Aslan G, ALGallad DA, Cesur S, El-Sokkary R, Bekiroğlu N, Vahaboglu H. Comparison of brucellar and tuberculous spondylodiscitis patients: results of the multicenter "Backbone-1 Study". Spine J 2015; 15:2509-17. [PMID: 26386176 DOI: 10.1016/j.spinee.2015.09.024] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/01/2015] [Revised: 08/24/2015] [Accepted: 09/03/2015] [Indexed: 02/09/2023]
Abstract
BACKGROUND CONTEXT No direct comparison between brucellar spondylodiscitis (BSD) and tuberculous spondylodiscitis (TSD) exists in the literature. PURPOSE This study aimed to compare directly the clinical features, laboratory and radiological aspects, treatment, and outcome data of patients diagnosed as BSD and TSD. STUDY DESIGN A retrospective, multinational, and multicenter study was used. PATIENT SAMPLE A total of 641 (TSD, 314 and BSD, 327) spondylodiscitis patients from 35 different centers in four countries (Turkey, Egypt, Albania, and Greece) were included. OUTCOME MEASURES The pre- and peri- or post-treatment spinal deformity and neurologic deficit parameters, and mortality were carried out. METHODS Brucellar spondylodiscitis and TSD groups were compared for demographics, clinical, laboratory, radiological, surgical interventions, treatment, and outcome data. The Student t test and Mann-Whitney U test were used for group comparisons. Significance was analyzed as two sided and inferred at 0.05 levels. RESULTS The median baseline laboratory parameters including white blood cell count, C-reactive protein, and erythrocyte sedimentation rate were higher in TSD than BSD (p<.0001). Prevertebral, paravertebral, epidural, and psoas abscess formations along with loss of vertebral corpus height and calcification were significantly more frequent in TSD compared with BSD (p<.01). Surgical interventions and percutaneous sampling or abscess drainage were applied more frequently in TSD (p<.0001). Spinal complications including gibbus deformity, kyphosis, and scoliosis, and the number of spinal neurologic deficits, including loss of sensation, motor weakness, and paralysis were significantly higher in the TSD group (p<.05). Mortality rate was 2.22% (7 patients) in TSD, and it was 0.61% (2 patients) in the BSD group (p=.1). CONCLUSIONS The results of this study show that TSD is a more suppurative disease with abscess formation requiring surgical intervention and characterized with spinal complications. We propose that using a constellation of constitutional symptoms (fever, back pain, and weight loss), pulmonary involvement, high inflammatory markers, and radiological findings will help to differentiate between TSD and BSD at an early stage before microbiological results are available.
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Affiliation(s)
- Hakan Erdem
- Department of Infectious Diseases and Clinical Microbiology, Gulhane Medical Academy, Ankara, Turkey.
| | - Nazif Elaldi
- Department of Infectious Diseases and Clinical Microbiology, Cumhuriyet University School of Medicine, Sivas, Turkey
| | - Ayse Batirel
- Department of Infectious Diseases and Clinical Microbiology, Dr. Lutfi Kirdar Training and Research Hospital, Istanbul, Turkey
| | - Sani Aliyu
- Clinical Microbiology and Public Health Laboratory, Cambridge University Hospitals Foundation Trust, Addenbrooke's Hospital, Cambridge, UK
| | - Gonul Sengoz
- Department of Infectious Diseases and Clinical Microbiology, Haseki Training and Research Hospital, Istanbul, Turkey
| | - Filiz Pehlivanoglu
- Department of Infectious Diseases and Clinical Microbiology, Haseki Training and Research Hospital, Istanbul, Turkey
| | - Ergys Ramosaco
- University Hospital Center "Mother Teresa", Infectious Diseases Hospital, Tirana, Albania
| | - Serda Gulsun
- Department of Infectious Diseases and Clinical Microbiology, Diyarbakir Training and Research Hospital, Diyarbakir, Turkey
| | - Recep Tekin
- Department of Infectious Diseases and Clinical Microbiology, Dicle University School of Medicine, Diyarbakir, Turkey
| | - Birgul Mete
- Department of Infectious Diseases and Clinical Microbiology, Istanbul University Cerrahpasa School of Medicine, Istanbul, Turkey
| | - Ilker Inanc Balkan
- Department of Infectious Diseases and Clinical Microbiology, Istanbul University Cerrahpasa School of Medicine, Istanbul, Turkey
| | - Dilek Yildiz Sevgi
- Department of Infectious Diseases and Clinical Microbiology, Sisli Etfal Training and Research Hospital, Istanbul, Turkey
| | - Efthymia Giannitsioti
- Department of Internal Medicine, Athens University Medical School, Attikon University General Hospital, Athens, Greece
| | - Archontoula Fragou
- Department of Internal Medicine, Athens University Medical School, Attikon University General Hospital, Athens, Greece
| | - Selcuk Kaya
- Department of Infectious Diseases and Clinical Microbiology, Karadeniz Technical University School of Medicine, Trabzon, Turkey
| | - Birsen Cetin
- Department of Infectious Diseases and Clinical Microbiology, Koc University School of Medicine, Istanbul, Turkey
| | - Tunc Oktenoglu
- Department of Neurosurgery, Koc University School of Medicine, Istanbul, Turkey
| | - Aygul DoganCelik
- Department of Infectious Diseases and Clinical Microbiology, Trakya University School of Medicine, Edirne, Turkey
| | - Banu Karaca
- Department of Infectious Diseases and Clinical Microbiology, Izmir Bozyaka Training and Research Hospital, Izmir, Turkey
| | - Elif Sahin Horasan
- Department of Infectious Diseases and Clinical Microbiology, Mersin University School of Medicine, Mersin, Turkey
| | - Mehmet Ulug
- Department of Infectious Diseases and Clinical Microbiology, Private Umit Hospital, Eskisehir, Turkey
| | - Asuman Inan
- Department of Infectious Diseases and Clinical Microbiology, Haydarpasa Numune Training and Research Hospital, Istanbul, Turkey
| | - Safak Kaya
- Department of Infectious Diseases and Clinical Microbiology, Diyarbakir Training and Research Hospital, Diyarbakir, Turkey
| | - Esra Arslanalp
- Department of Infectious Diseases and Clinical Microbiology, Kocaeli University School of Medicine, Kocaeli, Turkey
| | - Selma Ates-Guler
- Department of Infectious Diseases and Clinical Microbiology, School of Medicine, Sutcu Imam University, Kahramanmaras, Turkey
| | - Ayse Willke
- Department of Infectious Diseases and Clinical Microbiology, Kocaeli University School of Medicine, Kocaeli, Turkey
| | - Sebnem Senol
- Department of Infectious Diseases and Clinical Microbiology, School of Medicine, Celal Bayar University, Manisa, Turkey
| | - Dilara Inan
- Department of Infectious Diseases and Clinical Microbiology, Akdeniz University School of Medicine, Antalya, Turkey
| | - Ertugrul Guclu
- Department of Infectious Diseases and Clinical Microbiology, Sakarya University School of Medicine, Sakarya, Turkey
| | - Gunay Tuncer-Ertem
- Department of Infectious Diseases and Clinical Microbiology, Ankara Training and Research Hospital, Ankara, Turkey
| | - Meliha Meric-Koc
- Department of Infectious Diseases and Clinical Microbiology, Kocaeli University School of Medicine, Kocaeli, Turkey
| | - Meltem Tasbakan
- Department of Infectious Diseases and Clinical Microbiology, Ege University School of Medicine, Izmir, Turkey
| | - Seniha Senbayrak
- Department of Infectious Diseases and Clinical Microbiology, Haydarpasa Numune Training and Research Hospital, Istanbul, Turkey
| | - Gonul Cicek-Senturk
- Department of Infectious Diseases and Clinical Microbiology, Diskapi Yildirim Beyazit Training & Research Hospital, Ankara, Turkey
| | - Fatma Sırmatel
- Department of Infectious Diseases and Clinical Microbiology, Izzet Baysal University School of Medicine, Bolu, Turkey
| | - Gulfem Ocal
- Department of Infectious Diseases and Clinical Microbiology, Dr. Lutfi Kirdar Training and Research Hospital, Istanbul, Turkey
| | - Sesin Kocagoz
- Department of Infectious Diseases and Clinical Microbiology, Acibadem University School of Medicine, Istanbul, Turkey
| | - Hulya Kusoglu
- Department of Infectious Diseases and Clinical Microbiology, Acibadem University School of Medicine, Istanbul, Turkey
| | - Tumer Guven
- Department of Infectious Diseases and Clinical Microbiology, Ankara Atatürk Training & Research Hospital, Ankara, Turkey
| | - Ali Irfan Baran
- Department of Infectious Diseases and Clinical Microbiology, Yuzuncuyil University School of Medicine, Van, Turkey
| | - Behiye Dede
- Department of Infectious Diseases and Clinical Microbiology, Umraniye Training and Research Hospital, Istanbul, Turkey
| | - Fatma Yilmaz-Karadag
- Department of Infectious Diseases and Clinical Microbiology, Medeniyet University, Goztepe Training and Research Hospital, Istanbul, Turkey
| | - Sukran Kose
- Department of Infectious Diseases and Clinical Microbiology, Tepecik Training and Research Hospital, Izmir, Turkey
| | - Hava Yilmaz
- Department of Infectious Diseases and Clinical Microbiology, Ondokuz Mayis University School of Medicine, Samsun, Turkey
| | - Gonul Aslan
- Department of Infectious Diseases and Clinical Microbiology, Diskapi Yildirim Beyazit Training & Research Hospital, Ankara, Turkey
| | - D Ashraf ALGallad
- Infection Control Unit, Zagazig University Hospitals, Az Zagazig, Egypt
| | - Salih Cesur
- Department of Infectious Diseases and Clinical Microbiology, Ankara Training and Research Hospital, Ankara, Turkey
| | - Rehab El-Sokkary
- Infection Control Unit, Zagazig University Hospitals, Az Zagazig, Egypt
| | - Nural Bekiroğlu
- Department of Biostatistics, School of Medicine, Marmara University, Istanbul, Turkey
| | - Haluk Vahaboglu
- Department of Infectious Diseases and Clinical Microbiology, Medeniyet University, Goztepe Training and Research Hospital, Istanbul, Turkey
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