Bacillus cereus is a bacterium capable of causing late-onset neonatal sepsis. By analyzing 11 cases, this study investigates the diagnosis, treatment, and prognosis of Bacillus cereus infections, aiming to provide insights into clinical diagnosis and therapy. The study scrutinized 11 instances of late-onset neonatal sepsis, including two fatalities attributable to Bacillus cereus, one accompanied by cerebral hemorrhage. An examination and analysis of these cases\' symptoms, signs, laboratory tests, and treatment processes, along with a review of related literature from 2010 to 2020, revealed a high mortality rate of 41.38% in non-gastrointestinal infections caused by Bacillus cereus. Our findings underscore the critical importance of rapid diagnosis and effective antimicrobial therapy in reducing mortality rates. Once the source of infection is identified, implementing effective infection control measures is essential.

Staphylococcus lugdunensis is a gram-positive, coagulase-negative organism, typically found in the normal skin flora, predominantly colonizing the perineal region. It has gained recognition as an opportunistic pathogen capable of causing severe infections. This manuscript presents a case study of a 75-year-old female with multiple comorbidities, including hypertension, hyperlipidemia, atrial fibrillation on Xarelto, type 2 diabetes mellitus, hypothyroidism, and a bioprosthetic aortic valve. The patient exhibited symptoms of fever, chills, and lethargy following a dog scratch that resulted in wounds on the left lower extremity. Despite initial negative findings in the drug screen and unremarkable workup for other infectious etiologies, the patient\'s clinical course revealed the presence of S. lugdunensis in the blood cultures. Timely intervention with broad-spectrum intravenous antibiotics and a six-week course of cefazolin led to significant improvement without recurrence. Staphylococcus lugdunensis, previously considered a relatively benign microorganism, has become a significant player in infectious diseases, particularly causing skin and soft tissue infections and infective endocarditis (IE). It is considered an aggressive pathogen, especially in chronic immunocompromised personnel, with a high potential for morbidity and mortality. S. lugdunensis was found to be the fourth most common cause of IE. The manuscript discusses the epidemiology, clinical presentation, and management of S. lugdunensis infections, emphasizing the importance of early recognition and treatment to prevent potentially fatal outcomes.

暂无摘要。

BACKGROUND: In the era of rising carbapenem resistance, we aimed to investigate the change in mortality rate and positivity of carbapenemase genes in Acinetobacter baumannii.
METHODS: Preferred Reporting Items for Systematic Review (PRISMA) guidelines were adopted in this systematic review. Our literature search included the Cochrane Library, Pubmed, Scopus, Web of Science, Medline, Tubitak TR Dizin, and Harman databases for studies dating back from 2003 to 2023 reporting bloodstream A. baumannii infections in Türkiye. A simple linear regression model was used to determine the association between resistance, mortality, and time.
RESULTS: A total of 1717 studies were identified through a literature search, and 21 articles were selected based on the availability of the data regarding mortality and resistance rate (four articles) or the molecular epidemiology of carbapenem-resistant A. baumannii (17 articles) in Türkiye. From 2007 to 2018, the carbapenem resistance rate increased (p = 0.025). The OXA-23 and OXA-58 positivities were inversely correlated (p = 0.025).
CONCLUSIONS: Despite the emergence of carbapenem resistance, mortality did not increase in parallel, which may be due to improved medical advancements or the fitness cost of bacteria upon prolonged antimicrobial exposure. Therefore, we suggest further global research with the foresight to assess clonal relatedness that might affect the carbapenem resistance rate.

BACKGROUND: The Coronavirus Disease (COVID-19) caused by SARS-CoV-2 infections remains a significant health challenge worldwide. There is paucity of evidence on the influence of the universal health coverage (UHC) and global health security (GHS) nexus on SARS-CoV-2 infection risk and outcomes. This study aimed to investigate the effects of UHC and GHS nexus and interplay on SARS-CoV-2 infection rate and case-fatality rates (CFR) in Africa.
METHODS: The study employed descriptive methods to analyze the data drawn from multiple sources as well used structural equation modeling (SEM) with maximum likelihood estimation to model and assess the relationships between independent and dependent variables by performing path analysis.
RESULTS: In Africa, 100% and 18% of the effects of GHS on SARS-CoV-2 infection and RT-PCR CFR, respectively were direct. Increased SARS-CoV-2 CFR was associated with median age of the national population (β = -0.1244, [95% CI: -0.24, -0.01], P = 0.031 ); COVID-19 infection rate (β = -0.370, [95% CI: -0.66, -0.08], P = 0.012 ); and prevalence of obesity among adults aged 18 + years (β = 0.128, [95% CI: 0.06,0.20], P = 0.0001) were statistically significant. SARS-CoV-2 infection rates were strongly linked to median age of the national population (β = 0.118, [95% CI: 0.02,0.22 ], P = 0.024); population density per square kilometer, (β = -0.003, [95% CI: -0.0058, -0.00059], P = 0.016 ) and UHC for service coverage index (β = 0.089, [95% CI: 0.04,0.14, P = 0.001 ) in which their relationship was statistically significant.
CONCLUSIONS: The study shade a light that UHC for service coverage, and median age of the national population, population density have significant effect on COVID-19 infection rate while COVID-19 infection rate, median age of the national population and prevalence of obesity among adults aged 18 + years were associated with COVID-19 case-fatality rate. Both, UHC and GHS do not emerge to protect against COVID-19-related case fatality rate.

OBJECTIVE: To explore the effects of continuous renal replacement therapy (CRRT) on renal function and toxin clearance in patients with sepsis and concurrent acute kidney injury (AKI).
METHODS: A retrospective analysis was performed using the medical records of 115 patients with sepsis and AKI. Among them, 60 patients received routine treatment (group A) and 55 patients received CRRT plus routine treatment (group B).
RESULTS: After treatment, the clearance rates of serum creatinine, lactic acid, and urea nitrogen were significantly lower in group A than in group B. The decrease in high-sensitivity C-reactive protein and tumor necrosis factor-α levels after treatment was significantly higher in group B than in group A. For the Acute Physiology Chronic Health Evaluation (APACHE) II and Sequential Organ Failure Assessment (SOFA) scores from the two groups, the scores were significantly lower in group B than in group A. The mortality rate within 28 days was significantly higher in group A than in group B.
CONCLUSIONS: CRRT can effectively improve the condition of patients with sepsis and AKI, promote elimination of toxins (serum creatinine, lactic acid, and urea nitrogen) from the body, and reduce the mortality rate.

COVID-19 has become the biggest public health problem and one of the most important causes of death in many countries in the world. SARS-CoV-2 infection is most likely to be fatal in elderly patients with concomitant diseases. In this article we present two cases of asymptomatic SARS-CoV-2-positive patients suffering from cancer who were treated with chemotherapy. The first case, a patient with primary mediastinal B-cell lymphoma, shows that confirmed SARS-CoV-2 infection does not have to be a contraindication to chemotherapy. We describe the course of disease and discuss doubts related to the choice of chemotherapy regimen. The second patient was a male with metastatic sigmoid cancer treated with FOLFOX4 as first-line palliative chemotherapy. This case draws attention to asymptomatic SARS-CoV-2 carriers who underwent chemotherapy. Our patient was safely treated with chemotherapy without long break caused by viral infection. It should be remembered that there are asymptomatic carriers among cancer patients and that they may spread infection to others. On the other hand, delaying chemotherapy can cause rapid disease progression and reduce overall survival of our patients.

OBJECTIVE: COVID-19 has spread worldwide and leads to an increased risk of mortality. We aimed to analyze what actions have been effective in fighting COVID-19 in Turkey with a comparison to pandemic-affected countries.
METHODS: This was a retrospective observational cross-sectional study. The Republic of Turkey Ministry of Health official web page includes data reported daily from 11 March to 26 April. Global COVID-19 data were recorded daily from https://www.worldometers.info/coronavirus/country/. Data were analyzed for 31 days according to Intensive Care Unit (ICU) admission, intubation and mortality rates. Segmented regression analysis was used. The results from COVID-19-affected countries were compared with the results from Turkey for the first 65 days.
RESULTS: In total, 889.742 tests were performed (positive=110.130 [12.37%]). The mortality rate was 2.55% (n=2805) on 27 April 2020. The annual percent change (APC) values of the cases showed 5 segments ([23.1], [14.7] [11.4], [3.7], [0.7]; each p=0.001). ICU admission showed 4 segments (APC: [3.1, p=0.001], [-2.2, p=0.10], [-7.6, p=0.001], [-4.5, p=0.001]). The decline of APC for intubation rates showed 5 segments (APC: [1.1, p=0.10], [-1.1,p=0.001], [-2.0, p=0.001], [-0.4, p=0.40], [-2.7, p=0.001]). The mortality rates showed 4 segments (APC: [-6.3, p=0.001], [8.4, p=0.001], [0.2, p=0.30], [1.4, p=0.001]). Deaths were reported per 1 million individuals for the first 65 days: Spain 11.6%, Italy 11.4%, UK 11.3%, France 11.1%, USA 10.3%, Germany 8.4%, Iran 8.2%, Turkey 7.5%, South Korea 4.1% and China 2.4%.
CONCLUSIONS: Public health policies and protocols to combat COVID-19 helped control the spread and decrease positive cases and mortality rates in Turkey. Turkey managed COVID-19 better than Spain, Italy, UK, France, USA and Turkey managed COVID-19 similarly to Germany and Iran. China and South Korea were best at managing COVID-19.

We compared subgroup differences in COVID-19 case and mortality and investigated factors associated with case and mortality rate (MR) measured at the county level in Mississippi. Findings were based on data published by the Mississippi State Department of Health between March 11 and July 16, 2020. The COVID-19 case rate and case fatality rate (CFR) differed by gender and race, while MR only differed by race. Residents aged 80 years or older and those who live in a non-metro area had a higher case rate, CFR, and MR. After controlling for selected factors, researchers found that the percent of residents who are obese, low income, or with certain chronic conditions were associated with the county COVID-19 case rate, CFR, and/or MR, though some were negatively related. The findings may help the state to identify counties with higher COVID-19 case rate, CFR, and MR based on county demographics and the degree of its chronic conditions.

Many reasons restrict obtaining an accurate estimate of Case Fatality Rate (CFR) and Mortality Rate (MR) by COVID-19. The main concern is the number of infected people and deaths. We aimed to discuss some solutions for accurate estimating of CFR and MR.