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The gastrointestinal tract serves as a major viral reservoir in HIV infection, and persistent gut dysbiosis contributes to systemic inflammation and immune dysfunction despite effective antiretroviral therapy (ART). Integrase strand transfer inhibitor (INSTI)-based regimens are now preferred for their efficacy and tolerability; however, their impact on gut microbial restoration remains underexplored. This study analyzed fecal microbiota composition in 30 HIV-positive adults-10 ART-naïve, 7 receiving INSTI-based ART for <2 years, and 13 receiving INSTI-based ART for 2-5 years. 16S rRNA gene sequencing of stool samples (V3-V4 regions) was performed to evaluate bacterial diversity and taxonomic shifts. Microbial composition was compared across groups and correlated with CD4 T cell counts. Alpha diversity showed a non-significant yet progressive increase from ART-naïve to long-term INSTI-treated patients, suggesting partial restoration of microbial diversity. At the phylum level, Firmicutes increased and Bacteroidetes decreased in treated groups, indicating a shift toward eubiosis. Long-term INSTI therapy enriched beneficial taxa such as and , while reducing pro-inflammatory and . Moreover, higher CD4 T cell counts showed a positive correlation with the abundance of short-chain fatty acid-producing bacteria and with an increased Firmicutes/Bacteroidetes ratio, indicating improved mucosal integrity and immune homeostasis. Integrase inhibitor-based ART promotes partial normalization of gut microbiota composition in HIV-infected patients, enhancing beneficial taxa linked to immune recovery. These findings underscore the potential of microbiota-targeted adjunctive interventions-such as probiotics or dietary modulation-to support mucosal immunity and long-term health in people living with HIV.

Introduction: The primary aim of this study was to evaluate whether there was a difference between outpatient parenteral antibiotic therapy (OPAT) and inpatient parenteral antibiotic therapy (IPAT) costs of ertapenem for urinary tract infections (UTI\"s) due to extended-spectrum beta-lactamase (ESBL)-producing Gram-negative bacilli, and to discuss suitability of ertapenem for OPAT programme of Turkey for the near future. Materials and Methods: A total of 53 patients hospitalized with the diagnosis of UTI and treated with ertapenem were retrospectively evaluated. The cost of ertapenem treatment as IPAT was actual costs retrieved from the hospital records. The estimated cost of the same antibiotic for the same patients as an OPAT programme was then calculated and the costs were compared. Results: The cost difference between IPAT and OPAT was 12.305 (€ 5783). Outpatient parenteral antibiotic therapy programme would provide an estimated 20% reduction in treatment costs. The estimated number of bed days saved, if the patients had received the treatment as OPAT, was calculated to be 583 days, which constitutes about 5% of the total number of hospitalization days. Conclusion: Applying ertapenem therapy through OPAT programme for UTIs caused by ESBL-producing Gram-negative bacilli will decrease the financial burden of health expenditures and the number of inpatient bed days in Turkey.

Introduction: The incidence of Gram-negative bacterial meningitis (GNBM) has increased with the growing number of neurosurgical procedures. Concurrently, global antimicrobial resistance, particularly among Gram-negative pathogens causing healthcare-associated infections, has contributed to high morbidity and mortality. This study aimed to identify clinical and laboratory parameters associated with mortality in post-neurosurgical GNBM (PN-GNBM). Methodology: This retrospective study included adult patients who developed GNBM at least 48 hours after a neurosurgical procedure in the intensive care unit of a tertiary hospital between January 2019 and March 2024. Clinical findings and laboratory results before and at the time of diagnosis were obtained from the hospital information system. The factors associated with all-cause 28-day mortality were evaluated. Statistical analyses were performed using SPSS version 19, with p < 0.05 considered statistically significant. Results: A total of 21 PN-GNBM patients were included. The 28-day mortality rate was 60%. Evaluation of peripheral blood leukocyte ratios at the time of diagnosis revealed that a low lymphocyte-to-platelet ratio (LPR) significantly predicted mortality on days 7, 14, and 21 (p = 0.046, 0.003, and 0.005, respectively), whereas a high neutrophil-to-lymphocyte ratio (NLR) predicted 14-day mortality (p = 0.035). Acinetobacter baumannii was the most frequently isolated pathogen with 81.81% carbapenem resistance rate. Conclusions: NLR and LPR are inexpensive and readily accessible biomarkers that may support early mortality prediction and risk stratification in PN-GNBM. These preliminary findings should be validated in larger multicenter studies.

Objectives There are limited data about nosocomial coinfections of COVID-19 cases monitored in the intensive care unit. This study aims to investigate coinfections in COVID-19 patients followed in an intensive care unit of a university hospital. Methods This study analyzed retrospectively the data of coinfections of 351 COVID-19 patients in the period 28.02.2020–15.01.2021 in a tertiary care intensive care unit in a university hospital. Results Bacterial coinfections were present in 216 of the 351 cases. One hundred and thirty of these cases were evaluated as nosocomial infections. On the third day the Sequential Organ Failure Assessment Score, usage of invasive mechanical ventilation and presence of septic shock were significantly higher in the coinfected group. The neutrophil/lymphocyte ratio, polymorphonuclear leukocyte count, procalcitonin, ferritin, and blood urea nitrogen values were significantly higher in the coinfection group. White blood cells (WBC) (OR: 1.075, 95% CI 1.032–1.121, p  = 0.001) and ICU hospitalization day (OR: 1.114, 95% CI 1.063–1.167, p  < 0.001) were found to be independent risk factors for coinfection in the multivariate logistic regression analysis. The rates of hospitalization day on the day of arrival, the 21st day, as well as total mortality ( p  = 0.004), were significantly higher in the coinfected group. Conclusion Bacterial coinfections of COVID-19 patients in the intensive care unit remain a problem. Identifying the infectious agent, classifying colonizations and infections, and using the proper treatment of antibiotics are of great importance in the case management of COVID-19 patients in the intensive care unit.

Atypical measles has been described in persons who were exposed to wild measles virus several years after they were immunized with killed measles vaccine. Occasionally, it can be caused by live measles vaccines also. It is a clinical picture different from typical measles. In this report, an adult patient with a history of immunization, who presented with high fever, maculopapular rash starting at the palms and soles, and pneumonia, is presented. Atypical measles that was first reported in the 1970s in mostly kids should be considered for differential diagnosis in adult cases presenting with high fever, atypical rash and pneumonia even if patients have a history of immunization

Background Herein, we analyzed the efficacy of main antibiotic therapy regimens in the treatment of healthcare-associated meningitis (HCAM). Materials/methods This retrospective cohort study was conducted in 18 tertiary-care academic hospitals Turkey, India, Egypt and Romania. We extracted data and outcomes of all patients with post-neurosurgical meningitis cases fulfilling the study inclusion criteria and treated with empirical therapy between December 2006-September 2018. Results Twenty patients in the cefepime + vancomycin-(CV) group, 31 patients in the ceftazidime + vancomycin-(CFV) group, and 119 patients in the meropenem + vancomycin-(MV) group met the inclusion criteria. The MV subgroup had a significantly higher mean Glasgow Coma Score, a higher rate of admission to the intensive care unit within the previous month, and a higher rate of antibiot herapy within the previous month before the meningitis episode ( p  < 0.05). Microbiological success on Day 3–5, end of treatment (EOT) clinical success (80% vs. 54.8%% vs 57.9%), and overall success (EOT success followed by one-month survival without relapse or reinfection 65% vs. 51.6% vs. 45.3%), EOT all cause mortality (ACM) and day 30 ACM (15% vs. 22.6% vs. 26%) did not differ significantly ( p  > 0.05) among the three cohorts. No regimen was effective against carbapenem-resistant bacteria, and vancomycin resulted in an EOT clinical success rate of 60.6% in the methicillin-resistant staphylococci or ampicillin-resistant enterococci subgroup ( n  = 34). Conclusions Our study showed no significant difference in terms of clinical success and mortality among the three treatment options. All regimens were ineffective against carbapenem-resistant bacteria. Vancomycin was unsuccessful in approximately 40% of cases involving methicillin-resistant staphylococci or ampicillin-resistant enterococci.