Publications by authors named "Akova M"

Chronic granulomatous disease (CGD) is a congenital disorder impairing phagocyte function, causing recurrent, life-threatening infections, and is rarely seen in adulthood. We present a 36-year-old male initially diagnosed with pneumonia. Bronchoalveolar lavage and blood cultures yielded complex, sputum cultures .

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  • - The study examines the use of antimicrobial prophylaxis (AMP) in haematological patients, particularly those at high risk for bacterial infections due to prolonged neutropenia after chemotherapy, amidst the rise of multi-drug resistant Gram-negative bacteria (MDR-GNB).
  • - A survey conducted with 120 haematology centers across 28 European countries revealed that most centers (86.7%) routinely screen for MDR-GNB, with a significant number (39.2%) using fluoroquinolones for prophylaxis.
  • - While bloodstream infections (BSI) rates were slightly lower in patients receiving AMP, the overall increase in MDR-GNB infections highlights the need for improved antimicrobial stewardship and tailored prophylactic strategies.
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Objectives: COVID-19 unravelled new ethical issues in the neglected field of infectious diseases ethics (IDE). We investigated IDE involvement among infectious diseases professionals.

Methods: A global survey was disseminated during 2021-2022.

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Although occult fungal, viral, and multidrug-resistant bacterial infections can cause persistent fever in neutropenic patients with hematologic cancer, a variety of noninfectious entities should be considered on a case-by-case basis in the context of negative diagnostic workup for infection.

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  • A study was conducted on 227 febrile neutropenia (FN) patients to assess how a local guideline and a computerized decision support system (CDSS) affected the quality of treatment from April 2016 to January 2019.
  • The results showed a significant increase in appropriate empirical antibacterial treatment from 58.3% to 88.1% after the guideline's implementation, along with a reduced need for treatment escalation (49.5% to 35.3%).
  • Furthermore, the CDSS performed similarly to consulting physicians in recommending appropriate treatment, indicating its effectiveness in aligning with local treatment protocols.
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Background: There has been an unprecedented increase in the number of immunocompromised (IC) patients in clinical practice due to various reasons. Bacterial infections are a major cause of morbidity and mortality in this population. Emerging antibacterial resistance poses a significant challenge for prophylaxis and treatment.

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  • * The optimal treatment for certain resistant infections is ceftazidime/avibactam, with other alternatives like imipenem/cilastatin/relebactam and meropenem/vaborbactam serving as backup options, especially for KPC-positive cases.
  • * Emerging treatment strategies involve using combinations such as ceftazidime/avibactam with aztreonam for tougher infections, while AI-driven risk models can help predict infection risks in vulnerable patients.
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Objectives: We aimed to evaluate the prevalence and perception of scientific misconduct in infectious diseases (ID) and clinical microbiology (CM), as reported by the ID/CM community.

Methods: An anonymous online European Society of Clinical Microbiology and Infectious Diseases survey circulated among society members from October 2023 to June 2024; the questionnaire included data on participants' views on their own and their colleagues' scientific misconduct in the last 5 years.

Results: The survey received 220 responses.

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Introduction: Despite antifungal advancements, candidaemia still has a high mortality rate of up to 40%. The ECMM Candida III study in Europe investigated the changing epidemiology and outcomes of candidaemia for better understanding and management of these infections.

Methods: In this observational cohort study, participating hospitals enrolled the first ten consecutive adults with blood culture-proven candidemia.

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Objectives: To assess the safety and immunogenicity of a fourth vaccination (second booster) in individuals aged ≥75 years.

Methods: Participants were randomized to BNT162b2 (Comirnaty, 30 µg) or messenger RNA (mRNA)-1273 (Spikevax, 100 µg). The primary end point was the rate of two-fold antibody titer increase 14 days after vaccination, targeting the receptor binding domain (RBD) region of wild-type SARS-CoV-2.

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Background: Carbapenem-resistant Enterobacterales (CRE) bloodstream infections (BSIs) are a major threat to patients. To date, data on risk factors have been limited, with low internal and external validity. In this multicentre study, risk factors for CRE BSI were determined by comparison with two control groups: patients with carbapenem-susceptible Enterobacterales (CSE) BSI, and patients without Enterobacterales infection (uninfected patients).

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, a notable drug-resistant bacterium, often induces severe infections in healthcare settings, prompting a deeper exploration of treatment alternatives due to escalating carbapenem resistance. This study meticulously examined clinical, microbiological, and molecular aspects related to in-hospital mortality in patients with carbapenem-resistant . (CRAB) bloodstream infections (BSIs).

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Background: Hospital-acquired bloodstream infections are common in the intensive care unit (ICU) and have a high mortality rate. Patients with cirrhosis are especially susceptible to infections, yet there is a knowledge gap in the epidemiological distinctions in hospital-acquired bloodstream infections between cirrhotic and non-cirrhotic patients in the ICU. It has been suggested that cirrhotic patients, present a trend towards more gram-positive infections, and especially enterococcal infections.

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This large, multicenter, retrospective cohort study including onco-hematological neutropenic patients with bloodstream infection (PABSI) found that among 1213 episodes, 411 (33%) presented with septic shock. The presence of solid tumors (33.3% vs.

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  • The document outlines the goal of creating standardized research definitions for invasive fungal diseases (IFD) in adult ICU patients without typical risk factors for these infections.
  • A panel of experts assessed existing definitions and lab tests for IFD, using the RAND/UCLA method to reach a consensus on new definitions.
  • Key standardized definitions were made for conditions like invasive candidiasis and aspergillosis, but more data is needed for other IFDs, with the intent to enhance future research studies.
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Purpose: The primary objective of this study was to evaluate the associations between centre/country-based factors and two important process and outcome indicators in patients with hospital-acquired bloodstream infections (HABSI).

Methods: We used data on HABSI from the prospective EUROBACT-2 study to evaluate the associations between centre/country factors on a process or an outcome indicator: adequacy of antimicrobial therapy within the first 24 h or 28-day mortality, respectively. Mixed logistical models with clustering by centre identified factors associated with both indicators.

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Objectives: To assess the mortality attributable to infections caused by carbapenem-resistant Enterobacterales (CRE) and to investigate the effect of clinical management on differences in observed outcomes in a multinational matched cohort study.

Methods: A prospective matched-cohorts study (NCT02709408) was performed in 50 European hospitals from March 2016 to November 2018. The main outcome was 30-day mortality with an active post-discharge follow-up when applied.

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Underserved and hard-to-reach population groups are under-represented in vaccine trials. Thus, we aimed to identify the challenges of vaccine trial participation of these groups in member countries of the VACCELERATE network. Seventeen National Coordinators (NC), each representing their respective country (15 European countries, Israel, and Turkey), completed an online survey.

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Background: Vaccination remains crucial for protection against severe SARS-CoV-2 infection, especially for people of advanced age, however, optimal dosing regimens are as yet lacking.

Methods: EU-COVAT-1-AGED Part A is a randomised controlled, adaptive, multicentre phase II trial evaluating safety and immunogenicity of a 3rd vaccination (1st booster) in individuals ≥75 years. Fifty-three participants were randomised to full-doses of either mRNA-1273 (Spikevax®, 100 µg) or BNT162b2 (Comirnaty®, 30 µg).

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Patients can be immunocompromised from a diverse range of disease and treatment factors, including malignancies, autoimmune disorders and their treatments, and organ and stem-cell transplantation. Infections are a leading cause of morbidity and mortality in immunocompromised patients, and the disease treatment landscape is continually evolving. Despite being a critical but preventable and curable adverse event, the reporting of infection events in randomised trials lacks sufficient detail while inconsistency of categorisation and definition of infections in observational and registry studies limits comparability and future pooling of data.

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Article Synopsis
  • Cefiderocol is effective against carbapenem-resistant bacteria, but its susceptibility varies based on different interpretive criteria from EUCAST and CLSI.
  • Researchers tested 254 CRK blood isolates and found significant differences in resistance rates to cefiderocol when applying EUCAST versus CLSI criteria.
  • High cefiderocol resistance rates were especially noted among NDM producers using EUCAST guidelines, leading to the recommendation that these criteria should be prioritized for testing until more clinical data is available.
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