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    Distribution of the Prevalence of Human Leukocyte Antigen (HLA)-B*57:01 Positivity in HIV-1 Infected Individuals and Its Effects on Treatment: Türkiye Map-Buhasder Working Group
    (Ankara Microbiology Soc, 2024) Buyuktuna, Seyit Ali; Öksüz, Caner; Tahmaz, Alper; Sarigul Yildirim, Figen; Turken, Melda; Gunal, Ozgur; Topal, Seyma
    Human immunodeficiency virus (HIV)/acquired immundeficiency syndrome (AIDS) is a critical global public health problem that significantly affects both life expectancy and the overall quality of life of in dividuals in all age groups. The landscape of HIV infection has changed significantly in recent years due to the introduction of effective combination antiretroviral therapies (ART). A key component of first -line ART regimens for HIV treatment is abacavir, a nucleoside HIV reverse transcriptase inhibitor. Although ab acavir is effective in suppressing viral replication and managing disease, its clinical utility is overshadowed by the potential for life -threatening hypersensitivity reactions in HLA-B*57:01-positive patients. In our country, local data obtained from various centers regarding the prevalence of HLA-B*57:01 in HIV -1 -infected patients are available. In this study, it was aimed to determine the prevalence of the HLA-B*57:01 genotype in HIV -infected patients who were followed up and treated in many regions of our country. This retrospective study consists of the data of the patients aged 18 years and over diagnosed with HIV -1 infection between 01.01.2019 and 31.07.2022. Age, gender, place of birth, mode of transmission of the disease, death status, CD4+ T cell count and HIV RNA levels at the first clinical presentation, HLA-B*57:01 positivity, and the method used, clinical stage of the disease, virological response time with the treatment they received were recorded from the patient files. Data were collected from 16 centers and each center used different methods to detect HLA-B*57:01. These methods were sequence -specific oligonucleotide probe hybridization (SSOP), DNA sequence -based typing (SBT), single -specific primer-polymerase chain reaction (SSP-PCR), allele -specific PCR (AS-PCR) and quantitative PCR (Q-PCR). A total of 608 HIV -infected individuals, 523 males (86%) and 85 females (14%), were included in the study. The mean age of the patients was 36.9 +/- 11.9 (18-73) years. The prevalence of HLA-B*57:01 allele was found to be 3.6% (22 patients). The number of CD4+ T lymphocytes in HLA-B*57:01 allele -positive patients was > 500/ mm(3) in 10 patients (45.5%), while the number of CD4+ T lymphocytes in HLA-B*57:01 negative pa- tients was > 500/mm(3) in 216 patients (36.9%) (p> 0.05). Viral load at the time of diagnosis was found to be lower in patients with positive HLA-B*57:01 allele but it was not statistically significant (p> 0.05). Although different treatment algorithms were used in the centers following the patients, it was observed that the duration of virological response was shorter in HLA-B*57:01 positive patients (p= 0.006). Although the presence of the HLA-B*57:01 allele has a negative impact due to its association with hypersensitivity, it is likely to continue to attract interest due to its association with slower progression of HIV infection and reduced risk of developing AIDS. In addition, although the answer to the question of whether it is cost-effective to screen patients for HLA-B*57:01 before starting an abacavir-containing ART regimen for the treatment of HIV infection is being sought, it seems that HIV treatment guidelines will continue to recommend screening to identify patients at risk in this regard.
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    Paravertebral Abscess and Spondylodiscitis due to Streptococcus agalactiae after Transrectal Prostate Biopsy
    (Düzce Üniversitesi, 2019) Alkan Çeviker, Sevil; Tahmaz, Alper
    Streptococcus agalactiae, is the species designation for streptococci belonging to Lancefied group B and are facultative, gram-positive diplococci. In the previous years, it was known as urinary tract infection agent in pregnant women, it was rarely detected in other infections in adults. Nowadays, S. agalactiae is increasingly recognized as a cause of invasive infections such as bacteraemia without any focus, skin and soft tissue infections, upper respiratory tract infections, osteoarticular infections, peritonitis, cardiac infections, meningitis and other focal infections among non-pregnant adults, especially in the elderly and immunocompromised patients. Although rare in the literature, osteoarticular infections caused by S. agalactiae have been reported in adults. In this case report, we aimed to present a patient with iatrogenic spondylodiscitis due to S. agalactiae after ultrasound-guided transrectal prostate needle biopsy.
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    Sürekli Ayaktan Periton Diyalizi Hastasında Gelişen Siprofloksasinle Tedavi Edilen Chryseobacterium indologenes Peritoniti: Olgu Sunumu
    (Düzce Üniversitesi, 2019) Alkan Çeviker, Sevil; Günal, Özgür; Kılıç, Süleyman Sırrı; Tahmaz, Alper
    Sürekli ayaktan periton diyalizi (SAPD) alan hastalarda peritonit, artan hastane ve antibiyotik maliyetleri ile bu hastalarda mortalite ve morbiditenin en önemli nedenlerinden biridir. Peritonit vakalarının çoğuna Gram pozitif bakteriler neden olmasına rağmen, bazen beklenmeyen mikroorganizmalar peritonite neden olabilir. Chryseobacterium indologenes, insan florasının doğada yaygın olarak bulunan bir üyesidir ve nadiren insan enfeksiyonlarına neden olur. Bu olgu sunumunda, iki yıldır SAPD alan Chryseobacterium indologenes’e bağlı peritonitli 68 yaşında erkek hastanın sunulması amaçlanmıştır. Hasta intravenöz ilaveten intraperitoneal siprofloksasin tedavisine iyi cevap verdi. Bu durumda, periton diyalizi kateterinin çıkarılmasına gerek kalmadı. Chryseobacterium indologenes SAPD ile ilişkili, oldukça nadir görülen bir peritonit nedenidir. Bu mikroorganizma kaynaklı peritonit, periton kateterinin çekilmesine gerek kalmadan intravenöz artı intraperitoneal antibiyotiklerle başarılı bir şekilde tedavi edilebilir.