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Objectives: The probability of detecting viral and atypical agents in pneumonia patients has increased with the molecular methods used in recent years. We aimed to investigate pneumonia pathogens in endotracheal aspiration samples (ETA) of patients with severe community-acquired (CAP), hospital-acquired pneumonia (HAP), and ventilator-associated pneumonia (VAP) by multiplex polymerase chain reaction (m-PCR) and culture method. Methods: A prospective study was performed between December 2019 and October 2020. Patients 18 years and older with pneumonia followed in ICU on the mechanical ventilator were included. COVID-19 patients were excluded. Patients were grouped as CAP, HAP, and VAP. Two ETA samples were obtained from patients within 48 hours of the pneumonia diagnosis. Respiratory pathogens were investigated in samples by viral-bacterial m-PCR and bacterial culture methods. Results: 74 patients were included in the study. m-PCR of ETA samples achieved pathogen detection in 87.8% of patients compared with 58.1% with culture methods. The most common pathogen detected by m-PCR was Streptococcus pneumoniae in both CAP and HAP patients and Klebsiella spp. in VAP patients. The most common pathogen isolated by culture was Staphylococcus aureus in both CAP and HAP patients and Klebsiella spp. in VAP patients. Atypical pneumonia pathogens were positive for 14.9% of the patients. Atypical pathogens were recovered from 28.5% of CAP patients and 23.1% of HAP patients. Viruses constituted all of the atypical pathogens recovered from HAP patients. No atypical pathogen was found in VAP patients. Conclusion: In this study, S. pneumoniae was the most common pathogen detected with m-PCR, and S. aureus and Klebsiella spp. were the most common pathogens detected with culture. Determination of microbial etiology of lower respiratory tract samples by molecular methods for diagnosing severe CAP and HAP may be beneficial in terms of treatment.
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Objective: We evaluated PCR negativity in oropharyngeal and nasopharyngeal secretions of COVID-19 patients at the end of hydroxychloroquine and/or favipiravir treatments.Methods: Study inclusion criteria were being hospitalized, being older than 18 years, PCR positivity in oropharyngeal and nasopharyngeal secretions and being tested for SARS CoV-2-RNA PCR after treatment. Initially hydroxychloroquine treatment (group 1) was administered to the patients according to COVID-19 guide of Health Ministry. Favipiravir (group 2) alone or in combination with hydroxychloroquine (group 3) was administered to patients who were unresponsive to hydroxychloroquine or had severe pneumonia or were admitted to intensive care unit. Control respiratory specimens were taken no earlier than 24 hours, after the end of therapy. Repeated tests with 24-48-hour intervals were performed in patients with still positive PCR test results. The detection of SARS CoV-2-RNA was made by real-time PCR.Results: The study group included 492 patients who received treatment. Mean duration of symptoms was similar among three groups. PCR negativity rate was 52.8% in the specimens taken 24 hours after the end of treatment. PCR negativity rates was 27.9% (200/492) in 48 hours after the end of treatment, %13.8 (123/492) in 72nd hour and %3.8 (80/492) in 96th hour. The ratios of PCR negativity for all specimen days were similar in three groups. There was no statistically significant difference between the groups for time to PCR negativity from the date of positivity and after the end of treatment. We determined that early or late treatment did not make a difference in terms PCR negativity time.Conclusion: No difference was found in terms of the ratios of PCR negativity or time for negativity in oropharyngeal and/or nasopharyngeal specimens taken after the end of treatment in COVID-19 patients receiving hydroxychloro-quine and/or favipiravir treatment.
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Objective: The COVID-19 outbreak that has spread all around the world is still a threat for humankind. Epidemiological, clinical, laboratory, and radiological features of the disease are enlightened day by day. It was aimed to evaluate the characteristics of children and their parents with COVID-19 to aid in diagnosis and treatment. Material(s) and Method(s): A retrospective review of the medical records of pediatric patients and their parents who were confirmed as COVID-19 positive, between April 23, and May 28, 2020, was conducted. Result(s): A total of 93 children and 81 adults were evaluated in the present study. Asymptomatic and mild cases accounted for 63.5% of the children and 50% of the parents. Of the children, 3.2% had moderate illness, whereas this was 9.8% for the parents There was a statistically significant difference in terms of the severity of illness between the children and their parents (p =0.01). Although it had a milder clinical course in children, one child died. Increased levels of C-reactive protein (CRP) were observed in 8.6% of the children and 48.1% of the patients, and there was statistically significant difference in terms of CRP levels between the children and their parents (p =0.001). Conclusion(s): The clinical, laboratory, and radiological features of COVID-19 showed differences in the children and their parents. It should be kept in mind that COVID-19 can be fatal in children, although the course of the disease appears to be milder in children than in their parentsCopyright © 2023 Ankara Pediatric Hematology Oncology Training and Research Hospital. All rights reserved.
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Objective: We evaluated PCR negativity in oropharyngeal and nasopharyngeal secretions of COVID-19 patients at the end of hydroxychloroquine and/or favipiravir treatments. Method(s): Study inclusion criteria were being hospitalized, being older than 18 years, PCR positivity in oropharyngeal and nasopharyngeal secretions and being tested for SARS CoV-2-RNA PCR after treatment. Initially hydroxychloroquine treatment (group 1) was administered to the patients according to COVID-19 guide of Health Ministry. Favipiravir (group 2) alone or in combination with hydroxychloroquine (group 3) was administered to patients who were unre-sponsive to hydroxychloroquine or had severe pneumonia or were admitted to intensive care unit. Control respiratory specimens were taken no earlier than 24 hours, after the end of therapy. Repeated tests with 24-48-hour intervals were performed in patients with still positive PCR test results. The detection of SARS CoV-2-RNA was made by real-time PCR. Result(s): The study group included 492 patients who received treatment. Mean duration of symptoms was similar among three groups. PCR negativity rate was 52.8% in the specimens taken 24 hours after the end of treatment. PCR negativity rates was 27.9% (200/492) in 48 hours after the end of treatment, %13.8 (123/492) in 72nd hour and %3.8 (80/492) in 96th hour. The ratios of PCR negativity for all specimen days were similar in three groups. There was no statistically significant difference between the groups for time to PCR negativity from the date of positivity and after the end of treatment. We determined that early or late treatment did not make a difference in terms PCR negativity time. Conclusion(s): No difference was found in terms of the ratios of PCR negativity or time for negativity in oropharyngeal and/or nasopharyngeal specimens taken after the end of treatment in COVID-19 patients receiving hydroxychloro-quine and/or favipiravir treatment. Copyright © 2022, DOC Design and Informatics Co. Ltd.. All rights reserved.
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Objectives: The probability of detecting viral and atypical agents in pneumonia patients has increased with the molecular methods used in recent years. We aimed to investigate pneumonia pathogens in endotracheal aspiration samples (ETA) of patients with severe community-acquired (CAP), hospital-acquired pneumonia (HAP), and ventilator-asso-ciated pneumonia (VAP) by multiplex polymerase chain reaction (m-PCR) and culture method. Method(s): A prospective study was performed between December 2019 and October 2020. Patients 18 years and older with pneumonia followed in ICU on the mechanical ventilator were included. COVID-19 patients were excluded. Patients were grouped as CAP, HAP, and VAP. Two ETA samples were obtained from patients within 48 hours of the pneumonia diagnosis. Respiratory pathogens were investigated in samples by viral-bacterial m-PCR and bacterial culture methods. Result(s): 74 patients were included in the study. m-PCR of ETA samples achieved pathogen detection in 87.8% of patients compared with 58.1% with culture methods. The most common pathogen detected by m-PCR was Streptococcus pneumoniae in both CAP and HAP patients and Klebsiella spp. in VAP patients. The most common pathogen isolated by culture was Staphylococcus aureus in both CAP and HAP patients and Klebsiella spp. in VAP patients. Atypical pneumonia pathogens were positive for 14.9% of the patients. Atypical pathogens were recovered from 28.5% of CAP patients and 23.1% of HAP patients. Viruses constituted all of the atypical pathogens recovered from HAP patients. No atypical pathogen was found in VAP patients. Conclusion(s): In this study, S. pneumoniae was the most common pathogen detected with m-PCR, and S. aureus and Kleb-siella spp. were the most common pathogens detected with culture. Determination of microbial etiology of lower respiratory tract samples by molecular methods for diagnosing severe CAP and HAP may be beneficial in terms of treatment. Copyright © 2022, DOC Design and Informatics Co. Ltd.. All rights reserved.
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Contemporary healthcare systems contain diverse computing devices that construct very complex systems to manage patients‘ data more efficiently. Connected computing devices, such as the Internet of Things (IoT) that may have limited processing powers, have contributed more than ever with the advent of wearable body area networks (WBAN). These devices are connected to other medical devices to share sensitive health data with corresponding entities like hospitals, research institutions, and insurance companies. Since health data are very sensitive, they should be always available to authorized entities and unavailable to other entities. Moreover, COVID-19 pandemic has added additional value to health data which case increases cyber-attacks on (Electronic health) E-health systems with different tools dramatically. In this paper, several cyber-attacks on E-health systems are explored. Particularly, we have focused on attacks to IoT based wearable health devices for body area networks. The paper contains the architecture of wearable health devices to show the potential attack surface. One of the main contributions of the paper is to present cyber-attacks on wearable e-health devices with ground robots. A tactical ground robot is portable devices that may be used to carry out several cyber-attacks on E-health systems. Moreover, the paper contains analyses of the attacks with ground robots. © 2021, TUBITAK. All rights reserved.
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Streptococcus intermedius is part of the normal oropharyngeal, genitourinary and gastrointestinal flora, and can cause purulent infections characterized by abscess formation involving the brain and the liver tissue. In this report, multiple pyogenic liver abscesses due to S. intermedius in a 46-year-old male admitted to the emergency department with complaints of fever, cough, and weakness, and hospitalized with a diagnosis of suspected COVID-19 with pneumonia, is presented. The diagnosis was made by isolating the agent from the abscess. After percutaneous abscess drainage and antimicrobial treatment, the patient fully healed.