Introduction: The increasing prevalence of carbapenem-resistant Klebsiella pneumoniae (CR-Kp) limits effective treatment options. The aim of this study was to evaluate the susceptibility patterns of CR-Kp strains isolated from urine cultures to oral treatment options recommended by the Infectious Diseases Society of America guidelines, and ceftazidime-avibactam. Additionally, clinical data and outcomes of patients diagnosed with CR-Kp urinary tract infections (UTI) who were treated with fosfomycin sodium-including therapy regimens (FSITR) were analyzed. Methodology: This retrospective cohort study included adult patients with urine culture-proven CR-Kp between March 2016 and October 2022. Demographic and clinical data, antibiotic susceptibility, treatment outcomes, and one-month mortality (OMM) were evaluated. Results: A total of 179 patients were included. The susceptibility to fosfomycin tromethamol, nitrofurantoin, and co-trimoxazole (TMP-SMX) were (33.7%; 55/163), (7.7%; 13/167), and (11.1%; 20/179), respectively. All strains were resistant to ciprofloxacin. The susceptibility data compared until 2020 (pre-COVID-19) and afterwards, revealed TMP-SMX susceptibility (4.9% vs 24.1%, p = 0.0001) increased significantly. Susceptibility data for ceftazidime-avibactam were available for 22 isolates and 59% of the isolates were sensitive. OMM of the 179 patients with CR-Kp in urine cultures was 37.4% (67/179). There were 9 FSITR cases. Among those, microbiological eradication was achieved in 87.5% (7/8) and OMM was 44.4% (4/9). Conclusions: Clinical experience may be feasible and needed to assess the efficacy of nitrofurantoin and TMP-SMX. Fosfomycin-including regimens may serve as a salvage treatment option for CR-Kp UTI in selected patients. However, the retrospective and single-center design of the study should be considered as a limitation.

Candida auris is an emerging fungal pathogen that has become a critical global health concern due to its high antifungal resistance and potential to cause nosocomial outbreaks. Since its initial identification in Japan in 2009, C. auris has spread rapidly, posing significant treatment challenges across various healthcare settings worldwide. The biofilm formation ability of C. auris enhances its resilience against disinfectants and antifungal agents, complicating infection control in healthcare environments. This consensus report was developed by a collaboration between several Turkish medical societies including the Turkish Society of Infectious Diseases and Clinical Microbiology Specialty (EKMUD), the Turkish Society of Anesthesiology and Reanimation (TARD), the Turkish Intensive Care Society (TYBD), the Infectious Diseases - International Research Initiative (ID-IRI), the Clinical Microbiology Specialist Society (KLIMUD), the Turkish Microbiology Society (TMC), and the Public Health Institution of Türkiye (PHIT) under the Ministry of Health. The report provides a comprehensive overview of C. auris and its management, with a focus on the epidemiology, antifungal resistance mechanisms, recommendations for diagnostic and therapeutic challenges, infection control and prevention measures, and surveillance of C. auris. This consensus report aims to establish standardized diagnostic protocols, improve national surveillance systems, and promote effective infection control measures to mitigate C. auris-related health risks in Türkiye. It also offers comprehensive national recommendations and addresses the need for interinstitutional collaboration, improve public health, and strengthen the healthcare response to this pathogen.

Background The COVID-19 pandemic, which has killed millions of people worldwide, continues to be marked by waves of reinfections. We aimed to assess the incidence and clinical characteristics of reinfection in COVID- 19 cohort. Material and Methods A single-center descriptive study was conducted. Data were collected from all patients who tested positive for SARS-CoV-2 via PCR from March 18, 2020, the onset of the first major COVID-19 wave, until the end of 2020. All PCR-positive patients were followed-up, and those who had SARS-CoV-2 PCR positivity again at least 90 days after the initial onset were contacted via telemedicine. Results 5814 patients diagnosed with COVID-19 with PCR positive in the first wave were included. The incidence of reinfection among the cohort of patients infected with SARS-CoV-2 during the initial wave of COVID-19 was 0.73%. Among healthcare workers, the 1-year reinfection rate was 2.14%, 3.9 times higher than non-healthcare workers. We observed that the clinical course was milder and less complicated in patients who had reinfection. In cases of reinfection among fully vaccinated individuals, statistically significantly fewer symptoms were observed. Conclusions We observed that healthcare workers are at approximately four times greater risk of reinfection. Reinfections generally presented with a milder clinical course.

Background/Aim: To compare the effectiveness ceftaroline-rifampicin (CR) and vancomycin-rifampicin (VR), against methicillin-resistant Staphylococcus aureus (MRSA) in a rabbit meningitis model, to compare the effects on brain tissues in terms of inflammation and apoptosis and to test the antibiotics via in vitro time-kill and synergy tests. Method: Meningitis was induced using MRSA strain ATCC 43300. After 28 hours, the rabbits were split into three groups: control, VR, and CR. A CSF culture was taken at the start (T0) and end of treatment (EOT)-the 24th hour of treatment. At EOT, the animals' brain tissues were examined for inflammation and apoptosis. The study strain was tested for a 24-hour time kill assay. Results: At the EOT, statistically significant differences were observed between the treatment groups in terms of reducing the cerebrospinal fluid (CSF) bacterial count, achieving partial or complete treatment response, and exhibiting lower levels of neuronal apoptosis compared with the control group. However, there was no significant difference in all three parameters and in survival between the two treatment groups. The CR group exhibited a noticeable decrease in inflammation than the control group, but no significant difference was found between the control group versus VR and VR versus CR group. Rifampicin did not improve antibacterial efficacy in the in vitro time-kill assay. Conclusion: The CR arm showed better complete response and inflammation, but both treatments were similar in other parameters. CR combination was found as effective as VR combination for treating MRSA meningitis.

This multicentre (22 centres in Turkey) retrospective cohort study aimed to assess the clinical outcomes of patients with neutropenic fever and SARS-CoV-2 positivity. Study period was 15 March 2020–15 August 2021. A total of 170 cases (58 female, aged 59 ± 15.5 years) that fulfilled the inclusion criteria were included in the study. One-month mortality rate (OMM) was 44.8%. The logistic regression analysis showed the following significant variables for the mentioned dependent variables: (i) achieving PCR negativity: receiving a maximum of 5 days of favipiravir ( p = 0.005, OR 5.166, 95% CI 1.639–16.280); (ii) need for ICU: receiving glycopeptide therapy at any time during the COVID-19/FEN episode ( p = 0.001, OR 6.566, 95% CI 2.137–20.172), the need for mechanical ventilation ( p < 0.001, OR 62.042, 95% CI 9.528–404.011); (iii) need for mechanical ventilation: failure to recover from neutropenia ( p < 0.001, OR 17.869, 95% CI 3.592–88.907), receiving tocilizumab therapy ( p = 0.028, OR 32.227, 95% CI 1.469–707.053), septic shock ( p = 0.001, OR 15.4 96% CI 3.164–75.897), and the need for ICU ( p < 0.001, OR 91.818, 95% CI 15.360–548.873), (iv) OMM: [mechanical ventilation ( p = 0.001, OR 19.041, 95% CI 3.229–112.286) and septic shock ( p = 0.010, OR 5.589,95% CI 1.509–20.700)]. Although it includes a relatively limited number of patients, our findings suggest that COVID-19 and FEN are associated with significant mortality and morbidity.

Background: In this study it was aimed to evaluate the efficacy and timing with technique of the source control for the subgroup of septic shock (SS) patients with intraabdominal infections (IAI) in a tertiary-care educational hospital. Methods: Patients who had SS with IAI and consulted by Infectious Diseases consultants between December 2013 and October 2022 in our centre were analyzed retrospectively. Results: A total number of 390 patients were included. Overall day-30 mortality (OMM) was 42.5% on day 3 while day 14 and 30 mortality rates were 63.3% and 71.3%, respectively. Source control by surgical or percutaneous operation was performed in 123 of 390 cases (31.5%) and mortality rate was significantly lower in cases that were performed source control at anytime during SS (65/123-52.8% vs 213/267-79.8%, p<0.001). In 44 of 123 cases (35.7%) source control was performed during the first 12 hours and mortality was significantly lower in this group versus others (24/44-54.5% vs 254/346-73.4%, p=0.009). On the other hand, female gender (p<0.001, odds ratio(OR)=1.714-5.054, 95%CI=1.714-5.054), diabetes mellitus (p= 0.014, OR=2.284, 95%CI=1.179-4.424), carbapenem-resistant Gram-negative etiology (p=0.011, OR=4.386, 95%CI=1.398-13.759), SOFA≥10 (p<0.001, OR=3.036, 95%CI=1.802-5.114), lactate >3 mg/dl (p<0.001, OR=2.764, 95%CI=1.562-4.891) and lack of source control (p=0.001, OR=2.796, 95%CI=1.523-5.133) were significantly associated with OMM in logistic regression analysis. Conclusions: Source control has a vital importance in terms of mortality rates for IAI related septic shock patients. Our study underscores the need for additional research, as the present analysis indicates that early source control does not manifest as a protective factor in logistic regression.

Introduction: Consultations hold an important place in the daily practice of infectious diseases physicians. With the increasing average age of the patient population and the rise in the number of patients requiring multiple medications due to comorbidities, the management of antimicrobial side effects is becoming increasingly important. The identification, management, and reporting of side effects related to antimicrobials are crucial. This study aims to retrospectively evaluate the consultations requested due to side effects from the infectious diseases department in a tertiary care hospital, assess their management, and share real-life experiences. Materials and Methods: All inpatient consultations requested from the department of infectious diseases and clinical microbiology at our hospital between 01.10.2022 and 30.09.2023 were retrospectively evaluated. The reasons for the consultations, requests for medication revisions due to antibiotic side effects, and detailed information about the cases were obtained and recorded through the Hospital Information Management System. Results: Our study included 19.520 inpatient consultation requests, of which 0.70% (137/19.520) were requested due to antibiotic side effects. The most common side effects in patients were rash (41.6%), pruritus (16.7%), thrombocytopenia (8.01%), kidney function test disorder and international normalized ratio prolongation (7.2%). A history of antibiotic allergy was present in 16.05% of patients. The antibiotics most frequently associated with side effects were tigecycline (12.4%), piperacillin-tazobactam (10.2%), polymyxin B (8.7%), linezolid (7.2%), and meropenem (6.5%). The average time to develop side effects after starting antibiotics was 4.99 (+/- 5.69) days. Conclusion: Promoting the rational use of antibiotics can help successfully combat antibiotic resistance, reduce costs, and minimize potential side effects. Reporting side effects is crucial in this effort.

BACKGROUND-AIM In this retrospective matched cohort study, we aimed to compare the clinical outcomes of EMDCT including therapy receiving cases with MIDCT receiving CRKPI cases. MATERIALS/METHODS This study was performed at a 1800+ bedded tertiary-care hospital.Adult patients with culture proven CRKPI(bacteremia,pneumonia,UTI,other)treated with EMDCT or MIDCT including regimens between August 2016 and October 2023 were included in the study.Matching was performed as one MIDCT matched to minimum 1 or 2 EMDCT when n is possible i)according to the sample infecting strain was yielded (bacteremia vs.bacteremia etc.)ii)being in the clinic or intensive care unit at the time of the first Infectious Diseases consultation. RESULTS MIDCT was used in the ertapenem unavailable period in pan-resistant cases.A total of 140 patients (51 female, aged 64,59±13,46),80 cases in ECDCT group and 60 cases in MIDCT group diagnosed with CRKPN bacteremia(32 cases), pneumonia(34 cases), UTI(48 cases), other(26 cases) were included in the study.All isolates were resistant to ertapenem. Age, gender, duration of therapy, microbiological success, end of therapy clinical success, all cause day-30 mortality in the overall or only double carbapenem or those with any additional antibiotic cohorts as well as UTI and pneumonia subgroups did not differ significantly between two cohorts (Table-1).Prolonged infusion cases were significantly more and OMM in non-bacteremia/pneumonia/UTI cases in wards were significantly less in MIDCT subgroup.However, there was no significant difference in the same subgroup of ICU cases. CONCLUSIONS Although the number of cases is relatively low and non-randomized, EMDCT and MIDCT containing therapy resulted in similar outcomes in our matched cohort study.

AIM In this study it was aimed to analyse the clinical characteristics and outcomes of IE cases in our hospital. BACKGROUND Despite developments in antibiotics and medicine, infective endocarditis (IE) is associated with significant morbidity and mortality. METHODS Patients that were followed up for definite IE (diagnosed according to modified Duke criteria) in ourhospital between March 2007 and September 2023 were analyzed retrospectively. Patients were evaluated in terms of demographic features,underlying diseases, risk factors, clinical and laboratory findings, therapy responses, complications, and mortality. RESULTS There were 230 patients diagnosed with IE [79-52.6% femaie, aged 53.3±16.9 years, ranging 18-92 years] fulfilling the study inclusion criteria. Risk factors, complaints, laboratory findings and complications of patients was shown in Table 1. Blood culture was positive in 175 patients (75,5%). The most common etiologic agents were; S. viridans (26.08%), S. aureus (18.6%) and E. feacalis (10.8%). The antibiotherapy of 40 patients with native valve endocarditis comprised ampicillin/sulbactam and gentamicin (other therapy combinations were vancomycin and gentamicin [n=11], penicillin and gentamicin[n=38]). Nine of 49 patients with prosthetic valve endocarditis were treated with vancomycin, rifampicin and gentamicin while other nine were treated with daptomycin including therapy. In hospital mortality was (20%-46/230). Mortality rates between blood culture positive and negative cases were similar (Chi-square test p=1) while mortality in S. viridans was less than S. aureus or enterococci (Chi-square test p=0.0085, Table 2). CONCLUSIONS IE is still associated with significant mortality. More interventions are needed to further decrease the complication and mortality rates.

Neurobrucellosis is a rare and challenging complication of brucellosis. Its non-specific clinical presentation makes it challenging to diagnose. The coexistence of neurobrucellosis with subdural empyema is extremely rare, with only a few cases reported in the literature. Herein, we present the case of a 27-year-old male with a ventriculoperitoneal shunt in-situ and a history of exposure to Brucella via animal care and consumption of raw milk. The patient presented with a left frontal headache and vertigo following a head trauma. The initial cranial imaging demonstrated a left-sided subdural hematoma and slit ventricles. The patient underwent drainage by craniotomy. Brucella spp. was detected in the drained sample, and the patient was treated with a multi-modal approach, which included antibiotics and surgical drainage. The follow-up plan involved a repeat cranial computed tomography and shunt adjustment for recurrent subdural effusions. This case adds to the few reports of neurobrucellosis associated with subdural empyema. Furthermore, it highlights the importance of considering neurobrucellosis in patients with neurological symptoms and a subdural collection in brucellosis-endemic areas.

Objectives: Carbapenem-resistant A. baumannii is a common cause of nosocomial meningitis, and it presents a challenge in terms of treatment because of limited therapeutic options. Intravenous tigecycline has been considered a potential salvage therapy against multi-drug-resistant Acinetobacter baumannii. However, its effectiveness is limited by its poor ability to cross the blood-brain barrier. As an alternative treatment option, intrathecal tigecycline has shown promise with its minimal side effects and high concentration in cerebrospinal fluid.Methods: In this report, we present a series of four cases infected with multi-drug-resistant A. baumannii following neurosurgery and treated with intrathecal tigecycline, including antimicrobial therapy.Results: The rate of successful microbiological response was 2 out of 3 cases (66%) in whom microbiological response could be tested anytime during the intrathecal therapy, whereas the 30-day survival rate after treatment completion was 1/4 (25%).Conclusion: Although intrathecal tigecycline treatment has shown relative efficacy in achieving microbiological response, its impact on overall survival is still uncertain. Further studies involving larger groups of patients are necessary to evaluate the outcomes of intrathecal tigecycline therapy.

BACKGROUND-AIM Herein, we aimed to evaluate and compare the efficacy and susceptibility patterns of tigecycline in MDR A.baumannii pneumonia (MDRABP) in a recent vs retrospective cohort. METHODS The outcome of adult (>18 years old) patients who were consulted by Infectious Diseases consultants due to culture proven MDRABP and treated with tigecycline between March 2016 and October 2023(Group B) was compared with a similar previously published retrospective cohort from our center(Group A, Published J Chemother. 2011 dec;23(6):345-9). Statistical analysis was performed via Chi square test and a p value less then 0.05 was considered significant. RESULTS There were total of 202 cases of MDRABP(72 patients in group a and 130 patients in Group B). Forty-seven and 81 cases were considered as VAP in group A and B, respectively. Tigecycline and netilmicin susceptibility were significantly less in group b(Table). C/S combination and tigecycline monotherapy were significantly more common in group A while any combination therapy, colistin, fosfomycin and polymyxin b combination were more common in group B (p<0.05 table). Group A EOT microbiologic eradication was significantly higher in the overall cohorts as well as HAP and VAP subgroups(Table). In the combined data of group A and B microbiological response was similar in tigecycline sensitive vs. intermediately-sensitive strains (41/94-43.6% vs.22/48-45.8% p:0.801). Not overall clinical success but clinical success in combination therapy subgroup was significantly lower in group B(Table). CONCLUSION Our findings show that tigecycline resistance rates in MDRABP increased during years. Microbiological eradication rates but not clinical outcomes decreased significantly.

Aim: To evaluate the effect of timing of antimicrobial therapy on clinical progress of patients with septic shock.Materials and Method: We included 204 adult patients diagnosed with septic shock according to Sepsis-3 criteria between March 2016 and April 2021. One-month survival was evaluated using univariate and logistic regression analysis.Results: Antibiotic treatment was initiated within 1 h of the vasopressors in 26.4 % of patients. One-month mortality did not differ significantly between patients with and without empirical therapy coverage on etiological agents. Univariate factors that significantly affected one-month survival were starting antibiotics at the first hour, the unit where the case was diagnosed with septic shock, SOFA scores, qSOFA scores, and lactate level. In multivariate analysis, diagnosis of septic shock in the Emergency Service, SOFA score >= 11, qSOFA score of three and lactate level >= 4 were significantly associated with one-month mortality.Conclusion: Training programs should be designed to increase the awareness of septic shock diagnosis and treatment in the Emergency Service and other hospital units. Additionally, electronic patient files should have warning systems for earlier diagnosis and consultation.

AIM This study aimed to retrospectively evaluate the consultations requested from the Department of Infectious Diseases due to antibiotic side effects and to convey real-life experience. BACKGROUND Antibiotic side effect management is gaining importance day by day due to reasons such as the increasing average age of the patient population, multiple drug use due to comorbidities, and combined antibiotic treatments due to resistant microorganisms. Knowing the side effect profile of antibiotics frequently used in daily practice and reporting side effects are very important for infectious disease specialists. METHODS All consultations requested from the Infectious Diseases Department in our center were evaluated retrospectively, and the necessary information about the patients and medications in the consultations requested due to antibiotic side effects were recorded in a Microsoft Excel file. RESULTS 16.05% (22/137) of the patients had a previous history of antibiotic allergy. The frequency order of the antibiotics with side effects is shown in the table (Table 1). While 21.1% (29/137) of the antibiotics with side effects were original molecules, 78.8% (108/137) were equivalent products. The distribution of side effects observed in patients is shown in the table. (Table 2) The average time for patients to develop side effects after antibiotics was 4.99 (± 5.69) days. CONCLUSIONS It may be possible to combat antibiotic resistance and possible side effects by increasing the rational use of antibiotics. Side effect reporting is important in this fight.

BACKGROUND-AIM In this retrospective matched cohort study, we aimed to compare the clinical outcomes of polymyxin b (PMXB) including therapy receiving cases with colistin receiving cases on culture-proven carbapenem-resistant Gram-negative infections (CPCRGNI). METHOD This study was performed at a 1800+ bedded tertiary-care hospital. Adult patients with culture proven CRCRGNI (bacteremia, pneumonia etc.) treated with PMXB or colistin including regimens between August 2016 and October 2023 were included.Matching was performed as one PMXB matched to minimum 1 or 2 colistin whenever possible according to the clinical sample infecting strain was yielded (pneumonia vs. pneumonia etc.) RESULTS A total of 210 patients(72 (36,00%)female, aged 60,26±17,44),79 cases in PMXB group and 131 cases in colistin group diagnosed with CRCRGNI.Sixty strains had colistin susceptibility data and 56(93.3%) strains were sensitive to colistin.OMM in overall cohorts (56.96% in PMXB 58,01% in colistin p:0.881), overall acute kidney injury, overall microbiological success, and overall clinical success at the end of therapy did not differ significantly(Table). OMM in the overall UTI(3/6 50,0% vs 9/12 75,0% p0.288) and pneumonia subgroups(23/35 65,71% vs 46/70 65,71% p:1) were also similar. Both treatment group OMM were similar in Acinetobacter and Klebsiella subgroups, but significantly lower with PMXB in Pseudomonas subgroup (Table).OMM was also similar within known colistin-sensitive cases(34/56 -60,71%) vs others(77/154- 50,0%)(p:0.168). Interestingly, OMM in overall UTI(OMM 3/6-50% vs 7/12-58.3%) was not significantly different, but in favor of PMXB. CONCLUSIONS PMXB including therapy resulted nonsignificntly less OMM than colistin cohort and significantly less OMM in Pseudomonas subgroup. Nephrotoxicity was nonsignificantly less in PMXB cohort.

Herein, we aimed to describe the outcomes of patients with blood stream infections due to carbapenem-resistant Klebsiella pneumoniae (CR-Kp) who received ertapenem plus meropenem combination treatment (EMCT). A total of 53 patients with culture proven CR-Kp bacteremia treated with ertapenem + meropenem were included. The patients with secondary bacteremia due to urinary tract infection exhibited a significantly lower 1-month mortality (OMM), particularly in those with microbiological eradication and those with end-of-treatment success. Salvage EMCT resulted in 49% 1-month survival.

Amaç: Sağlık bakımı ile ilişkili enfeksiyonların önlenmesinde el yıkama, çevre temizliği, izolasyon kurallarına uyum gibi temel uygulamalar ile birlikte Enfeksiyon kontrol komitesinin yürüttüğü aktif sürveyans ve personel eğitimi büyük önem taşımaktadır. Bu çalışmada karbapenem dirençli Enterobacteriaceae (KDE) salgın yönetim tecrübesinin aktarılması ve yapılan uygulamaların değerlendirilmesi amaçlanmıştır. Gereç ve Yöntem: Organ Nakli Servis’inde 22.05.20 ile 14.06.20 tarihleri arasında yatan tüm hastalar çalışmaya dahil edilerek, verilerin toplanması ve geriye dönük değerlendirilmesi sırasında Enfeksiyon Kontrol Komitesi sürveyans kayıtları ve toplantı tutanakları kullanılmıştır. Bulgular: Organ Nakli Ünitesi’nde karbapenem dirençli Enterobacteriaceae enfeksiyonu/kolonizasyonu (5 enfeksiyon, 1 kolonizasyon) nedeniyle temas izolasyonunda izlenen hasta sayısının artması nedeniyle, enfeksiyon/kolonizasyonu olmayan hastalardan rektal sürüntü taraması yapılması planlanlanarak, 32 hastadan rektal sürüntü kültürü gönderildi. Tarama yapılan hastalardan sekizinde (8/32-%25) KDE kolonizasyonu saptandı. Enfeksiyon Kontrol Komitesi tarafından KDE yayılımının engellenmesi amacıyla yapılan uygulamalar, gözlemler ve eğitimler sonucunda izolasyondaki hasta sayısının (iki hasta) belirgin derecede azalmış olduğu gözlenmiştir. Sonuç: Standart önlemler ve temas izolasyonuna uyumsuzluk KDE kolonizasyonu ve ardından enfeksiyonların daha sık görülmesine neden olabilir. KDE’lerin yayılımının önlenmesinde el hijyeni ve temas izolasyon gibi temel önleyici tedbirleri birlikte Enfeksiyon kontrol komitesinin kararlı uygulama ve eğitimleri büyük önem taşımaktadır.

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.

Gram-positive pathogens, particularly Staphylococcus aureus, are more commonly isolated in septic arthritis cases. Compared to other Gram -negative pathogens, Salmonella spp. is a rarely encountered cause of septic arthritis. The aim of this study is to investigate the cases followed with the diagnosis of Salmonella septic arthritis at Ege University School of Medicine Hospital. This study aimed to retrospectively evaluate the clinical, laboratory, and treatment outcomes of patients with Salmonella enterica (S. enterica) growth in knee joint fluid cultures at Ege University Medical Faculty Hospital between April 2017 and April 2023. In four patients (one female, three males) [mean age 50.75 +/- 19.82 years, range 30-71 years] with a diagnosis of septic arthritis, Salmonella enterica spp. enterica was isolated. All four cases had a history of immunosuppressive drug use. They were successfully treated with surgical and medical interventions. Salmonella spp. commonly causes gastroenteritis. Bacteremia can occur, leading to localized infections. While Gram-positive pathogens are frequently isolated in septic arthritis, it should be considered that Gram-negative pathogens can also be responsible, and sampling from the joint fluid should be performed.