Throughout its history, humanity has had to fight and sometimes cooperate with viruses. From the black plague to the coronavirus, viral outbreaks have dramatically changed public health, the economy and the functioning of public life. Over time, we have got to know viruses better and started to better protect public health. Knowledge of the morphological, genetic and molecular structure of viruses plays an important role in this process. Combatting and controlling viruses will not only protect public health but also pave the way for scientific developments. Detection of viruses will allow understanding of all the organic structures that interact or may interact with them. This chapter gives a brief overview of the viruses, the importance of virus detection and finally the role of sensors in revolutionizing virus detection technologies.

Despite the quality of life (QoL) and biopsychosocial model gain importance in the management of people living with HIV (PLWH), there is lack of a suitable tool addressing the current demand. This longitudinal methodological study describes the validity, reliability, and responsiveness of the Bilişsel Egzersiz Terapi Yaklaşımı-Biopsychosocial Questionnaire (BETY-BQ), which was previously designed to assess biopsychosocial characteristics, including pain coping skills, functionality, fatigue, emotional state, sleep, sexuality, and sociability, resulting from chronic diseases in PLWH. BETY-BQ was administered to a total of 150 PLWH in the outpatient clinics of two different hospitals. The Short Form-36 (SF-36), the Hospital Anxiety and Depression Scale (HADS), the Clinical Frailty Scale (CFS), and the FRAIL Questionnaire were used for the validity. For both reliability and responsiveness analyses, assessments were conducted in 30 PLWH. Reliability was evaluated by repeating the assessments at 1-week intervals, and responsiveness was assessed by re-administering the same scales at 3-month intervals. Moderate to high correlations were found between BETY-BQ and SF-36, HADS, CFS, FRAIL. The correlations between BETY-BQ and SF-36 subheadings ranged from rho=-0.497 to rho=-0.650, p < 0.001, while there were correlations with HADS-Anxiety (rho = 0.717, < 0.001), HADS-Depression (rho = 0.653, < 0.001), CFS (rho = 0.467, < 0.001), FRAIL (rho = 0.559, < 0.001). The score distribution refuted floor and ceiling effects. The reliability of BETY-BQ was confirmed by test-retest strategy (ICC = 0.951). The Cronbach’s α value was 0.943 for the test and 0.963 for the retest. The time-dependent change responsiveness of BETY-BQ was moderately correlated with the depression subheading of the HADS. BETY-BQ is as a valid and reliable instrument by which, multidisciplinary-interdisciplinary healthcare teams can evaluate the biopsychosocial features among PLWH in a holistic and practical manner. Preliminary findings also suggest its potential sensitivity to change, particularly concerning depressive symptoms; however, further studies are needed to establish its responsiveness fully. Not applicable.

Carbapenem-resistant Pseudomonas aeruginosa (CRPA) has been classified by the World Health Organization as one of the most alarming antimicrobial-resistant microorganisms. Despite the availability of newer therapeutic options, polymyxins remain important last-resort agents for the treatment of CRPA infections in many settings. With the extended use of polymyxins in the treatment of extensively drug-resistant bacterial infections, both colistin resistance rates, colistin heteroresistance (CHR) rates and antibiotic treatment failures have risen. In this study, we aimed to: (i) determine the prevalence of CHR in P. aeruginosa bloodstream isolates, (ii) compare the accuracy of the antibiotic gradient test (GT) with the population analysis profiling (PAP) method, and (iii) identify clinical risk factors for CHR. CHR was investigated among 70 colistin-susceptible P. aeruginosa strains isolated from blood cultures using PAP and GT methods. Clinical and demographical data were retrospectively reviewed, and risk factors for CHR were analyzed using logistic regression. We detected a remarkably high prevalence of CHR (61.4

Objective HIV testing procedure in the presence of HIV indicator conditions is considered an effective strategy to identify undiagnosed people living with HIV. We aimed in this study to evaluate HIV testing and diagnosis rates obtained via non-targeted testing in seven hospitals across T & uuml;rkiye, specifically focusing on patients with HIV indicator conditions.Objective HIV testing procedure in the presence of HIV indicator conditions is considered an effective strategy to identify undiagnosed people living with HIV. We aimed in this study to evaluate HIV testing and diagnosis rates obtained via non-targeted testing in seven hospitals across T & uuml;rkiye, specifically focusing on patients with HIV indicator conditions.Methods Data from a total of 3,371,188 patients with hospital admissions for various clinical conditions were analyzed in this retrospective multicenter cross-sectional study, which was carried out in seven hospitals within a 6-months period. HIV testing and HIV diagnosis rates were retrospectively evaluated in the overall population and in the subgroups of patients with and without HIV-indicator conditions.Methods Data from a total of 3,371,188 patients with hospital admissions for various clinical conditions were analyzed in this retrospective multicenter cross-sectional study, which was carried out in seven hospitals within a 6-months period. HIV testing and HIV diagnosis rates were retrospectively evaluated in the overall population and in the subgroups of patients with and without HIV-indicator conditions.Methods Data from a total of 3,371,188 patients with hospital admissions for various clinical conditions were analyzed in this retrospective multicenter cross-sectional study, which was carried out in seven hospitals within a 6-months period. HIV testing and HIV diagnosis rates were retrospectively evaluated in the overall population and in the subgroups of patients with and without HIV-indicator conditions.Results Rates of HIV testing and positivity in the overall population of 3,371,188 patients screened across seven hospitals were 8.3% (281,321/3,371,188) and 0.2% (557/281,321), respectively. HIV testing and HIV positivity rates in 19,410 patients with HIV-indicator conditions were 11.5% (2,225/19,410) and 0.4% (9/2,225), respectively. HIV testing and HIV positivity rates in 3,351,778 patients without HIV-indicator conditions were 8.3% (279,096/3,351,778) and 0.2% (548/279,096), respectively. The rate of HIV testing and HIV positivity in patients with HIV-indicator conditions was statistically significantly higher than in the patients without HIV-indicator conditions (p = 0.000 and p = 0.047, respectively).Results Rates of HIV testing and positivity in the overall population of 3,371,188 patients screened across seven hospitals were 8.3% (281,321/3,371,188) and 0.2% (557/281,321), respectively. HIV testing and HIV positivity rates in 19,410 patients with HIV-indicator conditions were 11.5% (2,225/19,410) and 0.4% (9/2,225), respectively. HIV testing and HIV positivity rates in 3,351,778 patients without HIV-indicator conditions were 8.3% (279,096/3,351,778) and 0.2% (548/279,096), respectively. The rate of HIV testing and HIV positivity in patients with HIV-indicator conditions was statistically significantly higher than in the patients without HIV-indicator conditions (p = 0.000 and p = 0.047, respectively).Results Rates of HIV testing and positivity in the overall population of 3,371,188 patients screened across seven hospitals were 8.3% (281,321/3,371,188) and 0.2% (557/281,321), respectively. HIV testing and HIV positivity rates in 19,410 patients with HIV-indicator conditions were 11.5% (2,225/19,410) and 0.4% (9/2,225), respectively. HIV testing and HIV positivity rates in 3,351,778 patients without HIV-indicator conditions were 8.3% (279,096/3,351,778) and 0.2% (548/279,096), respectively. The rate of HIV testing and HIV positivity in patients with HIV-indicator conditions was statistically significantly higher than in the patients without HIV-indicator conditions (p = 0.000 and p = 0.047, respectively).Results Rates of HIV testing and positivity in the overall population of 3,371,188 patients screened across seven hospitals were 8.3% (281,321/3,371,188) and 0.2% (557/281,321), respectively. HIV testing and HIV positivity rates in 19,410 patients with HIV-indicator conditions were 11.5% (2,225/19,410) and 0.4% (9/2,225), respectively. HIV testing and HIV positivity rates in 3,351,778 patients without HIV-indicator conditions were 8.3% (279,096/3,351,778) and 0.2% (548/279,096), respectively. The rate of HIV testing and HIV positivity in patients with HIV-indicator conditions was statistically significantly higher than in the patients without HIV-indicator conditions (p = 0.000 and p = 0.047, respectively).Discussion Our findings revealed that only 11.5% of patients with HIV-indicator conditions underwent HIV testing, indicating that most patients are not timely diagnosed despite having HIV-indicator conditions, and these patients remain at risk of living with unknown HIV status. The utilization of testing outside the HIV-indicator conditions criteria in 8.3% of cases was also notable. The likelihood of a positive diagnosis rate was at least 2-fold increased when the screening was guided by HIV-indicator conditions.Discussion Our findings revealed that only 11.5% of patients with HIV-indicator conditions underwent HIV testing, indicating that most patients are not timely diagnosed despite having HIV-indicator conditions, and these patients remain at risk of living with unknown HIV status. The utilization of testing outside the HIV-indicator conditions criteria in 8.3% of cases was also notable. The likelihood of a positive diagnosis rate was at least 2-fold increased when the screening was guided by HIV-indicator conditions.Discussion Our findings revealed that only 11.5% of patients with HIV-indicator conditions underwent HIV testing, indicating that most patients are not timely diagnosed despite having HIV-indicator conditions, and these patients remain at risk of living with unknown HIV status. The utilization of testing outside the HIV-indicator conditions criteria in 8.3% of cases was also notable. The likelihood of a positive diagnosis rate was at least 2-fold increased when the screening was guided by HIV-indicator conditions.Conclusion In conclusion, according to the study, HIV testing in patients with HIV-indicator conditions increased the rate of HIV diagnosis, but the rate of requesting testing in the presence of HIV-indicator conditions was low. HIV testing practices among physicians in the Turkish healthcare settings should be improved with interventions for an improved awareness of HIV-indicator conditions-guided HIV testing, and adopting the related guidelines to appropriately identify undiagnosed HIV cases.Conclusion In conclusion, according to the study, HIV testing in patients with HIV-indicator conditions increased the rate of HIV diagnosis, but the rate of requesting testing in the presence of HIV-indicator conditions was low. HIV testing practices among physicians in the Turkish healthcare settings should be improved with interventions for an improved awareness of HIV-indicator conditions-guided HIV testing, and adopting the related guidelines to appropriately identify undiagnosed HIV cases.

OBJECTIVE:The objective of this study was to determine the association between viral subtype/clade and disease severity. DESIGN:Multicentre retrospective cohort study. SETTING:This study used data from the Global Influenza Hospital Surveillance Network (GIHSN). The dataset comprised hospitalised influenza patients with viral sequencing data across 14 countries, collected from August 2022 through October 2023. PARTICIPANTS:A total of 761 hospitalised patients were enrolled during the study period, and 745 patients were included in the analysis. We excluded patients with missing data on explanatory or outcome variables, those infected with viral clades represented by fewer than 11 sequences, and those enrolled at study sites contributing fewer than 5 patients. OUTCOME MEASURES:Disease severity was defined by admission to intensive care unit (ICU), receipt of non-invasive oxygen supplementation, 3-variable definition (ICU, mechanical ventilation or death) or 4-variable definition (3-variable plus oxygen supplementation).Outcomes were analysed in association with subtype or clade using the mixed-effects logistic regression models, adjusting for age group, sex, underlying medical conditions, influenza vaccination status, antiviral use, country income level and epidemic period, while study site was included as a random effect. RESULTS:745 patients were included: 263 A(H1N1)pdm09, 380 A(H3N2), 102 B/Victoria. A(H1N1)pdm09 infection was associated with increased odds of ICU admission (adjusted ORs (aORs) 2.5, 95% CI 1.1 to 5.8) compared with A(H3N2). 6B.1A.5a.2a.1 clade of A(H1N1)pdm09 was associated with increased severity compared with 6B.1A.5a.2a clade (aOR 3.0, 95% CI 1.0 to 9.5) and (aOR 5.4, 95% CI 1.6 to 18.3) for the 3-variable and 4-variable definitions respectively. Among A(H3N2), the (3C.2a1b.2a.)2b clade showed a trend toward increased severity using the 4-variable definition compared with the 2a.1b clade (aOR 2.9, 95% CI 0.8 to 10.0). CONCLUSIONS:This analysis highlights the differential impact of influenza subtypes and clades on disease severity in hospitalised patients. Future research should investigate the role of specific viral mutations of these clades in modulating immune evasion or disease severity. These findings reinforce the GIHSN's critical role in global surveillance. Ongoing genomic surveillance is crucial for understanding the clinical impact of emerging influenza variants and informing public health responses.

One of the most challenging factors for clinicians in managing COVID-19 has been differences in the clinical course. To investigate the parameters associated with severe disease in detail, along with examining known risk factors such as advanced age and comorbidities, understanding personal genetic factors is necessary, as the clinical course may change due to differences in the host genome. Human genetic variants reported to be associated with severe disease were genotyped in 68 patients in COVID-19 medical wards and 52 in COVID-19 intensive care units at Hacettepe University Adult Hospital. The rs17860115 variant was significantly more prevalent in our cohort than in the European (non-Finish) population, whereas the rs2298659, rs2298661, rs4290734, and rs9271609 variants were significantly less common, which may reflect genetic differentiation, selective pressures, or protective factors within this population. While no significant association was found between variants and disease severity, notably, the ACE2 rs1548474 allele frequency was 38.0

Background: Bioelectrical impedance analysis has been used to evaluate phase angle, which predicts cellular health and may even predict survival in people living with HIV. However, the relationship between the phase angle and geriatric syndromes is unclear. This study aims to evaluate geriatric syndromes and how they interact with issues affecting HIV patients by conducting a full geriatric evaluation and comparing phase angles. Methods: Fifty people living with HIV and 52 participants without HIV were included in the study. All participants underwent a comprehensive geriatric assessment. BIA was used to determine the phase angle, which was then predicted from impedance measurements. Results: The mean age of people living with HIV was 60.0 ± 12.0 years, and that of participants without HIV was 60.0 ± 5.0 years in participants without HIV (p = 0.93). The number of drugs used by people living with HIV infection was considerably higher than that used by those in the HIV-negative group (p = 0.018). There was a statistically significant difference in the phase angle between without HIV and with HIV. The median [interquartile range (IQR)] phase angle was 7.4 [4.0] degrees, and it was 5.7 [3.2] degrees (p = 0.004). Conclusions: Phase angle measurements between people living with HIV and without HIV could provide valuable insights into overall health status treatment response and prognosis. Further large-scale research is to corroborate our findings.

Evidence shows that bathing with chlorhexidine gluconate (CHG) solution reduces the colonization of microorganisms that cause healthcare-associated infections (HAIs). The aim of this study was to evaluate the effects of CHG bath on MRSA and VRE colonization in cancer patients hospitalized in the intensive care unit (ICU). This crossover design study compared standard soap + water baths and 2% CHG baths in cancer patients. Between September 2018 and July 2019, 78 patients were divided into two arms. Patients in the first arm were washed with soap + water for the first three days, followed by 2% CHG for three days. Interventions were administered to patients in the second arm in reverse order. During the control and intervention periods, a washout day was left between bath applications. Swab samples were taken from the nasal, groin and rectal areas before and after bathing. Samples inoculated on sheep blood medium were examined after 16-18 hours of incubation. Gram-positive isolates with positive catalase and coagulase tests were identified as Staphylococcus aureus. Methicillin resistance was determined by disk diffusion test using cefoxitin discs on Mueller-Hinton agar and confirmed by real-time PCR (Rt-PCR) BD MAX MRSA XT test (BD Diagnostics, BD-MAX system, Canada) showing the presence of mecA gene. Samples inoculated on chromID (R) VRE selective medium were examined after 24 hours of incubation. The suspicious colonies were identified as Enterococcus faecium by API-ID Strep. Vancomycin resistance was confirmed by Rt-PCR VIASURE test (BD Diagnostics, BD-MAX system, Amsterdam) for the presence of vanA and vanB genes. MRSA colonization was detected in six patients and VRE colonization was detected in nine patients. After starting the CHG bath, nasal MRSA colonization decreased in the first arm. When the arms were compared, MRSA colonization in nasal samples and VRE colonization in rectal samples were found to be higher in the first arm than in the second arm. Bathing practices in the ICUs are essential in preventing HAIs, which is one of the patient safety problems. The results of this study show that daily bathing with 2% CHG reduces nasal MRSA and rectal VRE colonization in cancer patients in the ICU.

Objectives Immunocompromised (IC) patients are at increased risk of herpes zoster (HZ; i.e. shingles) and subsequent complications which can significantly impact quality of life. While current evidence indicates a strong disease presence of HZ in Türkiye, literature on the management of HZ in this population is lacking.Methods We conducted a survey with 6 disease experts from various medical specialties in Türkiye to understand their opinions on the burden of HZ and the challenges faced by IC patients, in order to establish a comprehensive and evidence-based expert consensus.Results Experts agreed that the burden of HZ is significant among IC patients in Türkiye. However, they identified a need for increased local epidemiological data to better understand the health impact of HZ in Türkiye. Improved dissemination of information regarding HZ to physicians was also highlighted to increase awareness of HZ.Conclusions Strategies to enhance current practices and increase vaccine coverage should include incorporation of HZ vaccination into official guidelines and recommendations, with full or partial reimbursement for HZ vaccination in IC patients. Setting up official or society-initiated online platforms could also support ongoing collaboration and provide continuously updated guidelines reflecting the latest advances in HZ vaccination and disease management.

Levels of C-reactive protein (CRP), an acute-phase protein, and procalcitonin (PCT) in serum and certain body fluids increase during inflammatory conditions, particularly bacterial infections, and decrease following treatment or resolution of the triggering cause. Therefore, both biomarkers can be effectively utilized for diagnosing infectious diseases, differentiating between viral and bacterial infections, monitoring antibiotic treatment response, and making decisions regarding the cessation of therapy. In recent years, with the significant global and national increase in antimicrobial resistance, these biomarkers have become increasingly important as part of antimicrobial stewardship practices promoting rational antimicrobial use. This consensus report aims to guide the optimal utilization of CRP and PCT in managing infectious diseases in adult patients across various clinical settings and patient groups based on a review of the current literature and collaboration among seven relevant medical societies. We hope this report will benefit all physicians involved in diagnosing and treating adult infectious diseases.

OBJECTIVES:To report long-term clinical efficacy, safety, pharmacokinetics, immunogenicity and seroneutralization results of AZD7442 (monoclonal antibodies tixagevimab-cilgavimab) in patients hospitalized with COVID-19. METHODS:In this phase 3, double-blind, randomized, multicentre trial, hospitalized adults with PCR-confirmed SARS-CoV-2 infection were randomly assigned 1:1 to receive AZD7442 or placebo, and followed-up until day 456, with repeated blood sample collections until day 365. Clinical endpoints included clinical status, mortality, rehospitalization, SARS-CoV-2 reinfection, and adverse events. Antidrug antibodies and serum drug concentrations were measured. Analyses were performed on the modified intention-to-treat (mITT) populations, defined as participants who actually received the intervention. RESULTS:Between April 28, 2021, and June 23, 2022, 237 participants were randomly assigned to AZD7442 (n = 127) or placebo (n = 110), and 123 participants actually received AZD7442. Participants were infected with pre-Omicron variants in 58.8% (133/226) of cases, versus 33.2% (75/226) of Omicron BA1, BA2, or BA5, and 8% (18/226) missing data. There was no significant difference in the distribution of the 7-point ordinal scale between the AZD7442 and placebo groups, either on day 15 (primary endpoint) (OR = 0.93 [0.54-1.61], p 0.81), or any other time point. Significantly more rehospitalizations occurred between discharge and day 456 among participants who received AZD7442 in the global mITT population (OR = 2.04 [1.03-4.05], p 0.04), but not in the antigen-positive mITT population (OR = 1.78 [0.80-3.94], p 0.15). No significant differences were observed in mortality, SARS-CoV-2 reinfection, or adverse events. In the AZD7442 group, 12 of 87 participants (13.8%) had treatment-emergent antidrug antibodies versus 5 of 69 (7.2%) in the placebo group (OR = 2.02 [0.66-6.14], p 0.21). Serum drug concentrations were detectable up to day 365 for all sampled participants (35/35). Neutralizing antibody titres were significantly higher in the AZD7442 group up to day 180. CONCLUSIONS:AZD7442 did not demonstrate any clinical benefit and was safe up to 15 months. This study also provides valuable data on the pharmacokinetics, immunogenicity, and neutralizing activity of AZD7442 in patients hospitalized with COVID-19.

Pneumonia remains a leading cause of morbidity and mortality in older adults, particularly due to the age-related decline in immune function. The aim of this study was to evaluate the association between frailty, malnutrition, and the severity of pneumonia in older adults who received the 13-valent pneumococcal conjugate vaccine (PCV13). A retrospective analysis was made of 407 geriatric outpatients aged over 65 years who had received PCV13. Clinical and radiological data were collected from electronic health records and verified via telephone interviews. The primary outcomes were incidence and severity of pneumonia (mild vs. severe), hospitalization, mortality, and antibiotic use within one year following vaccination. Pneumonia severity was classified according to established criteria in the literature. Of the 407 patients evaluated (mean age 73.3 ± 6.3 years; range 65–91 years; 62.9

INTRODUCTION/OBJECTIVE:To reveal the epidemiology of kidney disease (KD) in people living with HIV (PWLH) and to report the antiretroviral treatment (ART) management in case of kidney disease. METHODS:This multicenter, retrospective observational study identified KD under four categories: acute kidney disease (AKD), chronic kidney disease (CKD), accelerated decline of glomerular filtration rate (GFR > 60 mL/min), and asymptomatic kidney disease indicated by markers of kidney damage. Clinical characteristics and etiological causes of KD in patients were evaluated. RESULTS:Among 2092 PLWH screened, 131 patients (6.26%) had at least one form of KD. All patients with KD were Caucasian; 112 (84.5%) were male, with a median age of 51 [range 21-80] years. The most common comorbidities were hyperlipidemia (43.5%), diabetes mellitus (33.6%), and hypertension (26.9%). AKD developed in 20 patients (0.95%), CKD in 35 patients (1.67%), accelerated GFR decline in 69 patients (3.29%), and asymptomatic KD in 7 patients (0.33%). Regarding the etiological causes, 39.7% of KD cases were attributed to ART-related nephrotoxicity, 21.4% to HIV-related nephropathy, 19.8% to comorbidity-associated KD, and 6.9% to non-ART drug nephrotoxicity. ART regimen modification was performed in 39 patients (29.6%) with ARTrelated nephropathy. Lamivudine-based ART required fewer treatment changes (9.5%) than tenofovir disoproxil fumarate (38.1%) or tenofovir alafenamide (36.4%) (P = 0.04). DISCUSSION:ART-related nephrotoxicity and comorbidity-associated kidney diseases are emerging challenges in the epidemiology of KD among PLWH. CONCLUSION:Lamivudine-based ART regimens appear to be favorable in cases of KD development, showing a greater likelihood of preserving the initial treatment regimen.

Fracture-related infections (FRIs) represent a significant complication in orthopedic trauma care, often leading to delayed bone healing, prolonged hospital stays, and increased patient morbidity. Pathogenesis involves microbial contamination during injury or surgery, compounded by patient-related risk factors such as diabetes, smoking, or immunosuppression. Diagnosis of FRI relies on a combination of clinical, radiological, and microbiological criteria. Common signs include persistent pain, swelling, erythema, purulent discharge, and non-union of the fracture. FRIs are classified based on the timing of infection onset into acute, delayed, and chronic forms, each requiring tailored management strategies. Treatment generally involves aggressive surgical debridement, possible hardware removal or retention, and targeted antibiotic therapy. In cases of severe tissue loss, reconstructive procedures may be necessary to restore bone and soft tissue integrity. Treatment strategies include early administration of prophylactic antibiotics, meticulous surgical technique, and timely soft tissue coverage in open fractures. A multidisciplinary approach involving orthopedic surgeons, infectious disease specialists, and microbiologists is essential for successful management. Early recognition and appropriate intervention are crucial to improving outcomes and minimizing long-term disability in patients with fracture-related infections.

Respiratory viruses represent a significant public health threat. There is the need for robust and coordinated surveillance to guide global health responses. Established in 2012, the Global Influenza Hospital Surveillance Network (GIHSN) addresses this need by collecting clinical and virological data on persons with acute respiratory illnesses across a network of hospitals worldwide. GIHSN utilizes a standardized patient enrolment and data collection protocol across its study sites. It leverages pre-existing national infrastructures and expert collaborations to facilitate comprehensive data collection. This includes demographic, clinical, epidemiological, and virologic data, and whole genome sequencing (WGS) for a subset of viruses. Sequencing data are shared in the Global Initiative on Sharing All Influenza Data (GISAID). GIHSN uses financing and governance approaches centered around public-private partnerships. Over time, GIHSN has included more than 100 hospitals across 27 countries and enrolled more than 168,000 hospitalized patients, identifying 27,562 cases of influenza and 44,629 of other respiratory viruses. GIHSN has expanded beyond influenza to include other respiratory viruses, particularly since the COVID-19 pandemic. In November 2023, GIHSN strengthened its global impact through a memorandum of understanding with the World Health Organization, aimed at enhancing collaborative efforts and data sharing for improved health responses. GIHSN exemplifies the value of integrating scientific research with public health initiatives through global collaboration and public-private partnerships governance. Future efforts should enhance the scalability of such models and ensure their sustainability through continued public and private support.

Background: V116 is a 21-valent pneumococcal conjugate vaccine (PCV) designed for adults. It contains the most prevalent serotypes associated with invasive pneumococcal disease (IPD) in adults in regions with established pediatric vaccination programs. This Phase 3 study compared the safety, tolerability, and immunogenicity of V116 with 23-valent pneumococcal polysaccharide vaccine (PPSV23) in adults ≥50 years of age. Methods: In this randomized, active comparator-controlled, parallel-group, multisite, double-blind study, participants were randomized 1:1 to receive a single dose of V116 or PPSV23 (NCT05569954). Primary immunogenicity outcomes assessed the opsonophagocytic activity (OPA) responses for (i) non-inferiority for 12 serotypes common to V116 and PPSV23 based on V116/PPSV23 geometric mean titers (GMTs) at Day 30, and (ii) superiority for nine serotypes unique to V116 using V116/PPSV23 GMTs and the proportions of participants with a ≥4-fold rise in OPA responses from baseline to 30 days post-vaccination. The primary safety outcome was evaluated as the proportion of participants with solicited injection-site and systemic adverse events through Day 5 post-vaccination, and vaccine-related serious adverse events up to 6 months post-vaccination. Findings: V116 was non-inferior to PPSV23 for all 12 common serotypes, superior to PPSV23 for all nine unique serotypes based on V116/PPSV23 GMTs, and superior to PPSV23 for eight of the nine serotypes unique to V116, based on the proportion of participants with a ≥4-fold rise in OPA responses (except for serotype 15C). The safety profile of V116 was comparable to that of PPSV23. Interpretation: In regions with established vaccination programs, V116 could broaden the serotype coverage for residual pneumococcal disease in adults.

INTRODUCTION:Monitoring transmitted drug resistance is crucial for guiding first-line antiretroviral therapy (ART) and controlling the rising HIV epidemic in Türkiye. This study aimed to determine the prevalence of transmitted antiretroviral resistance to protease inhibitors (PIs), nucleoside reverse transcriptase inhibitors (NRTIs), non-nucleoside reverse transcriptase inhibitors (NNRTIs), integrase strand transfer inhibitors (INSTIs) and capsid assembly inhibitors (CAIs). We also assessed the distribution of HIV-1 subtypes and circulating recombinant forms (CRFs) at one of the main national referral centres in Türkiye. METHODS:We included 104 consecutive ART-naïve people living with HIV who presented at Hacettepe University Hospital in Ankara between November 2021 and November 2022. Demographic data, probable transmission routes and geographic origins were recorded. HIV-1 genotyping was performed to identify subtypes and resistance-associated mutations using standard methods. RESULTS:Of the 104 individuals, 97 were from 25 different cities in Türkiye, while 7 originated from 5 different countries. The most probable transmission routes were men who have sex with men (MSM) (64.42%), heterosexual contact (30.77%) and unknown (4.81%). Resistance-associated mutations were detected in 14.42% of individuals. Resistance rates were 1.92% for PI, 4.80% for NRTI and 7.69% for NNRTI. No resistance mutations were found against INSTI or CAI. CONCLUSION:Transmitted resistance to PI, NRTI and NNRTI remains present in Türkiye, though at moderate levels. The absence of resistance to INSTI and CAI supports their potential utility as effective components of treatment regimens in Türkiye.

AIM To demonstrate the importance of an integrated viral surveillance to tackle the changing epidemiology and the continuing disease burden of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). BACKGROUND International institutions such as European Centre for Disease Prevention and Control provide guidance for integrated surveillance of respiratory viruses. However, SARS-CoV-2 is not an integral part of sentinel influenza like illness and severe acute respiratory infections surveillance in Türkiye. METHODS We utilized the database from the Global Influenza Hospital Surveillance Network project in Türkiye between November 1st, 2022 and May 31st, 2024 over two seasons. Patients admitted to five hospitals with influenza like illness symptoms in the last 7 days and stayed overnight in the hospital were screened three days a week and swabbed within 72 hours of admission in a standardized year around surveillance methodology. An oligonucleotide panel analysis was utilized during November 1st 2022 to October 31st 2023 and multiplex PCR was utilized thereafter to test for influenza A and B, SARS-CoV-2 and respiratory syncytial virus (RSV). RESULTS A total of 984 inpatients were enrolled and 969 of them, 724 (75%) of whom were adults, had valid laboratory results. RSV was the most prevalent pathogen detected in 4.9% of the samples, followed by SARS-CoV-2 (4.8%) and influenza A and B (3%). CONCLUSIONS SARS-CoV-2 is circulating and resulting in hospital admissions among all age groups adding onto the influenza and RSV peaks. Integrated respiratory virus surveillance is crucial to guide informed public health policies and effective vaccination programs.

There is little evidence of antimicrobial elimination via therapeutic plasma exchange (TPE) and no guidelines for antimicrobial optimal dosing in patients undergoing TPE. We aimed to assess current practices and knowledge regarding antimicrobial management during TPE. A structured online survey was conducted from May to November 2023, and physicians were invited to participate through national scientific platforms and professional societies. One hundred five participants completed the survey, of whom 61% were infectious disease physicians, with 68.6% having more than 10 years of experience. That the TPE procedure could significantly affect plasma concentrations of antimicrobial agents was reported by 74.3% of the respondents. Among the physicians, 42.9% suggest antimicrobial dose adjustment, and 38.1% recommend temporarily discontinuing antimicrobial drug administration during TPE. Therapeutic drug monitoring was recommended by 33.3% of the respondents for certain antimicrobials, mainly glycopeptides and aminoglycosides, in patients undergoing concurrent TPE. Furthermore, 59.3% of physicians sometimes consult with another healthcare professional for treatment management, most commonly a pharmacist or a clinical pharmacist and an infectious diseases specialist. The core questions regarding potential drug-, procedure-, and patient-related antimicrobial elimination factors via TPE were responded to accurately by less than half of the physicians. It was clear that they had a lack of clinical practices and knowledge regarding antimicrobial management during TPE. To ensure the therapeutic efficacy of antimicrobials and avoid treatment failure, physicians should improve their practice strategies and consider antimicrobial elimination factors with TPE in this data-poor setting.

This study- a secondary analysis of data from a randomized, observer-blinded, non-inferiority study among volunteers between 18–55 y old in Türkiye- evaluated the impact of previous SARS-CoV-2 infection before the first dose of inactive TURKOVAC on post-vaccine local and systemic adverse events (AEs) comparing with CoronaVac. Of 1266 participants analyzed, 27.7% had a previous COVID-19 history. Local and systemic AEs were observed in 37.3% and 39% of the participants. The frequency of AEs was slightly higher in the first 30 minutes and 24 hours among participants with a COVID-19 history; none were severe. 1203 participants had a second dose vaccination, and 27.3% had a history of COVID-19. The frequencies of local and systemic AEs after the second dose were similar between those with and without a COVID-19 history. The TURKOVAC and CoronaVac showed similar frequencies of local and systemic AEs in the first 30 minutes after vaccination.