Sabri Atalay

Pooled analysis of 2,408 cases of acute adult purulent meningitis from Turkey.

Objectives: The aim of this study was to systematically review the Turkish literature of acute adult purulent meningitis. Materials and Methods: The published series of three national databases and two international databases were searched to perform the review. In addition to the databases, abstracts of congresses held between 1994 and 2003 by the Turkish Clinical Microbiology and Infectious Diseases Association, Turkish Microbiology Association, and the Antibiotic and Chemotherapy Association were searched for reports about acute purulent meningitis. Results: Data for 2,408 patients with a diagnosis of acute purulent meningitis were obtained from 30 reports. In terms of clinical findings, 1,254 of 1,570 (79.8%) had fever (>38°C), 1,408 of 1,595 (88.2%) headache, 1,403 of 1,562 (89.8%) stiffness of the neck, and 649 of 784 (82.7%) leukocytosis (>10,000/mm3). Cerebrospinal fluid culture yielded a pathogen in 873 of 2,260 (38.6%) patients. The most common pathogen was Streptococcus pneumoniae, followed by Neisseria meningitidis and Staphylococcus aureus. Overall mortality was 425 of 2,408 (17.6%). Pathogen-specific mortality was 60 of 202 (29.7%) for S. pneumoniae and 6 of 100 (6%) for N. meningitidis. Conclusion: Meningitis is a serious, life-threatening disease. More preventive measures should be sought to further decrease the mortality and morbidity related to acute purulent meningitis.

Bacterial and viral etiology in hospitalized community acquired pneumonia with molecular methods and clinical evaluation.

INTRODUCTION Polymerase chain reaction (PCR) method has improved the diagnosis rates for patients with community-acquired pneumonia (CAP). We aimed to evaluate the bacterial and viral etiology of hospitalized CAP cases and compare clinical and laboratory findings of patients with pure bacterial and bacterial and viral (mixed) infections. METHODOLOGY A total of 55 patients hospitalized with CAP were enrolled into the prospective study between February 2010 and December 2010. Clinical and laboratory follow-up were performed on days 0, 7 and 14. Deep tracheal aspiration samples were examined for bacterial and viral pathogens by multiplex PCR, and standard bacteriological culture method. RESULTS The etiological identification rate in 50 patients for bacteria, viruses and mixed virus-bacteria combination by PCR were 62%, 4%, 32%, respectively and 60% in 55 patients by bacterial culture method. Streptococcus pneumoniae concomitant with Haemophilus influenzae (36%) and rhinovirus (16%) was very common, whereas atypical pathogens (only Mycoplasma pneumoniae) were rare (6%). Rhinovirus was the most common viral agent (20%). Recently identified viruses, human coronavirus HKU1 and human bocavirus were not detected except for human metapneumovirus (one case). There was no significant difference in terms of mean age, immune status, leukocyte count, C-reactive protein (CRP) values, hospitalization duration and CURB-65 score between bacterial and mixed viral-bacterial detections. Advanced age (p < 0.01) and higher CURB-65 score (p = 0.01) were found to be associated with increased mortality. CONCLUSION Concomitance of bacterial and viral agents is frequent and resemble with bacterial infections alone. Further studies are needed for the clinical significance of mixed detections.

Attitudes towards HIV/AIDS and other sexually transmitted diseases in secondary school students in Izmir, Turkey: changes in time:

The aim of this study was to evaluate the changes in the sexual attitudes of young people in a period of 7 years (1997-2004). The participants in the first and the second surveys were 633 and 654 grade 10 students from six high schools located in the central district of Izmir, Turkey, chosen randomly according to the stratified sampling method. The rate of having had sexual experience was 11.3% and 22.8% in the first and second surveys, respectively (x 2 P < 0.001).