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    Key predictors of mortality in Crimean-Congo haemorrhagic fever: a retrospective multicentre cohort study
    (Elsevier Sci Ltd, 2025) Gullu, Deniz; Yigci, Defne; Baykam, Nurcan; Celikbas, Aysel Kocagul; Yapar, Derya; Akdogan, Ozlem; Ozden, Kemalettin
    Objective: This study aimed to identify key predictors of mortality in patients with Crimean-Congo haemorrhagic fever (CCHF). Our specific goals included characterizing the demographic and clinical features of hospitalized CCHF patients in T & uuml;rkiye, determining the factors associated with mortality among these patients, and evaluating the impact of early ribavirin administration. Methods: A retrospective study was conducted on 1103 CCHF patients across 18 hospitals in T & uuml;rkiye from 1 January 2019 to 20 November 2024. All data were obtained via an online data collection system by the designated physician at each centre. Patients with laboratory-confirmed CCHF infection who were hospitalized were included in the study. Univariate analyses and time-dependent Cox regression were conducted. Results: Of the 1103 patients, 65.7% (725/1102) were men; 87.2% (962/1103) resided in rural areas; and the mean age was 53 years. Ticks were identified as the transmission route in 68.4% (755/1103) of the cases. Comorbidities included diabetes mellitus, chronic heart disease, and hypertension; 4.6% (51/1103) of the patients developed healthcare-related infections. Intensive care unit admission was required in 8.0% (88/1103) of the patients, and the overall mortality rate was 5.1% (56/1103). In univariate analyses, age >= 50 years (odds ratio [OR], 3.1; 95% CI, 1.58-6.08; p < 0.001) and diabetes mellitus (OR, 4.49; 95% CI, 2.20-9.18; p < 0.001) were associated with increased mortality. Both variables remained statistically significant predictors in the multivariate analysis. Although early ribavirin administration, <= 96 hours from symptom onset, did not reach statistical significance in univariate analysis (OR, 0.52; 95% CI, 0.26-1.05; p = 0.065), it was significantly associated with reduced mortality in time-dependent Cox regression (adjusted hazard ratios, 0.21; 95% CI, 0.07-0.69; p = 0.010). Discussion: Key factors such as age and comorbidities can predict mortality in CCHF patients. Timely identification of these predictors, along with early administration of ribavirin, may contribute to improved survival and better clinical outcomes. (c) 2025 European Society of Clinical Microbiology and Infectious Diseases. Published by Elsevier Ltd. All rights are reserved, including those for text and data mining, AI training, and similar technologies.
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    The Role of Pneumococcal Pneumonia among CommunityAcquired Pneumonia in Adult Turkish Population: TurkCAP Study
    (AVES, 2021) Şenol, Esin; Çilli, Aykut; Günen, Hakan; Şener, Alper; Dumlu, Rıdvan; Ödemiş, Ayşe; Topçu, Ayşe Füsun; Yıldız, Yeşim; Güner, Rahmet; Özhasenekler, Ayhan; Mutlu, Birsen; Köktürk, Nurdan; Sevimli, Nurgül; Baykam, Nurcan; Yapar, Derya; Ekin, Selami; Polatlı, Mehmet; Eren Gök, Şebnem; Kılınç, Oğuz; Sayıner, Abdullah; Karaşahin, Ömer; Çuhadaroğlu, Çağlar; Sesin Kocagöz, Ayşe; Togan, Turhan; Arpağ, Hüseyin; Katı, Hakan; Köksal, İftihar; Aksoy, Firdevs; Hasanoğlu, Canan
    OBJECTIVE: To evaluate the rate of pneumococcal pneumonia (PP) among patients with community-acquired pneumonia (CAP) in Turkey and to investigate and compare features of PP and non-PP CAP patients. MATERIAL AND METHODS: This multicenter, non-interventional, prospective, observational study included adult CAP patients (age = 18 years). Diagnosis of PP was based on the presence of at least 1 positive laboratory test result for Streptococcus pneumoniae (blood culture or sputum culture or urinary antigen test [UAT]) in patients with radiographic findings of pneumonia. RESULTS: Four hundred sixty-five patients were diagnosed with CAP, of whom 59 (12.7%) had PP. The most common comorbidity was chronic obstructive pulmonary disease (30.1%). The mean age, smoking history, presence of chronic neurological disease, and CURB-65 score were significantly higher in PP patients, when compared to non-PP patients. In PP patients, 84.8% were diagnosed based ony on the UAT. The overall rate of PP patients among CAP was calculated as 22.8% considering the UAT sensitivity ratio of 63% (95% confidence interval: 45-81). The rate of intensive care treatment was higher in PP patients (P =.007). While no PP patients were vaccinated for pneumococcus, 3.8% of the non-PP patients were vaccinated (P =.235). Antibiotic use in the preceding 48 hours was higher in the non-PP group than in the PP group (31.8% vs. 11.1%, P =.002). The CURB-65 score and the rate of patients requiring inpatient treatment according to this score were higher in the PP group. CONCLUSION: The facts that PP patients were older and required intensive care treatment more frequently as compared to non-PP patients underline the burden of PP.